Cordell R L, Waterman S H, Chang A, Saruwatari M, Brown M, Solomon S L
Special Studies Activity, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Arch Pediatr Adolesc Med. 1999 Mar;153(3):275-80. doi: 10.1001/archpedi.153.3.275.
To compare the incidence of provider-reported illness and absence due to illness among children attending small child-care homes, large child-care homes, and child care centers in a large metropolitan area.
From July 6, 1992, through January 28, 1994, we collected information from child-care providers on illness and absence due to illness at 64 small and 58 large child-care homes and 41 child-care centers. This included 113 446 child-weeks of information on 5360 children.
Providers reported 14 474 illness episodes (6.6 episodes per child-year) and 8593 days of absence due to illness (3.9 days per child-year). The incidence of illness episodes was greatest in children who were younger than 1 year, white, or enrolled in small child-care homes. The incidence of absence due to illness was greatest in children who were 1 year of age, Hispanic, or enrolled in child-care centers. Respiratory symptoms were most commonly associated with illness episodes and absence due to illness.
Children in child-care homes had a greater incidence of provider-reported illness than did those in centers. This risk varied by the type of facility and was greatest in small child-care homes. The increased risk for absence due to illness among children in child-care centers reflects exclusion and attendance patterns. It may be possible to reduce the incidence of absence due to illness and subsequent economic impact of child-care-associated illness by educating providers on exclusion guidelines.
比较在一个大都市地区，小型儿童保育家庭、大型儿童保育家庭和儿童保育中心中，提供者报告的儿童疾病发病率和因病缺勤率。
从1992年7月6日至1994年1月28日，我们收集了64家小型和58家大型儿童保育家庭以及41家儿童保育中心的儿童保育提供者关于疾病和因病缺勤的信息。这包括5360名儿童的113446个儿童周的信息。
提供者报告了14474次疾病发作（每名儿童每年6.6次发作）和8593天因病缺勤（每名儿童每年3.9天）。疾病发作的发生率在1岁以下、白人或就读于小型儿童保育家庭的儿童中最高。因病缺勤的发生率在1岁、西班牙裔或就读于儿童保育中心的儿童中最高。呼吸道症状最常与疾病发作和因病缺勤相关。
儿童保育家庭中的儿童，提供者报告的疾病发病率高于儿童保育中心的儿童。这种风险因设施类型而异，在小型儿童保育家庭中最大。儿童保育中心儿童因病缺勤风险增加反映了排除标准和出勤模式。通过对提供者进行排除标准的教育，有可能降低因病缺勤的发生率以及儿童保育相关疾病的后续经济影响。
