Social contact patterns and implications for infectious disease transmission – a systematic review and meta-analysis of contact surveys
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Abstract
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 focused 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 and 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).
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SciScore for 10.1101/2021.06.10.21258720: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics statement: All original studies included were approved by an institutional ethics review committee. Sex as a biological variable Studies which collated contact-level data were used to assess assortativity of mixing by age and gender for different country-income strata by calculating the proportions of contacts made by participants that are male or female and those that belong to three broad age groups (children, adults, and older adults; Supplementary Text 2). Randomization not detected. Blinding not detected. Power Analysis All analyses were stratified by three income strata (LICs and LMICs were combined to preserve statistical power) and included random-study effects, apart from … SciScore for 10.1101/2021.06.10.21258720: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics statement: All original studies included were approved by an institutional ethics review committee. Sex as a biological variable Studies which collated contact-level data were used to assess assortativity of mixing by age and gender for different country-income strata by calculating the proportions of contacts made by participants that are male or female and those that belong to three broad age groups (children, adults, and older adults; Supplementary Text 2). Randomization not detected. Blinding not detected. Power Analysis All analyses were stratified by three income strata (LICs and LMICs were combined to preserve statistical power) and included random-study effects, apart from models adjusting for methodology which did not vary by study. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are important caveats to these findings. Data constraints limited the numbers of factors we were able to explore – for example, despite evidence(Kiti et al., 2014) suggesting that contact patterns differ across rural and urban settings, only 3 studies(Kiti et al., 2014; O. le Polain de Waroux et al., 2018; Neal et al., 2020) contained information from both rural and urban sites, allowing classification. Similarly, we were unable to examine the impact of socioeconomic factors such as household wealth, despite experiences with COVID-19 having highlighted strong socio-economic disparities in both transmission and burden of disease(De Negri et al., 2021; Routledge et al., 2021; Ward et al., 2021; Winskill et al., 2020) and previous work suggesting that poorer individuals are less likely to be employed in occupations amenable to remote working(Loayza, 2020). A lack of suitably detailed information in the studies conducted precludes analysis of these factors but highlights the importance of incorporating economic questions into future contact surveys, such as household wealth and house square footage. Other factors also not controlled for here, but that may similarly shape contact patterns include school holidays or seasonal variations in population movement and composition that we are unable to capture given the cross-sectional nature of these studies. Another important limitation to the results presented here is that we are only able to consider a limited set of contact cha...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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