Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis
2008

Cost-Effectiveness of Tuberculosis Screening for Travelers

Sample size: 1000 publication Evidence: high

Author Information

Author(s): Tan Michael, Menzies Dick, Schwartzman Kevin

Primary Institution: Respiratory Epidemiology Unit, Montreal Chest Institute

Hypothesis

What is the cost-effectiveness of different tuberculosis screening strategies for travelers to high-incidence countries?

Conclusion

A single post-trip tuberculin skin test was the most cost-effective strategy for travelers from the United States or Canada.

Supporting Evidence

  • A single post-trip tuberculin test was the cheapest and most effective intervention.
  • The cost per case prevented varied significantly based on the travel destination.
  • Screening became more cost-effective with longer trip durations.
  • Travelers born in high-incidence countries may have longstanding infections.
  • Costs were expressed in 2005 US dollars.

Takeaway

If you travel to countries where tuberculosis is common, getting a skin test after your trip is the best way to check for infection without spending too much money.

Methodology

A decision analysis model was used to evaluate four screening interventions for 1,000 travelers visiting high-incidence countries.

Limitations

The analysis did not evaluate the use of interferon-gamma release assays and was limited to travelers from the US and Canada.

Participant Demographics

Travelers were assumed to be 21 years old and HIV-seronegative, with some born in the US or Canada and others in high-incidence countries.

Digital Object Identifier (DOI)

10.1186/1471-2458-8-201

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