Nesti Maria M, Goldbaum Moisés
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
J Pediatr (Rio J). 2007 Jul-Aug;83(4):299-312. doi: 10.2223/JPED.1649. Epub 2007 Jul 13.
To describe the increased risk of acquiring infectious diseases associated with out-of-home childcare and the effectiveness of measures for the control and prevention of diseases transmission at daycare and preschool education centers.
A review of literature in the MEDLINE, LILACS and Cochrane Library databases, found using the descriptors daycare, infection, infection control and infectious diseases and focusing on studies that have compared the risk of infectious diseases for children cared for in and out of the home, related risk to the type of out-of-home care and assessed the effectiveness of preventative measures.
Children cared for at daycare or in preschool education exhibit a two to three times greater risk of acquiring infections, which impacts both on individual health and on the dissemination of diseases through the community. Among other factors, the risk is associated with the characteristics of daycare centers, and simple preventative measures are effective for reducing transmission of diseases. Recommended measures include: appropriate hand washing after exposure; employment of standard precautions; standardized routines for changing and disposal of used diapers, location and cleanliness of changing area, cleaning and disinfection of contaminated areas; use of disposable tissues for blowing noses; separate workers and area for handling foods; notification of infectious diseases; training of workers and guidance for parents.
In the face of growing utilization of daycare and preschool education and their association with increased risk of acquired infections, control measures are indispensable to the prevention and control of infectious diseases.
描述与家庭外托育相关的感染性疾病患病风险增加情况,以及日托和学前教育中心疾病传播控制与预防措施的有效性。
对MEDLINE、LILACS和Cochrane图书馆数据库中的文献进行综述,通过使用描述词“日托”“感染”“感染控制”和“感染性疾病”进行检索,并重点关注比较在家照料和家庭外照料儿童的感染性疾病风险、与家庭外照料类型相关的风险以及评估预防措施有效性的研究。
在日托机构或接受学前教育的儿童感染风险高出两到三倍,这对个人健康以及疾病在社区中的传播均有影响。除其他因素外,该风险与日托中心的特征有关,简单的预防措施可有效减少疾病传播。推荐措施包括:接触后正确洗手;采用标准预防措施;规范更换和处理用过尿布的流程、更换区域的位置和清洁程度、对污染区域进行清洁和消毒;使用一次性纸巾擤鼻涕;食品处理人员和区域分开;报告感染性疾病;对工作人员进行培训并为家长提供指导。
鉴于日托和学前教育的使用日益增加及其与获得性感染风险增加的关联,控制措施对于预防和控制感染性疾病不可或缺。