From: Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model
Model Input | Point Estimate | Range/SD | Source |
---|---|---|---|
Demographic & Epidemiological Data | |||
 < 5 Population At Risk | 2,750,360 |  | President's Malaria Initiative 2019 [6] |
 Untreated Case Progression to Severe | 0.13 | 0.07–0.30 | Lubell 2011 [23] |
 Treatment Failure Progression to Severe | 0.02 |  | Lubell 2011 [23] |
 Inpatient Case Fatality Rate | 0.08 |  | Camponovo 2017 [24] |
 Case Fatality Rate Outside of Hospital | 0.15 |  | Camponovo 2017 [24] |
 Inpatient Severe Case Rate of NS | 0.032 | 0.0014 | Lubell 2011 [23] |
Care-Seeking Behavior (%) | |||
 Public Facilities | 67.5% |  | Zambian DHS 2018 [25] |
 Private Facilities | 4.6% |  | Zambian DHS 2018 [25] |
 Pharmacies | 0.3% |  | Zambian DHS 2018 [25] |
 Drug Stores | 0.8% |  | Zambian DHS 2018 [25] |
 CHWs | 3.0% |  | Zambian DHS 2018 [25] |
 Self/Neighbors | 9.2% |  | Zambian DHS 2018 [25] |
 No Treatment | 14.6% |  | Zambian DHS 2018 [25] |
Probability facility has antimalarial in stock | |||
 Public Facilities | 99.8% |  | ACTwatch 2014 [8] |
 Private Facilities | 90.5% |  | ACTwatch 2014 [8] |
 Pharmacies | 88.8% |  | ACTwatch 2014 [8] |
 Drug Stores | 92.1% |  | ACTwatch 2014 [8] |
Medication Effectiveness | |||
 ACTs Effectiveness | 0.962 | 0.044 | Nambozi 2011, Bassat 2009, 4ABC 2011, Hamainza 2014, Pekyi 2016, Chanda 2006, Depoortere 2005 [26,27,28,29,30,31,32] |
 SP Effectiveness | 0.759 | 0.741–0.905 | Depoortere 2005 [31] |
 Other Drug Effectiveness | 0.88 | 0.041 | |
Substandard and Falsified Parameters | |||
 Proportion of SF Antimalarials (API > 85%) | 0.103 |  | Bate 2010 [15] |
 Increase in Probability of Transitioning to Severe Malaria if Receive SF Drug | 50% |  | Assumption |
Treatment Adherence | Â | Coefficient | Â |
 Good: Probably Adherent | 0.3940 | 1 | Depoortere 2004 [35] |
 Fair: Perhaps Not Adherent | 0.3940 | 0.5 | Depoortere 2004 [35] |
 Poor: Definitely Not Adherent | 0.2120 | 0 | Depoortere 2004 [35] |
Patient Costs for Drugs | |||
Public Facilities | |||
  Average Costs of ACTs | $0.00 |  | ACTwatch 2014 [8] |
  Average Costs of SP | $0.00 |  | ACTwatch 2014 [8] |
  Average Costs of Other Treatments | $0.00 |  | ACTwatch 2014 [8] |
Private Facilities | |||
  Average Costs of ACTs | $5.23 | $2.09 - $12.81 | ACTwatch 2014 [8] |
  Average Costs of SP | $0.65 | $0.33 - $1.96 | ACTwatch 2014 [8] |
  Average Costs of Other Treatments | $5.23 | $0.00 - $8.24 | ACTwatch 2014 [8] |
Pharmacies | |||
  Average Costs of ACTs | $5.23 | $3.92 - $7.85 | ACTwatch 2014 [8] |
  Average Costs of SP | $0.33 | $0.26 - $0.65 | ACTwatch 2014 [8] |
  Average Costs of Other Treatments | $5.49 | $3.84 - $5.49 | ACTwatch 2014 [8] |
Drug Stores | |||
  Average Costs of ACTs | $1.96 | $1.31 - $3.14 | ACTwatch 2014 [8] |
  Average Costs of SP | $0.39 | $0.26 - $0.39 | ACTwatch 2014 [8] |
  Average Costs of Other Treatments | $1.37 | $0.00 - $0.00 | ACTwatch 2014 [8] |
Other Costs to Patients | |||
  Transport Costs (Public, Private) | $2.51 | $1.25 - $6.26 | Aspler 2008 [36] |
  Transport Costs (Pharmacies, Drug Stores) | $0.25 |  | Assumption based on: Aspler 2008 [36] |
  Costs of Special Food for Children | $3.12 | $0.96 - $6.26 | Aspler 2008 [36] |
  Costs per Pediatric Malaria Hospitalization | $10.56 | $2.69 | WHO CHOICE 2010 [37] |
  Productivity Loss per Sick Day | $3.21 |  | Calculation based on World Bank 2019 [38] |
  Productivity Loss from Death, Discounted at 3% | $30,155.30 |  | Calculation based on World Bank 2019 [38] |
  NS Disability Productivity Loss, Discounted at 3% | $12,477.37 |  | Calculation based on World Bank 2019 [38] |
Facility Costs | |||
  Facility Costs per Testing | $0.96 | $0.21 | Chanda 2009 [39] |
  Facility Costs per ACTs | $2.00 | $0.50 | Chanda 2007 [40] |
  Facility Costs per SP | $0.27 | $0.06 | Chanda 2007 [40] |
  Facility Costs per Other Treatments | $0.11 |  | Calculation |
  Public Facility Costs per Consultation | $6.40 | $1.51 | Chanda 2007 [40] |
  Facility Costs per Pediatric Malaria Hospitalization | $84.07 | $6.72 | Comfort 2014 [41] |
  Costs per CHW Treatment | $1.01 | $0.19 | Chanda 2011 [42] |
  Costs per CHW Testing | $3.14 | $0.79 | Haimanza 2014 [43] |
  Costs per CHW Visit | $3.32 | $0.79 | Chanda 2011 [42] |