The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements
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RESEARCH ARTICLE
Open Access
The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements Matthew Quaife1,2* , Kevin van Zandvoort1, Amy Gimma1, Kashvi Shah2, Nicky McCreesh1, Kiesha Prem1, Edwine Barasa3,4, Daniel Mwanga5, Beth Kangwana5, Jessie Pinchoff 6, CMMID COVID-19 Working Group, W. John Edmunds1, Christopher I. Jarvis1 and Karen Austrian5
Abstract Background: Many low- and middle-income countries have implemented control measures against coronavirus disease 2019 (COVID-19). However, it is not clear to what extent these measures explain the low numbers of recorded COVID-19 cases and deaths in Africa. One of the main aims of control measures is to reduce respiratory pathogen transmission through direct contact with others. In this study, we collect contact data from residents of informal settlements around Nairobi, Kenya, to assess if control measures have changed contact patterns, and estimate the impact of changes on the basic reproduction number (R0). Methods: We conducted a social contact survey with 213 residents of five informal settlements around Nairobi in early May 2020, 4 weeks after the Kenyan government introduced enhanced physical distancing measures and a curfew between 7 pm and 5 am. Respondents were asked to report all direct physical and non-physical contacts made the previous day, alongside a questionnaire asking about the social and economic impact of COVID-19 and control measures. We examined contact patterns by demographic factors, including socioeconomic status. We described the impact of COVID-19 and control measures on income and food security. We compared contact patterns during control measures to patterns from non-pandemic periods to estimate the change in R0. Results: We estimate that control measures reduced physical contacts by 62% and non-physical contacts by either 63% or 67%, depending on the pre-COVID-19 comparison matrix used. Masks were worn by at least one person in 92% of contacts. Respondents in the poorest socioeconomic quintile reported 1.5 times more contacts than those in the richest. Eighty-six percent of respondents reported a total or partial loss of income due to COVID-19, and 74% reported eating less or skipping meals due to having too little money for food. (Continued on next page)
* Correspondence: [email protected] 1 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK 2 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party materia
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