Predictors of Non-Adherence to Public Health Instructions During the COVID-19 Pandemic in the Democratic Republic of the Congo
Michel Kabamba Nzaji,1,2 Guillaume Ngoie Mwamba,1,3 Judith Mbidi Miema,2 Elie Kilolo Ngoy Umba,1 Ignace Bwana Kangulu,1 Deca Blood Banza Ndala,4 Paul Ciamala Mukendi,5 Denis Kabila Mutombo,4 Marie Claire Balela Kabasu,4 Moise Kanyki Katala,4 John Kabunda Mbala,4 Oscar Luboya Numbi6 1Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of the Congo; 2Operational Research Unit, Ministry of Health, National Expanded Program for Immunization, Kinshasa, Democratic Republic of the Congo; 3Village Reach, Kinshasa, Democratic Republic of the Congo; 4Department of Epidemiology and Public Health, Nursing Care Section, Higher Institute of Medical Techniques of Lubumbashi, Lubumbashi, Democratic Republic of the Congo; 5Department of Teaching and Administration in Nursing, Nursing Section, Higher Institute of Medical Techniques of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo; 6Department of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the CongoCorrespondence: Michel Kabamba Nzaji Email michelnzaji@yahoo.frBackground: Adherence to public health instructions for the COVID-19 is important for controlling the transmission and the pandemic's health and economic impacts. The aim of this study was to determine the associated factors of non-adherence to public health and social measures instructions.Methods: This was a cross-sectional study conducted with 1913 participants in two provinces of DRC, Mbuji-Mayi, and Kamina. Predictors of non-adherence to COVID-19 preventive measures were identified using binary logistic regression analysis. P-value< 0.05 was considered as a significant predictor.Results: Among 1913 participants (1057 [55.3%] male, age 34.1 [14.9] years), 36.6% were defined as non-adherents. Non-adherence was associated with never studied and primary education level [adjusted odds ratio (aOR)=1.63, CI=1.31– 2.03], unemployed status [aOR=1.29, CI=1.01– 1.67], living in Kamina (Haut-Lomami province) [aOR=1.63, CI=1.31– 2.03], female gender of head of household [aOR=1.53, CI=1.16– 2.03], no attending lectures/discussions about COVID-19 [aOR=1.61, CI=1.08– 2.40], not being satisfied with the measures taken by the Ministry of Health [aOR=2.26, CI=1.78– 2.81], not been regularly informed about the pandemic [aOR=2.25, CI=1.80– 2.03], and bad knowledge about COVID-19 [aOR=2.36, CI=1.90– 2.93].Conclusion: The rate of non-observance of preventive measures for the COVID-19 pandemic is high, and different factors contributed. The government has to counsel the permanent updating of messages taking into account the context and the progress of the pandemic by using several communication channels.Keywords: predictors, adherence, public health instructions, COVID-19 pandemic, DR Congo