Cost-effectiveness of QuantiFERON-TB Gold In-Tube versus tuberculin skin test for diagnosis and treatment of Latent Tuberculosis Infection in primary health care workers in Brazil.

ABSTRACT: OBJECTIVES:The goal of this study was to perform a cost-effectiveness analysis from the public health system perspective, comparing five strategies for Latent Tuberculosis Infection (LTBI) diagnosis in primary health care workers in Brazil. DESIGN:Analytical model for decision making, characterized by cost-effectiveness analysis. SETTING:Primary Care Level, considering primary health care workers in Brazil. PARTICIPANTS:An analytical model for decision making, characterized by a tree of probabilities of events, was developed considering a hypothetical cohort of 10,000 primary health care workers, using the software TreeAge Pro™ 2013 to simulate the clinical and economic impacts of new diagnostic technology (QuantiFERON®-TB Gold in-Tube) versus the traditional tuberculin skin test. METHODS:This model simulated five diagnostic strategies for LTBI in primary health care workers (HCW) in Brazil: tuberculin skin testing using ?5 mm cut-off, tuberculin skin testing ?10 mm cut-off, QuantiFERON®-TB Gold in-Tube, tuberculin skin testing using ?5 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive, tuberculin skin testing using ?10 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive. PRIMARY AND SECONDARY OUTCOME MEASURES:The outcome measures are the number of individuals correctly classified by the test and the number of Tuberculosis cases avoided. RESULTS:The most cost-effective strategy was the tuberculin skin test considering ?10mm cut-off. The isolated use of the QuantiFERON®-TB Gold In-Tube revealed the strategy of lower efficiency with incremental cost-effectiveness ratio (ICER) of US$ 146.05 for each HCW correctly classified by the test. CONCLUSIONS:The tuberculin skin test using ?10 mm cut-off was the most cost-effective strategy in the diagnosis of Latent Tuberculosis Infection in primary health care works in Brazil.

SUBMITTER: Loureiro RB 

PROVIDER: S-EPMC6855475 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature