Limits...
A scoping review of cost-effectiveness of screening and treatment for latent tubercolosis infection in migrants from high-incidence countries.

Zammarchi L, Casadei G, Strohmeyer M, Bartalesi F, Liendo C, Matteelli A, Bonati M, Gotuzzo E, Bartoloni A, COHEMI project study gro - BMC Health Serv Res (2015)

Bottom Line: LTBI screening was cost-effective according to seven studies.Two studies found that LTBI screening is cost-effective only if carried out in immigrants who are contacts of active TB cases.Our findings support the cost-effectiveness of LTBI diagnostic and treatment strategies in migrants especially if they are focused on young subjects from high incidence countries.

View Article: PubMed Central - PubMed

Affiliation: Infectious Diseases Unit, Department of Experimental & Clinical Medicine, University of Florence School of Medicine, Largo Brambilla 3, 50134, Florence, Italy. lorenzo.zammarchi@unifi.it.

ABSTRACT

Background: In low-incidence countries, most tuberculosis (TB) cases occur among migrants and are caused by reactivation of latent tuberculosis infection (LTBI) acquired in the country of origin. Diagnosis and treatment of LTBI are rarely implemented to reduce the burden of TB in immigrants, partly because the cost-effectiveness profile of this intervention is uncertain. The objective of this research is to perform a review of the literature to assess the cost-effectiveness of LTBI diagnosis and treatment strategies in migrants.

Methods: Scoping review of economic evaluations on LTBI screening strategies for migrants was carried out in Medline.

Results: Nine studies met the inclusion criteria. LTBI screening was cost-effective according to seven studies. Findings of four studies support interferon gamma release assay as the most cost-effective test for LTBI screening in migrants. Two studies found that LTBI screening is cost-effective only if carried out in immigrants who are contacts of active TB cases.

Discussion and conclusions: Our findings support the cost-effectiveness of LTBI diagnostic and treatment strategies in migrants especially if they are focused on young subjects from high incidence countries. These strategies could represent and adjunctive and synergistic tool to achieve the ambitious aim of TB elimination.

No MeSH data available.


Related in: MedlinePlus

Flow diagram showing the number of papers identified by the search and the selection process
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Fig1: Flow diagram showing the number of papers identified by the search and the selection process

Mentions: The literature search resulted in 109 titles. A total of 86 duplicates or non-pertinent or non-appropriate references were deleted, resulting in 23 potentially relevant studies. Reviewers agreed on 18 of 23 papers (78.3 %) selected for reliability check (K = 0.697), and disagreements were resolved by consensus. Ten of 23 papers (43.5 %) met inclusion criteria and were therefore included in the final step of review (Fig. 1).Fig. 1


A scoping review of cost-effectiveness of screening and treatment for latent tubercolosis infection in migrants from high-incidence countries.

Zammarchi L, Casadei G, Strohmeyer M, Bartalesi F, Liendo C, Matteelli A, Bonati M, Gotuzzo E, Bartoloni A, COHEMI project study gro - BMC Health Serv Res (2015)

Flow diagram showing the number of papers identified by the search and the selection process
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4581517&req=5

Fig1: Flow diagram showing the number of papers identified by the search and the selection process
Mentions: The literature search resulted in 109 titles. A total of 86 duplicates or non-pertinent or non-appropriate references were deleted, resulting in 23 potentially relevant studies. Reviewers agreed on 18 of 23 papers (78.3 %) selected for reliability check (K = 0.697), and disagreements were resolved by consensus. Ten of 23 papers (43.5 %) met inclusion criteria and were therefore included in the final step of review (Fig. 1).Fig. 1

Bottom Line: LTBI screening was cost-effective according to seven studies.Two studies found that LTBI screening is cost-effective only if carried out in immigrants who are contacts of active TB cases.Our findings support the cost-effectiveness of LTBI diagnostic and treatment strategies in migrants especially if they are focused on young subjects from high incidence countries.

View Article: PubMed Central - PubMed

Affiliation: Infectious Diseases Unit, Department of Experimental & Clinical Medicine, University of Florence School of Medicine, Largo Brambilla 3, 50134, Florence, Italy. lorenzo.zammarchi@unifi.it.

ABSTRACT

Background: In low-incidence countries, most tuberculosis (TB) cases occur among migrants and are caused by reactivation of latent tuberculosis infection (LTBI) acquired in the country of origin. Diagnosis and treatment of LTBI are rarely implemented to reduce the burden of TB in immigrants, partly because the cost-effectiveness profile of this intervention is uncertain. The objective of this research is to perform a review of the literature to assess the cost-effectiveness of LTBI diagnosis and treatment strategies in migrants.

Methods: Scoping review of economic evaluations on LTBI screening strategies for migrants was carried out in Medline.

Results: Nine studies met the inclusion criteria. LTBI screening was cost-effective according to seven studies. Findings of four studies support interferon gamma release assay as the most cost-effective test for LTBI screening in migrants. Two studies found that LTBI screening is cost-effective only if carried out in immigrants who are contacts of active TB cases.

Discussion and conclusions: Our findings support the cost-effectiveness of LTBI diagnostic and treatment strategies in migrants especially if they are focused on young subjects from high incidence countries. These strategies could represent and adjunctive and synergistic tool to achieve the ambitious aim of TB elimination.

No MeSH data available.


Related in: MedlinePlus