York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, YO10 5NQ, UK.
QIAGEN GmbH, 40724, Hilden, Germany.
Sci Rep. 2023 Feb 10;13(1):2390. doi: 10.1038/s41598-023-29648-z.
To estimate the costs and benefits of screening for latent tuberculosis infection (LTBI) in a migrant population in Malaysia. An economic model was developed from a Malaysian healthcare perspective to compare QuantiFERON-TB Gold Plus (QuantiFERON) with the tuberculin skin test (TST). A decision tree was used to capture outcomes relating to LTBI screening followed by a Markov model that simulated the lifetime costs and benefits of the patient cohort. The Markov model did not capture the impact of secondary infections. The model included an R shiny interactive interface to allow adaptation to other scenarios and settings. QuantiFERON is both more effective and less costly than TST (dominant). Compared with QuantiFERON, the lifetime risk of developing active TB increases by approximately 40% for TST due to missed LTBI cases during screening (i.e. a higher number of false negative cases for TST). For a migrant population in Malaysia, QuantiFERON is cost-effective when compared with TST. Further research should consider targeted LTBI screening for migrants in Malaysia based on common risk factors.
评估马来西亚移民人群中潜伏性结核感染（LTBI）筛查的成本效益。本经济模型从马来西亚医疗保健的角度出发，将 QuantiFERON-TB Gold Plus（QuantiFERON）与结核菌素皮肤试验（TST）进行比较。决策树用于捕获与 LTBI 筛查相关的结果，然后是模拟患者队列终生成本和效益的马尔可夫模型。该马尔可夫模型未捕获继发感染的影响。该模型包括一个 R shiny 交互式界面，以允许适应其他场景和设置。QuantiFERON 比 TST（优势）更有效且成本更低。与 QuantiFERON 相比，由于筛查期间漏诊 LTBI 病例（即 TST 的假阴性病例更多），TST 导致发生活动性 TB 的终生风险增加约 40%。对于马来西亚的移民人群，与 TST 相比，QuantiFERON 具有成本效益。进一步的研究应考虑根据常见的危险因素，为马来西亚的移民进行有针对性的 LTBI 筛查。
