Model diagram of strategies for <i>P</i>. <i>vivax</i> treatment in females.

<p>Model diagram of strategies for <i>P</i>. <i>vivax</i> treatment in females.</p

Two-way sensitivity analysis results showing the impact of changes in the level of adherence to primaquine regimens.

<p>Green represents disability-adjusted life-years (DALYs) averted by the screening strategy for a cohort of 1000 individuals. For costs, yellow indicates increased costs and blue indicates cost savings for the screening strategy for one individual. For net monetary benefit (<i>NMB</i>), purple indicates scenarios where the screening strategy would be cost-effective at a threshold of US$500 (<i>T</i>) where <i>NMB = T × ΔDALYs– ΔCosts</i>.</p

Model diagram of strategies for <i>P</i>. <i>vivax</i> treatment in males.

<p>Model diagram of strategies for <i>P</i>. <i>vivax</i> treatment in males.</p

One-way sensitivity analysis results on costs and disability-adjusted life-years (DALYs) for the comparison of the screening strategy with the chloroquine strategy in males.

<p>The ranges used are specified in <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0005602#pntd.0005602.t002" target="_blank">Table 2</a>. See <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0005602#pntd.0005602.s003" target="_blank">S3 Appendix</a> for all one-way sensitivity analysis results.</p

Summary of key components of each strategy.

<p>Summary of key components of each strategy.</p

Costs and disability adjusted life year (DALY) results over one year per primary episode treated in the base case analysis and probabilistic sensitivity analysis (PSA).

<p>All costs are in 2014 United States Dollars.</p

The table shows simulated outcomes for 1000 <i>P</i>. <i>vivax</i> malaria patients of undetermined G6PD status at attendance, if they were managed according to each of three strategies (chloroquine, primaquine and screening) according to G6PD status, treatment given and the test result if screened.

<p>The table shows simulated outcomes for 1000 <i>P</i>. <i>vivax</i> malaria patients of undetermined G6PD status at attendance, if they were managed according to each of three strategies (chloroquine, primaquine and screening) according to G6PD status, treatment given and the test result if screened.</p

Model parameters and sources.

<p>All costs are listed in 2014 United States Dollars.</p

One-way sensitivity analysis of the impact of changing the base case parameter value to low and high values on the incremental cost-effectiveness ratios (ICERs) for Scenarios 3 (high primaquine adherence) and 4 (low primaquine adherence) as compared to the baseline scenario for peri-urban Manaus, São Gabriel da Cachoeira, and Itaituba.

See Table 1 for the ranges used for this analysis. (TIF)</p

Map of incremental cost-effectiveness ratios (ICERs) in each malaria-endemic municipality for Scenario 1 (tafenoquine for adults, primaquine adherence 66.7%), Scenario 2 (tafenoquine for all, primaquine adherence 66.7%), Scenario 3 (tafenoquine for adults, high primaquine adherence of 90%), and Scenario 4 (tafenoquine for adults, low primaquine adherence of 30%), compared to baseline (7 day low-dose primaquine (0.5 mg/kg), adherence set at comparison scenario).

The municipality of Manaus is plotted using results for peri-urban Manaus. The ICER for the municipality of Caapiranga for Scenario 3 was US$60,273, well above the scale. Municipalities where a strategy increased DALYs as compared to baseline are shown in grey. Maps generated with shapefiles from the R package malariaAtlas (available from: https://cran.r-project.org/web/packages/malariaAtlas/index.html).</p