Achieving malaria testing and treatment targets for children under five in Mozambique: a cost-effectiveness analysis

Avanceña, Anton L. V.; Miller, Angie; Canana, Neide; Dula, Janeth; Saifodine, Abuchahama; Cadrinho, Baltazar; Maffioli, Elisa M.

doi:10.1186/s12936-022-04354-9

Table 2 Summary of selected parameter inputs and assumptions

From: Achieving malaria testing and treatment targets for children under five in Mozambique: a cost-effectiveness analysis

Input	Base value	Range	Distribution in PSA	Source
Probabilities
Prevalence of malaria among children (6–59 months)	0.39	0.01–0.57	Beta	[21]
Uncomplicated case given malaria infection	0.87	0.65–0.9	Beta	[22]
Uncomplicated cases that seek care	0.69	0.86–0.93	Beta	[21]
Uncomplicated cases that seek care from CHWs given care-seeking	0.029	0.017–0.028	Beta	[21]
Uncomplicated cases that seek care from private providers given care-seeking	0.0062	0.0053–0.0089	Beta	[21]
Uncomplicated cases that are tested	0.47	0.65–0.74	Beta	[21]
Uncomplicated cases that are tested with RDTs by CHWs given testing	0.69	0.52–0.86	Beta	[11]
Uncomplicated cases that are tested with RDTs by private providers given testing	0.69	0.52–0.86	Beta	[11]
Uncomplicated cases that are tested with RDTs by public providers given testing	0.69	0.52–0.86	Beta	[11]
Microscopy sensitivity	0.96	0.87–1	Beta	[23]
Microscopy specificity	0.25	0.2–0.3	Beta	[23]
Uncomplicated cases that are treated given positive test result	0.99	0.74–1	Beta	[21]
Uncomplicated cases that are treated given negative test result	0.92	0.71–1	Beta	[21]
Uncomplicated cases that self-treat given no care-seeking	0.70	0.53–0.88	Beta	[24]
Uncomplicated cases that are treated with AL given a positive result	0.84	0.66–1	Beta	[21]
Uncomplicated cases that are treated with AL given a negative result	0.05	0.66–1	Beta	[21]
Uncomplicated cases that do not seek care that self-treat with AL	0.36	0.66–1	Beta	[21]
Treatment effectiveness of AL on uncomplicated cases	0.96	0.93–0.98	Beta	[25]
Treatment effectiveness of other drugs on uncomplicated cases	0	NA	NA	^*
RDT sensitivity	0.90	0.83–0.9	Beta	[26]
RDT specificity	0.97	0.91–0.97	Beta	[26]
Death after untreated uncomplicated malaria	0.01	0.0075–0.0125	Beta	[27]
Accurate clinical diagnosis by CHWs	0.96	0.83–0.99	Beta	[28, 29]
Accurate clinical diagnosis by private providers	0.85	0.55–0.99	Beta	[24]
Accurate clinical diagnosis by public providers	0.76	0.54–1	Beta	[24]
Mortality from other causes	0.007	0.004–0.009	Beta	[8]
Costs (in 2019 US$)
AL for uncomplicated malaria	1.68	1.68–1.68	Gamma	[30, 31]
AS/AQ for uncomplicated malaria	0.57	0.57–0.57	Gamma	[30, 31]
Other drugs taken by uncomplicated cases	0.29	0.29–0.36	Gamma	[30, 31]
AS for severe malaria	8.05	8.05–8.05	Gamma	[30, 31]
Microscopy	1.26	0.94–1.57	Gamma	[32]
RDT	1.54	1.15–1.92	Gamma	[33]
Clinical diagnosis/service delivery	4.18	4.16–4.19	Gamma	[9]
Health outcome weights
Disability weight for uncomplicated malaria	0.006	0.002–0.012	Beta	[34]
Disability weight for severe malaria	0.133	0.088–0.19	Beta	[34]
Health utility for uncomplicated malaria	0.9802	0.9–1	Beta	[35]
Health utility for severe malaria	0.5363	0.41–0.66	Beta	[35]

For brevity, only probabilities that apply to uncomplicated malaria cases are shown here. For other probabilities used in the model, see Additional file 1
AL, artemether-lumefantrine; AS, artesunate; AS/AQ, artesunate-amodiaquine; CHWs, community health worker (also known as Agentes Polivalentes Elementares or APEs in Mozambique); RDT, rapid diagnostic test
^*Value assumed or set by authors
^†Base case value and/or range calculated by authors based on the cited references

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