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 Epidemiology and Society Health Review| ESHR 
Vol. 5, No. 1, 2023, pp. 32-40 ISSN 2656-6052 (online) | 2656-1107 (print) 
      http://journal2.uad.ac.id/index.php/eshr/index                                                   eshr@ikm.uad.ac.id 

 

 

      10.26555/eshr.v5i1.6216  

 
 

32 

 
 

  

 
Research Article  
 
Association between close contact history and the risk of 
COVID-19 in Purwakarta District, Indonesia 
 
Jihan Srikandhia Purnama1, Liena Sofiana1* 

1 Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia  
 
* Correspondence: liena.sofiana@ikm.uad.ac.id. Phone: +62274563515 
 
Received 25 June 2022; Accepted 02 February 2023; Published 11 March 2023 
 

ABSTRACT  

Background: COVID-19 pandemic is a global problem. One of the risk factors for COVID-
19 is close contact, which has a greater risk of being confirmed because virus transmission 
generally occurs directly through droplets. Based on regional risk zoning mapping, 
Purwakarta District is categorized as a moderate risk zone, and most of the confirmed cases 
are caused by a history of close contact. Still, people with a history of close contact only 
sometimes become established patients. This study aimed to determine the relationship 
between close contact status and the incidence of COVID-19 in the Purwakarta district year 
2020. 
Method: This study used observational analysis and a cross-sectional study design. The 
research data is secondary data from the Purwakarta Regency Health Office. Purposive 
sampling was used to select 2,650 people for the study. The data analysis method used is 
chi-square. 
Results: According to the respondents' characteristics, most are in their early adulthood 
(26.8 %) and male (52.3 %). According to bivariate analysis, there is a p-value = 0.002 
relationship between close contact status and the incidence of COVID-19. People with close 
contact status are 1.040 times more likely than people who do not have close contact status 
to get COVID-19 (95 % CI = 1.013-1.069). 
Conclusion: Close contact status is a risk factor for COVID-19 transmission in Purwakarta 
Regency during 2020.  

Keywords: COVID-19; close contact; risk factor. 

INTRODUCTION 

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute 
Respiratory Syndrome Coronavirus-2 (SARS-COV-2).1 Symptoms that arise due to COVID-



 
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19 infection include fever, cough, and shortness of breath. The average incubation period is 
about 5-6 days, with the longest being 14 days. Coronavirus is a family of viruses that can 
cause mild to severe symptoms. In extreme cases, COVID-19 can cause pneumonia, kidney 
failure, acute respiratory syndrome, and even death.2 Several types of Coronavirus are known 
to have severe symptoms, namely Middle East Respiratory Syndrome (MERS) and Severe 
Acute Respiratory Syndrome (SARS).  

The urgency of the COVID-19 disease was marked by the WHO's determination of pandemic 
status on March 12, 2021.1 The first report received by WHO on January 3, 2020, explained 
that the case originated in Wuhan, China, with 44 patients diagnosed with severe pneumonia.3 
The emergence of extraordinary events in Wuhan, Hubei province, China, marked this disease 
spreading. The problems caused by COVID-19 are not only local problems for residents of 
Wuhan, China. But also a severe problem worldwide due to increased cases that continue to 
increase daily.4 

In 2020, there were 83,060,276 confirmed cases of COVID-19, with the death toll reaching 
1,812,046 worldwide. The increase in COVID-19 cases is relatively fast; the spike evidences 
this in occasional cases. Based on the WHO report, the United States is one of the regions 
with the most confirmed cases, namely 20,216,991 cases with 350,778 deaths. Meanwhile, in 
the Asian region, the countries with the highest number of confirmed cases were India, Turkey, 
Iran, and Indonesia.5 The first 5 cases in Indonesia were confirmed on March 2, 2020. The 
increase in COVID-19 cases is still increasing every day. Based on a report from the 
Indonesian Ministry of Health, as of August 30, 2020, there were 172,053 confirmed cases 
with a higher mortality rate than global data, which was 4.3% or 7,343 deaths. The province 
with the highest number of confirmed cases is DKI Jakarta, with 39,037 cases. Meanwhile, 
the province with the lowest number of cases was East Nusa Tenggara, with 177 cases.6 

According to the Indonesia National Disaster Management Agency (BNPB), daily data on 
COVID-19 showed the five provinces with the highest number of cases: DKI Jakarta, East 
Java, Central Java, South Sulawesi, and West Java, which counted up to September 5, 2020.7 
The number of confirmed cases in Indonesia recorded throughout 2020 was 743,198 cases. 
This number continues to increase in cases every day. Twenty-five provinces experienced an 
increase in cases, one of which is West Java Province, with 83,579 cases. Based on the 
national COVID-19 case fatality rate, there has also been an increase of 22,138 people who 
died.8  

