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Household crowding, social mixing patterns and respiratory symptoms in seven countries of the African meningitis belt.

  • Ferraro, Claire F1
  • Trotter, Caroline L2
  • Nascimento, Maria C1
  • Jusot, Jean-François3
  • Omotara, Babatunji A4
  • Hodgson, Abraham5
  • Ali, Oumer6
  • Alavo, Serge7
  • Sow, Samba8
  • Daugla, Doumagoum Moto9
  • Stuart, James M1
  • 1 Department of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom. , (United Kingdom)
  • 2 Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom. , (United Kingdom)
  • 3 Unité d'Epidémiologie, Centre de Recherches Médicales et Sanitaires (CERMES), Niamey, Niger. , (Niger)
  • 4 Department of Community Medicine, University of Maiduguri, Maiduguri, Nigeria. , (Niger)
  • 5 Navrongo Health Research Centre, Navrongo, Ghana; Research and Development Division, Ghana Health Service, Ghana. , (Ghana)
  • 6 Armauer Hansen Research Institute, Addis Ababa, Ethiopia. , (Ethiopia)
  • 7 L'institut de recherche pour le développement, Dakar, Senegal. , (Senegal)
  • 8 Center for Vaccine Development-Mali (CVD-MALI), Bamako, Mali. , (Mali)
  • 9 Centre de Support en Santé Internationale (CSSI), Ndjamena, Chad. , (Chad)
Published Article
Public Library of Science
Publication Date
Jan 01, 2014
DOI: 10.1371/journal.pone.0101129
PMID: 24988195


To describe the variation in household crowding and social mixing patterns in the African meningitis belt and to assess any association with self-reported recent respiratory symptoms. In 2010, the African Meningococcal Carriage Consortium (MenAfriCar) conducted cross-sectional surveys in urban and rural areas of seven countries. The number of household members, rooms per household, attendance at social gatherings and meeting places were recorded. Associations with self-reported recent respiratory symptoms were analysed by univariate and multivariate regression models. The geometric mean people per room ranged from 1.9 to 2.8 between Ghana and Ethiopia respectively. Attendance at different types of social gatherings was variable by country, ranging from 0.5 to 1.5 per week. Those who attended 3 or more different types of social gatherings a week (frequent mixers) were more likely to be older, male (OR 1.27, p<0.001) and live in urban areas (OR 1.45, p<0.001). Frequent mixing and young age, but not increased household crowding, were associated with higher odds of self-reported respiratory symptoms (aOR 2.2, p<0.001 and OR 2.8, p<0.001 respectively). A limitation is that we did not measure school and workplace attendance. There are substantial variations in household crowding and social mixing patterns across the African meningitis belt. This study finds a clear association between age, increased social mixing and respiratory symptoms. It lays the foundation for designing and implementing more detailed studies of social contact patterns in this region.

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