부산대학교 도서관

Background: Human mobility among residential locations can drive dengue virus (DENV) transmission dynamics. Recently, it was shown that individuals with symptomatic DENV infection exhibit significant changes in their mobility patterns, spending more time at home during illness. This change in mobility is predicted to increase the risk of acquiring infection for those living with or visiting the ill individual. It has yet to be considered, however, whether social contacts are also changing their mobility, either by socially distancing themselves from the infectious individual or increasing contact to help care for them. Social, or physical, distancing and caregiving could have diverse yet important impacts on DENV transmission dynamics; therefore, it is necessary to better understand the nature and frequency of these behaviors including their effect on mobility. Methodology and principal findings: Through community-based febrile illness surveillance and RT-PCR infection confirmation, 67 DENV positive (DENV+) residents were identified in the city of Iquitos, Peru. Using retrospective interviews, data were collected on visitors and home-based care received during the illness. While 15% of participants lost visitors during their illness, 22% gained visitors; overall, 32% of all individuals (particularly females) received visitors while symptomatic. Caregiving was common (90%), particularly caring by housemates (91%) and caring for children (98%). Twenty-eight percent of caregivers changed their behavior enough to have their work (and, likely, mobility patterns) affected. This was significantly more likely when caring for individuals with low "health-related quality of well-being" during illness (Fisher's Exact, p = 0.01). Conclusions/Significance: Our study demonstrates that social contacts of individuals with dengue modify their patterns of visitation and caregiving. The observed mobility changes could impact a susceptible individual's exposure to virus or a presymptomatic/clinically inapparent individual's contribution to onward transmission. Accounting for changes in social contact mobility is imperative in order to get a more accurate understanding of DENV transmission. Author summary: Dengue is the most important mosquito-borne viral disease of humans worldwide. Due to the limited mobility of the mosquitoes that transmit dengue virus, human mobility is a key variable to understanding the spread of dengue through a population. Recently it was shown that individuals with symptomatic dengue have significantly reduced mobility patterns. To better understand how dengue illness affects the behavior of visitors and caregivers, we examined the nature and frequency of a symptomatic individual's social contacts to determine if their behaviors changed due to social distancing or caregiving. While many participants had a drop off in visitor frequency when ill, almost all participants received help from their housemates. These caregivers were most likely to have their work impacted when helping participants whose quality of life was most negatively affected by illness. We quantified how often these behavioral changes had a discernable effect on the social contact's mobility patterns. Accounting for mobility changes by social contacts provides a more accurate understanding of infection risk and potential for virus spread through a population. Dengue transmission models that incorporate mobility changes of symptomatic individuals and their social contacts will add currently missing epidemiologically relevant detail for evaluating different disease prevention strategies. [ABSTRACT FROM AUTHOR]