ArticleCommunications medicine2023
Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica.
Article in Communications medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Evidence of Face Masks and Masking Policies for the Prevention of SARS-CoV-2 Transmission and COVID-19 in Real-World Settings: A Systematic Literature Review.International journal of environmental research and public health · 2025Pooled it
- Concordance between SARS-CoV-2 index individuals and their household contacts on index individual COVID-19 transmission cofactors: a comparison of self-reported and contact-reported information.BMC public health · 2024Trial
- The roles of pre-season immunity, age, viral shedding, and community exposures in shaping influenza household transmission dynamics.Nature communications · 2026Article
- Assessing SARS-CoV-2 transmission in African households from the reanalysis of serosurveys.American journal of epidemiology · 2026Article
- SARS-CoV-2 mRNA Vaccine Effectiveness in the Borriana COVID-19 Cohort: A Prospective Population-Based Cohort Study.Epidemiologia (Basel, Switzerland) · 2025Article
- Article
- Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic.JAMA network open · 2024Article
- Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study.BMJ open · 2023Article
- Estimating the cumulative incidence of SARS-CoV-2 infection in Costa Rica: modelling seroprevalence data in a population-based cohort.Lancet regional health. Americas · 2023Article
- Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica.Communications medicine · 2023Article
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Authors and funding
19 authors at 7 institutions in 2 countries.
Funding
Abstract
introductionVariability in household secondary attack rates and transmission risks factors of SARS-CoV-2 remain poorly understood.
methodsWe conducted a household transmission study of SARS-CoV-2 in Costa Rica, with SARS-CoV-2 index cases selected from a larger prospective cohort study and their household contacts were enrolled. A total of 719 household contacts of 304 household index cases were enrolled from November 21, 2020, through July 31, 2021. Blood specimens were collected from contacts within 30-60 days of index case diagnosis; and serum was tested for presence of spike and nucleocapsid SARS-CoV-2 IgG antibodies. Evidence of SARS-CoV-2 prior infections among household contacts was defined based on the presence of both spike and nucleocapsid antibodies. We fitted a chain binomial model to the serologic data, to account for exogenous community infection risk and potential multi-generational transmissions within the household.
resultsOverall seroprevalence was 53% (95% confidence interval (CI) 48-58%) among household contacts. The estimated household secondary attack rate is 34% (95% CI 5-75%). Mask wearing by the index case is associated with the household transmission risk reduction by 67% (adjusted odds ratio = 0.33 with 95% CI: 0.09-0.75) and not sharing bedroom with the index case is associated with the risk reduction of household transmission by 78% (adjusted odds ratio = 0.22 with 95% CI 0.10-0.41). The estimated distribution of household secondary attack rates is highly heterogeneous across index cases, with 30% of index cases being the source for 80% of secondary cases.
conclusionsModeling analysis suggests that behavioral factors are important drivers of the observed SARS-CoV-2 transmission heterogeneity within the household.
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Registered trials
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