Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial
Abstract
BACKGROUND: Diarrheal infections are common in children who attend child care, and preventing transmission of disease in this setting depends on actions by child care staff. We set out to discover whether transmission of gastrointestinal infections in child care could be reduced by improved infection control procedures. METHODS: We performed a cluster randomized, controlled trial of an infection control intervention conducted in child care centers for 1 city in Australia. The intervention was training of child care staff about transmission of infection and handwashing and focused on both staff and child behavior. Implementation of the intervention was recorded by an observer. Illness was measured by parent report in telephone interviews every 2 weeks. RESULTS: There were 311 child-years of surveillance for diarrheal episodes. The rate of episodes of diarrhea was 1.9 per child-year in intervention centers and 2.7 per child-year in control centers. Multivariable analysis showed that diarrheal episodes were significantly reduced in intervention center children by 50%. However, the impact of the intervention was confined to children over 24 months of age. For those centers in which children's compliance with handwashing was high, diarrheal episodes were reduced by 66%. CONCLUSIONS: This trial supports education about infection control, for staff and children in child care, as a means of reducing transmission of diarrhea. Reduction in episodes of diarrhea in children in child care was limited to children over 24 months of age.
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Only one handwashing intervention reported results by sex.
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- Authors
- Roberts, L., Jorm, L., PhD, B., Patel, M., Smith, W., Douglas, R. M., & McGilchrist, C.
- Affiliations
- Australian National University (AU)
- Epidemiology and Surveillance Branch, New South Wales Health Department, Australia.
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2000-04-01
- Volume
- 105
- Issue
- 4
- Pages
- 743-746
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1966040440
- Cited by
- 113
- References
- 16
- Citations by year
- 2025: 2 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 9
- FWCI
- 7.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Keywords
- infection control, diarrhea, daycare centers, hand washing, hand hygiene compliance, childhood diseases
- MeSH terms
- Child Day Care Centers, Child, Preschool, Diarrhea, Infantile, Hand Disinfection, Humans, Infant, Prospective Studies, Multivariate Analysis, Cluster Analysis, Australian Capital Territory
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