Scandinavian Journal of Infectious Diseases
ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19
Otitis Media in Young Children in Different Types of Day-care Katherine Strangert To cite this article: Katherine Strangert (1977) Otitis Media in Young Children in Different Types of Day-care, Scandinavian Journal of Infectious Diseases, 9:2, 119-123, DOI: 10.3109/ inf.1977.9.issue-2.11 To link to this article: http://dx.doi.org/10.3109/inf.1977.9.issue-2.11
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Date: 16 April 2016, At: 21:45
Scand J Infect Dis 9: 119-123, 1977
Otitis Media in Young Children in Different Types of Day-care KATHERINE STRANGERT
Downloaded by [Monash University Library] at 21:45 16 April 2016
From the Department of Paediatrics, Karolinska Hospital, Stockholm, Sweden
ABSTRACT. The Occurrence of otitis media was studied in 108 Swedish children attending 14 day-care centers and compared with that in 57 children cared for in their own homes (usually with one or no sibling) and with that in 42 children in family day-care homes (where a woman cared for both her own and 1to 4 other children in her home during the day). The children were 6 months to 2 years old. In the day-care centers 37% of the children had otitis media at least once during 8 months with an average of 2.2 episodes each. Otitis media was more common in 6- to 17-month-old children in the day-care centers than in children of the same age cared for in their own homes. The Occurrences of otitis media in the day-care centers and in the family day-care homes were approximately equal. Children attending centers where those with signs of infection were excluded had otitis in about the same frequency as those attending centers where children with infections were accepted.
INTRODUCTION Respiratory tract infections are common in all age groups but most frequent in the pre-school children (2). During childhood an infection of the upper respiratory tract is often spread to the middle ear causing otitis media. This complication may be recurrent, and it may become chronic and cause permanent hearing impairment (3, 6, 7, 9, 11) and language retardation (5). Beside the possible medical complications of otitis media, there are social consequences for a child attending a day-care center if the diagnosis otitis media is made. The staff is reluctant to care for children with infections also when the symptoms are minor. Children treated with antibiotics, e.g. against otitis media, are usually excluded during the whole period of treatment. The main reason stated for the excluding policy is to prevent the spread of infection. The parents must find another baby-sitter which can be an inconvenience. This has to be weighed against the possible epidemiological advantages of an exclusion policy. The number of contacts between individuals in group care influences the occurrence of respiratory illnesses and, conceivably, that of otitis media. Dingle et al. (2) have shown that children in large families have respiratory illnesses more often than children in small families, but they did not study
otitis media. The incidence of otitis media in young children attending Swedish day-care centers has not been studied since Hesselvik in the late forties presented his results (4). The present investigation had the aim to study (1) the incidence of otitis media in young children attending Swedish day-care centers; (2) whether children in day-care centers have otitis media more often than children cared for in their own homes (=“home care”) or in “family day-care homes” (where a woman cares for both her own and 1 to 4 other children in her home during the day); (3) whether the frequency of otitis media in children in day-care centers can be reduced by the exclusion of children with signs of infection and/or limitation of the number of children per center; and (4)whether newcomers to a day-care center have otitis media more often than children of the same age who have been in a center longer. MATERIAL AND METHODS All children in the ages between 6 months and 2 years were studied in 14 day-care centers in Solna (a suburb of Stockholm). Another group matched with respect to age and sex was chosen from the waiting list for admittance to the day-care centers in Solna. These children were cared for either in home care or in family day-care homes. The study comprised 108 children in day-care centers, 57 children in home care and 42 in family day-care homes, all Scand J Infect Dis 9
120
K . Stranger1
Table 1. Occurrence of otitis media in children, 6 months-2 years of age, in different types of daycare Period of study: September 1973 through April 1974 No. of children by type of day-care and by no. of episodes of otitis media Episodes of otitis media
Downloaded by [Monash University Library] at 21:45 16 April 2016
0 1 2 3
Family Day-care day-care Home center home care 68 17 13 3 2 3 1
24 12 2
44 9 4
136 38 19 4 2 4 3
1
I 2
I
Total Total no. of episodes Mean no. of episodes per child
Total
1
108
42
57
207
88
36
17
141
0.8
0.9
0.3
0.7
remaining in the same type of day-care during the study period (September 1973 through April 1974). Half of the children in the center group, one fourth of those in the family day-care group, but only a few of those in home care, belonged to a single-parent family. Most children in all groups had only one or no sibling each and lived in a modern apartment of 3 rooms. In the family day-care homes there were an average of 4 children. Two children in the family day-care group had previously attended a day-care center but had been transferred because of recurrent infectious illnesses. Signs of infections were recorded daily during 4 months (September through December 1973) for all the children in the day-care centers, even when they stayed at home. Otitis media was recorded whenever a physician had inspected a child's tympanic membranes, told the parent that the child had an otitis media, and prescribed antibiotics. In the home care group and the family day-care group episodes of otitis media, defined as above, during the same 4 months, were instead recorded retrospectively through parental interviews by telephone in January 1974. In May 1974 the same procedure was applied to the children in all three groups to obtain data of otitis media, as defined above, in January through April.
