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. 2021 Jun 3;21(1):1055.
doi: 10.1186/s12889-021-11136-6.

A cross-sectional study measuring contact patterns using diaries in an urban and a rural community in South Africa, 2018

Jackie Kleynhans  1   2 , Stefano Tempia  3   4   5   6 , Meredith L McMorrow  4   5   7 , Anne von Gottberg  8   9 , Neil A Martinson  10   11   12 , Kathleen Kahn  13 , Jocelyn Moyes  8   3 , Thulisa Mkhencele  8 , Limakatso Lebina  10 , F Xavier Gómez-Olivé  13 , Floidy Wafawanaka  13 , Azwifarwi Mathunjwa  8 , Cheryl Cohen  8   3 ; PHIRST group
Collaborators, Affiliations

A cross-sectional study measuring contact patterns using diaries in an urban and a rural community in South Africa, 2018

Jackie Kleynhans et al. BMC Public Health. .

Abstract

Background: Describing contact patterns is crucial to understanding infectious disease transmission dynamics and guiding targeted transmission mitigation interventions. Data on contact patterns in Africa, especially South Africa, are limited. We measured and compared contact patterns in a rural and urban community, South Africa. We assessed participant and contact characteristics associated with differences in contact rates.

Methods: We conducted a cross-sectional study nested in a prospective household cohort study. We interviewed participants to collect information on persons in contact with for one day. We described self-reported contact rates as median number people contacted per day, assessed differences in contact rates based on participant characteristics using quantile regression, and used a Poisson model to assess differences in contact rates based on contact characteristics within age groups. We also calculated cumulative person hours in contact within age groups at different locations.

Results: We conducted 535 interviews (269 rural, 266 urban), with 17,252 contacts reported. The overall contact rate was 14 (interquartile range (IQR) 9-33) contacts per day. Those ≤18 years had higher contact rates at the rural site (coefficient 17, 95% confidence interval (95%CI) 10-23) compared to the urban site, for those aged 14-18 years (13, 95%CI 3-23) compared to < 7 years. No differences were observed for adults. There was a strong age-based mixing, with age groups interacting more with similar age groups, but also interaction of participants of all ages with adults. Children aged 14-18 years had the highest cumulative person hours in contact (116.3 rural and 76.4 urban).

Conclusions: Age played an important role in the number and duration of contact events, with children at the rural site having almost double the contact rate compared to the urban site. These contact rates can be utilized in mathematical models to assess transmission dynamics of infectious diseases in similar communities.

Keywords: Contact diaries; Infectious disease modelling; Rural; Urban.

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Conflict of interest statement

CC has received grant support from Sanofi Pasteur, Advanced Vaccine Initiative, U.S. Centers for Disease Control and Prevention, and payment of travel costs from Parexel. All other authors have no competing/conflict of interest. All other authors have no competing/conflict of interest.

Figures

Fig. 1
Fig. 1
Contact rate by age group, South Africa, 2018. Physical and conversational contacts (a) overall, (b) rural and (c) urban site. Line represents the median, cross represents the average, box represents the 25th and 75th percentile, whiskers represent 1st and 99th percentile, circles indicate outliers
Fig. 2
Fig. 2
Age-related contact matrix for total number of people contacted, South Africa, 2018. Physical, conversational and confined contacts by (a, c) rural and (b, d) urban site, showing (a, b) number of contacts and (c, d) proportion of contacts within age groups, with participant age on y axis and contact age on x axis
Fig. 3
Fig. 3
Cumulative person hours in contact reported by age, location and site, South Africa, 2018
See this image and copyright information in PMC

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