Infant contact in day-care centres in Vietnam: A cross-sectional study to understand infant infection risk

Abstract

Background: Infant contact information (skin-to-skin contact between infants and others) is important to understand Streptococcus pneumoniae transmission patterns. A few studies have investigated infant contact patterns by asking the mother/guardian to record all contacts a child makes in one day. However, this approach does not capture contact behaviour in day-care. Our study describes the frequency and nature of physical contacts of infants in day-care to understand infant infection risk in day-care in Nha Trang, Vietnam. Methods: This cross-sectional study enrolled infants aged <12 months, attending 10 randomly selected day-care centres in Nha Trang. Physical contacts of each infant for one day at the day-care centre were observed. The mean number of infants’ contacts and factors associated with contact numbers were assessed using negative binomial regression. Results: In total 14 infants, aged 6-11 months, were enrolled, and a total of 96 contacts were recorded. The mean number of contacts an infant made in one day was 6.9. Infants who walked independently (age-adjusted rate ratio 1.68, 95% confidence interval 1.06-2.68) and those cared for in a larger group (1.99, 1.42-2.79) had more contacts at day-care. About 50% of infants made contact with at least one person from a commune different from the infant’s, and 50% made contact with at least one other infant at day-care. Conclusion: This study found that day-care attendance may be one factor that increases contact rates of infants in Nha Trang and diversifies those contacts in terms of age and geographical spread. In this study, day-care attendance not only increased contact rates beyond those usually experienced by young children cared for at home but specifically increased contact rates with other children and adults from other communes. Day-care may play a key role in the transmission of respiratory pathogens like Streptococcus pneumoniae to infants.

Estimating the contribution of different age strata to vaccine serotype pneumococcal transmission in the pre vaccine era: a modelling study

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Age-time-specific transmission of hand-foot-and-mouth disease enterovirus serotypes in Vietnam: A catalytic model with maternal immunity

“…The HFMD infection among children aged 1–2 years in Vietnam may be attributed to the household contacts and the contacts with peers of similar ages and childcare adults during attendance at day-care centres. Existing evidence underscores the crucial role of day-care centres and adults with asymptomatic infection in virus transmission among young children, as observed in the transmission of streptococcus pneumoniae in Vietnam ( Toizumi et al, 2019 , Thi Nguyen et al, 2019 ). Currently the HFMD vaccines target children aged 6 months to 5 years old or 2 months to 71 months, and recommend early vaccination before 12 months ( Chinese Center for Disease Contro and Prevention, 2016 , Nguyen et al, 2022 ).…”

Association of pneumococcal carriage in infants with the risk of carriage among their contacts in Nha Trang, Vietnam: A nested cross-sectional survey

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