Should all suspected tuberculosis cases in high income countries be tested with GeneXpert? - 18/05/18
Abstract |
In countries with a low incidence of multidrug-resistant tuberculosis (MDR-TB), universal testing with GeneXpert might not be always cost-effective. This study provides hospital managers in low MDR-TB incidence countries with criteria on when decentralised universal GeneXpert testing would make sense. The alternatives taken into consideration include: universal microbiological culture and drug susceptibility testing (DST) only (comparator); as above but with concurrent centralized GeneXpert in a referral laboratory vs a decentralized GeneXpert system in every hospital to test smear-positive cases only; as above but testing all samples with GeneXpert regardless of smear status. The parameters were from the national TB statistics for England and from a systematic review. Decentralised GeneXpert to test any suspected TB case was the most cost-effective option when 6% or more TB patients belonged to the high-risk group, defined as previous TB diagnosis and or being born in countries with a high MDR-TB incidence. Hospital managers in England and other low MDR-TB incidence countries could use these findings to decide when to invest in GeneXpert or other molecular diagnostics with similar performance criteria for TB diagnostics.
Le texte complet de cet article est disponible en PDF.Keywords : Multi-drug resistant tuberculosis, Sensitivity, Specificity, QALYs, Cost-effectiveness
Plan
Vol 110
P. 112-120 - mai 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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