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https://www.arca.fiocruz.br/handle/icict/61938
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2030-12-31
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
- INI - Artigos de Periódicos [3645]
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THE ROLE OF CHILDREN IN HOUSEHOLD TRANSMISSION OF SARS-COV-2 ACROSS FOUR WAVES OF THE PANDEMIC
Author
Affilliation
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Division of Pediatric Infectious Diseases. David Geffen School of Medicine at UCLA. Los Angeles, California, USA.
International Public Health. London School of Hygiene and Tropical Medicine. London, UK.
Clinical Research Department. London School of Hygiene and Tropical Medicine. London, UK.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Presidency. Scientific Computing Program. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Division of Pediatric Infectious Diseases. David Geffen School of Medicine at UCLA. Los Angeles, California, USA.
International Public Health. London School of Hygiene and Tropical Medicine. London, UK.
Clinical Research Department. London School of Hygiene and Tropical Medicine. London, UK.
Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Respiratory Viruses and Measles. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Department of Acute Febrile Illnesses. Rio de Janeiro, RJ, Brazil.
Abstract
Background. It is important to understand the dynamics of SARS-CoV-2 transmission in close-contact settings such as house holds. We hypothesized that children would most often acquire SARS-CoV-2 from a symptomatic adult caregiver. Methods. This prospective cohort study was conducted from April 2020 to July 2022 in a low-resource, urban settlement in Brazil. We recruited families who brought their children to a public clinic. We collected nasopharyngeal and oral swabs from house hold members and tracked symptoms and vaccination. Results. In total, 1256 participants in 298 households were tested for SARS-CoV-2. A total of 4073 RT–PCR tests were run with 893 SARS-CoV-2 positive results (21.9%). SARS-CoV-2 cases were defined as isolated cases (N = 158) or well-defined transmission events (N = 175). The risk of household transmission was lower if the index case was a child (OR: 0.3 [95% CI: 0.16–0.55], P < .001) or was vaccinated (OR: 0.29 [95% CI: 0.1–0.85], P = .024), and higher if the index was symptomatic (OR: 2.53 [95% CI: 1.51–4.26], P < .001). The secondary attack rate for child index cases to child contacts was 0.29, whereas the secondary attack rate for adult index cases to child contacts was 0.47 (P = .08). Conclusions. In this community, children were significantly less infectious to their household contacts than adolescents or adults. Most children were infected by a symptomatic adult, usually their mother. There was a double benefit of vaccination as it pro tected the vaccine from severe illness and prevented onward transmission to household contacts. Our findings may also be valid for similar populations throughout Latin America.
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