BMC Infectious Diseases | |
QuantiFERON-TB gold in-tube implementation for latent tuberculosis diagnosis in a public health clinic: a cost-effectiveness analysis | |
Research Article | |
Maria Martins-Evora1  Vincent Marsiglia1  Howard Choi2  Kathryn Miele2  Susan Dorman2  Maunank Shah3  Danielle DiPietro4  | |
[1] Baltimore City Health Department, Baltimore, MD, USA;Johns Hopkins University School of Medicine, Baltimore, MD, USA;Johns Hopkins University School of Medicine, Baltimore, MD, USA;Division of Infectious Disease, Center for TB Research, Johns Hopkins University, School of Medicine, 1503 East Jefferson St, Room 118, 21231, Baltimore, MD, USA;Tulane University, New Orleans, LA, USA; | |
关键词: Tuberculosis; Diagnosis; Interferon-gamma release assay; Latent tuberculosis; Implementation; | |
DOI : 10.1186/1471-2334-12-360 | |
received in 2012-08-14, accepted in 2012-12-14, 发布年份 2012 | |
来源: Springer | |
【 摘 要 】
BackgroundThe tuberculin skin test (TST) has limitations for latent tuberculosis infection (LTBI) diagnosis in low-prevalence settings. Previously, all TST-positive individuals referred from the community to Baltimore City Health Department (BCHD) were offered LTBI treatment, after active TB was excluded. In 2010, BCHD introduced adjunctive QuantiFERON-TB Gold In-Tube (QFT-GIT) testing for TST-positive referrals. We evaluated costs and cost-effectiveness of this new diagnostic algorithm.MethodsA decision-analysis model compared the strategy of treating all TST-positive referrals versus only those with positive results on adjunctive QFT-GIT testing. Costs were collected at BCHD, and Incremental Cost-Effectiveness Ratios (ICERs) were utilized to report on cost-effectiveness.ResultsQFT-GIT testing at BCHD cost $43.51 per test. Implementation of QFT-GIT testing was associated with an ICER of $1,202 per quality-adjusted life-year gained and was considered highly cost-effective. In sensitivity analysis, the QFT-GIT strategy became cost-saving if QFT-GIT sensitivity increased above 92% or if less than 3.5% of individuals with LTBI progress to active TB disease.ConclusionsLTBI screening with TST in low-prevalence settings may lead to overtreatment and increased expenditures. In this public health clinic, additional QFT-GIT testing of individuals referred for a positive TST was cost-effective.
【 授权许可】
CC BY
© Shah et al.; licensee BioMed Central Ltd. 2012
【 预 览 】
Files | Size | Format | View |
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RO202311100574879ZK.pdf | 653KB | download |
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