The first year of the COVID-19 pandemic in humanitarian settings: epidemiology, health service utilization, and health care seeking behavior in Bangui and surrounding areas, Central African Republic

Altare, Chiara; Kostandova, Natalya; Gankpe, Gbètoho Fortuné; Nalimo, Patricia; Almoustapha Abaradine, Abdoul Azizi; Bruneau, Sophie; Antoine, Caroline; Spiegel, Paul B.

doi:10.1186/s13031-023-00523-y

Conflict and Health

Table 2 Interrupted time series results for outcome indicators, by district, CAR, 2017–2021: Incidence rate ratio for immediate change and change in slope; classification of heterogeneity; cumulative difference and average monthly change

From: The first year of the COVID-19 pandemic in humanitarian settings: epidemiology, health service utilization, and health care seeking behavior in Bangui and surrounding areas, Central African Republic

Health district	N facilities	Measure	IRR [95%CI]	Heterogeneity	Cumulative difference [CI]	Average monthly % change [CI]
OPD
Bangui 1	7	Immediate effect	0.884 [0.628; 1.244]	Moderate	− 38,121 [− 61,185; − 15,900]	− 25 [− 37; − 5]
Bangui 1	7	Change in slope	1 [0.919; 1.088]	High	− 38,121 [− 61,185; − 15,900]	− 25 [− 37; − 5]
Bangui 2	10	Immediate effect	0.795 [0.615; 1.028]	Low	− 17,722 [− 23,938; − 11,348]	− 13 [− 33; 8593]
Bangui 2	10	Change in slope	0.985 [0.956; 1.016]	Low	− 17,722 [− 23,938; − 11,348]	− 13 [− 33; 8593]
Bangui 3	6	Immediate effect	0.989 [0.809; 1.208]	Moderate	7250 [16,67; 12,435]	21 [6; 42]
Bangui 3	6	Change in slope	1.017 [0.97; 1.067]	Low	7250 [16,67; 12,435]	21 [6; 42]
Begoua	17	Immediate effect	0.983 [0.684; 1.414]	High	− 46,501 [− 82,113; − 19,922]	− 34 [− 53; − 7]
Begoua	17	Change in slope	1.02 [0.968; 1.074]	Low	− 46,501 [− 82,113; − 19,922]	− 34 [− 53; − 7]
Bimbo	15	Immediate effect	1.052 [0.937; 1.182]	Low	− 14,390 [− 27,341; − 2950]	− 12 [− 22; 1]
Bimbo	15	Change in slope	0.98 [0.952; 1.009]	Low	− 14,390 [− 27,341; − 2950]	− 12 [− 22; 1]
Malaria
Bangui 1	7	Immediate effect	0.734 [0.285; 1.892]	High	− 8594 [− 13,812; − 3283]	− 19 [− 31; 4]
Bangui 1	7	Change in slope	1.041 [0.941; 1.152]	High	− 8594 [− 13,812; − 3283]	− 19 [− 31; 4]
Bangui 2	9	Immediate effect	0.929 [0.67; 1.288]	Low	− 6593 [− 10,068; − 3299]	35 [− 20; 4080]
Bangui 2	9	Change in slope	0.979 [0.911; 1.051]	Low	− 6593 [− 10,068; − 3299]	35 [− 20; 4080]
Bangui 3	8	Immediate effect	1.091 [0.885; 1.344]	Low	4345 [1153; 6998]	18 [5; 31]
Bangui 3	8	Change in slope	1.02 [0.955; 1.089]	Low	4345 [1153; 6998]	18 [5; 31]
Begoua	18	Immediate effect	1.116 [0.684; 1.82]	High	− 17,826 [− 24,192; − 11,621]	− 36 [− 46; − 24]
Begoua	18	Change in slope	0.973 [0.931; 1.016]	Low	− 17,826 [− 24,192; − 11,621]	− 36 [− 46; − 24]
Bimbo	17	Immediate effect	1.261 [0.983; 1.617]	High	2894 [624; 4996]	12 [3; 23]
Bimbo	17	Change in slope	0.997 [0.963; 1.032]	Low	2894 [624; 4996]	12 [3; 23]
RTI
