Cost-effectiveness of contact screening strategies for tuberculosis among high-school adolescents in South Korea

H. Sohn, H. Y. Kim, S. H. Lee

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    7 Citations (Scopus)


    B A C K G R O U N D: Effective latent tuberculous infection (LTBI) control among adolescents is a critical component of tuberculosis (TB) elimination in Korea. O B J E C T I V E: To compare the cost-effectiveness of the following contact screening strategies for LTBI among high-school adolescents after TB outbreaks: QuantiFERON w -TB Gold In-Tube (QFT-GIT), the tuberculin skin test (TST), or TST/QFT-GIT (two-step strategy). M E T H O D: The costs of post-TB outbreak screening strategies were calculated using a mixed (top-down and bottom-up) cost analysis method and expressed in 2015 US dollars. Cost-effectiveness was evaluated using a decision analysis model from the health system perspective, comparing cumulative health care costs and the total number of TB cases averted. R E S U L T S: In a hypothetical cohort of 1000 students, screening using the TST-alone strategy averted 1.6 TB cases at a total cost of US$52 566. The QFT-GIT-alone strategy helped avert 2.0 TB cases, but was associated with a much higher total cost (US$108 435), resulting in an incremental cost-effectiveness ratio of US$140 933/ TB case averted. The two-step TST/QFT-GIT strategy was worse than the TST-alone strategy, averting 1.3 TB cases at US$75 267. C O N C L U S I O N: The TST-alone strategy was the most cost-effective; the QFT-GIT-alone strategy averted the greatest number of TB cases but incurred the highest cost in contact investigation for school TB outbreaks.

    Original languageEnglish
    Pages (from-to)496-503
    Number of pages8
    JournalInternational Journal of Tuberculosis and Lung Disease
    Issue number5
    Publication statusPublished - 2018 May 1

    Bibliographical note

    Funding Information:
    The authors thank R Steffen and A Trajman for sharing the Brazil model, which was integral to both the structural and the conceptual frame of this work. This research was supported by a grant from Korea University, Seoul, South Korea (K1722101). Conflicts of interest: none declared.

    Publisher Copyright:
    © 2018 The Union.


    • Contact screening
    • Cost-effectiveness
    • Latent tuberculous infection
    • QuantiFERONw test
    • Tuberculin skin test

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine
    • Infectious Diseases


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