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Day care attendance during the first 12 months of life and occurrence of infectious morbidities and symptoms. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Oliveira PDD, Bertoldi AD, Silva BGCD, Rodrigues Domingues M, Neumann NA, Silveira MFD. Day care attendance during the first 12 months of life and occurrence of infectious morbidities and symptoms. J Pediatr (Rio J) 2019; 95:657-666. [PMID: 31679611 DOI: 10.1016/j.jped.2018.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/17/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To investigate the occurrence of infectious morbidities according to day care attendance during the first year of life. METHODS This was a cross-sectional analysis of data from the 12-month follow-up of a medium-sized city birth cohort from children born in 2015, in the Southern Brazil. Main exposure variables were day care attendance from 0 to 11 months of age, type of day care center (public or private), and age at entering day care. Health outcomes were classified as follows: "non-specific respiratory symptoms," "upper respiratory tract infection," "lower respiratory tract infection," "flu/cold," "diarrhea," or "no health problem," considering the two weeks prior to the interview administered at 12 months of life. Associations were assessed using Poisson regression adjusted by demographic, behavioral, and socioeconomic variables. RESULTS The sample included 4018 children. Day care attendance was associated with all classifications of health outcomes mentioned above, except for flu/cold. These were stronger among children who entered day care at an age closer to the outcome time-point. An example are the results for lower respiratory tract infection and diarrhea, with adjusted prevalence ratios of 2.79 (95% CI: 1.67-4.64) and 2.04 (95% CI: 1.48-2.82), respectively, for those who entered day care after 8 months of age when compared with those who never attended day care. CONCLUSIONS The present study consistently demonstrated the association between day care attendance and higher occurrence of infectious morbidities and symptoms at 12 months of life. Hence, measures to prevent infectious diseases should give special attention to children attending day care centers.
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Affiliation(s)
- Paula Duarte de Oliveira
- Universidade Federal de Pelotas, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil.
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
| | | | - Marlos Rodrigues Domingues
- Universidade Federal de Pelotas, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil; Universidade Federal de Pelotas, Programa de Pós-graduação em Educação Física, Pelotas, RS, Brazil
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Darby J, Falco C. Infection Control and the Need for Family-/Child-Centered Care. HEALTHCARE-ASSOCIATED INFECTIONS IN CHILDREN 2019. [PMCID: PMC7122132 DOI: 10.1007/978-3-319-98122-2_4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patient- and family-centered care (FCC) has become central to the delivery of medical care over the last 20 years and has been shown to improve patient outcomes. Infection control practices have the potential to greatly influence family centeredness and care providers, and hospital personnel must consider the potential impacts of isolation and the use of personal protective equipment (PPE). Approaching infection control with the perspective of FCC requires balancing patient safety and overall patient well-being. In this chapter, authors consider infection control and the benefits of FCC, family and sibling visitation, the use of playrooms, animals in healthcare settings including animal-assisted interventions, the potential adverse effects of infection control practices, and strategies to mitigate these impacts.
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Clark J, Henk JK, Crandall PG, Crandall MA, O'Bryan CA. An observational study of handwashing compliance in a child care facility. Am J Infect Control 2016; 44:1469-1474. [PMID: 27908434 DOI: 10.1016/j.ajic.2016.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/09/2016] [Accepted: 08/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Handwashing (HW) compliance, although an effective means of limiting childhood illness, remains low among personnel in early childhood centers (ECCs). Our study determined HW compliance and efficacy of ECC personnel. METHODS Surveillance cameras were used to determine HW opportunities, compliance, occurrences, and effectiveness based on child-care oriented criteria. RESULTS We observed 349 HW triggering events, with 14 events per hour; a median of 2 personnel (caregivers, paraprofessional aides, or parents) were present at any given time period. Compliance was 30% (caregivers), 11% (paraprofessional aides), and 4% (parents), with an overall compliance of 22%. Between-room and between-age groups of children being cared for and compliance of caregivers and paraprofessional aides were not found to be significantly different (P < .05). For all personnel between the 10 different rooms, the median compliance was 20.2% (95% confidence interval, 8%-35%). Only 7% of personnel taking care of 2- to 3-year-old children washed their hands, the lowest compliance per age group. Of all steps in HW, paper towel usage had the highest compliance, with a 97% adherence, whereas turning off the faucet with a paper towel was the lowest at 17%. CONCLUSIONS Methods and strategies need to be developed to increase compliance. Current technology provides an effective means of gathering data for determining HW compliance in ECCs.
