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Table 1 Parameter estimates, ranges and sources

From: Artemisinin resistance – modelling the potential human and economic costs

Parameter Base case Range/distribution Comments Source
Probabilities for clinical parameters
ACT failure rate in a scenario of widespread resistance (P2) 30% 30-80% A conservative estimate as compared with recent ACT failure rates in Mae Sot, Thailand and those for chloroquine, amodiaquine and sulphadoxine-pyrimethamine in SSA and Asia. Assumption[10, 14]
ACT failure rates in the absence of widespread resistance (P2) 5% 0-10%   [14]
Treatment failure becomes severe (P3) 2% 0.5-5% Data from an artesunate efficacy trial in Cambodia and best fit to WHO incidence/mortality data [15, 24]
Beta distribution
(α = 3 β = 156)
Mortality rate for severe malaria treated with quinine – Asia, EM, LA 22% Beta distribution A large multisite in Asia (the trial data were also used to construct the probability distributions for the PSA) [3]
(α = 164 β = 567)
Mortality rate for severe malaria treated with artesunate – Asia, EM, LA (P5) 15% Beta distribution   [3]
(α = 107 β = 627)
Mortality rate for severe malaria treated with quinine – SSA (P5) 10.9% Beta distribution The largest study of severe malaria treatments in hospitalized patients [4]
(α = 297 β = 2,416)
Mortality rate for severe malaria treated with artesunate – SSA (P5) 8.5% Beta distribution   [4]
(α = 230 β = 2,482)
Mortality rate for untreated severe malaria – high transmission (P6) 50% 40-90%   [16, 24]
Beta distribution
(α = 5 β = 5)
Mortality rate for untreated severe malaria – low transmission (P6) 75% 40-90%   [16, 24]
Beta distribution
(α = 7 β = 3)
Access to care
Access to any anti-malarial (P1)   20-100% Country level data [2427]
Access to inpatient care (P4)   40-90% Determined by GDP per capita  
Costs
ACT $0.8/$1.6   Private sector prices are mostly higher which would imply higher costs for retreatment of failures [28]
Test $0.8 $0.5-1.5   [24]
Inpatient care for severe malaria $65    [18]
  1. SSA – sub-Saharan Africa; LA – Latin America; EM – Eastern Mediterranean; SEA – Southeast Asia; WP – Western Pacific.