Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

A scoping review of cost-effectiveness of screening and treatment for latent tuberculosis infection in migrants from high-incidence countries

Authors: Lorenzo Zammarchi, Gianluigi Casadei, Marianne Strohmeyer, Filippo Bartalesi, Carola Liendo, Alberto Matteelli, Maurizio Bonati, Eduardo Gotuzzo, Alessandro Bartoloni, the COHEMI project study group

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

In low-incidence countries, most tuberculosis (TB) cases occur among migrants and are caused by reactivation of latent tuberculosis infection (LTBI) acquired in the country of origin. Diagnosis and treatment of LTBI are rarely implemented to reduce the burden of TB in immigrants, partly because the cost-effectiveness profile of this intervention is uncertain.
The objective of this research is to perform a review of the literature to assess the cost-effectiveness of LTBI diagnosis and treatment strategies in migrants.

Methods

Scoping review of economic evaluations on LTBI screening strategies for migrants was carried out in Medline.

Results

Nine studies met the inclusion criteria. LTBI screening was cost-effective according to seven studies. Findings of four studies support interferon gamma release assay as the most cost-effective test for LTBI screening in migrants. Two studies found that LTBI screening is cost-effective only if carried out in immigrants who are contacts of active TB cases.

Discussion and Conclusions

Our findings support the cost-effectiveness of LTBI diagnostic and treatment strategies in migrants especially if they are focused on young subjects from high incidence countries. These strategies could represent and adjunctive and synergistic tool to achieve the ambitious aim of TB elimination.
Appendix
Available only for authorised users
Literature
1.
European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2012. 2012.
2.
Klinkenberg E, Manissero D, Semenza JC, Verver S. Migrant tuberculosis screening in the EU/EEA: yield, coverage and limitations. Eur Respir J. 2009;34(5):1180–9.CrossRefPubMed
3.
Codecasa LR, Porretta AD, Gori A, Franzetti F, Degli Esposti A, Lizioli A, et al. Tuberculosis among immigrants from developing countries in the province of Milan, 1993–1996. Int J Tuberc Lung Dis. 1999;3(7):589–95.PubMed
4.
Lillebaek T, Andersen AB, Bauer J, Dirksen A, Glismann S, de Haas P, et al. Risk of Mycobacterium tuberculosis transmission in a low-incidence country due to immigration from high-incidence areas. J Clin Microbiol. 2001;39(3):855–61.CrossRefPubMedPubMedCentral
5.
Diel R, Rusch-Gerdes S, Niemann S. Molecular epidemiology of tuberculosis among immigrants in Hamburg, Germany. J Clin Microbiol. 2004;42(7):2952–60.CrossRefPubMedPubMedCentral
6.
Lobato MN, Hopewell PC. Mycobacterium tuberculosis infection after travel to or contact with visitors from countries with a high prevalence of tuberculosis. Am J Respir Crit Care Med. 1998;158(6):1871–5.CrossRefPubMed
7.
Pareek M, Baussano I, Abubakar I, Dye C, Lalvani A. Evaluation of immigrant tuberculosis screening in industrialized countries. Emerg Infect Dis. 2012;18(9):1422–9.CrossRefPubMedPubMedCentral
8.
Franzetti F, Codecasa L, Matteelli A, Degli Esposti A, Bandera A, Lacchini C, et al. Genotyping analyses of tuberculosis transmission among immigrant residents in Italy. Clin Microbiol Infect. 2010;16(8):1149–54.CrossRefPubMed
9.
Hernandez-Garduno E, Kunimoto D, Wang L, Rodrigues M, Elwood RK, Black W, et al. Predictors of clustering of tuberculosis in Greater Vancouver: a molecular epidemiologic study. CMAJ. 2002;167(4):349–52.PubMedPubMedCentral
10.
Alvarez GG, Gushulak B, Abu Rumman K, Altpeter E, Chemtob D, Douglas P, et al. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates. BMC Infect Dis. 2011;11:3.CrossRefPubMedPubMedCentral
11.
Oxlade O, Schwartzman K, Menzies D. Interferon-gamma release assays and TB screening in high-income countries: a cost-effectiveness analysis. Int J Tuberc Lung Dis. 2007;11(1):16–26.PubMed
12.
Broekmans J, Migliori G, Rieder H, Lees J, Ruutu P, Loddenkemper R, et al. European framework for tuberculosis control and elimination in countries with a low incidence. Recommendations of the World Health Organization (WHO), International Union Against Tuberculosis and Lung Disease (IUATLD) and Royal Netherlands Tuberculosis Association (KNCV) Working Group. Eur Respir J. 2002;19(4):765–75.CrossRefPubMed
13.
World Health Organization. Global strategy and targets for tuberculosis prevention, care and control after 2015. Geneva: World Health Organization; 2014. EB134R4.
14.
15.
Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ, et al. Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis. Lancet Infect Dis. 2011;11(6):435–44.CrossRefPubMedPubMedCentral
16.
Pareek M, Bond M, Shorey J, Seneviratne S, Guy M, White P, Lalvani A, Kon OM. Community-based evaluation of immigrant tuberculosis screening using interferon γ release assays and tuberculin skin testing:observational study and economic analysis. Thorax. 2013 Mar;68(3):230-9. doi:10.​1136/​thoraxjnl-2011-201542. Epub 2012.
17.
