The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements.
The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements.
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DOI：
10.1186/s12916-020-01779-4
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发表时间：
2020-10-05
期刊：
影响因子：
9.3
通讯作者：
Austrian K
中科院分区：
文献类型：
--
作者：
Quaife M;van Zandvoort K;Gimma A;Shah K;McCreesh N;Prem K;Barasa E;Mwanga D;Kangwana B;Pinchoff J;CMMID COVID-19 Working Group;Edmunds WJ;Jarvis CI;Austrian K
许多低收入和中等收入国家已经实施了针对2019冠状病毒病（COVID-19）的控制措施。然而，目前尚不清楚这些措施在多大程度上解释了非洲记录的COVID-19病例和死亡人数较低的原因。控制措施的主要目的之一是减少通过与他人直接接触传播的呼吸道病原体。在这项研究中，我们收集了接触数据，从居民的非正式住区周围内罗毕，肯尼亚，以评估控制措施是否改变了接触模式，并估计的影响，基本繁殖数（R 0）的变化。我们于2020年5月初对内罗毕周边五个非正规住区的213名居民进行了一项社会接触调查，这是肯尼亚政府推出加强物理距离措施和晚上7点至凌晨5点宵禁的4周后。受访者被要求报告前一天进行的所有直接身体和非身体接触，并附上一份调查问卷，询问COVID-19的社会和经济影响以及控制措施。我们通过人口统计学因素（包括社会经济地位）检查了接触模式。我们描述了COVID-19和控制措施对收入和粮食安全的影响。我们比较了控制措施期间的接触模式与非大流行期间的模式，以估计R 0的变化。我们估计，控制措施使身体接触减少了62%，非身体接触减少了63%或67%，具体取决于所使用的2019冠状病毒病前比较矩阵。在92%的接触者中，至少有一人戴口罩。最贫穷的社会经济五分之一的受访者报告的接触次数是最富有的人的1.5倍。86%的受访者表示，由于COVID-19，他们的收入全部或部分减少，74%的人表示，由于没有太多的钱购买食物，他们吃得更少或不吃饭。COVID-19控制措施对直接接触产生了很大影响，因此也对传播产生了很大影响，但也造成了相当大的经济和粮食不安全。R 0的降低与肯尼亚和其他实施了类似早期控制措施的撒哈拉以南非洲国家相对较低的疫情增长相一致。然而，对经济和粮食安全的负面和不公平影响可能意味着控制措施从长远来看是不可持续的。
Many low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study, we collect contact data from residents of informal settlements around Nairobi, Kenya, to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R0). We conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, 4 weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7 pm and 5 am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R0. We estimate that control measures reduced physical contacts by 62% and non-physical contacts by either 63% or 67%, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. Eighty-six percent of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food. COVID-19 control measures have had a large impact on direct contacts and therefore transmission, but have also caused considerable economic and food insecurity. Reductions in R0 are consistent with the comparatively low epidemic growth in Kenya and other sub-Saharan African countries that implemented similar, early control measures. However, negative and inequitable impacts on economic and food security may mean control measures are not sustainable in the longer term.
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