Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil

Detalhes bibliográficos
Autor(a) principal: Steffen, Ricardo Ewbank
Data de Publicação: 2013
Outros Autores: Caetano, Rosângela, Pinto, Márcia, Chaves, Diogo, Ferrari, Rossini, Bastos, Mayara Lisboa Soares de, Abreu, Sandra Teixeira de, Menzies, Dick, Trajman, Anete
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/6714
Resumo: CNPq, FAPERJ, ICOHRTA, CNPq/PIBIC UGF
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spelling Steffen, Ricardo EwbankCaetano, RosângelaPinto, MárciaChaves, DiogoFerrari, RossiniBastos, Mayara Lisboa Soares deAbreu, Sandra Teixeira deMenzies, DickTrajman, Anete2013-07-22T17:40:45Z2013-07-22T17:40:45Z2013STEFFEN, 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.https://www.arca.fiocruz.br/handle/icict/671410.1371/journal.pone.0059546CNPq, FAPERJ, ICOHRTA, CNPq/PIBIC UGFUniversidade Federal do Rio de Janeiro. Programa de Pós-Graduação em Medicina Inter. Rio de Janeiro, RJ, BrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, BrasilUniversidade Gama Filho. Rio de Janeiro, RJ, BrasilUniversidade Gama Filho. Rio de Janeiro, RJ, BrasilUniversidade Gama Filho. Rio de Janeiro, RJ, BrasilHospital Santa Casa de Misericórdia do Rio de Janeiro. Laboratório Paschoal Granato. Rio de Janeiro, RJ, BrasilMcGill University. Montreal Chest Institute. Montreal, Quebec, CanadaUniversidade Gama Filho. Rio de Janeiro, RJ, Brasil / McGill University. Montreal Chest Institute. Montreal, Quebec, CanadaBACKGROUND: 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.engPublic Library of ScienceCost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleCustos de Cuidados de SaúdeSintomas TuberculínicosTuberculose Latenteinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-81914https://www.arca.fiocruz.br/bitstream/icict/6714/1/license.txt7d48279ffeed55da8dfe2f8e81f3b81fMD51ORIGINALjournal.pone.0059546.pdfjournal.pone.0059546.pdfapplication/pdf465528https://www.arca.fiocruz.br/bitstream/icict/6714/2/journal.pone.0059546.pdfe15fdd774cf9ffd4c01849bad970d675MD52TEXTjournal.pone.0059546.pdf.txtjournal.pone.0059546.pdf.txtExtracted texttext/plain38232https://www.arca.fiocruz.br/bitstream/icict/6714/5/journal.pone.0059546.pdf.txtf9d9abc28c36f4b53ca9b9311e8c93aeMD55THUMBNAILjournal.pone.0059546.pdf.jpgjournal.pone.0059546.pdf.jpgGenerated Thumbnailimage/jpeg2639https://www.arca.fiocruz.br/bitstream/icict/6714/4/journal.pone.0059546.pdf.jpga9bee5f4904096ef5af84c21b1404094MD54icict/67142020-04-07 10:43:19.898oai:www.arca.fiocruz.br:icict/6714Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352020-04-07T13:43:19Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
title Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
spellingShingle Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
Steffen, Ricardo Ewbank
Custos de Cuidados de Saúde
Sintomas Tuberculínicos
Tuberculose Latente
title_short Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
title_full Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
title_fullStr Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
title_full_unstemmed Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
title_sort Cost-effectiveness of quantiferon®-TB gold-in-tube versus tuberculin skin testing for contact screening and treatment of latent tuberculosis infection in Brazil
author Steffen, Ricardo Ewbank
author_facet Steffen, Ricardo Ewbank
Caetano, Rosângela
Pinto, Márcia
Chaves, Diogo
Ferrari, Rossini
Bastos, Mayara Lisboa Soares de
Abreu, Sandra Teixeira de
Menzies, Dick
Trajman, Anete
author_role author
author2 Caetano, Rosângela
Pinto, Márcia
Chaves, Diogo
Ferrari, Rossini
Bastos, Mayara Lisboa Soares de
Abreu, Sandra Teixeira de
Menzies, Dick
Trajman, Anete
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Steffen, Ricardo Ewbank
Caetano, Rosângela
Pinto, Márcia
Chaves, Diogo
Ferrari, Rossini
Bastos, Mayara Lisboa Soares de
Abreu, Sandra Teixeira de
Menzies, Dick
Trajman, Anete
dc.subject.decs.pt_BR.fl_str_mv Custos de Cuidados de Saúde
Sintomas Tuberculínicos
Tuberculose Latente
topic Custos de Cuidados de Saúde
Sintomas Tuberculínicos
Tuberculose Latente
description CNPq, FAPERJ, ICOHRTA, CNPq/PIBIC UGF
publishDate 2013
dc.date.accessioned.fl_str_mv 2013-07-22T17:40:45Z
dc.date.available.fl_str_mv 2013-07-22T17:40:45Z
dc.date.issued.fl_str_mv 2013
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dc.identifier.citation.fl_str_mv 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.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/6714
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pone.0059546
identifier_str_mv 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.
10.1371/journal.pone.0059546
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