Table 3.
Childcare centre characteristics associated with gastroenteritis among children in high-income countries, 1990–2018
| Risk factors | Pathogen/GI condition | Study citation | Significance |
|---|---|---|---|
| Childcare capacity | All-cause gastroenteritis | [55] | aIRRs = 1.001, 95% CI: 1.001–1.003 |
| Norovirus | [55] | aIRRs = 1.001, 95% CI: 1.001–1.002 | |
| [64] | aOR = 2·40, 95% CI: 1·61–3·56 | ||
| Personnel mixing between child groups | Rotavirus | [55] | aIRRs = 1·80, 95% CI: 1·00–3·60 |
| GAB | [65] | aOR = 4.70, 95% CI: 2.80–8.10 | |
| Staff multitasking | C. hominis | [55] | aIRRs = 2·70, 95% CI: 1·00–7·70 |
| Sandpits | Norovirus | [55] | aIRRs = 1·90, 95% CI:1·30–2·80 |
| Paddling pools | GUA | [65] | aOR = 2.40, 95% CI: 1.10–5.10 |
| Norovirus | [55] | aIRRs = 1·50, 95% CI:1·30–1·90 | |
| [64] | OR = 4·30, 95% CI: 2·27–8·15 | ||
| G. lamblia | [64] | OR = 2·03, 95% CI:1·16–3·55 | |
| Central diaper changing area | GAB | aOR = 3.60, 95% CI 1.70–7.60 | |
| Central laundry room | GAB | [65] | aOR = 2.30, 95% CI:1.10–4.90 |
| Using chlorine tablets to clean vomit | G. lamblia | [55] | aIRRs = 0.10, 95% CI: 0.04–0.30 |
| G. lamblia | [64] | aOR = 0.29, 95% CI: 0.11–0.76 | |
| Using paper towels and detergent for vomit cleanup | All-cause gastroenteritis | [55] | aIRRs = 0.6, 95% CI: 0.40–0.70 |
| Daily cleaning of toys | Astrovirus | [55] | aIRRs = 0.5, 95% CI: 0.20–0.90 |
| Cryptosporidium | [64] | aOR = 0.27, 95% CI: 0.08–0.92 | |
| Cleaning kids’ potties in a normal sink | Rotavirus | [55] | aIRRs = 1·90, 95% CI: 1·20–3·00 |
| Daily cleaning of bed linens | Norovirus | [55] | aIRRs = 0.70, 95% CI: 0.50–0.90 |
| Cleaning kids’ potties at a disposal area | Norovirus | [64] | aOR = 0·37, 95% CI: 0·20–0·69 |
| Disease control policies during a suspected outbreak | |||
| Extra cleaning of toys | G. lamblia | [55] | aIRRs = 0.40, 95% CI: 0.20–0.70 |
| [64] | aOR = 0.25, 95% CI: 0.11–0.60 | ||
| Norovirus | [64] | aOR = 0.54, 95% CI: 0.31–0.94 | |
| Excluding personnel with gastroenteritis | G. lamblia | [55] | aIRRs = 0.50, 95% CI: 0.30–0.80 |
| All-cause gastroenteritis | [55] | aIRRs = 0.50, 95% CI: 0.40–0.70 | |
| Excluding children with gastrointestinal symptoms | Cryptosporidium | [64] | aOR = 0.09, 95% CI: 0.02–0.37 |
| Not mixing of staff members in child groups | Norovirus | [55] | aIRRs = 0.60, 95% CI: 0.50–0.90 |
| Separate toilet for ill children | Rotavirus | [55] | aIRRs = 0.40, 95% CI: 0.20–0.80 |
GAB, Giardia Assemblage B, GAA, Giardia Assemblage A, GUA, Giardia Unknown Assemblage