Association of close-range contact patterns with SARS-CoV-2: a household transmission study

  1. Jackie Kleynhans  Is a corresponding author
  2. Lorenzo Dall'Amico
  3. Laetitia Gauvin
  4. Michele Tizzoni
  5. Lucia Maloma
  6. Sibongile Walaza
  7. Neil A Martinson
  8. Anne von Gottberg
  9. Nicole Wolter
  10. Mvuyo Makhasi
  11. Cheryl Cohen
  12. Ciro Cattuto
  13. Stefano Tempia
  14. For the SA‐S‐HTS Group
  1. National Health Laboratory Service, South Africa
  2. ISI Foundation, Italy
  3. University of the Witwatersrand, South Africa
  4. University of Turin, Italy

Abstract

Background: Households are an important location for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, especially during periods where travel and work was restricted to essential services. We aimed to assess the association of close-range contact patterns with SARS-CoV-2 transmission.

Methods: We deployed proximity sensors for two weeks to measure face-to-face interactions between household members after SARS-CoV-2 was identified in the household, in South Africa, 2020 - 2021. We calculated duration, frequency and average duration of close range proximity events with SARS-CoV-2 index cases. We assessed the association of contact parameters with SARS-CoV-2 transmission using mixed effects logistic regression accounting for index and household member characteristics.

Results: We included 340 individuals (88 SARS-CoV-2 index cases and 252 household members). On multivariable analysis, factors associated with SARS-CoV-2 acquisition were index cases with minimum Ct value <30 (aOR 10.6 95%CI 1.4-80.1) vs >35, and female contacts (aOR 2.4 95%CI 1.2-4.8). No contact parameters were associated with acquisition (aOR 1.0-1.1) for any of the duration, frequency, cumulative time in contact or average duration parameters.

Conclusion: We did not find an association between close-range proximity events and SARS-CoV-2 household transmission. Our findings may be due to study limitations, that droplet-mediated transmission during close-proximity contacts play a smaller role than airborne transmission of SARS-CoV-2 in the household, or due to high contact rates in households.

Funding: Wellcome Trust (Grant number 221003/Z/20/Z) in collaboration with the Foreign, Commonwealth and Development Office, United Kingdom.

Data availability

The contact network, selected individual characteristics and analysis script are available at https://github.com/crdm-nicd/sashts.git.

Article and author information

Author details

  1. Jackie Kleynhans

    National Health Laboratory Service, Sandringham, South Africa
    For correspondence
    jackiel@nicd.ac.za
    Competing interests
    Jackie Kleynhans, reports institutional grant funding from UK Foreign, Commonwealth and Development Office, Wellcome Trust, WHO AFRO, Africa Pathogen Genomics Initiative (Africa PGI) through African Society of Laboratory Medicine (ASLM) and Africa CDC, US Centers for Disease Control and Prevention, South African Medical Research Council (SAMRC) and UK Department of Health and Social Care and managed by the Fleming Fund: SEQAFRICA project. The author has no other competing interests to declare..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7081-6273
  2. Lorenzo Dall'Amico

    ISI Foundation, Turin, Italy
    Competing interests
    Lorenzo Dall'Amico, received support from the European Union's Horizon 2a020 research and innovation programme under grant agreements No. 101003688 (EpiPose) and No. 101016233 (PERISCOPE). The author acknowledges support from the Lagrange Project of ISI Foundation funded by CRT Foundation. They were awarded a PhD contract with Grenoble INP, and received support for attending meetings/travel from the ISP Foundation and Grenoble INP. The author has no other competing interests to declare..
  3. Laetitia Gauvin

    ISI Foundation, Turin, Italy
    Competing interests
    Laetitia Gauvin, has received Payment or honoraria for lectures from the University of Torino, Italy. They received support from the Lagrange Project of ISI Foundation funded by CRT Foundation. The authors has no other competing interests to declare..
  4. Michele Tizzoni

