Knowledge Attitudes and Practices of Students Regarding the Vaccine against Covid-19. Case of Students Living on the University Campuses of the University of Lubumbashi ()
1. Introduction
Coronaviruses (CoVs) are a group of related viruses that can cause respiratory tract infections in humans ranging from mild symptoms to lethal outcomes. Until now, there are seven genera of CoVs that are known to infect humans [2].
Vaccine hesitancy has been considered by the World Health Organization (WHO) as “one of the top-ten threats to global health” causing serious problems in achieving coverage for population immunity [3].
At the end of 2020, the new hope to counter the global pandemic―the COVID-19 vaccine―appeared. The first vaccines against COVID-19 were administered to the general public in Slovakia on 5 January [4].
The COVID-19 pandemic in the DRC is documented in the country from March 10, 2020, the date on which the first case was confirmed in the territory by the INRB. The DRC thus becomes the 11th African country affected by COVID-19. As of July 11, 2020, there are a total of 7,122 cases of COVID-19 infection, with 175 deaths and 1,785 recovered, bringing the number of active patients to 5162. As of the 11 of the same months, the cumulative cases increases to 7,905 cases, 189 deaths and 3,513 cured. Although very far from South Africa (250,687 cases), this number of infected places the DRC in 10th position (out of 57) among the most infected countries in Africa. Despite the efforts made so far in this country, it should be noted that there is still a long way to go to contain this pandemic and limit its spread, particularly in compliance with the barrier measures published by the authorities in the name of the population [5].
The COVID-19 pandemic is a global public health crisis. The stakes involved in the development of a vaccine are economic rather than political. Overall, 20% of those infected develop a severe or critical form of the disease, with a crude case fatality rate currently above 3%, which increases in the elderly and in those with certain underlying pathologies [6].
The spread of COVID-19 in the world is a real health shock in that, since its occurrence, it has significantly affected morbidity and mortality rates as well as the capacities of national health systems, even in advanced countries, to take good care for patients. On March 31, 2020, the number of infected people worldwide was estimated at 735,560, with a fatality rate of 4.76%. This figure changes very quickly over time. In the space of a month, as of April 30, 2020, the number of people infected with COVID-19 worldwide has increased to 3.33 million, a 4.53-fold increase with a fatality rate of 7% [7].
Vaccination in general has been considered the most life-saving intervention for a century and has gradually established itself as the best solution against infectious diseases. Vaccine hesitancy is ipso facto considered one of the ten greatest health threats by the WHO. In March 2020, 10 days after the first confinement, nearly 25% of the 5108 French people questioned, representatives of the general population, declared that they would probably or certainly refuse the vaccines against COVID-19 if it existed [1].
2. Methodology
We conducted a cross-sectional study on the campus of the university residences of the University of Lubumbashi in the Democratic Republic of the Congo in the province of Haut-Katanga, city of Lubumbashi from 01/01/2021 to 30/06/2021. Our study is descriptive cross-sectional, and the study population consists of students residing in university residences.
2.1. Study Population and Sampling
Our study population consisted of student living on the University of Lubumbashi campus.
Regularly registered students who are housed in one of two homes during our study period were included in our study, while all non-regularly registered students as well as those regularly registered and staying in one of the homes outside from our study were excluded from our study.
Our sampling is probabilistic at two stages: The first stage allowed us to identify the different homes that were considered as clusters. Of these homes, we have chosen two, one of which houses the girls (Wards 2) and the other the boys (Wards 10). The second stage consisted in choosing in a simple random way at the rate of 50% in each cluster after drawing up two sampling frames for the two clusters.
Regarding the sample size, as it was said in the sampling, we took 50% in each cluster. Home 2 accommodates 192 female students and Home 10 accommodates 193 students. The size is donations: 193 students.
2.2. Data Collection
The data of our study were collected on a form and encoded with Excel, analyzed with the software Epi info version 7.2.0.1 to be analyzed.
3. Results
From Figure 1, we notice that 95% or 49.22% of the students were of the Pentecostal religion.
As shown in Table 1, the average age is 23.3 years with a male predominance (50.3%).
As shown in Table 2, in 65.28% of cases, students were not ready to be vaccinated against 67% or 34.72%; One hundred and twenty-nine (129) students said that they always respect the barrier measures (gestures).
As shown in Table 3, there is a link between the acceptability of the vaccine and the post-injection manifestations as well as confidence in the vaccine (P = 0.00).
As shown in Table 4, confidence in the vaccine depends on post injection manifestations (P = 0.00).
As shown in Table 5, the obligatory nature of the vaccine depends on the confidence in the vaccine (P = 0.0003).
As shown in Table 6, knowledge of the importance of the vaccine depends on confidence in the vaccine as well as post-injection manifestations (P < 0.05).
As shown in Table 7, compliance with barrier measures has no connection with gender, level of education or age (P > 0.05).
4. Discussion
Figure 1 indicates that 95% or 49.22% of the students were of the Pentecostal religion.
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Figure 1. Distribution of student by religion.
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Table 1. Sociodemographic characteristics.
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Table 2. Distribution of students according to knowledge, attitudes and practices on COVID-19.
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Table 3. Association between acceptability and other study variables.
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Table 4. Association between confidence in the vaccine and the other variables.
