Table 1

Data inputs and assumptions

VariableEstimateSourceDistribution
Population characteristics
Population at risk—birth cohort (2017)69 212Joint Reporting Form data from Guinea-Bissau*Fixed
Life expectancy at birth57 yearsWorld Bank 2017†Fixed
Estimated no of TB cases in males aged 0–4 in 201674 (37–121)Global Burden of Disease Results Tool‡Log-normal
Estimated no of TB cases in females aged 0–4 in 201689 (47–145)Global Burden of Disease Results Tool‡Log-normal
Estimated no of TB deaths in males aged 0–4 in 201616 (8–36)Global Burden of Disease Results Tool‡Log-normal
Estimated no of TB deaths in females aged 0–4 in 201617 (5–52)Global Burden of Disease Results Tool‡Log-normal
Reported TB cases aged 0–4 years in Guinea-Bissau46Annual TB report 2017, Guinea-Bissau§Fixed
Case-fatality rate0.21Estimated from Global Burden of Disease estimates
(See online supplemental appendix 1.3.1)
Fixed
TB estimates used in sensitivity analyses
Estimated no of TB cases in males aged 0–4 in 2016290 (270–310)WHO TB data¶Log-normal
Estimated no of TB cases in females aged 0–4 in 2016240 (220–250)WHO TB data¶Log-normal
Estimated no of TB deaths in children aged 0–4 years in 2016238 (48–518)Dodd, Lancet Global Health, 2017**Log-normal
Individual daily all-cause mortality risk
Day 00.014184 (0.012901–0.015632)BHP HDSS routine data††Log-normal
Day 10.003370 (0.002757–0.004165)BHP HDSS routine data††Log-normal
Day 20.002100 (0.001646–0.002724)BHP HDSS routine data††Log-normal
Day 30.001090 (0.000772–0.001592)BHP HDSS routine data††Log-normal
Day 40.001123 (0.000799–0.001630)BHP HDSS routine data††Log-normal
Day 50.000787 (0.000518–0.001259)BHP HDSS routine data††Log-normal
Day 60.001110 (0.000785–0.001624)BHP HDSS routine data††Log-normal
Day 70.000547 (0.000319–0.001024)BHP HDSS routine data††Log-normal
Day 8–280.000142 (0.000115–0.000179)BHP HDSS routine data††Log-normal
Day 29–3650.000054 (0.000049–0.000058)BHP HDSS routine data††Log-normal
Day 366–18260.000018 (0.000017–0.000020)BHP HDSS routine data††Log-normal
Individual daily risk of all-cause hospital admission
Day 0–280.000083 (0.000065–0.000107)BHP HDSS routine data††Log-normal
Day 29–3650.000080 (0.000074–0.000085)BHP HDSS routine data††Log-normal
Day 366–18260.000042 (0.000039–0.000044)BHP HDSS routine data††Log-normal
BCG coverage distribution in baseline scenario figure 1 BHP HDSS routine data‡‡Fixed
BCG coverage distribution disregarding the vial-opening policy figure 1 BHP HDSS routine data‡‡Fixed
Vaccine characteristics TB-specific
Risk ratio of BCG on TB deaths0.34 (0.12–0.92)Abubakar, Health Technol Assess, 2013§§Log-normal
Duration of protection>5 yearsAbubakar, Health Technol Assess, 2013§§Fixed
Waning of protectionNoneAssumptionFixed
Prevention of transmission by BCGNoneAssumptionFixed
Vaccine characteristics all-cause effects
Risk ratio of BCG on all-cause deaths0.58 (0.42–0.81)Meta-estimate of studies from Guinea-Bissau¶¶Log-normal
Risk ratio of BCG on all-cause hospital admissions0.97 (0.72–1.31)Meta-estimate of studies from Guinea-Bissau***Log-normal
Duration of protection>5 yearsAssumptionFixed
Waning of protectionNoneAssumptionFixed
Prevention of transmission by BCGNoneAssumptionFixed
Cost estimates
BCG vaccine price per dose incl. freight0.20 USDNational department of the Expanded Programme on Immunisation*Fixed
Injection syringe price incl. freight0.05 USDNational department of the Expanded Programme on Immunisation*Fixed
Mixing syringe price incl. freight0.03 USDNational department of the Expanded Programme on Immunisation*Fixed
Safety box0.67 USDNational department of the Expanded Programme on Immunisation*Fixed
Median bed day per TB hospital admission60 daysPersonal communication: Victor Gomes, National TB Programme§Fixed
Median bed day per all-cause hospital admission5 daysBHP HDSS hospital admission data†††Fixed
Costs per hospital bed day incurred by health system15.58 USDEnemark, in preparation, 2019‡‡‡Fixed
Household productivity costs per bed day hospital admission2.98 USDKnight, PNAS, 2014§§§Fixed
Household costs of seeking BCG vaccination1.92 USDThysen, Vaccine, 2019¶¶¶Fixed
Average no of times seeking BCG vaccination—restrictive (baseline) scenario1.26Thysen, Vaccine, 2019¶¶¶Fixed
Average no of times seeking BCG vaccination—non-restrictive scenario1AssumptionFixed
Vaccine wastage—restrictive (baseline) scenario50%AssumptionFixed
Vaccine wastage—non-restrictive scenario95%AssumptionFixed
  • *Personal communication: Carlitos Bale, Director of the Expanded Programme on Immunisation in Guinea-Bissau.

  • †World Bank.17

  • ‡Institute for Health Metrics and Evaluation.18

  • §Personal communication: Victor Gomes, Programmatic Manager of MDR-TB, National TB Programme.

  • ¶WHO.31

  • **Dodd PJ etal 5

  • ††online supplemental appendix 1.2.1.

  • ‡‡online supplemental appendix 1.2.2.

  • §§Abubakar I et al 20

  • ¶¶online supplemental appendix 1.2.3, figure 2.

  • ***Schaltz-Buchholzer F et al 22

  • †††online supplemental appendix 1.2.6.

  • ‡‡‡Enemark U et al 24

  • §§§Knight GM et al 25

  • ¶¶¶Thysen SM etal 23

  • BHP, Bandim Health Project’s; HDSS, Health and Demographic Surveillance Systems; TB, tuberculosis.