RESULTS Overall incidence The incidence of otitis media in the total study population was 0.7 episodes per child during 8 months (Table I); 34% of the children had at least Sccrnd J lrlfect Dis 9
one episode with an average of 2.0 episodes each. Among the 112 boys the incidence was 0.8; 38% had at least one episode with an average of 2.0 episodes each. Among the 95 girls the corresponding figures were 0.6,31% and 1.9. Type of day-care In the day-care center group the incidence was 0.8 episodes per child during 8 months; 37% of the children had at least one episode with an average of 2.2 episodes each (Table I). The corresponding figures in the family day-care group were 0.9,43 % and 2.0; and in the home care group 0.3,23% and 1.3. In the day-care center group, the occurrence decreased with increasing age (Table 11). In the ages ranging from 6 to 17 months, otitis media occurred in 48% of the children in the day-care center group with an average of 2.3 episodes per child; in 28% of the children in the family day-care group with an average of 3.1 episodes per child, and in 20% in the home care group with an average of 1.4 episodes per child. The difference is significant between the percentage of children who had otitis media in the day-care center group and that in the home care group (2x2 table and X2-test;P
ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19
Otitis Media in Young Children in Different Types of Day-care Katherine Strangert To cite this article: Katherine Strangert (1977) Otitis Media in Young Children in Different Types of Day-care, Scandinavian Journal of Infectious Diseases, 9:2, 119-123, DOI: 10.3109/ inf.1977.9.issue-2.11 To link to this article: http://dx.doi.org/10.3109/inf.1977.9.issue-2.11
Published online: 02 Jan 2015.
Submit your article to this journal
Article views: 1
View related articles
Citing articles: 6 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=infd19 Download by: [Monash University Library]
Date: 16 April 2016, At: 21:45
Scand J Infect Dis 9: 119-123, 1977
Otitis Media in Young Children in Different Types of Day-care KATHERINE STRANGERT
Downloaded by [Monash University Library] at 21:45 16 April 2016
From the Department of Paediatrics, Karolinska Hospital, Stockholm, Sweden
ABSTRACT. The Occurrence of otitis media was studied in 108 Swedish children attending 14 day-care centers and compared with that in 57 children cared for in their own homes (usually with one or no sibling) and with that in 42 children in family day-care homes (where a woman cared for both her own and 1to 4 other children in her home during the day). The children were 6 months to 2 years old. In the day-care centers 37% of the children had otitis media at least once during 8 months with an average of 2.2 episodes each. Otitis media was more common in 6- to 17-month-old children in the day-care centers than in children of the same age cared for in their own homes. The Occurrences of otitis media in the day-care centers and in the family day-care homes were approximately equal. Children attending centers where those with signs of infection were excluded had otitis in about the same frequency as those attending centers where children with infections were accepted.
