Department of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
Department of Ophthalmology, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
Glob Health Sci Pract. 2020 Dec 23;8(4):638-653. doi: 10.9745/GHSP-D-20-00272.
The coronavirus disease (COVID-19) pandemic poses a grave threat to refugees and internally displaced persons (IDPs). We examined knowledge, attitudes, and practices with respect to COVID-19 prevention among IDPs in war-torn Eastern Democratic Republic of the Congo (DRC).
Mixed-methods study with qualitative (focus group discussions, [FGDs]) and quantitative (52-item survey questionnaire) data collection and synthesis.
FGDs (N=23) and survey questionnaires (N=164 IDPs; N=143 comparison group) were conducted in May 2020. FGD participants provided narratives of violence that they had fled. IDPs were statistically more likely to have larger household size, experience more extreme poverty, have lower educational attainment, and have less access to information through media and internet versus the comparison group (<.05 for the comparison group). IDPs had a high level of awareness (99%) and fear (98%) of COVID-19, but lower specific knowledge (15% sufficient knowledge versus 30% among the comparison group, <.0001), a difference which remained significant in a multivariable model adjusting for confounding. IDPs faced major barriers to implementing COVID-19 prevention measures. Physical distancing was impossible for IDPs in crowded shelters, and 70% reported coming in close contact with someone other than a family member within the past 24 hours (versus 56% of the comparison group, =.014). Frequent movements in and out of the camp for subsistence left IDPs vulnerable to the introduction of COVID-19: 61% left the camp on a daily basis and 65% had received a visitor in the past month. Despite acceptance of hand hygiene for prevention, 92% lacked soap (versus 65% of the comparison group, <.0001). IDPs' desire for peace and to return to their native homes, where COVID-19 precautions could be feasibly implemented, overshadowed their perceived benefits of measures such as a COVID-19 vaccine.
These findings provide empiric evidence supporting the vulnerability of IDPs to COVID-19 and call for action to protect neglected displaced populations.
冠状病毒病（COVID-19）大流行对难民和国内流离失所者（IDP）构成严重威胁。我们研究了饱受战争蹂躏的刚果民主共和国东部（DRC）的 IDP 对 COVID-19 预防的知识、态度和实践。
采用混合方法研究，结合定性（焦点小组讨论，FGD）和定量（52 项调查问卷调查）数据收集和综合分析。
2020 年 5 月进行了 FGD（N=23）和调查问卷调查（IDP 组 164 人；对照组 143 人）。FGD 参与者提供了他们逃离的暴力叙述。与对照组相比，IDP 组的家庭规模更大，经历更极端的贫困，教育程度更低，通过媒体和互联网获取信息的机会更少（<.05 对于对照组）。IDP 对 COVID-19 的认识程度很高（99%）和恐惧程度很高（98%），但具体知识水平较低（15%的知识足够，而对照组为 30%，<.0001），在调整混杂因素的多变量模型中，这种差异仍然具有统计学意义。IDP 实施 COVID-19 预防措施面临重大障碍。在拥挤的避难所中，IDP 无法保持身体距离，70%的人在过去 24 小时内与非家庭成员密切接触（而对照组为 56%，=.014）。为了生存而频繁进出营地使 IDP 容易感染 COVID-19：61%的人每天离开营地，65%的人在过去一个月内接待了访客。尽管接受了手部卫生来预防，但 92%的人缺乏肥皂（而对照组为 65%，<.0001）。IDP 对和平的渴望和返回他们的祖国，在那里可以切实实施 COVID-19 预防措施，超过了他们对 COVID-19 疫苗等措施的预期收益。
这些发现为 IDP 易感染 COVID-19 提供了经验证据，并呼吁采取行动保护被忽视的流离失所人口。
