Environmental and Behavioral Determinants of Community-Acquired Infections in a Peri-Urban Setting: A Cross-Sectional Study in Bokotola Neighborhood, Mbandaka, Democratic Republic of Congo
Abstract
Background
Community-acquired infections remain a persistent public health challenge, particularly in urban areas of low-income countries. In Mbandaka, Democratic Republic of Congo, the Bokotola neighborhood, characterized by its riverine location and deteriorating sanitation infrastructure, represents a hotspot of vulnerability to these diseases.
Objective
This study aimed to identify the major predisposing factors for community-acquired infections among households in Bokotola, with the goal of proposing evidence-based interventions.
Methods
A descriptive and analytical cross-sectional survey was conducted among a probabilistic sample of 400 heads of households. Data were collected using structured questionnaires and direct observation. Bivariate analysis employed Pearson's chi-square test, while multivariate logistic regression (backward stepwise method) was performed to identify independent risk factors, controlling for potential confounders.
Results
The prevalence of infectious episodes within households over the past 12 months was 70.0% (280/400). Access to essential services was critically inadequate: 75.0% of households relied on unimproved water sources, and 85.0% used non-hygienic latrines. Multivariate analysis identified three main independent determinants: lack of an operational handwashing station (aOR = 4.2; 95% CI: 1.8–9.4; p = 0.001), failure to treat drinking water at home (aOR = 3.85; 95% CI: 2.41–6.15; p = 0.001), and stagnation of wastewater or rainwater within the household plot (aOR = 2.8; 95% CI: 1.5–4.2; p = 0.005). Notably, home visits by community health workers showed no statistically significant association with reduced infection rates (p = 0.320).
Conclusion
Achieving a sustainable reduction in infectious incidence in Bokotola requires moving beyond simple awareness campaigns toward an integrated strategy that includes subsidizing inputs (water treatment products, soap), improving urban drainage, and promoting low-cost hygiene devices.
Keywords
Full text
How to cite
Ainane Booto, P. (2026). Environmental and Behavioral Determinants of Community-Acquired Infections in a Peri-Urban Setting: A Cross-Sectional Study in Bokotola Neighborhood, Mbandaka, Democratic Republic of Congo. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0054-environmental-and-behavioral-determinants-of-community-acquired-infect