[The role of the day-care nursery and early schooling on the incidence of infectious diseases].

OBJECTIVE

The purpose of this study was to study if early care away from home of infants and young children increases the incidence and severity of infectious disease episodes and to define the age group in which the infection risk is highest.

MATERIAL AND METHODS

A prospective cohort study was conducted in three pediatric clinics of a primary health care center.

RESULTS

The mean number of infectious disease episodes was 7.2 (< 2 years of age), 6.3 (2-3 years) and 5.05 (> 3 years) in children attending school for the first year and 4.0, 3.1 and 2.7 for children of the same age groups not attending school. For the first year of schooling, the relative risk (RR) and 95% confidence intervals (CI) for some specific diseases, in children between 6-24 months of age were 1.99 (1.03-3.83) for more than two episodes of otitis media and 4.59 (1.97-10.7) for more than three episodes of bronchial asthma. Children between 24 and 36 months of age had RR and CI of 4.63 (1.51-14.8) for more than two episodes of otitis media.

CONCLUSION

Infants and small children cared for outside of the home environment have a greater number of acute infectious disease episodes than those cared for at home. The risk is higher during the first year of schooling, particularly in those less than two years of age.