Variable | Estimate | Source | Distribution |
Population characteristics | |||
Population at risk—birth cohort (2017) | 69 212 | Joint Reporting Form data from Guinea-Bissau* | Fixed |
Life expectancy at birth | 57 years | World Bank 2017† | Fixed |
Estimated no of TB cases in males aged 0–4 in 2016 | 74 (37–121) | Global Burden of Disease Results Tool‡ | Log-normal |
Estimated no of TB cases in females aged 0–4 in 2016 | 89 (47–145) | Global Burden of Disease Results Tool‡ | Log-normal |
Estimated no of TB deaths in males aged 0–4 in 2016 | 16 (8–36) | Global Burden of Disease Results Tool‡ | Log-normal |
Estimated no of TB deaths in females aged 0–4 in 2016 | 17 (5–52) | Global Burden of Disease Results Tool‡ | Log-normal |
Reported TB cases aged 0–4 years in Guinea-Bissau | 46 | Annual TB report 2017, Guinea-Bissau§ | Fixed |
Case-fatality rate | 0.21 | Estimated 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 2016 | 290 (270–310) | WHO TB data¶ | Log-normal |
Estimated no of TB cases in females aged 0–4 in 2016 | 240 (220–250) | WHO TB data¶ | Log-normal |
Estimated no of TB deaths in children aged 0–4 years in 2016 | 238 (48–518) | Dodd, Lancet Global Health, 2017** | Log-normal |
Individual daily all-cause mortality risk | |||
Day 0 | 0.014184 (0.012901–0.015632) | BHP HDSS routine data†† | Log-normal |
Day 1 | 0.003370 (0.002757–0.004165) | BHP HDSS routine data†† | Log-normal |
Day 2 | 0.002100 (0.001646–0.002724) | BHP HDSS routine data†† | Log-normal |
Day 3 | 0.001090 (0.000772–0.001592) | BHP HDSS routine data†† | Log-normal |
Day 4 | 0.001123 (0.000799–0.001630) | BHP HDSS routine data†† | Log-normal |
Day 5 | 0.000787 (0.000518–0.001259) | BHP HDSS routine data†† | Log-normal |
Day 6 | 0.001110 (0.000785–0.001624) | BHP HDSS routine data†† | Log-normal |
Day 7 | 0.000547 (0.000319–0.001024) | BHP HDSS routine data†† | Log-normal |
Day 8–28 | 0.000142 (0.000115–0.000179) | BHP HDSS routine data†† | Log-normal |
Day 29–365 | 0.000054 (0.000049–0.000058) | BHP HDSS routine data†† | Log-normal |
Day 366–1826 | 0.000018 (0.000017–0.000020) | BHP HDSS routine data†† | Log-normal |
Individual daily risk of all-cause hospital admission | |||
Day 0–28 | 0.000083 (0.000065–0.000107) | BHP HDSS routine data†† | Log-normal |
Day 29–365 | 0.000080 (0.000074–0.000085) | BHP HDSS routine data†† | Log-normal |
Day 366–1826 | 0.000042 (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 deaths | 0.34 (0.12–0.92) | Abubakar, Health Technol Assess, 2013§§ | Log-normal |
Duration of protection | >5 years | Abubakar, Health Technol Assess, 2013§§ | Fixed |
Waning of protection | None | Assumption | Fixed |
Prevention of transmission by BCG | None | Assumption | Fixed |
Vaccine characteristics all-cause effects | |||
Risk ratio of BCG on all-cause deaths | 0.58 (0.42–0.81) | Meta-estimate of studies from Guinea-Bissau¶¶ | Log-normal |
Risk ratio of BCG on all-cause hospital admissions | 0.97 (0.72–1.31) | Meta-estimate of studies from Guinea-Bissau*** | Log-normal |
Duration of protection | >5 years | Assumption | Fixed |
Waning of protection | None | Assumption | Fixed |
Prevention of transmission by BCG | None | Assumption | Fixed |
Cost estimates | |||
BCG vaccine price per dose incl. freight | 0.20 USD | National department of the Expanded Programme on Immunisation* | Fixed |
Injection syringe price incl. freight | 0.05 USD | National department of the Expanded Programme on Immunisation* | Fixed |
Mixing syringe price incl. freight | 0.03 USD | National department of the Expanded Programme on Immunisation* | Fixed |
Safety box | 0.67 USD | National department of the Expanded Programme on Immunisation* | Fixed |
Median bed day per TB hospital admission | 60 days | Personal communication: Victor Gomes, National TB Programme§ | Fixed |
Median bed day per all-cause hospital admission | 5 days | BHP HDSS hospital admission data††† | Fixed |
Costs per hospital bed day incurred by health system | 15.58 USD | Enemark, in preparation, 2019‡‡‡ | Fixed |
Household productivity costs per bed day hospital admission | 2.98 USD | Knight, PNAS, 2014§§§ | Fixed |
Household costs of seeking BCG vaccination | 1.92 USD | Thysen, Vaccine, 2019¶¶¶ | Fixed |
Average no of times seeking BCG vaccination—restrictive (baseline) scenario | 1.26 | Thysen, Vaccine, 2019¶¶¶ | Fixed |
Average no of times seeking BCG vaccination—non-restrictive scenario | 1 | Assumption | Fixed |
Vaccine wastage—restrictive (baseline) scenario | 50% | Assumption | Fixed |
Vaccine wastage—non-restrictive scenario | 95% | Assumption | Fixed |
*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.