Evidence map›Paper›PMID 40008709›Full record

ArticleCadernos de saude publica2025

TB antigen-based skin tests and QFT-Plus for Mycobacterium tuberculosis infection diagnosis in Brazilian healthcare workers: a cost-effectiveness analysis.

Fernanda Mattos de Souza, Ricardo E Steffen, Márcia Ferreira Teixeira Pinto, Thiago Nascimento do Prado, Ethel Leonor Noia Maciel, Anete Trajman

Abstract read
In one paragraph

Article in Cadernos de saude publica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Fernanda Mattos de SouzaUniversidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.ORCID 0000-0003-2093-8816
Ricardo E SteffenCentro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.ORCID 0000-0002-9733-5098
Márcia Ferreira Teixeira PintoInstituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.ORCID 0000-0001-7568-5014
Thiago Nascimento do PradoPrograma de Pós-graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brasil.ORCID 0000-0001-8132-6288
Ethel Leonor Noia MacielCentro Biomédico, Universidade Federal do Espírito Santo, Vitória, Brasil.ORCID 0000-0003-4826-3355
Anete TrajmanMcGill University, Montreal, Canada.ORCID 0000-0002-4000-4984

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aimed to analyze the cost-effectiveness of three tuberculosis (TB) antigen-based skin tests (TBST) (Diaskintest, C-TST, and Cy-TB) and QFT-Plus for TB infection diagnosis compared to the current standard of care, PPD Rt-23 tuberculin skin test (TST), among healthcare workers in Brazil. A state-transition Markov model was employed, simulating a cohort of healthcare workers (five annual cycles) for testing and treating TB infection with three months of weekly doses of rifapentine and isoniazid (3HP) under the Brazilian public health system perspective. Effects (TB disease averted) and costs for screening and treating TB infection were discounted at 5%. Incremental cost-effectiveness per TB averted was estimated. One-way and probabilistic sensitivity analysis were performed. Brazil, an upper-middle-income country with a high burden of TB, shows one of the largest universal public health systems and provides free-of-charge diagnosis and treatment for TB and TB infection. TST is the standard of care, whereas QFT-Plus is available for very high-risk populations. The three new TBST are under validation for eventual incorporation. Patients or participants: a hypothetical cohort of 10,000 healthcare workers, working at any level of healthcare service, and negative TST results in the previous year of both sexes with a baseline negative TST result. Diaskintest, C-TST, Cy-TB, and QFT-Plus were found to show a higher specificity. Costs with QFT-Plus were higher due to equipment, human labor, and test price. Diaskintest was the most cost-saving strategy, followed by Cy-TB for TB preventive treatment with 3HP. In the Brazilian scenario, Diaskintest and Cy-TB are the most cost-effective tests for sequential testing of healthcare workers.

Indexed as

Antigens, BacterialHealth PersonnelMycobacterium tuberculosisTuberculin TestTuberculosisBrazilCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansIsoniazidMaleMarkov ChainsRifampinSensitivity and SpecificityAntigens, BacterialIsoniazidRifampin

Identifiers

PMID40008709
PMCPMC11863634

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.