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Table 1 Key structural and methodological differences between LiST and Spectrum-Malaria

From: Impact of malaria interventions on child mortality in endemic African settings: comparison and alignment between LiST and Spectrum-Malaria model

Aspect

LiST

Spectrum-Malaria

Health outcomes considered, that are impacted by malaria interventions

• Malaria-attributable, other-cause and all-cause mortality in children 0–4 years (separately for neonatal, 1–12 months and 13–59 months sub-groups)

• Maternal deaths

• Stillbirths

• Malaria-attributable mortality and case incidence, in 0–4 years, 5–14 years and 15+ years;

• Plasmodium falciparum infection prevalence (PfPR), in children 2–9 years

Interventions modelled

• Vector control (IRS and/or ITNs)

• Case management, uncomplicated malaria cases

• Intermittent Preventive Therapy for pregnant women

• ITNs

• IRS

• Case management, uncomplicated malaria cases (CMU)

• Case management, severe malaria cases

• Seasonal Malaria Chemoprophylaxis (SMC) in children 3–59 months

Determinants of impact of malaria intervention scale-up

Proportional reduction from baseline burden level, for a given proportional increase in intervention coverage – same within and across all countries

Proportional reduction from baseline burden level, varying with baseline endemicity (PfPR), seasonality in malaria transmission, and baseline and scale-up coverage levels of ITNs, IRS, CMU and SMC, which act in interaction), calculated at province-level and then aggregated to national level [13]

Determinants of impact, for a given coverage increase

Fixed effectiveness value (for ITNs and CMU: from sources below), for all years and all countries [48]

• Baseline malaria endemicity (PfPR in 2–9 years),

• Seasonality in malaria transmission,

• Baseline and scale-up coverage levels of other malaria interventions that have time-dynamic impacts (ITNs, IRS, SMC, and management of uncomplicated cases), and their variations between provinces, within and across countries [13].

Synergy or saturation across interventions?

No

Yes [13].

Saturation of incremental impacts at higher coverages?

No

Yes [13].

Time path of impact

No variation over time: impact is immediate from the year of scale-up; the post-intervention mortality level stays constant thereafter until coverage changes again

• Impact modelled with a 1-year lag after intervention scale-up;

• Separate impact functions for short term (years 2–6 after scale-up) and long term (years 7–15 after scale-up) [12, 14].

Basis and source of coverage-impact relationship: ITNs

United Nationals Child Health Epidemiology Reference Group (CHERG), meta-analysis of randomized ITN trials [9]

Dynamic transmission model simulations for a wide range of sub-Sahara-Africa like scenarios, varying in endemicity, seasonality and baseline intervention coverages, performed in the OpenMalaria model – summarized in multi-variate statistical models [13]. OpenMalaria intervention effectiveness assumptions were in turn based on meta-analysis of randomized ITN trials [9], and review of observational treatment impact studies [18, 49]

Basis and source of coverage-impact relationship: case management

Meta-analyses of published observational studies and a previous Delphi estimate [21]

  1. Differences in data sources, intervention coverage definitions and country baseline parameter values are described in Tables 1 and 2