Table 2.
Parameter estimates of the effect of COVID-19 and the lockdown policy on rates of total outpatient visits, visits for common infectious diseases and non-communicable diseases and maternal and child health services in Kinshasa, DRC
| 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.