Tuberculosis Clinical Trial
Official title:
Cost-effectiveness of Quantiferon Gold in VITRO Test of T-lymphocytic Response for Detection of Latent Tuberculosis in At-risk Healthcare Workers
The accuracy of tuberculin skin test (TST) for detecting latent tuberculosis is limited in countries with a high proportion of population having received vaccination with the BCG. We aim to determine the cost-effectiveness of Quantiferon gold (QTFG), compared to BCG vaccine to detect latent tuberculosis in exposed healthcare workers (HCWs)
The QUANTIPS study includes two components:
1. survey of HCWs working in high-risk units (respiratory diseases or infectious diseases
with at least 5 case of smear-positive pulmonary tuberculosis par year) from 14
University hospitals in France
2. Follow-up of HCWs with unexpected exposure to a patient with contagious tuberculosis
(delay in respiratory isolation of a smear-positive patient) in 4 University hospitals
Main objective: Therapeutic impact of tuberculosis screening using TST compared to
QFTG. The impact is defined by the decision to treat of not a HCW with latent
tuberculosis using QFTG, compared to the decision which would have been based on TST
alone
Secondary objectives:
- Cost-effectiveness of replacing TST by QFTG
- Prevalence and incidence of latent tuberculosis in exposed HCWs (Part 1)
- Incidence of latent tuberculosis in HCWs exposed to an index case (part 2) Inclusion:
HCWs who volunteer to participate in units with at least 5 patients with smear-positive
tuberculosis each year (Group 1), HCWs exposed to a smear-positive patient non isolated
at hospital admission (Group 2) Study population: 2000 (Group 1) and 600 (Group 2) HCWs
Study duration: inclusion during 3 months, follow-up of one year (Group 1 ); Inclusion
for one year, with a 3-month follow up (Group 2)
Study exams:
- Group 1 : TST, QFTG, chest radiography at baseline and after one year
- Group 2 : TST, QFTG, chest radiography at baseline (within 3 weeks after exposure) and
after 3 months
Endpoints:
- therapeutic decision regarding tuberculosis treatment, with a cost-effectiveness
analysis (Markov's modelling)
- prevalence and incidence of latent tuberculosis
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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