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M I Mahmood¹, M Ganason¹, Z A Aziz²

¹Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia.

|December 15, 2025

概括

量子菲龙 (QFT-plus) 比结核素皮肤测试 (TST) 更具成本效益,用于诊断马来西亚糖尿病患者的结核病感染. QFT-plus提供了更好的临床结果和长期的经济效益,支持其融入国家卫生指南.

科学领域:

公共卫生公共卫生
传染病流行病学传染病流行病学
卫生经济学卫生经济学

背景情况:

结核病 (TB) 仍然是一个全球卫生挑战,2021年有1060万例.
马来西亚面临着高结核病负担 (2022年将有25000例),加之是高患糖尿病 (DM) 的流行率,这是已知的结核病风险因素.
有效的诊断工具对于管理结核病至关重要,特别是在高风险人群中.

研究的目的:

评估QuantiFERON (QFT-plus) 与结核素皮肤测试 (TST) 相比的成本效益,用于诊断马来西亚DM患者的潜在结核病感染.
为了确定哪种诊断策略提供更好的价值和临床结果.

主要方法:

基于R的经济模型被用来比较QFT-plus和TST.
分析的重点是糖尿病患者,特别是那些HbA1c>10%的人.
主要结果指标包括成本,质量调整后寿命年 (QALYs),以及预防结核病病例的数量.

主要成果:

与TST (285.66美元) 相比,QFT-plus的人均成本较低 (111.29美元).
在QFT-plus中,每人QALY略高 (16.51),而不是TST (16.50).
尽管前期成本较高,但QFT-plus的卓越诊断准确性导致更早的治疗开始,与TST相比,减少了26%的活性结核病进展. 敏感性分析证实了QFT-plus的优势.

结论:

在马来西亚患有DM的患者中,QFT-plus在经济上有利,在临床上优于TST用于结核病诊断.
建议改变政策,将QFT-plus纳入国家结核病诊断指南.
进一步的研究应该探索实施策略和更广泛的社会经济影响.

关键词:

马来西亚马来西亚马来西亚在QuantiFERON测试中,糖尿病糖尿病患者糖尿病患者结核病是一种肺结核病.

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