Social contact patterns and implications for infectious disease transmission: a systematic review and meta-analysis of contact surveys
- Imperial College London, United Kingdom
- Indiana University School of Public Health, United States
- VITROME, Institut de Recherche pour le Developpement, Senegal
- University of Sheffield, United Kingdom
- Vanderbilt University Medical Center, United States
- KEMRI-Wellcome Trust Research Programme, Kenya
- All India Institute of Medical Sciences, India
- Bill and Melinda Gates Foundation, United States
- Chinese University of Hong Kong, China
- Instituto de Investigación Nutricional, Peru
- London School of Hygiene and Tropical Medicine, United Kingdom
- The University of Hong Kong, Hong Kong
- Chulabhorn Royal Academy, Thailand
- Bocconi University, Italy
- University of Cape Town, South Africa
- Health Directorate, Luxembourg
- Murdoch Children's Research Institute, Australia
- Mahidol University, Thailand
- National Institute for Allergies and Infectious Diseases, National Institutes of Health, United States
- US Centers for Disease Control and Prevention, India
- United States Department of Veterans Affairs, United States
- The Chinese University of Hong Kong, China
- Fudan University, China
Abstract
Background: Transmission of respiratory pathogens such as SARS-CoV-2 depends on patterns of contact and mixing across populations. Understanding this is crucial to predict pathogen spread and the effectiveness of control efforts. Most analyses of contact patterns to date have focussed on high-income settings.
Methods: Here, we conduct a systematic review and individual-participant meta-analysis of surveys carried out in low- and middle-income countries and compare patterns of contact in these settings to surveys previously carried out in high-income countries. Using individual-level data from 28,503 participants and 413,069 contacts across 27 surveys we explored how contact characteristics (number, location, duration and whether physical) vary across income settings.
Results: Contact rates declined with age in high- and upper-middle-income settings, but not in low-income settings, where adults aged 65+ made similar numbers of contacts as younger individuals and mixed with all age-groups. Across all settings, increasing household size was a key determinant of contact frequency and characteristics, with low-income settings characterised by the largest, most intergenerational households. A higher proportion of contacts were made at home in low-income settings, and work/school contacts were more frequent in high-income strata. We also observed contrasting effects of gender across income-strata on the frequency, duration and type of contacts individuals made.
Conclusions: These differences in contact patterns between settings have material consequences for both spread of respiratory pathogens, as well as the effectiveness of different non-pharmaceutical interventions.
Funding: This work is primarily being funded by joint Centre funding from the UK Medical Research Council and DFID (MR/R015600/1).
Data availability
All individual-level data across all studies and analysis code are available at https://github.com/mrc-ide/contact_patterns (see Supplementary Text 4 for data dictionary).
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Article and author information
Author details
Oliver John Watson
Funding
joint Centre funding from the UK Medical Research Council and DFID (MR/R015600/1)
- Andria Mousa
- Peter Winskill
- Patrick Walker
- Charles Whittaker
Australian National Health and Medical Research Council
- Fiona M Russell
WHO
- Fiona M Russell
Bill & Melinda Gates Foundation
- Fiona M Russell
Wellcome Trust
- Fiona M Russell
DFAT
- Fiona M Russell
EPSRC through the EPSRC Centre for Doctoral Training in Modern Statistics and Statistical Machine Learning
- Mélodie Monod
University of Washington
- Jonathan D Sugimoto
US National Institutes of Health, NIAID
- Jonathan D Sugimoto
NIH (K24AI148459)
- Carlos G Grijalva
General Medical Sciences / National Institute of Health (U01-GM070749)
- Gail E Potter
UK foreign Commonwealth and Development Office
- Oliver John Watson
Emmes Company
- Gail E Potter
CUHK Direct grant for research (2019.020)
- Kin O Kwok
Health and Medical Research Fund (INF-CUHK-1,17160302,18170312)
- Kin O Kwok
General Research Fund (14112818)
- Kin O Kwok
Early Career Scheme (24104920)
- Kin O Kwok
Wellcome Trust (200861/Z/16/Z)
- Kin O Kwok
UK Medical Research Council. UK-funded award is part of the EDCTP2 programme supported by the EU (MR/P022081/1)
- Peter J Dodd
Australian Government Research Training Program Scholarship
- Eleanor FG Neal
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: All original studies included were approved by an institutional ethics review committee. Ethics approval was not required for the present study.
Copyright
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
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Social contact patterns and implications for infectious disease transmission: a systematic review and meta-analysis of contact surveys
eLife 10:e70294.
https://doi.org/10.7554/eLife.70294
Further reading
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- Cancer Biology
- Epidemiology and Global Health
Cancer is considered a risk factor for COVID-19 mortality, yet several countries have reported that deaths with a primary code of cancer remained within historic levels during the COVID-19 pandemic. Here, we further elucidate the relationship between cancer mortality and COVID-19 on a population level in the US. We compared pandemic-related mortality patterns from underlying and multiple cause (MC) death data for six types of cancer, diabetes, and Alzheimer’s. Any pandemic-related changes in coding practices should be eliminated by study of MC data. Nationally in 2020, MC cancer mortality rose by only 3% over a pre-pandemic baseline, corresponding to ~13,600 excess deaths. Mortality elevation was measurably higher for less deadly cancers (breast, colorectal, and hematological, 2–7%) than cancers with a poor survival rate (lung and pancreatic, 0–1%). In comparison, there was substantial elevation in MC deaths from diabetes (37%) and Alzheimer’s (19%). To understand these differences, we simulated the expected excess mortality for each condition using COVID-19 attack rates, life expectancy, population size, and mean age of individuals living with each condition. We find that the observed mortality differences are primarily explained by differences in life expectancy, with the risk of death from deadly cancers outcompeting the risk of death from COVID-19.
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- Epidemiology and Global Health
Background:
The associations of age at diagnosis of breast cancer with incident myocardial infarction (MI) and heart failure (HF) remain unexamined. Addressing this problem could promote understanding of the cardiovascular impact of breast cancer.
Methods:
Data were obtained from the UK Biobank. Information on the diagnosis of breast cancer, MI, and HF was collected at baseline and follow-ups (median = 12.8 years). The propensity score matching method and Cox proportional hazards models were employed.
Results:
A total of 251,277 female participants (mean age: 56.8 ± 8.0 years), of whom 16,241 had breast cancer, were included. Among breast cancer participants, younger age at diagnosis (per 10-year decrease) was significantly associated with elevated risks of MI (hazard ratio [HR] = 1.36, 95% confidence interval [CI] 1.19–1.56, p<0.001) and HF (HR = 1.31, 95% CI 1.18–1.46, p<0.001). After propensity score matching, breast cancer patients with younger diagnosis age had significantly higher risks of MI and HF than controls without breast cancer.
Conclusions:
Younger age at diagnosis of breast cancer was associated with higher risks of incident MI and HF, underscoring the necessity to pay additional attention to the cardiovascular health of breast cancer patients diagnosed at younger age to conduct timely interventions to attenuate the subsequent risks of incident cardiovascular diseases.
Funding:
This study was supported by grants from the National Natural Science Foundation of China (82373665 and 81974490), the Nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences (2021-RC330-001), and the 2022 China Medical Board-open competition research grant (22-466).
