Were the COVID-19 self-isolation regulations feasible for everyone? Determinants of non-adherence to social distancing in two densely populated districts of KwaZulu-Natal Province, South Africa
1
Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
2
Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa
3
Communicable Disease Control, KwaZulu-Natal Provincial Department of Health, Pietermaritzburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
South Africa (SA) implemented self-isolation (SI) guidelines to combat COVID-19, but factors for adherence remained unknown in settings with multiple vulnerabilities. This study examined SI practices and factors influencing non-adherence to social distancing among COVID-19-infected patients in KwaZulu-Natal Province, SA.
METHODS:
We conducted a cross-sectional study analyzing data from 237 COVID-19-infected patients aged 18 years and above who were isolated at home. The study utilized the Pearson chi-square and a logistic regression model to analyze the determinants of non-adherence to self-isolation protocols.
RESULTS:
Of the 237 patients, 73% (n=174) received SI advice from healthcare practitioners. Over a third of the patients (34%, 81) were Africans, with 53% (43) of them practicing African traditions as their religion. Some households had multiple occupants (≥5 members), and 31% shared bathrooms and bedrooms with family members. Of the 63% who used facial masks, 30% occasionally removed masks during conversations. Males performed better in waste disposal, while females were more diligent about daily handwashing and mask changes. Chi-squared analysis revealed significant differences between males and females in sharing a bedroom (p=0.003), cleaning the bathroom (p=0.008), engaging in household chores (p<0.001), and participating in entertainment activities (p<0.001). Factors associated with non-adherence to social distancing include a lack of trust in the government system (aOR 5.0; 95% CI: 1.9-12.9; p=0.001), household income of less than R4000 (aOR 3.2; 95% CI: 1.2-8.2; p=0.016), sharing a household with more than 5 people (aOR 4.9; 95% CI: 1.9-13.0; p=0.001), receiving a grant (aOR 5.2; 95% CI: 2.4-11.2; p<0.001), and living in open-plan houses (aOR 7.4; 95% CI: 2.1-25.9; p<0.001).
CONCLUSIONS:
Non-adherence to SI guidelines was associated with socio-economic disadvantages of households, including sharing bedrooms, low income, and poor housing structure. The study emphasizes the importance of economic empowerment for households to enhance their capacity to adapt to new pandemics.
South Africa (SA) implemented self-isolation (SI) guidelines to combat COVID-19, but factors for adherence remained unknown in settings with multiple vulnerabilities. This study examined SI practices and factors influencing non-adherence to social distancing among COVID-19-infected patients in KwaZulu-Natal Province, SA.
METHODS:
We conducted a cross-sectional study analyzing data from 237 COVID-19-infected patients aged 18 years and above who were isolated at home. The study utilized the Pearson chi-square and a logistic regression model to analyze the determinants of non-adherence to self-isolation protocols.
RESULTS:
Of the 237 patients, 73% (n=174) received SI advice from healthcare practitioners. Over a third of the patients (34%, 81) were Africans, with 53% (43) of them practicing African traditions as their religion. Some households had multiple occupants (≥5 members), and 31% shared bathrooms and bedrooms with family members. Of the 63% who used facial masks, 30% occasionally removed masks during conversations. Males performed better in waste disposal, while females were more diligent about daily handwashing and mask changes. Chi-squared analysis revealed significant differences between males and females in sharing a bedroom (p=0.003), cleaning the bathroom (p=0.008), engaging in household chores (p<0.001), and participating in entertainment activities (p<0.001). Factors associated with non-adherence to social distancing include a lack of trust in the government system (aOR 5.0; 95% CI: 1.9-12.9; p=0.001), household income of less than R4000 (aOR 3.2; 95% CI: 1.2-8.2; p=0.016), sharing a household with more than 5 people (aOR 4.9; 95% CI: 1.9-13.0; p=0.001), receiving a grant (aOR 5.2; 95% CI: 2.4-11.2; p<0.001), and living in open-plan houses (aOR 7.4; 95% CI: 2.1-25.9; p<0.001).
CONCLUSIONS:
Non-adherence to SI guidelines was associated with socio-economic disadvantages of households, including sharing bedrooms, low income, and poor housing structure. The study emphasizes the importance of economic empowerment for households to enhance their capacity to adapt to new pandemics.
| eISSN: | 2654-1459 |
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