一个成本框架来比较结核病感染测试
Amanda Brumwell1,2, Jade Tso3,4, Viswanath Pingali5
1Advance Access & Delivery, Inc, Durham, North Carolina, USA brumwell@uw.edu.
BMJ global health
|November 30, 2023
概括
开发了结核病感染测试的框架,这项研究发现干扰素释测试 (IGRA) 比结核素皮肤测试 (TST) 提供了更高的准确性和成本效益. 伊格拉 (IGRA) 是一个
科学领域:
- 公共卫生 公共卫生
- 传染病诊断 传染病诊断 传染病诊断
- 卫生经济学 卫生经济学
背景情况:
- 结核病 (TB) 感染测试依赖于结核素皮肤测试 (TST) 和干扰素释测试 (IGRA).
- 在高负担环境中,准确且具有成本效益的结核病诊断至关重要.
- 将TST与IGRA的实际成本和程序影响进行比较对于优化结核病控制至关重要.
研究的目的:
- 开发和应用一个框架来估计结核病感染诊断的成本和方案影响.
- 在高结核病负担地区比较TST和IGRA的成本效益.
- 为结核病计划的决策提供有关诊断测试选择的信息.
主要方法:
- 开发了一个七步框架,以估计TBI患病率,测试准确性和相关成本.
- 方法包括计算测试管理,假阴性和治疗成本.
- 该框架应用于秘鲁利马的一个郊区.
主要成果:
- 干扰素玛释放试验 (IGRA) 显示出比TST更高的灵敏度,降低了误诊成本.
- 由于需要两次访问,TST会增加患者和工作人员的生产力成本.
- 在利马,经过672次测试,估计IGRA的好处超过了基础设施成本.
结论:
- 开发的框架为结核病计划提供了关于选择具有成本效益的TBI诊断的指导.
- 尽管最初的基础设施问题,IGRA提供了一个比TST更准确和潜在的节省成本的替代方案.
- 准确的诊断应该被视为改善治疗结果和减轻卫生系统成本的投资.
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