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.
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...
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| Format: | Article |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0225197 |
| _version_ | 1819259600596107264 |
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| author | Rafaela Borge Loureiro Ethel Leonor Noia Maciel Rosangela Caetano Renata Lyrio Peres Geisa Fregona Jonathan E Golub José Ueleres Braga |
| author_facet | Rafaela Borge Loureiro Ethel Leonor Noia Maciel Rosangela Caetano Renata Lyrio Peres Geisa Fregona Jonathan E Golub José Ueleres Braga |
| author_sort | Rafaela Borge Loureiro |
| collection | DOAJ |
| description | 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. |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-23T19:12:35Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-aca8d0277bb5454790285548c7faf7e42022-12-21T17:34:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011411e022519710.1371/journal.pone.0225197Cost-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.Rafaela Borge LoureiroEthel Leonor Noia MacielRosangela CaetanoRenata Lyrio PeresGeisa FregonaJonathan E GolubJosé Ueleres BragaOBJECTIVES: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.https://doi.org/10.1371/journal.pone.0225197 |
| spellingShingle | Rafaela Borge Loureiro Ethel Leonor Noia Maciel Rosangela Caetano Renata Lyrio Peres Geisa Fregona Jonathan E Golub José Ueleres Braga 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. PLoS ONE |
| title | 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. |
| title_full | 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. |
| title_fullStr | 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. |
| title_full_unstemmed | 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. |
| title_short | 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. |
| title_sort | 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 |
| url | https://doi.org/10.1371/journal.pone.0225197 |
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