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. 2023 Jun 15;17(6):e13165.
doi: 10.1111/irv.13165. eCollection 2023 Jun.

Household transmission investigation: Design, reporting and critical appraisal

David J Price  1   2 , Violeta Spirkoska  1   3 , Adrian J Marcato  1 , Niamh Meagher  1 , James E Fielding  1   3 , Amalia Karahalios  2 , Isabel Bergeri  4 , Hannah Lewis  4 , Marta Valenciano  4   5 , Richard Pebody  6 , Jodie McVernon  1   3 , Juan-Pablo Villanueva-Cabezas  1   7
Affiliations

Household transmission investigation: Design, reporting and critical appraisal

David J Price et al. Influenza Other Respir Viruses. .

Abstract

Background: Household transmission investigations (HHTIs) contribute timely epidemiologic knowledge in response to emerging pathogens. HHTIs conducted in the context of the COVID-19 pandemic in 2020-21 reported variable methodological approaches, producing epidemiological estimates that vary in meaning, precision and accuracy. Because specific tools to assist with the optimal design and critical appraisal of HHTIs are not available, the aggregation and pooling of inferences from HHTIs to inform policy and interventions may be challenging.

Methods: In this manuscript, we discuss key aspects of the HHTI design, provide recommendations for the reporting of these studies and propose an appraisal tool that contributes to the optimal design and critical appraisal of HHTIs.

Results: The appraisal tool consists of 12 questions that explore 10 aspects of HHTIs and can be answered 'yes', 'no' or 'unclear'. We provide an example of the use of this tool in the context of a systematic review that aimed to quantify the household secondary attack rate from HHTIs.

Conclusion: We seek to fill a gap in the epidemiologic literature and contribute to standardised HHTI approaches across settings to achieve richer and more informative datasets.

Keywords: COVID‐19; emerging infectious diseases; epidemiology; influenza; pandemic preparedness; public health.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Household transmission investigation (HHTI) design and reporting. Design: HHTI have a case series and cohort component; cases are ascertained from a source population (design; green square) within the target population and then households are enrolled and followed‐up. Reporting: The adequate contextualisation of HHTI and detailed reporting of key elements of the case series, cohort and analysis steps are essential to critically appraise these investigations.
FIGURE 2
FIGURE 2
A practical example. In the transmission of SARS‐CoV‐2 in standardised first few X cases and household transmission investigations: a systematic review and meta‐analysis, teams of two investigators critically appraised a total 80 studies eligible to be included in the systematic review.
See this image and copyright information in PMC

References

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    1. World Health Organization . Household transmission investigation protocol for 2019‐novel coronavirus (COVID‐19) infection. Accessed 18 October 2021. Available at https://www.who.int/publications/i/item/household-transmission-investiga...

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