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PIJNACKER R, MUGHINI-GRAS L, VENNEMA H, ENSERINK R, VAN DEN WIJNGAARD CC, KORTBEEK T, VAN PELT W. Characteristics of child daycare centres associated with clustering of major enteropathogens. Epidemiol Infect 2016; 144:2527-39. [PMID: 27483376 PMCID: PMC9150454 DOI: 10.1017/s0950268816001011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 02/12/2016] [Accepted: 05/02/2016] [Indexed: 01/05/2023] Open
Abstract
Insights into transmission dynamics of enteropathogens in children attending daycare are limited. Here we aimed at identifying daycare centre (DCC) characteristics associated with time-clustered occurrence of enteropathogens in DCC-attending children. For this purpose, we used the KIzSS network, which comprises 43 DCCs that participated in infectious disease surveillance in The Netherlands during February 2010-February 2013. Space-time scan statistics were used to identify clusters of rotavirus, norovirus, astrovirus, Giardia lamblia and Cryptosporidium spp. in a two-dimensional DCC characteristic space constructed using canonical correlation analysis. Logistic regression models were then used to further identify DCC characteristics associated with increased or decreased odds for clustering of enteropathogens. Factors associated with increased odds for enteropathogen clustering in DCCs were having indoor/outdoor paddling pools or sandpits, owning animals, high numbers of attending children, and reporting outbreaks to local health authorities. Factors associated with decreased odds for enteropathogen clustering in DCCs were cleaning child potties in designated waste disposal stations, cleaning vomit with chlorine-based products, daily cleaning of toys, extra cleaning of toys during a suspected outbreak, and excluding children with gastroenteritis. These factors provide targets for reducing the burden of gastrointestinal morbidity associated with time-clustered occurrence of major enteropathogens in DCC attendees.
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Affiliation(s)
- R. PIJNACKER
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - L. MUGHINI-GRAS
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, The Netherlands
| | - H. VENNEMA
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - R. ENSERINK
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - C. C. VAN DEN WIJNGAARD
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - T. KORTBEEK
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - W. VAN PELT
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), The Netherlands
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Abstract
Gastrointestinal and respiratory infections in children attending daycare centres (DCCs) are common and compliance with hand hygiene (HH) guidelines to prevent infections is generally low. An intervention was developed to increase HH compliance and reduce infections in DCCs. The objective of this paper was to evaluate the effectiveness of this intervention on HH compliance. The intervention was evaluated in a two-arm cluster randomized controlled trial in 71 DCCs in The Netherlands. Thirty-six DCCs received the intervention including: (1) HH products; (2) training about HH guidelines; (3) two team training sessions aimed at goal setting and formulating HH improvement activities; and (4) reminders and cues for action (posters/stickers). Intervention DCCs were compared to 35 control DCCs that continued usual practice. HH compliance of caregivers and children was observed at baseline and at 1, 3 and 6 months follow-up. Using multilevel logistic regression, odds ratios (ORs) with 95% confidence intervals (CIs) were obtained for the intervention effect. Of 795 caregivers, 5042 HH opportunities for caregivers and 5606 opportunities for supervising children's HH were observed. At 1 month follow-up caregivers' compliance in intervention DCCs was 66% vs. 43% in control DCCs (OR 6·33, 95% CI 3·71-10·80), and at 6 months 59% vs. 44% (OR 4·13, 95% CI 2·33-7·32). No effect of the intervention was found on supervising children's HH (36% vs. 32%; OR 0·64, 95% CI 0·18-2·33). In conclusion, HH compliance of caregivers increased due to the intervention, therefore dissemination of the intervention can be considered.
