Preventive malaria treatment for contacts of patients with Ebola virus disease in the context of the west Africa 2014–15 Ebola virus disease response: an economic analysis  Dr Cristina Carias, PhD, Bradford Greening, PhD, Caresse G Campbell, PhD, Martin I Meltzer, PhD, Mary J Hamel, MD  The Lancet Infectious Diseases  Volume 16, Issue 4, Pages 449-458 (April 2016) DOI: 10.1016/S1473-3099(15)00465-X Copyright © 2016 Elsevier Ltd Terms and Conditions

Figure 1 Decision tree model From a health-care provider perspective; the period of analyses is 1 year. EVD=Ebola virus disease. ETU=Ebola treatment unit. The Lancet Infectious Diseases 2016 16, 449-458DOI: (10.1016/S1473-3099(15)00465-X) Copyright © 2016 Elsevier Ltd Terms and Conditions

Figure 2 Cost of preventive malaria treatment per ETU admission averted (ACER) as a function of parasite prevalence in children aged 2–10 years, according to season In contacts younger than 5 years (A), aged 5–14 years (B), and 15 years and older (C). Base-case cost estimates are presented in table 2. We have not presented values of the ACER (y-axis) when the intervention was cost saving (ie, ACER less than $0), in accordance with cost-effectiveness reporting guidelines.9 The relation between parasite prevalence, incidence of malaria, and proportion of malaria cases per age group was as estimated by Griffin and colleagues.17 To calculate the age-group-specific malaria attack rate per 21 days, we used the population distribution of the African continent for 2014.19 We assumed that the proportion of malaria cases occurring during the 6-month wet season was 75% and the proportion occurring during the 6-month dry season was 25%. To consider no specific seasonality, we assumed that the proportion of malaria cases in every month of the year was equal.18 ACER=average cost-effectiveness ratio. The Lancet Infectious Diseases 2016 16, 449-458DOI: (10.1016/S1473-3099(15)00465-X) Copyright © 2016 Elsevier Ltd Terms and Conditions

Figure 3 Cost of preventive malaria treatment per ETU admission averted (ACER) as a function of the average daily cost of an ETU bed in Liberia, according to age group of contact In the wet season (A) and the dry season (B). We have not presented values of the ACER (y-axis) when the intervention was cost saving (ie, ACER less than $0), in accordance with cost-effectiveness reporting guidelines.9 For this sensitivity analysis, we used parasite prevalence and age distribution of clinical malaria cases as calculated for Liberia. We assumed that the proportion of malaria cases occurring in the 6-month wet season was 75% and the proportion occurring during the dry season was 25%.18 ACER=average cost-effectiveness ratio. ETU=Ebola treatment unit. The Lancet Infectious Diseases 2016 16, 449-458DOI: (10.1016/S1473-3099(15)00465-X) Copyright © 2016 Elsevier Ltd Terms and Conditions