title: Household crowding, social mixing patterns and respiratory symptoms in seven countries of the African meningitis belt.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Claire F
authors.initials: CF
authors.lastname: Ferraro
authors.affiliation: Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Trotter
authors.affiliation: Department of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Nascimento
authors.affiliation: Unité d'Epidémiologie, Centre de Recherches Médicales et Sanitaires (CERMES), Niamey, Niger.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Jusot
authors.affiliation: Department of Community Medicine, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: Babatunji A
authors.initials: BA
authors.lastname: Omotara
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana; Research and Development Division, Ghana Health Service, Ghana.
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
authors.forename: Oumer
authors.initials: O
authors.lastname: Ali
authors.affiliation: L'institut de recherche pour le développement, Dakar, Senegal.
authors.forename: Serge
authors.initials: S
authors.lastname: Alavo
authors.affiliation: Center for Vaccine Development-Mali (CVD-MALI), Bamako, Mali.
authors.forename: Samba
authors.initials: S
authors.lastname: Sow
authors.affiliation: Centre de Support en Santé Internationale (CSSI), Ndjamena, Chad.
authors.forename: Doumagoum Moto
authors.initials: DM
authors.lastname: Daugla
authors.affiliation: Department of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: James M
authors.initials: JM
authors.lastname: Stuart
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003441:Crowding; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000635:transmission*; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population