在科特迪瓦对家庭接触者进行结核病感染筛查

R.K. N’Guessan, D.A.B. Orsot, J. Ahui Brou, N.K. Bamba, M.E. Tchoutedjem Mefo, A.S. Bakayoko
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引用次数: 1

摘要

背景:科特迪瓦是一个结核病高发国家。目的:对科特迪瓦的家庭接触者进行结核病感染筛查(TBI)的成本效益分析,以评估实施干扰素-γ释放测定(IGRA)和结核菌素皮试(TST)的经济影响。设计:我们使用以前在中等结核病发病率环境中评估过的经济模型,比较了QuantiFERON-TB Gold Plus(QuantiFERON)和TST的效果。结果:事实证明,QuantiFERON 比 TST 更有效且成本更低。与定量FERON相比,使用TST会导致终生罹患活动性肺结核的风险增加约33%:对于科特迪瓦活动性肺结核病例的家庭接触者,与 TST 相比,QuantiFERON 具有成本效益。R闪亮的交互式界面可根据不同的情况、环境、风险群体和结核病接触筛查方法定制模型。应在类似环境中开展进一步研究,以推广研究结果。
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Screening of household contacts for TB infection in Cote d'Ivoire
SETTING: Côte d'Ivoire is a country with a high incidence of TB. The control of TB infection is focused on high-risk patients but has limited implementation.OBJECTIVE: Cost-benefit analysis of TB infection (TBI) screening of household contacts in Côte d'Ivoire to evaluate economic implications of the implementation of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST).DESIGN: We compared the effectiveness of QuantiFERON-TB Gold Plus (QuantiFERON) with the TST using an economic model previously evaluated in medium TB incidence settings. Principal outcomes relating to TBI screening, as well as the lifetime costs and benefits of the patient cohort, were captured using a decision tree, followed by a Markov model.RESULTS: QuantiFERON proved to be both more effective and less costly than TST. Compared to QuantiFERON, TST use leads to an approximate 33% increase in the lifetime risk of developing active TB.CONCLUSIONS: For household contacts of active TB cases in Côte d'Ivoire, QuantiFERON is cost-effective when compared with TST. R shiny interactive interface enables model customisation for different scenarios, settings, risk groups and TBI screening methods. Further research should be conducted in similar settings to generalise the results.
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