PEDIATRICS Vol. 90 No. 4 October 1992, pp. 582-588
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hillis, S. D.
Right arrow Articles by Weigle, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hillis, S. D.
Right arrow Articles by Weigle, K.

Day Care Center Attendance and Diarrheal Morbidity in Colombia

Susan D. Hillis PhD1, Clarybel M. Miranda MPH2, Margaret McCann PhD3, Deborah Bender PhD3, and Kristen Weigle MD, MPH3

1 From the Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina, Centers for Disease Control, Atlanta, Georgia 30333
2 From the Department of Health Sciences, University of Sucre, Sincelejo, Colombia
3 From the Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina

This study was designed to determine whether day care center attendance was associated with increased risk of diarrheal disease among poor children in an urban, developing country setting. From July 17 to December 18, 1988, mothers of 493 Colombian children less than 5 years old (241 attendees and 252 nonattendees) were interviewed weekly about diarrheal events during the previous week.

The incidence of diarrhea was greater for day care center attendees than for nonattendees (3.2 vs 2.0 episodes per child-year, P < .0005). For children less than 2 years of age, attendees experienced 7.2 episodes/child-year vs 3.5 episodes per child-year for nonattendees (P < .0005). Analyses controlling for water source and availability, excreta disposal, socioeconomic status, and duration of follow-up showed that the increased diarrheal risk was limited to children younger than 3 years of age spending more than 30 hours per week in the centers. In addition, although the risk among attendees of suffering diarrheal episodes of longer duration was fairly constant across levels of socioeconomic status, this risk was inversely proportional to socioeconomic status for nonattendees. In summary, the increase in risk of diarrhea among young, full-time day care attendees was modest, yet important, because diarrhea continues to be a major cause of morbidity and mortality in Colombian children.

Key Words: Child day care • diarrhea • developing countries

Submitted on November 11, 1991
Accepted on April 21, 1992