Original Title: Evaluación de la efectividad y costes del Quantiferon-TB Gold para el diagnóstico de infección tuberculosa latente en personal sanitario

Authors' objectives: The aims of this report go as follows: a) present a systematic revision of the literature that examines and synthesizes the scientific knowledge on the validity and effectiveness of QFG when compared to TST as a screening instrument to detect LTI in HCW; b) present the results of a comparative study of the two diagnostic tests; c) evaluate the costs of QFG when compared to those of TST.

Authors' results and conclusions: RESULTS: Our systematic revision found 473 articles, from which 6 were included. The works included study a total of more than 1,400 HCW, fundamentally from countries with a middle-high tuberculosis incidence (India, Japan and Korea) and with a high prevalence of BCG-vaccinated people (>70%). The prevalence of TST(+) ranged from 4-7% in the nonvaccinated population to 40-60% in the vaccinated one. The prevalence of QFG(+) was lower (0-10%), regardless of the vaccination state, except in the case of a study from India (40% of positive results with both tests). From 40% to 80% of the TST(+) subjects presented QFG(-), specially the vaccinated ones. However, most TST(-) were also QFG(-). In our comparative study participated 134 Spanish HCW (75% women, average age 33 (SD 9)). The prevalence of LTI diagnosed by any of the tests was 11.2% (IC 95% 6.6-18.1%). Twelve HCW showed TST(+) and 8 QFG(+) (8.9% vs 5.9%, non-significant differences). The concordance between both tests was of 94% (kappa index 0.56%). 6% of HCW showed unknown TST for not attending the reading of the test, whilst 2% of the QFG tests remained undetermined (non-significant differences). The costs of the QFG test were established at €42 per determination and those of the TST at €39. Both tests vary above all in the structure of their costs: in the case of TST, most of the total costs (70%) were indirect ones, basically time wasted by the participants, whereas QFG was more expensive in terms of fungible material, which meant 50% of the total costs. CONCLUSIONS: Our systematic revision leads us to conclude that the QFG test seems to be more specific than the TST one when it comes to detecting LTI in HCW, especially if the prevalence of those vaccinated is high. Nevertheless, the existence of discordant results in both cases makes it necessary to develop further research. The comparative study indicates that the Spanish HCW show a low prevalence of LTI. The degree of coincidence between both diagnostic tests is high, above all in the negative results. The cost analysis leads us to conclude that the total cost of the QFG test is comparable to that of the TST one, although the cost structure of each test varies considerably.

Project Status: Completed

Year Published: 2009

URL for published report: https://sescs.es/evaluacion-de-la-efectividad-y-costes-del-quantiferon-tb-gold-para-el-diagnostico-de-infeccion/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es