Impact of an Environmental Hygiene Intervention on Illness and Microbial Levels in Child Care Centers

Persistent Link:
http://hdl.handle.net/10150/195257
Title:
Impact of an Environmental Hygiene Intervention on Illness and Microbial Levels in Child Care Centers
Author:
Bronson-Lowe, Daniel
Issue Date:
2006
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Pathogens on surfaces in child care centers can contribute to illness among attendees and may thereby contribute to medical visits as well. This intervention study was conducted to assess the effect of using specific sanitizing products and cleaning protocols in child care centers on the incidences of lower respiratory infections, diarrheal illness, antibiotic use, and medical visits among children attending the centers and on the levels and antibiotic resistance of indicator bacteria in those centers. During the ten-week study period, children from twelve centers were observed. Six of the centers were randomly assigned to the intervention. The other six were controls. Intervention centers were given cleaning protocols and sanitizing products. Control centers were asked to retain their original procedures and products.Acute illness was determined from records kept by the center directors and telephone calls made to parents of ill children. A call was also made to one randomly selected healthy child's parents for every two ill children recorded. Parents were given a questionnaire requesting information including bedroom sharing status, environmental tobacco smoke exposure, and chronic illnesses.After controlling for within-center clustering and zero-inflation, statistically non-significant trends of reduction were seen in the weeks of lower respiratory infections, diarrheal illness, and medical visits. Multivariable zero-inflated Poisson regression revealed that the number of weeks intervention center children were using antibiotics was 32% lower than among the control center children. This was a statistically significant reduction (95% CI = 0.54-0.86; p = 0.001).Bacterial samples were collected from ten sites within each center at the beginning and the end of the study period to determine the effect of the intervention on the microbial population. The study determined the heterotrophic plate count bacteria numbers and the rates of resistance to ampicillin and cephalothin. Neither heterotrophic bacterial concentrations nor antibiotic resistance rates significantly changed over the course of the study.
Type:
text; Electronic Dissertation
Keywords:
epidemiology; child care; antibiotics; intervention; antibiotic resistance
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Epidemiology; Graduate College
Degree Grantor:
University of Arizona
Committee Chair:
Lebowitz, Michael

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleImpact of an Environmental Hygiene Intervention on Illness and Microbial Levels in Child Care Centersen_US
dc.creatorBronson-Lowe, Danielen_US
dc.contributor.authorBronson-Lowe, Danielen_US
dc.date.issued2006en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractPathogens on surfaces in child care centers can contribute to illness among attendees and may thereby contribute to medical visits as well. This intervention study was conducted to assess the effect of using specific sanitizing products and cleaning protocols in child care centers on the incidences of lower respiratory infections, diarrheal illness, antibiotic use, and medical visits among children attending the centers and on the levels and antibiotic resistance of indicator bacteria in those centers. During the ten-week study period, children from twelve centers were observed. Six of the centers were randomly assigned to the intervention. The other six were controls. Intervention centers were given cleaning protocols and sanitizing products. Control centers were asked to retain their original procedures and products.Acute illness was determined from records kept by the center directors and telephone calls made to parents of ill children. A call was also made to one randomly selected healthy child's parents for every two ill children recorded. Parents were given a questionnaire requesting information including bedroom sharing status, environmental tobacco smoke exposure, and chronic illnesses.After controlling for within-center clustering and zero-inflation, statistically non-significant trends of reduction were seen in the weeks of lower respiratory infections, diarrheal illness, and medical visits. Multivariable zero-inflated Poisson regression revealed that the number of weeks intervention center children were using antibiotics was 32% lower than among the control center children. This was a statistically significant reduction (95% CI = 0.54-0.86; p = 0.001).Bacterial samples were collected from ten sites within each center at the beginning and the end of the study period to determine the effect of the intervention on the microbial population. The study determined the heterotrophic plate count bacteria numbers and the rates of resistance to ampicillin and cephalothin. Neither heterotrophic bacterial concentrations nor antibiotic resistance rates significantly changed over the course of the study.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectepidemiologyen_US
dc.subjectchild careen_US
dc.subjectantibioticsen_US
dc.subjectinterventionen_US
dc.subjectantibiotic resistanceen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineEpidemiologyen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.chairLebowitz, Michaelen_US
dc.contributor.committeememberLebowitz, Michaelen_US
dc.contributor.committeememberGerba, Charlesen_US
dc.contributor.committeememberPetersen, Eskilden_US
dc.contributor.committeememberO'Rourke, Mary Kayen_US
dc.contributor.committeememberRanger-Moore, Jamesen_US
dc.identifier.proquest1503en_US
dc.identifier.oclc137356295en_US
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