Table 3 Model parameters
Variable | Value | Range | Source |
|---|---|---|---|
Demographic variables | |||
Annual maternal mortality rates | UNICEF [20] | ||
<12 months ART | |||
>350 cells/mm3 | 3.3% | - | |
200-350 cells/mm3 | 3.9% | - | |
<200 cells/mm3 | 11.1% | - | |
>12 months ART | |||
>350 cells/mm3 | 1.0% | - | |
200-350 cells/mm3 | 1.1% | - | |
<200 cells/mm3 | 1.8% | - | |
Number of children | 2.34 | 1-5 | Chart review |
Transition Probabilities | |||
Access to care | 82% | 50-95% | Ghana Health Service [7] |
Adherence to ART | 90% | 50-95% | Ghana Health Service [7] |
Transmission during pregnancy | |||
No therapy/non-adherence | 22% | 15-30% | Ghana Health Service [12] |
Option B | 10%Ϯ | 0-15% | Ghana Health Service [12] |
Option B-Plus | 1% | 0-5% | Ghana Health Service [12] |
Transmission during breastfeeding | |||
No therapy/non-adherence | 10% | 5-20% | Ghana Health Service [12] |
Option B | 1% | 0-5% | Ghana Health Service [12] |
Option B+ | 1% | 0-5% | Ghana Health Service [12] |
Changes to CD4 Count | |||
No therapy (every 3 months) | −12.75 cells/mm3 | 5-20 cells/mm3 | Holmes 2006 [15] |
Initiate therapy | +153 cells/mm3 | 100-400 cells/mm3 | Deeks 1999 [16] |
Continue therapy (every 3 months) | |||
Previously interrupted therapy | −0.06365 × [Current CD4] | - | Ickovics et al. 2001 [14] |
Continuous therapy | - 0.0099853 × [Current CD4] | - | Ickovics et al. 2001 [14] |
Costs in USD [GHS] | |||
Annual Cost of HIV Care | |||
First-Line ART | 385.45 [743.91] | 191-580 | |
Second-Line ART | 848.33 [1,637.28] | - | |
Lifetime Cost of Care for HIV+ Child (including ART costs) | 10,665.49 [20,584.40] | 5,181-15,544 | |
Quality-of-life Factor | |||
HIV+ adult (quality of life) | 0.8 | 0.50-1.0 | Tengs T.O., Lin T.H. 2002 [19] |
HIV+ child (lifetime QALYs) | 20.2ϮϮ | 10-30 | UN Impact of AIDS 2004 [32] |
HIV- child (lifetime QALYs) | 62.7 | 50-70 | UN Impact of AIDS 2004 [32] |
Discount rate | 0.03 | 0.00-0.05 | Weinstein et al. 1996 [23] |