Abstract
The way persons interact when ill could profoundly affect transmission of infectious agents. To obtain data on these patterns in Africa, we recorded self-reported named contacts and opportunities for casual contact in rural northern Malawi. We interviewed 384 patients and 257 caregivers about contacts over three 24-hour periods: day of the clinic visit for acute illness, the next day, and 2 weeks later when well. For participants of all ages, the number of adult contacts and the proportion using public transportation was higher on the day of the clinic visit than later when well. Compared with the day after the clinic visit, well participants (2 weeks later) named a mean of 0.4 extra contacts; the increase was larger for indoor or prolonged contacts. When well, participants were more likely to visit other houses and congregate settings. When ill, they had more visitors at home. These findings could help refine models of infection spread.
Highlights
The way persons interact when ill could profoundly affect transmission of infectious agents
A study of the effect of influenza-like symptoms in the United Kingdom indicated that changes in contact patterns after illness resulted in a reduced reproduction number to
To help learn whether similar changes occur in populations in Africa, we studied contact patterns during and after illness in a rural area in Karonga District, northern Malawi
Summary
The way persons interact when ill could profoundly affect transmission of infectious agents. Illness probably affects the contacts and movements of the sick persons and their household members These altered patterns will be a key determinant of infection spread but are largely unknown even in high-income settings [13,14]. A study of the effect of influenza-like symptoms in the United Kingdom indicated that changes in contact patterns after illness resulted in a reduced reproduction number (average number of cases generated by 1 case-patient) to
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