Impact of substandard and falsified antimalarials in Zambia: application of the SAFARI model

BMC Public Health

Table 3 Impact of Intervention Scenarios Compared to Baseline

	Deaths	Total Economic Impact		Total Productivity Losses
	Deaths	Estimate	95% CI	Estimate	95% CI
Baseline	2610	$141,470,907	(141,037,214 to 141,904,600)	$114,596,572	(114,200,504 to 114, 992,639)
No SF Antimalarials^a	−213	−$8,541,887	(−$8,547,760 to −$8,536,014)	−$7,707,639	(− $7,713,090 to −$7,702,188)
No stock-outs all outlets^b,c	−141	−$5,471,452	(−$5,490,113 to −$5,452,791)	−$5,092,216	(−$5,109,558 to −$5,074,874)
No public stock-outs^c	−69	−$2,920,369	(−$2,926,294 to −$2,914,444)	−$2,534,053	(−$2,539,559 to −$2,528,548)
No private stock-outs^c	−18	−$729,901	(−$735,857 to −$723,945)	−$584,179	(−$589,739 to −$578,620)
Only ACTs are available^d	2	−$56,718	(−$62,749 to −$50,688)	$85,065	($79,476 to $90,654)
Increase in care seeking habits^c,e	−345	−$12,713,276	(−$12,719,093 to −$12,707,459)	−$12,466,581	(−$12,471,928 to −$12,461,234)

ACTs artemisinin-based combination therapies, CI confidence interval, SF substandard and falsified
^aSimulated the prevalence of substandard and falsified antimalarials at 10.3%
^bThis includes public and private hospitals, pharmacies, general retailers, and drug stores
^cThese scenarios assumed that supply of antimalarials would increase to meet the demand, keeping the proportion of substandard and falsified antimalarials and the mix of available antimalarials the same as baseline
^dThis scenario was not statistically significantly different from baseline given high ACT availability at 97.4%
^e20% of those who did not seek care for child malaria were assumed to seek care

ISSN: 1471-2458