Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey

John Dinanga Ditekemena; Dalau Mukadi Nkamba; Hypolite Mavoko Muhindo; Joseph Nelson Fodjo Siewe; Christophe Luhata; Rafael Van den Bergh; Antoinette Tshefu Kitoto; Wim Van Damme; Jean Jacques Muyembe; Robert Colebunders

doi:10.1136/bmjopen-2020-043356

Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey

John Dinanga Ditekemena, Dalau Mukadi Nkamba, Hypolite Mavoko Muhindo, Joseph Nelson Fodjo Siewe, Christophe Luhata, Rafael Van den Bergh, Antoinette Tshefu Kitoto, Wim Van Damme, Jean Jacques Muyembe, Robert Colebunders

Health Policy

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Abstract

OBJECTIVES: We aimed to assess the level of adherence to COVID-19 preventive measures in the Democratic Republic of the Congo (DRC) and to identify factors associated with non-adherence.

DESIGN: A cross-sectional population-based online survey.

SETTINGS: The study was conducted in 22 provinces of the DRC. Five provinces with a satisfactory number of respondents were included in the analysis: Haut Katanga, Kasaï-Central, Kasaï-Oriental, Kinshasa and North Kivu.

PARTICIPANTS: The participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis.

INTERVENTIONS: Both convenience sampling (surveyors themselves contacted potential participants in different districts) and snowball sampling (the participants were requested to share the link of the questionnaire with their contacts) methods were used.

PRIMARY AND SECONDARY OUTCOME MEASURES: We computed adherence scores using responses to 10 questions concerning COVID-19 preventive measures recommended by the WHO and the DRC Ministry of Health. We used logistic regression analysis with generalised estimating equations to identify factors of poor adherence. We also asked about the presence or absence of flu-like symptoms during the preceding 14 days, whether a COVID-19 test was done and the test result.

RESULTS: Data from 3268 participants were analysed. Face masks were not used by 1789 (54.7%) participants. Non-adherence to physical distancing was reported by 1364 (41.7%) participants. 501 (15.3%) participants did not observe regular handwashing. Five variables were associated with poor adherence: lower education level, living with other people at home, being jobless/students, living with a partner and not being a healthcare worker.

CONCLUSION: Despite compulsory restrictions imposed by the government, only about half of the respondents adhered to COVID-19 preventive measures in the DRC. Disparities across the provinces are remarkable. There is an urgent need to further explore the reasons for these disparities and factors associated with non-adherence.

Original language	English
Article number	e043356
Journal	BMJ Open
Volume	11
Issue number	1
Number of pages	9
ISSN	2044-6055
DOIs	https://doi.org/10.1136/bmjopen-2020-043356
Publication status	Published - 2021

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Ditekemena, J. D., Nkamba, D. M., Muhindo, H. M., Siewe, J. N. F., Luhata, C., Van den Bergh, R., Tshefu Kitoto, A., Van Damme, W., Muyembe, J. J., & Colebunders, R. (2021). Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey. BMJ Open, 11(1), Article e043356. https://doi.org/10.1136/bmjopen-2020-043356

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title = "Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey",

abstract = "OBJECTIVES: We aimed to assess the level of adherence to COVID-19 preventive measures in the Democratic Republic of the Congo (DRC) and to identify factors associated with non-adherence.DESIGN: A cross-sectional population-based online survey.SETTINGS: The study was conducted in 22 provinces of the DRC. Five provinces with a satisfactory number of respondents were included in the analysis: Haut Katanga, Kasa{\"i}-Central, Kasa{\"i}-Oriental, Kinshasa and North Kivu.PARTICIPANTS: The participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis.INTERVENTIONS: Both convenience sampling (surveyors themselves contacted potential participants in different districts) and snowball sampling (the participants were requested to share the link of the questionnaire with their contacts) methods were used.PRIMARY AND SECONDARY OUTCOME MEASURES: We computed adherence scores using responses to 10 questions concerning COVID-19 preventive measures recommended by the WHO and the DRC Ministry of Health. We used logistic regression analysis with generalised estimating equations to identify factors of poor adherence. We also asked about the presence or absence of flu-like symptoms during the preceding 14 days, whether a COVID-19 test was done and the test result.RESULTS: Data from 3268 participants were analysed. Face masks were not used by 1789 (54.7%) participants. Non-adherence to physical distancing was reported by 1364 (41.7%) participants. 501 (15.3%) participants did not observe regular handwashing. Five variables were associated with poor adherence: lower education level, living with other people at home, being jobless/students, living with a partner and not being a healthcare worker.CONCLUSION: Despite compulsory restrictions imposed by the government, only about half of the respondents adhered to COVID-19 preventive measures in the DRC. Disparities across the provinces are remarkable. There is an urgent need to further explore the reasons for these disparities and factors associated with non-adherence.",

author = "Ditekemena, {John Dinanga} and Nkamba, {Dalau Mukadi} and Muhindo, {Hypolite Mavoko} and Siewe, {Joseph Nelson Fodjo} and Christophe Luhata and {Van den Bergh}, Rafael and {Tshefu Kitoto}, Antoinette and {Van Damme}, Wim and Muyembe, {Jean Jacques} and Robert Colebunders",

note = "FTX; DOAJ; (CC BY-NC 4.0)",

year = "2021",

doi = "10.1136/bmjopen-2020-043356",

language = "English",

volume = "11",

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number = "1",

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Ditekemena, JD, Nkamba, DM, Muhindo, HM, Siewe, JNF, Luhata, C, Van den Bergh, R, Tshefu Kitoto, A, Van Damme, W, Muyembe, JJ & Colebunders, R 2021, 'Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey', BMJ Open, vol. 11, no. 1, e043356. https://doi.org/10.1136/bmjopen-2020-043356