Risk factors for COVID-19 infection included comorbid conditions in patients, such as 
comorbid hypertension and diabetes mellitus. In addition, close contact factors, age, gender, 
and smoking habits also potentially risk COVID-19. Close contacts are suspected of having a 
greater chance of being confirmed because exposure to confirmed cases carried out 
continuously for more than 15 minutes will make people with close contact status more 
susceptible to contracting the virus.9 People with a history of close contact with confirmed 
cases are at high risk for exposure to the virus through droplet transmission. This generally 
occurs in cases of close household contact. Droplets from respiratory fluids can happen when 
a person is within one meter of an infected person. At the same time, contact transmission 
that occurs indirectly can be through the transmission of contaminated object surfaces or is 
called fomite transmission.10  



 
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The case report showed that the confirmed cases are related to transmission from COVID-19 
patients and generally have a history of close contact with confirmed COVID-19 patients.11 
People who have closed contact with COVID-19 patients are considered to be most at risk for 
contracting the SARS-CoV-2 virus. The same goes for people caring for patients, medical 
personnel, and family members.12 The results of research conducted in 2020 show that the 
SARS-COV-2 virus has a transmission rate of 5% to 6% in people with a history of close 
contact with patients with confirmed COVID-19. Transmission rates are higher when close 
contacts are in the family environment, up to 10%.13 The health workforce is one of the close 
contact groups most susceptible to catching the virus; previous research found a substantial 
correlation between a history of close contact and verified COVID-19 cases in Makassar city, 
with close contacts having a 6.802 times higher probability of being diagnosed with COVID-
19 than those without a history of close contacts. 11 

Confirmed cases of COVID-19 in West Java continued to increase every day until December 
20, 2021; there were 73,948 confirmed cases of COVID-19, with a cumulative incidence of 
163.49 per 100,000 population.8 The number of deaths in West Java due to COVID-19 
infection was 1,095 people. Based on the regional risk zoning mapping in 2020, Purwakarta 
District was categorized in the moderate risk zone.8 Purwakarta District is one of the regencies 
in West Java's province. During the pandemic, the Purwakarta district was not spared from 
confirmed cases of COVID-19. The first confirmed case occurred on March 15, 2020, with an 
increase in cases weekly. However, the incidence of COVID-19 in Purwakarta District is 
relatively unstable; this is because, in June 2020, Purwakarta District had reached zero cases 
which also coincided with the implementation of Large-Scale Social Restrictions called PSBB 
in several areas in Purwakarta District.14  

According to information from the Purwakarta District Health Office, most confirmed cases 
were also caused by prior close contact with patients who tested positive. Apart from the 
frequent interactions between workers at the same workplace, it is believed that the COVID-
19 virus was spread when workers went home without realizing it had already entered their 
bodies. So that interactions taking on in the environment around us become unrestrained. The 
Purwakarta District Health Office claimed that exchanges take place regularly. The chance of 
COVID-19 cases being transmitted to family members and coworkers is increased by a history 
of close interaction with relatively long-term confirmed patients (most of them are 
asymptomatic). A history of close interaction with positive patients, primarily from household 
and business clusters, increases the number of confirmed cases. However, not all individuals 
with a history of close interaction are verified sick. A small percentage of close contact cases 
only sometimes progress to confirmed cases, as observed from the COVID-19 surveillance 
report of the Purwakarta District Health Office. This study aimed to determine the relationship 
between a history of close contact and the prevalence of COVID-19 in Purwakarta. This 
investigation will contribute to efforts to prevent and control COVID-19.   

METHOD 

This was an analytic observational study with a cross-sectional design using secondary data 
from the Purwakarta District Health Office between March and December 2020, recorded in 
surveillance data at the Purwakarta District Health Office. We collected 4,986 data during that 
period. Based on a calculation of the minimum sample, we needed 357 samples. Purposive 



 
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sampling was used to select the sample with inclusion criteria Purwakarta District residents 
who screened for COVID-19 in 2020 by conducting a PCR swab test, rapid antibody, and 
antigen tests. The exclusion criteria in this study were respondents with incomplete data. Two 
thousand six hundred fifty people were obtained based on the inclusion and exclusion criteria, 
and all were included in this study. The chi-square test was used to analyze the data. 

RESULTS 

A few percent of the respondent (28.9%) of the cases of close contact belonged to the early 
adult age group, and 53.1% were male (Table 1).  

