Identification of risk factors that increase household transmission of COVID-19 in Afyonkarahisar, Turkey

Abstract

Introduction: COVID-19 is the greatest pandemic of the 21^st century. This cross-sectional study determined the factors that cause COVID-19 transmission in the household, increase in susceptibility of contacts, and increase in contagiousness of the primary case, and developed predictive calculations for determining secondary attack rate in the household.

Methodology: A total of 701 households with positive COVID-19 test cases, and 1813 adults living in these households, were studied from August 24-31, 2020 in Afyonkarahisar, Turkey. All the participants were interviewed by phone. The participants were divided into two groups: positives included those with positive Polymerase Chain Reaction (PCR) tests, negatives included those with a negative test and those who were without a PCR test. Descriptive statistics, Chi-square test, and multivariate logistic regression analysis were performed.

Results: The secondary attack rate was 31.5%. Being male, having an education level > 8 years, living in the city, low number of people living in the household, having a severe illness, non-compliance with isolation requirement, and nonadherence to wearing masks increased contagiousness. The factors that increased the sensitivity of the household were determined as being female, having an education level of over 8 years, and being obese.

Conclusions: The secondary attack rate (SAR) was higher in Turkey than in other countries and there was limited compliance with quarantine and isolation measures. Household transmission can be reduced by interventions such as masks, isolation, and quarantine. The transmission of COVID-19 in households can be reduced if preventive measures are taken in the early stages of infection.