| Author | Steffen, Ricardo Ewbank | |
| Author | Caetano, Rosângela | |
| Author | Pinto, Márcia | |
| Author | Chaves, Diogo | |
| Author | Ferrari, Rossini | |
| Author | Bastos, Mayara Lisboa Soares de | |
| Author | Abreu, Sandra Teixeira de | |
| Author | Menzies, Dick | |
| Author | Trajman, Anete | |
| Access date | 2013-07-22T17:40:45Z | |
| Available date | 2013-07-22T17:40:45Z | |
| Document date | 2013 | |
| Citation | STEFFEN, Ricardo Ewbank et al. Cost-effectiveness of quantiferon®-tb gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil. PLos ONE, San Francisco, v. 8, n. 4, apr. 2013. | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/6714 | |
| Sponsorship | CNPq, FAPERJ, ICOHRTA, CNPq/PIBIC UGF | pt_BR |
| Language | eng | pt_BR |
| Publisher | Public Library of Science | pt_BR |
| Rights | open access | |
| Title | Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1371/journal.pone.0059546 | |
| Abstract | BACKGROUND:
Latent tuberculosis infection (LTBI) is a reservoir for new TB cases. Isoniazid preventive therapy (IPT) reduces the risk of active TB by as much as 90%, but LTBI screening has limitations. Unlike tuberculin skin testing (TST), interferon-gamma release assays are not affected by BCG vaccination, and have been reported to be cost-effective in low-burden countries. The goal of this study was to perform a cost-effectiveness analysis from the health system perspective, comparing three strategies for LTBI diagnosis in TB contacts: tuberculin skin testing (TST), QuantiFERON®-TB Gold-in-Tube (QFT-GIT) and TST confirmed by QFT-GIT if positive (TST/QFT-GIT) in Brazil, a middle-income, high-burden country with universal BCG coverage.
METHODOLOGY/PRINCIPAL FINDINGS:
Costs for LTBI diagnosis and treatment of a hypothetical cohort of 1,000 adult immunocompetent close contacts were considered. The effectiveness measure employed was the number of averted TB cases in two years. Health system costs were US$ 105,096 for TST, US$ 121,054 for QFT-GIT and US$ 101,948 for TST/QFT-GIT; these strategies averted 6.56, 6.63 and 4.59 TB cases, respectively. The most cost-effective strategy was TST (US$ 16,021/averted case). The incremental cost-effectiveness ratio was US$ 227,977/averted TB case for QFT-GIT. TST/QFT-GIT was dominated.
CONCLUSIONS:
Unlike previous studies, TST was the most cost-effective strategy for averting new TB cases in the short term. QFT-GIT would be more cost-effective if its costs could be reduced to US$ 26.95, considering a TST specificity of 59% and US$ 18 considering a more realistic TST specificity of 80%. Nevertheless, with TST, 207.4 additional people per 1,000 will be prescribed IPT compared with QFT. | pt_BR |
| Affilliation | Universidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Medicina Inter. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Universidade Gama Filho. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Universidade Gama Filho. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Universidade Gama Filho. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Hospital Santa Casa de Misericórdia do Rio de Janeiro. Laboratório Paschoal Granato. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | McGill University. Montreal Chest Institute. Montreal, Quebec, Canada | pt_BR |
| Affilliation | Universidade Gama Filho. Rio de Janeiro, RJ, Brasil / McGill University. Montreal Chest Institute. Montreal, Quebec, Canada | pt_BR |
| DeCS | Custos de Cuidados de Saúde | pt_BR |
| DeCS | Sintomas Tuberculínicos | pt_BR |
| DeCS | Tuberculose Latente | pt_BR |
