Directly observed social contact patterns among school children in rural Gambia
Isaac Osei,
Emmanuel Mendy,
Kevin van Zandvoort,
Olimatou Jobe,
Golam Sarwar,
Baleng Mahama Wutor,
Stefan Flasche,
Nuredin I. Mohammed,
Jane Bruce,
Brian Greenwood,
Grant A. Mackenzie
Affiliations
Isaac Osei
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Correspondence to: MRCG at LSHTM, PO Box 273, Banjul, West Africa, the Gambia.
Emmanuel Mendy
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
Kevin van Zandvoort
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
Olimatou Jobe
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
Golam Sarwar
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
Baleng Mahama Wutor
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
Stefan Flasche
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK; Centre of Global Health, Charite – Universitätsmedizin, Berlin, Germany
Nuredin I. Mohammed
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia
Jane Bruce
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
Brian Greenwood
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
Grant A. Mackenzie
Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, the Gambia; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Murdoch Children’s Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Australia
Introduction: School-aged children play a major role in the transmission of many respiratory pathogens due to high rate of close contacts in schools. The validity and accuracy of proxy-reported contact data may be limited, particularly for children when attending school. We observed social contacts within schools and assessed the accuracy of proxy-reported versus observed physical contact data among students in rural Gambia. Methods: We enrolled school children who had also been recruited to a survey of Streptococcus pneumoniae carriage and social contacts. We visited participants at school and observed their contact patterns within and outside the classroom for two hours. We recorded the contact type, gender and approximate age of the contactee, and class size. We calculated age-stratified contact matrices to determine in-school contact patterns. We compared proxy-reported estimated physical contacts for the subset of participants (18 %) randomised to be observed on the same day for which the parent or caregiver reported the school contacts. Results: We recorded 3822 contacts for 219 participants from 114 schools. The median number of contacts was 15 (IQR: 11–20). Contact patterns were strongly age-assortative, and mainly involved physical touch (67.5 %). Those aged 5–9 years had the highest mean number of contacts [19.0 (95 %CI: 16.7–21.3)] while the ≥ 15-year age group had fewer contacts [12.8 (95 %CI: 10.9–14.7)]. Forty (18 %) participants had their school-observed contact data collected on the same day as their caregiver reported their estimated physical contacts at school; only 22.5 % had agreement within ±2 contacts between the observed and reported contacts. Fifty-eight percent of proxy-reported contacts were under-estimates. Conclusions: Social contact rates observed among pupils at schools in rural Gambia were high, strongly age-assortative, and physical. Reporting of school contacts by proxies may underestimate the effect of school-age children in modelling studies of transmission of infections. New approaches are needed to quantify contacts within schools.
