Logo image
Back
Density of day cares in relation to reported pertussis incidence in Philadelphia
Journal article   Peer reviewed

Density of day cares in relation to reported pertussis incidence in Philadelphia

N.D. Goldstein, E.C. Newbern, L.P. Tabb and S.L. Welles
Public health (London), v 146
May 2017
DOI: https://doi.org/10.1016/j.puhe.2017.01.015
PMID: 28404464
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Day care/child care Multilevel modeling Neighborhood Pertussis Vaccination
Reported pertussis incidence has increased markedly in recent years. In addition to the documented increase in under-immunization and waning immunity, the increase may be related to the more frequent use of child care services by parents over the last few decades. Additionally, clustering of outbreaks may be related to neighborhood characteristics not previously identified. We conducted a citywide case–control study of children in Philadelphia aged birth through six years, between 2001 and 2013. Cases were reported as probable pertussis diagnoses to the Health Department. Controls were sampled from the city's immunization information system and matched to the cases by date of birth. Multilevel logistic regression was used to isolate the independent contributions of individual and neighborhood risk factors and the corresponding relative odds of pertussis. The density of day cares in each neighborhood served as the main exposure and reported incident cases of confirmed and probable pertussis was the main outcome. Between 2001 and 2013, 410 cases of confirmed and probable pertussis were included with four controls matched per case yielding a final sample of 2050 children from 45 Philadelphia neighborhoods. There was a 30% increase in the risk of pertussis based solely on the neighborhood where the children resided (median odds ratio 1.3, 95% credible interval 1.1, 1.6). The density of day cares in each neighborhood was unrelated to the distribution of pertussis cases. Pertussis clustering was observed at the neighborhood level in Philadelphia, but was unrelated to the neighborhood's day care density. From a Health Department perspective, the highest risk neighborhoods should be targeted for vaccine campaigns and further research to identify the etiologic risk factors. •Contagious respiratory diseases among children, such as pertussis, often occur in congregant settings, such as day cares.•Pertussis incidence varied with respect to Philadelphia neighborhood.•Day cares did not appear to be a source of pertussis risk, possibly owing to the vaccination requirements for attendance.•Correlates of infection appear to be driven primarily by familial and individual factors rather than ecological exposures.

Metrics

14 Record Views
2 citations in Web of Science

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Public, Environmental & Occupational Health
Logo image