Table 4.
Sensitivity analysis of the costs of malaria intermittent screening and treatment in schools in coastal Kenya
| Parameter | Parameter Baseline Value | Variation and Justification | Cost Per Child Screened (% Change) |
|
|---|---|---|---|---|
| Baseline Result: | $6.24 | |||
| Lower Value | Upper Value | |||
| RDT | Paracheck: $1.32 | First Response: $0.61 NOW Malaria: $3.21 The cheapest and most expensive high performing alternatives considered by the Kenyan government. |
$5.52 (-12%) |
$8.31 (+33%) |
| Anti-malarial | AL: $0.31 - 1.23 depending on child weight | AQ + SP: $0.125 DP: $0.741 Dihydroartemisinin Piperaquine (DP) is an alternative ACT while Amodiaquine Sulphadoxine-Pyrimethamine (AQ + SP) is a cheap alternative that might be used in an area where SP is still effective. |
$6.12 (-2%) |
$6.24 (< 1%) |
| Treatment Follow Up | Treatment follow up carried out by nurses as described | Unsupervised treatment has been shown to be similarly efficacious [37,38] and national guidelines permit unsupervised treatment [39]. Alternative treatment may also reduce follow up requirements. | $4.95 (-21%) |
- |
| Health Team Personnel | Technicians used by trial to carry out RDT and blood slide. | Nurses implement IST without technicians. Personnel may be reduced by removing research tasks such as taking blood slides and anthropometry. |
$5.79 (-7%) |
- |
| Salaries | Midpoint of relevant pay scales. | ± 20% Salaries are likely to vary by region or over time |
$5.80 (-7%) |
$6.73 (+8%) |
| Discount Rate | 3% Recommended by WHO [20] |
0% and 5% 0% reflects un adjusted programme costs. Some argue that time preferences for delay of costs are not necessarily rational and should not be included in decision-making. 5% represents a greater time preference, argued by some to be more relevant to developing country contexts. |
$6.63 (+6%) |
$6.04 (-3%) |
| Wastage | 10% | 0% and 20% No empirical evidence. Based on literature precedent. |
$6.06 (-3%) |
$6.47 (+4%) |