High-resolution contact data and infectious disease absenteeism in kindergarten populations

High-resolution contact data and infectious disease absenteeism in kindergarten populations | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article High-resolution contact data and infectious disease absenteeism in kindergarten populations Fan Jiang, Ying Wen, fangfang Lu, Deji CiRen, Yingluan Zhang, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7833453/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Close social interactions are a fundamental driver of infectious disease transmission in early childhood education settings. However, high-resolution empirical contact data from these environments remain scarce, limiting our understanding of transmission dynamics and prevention strategies. Methods We deployed name-tag devices equipped with ultra-wideband (UWB) positioning technology in a public kindergarten in Shenzhen, China, to continuously record close-proximity contact events (< 2 meters) during a typical school day. Contact events were classified into four risk categories based on contact duration and proximity. We then conducted a joint analysis of temporally segmented, risk-stratified networks and six months of infectious-disease-related absenteeism records. Results The study achieved an 88.68% participation rate (282 of 318 children) and full participation of 30 teachers, yielding 389,617 contact events. On average, each child interacted with 57.91 distinct individuals daily. Outdoor activities were associated with fewer and lower-risk contacts, whereas nap time — despite being a sedentary activity — accounted for the highest proportion of high-risk total contact time (14.38%). Children with absenteeism records engaged in longer and more frequent contacts, and with a greater number of contacted individuals, across medium-low, medium-high, and high-risk layers compared with their non-absent peers. However, these differences diminished when low-risk contacts were included, resulting in no significant group-level differences over the full day. At the class level, absenteeism rates were strongly correlated with the density of medium-high (r = 0.833, p = 0.005) and high-risk (r = 0.733, p = 0.025) contact layers. Conclusions Our findings reveal substantial structural and contextual heterogeneity within kindergarten contact networks and provide quantitative evidence linking contact patterns to health outcomes. High-resolution proximity data offer valuable insights into transmission risk and inform the design of targeted prevention and risk management strategies in early childhood education settings. ultra-wideband proximity sensing contact networks early childhood education settings Risk Stratification Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementarydata.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 07 Mar, 2026 Reviews received at journal 02 Mar, 2026 Reviewers agreed at journal 01 Feb, 2026 Reviews received at journal 26 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers invited by journal 06 Nov, 2025 Editor invited by journal 06 Nov, 2025 Editor assigned by journal 16 Oct, 2025 Submission checks completed at journal 15 Oct, 2025 First submitted to journal 15 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7833453","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":545798563,"identity":"25efb9ff-5667-4cc2-a96f-a484a6d3de4c","order_by":0,"name":"Fan Jiang","email":"","orcid":"","institution":"Southern Medical University School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Jiang","suffix":""},{"id":545798564,"identity":"ff3da362-78bd-4ada-aa4c-c3c1d7aad643","order_by":1,"name":"Ying Wen","email":"","orcid":"","institution":"Shenzhen Center for Disease Control and 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populations","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ultra-wideband proximity sensing, contact networks, early childhood education settings, Risk Stratification","lastPublishedDoi":"10.21203/rs.3.rs-7833453/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7833453/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eClose social interactions are a fundamental driver of infectious disease transmission in early childhood education settings. However, high-resolution empirical contact data from these environments remain scarce, limiting our understanding of transmission dynamics and prevention strategies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe deployed name-tag devices equipped with ultra-wideband (UWB) positioning technology in a public kindergarten in Shenzhen, China, to continuously record close-proximity contact events (\u0026lt;\u0026thinsp;2 meters) during a typical school day. Contact events were classified into four risk categories based on contact duration and proximity. We then conducted a joint analysis of temporally segmented, risk-stratified networks and six months of infectious-disease-related absenteeism records.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe study achieved an 88.68% participation rate (282 of 318 children) and full participation of 30 teachers, yielding 389,617 contact events. On average, each child interacted with 57.91 distinct individuals daily. Outdoor activities were associated with fewer and lower-risk contacts, whereas nap time \u0026mdash; despite being a sedentary activity \u0026mdash; accounted for the highest proportion of high-risk total contact time (14.38%). Children with absenteeism records engaged in longer and more frequent contacts, and with a greater number of contacted individuals, across medium-low, medium-high, and high-risk layers compared with their non-absent peers. However, these differences diminished when low-risk contacts were included, resulting in no significant group-level differences over the full day. At the class level, absenteeism rates were strongly correlated with the density of medium-high (r\u0026thinsp;=\u0026thinsp;0.833, p\u0026thinsp;=\u0026thinsp;0.005) and high-risk (r\u0026thinsp;=\u0026thinsp;0.733, p\u0026thinsp;=\u0026thinsp;0.025) contact layers.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eOur findings reveal substantial structural and contextual heterogeneity within kindergarten contact networks and provide quantitative evidence linking contact patterns to health outcomes. High-resolution proximity data offer valuable insights into transmission risk and inform the design of targeted prevention and risk management strategies in early childhood education settings.\u003c/p\u003e","manuscriptTitle":"High-resolution contact data and infectious disease absenteeism in kindergarten populations","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-17 15:41:04","doi":"10.21203/rs.3.rs-7833453/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-07T06:24:44+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-02T15:26:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"108481945924114724680803723251941549888","date":"2026-02-01T16:33:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-26T10:33:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"213585034429933427843001720512864613592","date":"2026-01-20T12:38:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-06T14:15:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-06T06:29:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-16T06:08:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-16T02:50:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-10-16T02:47:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6b373db1-25cc-419e-87bf-10feaf1b4706","owner":[],"postedDate":"November 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-22T05:09:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-17 15:41:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7833453","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7833453","identity":"rs-7833453","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}