Quantiferon for Detection of Latent Tuberculosis in Healthcare Workers
Quantiferon for Detection of Latent Tuberculosis in 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
INCLUSION CRITERIA:

 Group 1:

 -  Healthcare worker volunteering for the study

 -  Stable (expected employment in the unit > one year)

 -  Working in a high-risk units for tuberculosis (at least 5 cases of smear-positive
 pulmonary tuberculosis per year)

 Group 2 :

 -  Healthcare worker volunteering for the study

 -  With an unexpected exposure to a patient with contagious tuberculosis (delay in
 respiratory isolation of a smear-positive patient)

 EXCLUSION CRITERIA:

 -  No informed consent

 -  Age < 18 years

 -  Employment in this unit < one year