High-resolution contact data and infectious disease absenteeism in kindergarten populations

Background Close social interactions are a fundamental driver of infectious disease transmission in early childhood education settings. However, high-resolution empirical contact data from these environments remain scarce, limiting our understanding of transmission dynamics and prevention strategies. Methods We deployed name-tag devices equipped with ultra-wideband (UWB) positioning technology in a public kindergarten in Shenzhen, China, to continuously record close-proximity contact events (< 2 meters) during a typical school day. Contact events were classified into four risk categories based on contact duration and proximity. We then conducted a joint analysis of temporally segmented, risk-stratified networks and six months of infectious-disease-related absenteeism records. Results The study achieved an 88.68% participation rate (282 of 318 children) and full participation of 30 teachers, yielding 389,617 contact events. On average, each child interacted with 57.91 distinct individuals daily. Outdoor activities were associated with fewer and lower-risk contacts, whereas nap time — despite being a sedentary activity — accounted for the highest proportion of high-risk total contact time (14.38%). Children with absenteeism records engaged in longer and more frequent contacts, and with a greater number of contacted individuals, across medium-low, medium-high, and high-risk layers compared with their non-absent peers. However, these differences diminished when low-risk contacts were included, resulting in no significant group-level differences over the full day. At the class level, absenteeism rates were strongly correlated with the density of medium-high (r = 0.833, p = 0.005) and high-risk (r = 0.733, p = 0.025) contact layers. Conclusions Our findings reveal substantial structural and contextual heterogeneity within kindergarten contact networks and provide quantitative evidence linking contact patterns to health outcomes. High-resolution proximity data offer valuable insights into transmission risk and inform the design of targeted prevention and risk management strategies in early childhood education settings.