Bangui 1	6	Immediate effect	0.984 [0.649; 1.494]	Low	301 [− 1394; 1688]	7 [− 6; 24]
Bangui 1	6	Change in slope	0.995 [0.905; 1.094]	Low	301 [− 1394; 1688]	7 [− 6; 24]
Bangui 2	9	Immediate effect	0.639 [0.404; 1.011]	High	− 8496 [− 12,824; − 4931]	742 [− 56; 2535]
Bangui 2	9	Change in slope	1.002 [0.945; 1.063]	Low	− 8496 [− 12,824; − 4931]	742 [− 56; 2535]
Bangui 3	5	Immediate effect	1.022 [0.55; 1.897]	Moderate	− 46 [− 1415; 1325]	6 [− 14; 33]
Bangui 3	5	Change in slope	1.031 [0.932; 1.141]	Low	− 46 [− 1415; 1325]	6 [− 14; 33]
Begoua	13	Immediate effect	0.888 [0.496; 1.591]	High	− 9337 [− 14,858; − 5479]	− 52 [− 63; − 40]
Begoua	13	Change in slope	0.972 [0.946; 0.999]	Low	− 9337 [− 14,858; − 5479]	− 52 [− 63; − 40]
Bimbo	17	Immediate effect	0.921 [0.72; 1.178]	Moderate	− 706 [− 2191; 869]	− 2 [− 11; 8]
Bimbo	17	Change in slope	1.007 [0.97; 1.044]	Low	− 706 [− 2191; 869]	− 2 [− 11; 8]
ANC1
Bangui 1	7	Immediate effect	0.882 [0.599; 1.299]	High	− 913 [− 1286; − 535]	− 13 [− 17; − 8]
Bangui 1	7	Change in slope	0.996 [0.965; 1.027]	High	− 913 [− 1286; − 535]	− 13 [− 17; − 8]
Bangui 2	8	Immediate effect	1.014 [0.784; 1.311]	High	702 [235; 1129]	11 [1; 40]
Bangui 2	8	Change in slope	0.984 [0.945; 1.025]	High	702 [235; 1129]	11 [1; 40]
Bangui 3	4	Immediate effect	0.852 [0.629; 1.155]	Low	− 253 [− 585; 76]	− 5 [− 12; 4]
Bangui 3	4	Change in slope	1.022 [0.953; 1.095]	Low	− 253 [− 585; 76]	− 5 [− 12; 4]
Begoua	15	Immediate effect	0.882 [0.749; 1.039]	Low	− 198 [− 435; 28]	− 4 [− 10; 3]
Begoua	15	Change in slope	1.018 [0.991; 1.046]	Low	− 198 [− 435; 28]	− 4 [− 10; 3]
Bimbo	13	Immediate effect	0.866 [0.755; 0.994]	Low	− 2895 [− 4169; − 1790]	− 28 [− 35; − 19]
Bimbo	13	Change in slope	0.997 [0.977; 1.018]	Low	− 2895 [− 4169; − 1790]	− 28 [− 35; − 19]
BCG
Bangui 1	5	Immediate effect	1.04 [0.765; 1.415]	Low	− 1574 [− 2655; − 657]	− 24 [− 43; 4]
Bangui 1	5	Change in slope	0.963 [0.84; 1.105]	Low	− 1574 [− 2655; − 657]	− 24 [− 43; 4]
Bangui 2	3	Immediate effect	1.56 [0.326; 7.466]	Low	− 659 [− 1054; − 249]	− 22 [− 47; 485]
Bangui 2	3	Change in slope	0.847 [0.664; 1.081]	Low	− 659 [− 1054; − 249]	− 22 [− 47; 485]
Bangui 3	5	Immediate effect	1.347 [0.86; 2.11]	Low	2399 [1599; 3056]	72 [41; 121]
Bangui 3	5	Change in slope	0.996 [0.8; 1.24]	High	2399 [1599; 3056]	72 [41; 121]
Begoua	9	Immediate effect	0.905 [0.543; 1.506]	High	− 2660 [− 3172; − 2247]	− 46 [− 52; − 41]
Begoua	9	Change in slope	1.003 [0.793; 1.269]	High	− 2660 [− 3172; − 2247]	− 46 [− 52; − 41]
Bimbo	7	Immediate effect	1.577 [1.136; 2.19]	Low	− 1382 [− 1989; − 796]	− 22 [− 31; − 12]
Bimbo	7	Change in slope	0.867 [0.802; 0.938]	High	− 1382 [− 1989; − 796]	− 22 [− 31; − 12]

*Bold cells indicate that results are statistically significant at 0.05, reflected in confidence intervals not including 1

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ISSN: 1752-1505

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