Social Mixing Patterns Within a South African Township Community: Implications for Respiratory Disease Transmission and Control
Social Mixing Patterns Within a South African Township Community: Implications for Respiratory Disease Transmission and Control
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DOI：
10.1093/aje/kwr251
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发表时间：
2011-12-01
影响因子：
5
通讯作者：
Wood, Robin
中科院分区：
文献类型：
--
作者：
Johnstone-Robertson, Simon P.;Mark, Daniella;Wood, Robin
2010 年，在南非的一个乡镇进行了一项关于与大飞沫（例如流感）或小飞沫核（例如结核病）传播呼吸道疾病相关的社会混合模式的前瞻性调查。总共 571 名随机选择的参与者记录了每天接触的密切接触者（身体/非身体）和室内偶然接触者的数量、时间和地点。身体接触人数中位数为 12 人（四分位距（IQR），7-18），密切接触人数中位数为 20 人（IQR，13-29），室内接触总数为 30 人（IQR，12-54）。身体接触和密切接触在 5-19 岁的青少年中最为频繁且与年龄相关。密切接触者数量比工业化国家相应人群高 40%（P < 0.001）。这可能会使乡镇社区面临急性呼吸道疾病流行的更高风险。急性流感流行的模拟主要涉及青少年和年轻人，表明控制策略应针对这些年龄组。在所有接触者中，86.2%发生在可能接触呼吸道飞沫核的室内，其中分别有27.2%、20.1%、20.0%和8.0%发生在交通工具、自家、托儿所/学校和工作场所。家庭中室内接触时间较长，运输过程中室内接触时间较短。大量的室内接触以及家庭和交通中的代际混合可能导致社区报告的结核病传播率异常高。
A prospective survey of social mixing patterns relevant to respiratory disease transmission by large droplets (e.g., influenza) or small droplet nuclei (e. g., tuberculosis) was performed in a South African township in 2010. A total of 571 randomly selected participants recorded the numbers, times, and locations of close contacts (physical/nonphysical) and indoor casual contacts met daily. The median number of physical contacts was 12 (interquartile range (IQR), 7-18), the median number of close contacts was 20 (IQR, 13-29), and the total number of indoor contacts was 30 (IQR, 12-54). Physical and close contacts were most frequent and age-associative in youths aged 5-19 years. Numbers of close contacts were 40% higher than in corresponding populations in industrialized countries (P < 0.001). This may put township communities at higher risk for epidemics of acute respiratory illnesses. Simulations of an acute influenza epidemic predominantly involved adolescents and young adults, indicating that control strategies should be directed toward these age groups. Of all contacts, 86.2% occurred indoors with potential exposure to respiratory droplet nuclei, of which 27.2%, 20.1%, 20.0%, and 8.0% were in transport, own household, creche/school, and work locations, respectively. Indoor contact time was long in households and short during transport. High numbers of indoor contacts and intergenerational mixing in households and transport may contribute to exceptionally high rates of tuberculosis transmission reported in the community.