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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 evaluate the frequency of and factors associated with indeterminate interferon-gamma release assay (IGRA) results in people living with HIV/AIDS (PLWHA).
Many school-based recess interventions have been shown to be effective in increasing physical activity but their relative efficiency compared to other school-based programs are unknown. This study exa...
Interventions based around objective measurement of adherence to antiretroviral drugs for HIV have potential to improve adherence and to enable differentiation of care such that clinical visits are re...
The current mixed methods review aims to develop an aggregated synthesis of quantitative, qualitative and economic systematic evidence on chronic hepatitis C virus (HCV) infection management intervent...
New blood tests have become available to detect either latent or active tuberculosis. These tests - which according to the CDC can replace the tuberculin skin test - measure the production...
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...
The assay of INTERFERON-GAMMA released from lymphocytes after their exposure to a specific test antigen, to check for IMMUNOLOGIC MEMORY resulting from a previous exposure to the antigen. The amount of interferon-gamma released is usually assayed by an ENZYME-LINKED IMMUNOSORBENT ASSAY.
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.
A type II interferon produced by recombinant DNA technology. It is similar to the interferon secreted by lymphocytes and has antiviral and antineoplastic activity.
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 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. ...
Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...