TY - JOUR

T1 - Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey

AU - Ditekemena, John Dinanga

AU - Nkamba, Dalau Mukadi

AU - Muhindo, Hypolite Mavoko

AU - Siewe, Joseph Nelson Fodjo

AU - Luhata, Christophe

AU - Van den Bergh, Rafael

AU - Tshefu Kitoto, Antoinette

AU - Van Damme, Wim

AU - Muyembe, Jean Jacques

AU - Colebunders, Robert

N1 - FTX; DOAJ; (CC BY-NC 4.0)

PY - 2021

Y1 - 2021

N2 - OBJECTIVES: We aimed to assess the level of adherence to COVID-19 preventive measures in the Democratic Republic of the Congo (DRC) and to identify factors associated with non-adherence.DESIGN: A cross-sectional population-based online survey.SETTINGS: The study was conducted in 22 provinces of the DRC. Five provinces with a satisfactory number of respondents were included in the analysis: Haut Katanga, Kasaï-Central, Kasaï-Oriental, Kinshasa and North Kivu.PARTICIPANTS: The participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis.INTERVENTIONS: Both convenience sampling (surveyors themselves contacted potential participants in different districts) and snowball sampling (the participants were requested to share the link of the questionnaire with their contacts) methods were used.PRIMARY AND SECONDARY OUTCOME MEASURES: We computed adherence scores using responses to 10 questions concerning COVID-19 preventive measures recommended by the WHO and the DRC Ministry of Health. We used logistic regression analysis with generalised estimating equations to identify factors of poor adherence. We also asked about the presence or absence of flu-like symptoms during the preceding 14 days, whether a COVID-19 test was done and the test result.RESULTS: Data from 3268 participants were analysed. Face masks were not used by 1789 (54.7%) participants. Non-adherence to physical distancing was reported by 1364 (41.7%) participants. 501 (15.3%) participants did not observe regular handwashing. Five variables were associated with poor adherence: lower education level, living with other people at home, being jobless/students, living with a partner and not being a healthcare worker.CONCLUSION: Despite compulsory restrictions imposed by the government, only about half of the respondents adhered to COVID-19 preventive measures in the DRC. Disparities across the provinces are remarkable. There is an urgent need to further explore the reasons for these disparities and factors associated with non-adherence.

AB - OBJECTIVES: We aimed to assess the level of adherence to COVID-19 preventive measures in the Democratic Republic of the Congo (DRC) and to identify factors associated with non-adherence.DESIGN: A cross-sectional population-based online survey.SETTINGS: The study was conducted in 22 provinces of the DRC. Five provinces with a satisfactory number of respondents were included in the analysis: Haut Katanga, Kasaï-Central, Kasaï-Oriental, Kinshasa and North Kivu.PARTICIPANTS: The participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis.INTERVENTIONS: Both convenience sampling (surveyors themselves contacted potential participants in different districts) and snowball sampling (the participants were requested to share the link of the questionnaire with their contacts) methods were used.PRIMARY AND SECONDARY OUTCOME MEASURES: We computed adherence scores using responses to 10 questions concerning COVID-19 preventive measures recommended by the WHO and the DRC Ministry of Health. We used logistic regression analysis with generalised estimating equations to identify factors of poor adherence. We also asked about the presence or absence of flu-like symptoms during the preceding 14 days, whether a COVID-19 test was done and the test result.RESULTS: Data from 3268 participants were analysed. Face masks were not used by 1789 (54.7%) participants. Non-adherence to physical distancing was reported by 1364 (41.7%) participants. 501 (15.3%) participants did not observe regular handwashing. Five variables were associated with poor adherence: lower education level, living with other people at home, being jobless/students, living with a partner and not being a healthcare worker.CONCLUSION: Despite compulsory restrictions imposed by the government, only about half of the respondents adhered to COVID-19 preventive measures in the DRC. Disparities across the provinces are remarkable. There is an urgent need to further explore the reasons for these disparities and factors associated with non-adherence.

U2 - 10.1136/bmjopen-2020-043356

DO - 10.1136/bmjopen-2020-043356

M3 - A1: Web of Science-article

C2 - 33462101

SN - 2044-6055

VL - 11

JO - BMJ Open

JF - BMJ Open

IS - 1

M1 - e043356

ER -

Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey

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