# Spreading potential in disease relevant networks: Predicting centralities in rural Northeast Madagascar

## TL;DR

This study explores how contact patterns in rural Madagascar influence disease spread, finding that gender and wealth are key factors in transmission potential.

## Contribution

The novel contribution is identifying gender and wealth as predictors of centrality in different transmission networks using mixed effects models in rural Madagascar.

## Key findings

- Gender and wealth based on household materials were significant predictors of network centrality.
- Men were more central in environmental overlap networks compared to women.
- Wealth was positively associated with close contact network centrality.

## Abstract

Heterogeneity in contact patterns can have marked effects on disease transmission, including through superspreading where few individuals drive most infections. Networks based on different types of human-human contacts quantify individuals’ centrality, which can be used to identify individuals or sub-populations who are at increased risk of spreading disease. By understanding the predictors of centrality, high-risk individuals and sub-populations can be targeted to improve public health intervention strategies, even when detailed network data are unavailable. This study inferred transmission potential networks representing different pathogen transmission pathways among people living in rural villages of northeast Madagascar. We constructed four network types: social, close contact, household proximity, and environmental overlap using survey data and global positioning system (GPS) trackers. We then investigated how sociodemographic and anthropometric variables predicted different types of network centralities using multiple mixed effects linear models. Gender and wealth based on household material quality tended to be the most important sociodemographic predictors of centrality, but centrality outcomes varied by network type and had wide confidence intervals. Men tended to be more central to their environmental overlap network than women. Further, wealth based on household materials was an important, positive predictor of close contact network centrality. Gender and wealth were associated with centrality in transmission-potential networks but varied in their importance across different network types. Our study results suggest that targeted intervention efforts focused on diseases that are transmitted through shared environments (i.e., parasites shared through soil or water) or direct contact (i.e., respiratory infections) in similar agricultural settings should consider gender- and wealth-associated differences in contact patterns.