Revisiting annual screening for latent tuberculosis infection in healthcare workers: a cost-effectiveness analysis

BMC Medicine
Guillaume A MullieDieynaba S N'Diaye

Abstract

In North America, tuberculosis incidence is now very low and risk to healthcare workers has fallen. Indeed, recent cohort data question routine annual tuberculosis screening in this context. We compared the cost-effectiveness of three potential strategies for ongoing screening of North American healthcare workers at risk of exposure. The analysis did not evaluate the cost-effectiveness of screening at hiring, and considered only workers with negative baseline tests. A decision analysis model simulated a hypothetical cohort of 1000 workers following negative baseline tests, considering duties, tuberculosis exposure, testing and treatment. Two tests were modelled, the tuberculin skin test (TST) and QuantiFERON®-TB-Gold In-Tube (QFT). Three screening strategies were compared: (1) annual screening, where workers were tested yearly; (2) targeted screening, where workers with high-risk duties (e.g. respiratory therapy) were tested yearly and other workers only after recognised exposure; and (3) post exposure-only screening, where all workers were tested only after recognised exposure. Workers with high-risk duties had 1% annual risk of infection, while workers with standard patient care duties had 0.3%. In an alternate higher-risk sc...Continue Reading

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Citations

Feb 23, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·May Ee PngNatasha Bagdasarian
Nov 29, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·N BagdasarianD A Fisher
Jun 13, 2019·Future Microbiology·Caterina LeddaVenerando Rapisarda
Jul 26, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Lynn E SosaRobert Belknap
Apr 3, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jeffrey M CollinsSusan M Ray
Mar 11, 2020·International Journal of Environmental Research and Public Health·Luca CoppetaAntonio Pietroiusti
May 1, 2021·International Journal of Environmental Research and Public Health·Piyapong SirinapakulPhanumas Krisorn

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