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Table 5. Association between the obligatory nature of the vaccine and the other variables of the study.
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Table 6. Association between knowledge of vaccine importance and study variables.
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Table 7. Association between compliance with barrier measures and study variables.
Table 1 indicates that there were more students whose age is between 18 and 24 years old with an average age of 23.3 years old, a minimum age of 18 years old and a maximum age of 30 years old. This result can be explained by the fact that the age between 18 and 24 represents the age group of most Congolese students. These observations have also been made in Algeria [8].
We observed a large proportion of male students 97 (50.3%) (Table 3). Our results are different from those of a study conducted at the Higher Institute of Medical Techniques of Lubumbashi which reveals that most respondents were under the age of 25 (49.2%); the mean age was 26.4 ± 6.5 years. Female students were more observed (75.2%) [9]. On the other hand, some studies have found that women were in the majority [8].
According to Table 2, most students (65.3%) do not agree to be vaccinated and post-injection manifestations represent the large proportion of refusal to be vaccinated. Vaccine acceptability has a significant relationship with post-injection manifestations (Table 4). Our results are different from the study of medical students at a single allopathic medical school in Southeast Michigan which found that nearly all participants had positive attitudes toward vaccines; however, only 53% indicated they would participate in a COVID-19 vaccine trial and 23% were unwilling to take a COVID-19 vaccine [10]. Arati and the other authors found the same results in a study conducted on medical and dental students [11]. In Morocco, among health science students in Morocco, 26.9% of participants said they were willing to receive the vaccine against COVID-19 [12]. In Italy, Barello et al., found that 86.1% of students would choose to be vaccinated against the COVID-19 coronavirus compared to 13.9% who would not [13].
The post-injection manifestations as well as the confidence in the vaccine are the basis of the refusal to be vaccinated (P = 0.00). Confidence in the vaccine is influenced by post-injection manifestations (P = 0.00). Our results are similar to those found by Lucia et al. who found that fear of serious side effects was independently predictive of a lower likelihood of intention to participate in a COVID-19 vaccine trial (AOR = 0.41, P = 0.01) [10]. In the United States, according to a theory-based analysis (multi-theory model: MTM), behavioural trust (b = 0.089, p < 0.001), participatory dialogue (b = 0.056, p < 0.001) and changes in the Physical environment (b = 0.066, p = 0.001) were significantly associated with acceptance of the COVID-19 vaccine among those who were not hesitant to take the vaccine and accounted for 54.8% of the variance. Of those who were hesitant to take the COVID-19 vaccine, the MTM construct of behavioural trust (b = 0.022, p < 0.001) was significant with political affiliation to the Republican Party (b = −0.464, p = 0.004), which was negatively associated with vaccine acceptance [14]. In Egypt, the most confirmed barriers to vaccination against COVID-19 were insufficient data regarding the adverse effects of the vaccine (potential 74.17% and unknown 56.31%) and insufficient information regarding the vaccine itself (72.76%) [15]. In Italy, the most common reasons given for refusing the vaccine were: being against vaccines in general, safety concerns/thinking that a hastily produced vaccine is too dangerous, seeing the vaccine as unnecessary due to the harmless nature of COVID-19, general lack of trust, doubts about the effectiveness of the vaccine, belief of being already immune, doubt about the provenance of the vaccine [16].
Regarding the time indicated to respect the barrier measures (rules), 66.8% of students always observe them while 33.2% only respect them at their faculty or school (Table 2). Compliance with the barrier measures against the “COVID-19” coronavirus in the premises of the Faculty of Medicine of Sousse was an obligation for all students. Failure to comply with this measure may be subject to disciplinary action for breach of article 18 of the internal regulations “Student behaviour” [17]. In addition, Ngoyi in his study conducted in Lubumbashi indicates that 82.9% of students do not respect the barrier measures [9].
Regarding knowledge of the source of COVID-19, Table 2 shows that bad luck was cited in 27.9% of cases, the disease of dirty hands diseases (13.5%) while most students cited other causes (58.5%).
People who do not trust the vaccine do not advocate for the compulsory nature of the vaccine against COVID-19 (Table 5) and the compulsory nature of the vaccine depends on the trust in the vaccine (P = 0.0003). In France, the Ministry of Solidarity and Public Health as well as the Ministry of Higher Education, Research and Innovation had instructed the implementation of the vaccination obligation for students and pupils in Health [18].
Concerning the Knowledge of the importance of the vaccine, Table 6 shows a significant link with confidence in the vaccine (P = 0.00), and post-injection manifestations (P = 0.0002).
Knowledge of the importance of the vaccine depends on confidence in the vaccine as well as post-injection manifestations (P < 0.05) (Table 6).
In our study, we found no link between compliance with barrier measures and gender, level of education and age (P > 0.05) as shown in Table 7.
5. Conclusion
We conducted a cross-sectional study on the acceptability of the COVID-19 vaccine in the university residences of the University of Lubumbashi. In 49.22% of cases, the students were of the Pentecostal religion with an average age of 23.3 years old. Most students (65.3%) do not agree to be vaccinated and post-injection manifestations represent a large proportion of refusal to be vaccinated. Vaccine acceptability has a significant relationship with post-injection manifestations. It is important that good awareness of vaccination is done to make the vaccine against COVID-19 acceptable among students.