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

Autor:	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.; Instituto de Ciências Matemáticas e Computação, Universidade de São Paulo, Brazil., Réquia WJ; Escola de Políticas Públicas e Governo, Fundação Getulio Vargas, Brasília, Brazil., Motta FC; Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil., Siqueira MM; Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil., Vasconcelos ATR; Laboratório de Bioinformática, Laboratório Nacional de Computação Científica (LNCC), Petrópolis, 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; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil., Amancio RT; Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil., Villela DAM; Programa de Computação Científica (PROCC), FIOCRUZ, Rio de Janeiro, Brazil.; Center for Health and Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ, USA., Pereira T; Instituto de Ciências Matemáticas e Computação, Universidade de São Paulo, Brazil., Goedert GT; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil., Santos CVBD; Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil., Rodrigues NCP; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil.; Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil., Bormann de Souza Filho BA; Escola Nacional de Saúde Pública Sérgio Arouca, FIOCRUZ, Rio de Janeiro, Brazil.; Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Rio Grande do Norte, Brazil., Csillag D; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil., Grinsztejn B; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil., Veloso VG; Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil., Struchiner CJ; Escola de Matemática Aplicada, Fundação Getulio Vargas, Rio de Janeiro, Brazil.; Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2024 Jun 18; Vol. 36, pp. 100824. Date of Electronic Publication: 2024 Jun 18 (Print Publication: 2024).
DOI:	10.1016/j.lana.2024.100824
Abstrakt:	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. Competing Interests: CJS is a member of PAHO and WHO advisory boards (no payment involved). All other authors declare that they have no competing interests. (© 2024 The Authors.)
Databáze:	MEDLINE
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