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

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.