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Koningstein M, Leenen MA, Mughini-Gras L, Scholts RMC, van Huisstede-Vlaanderen KW, Enserink R, Zuidema R, Kooistra-Smid MAMD, Veldman K, Mevius D, van Pelt W. Prevalence and Risk Factors for Colonization With Extended-Spectrum Cephalosporin-Resistant Escherichia coli in Children Attending Daycare Centers: A Cohort Study in the Netherlands. J Pediatric Infect Dis Soc 2015; 4:e93-9. [PMID: 26407274 DOI: 10.1093/jpids/piv042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 06/24/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The purpose of this study was to determine the prevalence and risk factors for colonization with extended-spectrum cephalosporin-resistant (ESC-R) Escherichia coli in daycare center (DCC)-attending children. METHODS This is a prospective cohort study including 44 DCCs in the Netherlands, combining DCC characteristics and monthly collected stool samples from their attendees, and was performed in 2010-2012. During a 22-month study period, 852 stool samples were collected and screened for ESC-R E coli. Risk factors were studied using logistic regression analysis. RESULTS In DCC-attending children (<4 years old), the overall prevalence of ESC-R E coli was 4.5%, and it was 8% in <1-year-old attendees. Among the 38 children carrying ESC-R E coli, the most common types were blaCMY-2 (26%), blaCTX-M-1 (16%), and chromosomal AmpC type 3 promoter mutants (13%). Extended-spectrum cephalosporin-resistant E coli was less common in DCCs where stricter hygiene protocols were enforced, eg, not allowing ill children to enter the DCC (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.14-0.84), performing extra checks on handwashing of ill children (OR, 0.42; 95% CI, 0.20-0.87), and reporting suspected outbreaks to local health authorities (OR, 0.27; 95% CI, 0.11-0.69). CONCLUSIONS The distribution of ESC-R E coli types in DCCs differs from that of the general population. Extended-spectrum cephalosporin-resistant E coli carriage in DCC-attending children is associated with the hygiene policies enforced in the DCC. Although our results are not conclusive enough to change current DCC practice beyond ensuring compliance with standing policies, they generated hypotheses and defined the degree of ESC resistance among DCC attendees, which may influence empiric antibiotic therapy choices, and tracked the increasing trend in ESC resistance.
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Affiliation(s)
- Maike Koningstein
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Margriet A Leenen
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands Faculty of Medicine, Utrecht University, the Netherlands
| | - Lapo Mughini-Gras
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands Department of Infectious Diseases and Immunology, Utrecht University, Faculty of Veterinary Medicine, the Netherlands
| | - Rianne M C Scholts
- Certe - Laboratory for Infectious Diseases, Department of Research and Development, Groningen, the Netherlands
| | | | - Remko Enserink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Rody Zuidema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mirjam A M D Kooistra-Smid
- Certe - Laboratory for Infectious Diseases, Department of Research and Development, Groningen, the Netherlands Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Kees Veldman
- Department of Bacteriology and TSEs, Central Veterinary Institute of Wageningen UR, Lelystad, the Netherlands
| | - Dik Mevius
- Department of Bacteriology and TSEs, Central Veterinary Institute of Wageningen UR, Lelystad, the Netherlands Department of Infectious Diseases and Immunology, Utrecht University, Faculty of Veterinary Medicine, the Netherlands
| | - Wilfrid van Pelt
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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A hand hygiene intervention to reduce infections in child daycare: a randomized controlled trial. Epidemiol Infect 2015; 143:2494-502. [PMID: 25566827 PMCID: PMC4531476 DOI: 10.1017/s095026881400329x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Infections are common in children attending daycare centres (DCCs). We evaluated the effect of a hand hygiene (HH) intervention for caregivers on the incidence of gastrointestinal and respiratory infections in children. The intervention was evaluated in a two-arm cluster randomized controlled trial. Thirty-six DCCs received the intervention including HH products, training sessions, and posters/stickers. Thirty-five control DCCs continued usual practice. Incidence of episodes of diarrhoea and the common cold in children was monitored by parents during 6 months. Using multilevel Poisson regression, incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were obtained. Diarrhoeal incidence was monitored in 545 children for 91 937 days. During follow-up, the incidence was 3·0 episodes per child-year in intervention DCCs vs. 3·4 in control DCCs (IRR 0·90, 95% CI 0·73–1·11). Incidence of the common cold was monitored in 541 children for 91 373 days. During follow-up, the incidence was 8·2 episodes per child-year in intervention DCCs vs. 7·4 in control DCCs (IRR 1·07, 95% CI 0·97–1·19). In this study, no evidence for an effect of the intervention was demonstrated on the incidence of episodes of diarrhoea and the common cold.
