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

Hojoon Sohn, H. Y. Kim, S. H. Lee

Research output: Contribution to journalArticle

Abstract

B A C K G R O U N D: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. O B J E C T I V E: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: QuantiFERON w -TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QFT-GIT (two-step strategy). M E T H O D: 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. R E S U L T S: 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 QFT-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. C O N C L U S I O N: 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.

Original languageEnglish (US)
Pages (from-to)496-503
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume22
Issue number5
DOIs
StatePublished - May 1 2018

Fingerprint

Republic of Korea
Cost-Benefit Analysis
Tuberculosis
Tuberculin Test
Skin Tests
Gold
Costs and Cost Analysis
Disease Outbreaks
Decision Support Techniques
Korea
Infection Control
Health Care Costs
Students

Keywords

  • Contact screening
  • Cost-effectiveness
  • Latent tuberculous infection
  • QuantiFERONw test
  • Tuberculin skin test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Cost-effectiveness of contact screening strategies for tuberculosis among high-school adolescents in South Korea. / Sohn, Hojoon; Kim, H. Y.; Lee, S. H.

In: International Journal of Tuberculosis and Lung Disease, Vol. 22, No. 5, 01.05.2018, p. 496-503.

Research output: Contribution to journalArticle

@article{0cb02208e5c246a2b19f0ad37100d003,
title = "Cost-effectiveness of contact screening strategies for tuberculosis among high-school adolescents in South Korea",
abstract = "B A C K G R O U N D: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. O B J E C T I V E: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: QuantiFERON w -TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QFT-GIT (two-step strategy). M E T H O D: 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. R E S U L T S: 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 QFT-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. C O N C L U S I O N: 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.",
keywords = "Contact screening, Cost-effectiveness, Latent tuberculous infection, QuantiFERONw test, Tuberculin skin test",
author = "Hojoon Sohn and Kim, {H. Y.} and Lee, {S. H.}",
year = "2018",
month = "5",
day = "1",
doi = "10.5588/ijtld.17.0718",
language = "English (US)",
volume = "22",
pages = "496--503",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "5",

}

TY - JOUR

T1 - Cost-effectiveness of contact screening strategies for tuberculosis among high-school adolescents in South Korea

AU - Sohn, Hojoon

AU - Kim, H. Y.

AU - Lee, S. H.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - B A C K G R O U N D: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. O B J E C T I V E: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: QuantiFERON w -TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QFT-GIT (two-step strategy). M E T H O D: 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. R E S U L T S: 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 QFT-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. C O N C L U S I O N: 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.

AB - B A C K G R O U N D: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. O B J E C T I V E: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: QuantiFERON w -TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QFT-GIT (two-step strategy). M E T H O D: 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. R E S U L T S: 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 QFT-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. C O N C L U S I O N: 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.

KW - Contact screening

KW - Cost-effectiveness

KW - Latent tuberculous infection

KW - QuantiFERONw test

KW - Tuberculin skin test

UR - http://www.scopus.com/inward/record.url?scp=85046288111&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046288111&partnerID=8YFLogxK

U2 - 10.5588/ijtld.17.0718

DO - 10.5588/ijtld.17.0718

M3 - Article

VL - 22

SP - 496

EP - 503

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 5

ER -