Table 1. Distribution of respondents with close contact status by age and gender in 
Purwakarta District in 2020 with (n=2,650) 

 

Characteristics 
Close contact history 

Yes No 
n % n % 

Age  
Toddler (0-5) 
Children (5-11) 
Early teenager (12-16) 
Late teenager (17-25) 
Early adult (26-35) 
Late adult (36-45) 
Early elderly (46-55) 
Late elderly (56-65) 
Elderly (>65) 

 
33 
33 
45 

227 
531 
430 
326 
167 
43 

 
1.8 
1.8 
2.5 

12.4 
28.9 
23.4 
17.8 
9.1 
2.3 

 
14 
13 
12 

108 
179 
136 
165 
114 
74 

 
1.7 
1.6 
1.5 

13.3 
22.0 
16.7 
20.2 
14.0 
9.1 

Gender 
Male 
Female 

 
974 
861 

 
53.1 
46.9 

 
412 
403 

 
50.6 
49.4 

 

Table 2. Frequency distribution of respondents with confirmed COVID-19 status by 
age and gender in Purwakarta Regency in 2020 (n=2,650) 

Characteristics 
COVID-19 confirmation status 

Yes No 
n % n % 

Age  
Toddler (0-5th) 
Children (5-11th) 
Early teenager (12-16th) 
Late teenager (17-25th) 
Early adult (26-35th) 
Late adult (36-45th) 
Early elderly (46-55th) 
Late elderly (56-65th) 
Elderly (>65th) 

 
39 
39 
53 

302 
657 
519 
449 
260 
112 

 
1.6 
1.6 
2.2 

12.4 
27.0 
21.4 
18.5 
10.7 
4.6 

 
8 
7 
4 

33 
53 
47 
42 
21 
5 

 
3.6 
3.2 
1.8 

15.0 
24.1 
21.4 
19.1 
9.5 
2.3 

Gender 
Male 
Female 

 
1,280 
1,150 

 
52.7 
47.3 

 
106 
114 

 
48.2 
51.8 

 



 
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The description of respondents based on the confirmed status of COVID-19 shows that most 
of the confirmed cases of COVID-19 also belong to the early adult age group of 27.0% and 
males at 52.7% (Table 2). The contact status variable was closely related to the incidence of 
COVID-19 with a value of sig = 0.002. The Prevalence Ratio (PR) = 1.040 (95% CI = 1.013-
1.069), which means that people with close contact status have a 1.040 times greater risk of 
contracting COVID-19 than people without close contact status (Table 3). 

Table 3. The results of the bivariate test of the relationship between close contact 
status and the incidence of COVID-19 in Purwakarta Regency in 2020 

Close contact 
history 

Status of COVID-19 
Sig PR (CI 95%) Yes No 

n % n % 
Yes 1,704 70.1 132 69.2 

0.002 1.040 
(1.013-1.069) No 727 29.9 88 30.8 

Total 2,430 100 220 100 

DISCUSSION  

COVID-19 is transmitted from person to person with close relationships with family members, 
friends, relatives, or direct contact with patients confirmed to be COVID-19,15, especially for 
those in close contact with confirmed cases. A person who is declared to have close contact 
is if he has a history of contact with a probable COVID-19 case, he can be caught because he 
is close to a possible case within a 1-meter radius for 15 minutes or more, direct physical 
touch, people who provide direct care without using tools self-protection.16  It increases the 
risk of COVID-19 transmission in the community, particularly for those in close contact with 
confirmed cases. This is confirmed by the WHO statement, which states that the transmission 
of the SARS-CoV-2 virus occurs through droplets and close contact with asymptomatic 
infected cases.10 

Public awareness of maintaining their distance and implementing health protocols is the 
primary key to breaking the chain of transmission of COVID-19. Public knowledge and 
awareness about the Coronavirus can provide deeper insight into current perceptions and 
practicing habits to prevent COVID-19.17 People may have gained awareness and learn about 
the disease and its transmission via television, newspaper, and other platforms, to protect 
themselves and their families.18 Low public awareness in accessing health services will also 
exacerbate the situation, causing high cases of COVID-19.19 

The main transmission occurs through droplets originating from the respiratory tract. In 
addition, the transmission also occurs due to close contact with COVID-19 sufferers. Thus, 
people with a history of close contact have a high risk of exposure to the SARS-CoV-2 virus.20 
People at risk of contracting COVID-19 have close contact with COVID-19 patients, including 
those who care for patients.21 In direct close contact, indicating that a healthy person 
accidentally touched a person infected with the SARS-CoV-2 virus or the person touched the 
surface of an object that a person touched with confirmed COVID-19 (fomite transmission). In 
general, the surface of these objects has been contaminated with droplets containing the 
SARS-CoV-2 virus from COVID-19 patients. The virus can remain stable for a certain period. 



