HOSTED-England's Household Transmission Evaluation Dataset: preliminary findings from a novel passive surveillance system of COVID-19
HOSTED-England's Household Transmission Evaluation Dataset: preliminary findings from a novel passive surveillance system of COVID-19
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DOI：
10.1093/ije/dyab057
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发表时间：
2021-04-09
影响因子：
7.7
通讯作者：
Dunbar, J. K.
中科院分区：
文献类型：
--
作者：
Hall, J. A.;Harris, R. J.;Dunbar, J. K.
背景：SARS-CoV-2 的家庭传播是该流行病社区传播的重要组成部分。人们对与家庭传播相关的因素（在病例、接触者或家庭层面）以及这些因素在大流行过程中如何变化知之甚少。方法：家庭传播评估数据集 (HOSTED) 是一个被动监测系统，将实验室确诊的 COVID-19 病例与居住在英格兰同一家庭的个人联系起来。我们根据 2020 年 4 月至 9 月期间病例和接触者的年龄、性别、地区、贫困、月份和家庭构成来探讨家庭传播的风险，建立多变量模型。结果：在研究期间，英格兰平均有 5.5% 的家庭接触者被诊断为病例。家庭传播在成人病例和年龄相仿的接触者之间最常见。有一些证据表明 16 岁以下儿童的传播率较低[调整后的比值比 (aOR) 0.70，95% 置信区间 (CI) 0.66-0.74）。存在明显的地区差异，英格兰北部和中部地区的家庭传播率较高。贫困程度较低的地区家庭传播的风险较低。控制地区后，没有剥夺的影响，但多人居住的房屋的家庭传播率较低[aOR 0.74（0.66-0.83）]。结论：儿童通过家庭传播感染SARS-CoV-2的可能性较小，因此有儿童的家庭传播风险没有差异。能够有效隔离病例的家庭，例如多人居住的房屋，家庭传播率较低。支持将病例与其家庭接触者有效隔离的政策可以降低家庭传播水平。
Background: Household transmission of SARS-CoV-2 is an important component of the community spread of the pandemic. Little is known about the factors associated with household transmission, at the level of the case, contact or household, or how these have varied over the course of the pandemic.Methods: The Household Transmission Evaluation Dataset (HOSTED) is a passive surveillance system linking laboratory-confirmed COVID-19 cases to individuals living in the same household in England. We explored the risk of household transmission according to: age of case and contact, sex, region, deprivation, month and household composition between April and September 2020, building a multivariate model.Results: In the period studied, on average, 5.5% of household contacts in England were diagnosed as cases. Household transmission was most common between adult cases and contacts of a similar age. There was some evidence of lower transmission rates to under-16s [adjusted odds ratios (aOR) 0.70, 95% confidence interval (CI) 0.66-0.74). There were clear regional differences, with higher rates of household transmission in the north of England and the Midlands. Less deprived areas had a lower risk of household transmission. After controlling for region, there was no effect of deprivation, but houses of multiple occupancy had lower rates of household transmission [aOR 0.74 (0.66-0.83)].Conclusions: Children are less likely to acquire SARS-CoV-2 via household transmission, and consequently there was no difference in the risk of transmission in households with children. Households in which cases could isolate effectively, such as houses of multiple occupancy, had lower rates of household transmission. Policies to support the effective isolation of cases from their household contacts could lower the level of household transmission.