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Cost-effectiveness of interferon-gamma release assay for entry tuberculosis screening in prisons

  • A. KOWADA (a1)
  • DOI:
  • Published online: 03 January 2013

The incidence of active tuberculosis (TB) and latent tuberculosis infection (LTBI) in inmates and prison staff is higher than that in the general population. Mycobacterium tuberculosis-specific interferon-gamma release assays (IGRAs) provide more accurate diagnosis of M. tuberculosis infection with higher specificity than the tuberculin skin test (TST). To assess the cost-effectiveness of QuantiFERON®-TB Gold In-Tube (QFT) compared to TST, TST followed by QFT and chest X-ray, we constructed Markov models using a societal perspective on the lifetime horizon. The main outcome measure of effectiveness was quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness was compared. The QFT-alone strategy was the most cost-effective for entry TB screening in prisons in developed countries. Cost-effectiveness was not sensitive to the rates of BCG vaccination, LTBI, TB, HIV infection and multidrug-resistant TB. Entry TB screening using an IGRA in prisons should be considered on the basis of its cost-effectiveness by public health intervention.

Corresponding author
*Address for correspondence: Dr A. Kowada, Kojiya Haneda Healthcare Service, Ota City Public Health Office, Tokyo, Japan. (Email:
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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