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Table 1 Model parameters

From: Cost-effectiveness of malaria preventive treatment for HIV-infected pregnant women in sub-Saharan Africa

Variable

Value

Distribution

Source

Demographic

 Malaria prevalence in HIV-infected pregnant women

31.0%

Beta(3.1,6.9)

[46]

 CD4 count

390

Normal(390,220)

[47]

Incidence

 Relative risk of malaria in HIV-infected pregnant woman

1.6

Gamma(1.6,1)

[48]

 CD4 change while on ART

70

Normal(70,100)

[49]

Mortality

 Neonatal mortality risk due to low birth weight

6.93%

Beta(0.007,0.093)

[30]

 Annual mortality due to malaria during pregnancy

0.33%

Beta(0.033,9.967)

[30]

 Annual mortality due to anaemia in pregnancy

1.0%

Beta(0.1,9.9)

[30]

 Annual HIV mortality among HIV-infected pregnant women

0.0161%

Beta(0.16,9.84)

[50]

 Annual HIV mortality among HIV-infected pregnant women on ART

0.007%

Beta(0.07,9.93)

[47, 50]

 Relative risk of HIV mortality of CTX while on ART

0.47

Beta(8,9)

[35]

DALY calculations

 Annual discount rate

3%

3%

[51]

 Average age (years)

22.83

22.83

[29]

 Life expectancy for women aged 20–24 (years)

47.24

Normal(47,3)

[32]

 Life expectancy at birth (years)

57.96

Normal(58,3)

[32]

 Disability weight—malaria during pregnancy

0.21

Normal(0.21,0.03)

[31]

 Disability weight—maternal anaemia due to malaria

0.06

Normal(0.06,0.02)

[31]

 Disability weight—low birth weight

0.11

0.11

[33]

 Length of disability (years)—malaria during pregnancy

0.01

Gamma(2.0,0.004)

[30]

 Length of disability (years)—maternal anaemia due to malaria

0.06

Gamma(1.2,0.04)

[52]

 Length of disability (years)—low birth weight

57.96

Gamma(32,1.8)

[32]

Costs (USD 2015)

 Drug cost

  Intermittent preventive treatment (per dose)

$0.20

Normal(0.2,0.01)

[30, 53]

  Cotrimoxazole, 480 mg twice daily (per year)

$6.28

Gamma(3.9,1.61)

[54]

 Healthcare labor costa

  Labor time per IPTp-SP administration (min)

8.31

Gamma(13.85,0.6)

[30]

  Nurses’ monthly cost of labor

542.76

Gamma(29.3,18.5)

[30]

 Household cost

  Antenatal care visit direct cost

0.47

Gamma(92.4,0.005)

[30]

  Antenatal care visit indirect cost

1.17

Gamma(146,0.008)

[30]

  ART treatment (per year)

$193.61

Gamma(2,97)

[55]

Efficacy

 Low birth weight

  Relative risk baseline (IPTp-SP 0–1 dose) vs. 2 dose IPTp-SP

3.25

Gamma(1.1,2.95)

[45]

  Incidence per 1000 women given IPTp-SP 2 dosesb

175

(91–222)a

[29]

  Relative risk IPTp-SP 3 doses vs. 2 doses

0.86

Normal(0.86,0.21)

[29]

  Relative risk CTX vs. 2 dose IPTp-SP

1.16

Gamma (1.05,1.1)

[34, 56]

 Maternal parasitaemia

  Relative risk baseline (IPTp-SP 0–1 dose) vs. 2 dose IPTp-SP

1.4

Gamma(1.15,1.2)

[19]

  Incidence per 1000 women given IPTp-SP 2 dosesb

112

(0–359)a

[29]

  Relative risk IPTp-SP 3 doses vs. 2 doses

0.26

Normal(0.26,0.08)

[29]

  Relative risk CTX vs. 2 dose IPTp-SP

0.44

Lognormal(−1.05,0.7)

[19, 34]

  Relative risk CTX + ART vs. CTX

0.38

Lognormal(−1.2,0.7)

[21]

 Anaemia

  Relative risk baseline (IPTp-SP 0–1 dose) vs. 2 dose IPTp-SP

1.03

Gamma(0.85,1.2)

[45]

  Incidence per 1000 women given IPTp-SP 2 dosesb

582

(333–795)a

[29]

  Relative risk IPTp-SP 3 doses vs. 2 doses

582

Normal(0.96,0.07)

[29]

  Relative risk CTX vs. 2 dose IPTp-SP

0.72

Normal(0.72,0.05)

[19]

  1. ART antiretroviral therapy for HIV, CTX cotrimoxazole, DALY disability-adjusted life year, IPTp-SP intermittent preventive treatment with sulfadoxine–pyrimethamine
  2. aLabor cost calculations assume that maximum hours of work is 48 h per week, 4.3 weeks per month [57]
  3. bAge-adjusted incidence per 1000 women (the range is provided to illustrate low and high risk) under the 2-IPT Low Strategy (the Reference Strategy)