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Intervention with an Infection Control Bundle to Reduce Transmission of Influenza-Like Illnesses in a Thai Preschool

Part of: WILLIAM JARVIS AWARD RECIPIENTS

Published online by Cambridge University Press:  02 January 2015

Anucha Apisarnthanarak ,
Piyaporn Apisarnthanarak ,
Boonsri Cheevakumjorn  and
Linda M. Mundy
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Thailand
Piyaporn Apisarnthanarak
Affiliation:
Department of Radiology, Siriraj Hospital, Bangkok, Thailand
Boonsri Cheevakumjorn
Affiliation:
Kindergarten Division, Satit School of Rangsit University, Pratumthani, Thailand
Linda M. Mundy
Affiliation:
Saint Louis University School of Public Health, St. Louis, Missouri
*
Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand12120 ([email protected])
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Abstract

Background.

Infection-control interventions are needed to minimize transmission of influenza-like illness (ILI) and other infections in settings where children are in close proximity.

Setting.

A 240-children Thai kindergarten.

Methods.

Three-year, quasi-experimental study was conducted to assess the association between the use of a bundle of 4 infection control interventions and the incidence of ILI, diarrheal illnesses, and hand-foot-mouth infections among preschool children. The numbers of incident infections were calculated for the preintervention year (period 1), the immediate postintervention year (period 2), and the sustained postintervention year (period 3).

Results.

The monthly incidence of ILI in period 1 (mean, 124 episodes per month) was 25.8 cases per 1,000 child-days; in period 2, it was 10.1 cases per 1,000 child-days (a reduction of 60.8%; P = .008); and in period 3, it was 8.2 cases per 1,000 child-days (a further reduction of 19%; P = .002). The monthly incidence of diarrheal illnesses in period 1 was 14 cases per 1,000 child-days; in period 2, it was 4 cases per 1,000 child-days (P = .01); and in period 3, it was 3 cases per 1,000 child-days (P = .007). The yearly incidence of hand-foot-mouth infection in period 1 was 10 cases per 1,000 child-days; in period 2, it was 1 case per 1,000 child-days (P = .01); and in period 3, it was 0.5 cases per 1,000 child-days per year (P = .007).

Conclusion.

Use of the infection control intervention bundle was associated with reduced incidence of ILI at the Thai preschool.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 9 , September 2009 , pp. 817 - 822
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Fleming, DW, Cochi, SL, Hightower, AW, Broome, CV. Childhood upper respiratory tract infections: to what degree is incidence affected by daycare attendance? Pediatrics 1987;79:55–60.CrossRefGoogle Scholar
2.Wald, ER, Dashefsky, B, Byers, C, Guerra, N, Taylor, F. Frequency and severity of infections in day care. J Pediatr 1988;112:540–546.CrossRefGoogle ScholarPubMed
3.Strangert, K. Respiratory illness in preschool children with different forms of day care. Pediatrics 1976;57:191–196.Google Scholar
4.Basu, G, Rossouw, J, Sebunya, TK, et al.Prevalence of rotavirus, adenovirus and astrovirus infection in young children with gastroenteritis in Gaborone, Botswana. East Afr Med J 2003;80:652–655.Google Scholar
5.Suwanjutha, S, Chantarojanasiri, T, Watthana-kasetr, S, et al.A study of nonbacterial agents of acute lower respiratory tract infection in Thai children. Rev Infect Dis 1990;12(Suppl 8):S923–928.CrossRefGoogle ScholarPubMed
6.Hooi, PS, Chua, BH, Lee, CS, Lam, SK, Chua, KB. Hand, foot and mouth disease: University Malaya medical center experience. Med J Malaysia 2002;57:88–91.Google Scholar
7.Cowling, BJ, Fung, RO, Cheng, CK, et al.Preliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in households. PLoS One 2008;3:e2101.Google Scholar
8.Simmerman, JM, Thawatsupha, P, Kingnate, D, Fukuda, K, Chaising, A, Dowell, SF. Influenza in Thailand: a case study for middle income countries. Vacane 2004;23:182–187.Google Scholar
9.Jefferson, T, Foxlee, R, Del Mar, C, et al.Interventions for the interruption or reduction of the spread of respiratory viruses. Cochrane Database Syst Rev 2007;4:CD006207.Google Scholar
10.American Academy of Pediatrics Committee on Infectious Diseases. Infection prevention and control in pediatric ambulatory settings. Pediatrics 2007;120:650–665.Google Scholar
11.van den Dool, C, Hak, E, Wallinga, J, van Loon, A, Lammers, J, Bonten, M. Symptoms of influenza virus infection in hospitalized patients. Infect Control Hosp Epidemiol 2008;29:314–319.Google Scholar
12.Sandora, TJ, Shih, MC, Goldmann, DA. Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention. Pediatrics 2008;121:e1555–1562.Google Scholar
13.King, JC Jr, Stoddard, JJ, Gaglani, MJ, et al.Effectiveness of school-based influenza vaccination. N Engl J Med 2006;355:2523–2532.Google Scholar
14.Jefferson, T, Smith, S, Demicheli, V, Harnden, A, Rivetti, A, Di Pietrantoni, C. Assessment of the efficacy and effectiveness of influenza vaccines in healthy children: systematic review. Lancet 2005;365:733–780.Google Scholar
15.Sandora, TJ, Taveras, EM, Shih, MC, et al.A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home. Pediatrics 2005;116:587–594.Google Scholar
16.Bell, DM; World Health Organization Writing Group. Non-pharmaceutical interventions for pandemic influenza, national and community measures. Emerg Infect Dis 2006;12:88–94.Google Scholar
17.Apisarnthanarak, A, Apisarnthanarak, P, Mundy, LM. Knowledge and attitudes of influenza vaccination among parents of preschool children in a region with avian influenza (H5N1). Am J Infect Control 2008;35:604–605.CrossRefGoogle Scholar
18.Apisarnthanarak, A, Phattanakeitchai, P, Warren, DK, Fraser, VJ. Impact of knowledge and positive attitudes about avian influenza (H5N1 virus infection) on infection control and influenza vaccination practices of Thai healthcare workers. Infect Control Hosp Epidemiol 2008;29:472–474.Google Scholar
19.Larson, EL. Warned, but not well armed: preventing viral upper respiratory infections in households. Public Health Nurs 2007;24:48–59.Google Scholar
20.Yuan, CT, Dembry, LM, Higa, B, Fu, M, Wang, H, Bradley, EH. Perceptions of hand hygiene practices in China. J Hosp Infect 2009;71:157–162.Google Scholar
21.Aboelela, SW, Stone, PW, Larson, EL. Effectiveness of bundled behavioural interventions to control healthcare-associated infections: a systematic review of the literature. J Hosp Infect 2007;66:101–108.Google Scholar