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Am J Infect Control. 2011 Dec;39(10):e67-72. doi: 10.1016/j.ajic.2011.04.329. Epub 2011 Aug 12.

Cost-effectiveness of interferon-γ release assay versus chest X-ray for tuberculosis screening of employees.

Author information

  • Public Health Promotion Division, Tamagawa District Administration Office, City of Setagaya, Tokyo, Japan. Kowada101@mb.city.setagaya.tokyo.jp

Abstract

BACKGROUND:

Currently, an annual chest X-ray examination (CXR) for detection of active tuberculosis (TB) in employees aged ≥40 years is recommended in the guidelines of the Japan Industrial Safety and Health Law. Interferon-γ release assays are new alternatives to the tuberculin skin test for detecting Mycobacterium tuberculosis infection, with higher specificity than the tuberculin skin test and without cross-reactivity with the Bacille Calmette-Guérin vaccine. This study aimed to assess the cost-effectiveness of employee TB screening using QuantiFERON-TB Gold In-Tube (QFT) versus CXR.

METHODS:

Markov models were constructed. The target population was a hypothetical cohort of immunocompetent 40-year-old individuals, using a societal perspective and a lifetime horizon. All costs and clinical benefits were discounted at a fixed annual rate of 3%.

RESULTS:

In a base-case analysis, the QFT strategy was the most cost-effective ($US 262.84; 22.87049 quality-adjusted life-years [QALYs]) compared with no screening ($448.38; 22.85452 QALYs) and CXR ($543.50; 22.85453 QALYs) [year 2009 values].

CONCLUSION:

The QFT strategy is currently robust for screening Bacille Calmette-Guérin- vaccinated employees in Japan. There appears to be little role for CXR. These findings may be applicable to other countries in terms of choosing optimal TB screening for employees.

Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

PMID:
21839543
[PubMed - indexed for MEDLINE]
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