Part 1. An 8.5 month prospective study was carried out to compare the risk of repeated infections in children attending different type of daycare facilities. Compared to children in family daycare, children in small daycare centres ($ le$20 children) had an increased risk of having $ ge$6 infections (odds ratio (OR) = 2.3; 95% confidence interval (CI) = 2.5-3.6); $ ge$5 upper respiratory tract infections (OR = 2.2; CI = 1.4-3.4); $ ge$2 occurrence of otitis media (OR = 2.6; CI = 1.0-2.6); and $ ge$2 episodes of gastroenteritis (OR = 1.5; CI = 0.9-2.4). Surprisingly this risk was not as high for children attending large daycare centres. Children who had spent at least 3 months in daycare before the beginning of the study were significantly protected compared to new attenders. These infections have important social and economical consequences since 96% of all episodes required a medical consultation. 68% were treated with antibiotics; and approximately 40% of episodes resulted in a parent taking time off work to look after their sick child. Further studies should be performs to assess the long term consequences of repeated infections. / Part 2. A randomized double-blind placebo-controlled trial was implemented to evaluate the efficacy of an immunostimulator in reducing the occurrence of recurrent respiratory or ear, nose, and throat infections. The parents of 423 children agreed to participate (210 Imocur$ sp circler$ and 213 Placebo). One capsule was administered orally for 10 consecutive days a month for 3 months. Children were followed for a further 4.5 months giving a total of 7.5 months for the study. For the total study period the risk of presenting at least 4 episodes of respiratory or ear, nose, and throat infections was lower in the treated group than in the placebo group (26.7% versus 33.8%), but the difference was not statistically significant (relative risk (RR) = 0.79; confidence interval (CI) = 0.59-1.06). A similar result was observed for the risk of having $ ge$2 episodes of gastroenteritis (RR = 0.77; 95% CI = 0.47-1.25). In contrast, at the end of the three-month treatment period we observed a 48% reduction in risk of presenting $ ge$3 episodes of respiratory or ear nose and throat infections (RR = 0.52; 95% CI = 0.45-0.87) in the treated group. However, this clinically important and statistically significant decrease in risk of recurrent infections did not extend beyond this period. The tolerance of the drug during the trial was excellent. Since these results were obtained from an exploratory analysis, they should be confirmed in further studies.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.39351 |
| Date | January 1992 |
| Creators | Collet, Jean-Paul |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | French |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001276949, proquestno: NN74921, Theses scanned by UMI/ProQuest. |
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