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SARS-CoV-2 transmission in a highly vulnerable population of Brazil: a household cohort study.


ABSTRACT:

Background

Household transmission studies seek to understand the transmission dynamics of a pathogen by estimating the risk of infection from household contacts and community exposures. We estimated within/extra-household SARS-CoV-2 infection risk and associated factors in a household cohort study in one of the most vulnerable neighbourhoods in Rio de Janeiro city.

Methods

Individuals ≥1 years-old with suspected or confirmed COVID-19 in the past 30 days (index cases) and household members aged ≥1 year were enrolled and followed at 14 and 28 days (study period November/2020-December/2021). RT-PCR testing, COVID-19 symptoms, and SARS-CoV-2 serologies were ascertained in all visits. Chain binomial household transmission models were fitted using data from 2024 individuals (593 households).

Findings

Extra-household infection risk was 74.2% (95% credible interval [CrI] 70.3-77.8), while within-household infection risk was 11.4% (95% CrI 5.7-17.2). Participants reporting having received two doses of a COVID-19 vaccine had lower extra-household (68.9%, 95% CrI 57.3-77.6) and within-household (4.1%, 95% CrI 0.4-16.6) infection risk. Within-household infection risk was higher among participants aged 10-19 years, from overcrowded households, and with low family income. Contrastingly, extra-household infection risk was higher among participants aged 20-29 years, unemployed, and public transportation users.

Interpretation

Our study provides important insights into COVID-19 household/community transmission in a vulnerable population that resided in overcrowded households and who struggled to adhere to lockdown policies and social distancing measures. The high extra-household infection risk highlights the extreme social vulnerability of this population. Prioritising vaccination of the most socially vulnerable could protect these individuals and reduce widespread community transmission.

Funding

Fundação Oswaldo Cruz, CNPq, FAPERJ, Royal Society, Instituto Serrapilheira, FAPESP.

SUBMITTER: Coelho LE 

PROVIDER: S-EPMC11237915 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

SARS-CoV-2 transmission in a highly vulnerable population of Brazil: a household cohort study.

Coelho Lara E LE   Luz Paula M PM   Pires Débora C DC   Jalil Emilia M EM   Perazzo Hugo H   Torres Thiago S TS   Cardoso Sandra W SW   Peixoto Eduardo M EM   Nazer Sandro S   Massad Eduardo E   Carvalho Luiz Max LM   Réquia Weeberb J WJ   Motta Fernando Couto FC   Siqueira Marilda Mendonça MM   Vasconcelos Ana T R ATR   da Fonseca Guilherme C GC   Cavalcante Liliane T F LTF   Costa Carlos A M CAM   Amancio Rodrigo T RT   Villela Daniel A M DAM   Pereira Tiago T   Goedert Guilherme T GT   Santos Cleber V B D CVBD   Rodrigues Nadia C P NCP   Bormann de Souza Filho Breno Augusto BA   Csillag Daniel D   Grinsztejn Beatriz B   Veloso Valdilea G VG   Struchiner Claudio J CJ  

Lancet regional health. Americas 20240618


<h4>Background</h4>Household transmission studies seek to understand the transmission dynamics of a pathogen by estimating the risk of infection from household contacts and community exposures. We estimated within/extra-household SARS-CoV-2 infection risk and associated factors in a household cohort study in one of the most vulnerable neighbourhoods in Rio de Janeiro city.<h4>Methods</h4>Individuals ≥1 years-old with suspected or confirmed COVID-19 in the past 30 days (index cases) and household  ...[more]

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