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Volume 26, Number 2—February 2020
Research

Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands

Pieter T. de BoerComments to Author , Marit M.A. de Lange, Cornelia C.H. Wielders, Frederika Dijkstra, Sonja E. van Roeden, Chantal P. Bleeker-Rovers, Jan Jelrik Oosterheert, Peter M. Schneeberger, and Wim van der Hoek
Author affiliations: National Institute for Public Health and the Environment, Bilthoven, the Netherlands (P.T. de Boer, M.M.A. de Lange, C.C.H. Wielders, F. Dijkstra, W. van der Hoek); University Medical Centre Utrecht, Utrecht, the Netherlands (S.E. van Roeden, J.J. Oosterheert); Radboud university medical center, Nijmegen, the Netherlands (C.P. Bleeker-Rovers); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (P.M. Schneeberger)

Main Article

Table 2

Prevalence scenarios explored in a study of the cost-effectiveness of screening for CQF, the Netherlands, 2017*

Parameter Low CQF prevalence scenario High CQF prevalence scenario
Risk for Coxiella burnetii infection
 Based on incidence rates of new infections during the epidemic period, adjusted for underreporting
 Based on overall seroprevalences from the literature (24,25)
High incidence area, % 2.15 10.7
Middle incidence area, % 0.15 2.30
Low incidence area, %
 0.027
 1.00
Risk for CQF after C. burnetii infection
 Equal for low and high CQF prevalence scenarios. Risk for CQF after infection is 7% for patients with heart valve disorders/prostheses, 29.3% for patients with vascular disorders/prostheses, and 6.9% for immunocompromised patients (probable or proven CQF). Risk for possible CQF in patients without risk factor is 0.2%.
Adjustment factor to account for reduction of CQF prevalence from directly after epidemic (2010–2012) to year of screening (2017) 0.25 0.52

*The epidemic period was 2007–2010. CQF, chronic Q fever.

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