Influence of contact definitions in assessment of the relative importance of social settings in disease transmission risk

Influence of setting-dependent contacts and protective behaviours on asymptomatic SARS-CoV-2 infection amongst members of a UK university

We survey 62 users of a university asymptomatic SARS-CoV-2 testing service on details of their activities, protective behaviours and contacts in the 7 days prior to receiving a positive or negative SARS-CoV-2 PCR test result in the period October 2020-March 2021. The resulting data set is novel in capturing very detailed social contact history linked to asymptomatic disease status during a period of significant restriction on social activities. We use this data to explore 3 questions: (i) Did participation in university activities enhance infection risk? (ii) How do contact definitions rank in their ability to explain test outcome during periods of social restrictions? (iii) Do patterns in the protective behaviours help explain discrepancies between the explanatory performance of different contact measures? We classify activities into settings and use Bayesian logistic regression to model test outcome, computing posterior model probabilities to compare the performance of models adopting different contact definitions. Associations between protective behaviours, participant characteristics and setting are explored at the level of individual activities using multiple correspondence analysis (MCA). We find that participation in air travel or non-university work activities was associated with a positive asymptomatic SARS-CoV-2 PCR test, in contrast to participation in research and teaching settings. Intriguingly, logistic regression models with binary measures of contact in a setting performed better than more traditional contact numbers or person contact hours (PCH). The MCA indicates that patterns of protective behaviours vary between setting, in a manner which may help explain the preference for any participation as a contact measure. We conclude that linked PCR testing and social contact data can in principle be used to test the utility of contact definitions, and the investigation of contact definitions in larger linked studies is warranted to ensure contact data can capture environmental and social factors influencing transmission risk.

Capturing Household Structure and Mobility within and between Remote Aboriginal Communities in Northern Australia Using Longitudinal Data: A Pilot Study

Cultural practices and development level can influence a population's household structures and mixing patterns. Within some populations, households can be organized across multiple dwellings. This likely affects the spread of infectious disease through these communities; however, current demographic data collection tools do not record these data.

METHODS

Between June and October 2018, the Contact And Mobility Patterns in remote Aboriginal Australian communities (CAMP-remote) pilot study recruited Aboriginal mothers with infants in a remote northern Australian community to complete a monthly iPad-based contact survey.

RESULTS

Thirteen mother-infant pairs (participants) completed 69 study visits between recruitment and the end of May 2019. Participants reported they and their other children slept in 28 dwellings during the study. The median dwelling occupancy, defined as people sleeping in the same dwelling on the previous night, was ten (range: 3.5-25). Participants who completed at least three responses (n = 8) slept in a median of three dwellings (range: 2-9). Each month, a median of 28% (range: 0-63%) of the participants travelled out of the community. Including these data in disease transmission models amplified estimates of infectious disease spread in the study community, compared to models parameterized using census data.

CONCLUSIONS

The lack of data on mixing patterns in populations where households can be organized across dwellings may impact the accuracy of infectious disease models for these communities and the efficacy of public health actions they inform.

Effect of COVID-19 driven lockdown on social contact pattern in Puducherry, India: A longitudinal study

Objective

This study was undertaken to assess the change in social contact and transmission dynamics among adults in the Puducherry district during the different phases of country-wide lockdown.

Methods

Adults aged 18-69 years in Puducherry were assessed for frequency and duration of contacts in the following time points: prior to lockdown (March 2020), during lockdown, immediate post-lockdown (April, June 2020), and seven months post-lockdown (February 2021). Adjusted incidence rate ratios (aIRR) were obtained using a generalized estimating equation. We also assessed the exponential trajectory of the time-varying reproduction number (R_t) during and after lockdown.

Results

Compared to pre-lockdown phase, frequency of social contacts during 1^st week, 4^th week of lockdown, and immediate post-lockdown were reduced by 89% (aIRR = 0.11; 95% CI: 0.09-0.13), 40% (aIRR = 0.60; 95% CI: 0.52-0.69) and 91% (aIRR = 0.09; 95% CI: 0.07-0.10) respectively. However, the decline was not statistically significant at seven months post-lockdown. Correspondingly, we observed an initial spike in R_t during the lockdown phase followed by a gradual decline during the immediate post-lockdown phase. However, seven months post-lockdown, R_t has increased again.

Conclusion

The study showed high compliance to the lockdown measures in Puducherry during the lockdown and immediate post-lockdown periods. However, as the lockdown measures were relaxed, the contact rate returned to the pre-lockdown state.

