Indicators | Gombe health zone | Other health zones (n=34) | ||||||||||
COVID-19 exposure and lockdown* | COVID-19 exposure and lockdown lifted† | COVID-19 exposure and no lockdown‡ | ||||||||||
Level change | Trend change | Level change | Trend change | Level change | Trend change | |||||||
IRR (95% CI) | P value | IRR (95% CI) | P value | IRR (95% CI) | P value | IRR (95% CI) | P value | IRR (95% CI) | P value | IRR (95% CI) | P value | |
Overall visits and by sex, age and facility tier | ||||||||||||
Total outpatient visits | 0.19 (0.12 to 0.32) | <0.001 | 1.05 (0.85 to 1.30) | 0.62 | 2.50 (1.81 to 3.45) | <0.001 | 0.90 (0.72 to 1.12) | 0.35 | 0.84 (0.81 to 0.86) | <0.001 | 1.00 (0.99 to 1.01) | 0.04 |
Female | 0.16 (0.08 to 0.33) | <0.001 | 1.12 (0.82 to 1.53) | 0.44 | 2.55 (1.60 to 4.06) | <0.001 | 0.83 (0.60 to 1.14) | 0.25 | 0.84 (0.82 to 0.88) | <0.001 | 1.01 (1.00 to 1.02) | 0.04 |
Male | 0.24 (0.12 to 0.46) | <0.001 | 0.98 (0.74 to 1.30) | <0.90 | 2.42 (1.57 to 3.74) | <0.001 | 0.98 (0.73 to 1.31) | 0.90 | 0.82 (0.79 to 0.85) | <0.001 | 1.01 (1.00 to 1.01) | 0.04 |
Under 5 years | 0.12 (0.07 to 0.22) | <0.001 | 1.05 (0.82 to 1.35) | <0.67 | 2.42 (1.68 to 3.50) | <0.001 | 0.97 (0.75 to 1.25) | 0.81 | 0.85 (0.82 to 0.88) | <0.001 | 0.99 (0.99 to 1.00) | 0.93 |
5 years and over | 0.21 (0.14 to 0.30) | <0.001 | 1.08 (0.92 to 1.28) | 0.32 | 2.40 (1.86 to 3.11) | <0.001 | 0.85 (0.72 to 1 to 01) | 0.07 | 0.83 (0.81 to 0.85) | <0.001 | 1.01 (1.00 to 1.01) | to 0.001 |
Health centres | 0.18 (0.08 to 0.37) | <0.001 | 1.27 (0.94 to 1.71) | 0.10 | 2.14 (1.42 to 3.22) | <0.001 | 0.77 (0.56 to 1.04) | 0.09 | 0.90 (0.87 to 0.92) | <0.001 | 1.00 (0.99 to 1.01) | 0.09 |
Hospitals | 0.21 (0.09 to 0.47) | <0.001 | 0.95 (0.65 to 1.38) | 0.78 | 2.65 (1.44 to 4.87) | 0.001 | 0.99 (0.67 to 1.47) | 0.99 | 0.71 (0.66 to 0.77) | <0.001 | 1.01 (0.99 to 1.02) | 0.10 |
Common IDs | ||||||||||||
Malaria case diagnoses | 0.10 (0.05 to 0.20) | <0.001 | 1.48 (1.10 to 1.99) | 0.008 | 1.72 (1.10 to 2.68) | 0.01 | 0.64 (0.47 to 0.87) | 0.004 | 0.81 (0.78 to 0.85) | <0.001 | 1.00 (1.00 to 1.02) | 0.003 |
RDT for malaria done | 0.12 (0.06 to 0.27) | <0.001 | 1.18 (0.85 to 1.62) | 0.32 | 2.07 (1.25 to 3.43) | 0.004 | 0.79 (0.57 to 1.11) | 0.18 | 0.77 (0.74 to 0.80) | <0.001 | 1.01 (1.00 to 1.02) | 0.004 |
Diarrhoea case diagnoses | 0.19 (0.08 to 0.43) | <0.001 | 1.48 (1.05 to 2.09) | 0.02 | 1.75 (1.05 to 2.93) | 0.03 | 0.60 (0.42 to 0.85) | 0.004 | 0.75 (0.71 to 0.79) | <0.001 | 1.01 (1.00 to 1.02) | <0.001 |
Pneumonia case diagnoses | 0.25 (0.09 to 0.69) | 0.008 | 1.21 (0.78 to 1.86) | 0.38 | 1.59 (0.79 to 3.19) | 0.19 | 0.83 (0.52 to 1.30) | 0.41 | 0.71 (0.66 to 0.76) | <0.001 | 1.03 (1.02 to 1.04) | <0.001 |
NCDs | ||||||||||||
Diabetes new case diagnoses | 0.07 (0.03 to 0.19) | <0.001 | 1.55 (1.01 to 2.39) | 0.04 | 1.53 (0.85 to 2.39) | 0.15 | 0.70 (0.45 to 1.09) | 0.11 | 0.91 (0.82 to 0.99) | 0.03 | 0.98 (0.96 to 0.99) | 0.02 |
Hypertension new case diagnoses | 0.23 (0.07 to 0.70) | 0.01 | 1.11 (0.68 to 1.81) | 0.66 | 1.51 (0.72 to 3.2) | 0.27 | 0.90 (0.55 to 1.49) | 0.69 | 0.84 (0.79 to 0.89) | 0.001 | 1.00 (0.99 to 1.02) | 0.15 |
Maternal health | ||||||||||||
ANC1 visits | 0.57 (0.35 to 0.91) | 0.02 | 1.09 (0.89 to 1.34) | 0.39 | 1.11 (0.79 to 1.56) | 0.55 | 0.94 (0.76 to 1.17) | 0.63 | 1.04 (1.01 to 1.08) | 0.003 | 0.99 (0.99 to 1.00) | 0.59 |
Facility-based childbirth | 0.89 (0.64 to 1.25) | 0.51 | 0.98 (0.85 to 1.13) | 0.78 | 1.03 (0.79 to 1.33) | 0.81 | 0.99 (0.85 to 1.16) | 0.99 | 1.08 (1.04 to 1.11) | <0.001 | 1.00 (0.99 to 1.01) | 0.29 |
PNC2 visits | 1.02 (0.55 to 1.91) | 0.93 | 0.87 (0.67 to 1.14) | 0.33 | 0.89 (0.56 to 1.42) | 0.63 | 1.15 (0.87 to 1.53) | 0.32 | 1.07 (1.03 to 12) | <0.001 | 1.00 (0.99 to 1.01) | 0.13 |
Baseline (unexposed) period was January 2018 to February 2020.
*Exposed period: April to June 2020.
†Exposed period: July to December 2020.
‡Exposed period: April to December 2020.
ANC1, first antenatal care; DRC, Democratic Republic of the Congo; ID, infectious disease; IRR, incidence rate ratio; NCD, non-communicable disease; PNC2, second postnatal care; RDT, rapid diagnostic test.