COVID-19 Preventive Behaviours in Cameroon: A Six-Month Online National Survey

Background: Cameroon was not spared by the coronavirus 2019 (COVID-19) pandemic, prompting the Cameroonian government to implement nationwide measures to stall viral transmission. However little is known about how well these unprecedented measures are being observed as the pandemic evolves. Methods: We conducted a six-month online survey to assess the preventive behaviour of Cameroonian adults during the COVID-19 outbreak. Sociodemographic data and personal history of respondents were obtained, and a 5-point adherence score was constructed based on self-reported observance of the following preventive measures: physical distancing, face mask use, hand hygiene, not touching one’s face, and covering the mouth when coughing or sneezing. Predictors of adherence were investigated using ordinal logistic regression models. Findings: Overall, 7,381 responses from all ten regions of Cameroon were analysed (mean age: 32·8±10·8; 73·3% male). During the two weeks preceding participation in the survey, 20 of the 496 tested respondents were positive for COVID-19 (positivity rate: 4·0%). Overall mean adherence score was 3·96±1·11 on a scale of 0–5. Mean weekly adherence scores were initially high, but gradually decreased over time accompanied by increasing incidence of COVID-19 during the last study weeks. Multivariable analyses revealed that older persons, those receiving COVID-19 information from health personnel, and those who agreed with the necessity of lockdown measures had higher odds for adherence, while experiencing flu-like symptoms was associated with poor adherence. Interpretation: Pending more permanent solutions like large scale COVID-19 vaccination, continuous observance of preventive measures should be encouraged among Cameroonians to avoid a resurgence in COVID-19 infections. Funding Statement: ERC Advanced Grant (671055) and VLIRUOS (Flemish University cooperation). Declaration of Interests: The authors have no conflicts of interest to declare. Ethics Approval Statement: This study was approved by the National Ethics Committee of Cameroon (Ref: 2020/05/1229/CE/CNERSH/SP of 06.5.20) as well as the Ethics Committee of the University of Antwerp, Belgium (Ref: 20/13/148).