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] |