Table 4. Detailed assumptions used for base case costing and cost-effectiveness analysis (scenario ES*).
| Unit | Base case analysis | Notes | |
| Testing Costs | |||
| Materials to complete one RST | US$ | 1.53 | See Table 1 |
| Staff hourly salary | US$ | 3.55 | See note** |
| Additional staff time per test | Hours | 0.292 | 17.5 minutes per test from Zuznik et al. |
| Staff salary cost per test | US$ | 1.03 | |
| Materials and staff per test | US$ | 2.56 | |
| Monthly equivalent training cost per nurse | US$ | 19.62 | See Table 3 |
| New ANC patients per month | Patients | 36.00 | BUPIP records, evaluation study sites |
| Training cost per patient | US$ | 0.54 | |
| Total cost per patient tested | US$ | 3.10 | Materials, staff time, and training |
| Treatment Costs | |||
| Materials for 1 dose of penicillin | 0.54 | See Table 2 | |
| Additional staff time per injection | US$ | 0.08 | Authors' estimate |
| Additional staff salary cost per injection | Hours | 0.30 | |
| Total cost for one dose of penicillin | US$ | 0.83 | |
| Proportion receiving 3 doses | US$ | 1.00 | |
| Additional Information | |||
| Proportion testing positive | 0.028 | Bonawitz et al. | |
| Proportion patients that are true positives | 0.008335 | Authors' calculations*** | |
| RST sensitivity | 0.98 | Authors' calculations*** | |
| RST specificity | 0.98 | Authors' calculations*** | |
| Proportion tested | 0.62 | Bonawitz et al. | |
| Proportion treated if tested positive | 0.104 | Bonawitz et al. | |
| Proportion of true positives with active syphilis | 0.8 | Kahn et al. | |
| Additional adverse birth outcomes due to syphilis (stillbirth/fetal loss, neonatal death) | Proportion | 0.3 | Gomez et al. |
| DALYs(3,0) per ABO attributable to syphilis | 26.93 | Authors calculations, 3% discount rate, no age weighting, life expectancy at birth equal to 55 years | |
| Exchange Rate | ZMW/$ | 5.2 | Annual average, 2012, OANDA.COM |
*The base case scenario, called Scenario ES, is the full set of information that is used to estimate costs per 1,000 new ANC patients and cost effectiveness. Information in Scenario is based on prevalence and patient management as observed during the evaluation study (a 12 month period following RST training and the roll out in Kalomo District) and information on costs as presented in Tables 1–3 and additional information as needed. Sources for all information are provided in the table.
**Nurse level MS08 on government salary scale, ZMW 32,451 annual salary and all benefits, 220 working days per year, 8 hours per day.
***With 2.8% testing positive during the evaluation study, we identified the combination of true prevalence, sensitivity, and specificity that are consistent with the 2.8% testing positive.