• John Dinanga Ditekemena, Dalau Mukadi Nkamba, Hypolite Mavoko Muhindo, Joseph Nelson Fodjo Siewe, Christophe Luhata, Rafael Van den Bergh, Tshefu KitotoAntoinetteAEcole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo., Wim Van Damme, Jean Jacques Muyembe, and Robert Colebunders.
• Ecole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo jditekemena@hotmail.fr.
• BMJ Open. 2021 Jan 18; 11 (1): e043356.

ObjectivesWe 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.DesignA cross-sectional population-based online survey.SettingsThe 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.ParticipantsThe participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis.InterventionsBoth 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 MeasuresWe 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.ResultsData 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.ConclusionDespite 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(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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