The emergence of COVID-19 in the Democratic Republic of Congo: Community knowledge, attitudes, and practices in Kinshasa

BackgroundThe first COVID-19 case in the Democratic Republic of Congo (DRC) was reported on 10 March 2020 in Kinshasa, prompting the government to promote internationally agreed non-pharmacological interventions for infection prevention and control. Public compliance to these measures is critical and depends on the knowledge, attitudes, and practices (KAP) of communities regarding COVID-19, for which there was no data. This study aimed to bridge that gap. MethodsA community-based cross-sectional study was conducted in Kinshasa in June 2020, during the emergency state, following a four-stage sampling process. Master's students from the Kinshasa School of Public Health conducted the survey. Descriptive and regression analyses were performed. ResultsThe study enrolled 726 women and 600 men (mean age: 43; SD 16-85). Nearly everyone heard about COVID-19 (mainly through television, radio, and street reports), but only 17% were highly knowledgeable about its transmission modes, signs and symptoms, and preventive measures. More than 80% of participants believed in the disease's seriousness; however, only 21% found the total lockdown acceptable. Nonetheless, 86% reported regular hand cleaning and mask-wearing followed by physical distancing (72%). Poorer, younger, and non-Catholic participants were overall markedly less knowledgeable and had comparatively lower levels of health-protective attitudes, acceptance, and practices. The education level and household size did not matter. Female participants tended to show fewer enabling attitudes and practices toward COVID-19 prevention measures compared to men. ConclusionAdequate public health information to improve the population's KAP related to COVID-19 is critical and must be designed with and delivered to the community-considering the specific needs of diverse sub-groups and contexts. Studies in Kinshasa and similar settings are necessary to understand the barriers to and enablers of acquiring, applying, and maintaining the optimal population's KAP for COVID-19 prevention and control.