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Purpose: To assess the cost effectiveness of school-based tuberculosis (TB) screening using QuantiFERON®-TB Gold In-Tube (QFT) versus the tuberculin skin test (TST) and chest x-ray examination (CXR). Methods: We constructed Markov models of first-year high-school and university students, using a societal perspective, and followed them up until the age of 80 years. Three strategies (QFT, TST, and CXR) were modeled. All costs and clinical benefits were discounted at a fixed annual rate of 3%. Results: In the base-case analyses of 16-year-old high-school students and 19-year-old university students, the QFT strategy yielded the greatest benefits at the lowest cost [in year 2009 values] (16-year-olds: $US627.89, 29.69835 quality-adjusted life-years [QALYs]; 19-year-olds: $US646.04, 29.15361 QALYs), compared with the TST strategy (16-year-olds: $US943.50, 29.69767 QALYs; 19-year-olds: $US998.62, 29.15288 QALYs) and the CXR strategy (16-year-olds: $US7286.24, 29.69532 QALYs; 19-year-olds: $US7305.19, 29.14911 QALYs). On one-way sensitivity analyses, the bacillus Calmette-Guérin (BCG) vaccination rate was not sensitive to the TST strategy. On probabilistic sensitivity analysis, the QFT strategy was the most cost effective, with a willingness-to-pay level of $US50 000/QALY gained. Conclusion: The QFT strategy provided the greatest benefits at the lowest cost for school-based TB screening. There appears to be little role for TST or CXR in screening of school populations. Current practices using either TST or CXR screening should be reconsidered on the basis of cost effectiveness.
Kojiya Haneda Healthcare Service, Ota City Public Health Office, Tokyo, Japan.
This article was published in the following journal.
Name: Molecular diagnosis & therapy
To examine the usefulness of an interferon-gamma release assay (IGRA) for the diagnosis of smear-negative tuberculosis (TB) in China.
Contribution of a heparin-binding haemagglutinin interferon-gamma release assay to the detection of Mycobacterium tuberculosis infection in HIV-infected patients: comparison with the tuberculin skin test and the QuantiFERON®-TB Gold In-tube.
The screening and treatment of latent tuberculosis (TB) infection reduces the risk of progression to active disease and is currently recommended for HIV-infected patients. The aim of this study is to ...
South Koreans receive the bacillus Calmette-Guerin (BCG) vaccination, which influence the result of the tuberculin skin test (TST); however, only a few studies have described the usefulness of the TST...
The whole-blood interferon (IFN)-γ release assay (IGRA) has been studied mainly for diagnosing latent tuberculosis (TB). We prospectively evaluated its diagnostic usefulness in patients with suspecte...
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The ministry of health in Israel requires all health-care workers to undergo screening for latent Tuberculosis infection (LTBI) prior to starting work. This is based on the Mantoux skin te...
The purpose of this research study is to test the safety and effectiveness of inhaled Interferon gamma-1b (IFN-g 1b), when administered for 48 weeks and in combination with oral antibiotic...
The purpose of this research study is to evaluate the safety and effectiveness of Interferon gamma-1b (IFN-g 1b) on lung function when given to patients with cystic fibrosis by inhalation ...
When administered simultaneously, interferon-alpha 2b + interferon-gamma result in dramatic antiviral synergy.Ribavirin has shown to enhance interferon-gamma levels in patients with chroni...
A type II interferon produced by recombinant DNA technology. It is similar to the interferon secreted by lymphocytes and has antiviral and antineoplastic activity.
A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.
The major interferon produced by mitogenically or antigenically stimulated LYMPHOCYTES. It is structurally different from TYPE I INTERFERON and its major activity is immunoregulation. It has been implicated in the expression of CLASS II HISTOCOMPATIBILITY ANTIGENS in cells that do not normally produce them, leading to AUTOIMMUNE DISEASES.
Coded listings of physician or other professional services using units that indicate the relative value of the various services they perform. They take into account time, skill, and overhead cost required for each service, but generally do not consider the relative cost-effectiveness. Appropriate conversion factors can be used to translate the abstract units of the relative value scales into dollar fees for each service based on work expended, practice costs, and training costs.
An interferon regulatory factor that recruits STAT1 PROTEIN and STAT2 PROTEIN heterodimers to interferon-stimulated response elements and functions as an immediate-early protein.
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An assay is an analytic procedure for qualitatively assessing or quantitatively measuring the presence or amount or the functional activity of a target entity. This can be a drug or biochemical substance or a cell in an organism or organic sample. ...
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