Table 1.
Parameters used in the model and their distributions
| Parameters | Estimates | Distributions | Sources |
|---|---|---|---|
| Cohort size of children aged under 5 years | 7,273,832 ± 20 % | Normal | [14] |
| Weekly cohort growth rate | 8466 ± 20 % | Normal | [14, 16] |
| Under-five mortality rate per 1000 live births | 81 (72–90 %) | Beta | [17] |
| Malaria-attributed deaths in children aged under 5 years | 11 % | Point estimate | [18] |
| 2-Week incidences of fever episodes per child | 0.20 ± 20 % | Beta | [15] |
| Percentage of febrile episodes attributed to malaria | 10.5 ± 20 % | Beta | [2] |
| Case fatality rate of untreated severe malaria | 60 (45–80 %) | Beta | [43] |
| Case fatality rate of treated severe malaria | 10.9 % | Beta | [49] |
| Early treatment failure leads to severe malaria | 5 (3–7 %) | Beta | [41] |
| Untreated malaria becomes severe | 5 (3–7 %) | Beta | [25] |
| Probability of care seeking in formal facilities | 79 (77–81 %) | Beta | [15] |
| Percentage of formal facilities belonging to public sector | 60 (50–70 %) | Beta | [28] |
| Percentage of severe cases with access to inpatient care | 90 (80–100 %) | Beta | [42] |
| Access to first-line drugs in public facilities | 60 (40–80 %) | Beta | [35] |
| Access to second-line drugs in public facilities | 50 (40–60 %) | Beta | Assumption |
| Percentage of children given anti-malarials in private facilities | 70 (60–80 %) | Beta | [39] |
| Percentage of anti-malarials that are ACT in private facilitiesa | 50 (40–60 %) | Beta | [36, 40] |
| Efficacy of DhP | 97.3 (94.9–99.7 %) | Beta | [19] |
| Efficacy of AL | 95.5 (93.1–97.9 %) | Beta | [19] |
| Efficacy of quinine | 93.0 (88.0–98.0 %) | Beta | [21] |
| Compliance with AL | 70 (60–80 %) | Normal | [10, 20] |
| Compliance with DhP | 80 (70–90 %) | Normal | [10, 20] |
| Compliance with quinine | 50 (40–60 %) | Normal | [22, 23] |
| Non-compliers with treatments who recover | 20 (10–30 %) | Beta | [24, 25] |
| Sensitivity of mRDT | 95 (94.2–96.6 %) | Beta | [33] |
| Specificity of mRDT | 96 (94.8–97.0 %) | Beta | [33] |
| Sensitivity of clinical diagnosis | 30 (20–40 %) | Beta | [34] |
| Specificity of clinical diagnosis | 90 (80–100 %) | Beta | [34] |
| Adherence to a negative mRDT resultb | 10.5 (7.0–14.0 %) | Beta | [31, 32] |
| Drugs and diagnostic costs ($US per dose/test) | |||
| DhP: Dh 40 mg, P 320 mg (“3 × 1” pack) | 0.77 (0.56–0.93) | Gamma | [45] |
| AL: A 20 mg, L 120 mg (“6 × 2” pack) | 0.67 (0.54–0.84) | Gamma | [45] |
| Quinine 300 mg/tablet | 0.59 (0.47–0.70) | Gamma | [46] |
| SP: S 500 mg, pyrimethamine 25 mg (“3 × 1” pack) | 0.32 (0.25–0.38) | Gamma | [46] |
| Quinine injection 300 mg/mL (2 mL ampoule) | 2.40 (1.92–2.87) | Gamma | [47] |
| Diazepam injection 5 mg/mL (2 mL ampoule) | 0.23 (0.18–0.27) | Gamma | [47] |
| Diclofenac injection 25 mg/mL (3 mL ampoule) | 0.29 (0.23–0.35) | Gamma | [47] |
| Dextrose 5 % (500 mL bottle) | 3.95 (3.16–4.74) | Gamma | [47] |
| Ferrous sulphate + folic acid 200 + 0.25 mg | 0.26 (0.21–0.31) | Gamma | [47] |
| Cost of mRDT | 0.45 (0.36–0.55) | Gamma | [30] |
Numbers in the parentheses represent ranges
A artemether, ACT artemisinin-based combination therapy, AL artemether–lumefantrine, Dh dihydroartemisinin, DhP dihydroartemisinin–piperaquine, L lumefantrine, mRDT Rapid Diagnostic Test for malaria, P piperaquine, S sulfadoxine, SP sulfadoxine–pyrimethamine
aAs a proportion of dispensed anti-malarial drugs
bProportion of children who will be treated despite having a negative test result