M Uhari1, M Möttönen. 1. Department of Pediatrics, University of Oulu, Finland. matti.uhari@oulu.fi
Abstract
OBJECTIVE: Child care outside the home increases children's infections substantially. We have to evaluate the possibilities for reducing the transmission of infections by an infection prevention program. DESIGN AND METHODS: A 15-month randomized controlled trial involving 20 day-care centers was conducted to evaluate the efficacy of an infection prevention program. The program was introduced in 10 centers and the other matched 10 centers served as controls. Records were made of the occurrence of infections and absences from care or work because of infections among the children, their parents and the personnel of the day-care centers. RESULTS: Both the children and the personnel in the program centers had significantly fewer infections than those in the control centers, the reduction being 9% [95% confidence interval (95% CI), 4 to 16%, P < 0.002] among 3-year-old children and 8% (95% CI 0 to 14%, P = 0.049) among the older children. The children at the program centers received 24% fewer prescriptions of antimicrobials (95% CI 22 to 27%, P < 0.001). Likewise there were 2.5 man-year fewer absences from work on the part of parents because of a child's illness during 1 year in the program centers, a 24% difference (95% CI 18 to 29%, P < 0.001). CONCLUSIONS: Effective prevention of infections is possible in child day-care centers, and this can benefit both the families and the personnel. Such a program is cost-effective even if a specialist nurse implements it.
RCT Entities:
OBJECTIVE:Child care outside the home increases children's infections substantially. We have to evaluate the possibilities for reducing the transmission of infections by an infection prevention program. DESIGN AND METHODS: A 15-month randomized controlled trial involving 20 day-care centers was conducted to evaluate the efficacy of an infection prevention program. The program was introduced in 10 centers and the other matched 10 centers served as controls. Records were made of the occurrence of infections and absences from care or work because of infections among the children, their parents and the personnel of the day-care centers. RESULTS: Both the children and the personnel in the program centers had significantly fewer infections than those in the control centers, the reduction being 9% [95% confidence interval (95% CI), 4 to 16%, P < 0.002] among 3-year-old children and 8% (95% CI 0 to 14%, P = 0.049) among the older children. The children at the program centers received 24% fewer prescriptions of antimicrobials (95% CI 22 to 27%, P < 0.001). Likewise there were 2.5 man-year fewer absences from work on the part of parents because of a child's illness during 1 year in the program centers, a 24% difference (95% CI 18 to 29%, P < 0.001). CONCLUSIONS: Effective prevention of infections is possible in child day-care centers, and this can benefit both the families and the personnel. Such a program is cost-effective even if a specialist nurse implements it.
Authors: Carita Savolainen-Kopra; Jaason Haapakoski; Piia A Peltola; Thedi Ziegler; Terttu Korpela; Pirjo Anttila; Ali Amiryousefi; Pentti Huovinen; Markku Huvinen; Heikki Noronen; Pia Riikkala; Merja Roivainen; Petri Ruutu; Juha Teirilä; Erkki Vartiainen; Tapani Hovi Journal: Trials Date: 2010-06-04 Impact factor: 2.279
Authors: Carita Savolainen-Kopra; Jaason Haapakoski; Piia A Peltola; Thedi Ziegler; Terttu Korpela; Pirjo Anttila; Ali Amiryousefi; Pentti Huovinen; Markku Huvinen; Heikki Noronen; Pia Riikkala; Merja Roivainen; Petri Ruutu; Juha Teirilä; Erkki Vartiainen; Tapani Hovi Journal: Trials Date: 2012-01-16 Impact factor: 2.279
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Authors: Joanne E McKenzie; Patricia Priest; Rick Audas; Marion R Poore; Cheryl R Brunton; Lesley M Reeves Journal: Trials Date: 2010-01-23 Impact factor: 2.279
Authors: David Bell; Angus Nicoll; Keiji Fukuda; Peter Horby; Arnold Monto; Frederick Hayden; Clare Wylks; Lance Sanders; Jonathan van Tam Journal: Emerg Infect Dis Date: 2006-01 Impact factor: 6.883
Authors: Tom Jefferson; Chris B Del Mar; Liz Dooley; Eliana Ferroni; Lubna A Al-Ansary; Ghada A Bawazeer; Mieke L van Driel; Mark A Jones; Sarah Thorning; Elaine M Beller; Justin Clark; Tammy C Hoffmann; Paul P Glasziou; John M Conly Journal: Cochrane Database Syst Rev Date: 2020-11-20