Brassard P, Steensma C, Cadieux L, Lands LC. Evaluation of a school-based tuberculosis-screening program and associate investigation targeting recently immigrated children in a low-burden country. Pediatrics. 2006;117(2):e148–56.CrossRefPubMed
18.
Khan K, Muennig P, Behta M, Zivin JG. Global drug-resistance patterns and the management of latent tuberculosis infection in immigrants to the United States. N Engl J Med. 2002;347(23):1850–9.CrossRefPubMed
19.
Dasgupta K, Schwartzman K, Marchand R, Tennenbaum TN, Brassard P, Menzies D. Comparison of cost-effectiveness of tuberculosis screening of close contacts and foreign-born populations. Am J Respir Crit Care Med. 2000;162(6):2079–86.CrossRefPubMed
20.
Porco TC, Lewis B, Marseille E, Grinsdale J, Flood JM, Royce SE. Cost-effectiveness of tuberculosis evaluation and treatment of newly-arrived immigrants. BMC Public Health. 2006;6:157.CrossRefPubMedPubMedCentral
21.
Hardy AB, Varma R, Collyns T, Moffitt SJ, Mullarkey C, Watson JP. Cost-effectiveness of the NICE guidelines for screening for latent tuberculosis infection: the QuantiFERON-TB Gold IGRA alone is more cost-effective for immigrants from high burden countries. Thorax. 2010;65(2):178–80.CrossRefPubMed
22.
Iqbal AZ, Leighton J, Anthony J, Knaup RC, Peters EB, Bailey TC. Cost-effectiveness of using Quantiferon Gold (QFT-G)(R) versus tuberculin skin test (TST) among U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis. Public Health Nurs (Boston, Mass). 2014;31(2):144–52.CrossRef
23.
Linas BP, Wong AY, Freedberg KA, Horsburgh Jr CR. Priorities for screening and treatment of latent tuberculosis infection in the United States. Am J Respir Crit Care Med. 2011;184(5):590–601.CrossRefPubMedPubMedCentral
24.
Oxlade O, Pinto M, Trajman A, Menzies D. How methodologic differences affect results of economic analyses: a systematic review of interferon gamma release assays for the diagnosis of LTBI. PLoS One. 2013;8(3), e56044.CrossRefPubMedPubMedCentral
25.
Matteelli A, Casalini C, Raviglione MC, El-Hamad I, Scolari C, Bombana E, et al. Supervised preventive therapy for latent tuberculosis infection in illegal immigrants in Italy. Am J Respir Crit Care Med. 2000;162(5):1653–5.CrossRefPubMed
26.
Sterling T, Munsiff SS, Frieden TR. Management of latent tuberculosis infection in immigrants. N Engl J Med. 2003;348(13):1289–92. author reply 1289–1292.CrossRefPubMed
27.
Shepardson D, Marks SM, Chesson H, Kerrigan A, Holland DP, Scott N, et al. Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States. Int J Tuberc Lung Dis. 2013;17(12):1531–7.CrossRefPubMed
28.
Gagliotti C, Resi D, Moro ML. Delay in the treatment of pulmonary TB in a changing demographic scenario. Int J Tuberc Lung Dis. 2006;10(3):305–9.PubMed
29.
Mor Z, Kolb H, Lidji M, Migliori G, Leventhal A. Tuberculosis diagnostic delay and therapy outcomes of nonnational migrants in Tel Aviv, 1998-2008. Euro Surveill. 2013;18(12). pii: 20433.
30.
Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J. 2013;41(1):140–56.CrossRefPubMed
31.
World Health Organization. Global tuberculosis control 2011. 2011.
32.
European Centre for Disease Control and Prevention, World Health Organization Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2012. In: Surveillance report. Stockholm: European Centre for Disease Control and Prevention; 2012. p. 73–97.
33.
Hargreaves JR, Boccia D, Evans CA, Adato M, Petticrew M, Porter JD. The social determinants of tuberculosis: from evidence to action. Am J Public Health. 2011;101(4):654–62.CrossRefPubMedPubMedCentral
34.
Rasanathan K, Sivasankara Kurup A, Jaramillo E, Lonnroth K. The social determinants of health: key to global tuberculosis control. Int J Tuberc Lung Dis. 2011;15 Suppl 2:S30–6.CrossRefPubMed
35.
Ministero della Salute. Aggiornamento delle raccomandazioni per le attività di controllo della tubercolosi. “Politiche efficaci a contrastare la tubercolosi nella popolazione immigrata”. 2010.
Metadata
Title
A scoping review of cost-effectiveness of screening and treatment for latent tuberculosis infection in migrants from high-incidence countries
Authors
Lorenzo Zammarchi
Gianluigi Casadei
Marianne Strohmeyer
Filippo Bartalesi
Carola Liendo
Alberto Matteelli
Maurizio Bonati
Eduardo Gotuzzo
Alessandro Bartoloni
the COHEMI project study group
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1045-3

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue

Research article

Thai health care provider knowledge of neonatal male circumcision in reducing transmission of HIV and other STIs

Research article

Development and feasibility of an automated call monitoring intervention for older wheelchair users: the MOvIT project

Study protocol

Randomised evaluation of the Italian medicines use review provided by community pharmacists using asthma as a model (RE I-MUR)

Research article

Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic

Research article

Lost in translation: a case-study of the travel of lean thinking in a hospital

Research article

The potential for using a Universal Medication Schedule (UMS) to improve adherence in patients taking multiple medications in the UK: a qualitative evaluation