{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:00:30Z","timestamp":1785222030155,"version":"3.55.0"},"reference-count":24,"publisher":"Baishideng Publishing Group Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Clin Pediatr"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Acute respiratory tract infections (ARTIs) are a major cause of pediatric morbidity. Daycare centers (DCCs) are high-risk environments where close interpersonal contact facilitates rapid viral transmission. Effective and practical preventive strategies are therefore essential to reduce infection-related burden in these settings.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To determine the incidence of ARTIs in DCCs following implementation of a structured protocol designed to mitigate respiratory virus transmission.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>A cluster study was conducted in which two centers were centers to either intervention or control groups via  lottery. Although allocation was randomized, the study was not designed as a randomized controlled trial; therefore, potential bias and confounding were considered. Participants were followed for 25 weeks. The primary outcome was physician-diagnosed ARTIs per 100 child-weeks. Incidence rate ratios (IRRs) with 95%CIs were estimated using Poisson regression with a log link and person-time offset, adjusting for covariates under the intention-to-treat principle. Results cautious interpretation Due to limited clusters, results require cautious interpretation. Statistical significance was defined as P  &lt; 0.05.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>A total of 223 children (149 intervention, 74 control) across 2 clusters were enrolled. By week 25, the cumulative proportion of ARTIs was 18.1% in the intervention group compared with 60.8% in the control group. The incidence rate of ARTIs was lower in the intervention group, with adjusted rates of 1.09 per 100 child-weeks vs  13.00 per 100 child-weeks. The adjusted IRR was 0.14 (95%CI: 0.09-0.22; P  &lt; 0.001), suggesting an observed difference in incidence between groups under the study conditions.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>Protocol implementation was associated with a lower observed incidence of ARTIs under the study conditions. However, interpretation is constrained by the study design, the small number of clusters, and potential sources of bias. Larger, well-designed randomized studies are required to further evaluate this association in daycare settings.<\/jats:p>","DOI":"10.5409\/wjcp.121288","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T16:08:04Z","timestamp":1780416484000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a structured protocol for the prevention of acute respiratory tract infections in daycare centers: A quasi-experimental study"],"prefix":"10.5409","volume":"15","author":[{"given":"Klaita","family":"Srisingh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nittaya","family":"Sribuarom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanikan","family":"Suasing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagoontee","family":"Inkate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60206-1"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2471\/blt.07.048769"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2024-2170"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/children9121990"},{"key":"B5","unstructured":"Teeratakulpisarn J, Uppala R, Thepsuthammarat K, Sutra S. 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