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

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. Analytical model for decision making, characterized by cost-effectiven...

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Bibliographic Details
Published in:PloS one Vol. 14; no. 11; p. e0225197
Main Authors: Loureiro, Rafaela Borge, Maciel, Ethel Leonor Noia, Caetano, Rosangela, Peres, Renata Lyrio, Fregona, Geisa, Golub, Jonathan E., Braga, José Ueleres
Format: Journal Article
Language:English
Published: United States Public Library of Science 14.11.2019
Public Library of Science (PLoS)
Subjects:
Adult
Aged
Analysis
Clinical Decision-Making
Computer simulation
Cost analysis
Cost benefit analysis
Decision analysis
Decision making
Decision Trees
Diagnosis
Diagnostic systems
Economic aspects
Economic impact
Epidemiology
Female
Gold
Health aspects
Health care
Health care policy
Health Personnel
Humans
Infections
Infectious diseases
Laboratories
Latent Tuberculosis - diagnosis
Latent Tuberculosis - epidemiology
Latent Tuberculosis - therapy
Male
Mass Screening - economics
Mass Screening - methods
Medical diagnosis
Medical personnel
Medical tests
Medicine and Health Sciences
Middle Aged
Model testing
Mortality
People and places
Primary Health Care
Public health
Public health movements
Reproducibility of Results
Sensitivity and Specificity
Skin
Skin tests
Social Sciences
Strategy
Technology
Tuberculin
Tuberculin Test - economics
Tuberculin Test - methods
Tuberculin Test - standards
Tuberculosis
Workers
Young Adult
Brazil
United States > US
Rio de Janeiro Brazil
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary: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. Analytical model for decision making, characterized by cost-effectiveness analysis. Primary Care Level, considering primary health care workers in Brazil. 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. 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. The outcome measures are the number of individuals correctly classified by the test and the number of Tuberculosis cases avoided. 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. 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.
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Competing Interests: The authors have declared that no competing interests exist. This study has not been submitted elsewhere for publication. All authors have approved the manuscript.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0225197