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.
Reviewing Editor
- Isabel Rodriguez-Barraquer, University of California, San Francisco, United States
Version history
- Received: May 12, 2021
- Accepted: November 24, 2021
- Accepted Manuscript published: November 25, 2021 (version 1)
- Version of Record published: January 18, 2022 (version 2)
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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- Epidemiology and Global Health
A large observational study has found that irregular sleep-wake patterns are associated with a higher risk of overall mortality, and also mortality from cancers and cardiovascular disease.
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- Epidemiology and Global Health
Background:
Irregular sleep-wake timing may cause circadian disruption leading to several chronic age-related diseases. We examined the relationship between sleep regularity and risk of all-cause, cardiovascular disease (CVD), and cancer mortality in 88,975 participants from the prospective UK Biobank cohort.
Methods:
The sleep regularity index (SRI) was calculated as the probability of an individual being in the same state (asleep or awake) at any two time points 24 hr apart, averaged over 7 days of accelerometry (range 0–100, with 100 being perfectly regular). The SRI was related to the risk of mortality in time-to-event models.
Results:
The mean sample age was 62 years (standard deviation [SD], 8), 56% were women, and the median SRI was 60 (SD, 10). There were 3010 deaths during a mean follow-up of 7.1 years. Following adjustments for demographic and clinical variables, we identified a non-linear relationship between the SRI and all-cause mortality hazard (p [global test of spline term]<0.001). Hazard ratios, relative to the median SRI, were 1.53 (95% confidence interval [CI]: 1.41, 1.66) for participants with SRI at the 5th percentile (SRI = 41) and 0.90 (95% CI: 0.81, 1.00) for those with SRI at the 95th percentile (SRI = 75), respectively. Findings for CVD mortality and cancer mortality followed a similar pattern.
Conclusions:
Irregular sleep-wake patterns are associated with higher mortality risk.
Funding:
National Health and Medical Research Council of Australia (GTN2009264; GTN1158384), National Institute on Aging (AG062531), Alzheimer’s Association (2018-AARG-591358), and the Banting Fellowship Program (#454104).
