Household Disposal of Unused and Expired Medications: A Cross-Sectional Study on Awareness, Attitude, and Practice in Boma Health Zone, Democratic Republic of Congo, 2024.

Background: The accumulation of unused and expired medications (UEM) in households represents a growing public health and environmental concern, particularly in low-resource settings such as the Democratic Republic of Congo (DRC), where safe disposal infrastructure is limited and regulatory frameworks are weak. In the Boma Health Zone, previous environmental studies have documented pollution of the Kalamu River by solid and liquid waste, including pharmaceuticals, altering its physico-chemical and bacteriological properties. However, no systems for safe medication disposal are available to the public, and empirical data on household UEM disposal practices in the DRC are virtually nonexistent, highlighting the critical need for this research. Objective: This study assessed the knowledge, attitude, and practice (KAP) regarding UEM disposal among households in the Boma Health Zone, DRC. Methods: A community-based cross-sectional survey was conducted in April 2024 among 384 households, selected using a four-stage random sampling technique. Data were collected through face-to-face interviews using a structured questionnaire adapted from validated KAP surveys and administered via the Open Data Kit (ODK) app. Reliability was assessed using Cronbach's alpha ( Results: More than half of households (53.4%, Conclusion: Critical gaps in awareness and practice regarding UEM disposal persist in Boma, despite a willingness to engage in safer practices. Urgent, multilevel interventions are needed, including community awareness campaigns, the establishment of accessible take-back programs, and the development of a national pharmaceutical waste management policy.