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. 2022 Jul 15;7(7):e008784. doi: 10.1136/bmjgh-2022-008784

Table 2.

Other parameters used in model

Estimate Distribution Reference/source
Additional cost parameters and assumptions
Parameters to estimate cost of wheelchair to both household and provider
 % of children needing a wheelchair: severe CZS 81.9% Point estimate Expert opinion
 % of children needing a wheelchair: moderate CZS 5.0% Point estimate Expert opinion
 % of children needing a wheelchair: no CZS 0.1% Point estimate Expert opinion
 Wheelchair cost to the health provider (R$962.5) US$, 2017 301.4 Point estimate 27
 Wheelchair cost (incl. adaptation) to the household (R$4000) US$, 2017 1252.7 Point estimate Expert opinion
 Replacement wheelchair at age (years) 3,4,5,6,7 and 10 Point estimate Expert opinion
Other costs to the government (education and disability benefit)
 Special creche from age 3 years for CZS (federal payment per pupil R$4420.7) US$, 2017 1384.5 Gamma* 45
 Primary education from age 4 (federal payment per pupil: R$4080.7) US$, 2017 1278.0 Gamma* 37
 Ratio cost special needs education/cost primary education 1.2 Lognormal Expert opinion
 Disability benefit per year (monthly min. wage: R$937) US$, 2017 3521.5 Point estimate 46
Parameters to model costs and outcomes
General
 Discount rate costs 5% Point estimate 35
 Discount rate outcomes 5% Point estimate 35
 Model length (years) 5 and 10 Assumption
 Exchange rate Brazilian Real to US$, 2017 0.31 Point estimate 31
 Average annual inflation rate Brazil 2008–2017 (mean, SE) 6.1%, 1.9% Beta 36
Modelling clinical burden
 Mortality severe CZS year 1 (%, alpha, beta) 4.9%, 6, 116 Beta Estimated from Rio de Janeiro Cohort
 Mortality severe CZS year 2 (%, alpha, beta) 2.6%, 3, 113 Beta Estimated from Rio de Janeiro Cohort
 Mortality severe CZS year 3 (%, alpha, beta) 0.9%, 1, 112 Beta Estimated from Rio de Janeiro Cohort
 Mortality severe CZS year 4 (%, alpha, beta) 0.9%, 1, 111 Beta Assumed to be the same as year 3
 Mortality severe CZS year 5 (%, alpha, beta) 0.9%, 1, 110 Beta Assumed to be the same as year 3
 Mortality severe CZS year 6–10 per year (%) 0.3% Beta Assumed to be 1/3 of mortality in years 3–5
 Mortality Brazil (moderate CZS and controls) year 1 (%, alpha, beta) 1.30%, 13.0, 987.0 Beta 47
 Mortality Brazil (moderate CZS and controls) year 2 (%, alpha, beta) 0.10%, 1.0, 999.0 Beta Estimate based on infant and <5-year mortality47
 Mortality Brazil (moderate CZS and controls) year 3 (%, alpha, beta) 0.03%, 0.3, 999.7 Beta Estimate based on infant and <5-year mortality47
 Mortality Brazil (moderate CZS and controls) year 4 (%, alpha, beta) 0.03%, 0.3, 999.7 Beta Estimate based on infant and <5-year mortality47
 Mortality Brazil (moderate CZS and controls) year 5 (%, alpha, beta) 0.03%, 0.3, 999.7 Beta Estimate based on infant and <5-year mortality47
 Mortality Brazil (moderate CZS and controls) year 6–10 per year (%, alpha, beta) 0.01% Beta Assumed to be 1/3 of mortality in years 3–5
 Cases of CZS Brazil confirmed 3474 Point Estimate 5
 Cases of CZS Brazil under investigation 2659 point estimate 5
 Cases of CZS Brazil probable 743 Point estimate 5
 Cases of CZS Brazil deceased (fetal death, stillbirth, infant death and child death) 505 Point estimate 5
 Disability weight severe cerebral palsy for severe CZS 0.82 Lognormal * 33
 Disability weight mild/moderate cerebral palsy for mild/moderate CZS 0.36 Lognormal * 33
 Length disability=time horizon of model (years) 5 and 10 Point estimate Decided by study team

Table 2 shows parameters used in the economic burden model, that were not estimated in the costing analysis. This includes parameters to model the cost of a wheelchair as well as other costs to the government, general model parameters such as discount rate and also parameters to model the epidemiological burden of CZS.

*Standard error assumed to be 10% of mean.

CZS, congenital Zika Syndrome.