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Childcare attendance and Helicobacter pylori infection: systematic review and meta-analysis. Eur J Cancer Prev 2013; 22:311-9. [PMID: 23242007 DOI: 10.1097/cej.0b013e32835b69aa] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Helicobacter pylori infection is acquired predominantly during childhood. Childcare promotes interpersonal contact and may be an important determinant of infection. The aim was to quantify the association between childcare attendance and H. pylori infection in childhood or adolescence. PubMed was searched up to July 2012 to identify eligible studies. The DerSimonian and Laird method was used to compute summary odds ratio (OR) estimates and 95% confidence intervals (CIs); heterogeneity was quantified with the I statistic and explained through stratified analyses and metaregression. Sixteen studies compared participants attending childcare with those not exposed. The summary OR was 1.12 (95% CI: 0.82-1.52, I=77.4%). Summary estimates were similar for crude and adjusted estimates, and higher when the infection was evaluated in children of 3 years or younger (OR=2.00, 95% CI: 0.94-4.29, I=55.0%). Studies based on the detection of stool antigens yielded higher estimates (OR=2.65, 95% CI: 1.24-5.66, I=36.4%). Those conducted in settings with a high prevalence of H. pylori infection yielded stronger associations (OR=1.44, 95% CI: 0.94-2.20, I=74.3%). In multivariate metaregression, there was no significant association with any of these variables; taking them into account contributed to a reduction of I to 67%. The role of childcare as a risk factor for H. pylori infection is confirmed by our results, especially in settings with a high prevalence of infection. However, the association was moderate, and the effect of the type of childcare setting or the duration or the intensity of exposure was seldom addressed, leaving considerable scope for improving our understanding of how this modifiable exposure contributes towards H. pylori infection.
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Gudnason T, Hrafnkelsson B, Laxdal B, Kristinsson KG. Does hygiene intervention at day care centres reduce infectious illnesses in children? An intervention cohort study. ACTA ACUST UNITED AC 2012; 45:397-403. [PMID: 23227962 DOI: 10.3109/00365548.2012.749424] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Thorolfur Gudnason
- Chief Epidemiologist's Office, Directorate of Health, Reykjavík, Iceland.
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Gudnason T, Hrafnkelsson B, Laxdal B, Kristinsson KG. Can risk factors for infectious illnesses in children at day care centres be identified? ACTA ACUST UNITED AC 2011; 44:149-56. [DOI: 10.3109/00365548.2011.599331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lafuente Mesanza P, Lizarraga Azparren MA, Ojembarrena Martínez E, Gorostiza Garay E, Hernaiz Barandiarán JR, Olascoaga Arrate A, Cantero González D. [Influence of out-of-home day care on the incidence of infectious processes in 0-3-year-olds]. An Pediatr (Barc) 2008; 68:30-8. [PMID: 18194625 DOI: 10.1157/13114468] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION A number of studies have shown that out-of-home day care in very young children increases the incidence of infectious processes in comparison with that in children cared for in a family environment. The aim of this study was to assess the influence of the type of childcare (family environment vs. collective care) and the age at which schooling begins on morbidity due to infectious processes and to determine the repercussions on the health system (frequency of visits and antibiotic consumption). PATIENTS AND METHODS The study population was composed of a cohort of children born between 1st January 2001 and 31st December 2003, drawn from five pediatric clinics. Infectious processes and health service use were recorded prospectively by the pediatrician over the 10 months of the study. The mean number and incidence of infectious processes in children attending day care and those cared for at home were compared. RESULTS A total of 764 children were studied, of which 47% attended day care centers. Compared with children cared for at home, children attending day care had a significantly higher mean number of infectious episodes (6.7 vs. 4.1), antibiotic use (1.3 vs. 0.4), visits to the pediatrician (10.3 vs. 6.3) and hospital emergency visits (0.6 vs. 0.4) (p<0.0001). For each age group, the greatest difference between children in day care and those kept at home was found in the first year of schooling. This difference was largest in the youngest age group (RR=2.3). CONCLUSIONS If parents request advice, pediatricians should inform them of the increase in infectious morbidity that children can be predicted to experience during the first year of schooling.
