Comparison of cost-effectiveness between the quantiFERON-TB Gold-In-Tube and T-Spot tests for screening health-care workers for latent tuberculosis infection.
There are several methods used to screen for latent tuberculosis (TB) infection (LTBI) including the QuantiFERON-TB Gold-in-Tube (QFT-GIT) and T-SPOT-TB (T-SPOT) tests. Many studies have reported the equivalence of these two methods, but it is unclear which of them is more cost effective. We investigated the age and cost issues of these tests in screening for LTBI among health-care workers.



One hundred and forty new employees during 2008-2011 in our hospital were screened using the QFT-GIT test, and 140 new employees during 2011-2014 were screened with the T-SPOT test for LTBI. The results of both tests were classified as positive, undetermined (retesting required), or negative.



There were six positive results (4.29%), eight undetermined results (5.71%), and 126 negative results (90.0%) with the QFT-GIT test. As for the T-SPOT test, there were eight positive results (5.71%), three undetermined results (2.14%), and 129 negative results (92.1%). Fourteen LTBI employees (6 in QFT-GIT and 8 in T-SPOT) were detected statistically equally using the two methods (P = 0.79). The total costs, including those incurred for retesting, were $7,711.86 (US dollar) and $6,525.42 for the QFT-GIT and T-SPOT tests (cost of one test is $55.08 for QFT-GIT and $46.61 for T-SPOT), respectively.



T-SPOT is one of the options for screening for LTBI partly owing to the viewpoint of cost-effectiveness. Further prospective studies need to be considered for a definitive conclusion.
Infection Control Team, Hyogo Prefectural Rehabilitation Central Hospital, Sanda, Japan.
Shigeto
S
Mukai
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine; Department of International Health, Kobe University Graduate School of Health Science, Sanda, Japan.
Katsumi
K
Shigemura
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Sanda, Japan.
Fukashi
F
Yamamichi
Division of Translational Research for Biologics, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.
Koichi
K
Kitagawa
Infection Control Team, Hyogo Prefectural Rehabilitation Central Hospital, Sanda, Japan.
Nozomi
N
Takami
Infection Control Team, Hyogo Prefectural Rehabilitation Central Hospital, Sanda, Japan.
Masashi
M
Nomi
Department of Urology, Sanda Municipal Hospital, Sanda, Japan.
Soichi
S
Arakawa
Infection Control Team, Hyogo Prefectural Rehabilitation Central Hospital, Sanda, Japan.
Masato
M
Fujisawa
D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006282:Health Personnel; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000191:economics*; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic / Q000191:economics; D014374:Tuberculin Test / Q000191:economics; D055815:Young Adult
D011933:Reagent Kits, Diagnostic