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Table 1 Input variables for the cost consequence analysis and the base case and probabilistic cost-effectiveness analysis

From: Cost effectiveness of intermittent screening followed by treatment versus intermittent preventive treatment during pregnancy in West Africa: analysis and modelling of results from a non-inferiority trial

Parameter Base case Low High Distribution for PSA Source
Cost estimates
Health care worker time cost
 Time nurses take to provide 1 dose IPTp-SP in Ghana (min)
95 % CI (N = 18)
18.00 15.54 20.46 Gamma Observational study of trial participants: (Ghana)
 Time nurses take to provide 1 dose IPTp-SP in Malawi (min)
95 % CI (N = 18)
3.55 2.58 4.52 Gamma Observational study of trial participants: (Malawi)
 Time nurses take to provide 1 admin ISTp-AL in Ghana (min)
95 % CI (N = 3) if RDT neg
13.67 9.87 17.46 Gamma Observational study of trial participants: (Ghana)
 Time nurses take to provide 1 admin ISTp-AL in Ghana (min)
95 % CI (N = 13) if RDT pos
24.29 21.43 27.16 Gamma Observational study of trial participants: (Ghana)
 Time nurses take to provide 1 admin ISTp-AL in Malawi (min)
95 % CI (N = 22) if RDT neg
5.67 4.91 6.44 Gamma Observational study of trial participants: (Malawi)
 Time nurses take to provide 1 admin ISTp-AL in Malawi (min)
95 % CI (N = 8) if RDT pos
12.65 11.52 13.78 Gamma Observational study of trial participants: (Malawi)
 Number of administrations in IPTp-SP arm 2.06 Point estimate [20]
 Number of administrations in ISTp-AL arm 2.76 Point estimate [20]
 % of administrations of ISTp with a positive RDT result 24.7 %    Point estimate [20]
 Nurses’ monthly cost of labour, 95 % CI (US$ 2012) 346.33 164.83 527.84 Gamma Countries MoHa
Drug costs
 Average SP price per administration, 95 % CI (US$ 2012) 0.20 0.16 0.27 Lognormal International procurement databasesb
 Average AL price per administration, 95 % CI (US$ 2012) 2.39 1.71 3.06 Lognormal International procurement databasesb
 Average RDT price per administration, 95 % CI (US$ 2012) 0.81 0.58 0.90 Lognormal International procurement databasesb
Costs from consequences
 Incremental days in hospital comparing LBW versus NBW (days) 0.64 0.40 0.89 Normal Trial post partum follow up data
 Cost per paediatric IP day (excluding medical supplies) (US$ 2012) 63.46 31.73 95.19 Gamma Health facility costings (Ghana, Mali)
 Cost per OP visit (excluding medical supplies) (US$ 2012) 11.76 8.45 15.06 Gamma Health facility costings (Ghana, Mali)
 Cost per IP day (excluding medical supplies) (US$ 2012) 35.25 17.63 52.88 Gamma Health facility costings (Ghana, Mali)
Daly calculations
 Discount rate r 0.03 0.00 0.05 Point estimate Assumption
 Average age (years)c 20.40 Point estimate [20]
 Life expectancy women aged 20–24 years 50.12 45.11 55.13 Lognormal GBD study 2010d [32]
 Life expectancy at birth 61.56 56.86 66.31 Lognormal GBD study 2010d [32]
 Length disability—malaria during pregnancy (3.5 days, range 2–6) 0.010 0.005 0.016 Gamma Assumption
 Length disability—malaria related anaemia (21 days, range 14–42) 0.06 0.04 0.12 Gamma Price et al. [33]
 Length disability—LBW (years) 57.96 52.91 64.80 Lognormal GBD 2010 study [32]
 Disability weight infectious disease severe acute episode (95 % CI) 0.21 0.14 0.30 Lognormal GBD 2010 study [25]
 Disability weight maternal anaemia: moderate (95 % CI) 0.06 0.04 0.09 Lognormal GBD 2010 study [25]
 Disability weight LBW 0.11 Point estimate GBD 2004 update (data from 1990) [26]
Mortality estimates
 LBW attributable neonatal mortality risk % 6.93 4.36 9.50 Beta Marchant et al. [34]
 CFR malaria during pregnancy % 0.0033 0.0026 0.0045 Beta Sicuri et al. [35]
 CFR moderate/severe anaemia in pregnancy % 0.01 Beta Brabin et al. [36]
Measures of effect (trial conducted in Primi- and secundigravidae only)
Low birth weight
 LBW risk IPTp-SP arm per 1000 women 151.2 136.8 166.8 Beta [20]
 LBW risk ISTp-AL arm per 1000 women 155.8 141.3 171.5 Beta [20]
Moderate/severe maternal anaemia (<8, 7, or 6 g/dl)
 Moderate/severe anaemia risk at last ANC visit IPTp-SP arm per 1000 women 16.9 11.6 24.7 Beta [20]
 Moderate/severe anaemia risk at last ANC visit ISTp-AL arm per 1000 women 23.1 16.8 31.7 Beta [20]
Episodes of clinical malaria
 0 episode clinical malaria IPTp-SP arm per 1000 women 932.41 922.26 941.33 Dirichlet [20]
 1 episode clinical malaria IPTp-SP arm per 1000 women 61.99 53.45 71.78 Dirichlet [20]
 2 episodes clinical malaria IPTp-SP arm per 1000 women 5.6 3.38 9.27 Dirichlet [20]
 3 episodes clinical malaria IPTp-SP arm per 1000 women 0.4 0.36 0.44 Dirichlet [20]
 0 episode clinical malaria ISTp-AL arm per 1000 women 899.85 887.88 910.67 Dirichlet [20]
 1 episode clinical malaria ISTp-AL arm per 1000 women 84.08 74.14 95.21 Dirichlet [20]
 2 episodes clinical malaria ISTp-AL arm per 1000 women 14.95 10.98 20.32 Dirichlet [20]
 3 episodes clinical malaria ISTp-AL arm per 1000 women 0.37 0.05 2.65 Dirichlet [20]
Measures of effect from cochrane review used for modelling of decreasing SP efficacy in IPTp arm
 Relative risk of LBW comparing IPTp-SP versus none or placebo 0.81 0.67 0.99 n/a [30]
 Relative risk of sev/mod anaemia comparing IPTp-SP versus none or placebo 0.60 0.47 0.75 n/a [30]
 Relative risk of antenatal parasitaemia comparing IPTp-SP versus none or placebo 0.38 0.24 0.59 n/a [30]
  1. Parameters are shown for all countries where the clinical trial was conducted in [32] (Burkina Faso, Ghana, Mali and The Gambia)
  2. ANC antenatal care; CFR case fatality rate; DALY disability adjusted life years; HCW health care worker; IPTp-SP intermittent preventive treatment with sulfadoxine-pyrimethamine; ISTp-AL intermittent screening and if positive followed by treatment with arthemether-lumefantrine; LBW low birth weight; MoH Ministry of Health; 95 % CI 95 % confidence interval
  3. aSalary scale and an average allowance package for nurses from Ministry of Health in Burkina Faso, Ghana, Mali and The Gambia for 2012
  4. bCost for dose of SP, AL and per RDT was calculated accounting for 5 % wastage, 10 % insurance and freight and 10 % in country transport
  5. cAverage age was used from the trial
  6. dThe life expectancy was analysed from the Global burden of disease 2010 database for the subgroups of interest (i.e. female only, age 20–24, trial countries and both gender, at birth, trial countries respectively)