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Rocha DDS, Lamounier JA, Capanema FD, Franceschini SDCC, Norton RDC, Costa ABP, Rodrigues MTG, Carvalho MRD, Chaves TS. Estado nutricional e prevalência de anemia em crianças que freqüentam creches em Belo Horizonte, Minas Gerais. REVISTA PAULISTA DE PEDIATRIA 2008. [DOI: 10.1590/s0103-05822008000100002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia em crianças de sete a 74 meses, que freqüentam creches. MÉTODOS: Estudo transversal em 25 creches da regional leste de Belo Horizonte, Minas Gerais. Realizaram-se avaliação antropométrica e dosagem de hemoglobina por hemoglobinômetro portátil. Considerou-se anemia se hemoglobina <11,0g/dL para crianças menores que 60 meses e <11,5g/dL, para maiores de 5 anos. Na avaliação do estado nutricional, utilizaram-se os índices peso/idade, estatura/idade e peso/estatura, sendo categorizados em três intervalos: abaixo de -2 escores Z (desnutrição/baixa estatura), de -2 a -1 escore Z (risco para desnutrição/baixa estatura) e maior ou igual a -1 escore Z. A análise estatística incluiu: qui-quadrado, qui-quadrado de tendência linear e análise de variância (ANOVA) seguida pelo teste de Tukey, sendo significante p<0,05. RESULTADOS: Foram avaliadas 402 crianças, com mediana de idade de 46,3 meses. A prevalência de anemia foi 28,8%, observando-se o dobro da prevalência nas crianças com idade inferior a 24 meses (70,4%), comparada às de faixa etária maior. A prevalência de desnutrição correspondeu a 5,0 e 5,5% da população para os índices peso/estatura e peso/idade, respectivamente. A prevalência de baixa estatura foi 4,2%. Em crianças menores de 5 anos, a anemia associou-se à idade e ao deficit estatural. CONCLUSÕES: A anemia em crianças matriculadas nas creches da regional leste de Belo Horizonte constitui importante problema de saúde pública, acometendo, principalmente, os menores de 24 meses. Os deficits nutricionais estiveram acima dos valores esperados.
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Victora CG, Hallal PC, Araújo CL, Menezes AM, Wells JC, Barros FC. Cohort profile: the 1993 Pelotas (Brazil) birth cohort study. Int J Epidemiol 2007; 37:704-9. [PMID: 17846051 DOI: 10.1093/ije/dym177] [Citation(s) in RCA: 183] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Teixeira-Palombo CN, Fujimori E. Conhecimentos e práticas de educadoras infantis sobre anemia. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2006. [DOI: 10.1590/s1519-38292006000200008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: identificar e analisar conhecimentos e práticas de educadoras de uma creche, relativos à anemia. MÉTODOS: estudo desenvolvido em creche pública que atende população da periferia da cidade de São Paulo. A maioria das crianças freqüentava posto de saúde, creche há mais de seis meses e pertencia a famílias de baixa renda. Todas as 15 educadoras haviam concluído o segundo grau. As entrevistas foram gravadas, transcritas e submetidas à análise de conteúdo. RESULTADOS: os conhecimentos e práticas das educadoras decorriam do senso comum, sendo adquiridos no dia-a-dia, com a própria experiência. Muitas apresentaram conceitos equivocados, que podem prejudicar a prestação de cuidados. Para elas, o controle e a prevenção da anemia depende da "educação dos pais", perspectiva que pode dificultar a construção da parceria educadores/pais, pois impede a percepção de que os problemas são determinados socialmente e não decorrentes apenas dos cuidados prestados pela família. Algumas reconheciam crianças anêmicas e procuravam contribuir para seu controle, porém a maioria atribuía essa responsabilidade aos profissionais de saúde, não relacionando com as condições e práticas de cuidado de sua competência. CONCLUSÕES: aponta-se a necessidade de incluir conhecimentos sobre anemia e práticas de cuidados, tanto na formação inicial, quanto continuada dos educadores infantis.
