Alexander C S, Zinzeleta E M, Mackenzie E J, Vernon A, Markowitz R K
Department of Maternal and Child Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Am J Epidemiol. 1990 Jan;131(1):124-31. doi: 10.1093/oxfordjournals.aje.a115465.
This study uses data from the 1981 National Health Interview and the 1981 Child Health Supplement to assess the extent to which family day care homes and child care centers pose a risk of acute gastrointestinal illness among preschool children. The study uses a nationally representative sample of children 0-5 years of age (n = 4,845). Acute gastrointestinal illness was identified from parental reports of acute illness in a 2-week period. Information on type and duration of child care, as well as a variety of sociodemographic and environmental factors (e.g., crowding, seasonality), were obtained. The authors hypothesize that risk of acute gastrointestinal illness would vary by group size. Center attendees were thought to have the greatest exposure to infectious agents, followed by children in day care homes, and lastly by those receiving care in their own homes. Risk models were estimated separately for children less than 3 years of age and for children aged 3-5 years. Our results show that an elevated risk of acute gastrointestinal illness associated with child care is confined to children less than 3 years of age who regularly attend centers/nursery schools (odds ratio = 3.49, 95% confidence interval 0.99-4.77), controlling for other confounding variables. For children aged 3-5 years, low socioeconomic status, poverty, and seasonality are stronger predictors of acute gastrointestinal illness than is center care. Family day care appears to be unrelated to the risk of illness for both age groups.
本研究使用了1981年全国健康访谈和1981年儿童健康补充调查的数据，以评估家庭日托所和儿童保育中心在多大程度上会给学龄前儿童带来急性胃肠疾病风险。该研究采用了一个具有全国代表性的0至5岁儿童样本（n = 4,845）。急性胃肠疾病是根据家长报告的两周内急性疾病情况确定的。获取了有关儿童保育类型和时长以及各种社会人口统计学和环境因素（如拥挤程度、季节性）的信息。作者假设急性胃肠疾病风险会因群体规模而异。人们认为，在儿童保育中心的儿童接触传染源的机会最大，其次是家庭日托所的儿童，最后是在家接受照料的儿童。分别针对3岁以下儿童和3至5岁儿童估计了风险模型。我们的结果表明，在控制其他混杂变量的情况下，与儿童保育相关的急性胃肠疾病风险升高仅限于经常去儿童保育中心/幼儿园的3岁以下儿童（优势比 = 3.49，95%置信区间0.99 - 4.77）。对于3至5岁儿童，社会经济地位低、贫困和季节性比在儿童保育中心接受照料更能预测急性胃肠疾病。家庭日托似乎与这两个年龄组的患病风险无关。
