UCL  IRIS
Institutional Research Information Service
UCL Logo
Please report any queries concerning the funding data grouped in the sections named "Externally Awarded" or "Internally Disbursed" (shown on the profile page) to your Research Finance Administrator. Your can find your Research Finance Administrator at https://www.ucl.ac.uk/finance/research/rs-contacts.php by entering your department
Please report any queries concerning the student data shown on the profile page to:

Email: portico-services@ucl.ac.uk

Help Desk: http://www.ucl.ac.uk/ras/portico/helpdesk
Publication Detail
Social mixing patterns relevant to infectious diseases spread by close contact in urban Blantyre, Malawi
  • Publication Type:
    Journal article
  • Authors:
    Thindwa D, Jambo KC, Ojal J, MacPherson P, Dennis Phiri M, Pinsent A, Khundi M, Chiume L, Gallagher KE, Heyderman RS, Corbett EL, French N, Flasche S
  • Publication date:
    01/09/2022
  • Journal:
    Epidemics
  • Volume:
    40
  • Article number:
    100590
  • Status:
    Accepted
  • Language:
    English
  • Keywords:
    Social contacts, Transmission, Mixing data, Infectious disease, Malawi, Africa
  • Notes:
    © 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Abstract
Introduction: Understanding human mixing patterns relevant to infectious diseases spread through close contact is vital for modelling transmission dynamics and optimisation of disease control strategies. Mixing patterns in low-income countries like Malawi are not well known. Methodology: We conducted a social mixing survey in urban Blantyre, Malawi between April and July 2021 (between the 2nd and 3rd wave of COVID-19 infections). Participants living in densely-populated neighbourhoods were randomly sampled and, if they consented, reported their physical and non-physical contacts within and outside homes lasting at least 5 min during the previous day. Age-specific mixing rates were calculated, and a negative binomial mixed effects model was used to estimate determinants of contact behaviour. Results: Of 1201 individuals enroled, 702 (58.5%) were female, the median age was 15 years (interquartile range [IQR] 5–32) and 127 (10.6%) were HIV-positive. On average, participants reported 10.3 contacts per day (range: 1–25). Mixing patterns were highly age-assortative, particularly those within the community and with skin-to-skin contact. Adults aged 20–49 y reported the most contacts (median:11, IQR: 8–15) of all age groups; 38% (95%CI: 16–63) more than infants (median: 8, IQR: 5–10), who had the least contacts. Household contact frequency increased by 3% (95%CI: 2–5) per additional household member. Unemployed participants had 15% (95%CI: 9–21) fewer contacts than other adults. Among long range (>30 m away from home) contacts, secondary school children had the largest median contact distance from home (257 m, IQR 78–761). HIV-positive status in adults >=18 years-old was not associated with changed contact patterns (rate ratio: 1.01, 95%CI: (0.91–1.12)). During this period of relatively low COVID-19 incidence in Malawi, 301 (25.1%) individuals stated that they had limited their contact with others due to COVID-19 precautions; however, their reported contacts were 8% (95%CI: 1–13) higher. Conclusion: In urban Malawi, contact rates, are high and age-assortative, with little reported behavioural change due to either HIV-status or COVID-19 circulation. This highlights the limits of contact-restriction-based mitigation strategies in such settings and the need for pandemic preparedness to better understand how contact reductions can be enabled and motivated.
Publication data is maintained in RPS. Visit https://rps.ucl.ac.uk
 More search options
UCL Researchers
Author
Div of Infection & Immunity
University College London - Gower Street - London - WC1E 6BT Tel:+44 (0)20 7679 2000

© UCL 1999–2011

Search by