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Cavalcante SS, Clotildes Nunes de Melo M, Bustani Carneiro N, Rodrigues Silva L. The knowledge of staff in day nurseries about some basic measures which promote child health. HEALTH EDUCATION 2005. [DOI: 10.1108/09654280510595263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to determine the knowledge that staff in day nurseries in Brazil had of basic measures to promote child health which are connected with high child mortality. These measures included breastfeeding, oral rehydration therapy, child growth follow‐up, immunization and the identification of signs that indicate that the child must be referred to a health facility.Design/methodology/approachA cross‐sectional study was performed in day nurseries in the state of Bahia, Brazil, involving 194 care staff from 77 different establishments. Questionnaires, the observation of practical exercises and documentary evidence were used to assess knowledge.FindingsSeventeen percent of professionals were able to use growth charts correctly, 37.1 percent were able to prepare an oral rehydration solution adequately, 77.8 percent were able to provide appropriate breastfeeding counseling, 65.0 percent were able to identify children who showed respiratory danger signs and refer them to a health facility, and 58.5 percent were able to check the immunization status. This suggests a serious lack of basic knowledge in key areas.Research limitations/implicationsThe losses observed in the beginning of the study and the possibility of the existence of memory bias related to the verbal information obtained might have influenced the results.Practical implicationsThese findings suggest that there is an urgent need to address the lack of knowledge about basic child health measures shown by these key workers through appropriate educational programs.Originality/valueThis is one of the first studies of levels of knowledge about basic child health measures in professionals who work outside the medical profession, and in particular in day nurseries. It also provides valuable information about health knowledge in a developing country.
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Barros H, Lunet N. Association between child-care and acute diarrhea: a study in Portuguese children. Rev Saude Publica 2003; 37:603-8. [PMID: 14569336 DOI: 10.1590/s0034-89102003000500009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To quantify the influence of the type of child-care on the occurrence of acute diarrhea with special emphasis on the effect of children grouping during care. METHODS From October 1998 to January 1999 292 children, aged 24 to 36 months, recruited using a previously assembled cohort of newborns, were evaluated. Information on the type of care and occurrence of diarrhea in the previous year was obtained from parents by telephone interview. The Chi2 and Kruskal-Wallis tests were used to compare proportions and quantitative variables, respectively. The risk of diarrhea was estimated through the calculation of incident odds ratios (OR) and their respective 95% confidence intervals (95% CI), crude and adjusted by unconditional logistic regression. RESULTS Using as reference category children cared individually at home, the adjusted ORs for diarrhea occurrence were 3.18, 95% CI [1.49, 6.77] for children cared in group at home, 2.28, 95% CI [0.92, 5.67] for children cared in group in day-care homes and 2.54, 95% CI [1.21, 5.33] for children cared in day-care centers. Children that changed from any other type of child-care setting to child-care centers in the year preceding the study showed a risk even higher (OR 7.65, 95% CI [3.25, 18.02]). CONCLUSIONS Group care increases the risk of acute diarrhea whatsoever the specific setting.
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Affiliation(s)
- Henrique Barros
- Servição de Higiene e Epidemiologia, Faculdade de Medicina do Porto, Porto, Portugal.
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Barros AJ, Gonçalves EV, de Borba CR, Lorenzatto CS, Motta DB, da Silva VR, Schiroky VM. [Daycare centers in a medium-sized Brazilian city: operations, child-care practices, infrastructure, and safety]. CAD SAUDE PUBLICA 1999; 15:597-604. [PMID: 10502156 DOI: 10.1590/s0102-311x1999000300017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ninety-two daycare centers (23 public, 10 charitable, and 59 private) were identified in the municipality of Pelotas, RS, Southern Brazil. These centers were studied in relation to their organization, services, child-care practices, and infrastructure. All public centers worked full-time, while most private centers operated in the afternoon and received a smaller proportion of children under the age of two. The child-to-attendant ratio was similar in both types of centers, and the nurseries were the classes most frequently above the recommended maximum. Group and center sizes were larger in the public centers. Attendant schooling was higher in the private centers, but task specificity was lower. The infrastructure deficiencies most commonly observed in the public centers were lack of an internal recreational area and playground equipment. Private centers lacked adequate diapering facilities and exclusive toilets for the children. A small proportion of centers had staff trained to handle fire emergencies and administer first aid, revealing insufficient concern over safety issues.
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Affiliation(s)
- A J Barros
- Departamento de Medicina Social, Universidade Federal de Pelotas, C. P. 464, Pelotas, RS 96001-970, Brasil.
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