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Table 1 Summary of model parameters for Extended Cost-Effectiveness Analysis (ECEA)

From: Addressing child health inequity through case management of under-five malaria in Nigeria: an extended cost-effectiveness analysis

 

Parameter

Value for each wealth quintile (Q1–Q5) if applicable

References and notes

Demographics

Number of under-five children in Nigeria

Q1 = 8,822,526

Q2 = 7,737,789

Q3 = 6,436,105

Q4 = 5,806,958

Q5 = 5,185,042

Authors’ calculation using national population size, median household size, and number of under-fives per households from [16]

Epidemiology

Treatment sought for under-5 malaria (%)

Q1 = 67.8

Q2 = 70.4

Q3 = 72.4

Q4 = 79.1

Q5 = 85.2

[16]

 

Annual cases of under-five malaria in Nigeria

Q1 = 6,960,185

Q2 = 6,468,963

Q3 = 5,261,275

Q4 = 3,361,056

Q5 = 1,318,521

Authors’ calculation using prevalence data from [16]

 

Cumulative annual incidence of uncomplicated under-five malaria (%)

Q1 = 77.1

Q2 = 81.9

Q3 = 80.2

Q4 = 57.0

Q5 = 25.2

Authors’ calculation using treatment-seeking behaviour and probability of disease progression to severe from [16] and [53]

 

Cumulative annual incidence of severe under-five malaria (%)

Q1 = 1.8

Q2 = 1.7

Q3 = 1.6

Q4 = 0.8

Q5 = 0.3

Authors’ calculation using treatment-seeking behaviour and probability of disease progression to severe from [16] and [53]

 

Treatment coverage increase for 50% DMC subsidy (percentage point)

Q1 = 2.5

Q2 = 2

Q3 = 1.5

Q4 = 1

Q5 = 0.5

Authors’ assumption

 

Treatment coverage increase for full DMC subsidy (percentage point)

Q1 = 5

Q2 = 4

Q3 = 3

Q4 = 2

Q5 = 1

Authors’ assumption

 

Treatment coverage increase for full DMC + NMC + IC subsidy (percentage point)

Q1 = 10

Q2 = 8

Q3 = 6

Q4 = 4

Q5 = 2

Authors’ assumption

 

ACT prescribed in those seeking treatment (%)

Q1 = 46.6

Q2 = 51.5

Q3 = 52.5

Q4 = 53.1

Q5 = 61

[16]

Treatment

ACT efficacy (%)

98.3

[14]

 

Adherence to treatment for uncomplicated cases (%)

Q1 = 66

Q2 = 71

Q3 = 76

Q4 = 81

Q5 = 86

Authors’ assumption using overall estimate of adherence across all wealth indices from [40]

 

Efficacy of ACT for uncomplicated cases given non-adherence as a proportion of theoretical efficacy (%)

94.7

[54]

 

Non-ACT efficacy (%)

63

Authors’ calculation using efficacy of chloroquine and all other non-ACTs from [6]

 

Probability that untreated case progresses to severe (%)

7

Calibrated with low estimates from [53]

 

Probability that treatment failure progresses to severe (%)

2

[55]

 

CFR of untreated severe malaria (%)

45

Calibrated with low estimates from [52]

 

CFR of treated severe malaria (%)

4.9

[56]

 

CFR of untreated uncomplicated malaria (%)

0.1

Authors’ assumption based on [57]

Costing (2020 $US)

Outpatient OOP direct medical costs per case, ACTs used

7.98

Authors’ calculation using forthcoming data from multi-facility Duke costing study (see Additional file 1 Section I, Table S8)

 

Outpatient OOP direct medical costs per case, non-ACTs used

6.29

Authors’ calculation using [6]. and forthcoming data from multi-facility Duke costing study (see Additional file 1 Section I, Tables S8 and S9)

 

Outpatient OOP direct non-medical costs per case

2.26

Authors’ calculation using forthcoming data from multi-facility Duke costing study (see Additional file 1 Section I, Table S10)

 

Outpatient OOP indirect costs per case

Q1 = 0.49

Q2 = 0.78

Q3 = 1.14

Q4 = 1.70

Q5 = 3.16

Authors’ calculation using data on daily consumption and days spent caregiving from [58]

 

Inpatient OOP direct medical costs per case

39.25

Authors’ calculation using forthcoming data from multi-facility Duke costing study (see Additional file 1 Section I, Table S8)

 

Inpatient OOP direct non-medical costs per case

4.16

Authors’ calculation using forthcoming data from multi-facility Duke costing study (see Additional file 1 Section I, Table S10)

 

Inpatient OOP indirect costs per case

Q1 = 2.98

Q2 = 4.75

Q3 = 6.91

Q4 = 10.36

Q5 = 19.26

Authors’ calculation using data on daily consumption and days spent caregiving from [58, 59]

 

OOP indirect cost of non-treatment per untreated case (uncomplicated)

Q1 = 2.45

Q2 = 3.9

Q3 = 5.67

Q4 = 8.49

Q5 = 15.79

Authors’ calculation using data on daily consumption and days spent caregiving from [58, 59]

 

OOP indirect cost of non-treatment per case (severe)

Q1 = 4.89

Q2 = 7.79

Q3 = 11.34

Q4 = 16.99

Q5 = 31.58

Authors’ calculation using data on daily consumption and days spent caregiving from [58, 59]

 

Outpatient cost of implementation per case, ACTs used

10.50

Authors’ calculation using estimates of OOP expenditure as a percentage of total health expenditure in Nigeria [43]

 

Outpatient cost of implementation per case, non-ACTs used

8.28

Authors’ calculation using estimates of OOP expenditure as a percentage of total health expenditure in Nigeria [43]

 

Inpatient cost of implementation per case

51.65

Authors’ calculation using estimates of OOP expenditure as a percentage of total health expenditure in Nigeria [43]

 

Nigeria GNI

2030

[60]

 

Nigeria Gini Index

35.1

[61]

  1. DMC direct medical cost, NMC non-medical cost, IC indirect cost, ACT artemisinin-based combination therapy, CFR case-fatality rate, OOP out-of-pocket, GNI gross national income