Cost-effectiveness of Latent Tuberculosis Infection Screening before Immigration to Low-Incidence Countries

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Campbell, Jonathon R. ; Johnston, James C. ; Cook, Victoria J. ; Sadatsafavi, Mohsen ; Elwood, R. Kevin ; Marra, Fawziah
• Description:
  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.
• Subjects:
  Cost-Benefit Analysis Emigration And Immigration Humans Incidence Interferon-Gamma Release Tests Latent Tuberculosis Mass Screening Quality-Adjusted Life Years Sensitivity And Specificity Transients And Migrants Tuberculin Test

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• Source:
  Emerg Infect Dis. 25(4):661-671
• Pubmed ID:
  30882302
• Pubmed Central ID:
  PMC6433018
• Document Type:
  Journal Article
• Place as Subject:
  Canada
• Volume:
  25
• Issue:
  4
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:d63d22d19358f83012a74e86c6fd04286142c6b27dd3772a49bb2f5289981041
• Download URL:
  https://stacks.cdc.gov/view/cdc/77124/cdc_77124_DS1.pdf
• File Type:
  [PDF - 2.57 MB ]