Latent Tuberculosis Infection Testing Strategies for HIV-Positive Individuals in Hong Kong

Wong, Ngai Sze; Chan, Kenny Chi Wai; Wong, Billy; Leung, Chi Chiu; Chan, Wai Kit; Lin, Ada Wai Chi; Lui, Grace; Mitchell, Kate; Lee, Shui Shan

doi:10.1001/jamanetworkopen.2019.10960

Cited by 9 publications

(48 citation statements)

References 27 publications

(67 reference statements)

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“…Database searches identified 2644 titles to screen after removing duplicates, resulting in 17 articles that went to full-text review (Figure 1). Full-text review identified nine studies for inclusion and in-depth analysis [22][23][24][25][26][27][28][29][30] .…”

Section: Search Resultsmentioning

confidence: 99%

Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review

et al. 2021

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Introduction: In lower tuberculosis (TB) incidence countries (<100 cases/100,000/year), screening and preventive treatment (PT) for latent TB infection (LTBI) among people living with HIV (PLWH) is often recommended, yet guidelines advising which groups to prioritise for screening can be contradictory and implementation patchy. Evidence of LTBI screening cost-effectiveness may improve uptake and health outcomes at reasonable cost. Methods: Our systematic review assessed cost-effectiveness estimates of LTBI screening/PT strategies among PLWH in lower TB incidence countries to identify model-driving inputs and methodological differences. Databases were searched 1980-2020. Studies including health economic evaluation of LTBI screening of PLWH in lower TB incidence countries (<100 cases/100,000/year) were included. Study quality was assessed using the CHEERS checklist. Results: Of 2,644 articles screened, nine studies were included. Cost-effectiveness estimates of LTBI screening/PT for PLWH varied widely, with universal screening/PT found highly cost-effective by some studies, while only targeting to high-risk groups (such as those from mid/high TB incidence countries) deemed cost-effective by others. Cost-effectiveness of strategies screening all PLWH from studies published in the past five years varied from US$2828 to US$144,929/quality-adjusted life-year gained (2018 prices). Study quality varied, with inconsistent reporting of methods and results limiting comparability of studies. Cost-effectiveness varied markedly by screening guideline, with British HIV Association guidelines more cost-effective than NICE guidelines in the UK. Discussion: Cost-effectiveness studies of LTBI screening/PT for PLWH in lower TB incidence settings are scarce, with large variations in methods and assumptions used, target populations and screening/PT strategies evaluated. The limited evidence suggests LTBI screening/PT may be cost-effective for some PLWH groups but further research is required, particularly on strategies targeting screening/PT to PLWH at higher risk. Standardisation of model descriptions and results reporting could facilitate reliable comparisons between studies, particularly to identify those factors driving the wide disparity between cost-effectiveness estimates. Registration: PROSPERO CRD42020166338 (18/03/2020).

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Section: Search Resultsmentioning

confidence: 99%

Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review

et al. 2021

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“…So, to achieve the second WHO milestone, new measures must be taken. In order to improve the diagnosis [ 32 – 35 ], treatment [ 36 , 37 ] and TB prevention services [ 38 – 40 ], a lot of research have been carried out around the world. A study from Nepal found that active case finding could reduce catastrophic costs [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis and predication of tuberculosis registration rates in Henan Province, China: an exponential smoothing model study

Zhang

et al. 2020

Infect Dis Poverty

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“…So, to achieve the second WHO milestone, new measures must be taken. In order to improve the diagnosis [32][33][34][35], treatment [36,37] and TB prevention services [38][39][40], a lot of research have been carried out around the world. A study from Nepal found that active case nding could reduce catastrophic costs [41].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?

Zhang

Li³

et al. 2020

Preprint

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Background: The World Health Organization (WHO) End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20% and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854,672 active PTB cases were registered and treated in Henan Province, China. We need to assess whether the WHO milestones could be achieved in Henan Province.Methods: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System (CTIMS) were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted.Results: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter’s multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) and 34.4 (95% CI: 18.6-50.2) per 100,000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI: 3.2%-44.1%) and 46.8% (95% CI: 21.4%-72.1%) in 2020 and 2025, respectively.Conclusions: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the confidence interval, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.

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Latent Tuberculosis Infection Testing Strategies for HIV-Positive Individuals in Hong Kong

Cited by 9 publications

References 27 publications

Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review

Health economic analyses of latent tuberculosis infection screening and preventive treatment among people living with HIV in lower tuberculosis incidence settings: a systematic review

Analysis and predication of tuberculosis registration rates in Henan Province, China: an exponential smoothing model study

Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?

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