Abstract
BackgroundDescribing contact patterns is crucial to understanding infectious disease transmission dynamics and guiding targeted transmission mitigation interventions. Data on contact patterns in Africa, especially South Africa, are limited. We measured and compared contact patterns in a rural and urban community, South Africa. We assessed participant and contact characteristics associated with differences in contact rates.MethodsWe conducted a cross-sectional study nested in a prospective household cohort study. We interviewed participants to collect information on persons in contact with for one day. We described self-reported contact rates as median number people contacted per day, assessed differences in contact rates based on participant characteristics using quantile regression, and used a Poisson model to assess differences in contact rates based on contact characteristics within age groups. We also calculated cumulative person hours in contact within age groups at different locations.ResultsWe conducted 535 interviews (269 rural, 266 urban), with 17,252 contacts reported. The overall contact rate was 14 (interquartile range (IQR) 9–33) contacts per day. Those ≤18 years had higher contact rates at the rural site (coefficient 17, 95% confidence interval (95%CI) 10–23) compared to the urban site, for those aged 14–18 years (13, 95%CI 3–23) compared to < 7 years. No differences were observed for adults. There was a strong age-based mixing, with age groups interacting more with similar age groups, but also interaction of participants of all ages with adults. Children aged 14–18 years had the highest cumulative person hours in contact (116.3 rural and 76.4 urban).ConclusionsAge played an important role in the number and duration of contact events, with children at the rural site having almost double the contact rate compared to the urban site. These contact rates can be utilized in mathematical models to assess transmission dynamics of infectious diseases in similar communities.
Highlights
Contact patterns within communities impact disease transmission and may inform development of interventions to reduce transmission [1]
There were 58/269 (21.6%) participants at the rural site and 20/266 (7.5%) at the urban site that reported more than 50 contacts for the day
The contact rate recorded in a prior study of the Cape Town community in South Africa was more comparable to the rural site, with in Cape Town compared to contacts at the rural and 12 at the urban site in our study [13]
Summary
Contact patterns within communities impact disease transmission and may inform development of interventions to reduce transmission [1]. To evaluate the impact of both pharmaceutical and non-pharmaceutical interventions on disease transmission, mathematical models are utilized when intervention studies may be unethical or too expensive to perform [2]. Disease transmission models usually require accurate agerelated contact patterns [3]. Sub-Saharan Africa has the highest burden of infectious diseases globally, [4] data on contact patterns within the region are limited, making modelling infectious disease transmission challenging [5]. Data on contact patterns in Africa, especially South Africa, are limited. We measured and compared contact patterns in a rural and urban community, South Africa. We assessed participant and contact characteristics associated with differences in contact rates
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