Objective To analyze the cost-effectiveness per case of different screening methods for latent infection of mycobacterium tuberculosis (MTB) in the student population in Chongqing, thus providing a scientific basis for optimizing large-scale tuberculosis screening among students.
Methods The tuberculin skin test (TST) and recombinant MTB fusion protein skin test (EC-ST) were adopted to conduct tuberculosis examination and close contact screening among 46 531 students in grades one and two of 46 senior high schools in Chongqing from January to December 2024. The positive detection and cost-effectiveness of TST and EC-ST in tuberculosis examination and close contact screening were compared.
Results The infection rates of MTB detected by TST and EC-ST were 35.74% (8 132/22 751) and 5.73% (1 304/22 748), respectively. The average detection cost per case of MTB infection was 83.93 CNY for TST and 872.24 CNY for EC-ST. In the close contact screening, the infection rates of MTB detected by TST and EC-ST were 46.36% (210/453) and 6.74% (39/579), respectively. The average detection cost per case of MTB infection was 64.71 CNY for TST and 742.31 CNY for EC-ST. Among the 39 MTB-infected patients detected by EC-ST, 8 tuberculosis patients were detected, and the average detection cost was 7 237.50 CNY. Among the 210 MTB-infected patients detected by TST, no tuberculosis patient was detected.
Conclusions EC-ST is suitable for accurate screening of high-risk close contacts, and TST with a low cost is still a reasonable choice for large-scale tuberculosis examination in the general student population.
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