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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A systematic review of cost-utility analyses of screening methods in latent tuberculosis infection in high-risk populations
BMC Pulmonary Medicine, Volume 22, No. 1, Article 375, Year 2022
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Description
Background: The World Health Organisation (WHO) recommends that testing and treatment for latent tuberculosis infection (LTBI) should be undertaken in high-risk groups using either interferon gamma release assays (IGRAs) or a tuberculin skin test (TST). As IGRAs are more expensive than TST, an assessment of the cost-effectiveness of IGRAs can guide decision makers on the most appropriate choice of test for different high-risk populations. This current review aimed to provide the most up to date evidence on the cost-effectiveness evidence on LTBI testing in high-risk groups—specifically evidence reporting the costs per QALY of different testing strategies. Methods: A comprehensive search of databases including MEDLINE, EMBASE and NHS-EED was undertaken from 2011 up to March 2021. Studies were screened and extracted by two independent reviewers. The study quality was assessed using the Bias in Economic Evaluation Checklist (ECOBIAS). A narrative synthesis of the included studies was undertaken. Results: Thirty-two studies reported in thirty-three documents were included in this review. Quality of included studies was generally high, although there was a weakness across all studies referencing sources correctly and/or justifying choices of parameter values chosen or assumptions where parameter values were not available. Inclusions of IGRAs in testing strategies was consistently found across studies to be cost-effective but this result was sensitive to underlying LTBI prevalence rates. Conclusion: While some concerns remain about uncertainty in parameter values used across included studies, the evidence base since 2010 has grown with modelling approaches addressing the weakness pointed out in previous reviews but still reaching the same conclusion that IGRAs are likely to be cost-effective in high-income countries for high-risk populations. Evidence is also required on the cost-effectiveness of different strategies in low to middle income countries and countries with high TB burden. © 2022, The Author(s).
Authors & Co-Authors
Mahon, James
United Kingdom, York
University of York
Nikolayevskyy, Vladyslav N.
Unknown Affiliation
Alagna, Riccardo
Unknown Affiliation
Manissero, Davide
Unknown Affiliation
Dowdy, David W.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Migliori, Giovanni Battista
Italy, Pavia
Istituti Clinici Scientifici Maugeri Spa – sb
Sotgiu, Giovanni
Italy, Sassari
Università Degli Studi Di Sassari
Duarte, R. A.B.
Portugal, Porto
Universidade do Porto
Portugal, Vila Nova de Gaia
Centro Hospitalar de Vila Nova de Gaia
Statistics
Citations: 8
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1186/s12890-022-02149-x
ISSN:
14712466
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Narrative Study
Study Approach
Qualitative
Systematic review