A cross-sectional study examining generalized anxiety disorder among healthcare workers during the COVID-19 pandemic within the Democratic Republic of the Congo

Mental health resilience during outbreaks within insecure regions, and the subsequent mental health toll on healthcare workers (HCW), remains a largely unstudied and minimally understood phenomenon. This study examined generalized anxiety disorder (GAD) among healthcare workers (HCWs) and community members in the Democratic Republic of the Congo (DRC) during the COVID-19 pandemic, with a primary focus on the relationship between regional insecurity and GAD. A cross-sectional analysis was conducted using data from 5,622 participants across all 26 DRC provinces collected between February and September 2022. GAD was measured using the GAD-7 screening tool. Multivariate logistic regression was used to assess associations between mild to severe anxiety (GAD score >5) and participant characteristics, including region, housing, and vaccination status. Mild to severe anxiety was identified in 4% of participants. No significant association was found between residence in insecure regions and anxiety. However, being vaccinated against COVID-19 (aOR: 0.68, 95% CI: 0.52-0.89) and having stable housing (aOR: 0.13, 95% CI: 0.05-0.32) were significantly protective. While regional insecurity was not associated with anxiety in this analysis, access to vaccination and housing emerged as key protective factors. These findings highlight urgent directions for intervention and further research on mental health resilience in crisis settings.