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Cost-effectiveness of contact screening strategies for tuberculosis among high-school adolescents in South Korea

Authors
Sohn, H.Kim, H-YLee, S. H.
Issue Date
5월-2018
Publisher
INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
Keywords
latent tuberculous infection; contact screening; QuantiFERON (R) test; tuberculin skin test; cost-effectiveness
Citation
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, v.22, no.5, pp.496 - +
Indexed
SCIE
SCOPUS
Journal Title
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
Volume
22
Number
5
Start Page
496
End Page
+
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/75690
DOI
10.5588/ijtld.17.0718
ISSN
1027-3719
Abstract
BACKGROUND: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. OBJECTIVE: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: Quanti-FERON (R)-TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QI-T-GIT (two-step strategy). METHOD: The costs of post-TB outbreak screening strategies were calculated using a mixed (top-down and bottom-up) cost analysis method and expressed in 2015 US dollars. Cost-effectiveness was evaluated using a decision analysis model from the health system perspective, comparing cumulative health care costs and the total number of TB cases averted. RESULTS: In a hypothetical cohort of 1000 students, screening using the TST-alone strategy averted 1.6 TB cases at a total cost of US$52 566. The QI-T-GIT-alone strategy helped avert 2.0 TB cases, but was associated with a much higher total cost (US$108 435), resulting in an incremental cost-effectiveness ratio of US$140 933/ TB case averted. The two-step TST/QFT-GIT strategy was worse than the TST-alone strategy, averting 1.3 TB cases at US$75 267. CONCLUSION: The TST-alone strategy was the most cost-effective; the QFT-GIT-alone strategy averted the greatest number of TB cases but incurred the highest cost in contact investigation for school TB outbreaks.
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