IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i5p1697-d328748.html
   My bibliography  Save this article

Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study

Author

Listed:
  • Luca Coppeta

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Giuseppina Somma

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Savino Baldi

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Elisabetta Tursi

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Iacopo D’Alessandro

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Andrea Torrente

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Stefano Perrone

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

  • Antonio Pietroiusti

    (Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Viale Montpellier 1, 00185 Roma, Italy)

Abstract

Background. In the past few years, healthcare workers (HCWs) have been considered at higher risk for tuberculosis (TB) infection than the general population. On the other hand, recent studies have reported a low conversion rate among these workers. Recently, the Center for Disease Control (CDC) updated its recommendations, suggesting that an annual screening should not be performed in the absence of a documented exposure but only in workers with high-risk duties or with job tasks in settings at high risk of tuberculosis contagion (e.g., departments of infectious or pulmonary diseases). In fact, some studies showed that annual tuberculosis screening for all the HCWs was not cost-effective in countries with a low incidence of TB. In this study, we evaluated the conversion rate and the cost-effectiveness of two different tuberculosis screening strategies in a large population of Italian HCWs. Methods. In our retrospective study, we reviewed data coming from a tuberculosis screening conducted on 1451 HCWs in a teaching hospital of Rome. All workers were evaluated annually by means of the Quantiferon test (QFT) for a five-year period. Then, the conversion rate was calculated. Results. We found a cumulative conversion rate of 0.6%. Considering the cost of the QFT test (48.26 euros per person), the screening of the HCWs resulted in a high financial burden (38,902.90 euros per seroconversion). Only one seroconversion would have been missed by applying the CDC updated recommendations, with a relevant drop of the costs: 6756.40 euros per seroconversion, with a global save of 296,075.10 euros. Conclusion: The risk of TB conversion among our study population was extremely low and it was related to the risk classification of the setting. Giving these results, the annual tuberculosis screening appeared to not be cost effective. We conclude that a targeted screening would be a better alternative in HCWs with a higher risk of TB exposure.

Suggested Citation

  • Luca Coppeta & Giuseppina Somma & Savino Baldi & Elisabetta Tursi & Iacopo D’Alessandro & Andrea Torrente & Stefano Perrone & Antonio Pietroiusti, 2020. "Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study," IJERPH, MDPI, vol. 17(5), pages 1-7, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1697-:d:328748
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/5/1697/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/5/1697/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Lisa Hermes & Jan Felix Kersten & Albert Nienhaus & Anja Schablon, 2020. "Risk Analysis of Latent Tuberculosis Infection among Health Workers Compared to Employees in Other Sectors," IJERPH, MDPI, vol. 17(13), pages 1-10, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rebecca Malsam & Albert Nienhaus, 2021. "Occupational Infections among Dental Health Workers in Germany—14-Year Time Trends," IJERPH, MDPI, vol. 18(19), pages 1-17, September.
    2. Nika Zielinski & Johanna Stranzinger & Hajo Zeeb & Jan Felix Kersten & Albert Nienhaus, 2021. "Latent Tuberculosis Infection among Health Workers in Germany—A Retrospective Study on Progression Risk and Use of Preventive Therapy," IJERPH, MDPI, vol. 18(13), pages 1-9, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1697-:d:328748. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.