"It makes me feel not so alone": features of the Choose to Move physical activity intervention that reduce loneliness in older adults

BACKGROUND

Despite the well-known health benefits of physical activity (PA), older adults are the least active citizens. Older adults are also at risk for loneliness. Given that lonely individuals are at risk for accelerated loss of physical functioning and health with age, PA interventions that aim to enhance social connectedness may decrease loneliness and increase long-term PA participation. The objectives of this mixed-method study are to: (1) evaluate whether an evidence-based PA intervention (Choose to Move; CTM) influenced PA and loneliness differently among self-identified 'lonely' versus 'not lonely' older adults and (2) to describe factors within CTM components most likely to promote social connectedness/reduce loneliness.

METHODS

CTM is a flexible, scalable, community-based health promoting physical activity intervention for older adults. Two community delivery partner organizations delivered 56 CTM programs in 26 urban locations across British Columbia. We collected survey data from participants (n = 458 at baseline) at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We conducted in depth interviews with a subset of older adults to understand how CTM facilitated or impeded their PA and social connectedness.

RESULTS

PA increased significantly from baseline to 3 months in lonely and not lonely participants. PA decreased significantly from 3 to 6 months in lonely participants; however, PA at 6 months remained significantly above baseline levels in both groups. Loneliness decreased significantly from baseline to 3 and 6 months in participants identifying as lonely at baseline. Factors within CTM components that promote social connectedness/reduce loneliness include: Activity coach characteristics/personality traits and approaches; opportunity to share information and experiences and learn from others; engagement with others who share similar/familiar experiences; increased opportunity for meaningful interaction; and accountability.

CONCLUSION

Health promoting interventions that focus on PA and social connectedness through group-based activities can effectively reduce social isolation and loneliness of older adults. Given the 'epidemic of loneliness' that plagues many countries currently, these kinds of interventions are timely and important. Research that further delineates mechanisms (e.g., sharing experiences vs. lectures), that modify the effect of an intervention on social connectedness outcomes for older adults engaged in community-based PA programs would be a welcome addition to the literature.

Dynamic Network of Interactions in the Wildlife-Livestock Interface in Mediterranean Spain: An Epidemiological Point of View

The correct management of diseases that are transmitted between wildlife and livestock requires a reliable estimate of the pathogen transmission rate. The calculation of this parameter is a challenge for epidemiologists, since transmission can occur through multiple pathways. The social network analysis is a widely used tool in epidemiology due to its capacity to identify individuals and communities with relevant roles for pathogen transmission. In the present work, we studied the dynamic network of interactions in a complex epidemiological scenario using information from different methodologies. In 2015, nine red deer, seven fallow deer, six wild boar and nine cattle were simultaneously monitored using GPS-GSM-Proximity collars in Doñana National Park. In addition, 16 proximity loggers were set in aggregation points. Using the social network analysis, we studied the dynamic network of interactions, including direct and indirect interactions, between individuals of different species and the potential transmission of pathogens within this network. The results show a high connection between species through indirect interactions, with a marked seasonality in the conformation of new interactions. Within the network, we differentiated four communities that included individuals of all the species. Regarding the transmission of pathogens, we observed the important role that fallow deer could be playing in the maintenance and transmission of pathogens to livestock. The present work shows the need to consider different types of methodologies in order to understand the complete functioning of the network of interactions at the wildlife/livestock interface. It also provides a methodological approach applicable to the management of shared diseases.

Associations between ethnicity, social contact, and pneumococcal carriage three years post-PCV10 in Fiji

BACKGROUND

Pneumococcal carriage is a prerequisite for pneumococcal disease. Little is known about whether social contact frequency and intensity are associated with pneumococcal carriage. In Fiji, indigenous iTaukei have higher prevalence of pneumococcal carriage compared with Fijians of Indian Descent (FID). We hypothesised that contact differences may contribute to ethnic differences in pneumococcal carriage prevalence and density.

METHODS

In 2015, young infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and caregivers from Suva and surrounding areas, participated in a cross-sectional survey (n = 2014), three years post pneumococcal conjugate vaccine introduction. Demographic and contact data, and nasopharyngeal swabs were collected. Pneumococci were detected, and quantified using quantitative real-time PCR, with molecular serotyping by microarray. Associations between ethnicity, contact, and pneumococcal carriage and density were estimated using multivariable generalised estimating equation regression models.

