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Saima Bashir¹, Shehzad Ali², Seda Yerlikaya¹

¹Department of Infectious Disease and Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.

PLOS global public health

|November 13, 2024

概括

在印度和巴西,Diaskintest是一种比印度和巴西的TST-PPD更具成本效益的结核病 (TB) 感染诊断的皮肤测试. TSPOT.TB 血液测试比其他IGRA更有效,提供更高的诊断价值.

科学领域:

公共卫生公共卫生
卫生经济学卫生经济学
传染病诊断传染病诊断传染病诊断

背景情况:

针对结核病 (TB) 感染诊断的新型皮肤测试和干扰素释测试 (IGRAs) 的经济价值仍未得到充分研究.
准确且具有成本效益的诊断工具对于高结核负担国家的结核控制至关重要.

研究的目的:

评估印度和巴西新的结核病诊断测试的成本和成本效益.
将Diaskintest和Cy-Tb与纯化蛋白衍生物 (PPD) - 结核素皮肤测试 (TST) 进行比较.
将标准E TB-Feron ELISA (TBF) 和TSPOT.TB与QuantiFERON-TB Gold Plus (QFT-GP) 进行比较,并确定最具成本效益的皮肤测试与IGRA.

主要方法:

从印度和巴西的卫生系统角度开发了一个决策树模型.
进行了单变量和概率灵敏度分析,以评估参数可变性和不确定性.
通过比较诊断准确度,成本和增量成本效益比率 (ICER) 来确定成本效益.

主要成果:

隔膜肠道比TST-PPD更具成本效益,每次正确诊断的结核病感染的成本为22.6美元 (巴西) 和41.0美元 (印度).
与QFT-GP和TBF相比,TSPOT.TB显示出更高的有效性和更低的成本.
TSPOT.TB的有效性高于Diaskintest,每例的增量成本为8美元 (印度) 和6美元 (巴西).

结论:

在高负担环境中,Diaskintest为结核病感染诊断提供了TST-PPD的经济有效的替代方案.
虽然Diaskintest可能节省了成本,但TSPOT.TB提供了更高的诊断效率,证明了其在印度和巴西的增量成本.
该研究强调了在选择结核病诊断策略时考虑成本和有效性的重要性.

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