Diarrhea in children newly enrolled in day care centers - Tips from Other Journals
Categories: Child Care and Health TipsAcute diarrhea is a common problem in day care centers, especially in centers providing care for children who are not yet toilet trained. Staat and colleagues hypothesized that children first entering day care centers have a greater incidence of diarrhea than children already enrolled in day care centers. The investigators conducted a study to compare the incidence of diarrhea in children who were newly enrolled in day care centers with the incidence in children who had attended the same day care centers for longer periods.
The study included 442 children under two years of age who were enrolled in 13 randomly selected day care centers in Houston. Demographic information was obtained from a standardized questionnaire completed by a parent. The children were monitored over a 14.5-month period for the occurrence of diarrhea. Research nurses visited the day care center twice a week to record episodes of diarrhea and to collect stool specimens.
The overall incidence of diarrhea was 2.8 cases per child-year. However, children were at greatest risk in the first four weeks that they attended a new day care center. During this four-week interval, the incidence was 4.4 cases per child-year. The incidence was higher in boys than in girls. No relatioship was found between the incidence of diarrhea and ethnicity, size of the day care center or season of the year. No difference was found in children who had also attended another day care center. Rotavirus was identified in 18 percent of the cases of diarrhea.
The authors believe that parents considering day care for their children should be aware that children may have diarrhea when they first enter a day care center. Children under one year of age are particularly at risk, but this risk decreases with time. Previous attendance at another day care center may not decrease the risk of diarrhea. Use of appropriate hygienic procedures, including handwashing and environmental cleaning, may be the most effective preventive measures. (Pediatric Infectious Disease Journal, April 1991, vol.10, p.282.)