RESULTS

iTaukei participants had larger household sizes, higher pneumococcal carriage rates, more contacts, and more frequent contacts of longer duration, compared with FID. The odds of vaccine-type carriage increased by 28% (95% CI 8-53%) P < 0.01 in association with physical contact with 7-14 year old children. iTaukei ethnicity was associated with vaccine-type carriage (aOR) 1.73; 95% CI 1.06-2.82, P = 0.03) and non-vaccine type carriage (aOR 5.98; 95% CI 4.47-8.00, P < 0.01). Ethnicity and contact were not associated with pneumococcal density.

CONCLUSIONS

iTaukei had greater frequency and intensity of contact compared with FID. Physical contact was associated with pneumococcal carriage. Observed differences in pneumococcal nasopharyngeal carriage prevalence between iTaukei and FID were not explained by differences in social contact patterns by ethnicity.

Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda

Background

Quantification of human interactions relevant to infectious disease transmission through social contact is central to predict disease dynamics, yet data from low-resource settings remain scarce.

Methods

We undertook a social contact survey in rural Uganda, whereby participants were asked to recall details about the frequency, type, and socio-demographic characteristics of any conversational encounter that lasted for ≥5 min (henceforth defined as ‘contacts’) during the previous day. An estimate of the number of ‘casual contacts’ (i.e. < 5 min) was also obtained.

Results

In total, 566 individuals were included in the study. On average participants reported having routine contact with 7.2 individuals (range 1-25). Children aged 5-14 years had the highest frequency of contacts and the elderly (≥65 years) the fewest (P < 0.001). A strong age-assortative pattern was seen, particularly outside the household and increasingly so for contacts occurring further away from home. Adults aged 25-64 years tended to travel more often and further than others, and males travelled more frequently than females.

Conclusion

Our study provides detailed information on contact patterns and their spatial characteristics in an African setting. It therefore fills an important knowledge gap that will help more accurately predict transmission dynamics and the impact of control strategies in such areas.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3073-1) contains supplementary material, which is available to authorized users.

Place-based social contact and mixing: a typology of generic meeting places of relevance for infectious disease transmission

This study aims to develop a typology of generic meeting places based on social contact and mixing of relevance for infectious disease transmission. Data were collected by means of a contact diary survey conducted on a representative sample of the Swedish population. The typology is derived from a cluster analysis accounting for four dimensions associated with transmission risk: visit propensity and its characteristics in terms of duration, number of other persons present and likelihood of physical contact. In the analysis, we also study demographic, socio-economic and geographical differences in the propensity of visiting meeting places. The typology identifies the family venue, the fixed activity site, the family vehicle, the trading plaza and the social network hub as generic meeting places. The meeting place typology represents a spatially explicit account of social contact and mixing relevant to infectious disease modelling, where the social context of the outbreak can be highlighted in light of the actual infectious disease.

Social encounter profiles of greater Melbourne residents, by location--a telephone survey

Background

Models of infectious disease increasingly seek to incorporate heterogeneity of social interactions to more accurately characterise disease spread. We measured attributes of social encounters in two areas of Greater Melbourne, using a telephone survey.

Methods

A market research company conducted computer assisted telephone interviews (CATIs) of residents of the Boroondara and Hume local government areas (LGAs), which differ markedly in ethnic composition, age distribution and household socioeconomic status. Survey items included household demographic and socio-economic characteristics, locations visited during the preceding day, and social encounters involving two-way conversation or physical contact. Descriptive summary measures were reported and compared using weight adjusted Wald tests of group means.

Results

The overall response rate was 37.6 %, higher in Boroondara [n = 650, (46 %)] than Hume [n = 657 (32 %)]. Survey conduct through the CATI format was challenging, with implications for representativeness and data quality. Marked heterogeneity of encounter profiles was observed across age groups and locations. Household settings afforded greatest opportunity for prolonged close contact, particularly between women and children. Young and middle-aged men reported more age-assortative mixing, often with non-household members. Preliminary comparisons between LGAs suggested that mixing occurred in different settings. In addition, gender differences in mixing with household and non-household members, including strangers, were observed by area.

Conclusions

Survey administration by CATI was challenging, but rich data were obtained, revealing marked heterogeneity of social behaviour. Marked dissimilarities in patterns of prolonged close mixing were demonstrated by gender. In addition, preliminary observations of between-area differences in socialisation warrant further evaluation.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-015-1237-9) contains supplementary material, which is available to authorized users.

