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

Coelho, Lara E; Luz, Paula M; Pires, Débora C; Jalil, Emilia M; Perazzo, Hugo; Torres, Thiago S; Cardoso, Sandra W; Peixoto, Eduardo M; Nazer, Sandro; Massad, Eduardo; Carvalho, Luiz Max; Réquia, Weeberb J; Motta, Fernando Couto; Siqueira, Marilda Mendonça; Vasconcelos, Ana T R; da Fonseca, Guilherme C; Cavalcante, Liliane T F; Costa, Carlos A M; Amancio, Rodrigo T; Villela, Daniel A M; Pereira, Tiago; Goedert, Guilherme T; Santos, Cleber V B D; Rodrigues, Nadia C P; Bormann de Souza Filho, Breno Augusto; Csillag, Daniel; Grinsztejn, Beatriz; Veloso, Valdilea G; Struchiner, Claudio J

Coelho, Lara E; Luz, Paula M; Pires, Débora C; Jalil, Emilia M; Perazzo, Hugo; Torres, Thiago S; Cardoso, Sandra W; Peixoto, Eduardo M; Nazer, Sandro; Massad, Eduardo; Carvalho, Luiz Max; Réquia, Weeberb J; Motta, Fernando Couto; Siqueira, Marilda Mendonça; Vasconcelos, Ana T R; da Fonseca, Guilherme C; Cavalcante, Liliane T F; Costa, Carlos A M; Amancio, Rodrigo T; Villela, Daniel A M; Pereira, Tiago; Goedert, Guilherme T; Santos, Cleber V B D; Rodrigues, Nadia C P; Bormann de Souza Filho, Breno Augusto; Csillag, Daniel; Grinsztejn, Beatriz; Veloso, Valdilea G; Struchiner, Claudio J.

Afiliação

Coelho LE; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Luz PM; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Pires DC; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Jalil EM; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Perazzo H; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Torres TS; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Cardoso SW; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Peixoto EM; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Nazer S; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil.
Massad E; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil.
Carvalho LM; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil.
Réquia WJ; Instituto de Ciências Matemáticas e Computação, Universidade de São Paulo, Brazil.
Motta FC; Escola de Políticas Públicas e Governo, Fundação Getulio Vargas, Brasília, Brazil.
Siqueira MM; Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
Vasconcelos ATR; Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
da Fonseca GC; Laboratório de Bioinformática, Laboratório Nacional de Computação Científica (LNCC), Petrópolis, Brazil.
Cavalcante LTF; Laboratório de Bioinformática, Laboratório Nacional de Computação Científica (LNCC), Petrópolis, Brazil.
Costa CAM; Laboratório de Bioinformática, Laboratório Nacional de Computação Científica (LNCC), Petrópolis, Brazil.
Amancio RT; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil.
Villela DAM; Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Pereira T; Programa de Computação Científica (PROCC), FIOCRUZ, Rio de Janeiro, Brazil.
Goedert GT; Center for Health and Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ, USA.
Santos CVBD; Instituto de Ciências Matemáticas e Computação, Universidade de São Paulo, Brazil.
Rodrigues NCP; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil.
Bormann de Souza Filho BA; Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Csillag D; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil.
Grinsztejn B; Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Veloso VG; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil.
Struchiner CJ; Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Rio Grande do Norte, Brazil.

Lancet Reg Health Am ; 36: 100824, 2024 Aug.

Article em En | MEDLINE | ID: mdl-38993539

ABSTRACT

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.