Table 1.
Model input parameters and uncertainty ranges.
| Variables | Units | Values | Standard errors or uncertainty ranges | Sources |
|---|---|---|---|---|
| Epidemiologic & demographic | ||||
| Population under age 5 | Thousand | 6997 | – | UN DESA 11 |
| Life expectancy at birth | Year | 61.10 | – | UNICEF 12 |
| Pneumonia incidence for children under age 5 | % | 3.40 | 2.64–4.23 | O’Brien et al. 13 |
| Pneumonia prescribed with amoxicillin | % | 80 | 70–90 | Authors’ assumption |
| Care seeking from hospital | % | 61.98 | – | Nair et al. 14 |
| Distribution of patients | ||||
| National hospital | % | 24 | 3 | Ayieko et al. 15 |
| Provincial hospital | % | 20 | 3 | Ayieko et al. 15 |
| District hospital | % | 23 | 3 | Ayieko et al. 15 |
| Mission hospital | % | 31 | 3 | Ayieko et al. 15 |
| Average length of stay | ||||
| National hospital | Day | 8.20 | 2.05 | Ayieko et al. 15 |
| Provincial hospital | Day | 6.60 | 1.65 | Ayieko et al. 15 |
| District hospital | Day | 5.42 | 1.35 | Ayieko et al. 15 |
| Mission hospital | Day | 6.06 | 1.52 | Ayieko et al. 15 |
| Case-fatality ratio | ||||
| Hospital | % | 3.90 | 0.8 | Nair et al. 14 |
| Community | % | 9.20 | 2.3 | WHO 1 |
| Medicine quality testing | ||||
| Screening sensitivity | ||||
| PADs | % | 100 | – | Weaver et al. 6 |
| aPADs | % | 97 | – | Myers et al. 7 |
| HPLC | % | 100 | – | U.S. Pharmacopeia 16 |
| Screening specificity | ||||
| PADs | % | 100 | – | Weaver et al. 6 |
| aPADs | % | 92 | – | Myers et al. 7 |
| HPLC | % | 100 | – | U.S. Pharmacopeia 16 |
| Quality control for PADs | % | 10 | – | Authors’ assumption |
| Pills needed for each sample tested | ||||
| PADs | n | 1 | – | Weaver et al. 6 |
| aPADs | n | 1 | – | Weaver et al. 6 |
| HPLC | n | 100 | – | KPPB 17 |
| Substandard & falsified antibiotics | ||||
| Extra treatment time for SF antibiotics | Day | 5 | – | Authors’ assumption |
| Relative risk of mortality if receiving SF antibiotics | 2.00 | – | WHO 1 | |
| Market share and brand specific SF proportion | ||||
| Brand 1 | n (% SF) | 13 (0) | – | Myers et al. 17 |
| Brand 2 | n (% SF) | 37 (0) | – | |
| Brand 3 | n (% SF) | 9 (11) | 10% a | |
| Brand 4 | n (% SF) | 2 (0) | – | |
| Brand 5 | n (% SF) | 20 (0) | – | |
| Brand 6 | n (% SF) | 4 (0) | – | |
| Brand 7 | n (% SF) | 2 (0) | – | |
| Brand 8 | n (% SF) | 1 (0) | – | |
| Brand 9 | n (% SF) | 9 (0) | – | |
| Brand 10 | n (% SF) | 10 (0) | – | |
| Brand 11 | n (% SF) | 37 (59) | 8% a | |
| Brand 12 | n (% SF) | 1 (0) | – | |
| Brand 13 | n (% SF) | 9 (0) | – | |
| Costs | ||||
| Testing costs | ||||
| PADs | USD | 3.00 | 0.75 b | Personal Communication |
| aPADs | USD | 3.00 | 0.75 b | Personal Communication |
| HPLC | USD | 606.00 | 151.50 b | Quote from MEDS 18 |
| Personnel sampling costs | USD/week | 250.00 | – | Expert opinion |
| Amoxicillin (250 mg/tab) price | USD | 0.005 | 0.001 b | Calculated based on UNICEF’s report 8 |
| Diagnostic costs | ||||
| National hospital | USD | 23.73 | 85.26 | Ayieko et al. 15 |
| Provincial hospital | USD | 4.48 | 16.98 | Ayieko et al. 15 |
| District hospital | USD | 9.34 | 12.61 | Ayieko et al. 15 |
| Mission hospital | USD | 31.22 | 27.75 | Ayieko et al. 15 |
| Treatment costs | ||||
| National hospital | USD | 19.25 | 76.79 | Ayieko et al. 15 |
| Provincial hospital | USD | 8.34 | 23.14 | Ayieko et al. 15 |
| District hospital | USD | 3.74 | 7.05 | Ayieko et al. 15 |
| Mission hospital | USD | 26.48 | 25.03 | Ayieko et al. 15 |
| Daily hospital bed costs | ||||
| National hospital | USD | 22.17 | 28.78 | Ayieko et al. 15 |
| Provincial hospital | USD | 17.24 | 12.97 | Ayieko et al. 15 |
| District hospital | USD | 12.13 | 9.53 | Ayieko et al. 15 |
| Mission hospital | USD | 12.18 | 11.21 | Ayieko et al. 15 |
| Discount rate | % | 3.00 | – | Authors’ assumption |
| GDP per capita | USD | 1455.40 | – | World Bank 20 |
GDP: gross domestic product; HPLC: high-performance liquid chromatography; KPPB: Kenya Pharmacy and Poisons Board; MEDS: Mission for Essential Drugs and Supplies (Kenya); PADs/aPADs: paper analytical devices/antibiotic paper analytical devices; SF: substandard and falsified; UNDESA: United Nations Department of Economic and Social Affairs; UNICEF: United Nations Children’s Fund; USD: United States dollar; WHO: World Health Organization.
a
Standard error was estimated for brand specific substandard and falsified proportions.
b
Standard error was calculated based on 25% of the mean.