INTRODUCTION Respiratory tract infections are common in all age groups but most frequent in the pre-school children (2). During childhood an infection of the upper respiratory tract is often spread to the middle ear causing otitis media. This complication may be recurrent, and it may become chronic and cause permanent hearing impairment (3, 6, 7, 9, 11) and language retardation (5). Beside the possible medical complications of otitis media, there are social consequences for a child attending a day-care center if the diagnosis otitis media is made. The staff is reluctant to care for children with infections also when the symptoms are minor. Children treated with antibiotics, e.g. against otitis media, are usually excluded during the whole period of treatment. The main reason stated for the excluding policy is to prevent the spread of infection. The parents must find another baby-sitter which can be an inconvenience. This has to be weighed against the possible epidemiological advantages of an exclusion policy. The number of contacts between individuals in group care influences the occurrence of respiratory illnesses and, conceivably, that of otitis media. Dingle et al. (2) have shown that children in large families have respiratory illnesses more often than children in small families, but they did not study
otitis media. The incidence of otitis media in young children attending Swedish day-care centers has not been studied since Hesselvik in the late forties presented his results (4). The present investigation had the aim to study (1) the incidence of otitis media in young children attending Swedish day-care centers; (2) whether children in day-care centers have otitis media more often than children cared for in their own homes (=“home care”) or in “family day-care homes” (where a woman cares for both her own and 1 to 4 other children in her home during the day); (3) whether the frequency of otitis media in children in day-care centers can be reduced by the exclusion of children with signs of infection and/or limitation of the number of children per center; and (4)whether newcomers to a day-care center have otitis media more often than children of the same age who have been in a center longer. MATERIAL AND METHODS All children in the ages between 6 months and 2 years were studied in 14 day-care centers in Solna (a suburb of Stockholm). Another group matched with respect to age and sex was chosen from the waiting list for admittance to the day-care centers in Solna. These children were cared for either in home care or in family day-care homes. The study comprised 108 children in day-care centers, 57 children in home care and 42 in family day-care homes, all Scand J Infect Dis 9
120
K . Stranger1
Table 1. Occurrence of otitis media in children, 6 months-2 years of age, in different types of daycare Period of study: September 1973 through April 1974 No. of children by type of day-care and by no. of episodes of otitis media Episodes of otitis media
Downloaded by [Monash University Library] at 21:45 16 April 2016
0 1 2 3
Family Day-care day-care Home center home care 68 17 13 3 2 3 1
24 12 2
44 9 4
136 38 19 4 2 4 3
1
I 2
I
Total Total no. of episodes Mean no. of episodes per child
Total
1
108
42
57
207
88
36
17
141
0.8
0.9
0.3
0.7
remaining in the same type of day-care during the study period (September 1973 through April 1974). Half of the children in the center group, one fourth of those in the family day-care group, but only a few of those in home care, belonged to a single-parent family. Most children in all groups had only one or no sibling each and lived in a modern apartment of 3 rooms. In the family day-care homes there were an average of 4 children. Two children in the family day-care group had previously attended a day-care center but had been transferred because of recurrent infectious illnesses. Signs of infections were recorded daily during 4 months (September through December 1973) for all the children in the day-care centers, even when they stayed at home. Otitis media was recorded whenever a physician had inspected a child's tympanic membranes, told the parent that the child had an otitis media, and prescribed antibiotics. In the home care group and the family day-care group episodes of otitis media, defined as above, during the same 4 months, were instead recorded retrospectively through parental interviews by telephone in January 1974. In May 1974 the same procedure was applied to the children in all three groups to obtain data of otitis media, as defined above, in January through April.
RESULTS Overall incidence The incidence of otitis media in the total study population was 0.7 episodes per child during 8 months (Table I); 34% of the children had at least Sccrnd J lrlfect Dis 9
one episode with an average of 2.0 episodes each. Among the 112 boys the incidence was 0.8; 38% had at least one episode with an average of 2.0 episodes each. Among the 95 girls the corresponding figures were 0.6,31% and 1.9. Type of day-care In the day-care center group the incidence was 0.8 episodes per child during 8 months; 37% of the children had at least one episode with an average of 2.2 episodes each (Table I). The corresponding figures in the family day-care group were 0.9,43 % and 2.0; and in the home care group 0.3,23% and 1.3. In the day-care center group, the occurrence decreased with increasing age (Table 11). In the ages ranging from 6 to 17 months, otitis media occurred in 48% of the children in the day-care center group with an average of 2.3 episodes per child; in 28% of the children in the family day-care group with an average of 3.1 episodes per child, and in 20% in the home care group with an average of 1.4 episodes per child. The difference is significant between the percentage of children who had otitis media in the day-care center group and that in the home care group (2x2 table and X2-test;P
