Does hygiene intervention at day care centres reduce infectious illnesses in children? An intervention cohort study.

• Published in: Scandinavian Journal of Infectious Diseases
• Main Authors: Gudnason, Thorolfur, Hrafnkelsson, Birgir, Laxdal, Brynja, Kristinsson, Karl G
• Other Authors: The Chief Epidemiologist's Office, Directorate of Health, Department of Paediatrics, Landspitali University Hospital, Department of Mathematics, Faculty of Physical Sciences, University of Iceland, Department of Clinical Microbiology, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Informa Healthcare 2013
• Subjects: Leikskólar; Hreinlæti; Child Day Care Centers; Child; Preschool; Cohort Studies; Female; Hand Hygiene; Health Education; Humans; Iceland; Incidence; Male; Poisson Distribution; Respiratory Tract Infections; Risk Factors
• Online Access: http://hdl.handle.net/2336/314219; https://doi.org/10.3109/00365548.2012.749424

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field. Day care attendance is a major risk factor for respiratory and gastrointestinal illnesses in preschool children. In this study, we describe the results of a hygiene intervention cohort trial at day care centres (DCCs) on the rates of febrile, respiratory, and gastrointestinal illnesses in preschool children. Thirty DCCs in 2 communities were included. The number of illness episodes was registered for each child every 6 months, as well as potential risk factors. The hygiene intervention was introduced in half of the DCCs and the results analysed using a multivariate mixed effects hierarchical Poisson regression model. The study lasted 2.5 y, of which the hygiene intervention lasted 1.5 y. Two thousand three hundred and forty-nine children participated, delivering 2832 person-y. Adjusted incidence rate ratios of the illnesses at the intervention and non-intervention DCCs were not significantly different for any of the illnesses. The intervention was not more effective in children less than 3 y of age than in older children and no significant effects were seen with time. Compliance with the hygiene protocol was good as measured by the use of hygiene products and by a survey among the staff at the DCCs. The most likely explanation for the lack of effects of the intervention is that the baseline standard of hygiene at the DCCs was probably too high for the intervention to demonstrate significant results, but recall bias cannot be excluded. Even though hygiene is important for minimizing the spread of microbes at DCCs, other risk factors need to be studied. EC/QLK2-CT-2000-01020 (EURIS) The Icelandic Centre for Research (RANNIS; 00-067-FS).