 
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Therefore, it can support the entry of the virus into the body of healthy people, and the infection 
process will continue.22 

The household member number is the most significant proportion of the risk of exposure to 
COVID-19. The analysis results in China also found that 78-85% of the clusters occurred 
within the household. This proves that the transmission occurred in long, close contact.23 
Confirmation cases originating from the company cluster occurred due to close contact with 
the same activity in a closed room for an hour or more with confirmation cases, which can 
pose a high risk for the infected.10 Seventy percent of the cases identified were from close 
household contacts. Close household contact is also considered one of the most dangerous 
contacts.24 This is due to the relatively small scope of the household, which allows high-speed 
person-to-person transmission. 

Of the proportion of close contacts diagnosed with COVID-19, 44.2% were asymptomatic. 
This is more concerning because the risk of spreading the virus to others is greater and 
uncontrollable. According to WHO, the community's asymptomatic infection rate is still 
unknown. The proportion of asymptomatic cases may vary according to age and the presence 
of coexisting conditions.24 However, efforts made to trace contacts and epidemiological 
investigations of cases and close contacts can provide information for disease management 
planning. Information gleaned from contact tracing suggests that asymptomatic people are 
less likely to transmit the virus than symptomatic people.10 

The SARS-CoV-2 virus is more likely to be transmitted between household members through 
droplets or direct contact with contaminated surfaces. People with confirmed patients have a 
higher risk of infection than those who do not live in the same environment as confirmed 
patients. Patients demonstrated as symptomatic or asymptomatic are advised to perform 
independent isolation at home. On the other hand, implementing self-isolation for exposed 
family members allows for much greater exposure and risk for other family members, which 
causes close contact status, especially for families unable to provide a particular room for 
patients to isolate properly.23 

We observed that most confirmed and close contact cases in Purwakarta District are 
dominated by early adulthood. According to the Health Office of Purwakarta District, this is 
most likely caused by transmission due to close contact in the work environment. Exposure to 
viruses in the workplace can occur anytime and anywhere, whether on business trips or while 
working in a room. Close contact in the work environment is related to age and can be 
exacerbated by comorbid diseases in patients. According to WHO, the risk of occupational 
exposure to COVID-19 depends on the likelihood of close contact (distance between people 
of less than 1 meter) or the frequency of contact with an infected person. Transmission can 
also occur through contact with surfaces contaminated with the SARS-CoV-2 virus.25 
Respiratory tract secretions released from infected persons can contaminate objects in the 
surrounding environment, causing the formation of fomites (contaminated surfaces). People 
who come into contact with contaminated surfaces often have close contact with infectious 
people, so droplet and fomite transmission are challenging to distinguish.10 

The importance making efforts to break the spread of the COVID-19 virus can be done by 
complying with existing health protocols as a preventive measure in the spread of COVID-19. 
Efforts that all parties can take include social distancing, using masks outside the home, 



 
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washing hands with soap, and immediately cleaning up after activities outside the home.26 
Social distancing has a vital role in efforts to minimize interactions and crowds with many 
people. Social distancing is also one way to prevent the spread of the SARS-CoV-2 virus in a 
social group. This is because social distancing behavior will limit the reproduction rate in the 
spread of the virus among communities. In maintaining social distancing, people are strongly 
advised to postpone/avoid traveling to densely populated areas because they have a high risk 
of exposure.22 Another thing that can be done is a regional quarantine, also stated in the health 
emergency regulations. Regional quarantine is a restriction on the population in an area, 
including the entrance area and its contents suspected of being infected with a disease, to 
prevent the possibility of a more massive spread of COVID-19.21 

CONCLUSION 

The conclusion is made in one paragraph without any citation. The conclusion should not 
merely repeat points made in the preceding sections. 

Acknowledgment 

Based on the results and discussion, it can be concluded that contact is closely related to 
COVID-19 and is a risk factor. The community is expected to have the awareness to properly 
implement health protocols and minimize exposure by continuing to use masks if it requires 
activities with many people as an effort to reduce risks due to close contact. 

Declarations 

Authors' contribution 

The first and second authors contributed to the research design, data collection, analysis, 
and manuscript.  

Funding Statement 

 This research has not received external funding 

Conflict of interest 

There is no conflict of interest in this research.  

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