    ISI Foundation, Turin, Italy
    Competing interests
    Michele Tizzoni, acknowledges support from the Lagrange Project of ISI Foundation funded by CRT Foundation..
  5. Lucia Maloma

    Perinatal HIV Research Unit, University of the Witwatersrand, Soweto, South Africa
    Competing interests
    No competing interests declared.
  6. Sibongile Walaza

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    Sibongile Walaza, reports institutional grant funding from WHO AFRO, Africa Pathogen Genomics Initiative (Africa PGI) through African Society of Laboratory Medicine (ASLM) and Africa CDC, US Centers for Disease Control and Prevention, South African Medical Research Council (SAMRC), UK Department of Health and Social Care and managed by the Fleming Fund: SEQAFRICA project and the Wellcome Trust. The author has no other competing interests to declare..
  7. Neil A Martinson

    Perinatal HIV Research Unit, University of the Witwatersrand, Soweto, South Africa
    Competing interests
    Neil A Martinson, received grant funds from Pfizer. They participated on the data safety monitoring board of a TB HDT trial, and on the Scientific Advisory Board of a trial of an electronic reminder to take daily TB treatment. They hold an unpaid leadership role at the Setshaba Research Center. The authors has no other competing interests to declare..
  8. Anne von Gottberg

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    Anne von Gottberg, reports receiving grant funds from Sanofi Pasteur and Bill & Melinda Gates Foundation. They act as chairperson of the National Advisory Group on Immunisation. The author has no other competing interests to declare..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-0243-7455
  9. Nicole Wolter

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    Nicole Wolter, received grants from Sanofi Pasteur and Bill & Melinda Gates Foundation, and from US Centers for Disease Control and Prevention. The author has no other competing interests to declare..
  10. Mvuyo Makhasi

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    No competing interests declared.
  11. Cheryl Cohen

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    Cheryl Cohen, has received grant support from Sanofi Pasteur, US Centers for Disease Control and Prevention, Welcome Trust, Programme for Applied Technologies in Health (PATH), Bill & Melinda Gates Foundation and South African Medical Research Council (SA-MRC). The author has no other competing interests to declare..
  12. Ciro Cattuto

    Department of Informatics, University of Turin, Turin, Italy
    Competing interests
    Ciro Cattuto, received support from the European Union's Horizon 2020 research and innovation programme under grant agreements No. 101003688 (EpiPose) and No. 101016233 (PERISCOPE), and from Fondation Botnar, EPFL COVID-19 Real Time Epidemiology I-DAIR Pathfinder. They also received support from the Lagrange Project of ISI Foundation funded by CRT Foundation, and received equipment from the European Space Agency. They were issued the patent US8660490B2. They received support for attending meetings/travel from Gulbenkian Foundation, and participate as a Steering Board Member at CRT Foundation, on the Advisory Board at The Data Guild and on the Advisory Board in GovLab's 100 Questions Initiative and Open Data Policy Lab. The authors has no other competing interests to declare..
  13. Stefano Tempia

    National Health Laboratory Service, Sandringham, South Africa
    Competing interests
    No competing interests declared.

Funding

Wellcome Trust (221003/Z/20/Z)

  • Cheryl Cohen

Horizon 2020 Framework Programme (101016233)

  • Ciro Cattuto

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: The study protocol was reviewed and approved by University of the Witwatersrand Human Research Ethics Committee (Reference M2008114). The study was structured in accordance with the Declaration of Helsinki. Written informed consent was obtained from all household members aged {greater than or equal to}18 years; assent was obtained from children aged 7-17 years, and consent from a parent/ guardian of children aged <18 years. Informed consent was administered by a study team member who explained the study and requirements to participants, and shared an information leaflet with participants to keep. Consent included the enrolment into the study and all required procedures, as well as the anonymous processing of personal data for the final study report. Participants in follow-up received grocery store vouchers of USD 3 per visit to compensate for time required for specimen collection and interview, and an additional voucher once proximity sensors were returned with no visible damage.

