Emerging Infectious Diseases
Volume 25, Issue 4, 2019, Pages 661-671

Cost-effectiveness of latent tuberculosis infection screening before immigration to low-incidence countries (Article) (Open Access)

Campbell J.R. , Johnston J.C. , Cook V.J. , Sadatsafavi M. , Elwood R.K. , Marra F.*
  • a University of British Columbia, Vancouver, BC, Canada, British Columbia Centre for Disease Control, Vancouver, Canada
  • b University of British Columbia, Vancouver, BC, Canada
  • c University of British Columbia, Vancouver, BC, Canada, British Columbia Centre for Disease Control, Vancouver, Canada
  • d University of British Columbia, Vancouver, BC, Canada
  • e University of British Columbia, Vancouver, BC, Canada, British Columbia Centre for Disease Control, Vancouver, Canada
  • f University of British Columbia, Vancouver, BC, Canada

Abstract

Prospective migrants to countries where the incidence of tuberculosis (TB) is low (low-incidence countries) receive TB screening; however, screening for latent TB infection (LTBI) before immigration is rare. We evaluated the cost-effectiveness of mandated and sponsored preimmigration LTBI screening for migrants to low-incidence countries. We used discrete event simulation to model preimmigration LTBI screening coupled with postarrival follow-up and treatment for those who test positive. Preimmigration interferon-gamma release assay screening and postarrival rifampin treatment was preferred in deterministic analysis. We calculated cost per quality-adjusted life-year gained for migrants from countries with different TB incidences. Our analysis provides evidence of the cost-effectiveness of preimmigration LTBI screening for migrants to low-incidence countries. Coupled with research on sustainability, acceptability, and program implementation, these results can inform policy decisions. © 2019, Centers for Disease Control and Prevention (CDC). All Rights Reserved.

Author Keywords

[No Keywords available]

Index Keywords

medical assessment immigrant hospitalization drug cost health care policy follow up human immigration interferon gamma release assay sensitivity analysis quality adjusted life year health care cost recurrence risk latent tuberculosis infection tuberculosis BCG vaccination gamma interferon prevalence Incidence Article disease transmission tuberculin test isoniazid simulation thorax radiography health care system vaccination rifampicin cost effectiveness analysis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063283257&doi=10.3201%2feid2504.171630&partnerID=40&md5=42ef5ead46a84df881563f81a6a21845
DOI: 10.3201/eid2504.171630
ISSN: 10806040
Cited by: 1
Original Language: English