Purpose: This study aims to estimate the acceptability of a future vaccine against COVID-19 and associated factors if offered in Congolese health-care workers (HCWs), since they have the highest direct exposure to the disease. Patients and Methods: We conducted an analytical cross-sectional study among 23 Congolese referral hospitals, including three university hospitals, located in three towns from March through 30 April 2020. The main outcome variable was healthcare workers’ acceptance of a future vaccine against COVID-19. The associated factors of vaccination willingness were identified through a logistic regression analysis. Results: A sample of 613 HCWs participated in the study and completed the study questionnaire, including 312 (50.9%) men and 301 (49.1%) women. Only 27.7% of HCWs said that they would accept a COVID-19 vaccine if it was available. From the logistic regression analysis, male healthcare workers (ORa=1.17, 95% CI: 1.15– 2.60), primarily doctors (ORa=1.59; 95% CI:1.03– 2.44) and having a positive attitude towards a COVID-19 vaccine (ORa=11.49; 95% CI: 5.88– 22.46) were significantly associated with reporting willingness to be vaccinated. Conclusion: For acceptability of vaccination against COVID-19 among others education among HCWs is crucial because health professionals’ attitudes about vaccines are an important determinant of their own vaccine uptake and their likelihood of recommending the vaccine to their patients.

Background: 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.

The SARS-CoV-2 (COVID-19) pandemic has had a tremendous impact on the functionality of health systems and world affairs. We assessed knowledge, attitudes, and practices (KAPs) of healthcare workers (HCWs) in the Democratic Republic of the Congo (DRC). This was a cross-sectional study conducted in 23 referral hospitals located in three towns of the DRC (Lubumbashi, Kamina, Mbuji-Mayi). In total, 613 HCWs were surveyed using the World Health Organization’s (WHO’s) “Exposure Risk Assessment in the Context of COVID-19” questionnaire. Participants included medical doctors (27.2%) and other categories of HCWs (72.8%). The mean age was 40.3 ± 11.7 years. Over 80% (range: 83–96%) of respondents had sufficient knowledge on each of the three domains: COVID-19 symptoms, disease transmission, and patient care approach. However, attitudes and practices scores were relatively low. Only 27.7% of HCWs were willing to receive a COVID-19 vaccine when it is available, whereas 55% of HCWs complied with good practices; 49.4% wore masks consistently and, surprisingly, only 54.9% used personal protective equipment (PPE) consistently at work and during contact with patients. Knowledge level was positively associated with the use of social media as a primary source of COVID-19-related information and the category of residence, with HCWs from towns already affected by the COVID-19 epidemic being more likely to have positive attitudes (adjusted OR, 1.64; 95%CI, 1.32–2.20) and comply with good practices (aOR, 2.79; 95%CI, 1.93-4.06). This study showed that most Congolese HCWs had sufficient knowledge on COVID-19, whereas the majority did not comply with consistent PPE use. The government of the DRC should urgently take major steps in capacity building for HCWs in outbreak preparedness and supplying hospitals with PPE.

Significance: This paper describes findings from a seroepidemiologic study involving a cohort of Ebola-vaccinated individuals from North Kivu, Democratic Republic of the Congo (DRC), who were studied as part of a collaborative effort between American and Congolese scientists and epidemiologists. Our study examines antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among Ebola virus disease–exposed and potentially exposed populations in the DRC. At 21 d of follow-up, 87.2% had an antibody response. Additionally, 95.6% demonstrated antibody persistence at 6 mo of follow-up. These findings give crucial evidence that antibody response and persistence after Ebola vaccination is robust in outbreak settings in the DRC, knowledge that significantly informs the use of vaccination for outbreak control.

Background: Malnourished children in low- and middle-income countries (LMICs) often exhibit reduced vaccine efficacy, particularly for oral vaccines like polio and rotavirus, due to impaired immune responses. Nutritional deficiencies, such as in vitamin A and zinc, along with environmental factors like poor sanitation, exacerbate this issue. Existing research has explored the individual impacts of malnutrition on vaccine outcomes, but a comprehensive framework that integrates nutritional, immune, and environmental factors has been lacking. Objective: This article proposes a new conceptual framework that integrates nutritional status, immune function, and environmental context to explain the reduced vaccine efficacy in malnourished populations. The study highlights practical interventions to improve vaccine outcomes in these vulnerable populations. Methods: A comprehensive literature review was conducted, focusing on vaccine efficacy in malnourished children, with data drawn from cross-sectional surveys, program evaluations, and peer-reviewed studies. Key interventions, including vitamin A supplementation, flexible immunization schedules, and environmental health programs, were analyzed for their impact on improving seroconversion rates. Results: The review confirms that malnourished children exhibit significantly lower seroconversion rates for vaccines like oral polio and rotavirus, with a 30– 40% reduction in efficacy for OPV and up to a 50% reduction for rotavirus. Nutritional interventions, particularly vitamin A supplementation, increased seroconversion rates by up to 30%, while flexible vaccination schedules and environmental improvements further enhanced vaccine responses in severely malnourished populations. Conclusion: This framework addresses a critical gap in the literature by offering a holistic approach that integrates nutrition, immunization, and environmental health. Global health organizations, such as WHO and UNICEF, must prioritize the integration of nutrition and immunization programs, alongside environmental health initiatives, to reduce the burden of vaccine-preventable diseases in malnourished populations. Future research should focus on longitudinal studies to assess the long-term impact of these integrated interventions.

Hesitancy to receive the COVID-19 vaccine among healthcare workers (HCWs) in low-resource settings, such as the Democratic Republic of the Congo (DRC), is a major global health challenge. This study identifies changes in willingness to receive vaccination among 588 HCWs in the DRC and reported influences on COVID-19 vaccination intentions. Up to 25 repeated measures were collected from participants between August 2020 to August 2021. Among the overall cohort, between August 2020 and mid-March 2021, the proportion of HCWs in each period of data collection reporting COVID-19 vaccine hesitancy ranged from 8.6% (95% CI: 5.97, 11.24) to 24.3% (95% CI: 20.12, 28.55). By early April 2021, the proportion reporting hesitancy more than doubled (52.0%; 95% CI: 46.22, 57.83). While hesitancy in the cohort began to decline by late-June 2021, 22.6% (95% CI: 18.05, 27.18) respondents indicated hesitancy in late-August 2021 which remains greater than the proportion of hesitancy at any time prior to early-March 2021. Patterns in reported influences on COVID-19 vaccination were varied with the proportion reporting some influences (e.g., no serious side effects, country of vaccine production) remaining stable throughout the year and other factors (e.g., recommendation of Ministry of Health, ease of vaccination) falling in popularity among respondents. Agreement that the national vaccination schedule should be followed apart from the COVID-19 vaccine remained high among respondents throughout the study period. This study shows that, among a cohort of HCWs in the DRC who have likely been influenced by regional, national, and global factors, COVID-19 vaccine hesitancy has fluctuated during the pandemic and should not be treated as a static factor. Additional research to determine which factors most influence HCWs’ willingness to receive the COVID-19 vaccine offers opportunities to reduce vaccine hesitancy among this important population through tailored public health messaging.