Copyright

© 2023, Kleynhans et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

Metrics

  • 1,099
    views
  • 129
    downloads
  • 4
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. Jackie Kleynhans
  2. Lorenzo Dall'Amico
  3. Laetitia Gauvin
  4. Michele Tizzoni
  5. Lucia Maloma
  6. Sibongile Walaza
  7. Neil A Martinson
  8. Anne von Gottberg
  9. Nicole Wolter
  10. Mvuyo Makhasi
  11. Cheryl Cohen
  12. Ciro Cattuto
  13. Stefano Tempia
  14. For the SA‐S‐HTS Group
(2023)
Association of close-range contact patterns with SARS-CoV-2: a household transmission study
eLife 12:e84753.
https://doi.org/10.7554/eLife.84753

Share this article

https://doi.org/10.7554/eLife.84753

Further reading

    1. Epidemiology and Global Health
    Marina Padilha, Victor Nahuel Keller ... Gilberto Kac
    Research Article

    Background: The role of circulating metabolites on child development is understudied. We investigated associations between children's serum metabolome and early childhood development (ECD).

    Methods: Untargeted metabolomics was performed on serum samples of 5,004 children aged 6-59 months, a subset of participants from the Brazilian National Survey on Child Nutrition (ENANI-2019). ECD was assessed using the Survey of Well-being of Young Children's milestones questionnaire. The graded response model was used to estimate developmental age. Developmental quotient (DQ) was calculated as the developmental age divided by chronological age. Partial least square regression selected metabolites with a variable importance projection ≥ 1. The interaction between significant metabolites and the child's age was tested.

    Results: Twenty-eight top-ranked metabolites were included in linear regression models adjusted for the child's nutritional status, diet quality, and infant age. Cresol sulfate (β = -0.07; adjusted-p < 0.001), hippuric acid (β = -0.06; adjusted-p < 0.001), phenylacetylglutamine (β = -0.06; adjusted-p < 0.001), and trimethylamine-N-oxide (β = -0.05; adjusted-p = 0.002) showed inverse associations with DQ. We observed opposite directions in the association of DQ for creatinine (for children aged -1 SD: β = -0.05; p =0.01; +1 SD: β = 0.05; p =0.02) and methylhistidine (-1 SD: β = - 0.04; p =0.04; +1 SD: β = 0.04; p =0.03).

    Conclusion: Serum biomarkers, including dietary and microbial-derived metabolites involved in the gut-brain axis, may potentially be used to track children at risk for developmental delays.

    Funding: Supported by the Brazilian Ministry of Health and the Brazilian National Research Council.

    1. Epidemiology and Global Health
    Riccardo Spott, Mathias W Pletz ... Christian Brandt
    Research Article

    Given the rapid cross-country spread of SARS-CoV-2 and the resulting difficulty in tracking lineage spread, we investigated the potential of combining mobile service data and fine-granular metadata (such as postal codes and genomic data) to advance integrated genomic surveillance of the pandemic in the federal state of Thuringia, Germany. We sequenced over 6500 SARS-CoV-2 Alpha genomes (B.1.1.7) across 7 months within Thuringia while collecting patients’ isolation dates and postal codes. Our dataset is complemented by over 66,000 publicly available German Alpha genomes and mobile service data for Thuringia. We identified the existence and spread of nine persistent mutation variants within the Alpha lineage, seven of which formed separate phylogenetic clusters with different spreading patterns in Thuringia. The remaining two are subclusters. Mobile service data can indicate these clusters’ spread and highlight a potential sampling bias, especially of low-prevalence variants. Thereby, mobile service data can be used either retrospectively to assess surveillance coverage and efficiency from already collected data or to actively guide part of a surveillance sampling process to districts where these variants are expected to emerge. The latter concept was successfully implemented as a proof-of-concept for a mobility-guided sampling strategy in response to the surveillance of Omicron sublineage BQ.1.1. The combination of mobile service data and SARS-CoV-2 surveillance by genome sequencing is a valuable tool for more targeted and responsive surveillance.