Relationship between household attributes and contact patterns in urban and rural South Africa

Households play a crucial role in the propagation of infectious diseases due to the frequent and prolonged interactions that typically occur between their members. Recent studies advocated for the importance of including socioeconomic variables in epidemic models to account for the heterogeneity induced by human behavior. While sub-Saharan Africa suffers the highest burden of infectious disease diffusion, limited efforts have been carried out to investigate the mixing patterns in the countries and their relation with social indicators. This work analyzes household contact matrices measured with wearable proximity sensors in a rural and an urban village in South Africa. Leveraging a rich data collection describing additional individual and household attributes, we investigate how the household contact matrix varies according to the household type (whether it is composed only of a familiar nucleus or by a larger group), the gender of its head (the primary decision-maker), the rural or urban context and the season in which it was measured. We show the household type and the gender of its head induce differences in the interaction patterns between household members, particularly regarding child caregiving. We argue the observed differences directly influence the basic reproductive number of an epidemic and should hence be accounted for the design of effective epidemic mitigation strategies.