Quality of life and factors associated among caregivers of adolescent and young adult Ebola survivors in Democratic Republic of the Congo, a cross-sectional study | BMC Public Health

Study design

This was a cross-sectional study.

Setting

The study was conducted in the health districts of Beni and Katwa in North Kivu, Democratic Republic of the Congo (DRC). North Kivu is one of the provinces in Eastern part of DRC and has a population of about 1.9 million. It borders Lake Kivu.

Study period

The study was carried out during a 4 months’ period from April to August 2022.

Study participants

Participants of the study were caregivers of adolescents and young adult Ebola virus survivors. Random sampling technique was used to select the 68 study participants.

Caregivers of adolescents and young adult Ebola virus survivors were enrolled when they stayed for 4 months with adolescents or young adult Ebola virus survivors in the study setting.

Caregivers had a thorough history and a complete physical examination undertaken to capture their social demographics, co morbidities as well as the bio-medical characteristics, using the designed questionnaire for data collection. Further information regarding other chronic illnesses (asthma, renal, hepatic, cardiac impairment and known cases of symptomatic HIV/AIDS) as well as chronic medication was also obtained through reviewing the caregiver’s medical records. Severely ill caregivers with chronic health problems and who were unable to provide adequate information were excluded to the study.

The provision of written informed consent was required for all study participants before enrolment into the study.

Sample size calculations

A total sample size of 68 participants was estimated using the Kish Leslie (1965) formula for finite populations, based on determinants of quality of life among adolescent and young adult Ebola survivors in Democratic Republic [10]. The formula for the sample size of surveys i.e. the Kish Leslie (1965) formula below was used (adjusted for available population): sample size = n/1 + n/N, where n = z² x p (1-p)/e².

Study procedures

Data was collected using CommCare by Dimagi.Inc. Version 2.52.1. Sociodemographic, community and medical variables were collected. Socio-demographic variables included; age (25–55 and > 55), sex, education level (None/Primary, Secondary, higher), marital status (married, single), residence (rural, urban), religion (protestant, catholic, other) and socio-economic status. The medical variables were muscle pain, chest pain, fatigue, sleep problems. Community variables wee social support, stigma, experienced stress. Data was collected using the interviewer administered pretested questionnaires of WHO quality of life BREF (WHOQOL-BREF). A total score < 78 was regarded as poo quality of life and a sum of ≥ 78 indicates good quality of life [10, 11]. A Likert scale was used to measure the quality of life ranging from 1- not at all, 2- slight, 3- moderate, 4- very, 5- complete. The assessed parameters on WHO quality of life BREF were physical health, psychological health, social health and environment health.

Data were collected by trained research assistants who interviewed the caregivers of adolescents and young adult EVD survivors.

Statistical analysis

Data was entered using CommCare by Dimagi.Inc. lastest Version 2.52.1 and exported into STATA version 12 for analysis. Descriptive analysis was used. Categorical variables were analysed using frequencies, proportions and percentages. The regression analysis produced odds ratio (OR), 95% confidence interval (CI), and p-value. The final multivariate model contained variables that were significant in the bivariate analysis. The research used the assumption that each pair of outcomes had a proportional chance of being either bad or good quality of life. The factors with P-values less than 0.05 were considered significant.

Ethical aspects

Prior to data collection, a research permit from National Ethical Committee of Research in Democratic Republic of Congo and Great Lake University of Kisumu-Kenya, helped to alleviate mistrust and allowed the participants to reveal much of the information required for the study. Written informed consents were obtained from literate or illiterate caregivers of adolescent and young adult Ebola survivors before enrolment into the study. Throughout the study, participants’ privacy and confidentiality were respected.