Inferring a district-based hierarchical structure of social contacts from census data

Researchers have recently paid attention to social contact patterns among individuals due to their useful applications in such areas as epidemic evaluation and control, public health decisions, chronic disease research and social network research. Although some studies have estimated social contact patterns from social networks and surveys, few have considered how to infer the hierarchical structure of social contacts directly from census data. In this paper, we focus on inferring an individual’s social contact patterns from detailed census data, and generate various types of social contact patterns such as hierarchical-district-structure-based, cross-district and age-district-based patterns. We evaluate newly generated contact patterns derived from detailed 2011 Hong Kong census data by incorporating them into a model and simulation of the 2009 Hong Kong H1N1 epidemic. We then compare the newly generated social contact patterns with the mixing patterns that are often used in the literature, and draw the following conclusions. First, the generation of social contact patterns based on a hierarchical district structure allows for simulations at different district levels. Second, the newly generated social contact patterns reflect individuals social contacts. Third, the newly generated social contact patterns improve the accuracy of the SEIR-based epidemic model.

Comparison of contact patterns relevant for transmission of respiratory pathogens in Thailand and The Netherlands using respondent-driven sampling

Understanding infection dynamics of respiratory diseases requires the identification and quantification of behavioural, social and environmental factors that permit the transmission of these infections between humans. Little empirical information is available about contact patterns within real-world social networks, let alone on differences in these contact networks between populations that differ considerably on a socio-cultural level. Here we compared contact network data that were collected in The Netherlands and Thailand using a similar online respondent-driven method. By asking participants to recruit contact persons we studied network links relevant for the transmission of respiratory infections. We studied correlations between recruiter and recruited contacts to investigate mixing patterns in the observed social network components. In both countries, mixing patterns were assortative by demographic variables and random by total numbers of contacts. However, in Thailand participants reported overall more contacts which resulted in higher effective contact rates. Our findings provide new insights on numbers of contacts and mixing patterns in two different populations. These data could be used to improve parameterisation of mathematical models used to design control strategies. Although the spread of infections through populations depends on more factors, found similarities suggest that spread may be similar in The Netherlands and Thailand.

Network epidemiology and plant trade networks

Models of epidemics in complex networks are improving our predictive understanding of infectious disease outbreaks. Nonetheless, applying network theory to plant pathology is still a challenge. This overview summarizes some key developments in network epidemiology that are likely to facilitate its application in the study and management of plant diseases. Recent surveys have provided much-needed datasets on contact patterns and human mobility in social networks, but plant trade networks are still understudied. Human (and plant) mobility levels across the planet are unprecedented-there is thus much potential in the use of network theory by plant health authorities and researchers. Given the directed and hierarchical nature of plant trade networks, there is a need for plant epidemiologists to further develop models based on undirected and homogeneous networks. More realistic plant health scenarios would also be obtained by developing epidemic models in dynamic, rather than static, networks. For plant diseases spread by the horticultural and ornamental trade, there is the challenge of developing spatio-temporal epidemic simulations integrating network data. The use of network theory in plant epidemiology is a promising avenue and could contribute to anticipating and preventing plant health emergencies such as European ash dieback.

Online respondent-driven sampling for studying contact patterns relevant for the spread of close-contact pathogens: a pilot study in Thailand

Background

Information on social interactions is needed to understand the spread of airborne infections through a population. Previous studies mostly collected egocentric information of independent respondents with self-reported information about contacts. Respondent-driven sampling (RDS) is a sampling technique allowing respondents to recruit contacts from their social network. We explored the feasibility of webRDS for studying contact patterns relevant for the spread of respiratory pathogens.

Materials and Methods

We developed a webRDS system for facilitating and tracking recruitment by Facebook and email. One-day diary surveys were conducted by applying webRDS among a convenience sample of Thai students. Students were asked to record numbers of contacts at different settings and self-reported influenza-like-illness symptoms, and to recruit four contacts whom they had met in the previous week. Contacts were asked to do the same to create a network tree of socially connected individuals. Correlations between linked individuals were analysed to investigate assortativity within networks.

Results

We reached up to 6 waves of contacts of initial respondents, using only non-material incentives. Forty-four (23.0%) of the initially approached students recruited one or more contacts. In total 257 persons participated, of which 168 (65.4%) were recruited by others. Facebook was the most popular recruitment option (45.1%). Strong assortative mixing was seen by age, gender and education, indicating a tendency of respondents to connect to contacts with similar characteristics. Random mixing was seen by reported number of daily contacts.

Conclusions

Despite methodological challenges (e.g. clustering among respondents and their contacts), applying RDS provides new insights in mixing patterns relevant for close-contact infections in real-world networks. Such information increases our knowledge of the transmission of respiratory infections within populations and can be used to improve existing modelling approaches. It is worthwhile to further develop and explore webRDS for the detection of clusters of respiratory symptoms in social networks.