臺灣博碩士論文加值系統

背景
過去的研究顯示糖尿病會增加結核病（TB）的風險，和不利的結核病治療結果，例如:結核病的治療失敗和治療期間死亡; 特別是在發展中國家其糖尿病的盛行率不斷增加，將可能造成結核病與糖尿病共病流行的風險。目前的研究還不清楚糖尿病是否也增加了已完成治療結核病的病人再次復發的風險。

方法
以台灣2006-2007年所有確診的肺結核世代完成治療後分析結核病的復發率。接著以同一追蹤世代進行以人群為基礎的嵌入型回溯性病例對照研究，來探討糖尿病與結核病復發的相關性。研究世代是以在2006-2007年台灣所有確診的肺結核通報病例，在完成治療後，追蹤直到2010年12月31日。復發的病例定義為須細菌學或病理確認結核病復發並且通報至全國結核病資料庫。對照組的選擇採取發生密度抽樣，亦即在復發病人通報至結核病通報系統的同日，從研究世代中選取未復發的個案作為對照組，病例與對照個案數使用1:1的比例，並且以相同的結核病完成治療後的追蹤時間作為配對條件。我們自結核病通報系統收集人口學特徵，並且進行回溯性病歷回顧，收集在前次結核病治療期間的臨床資訊。我們用條件式邏輯斯回歸分析來衡量糖尿病和結核病復發之間的相關性。

結果
截至2010年12月31日共計有305位的復發病人, 佔21939位追蹤世代的1.4％。結核病復發的發生率487.6/100,000 (434.4-545.5/100,000)。在排除了經病歷回顧後不符合復發定義，和欲分析變項資料不明個案之後，一共有251位病例和251位對照個案進行最後的相關性分析。有糖尿病的結核病病人相較於沒有糖尿病病人有較高的結核病復發風險（勝算比 1.74，95％信賴區間：1.18 - 2.59）。在調整了性別、年齡、是否為原住民、是否飲酒、吸煙、癌症、末期腎臟疾病、同時合併肺外結核病、是否具有開洞病灶、是否結核病治療為非標準治療處方、以及公衛人員直接觀察病人服藥是否超過60％的前次結核病治療時間，糖尿病仍然增加結核病的復發風險（調整後勝算比1.84, 95％信賴區間：1.14-2.98）。

結論
糖尿病增加結核病復發的風險。而血糖的控制與結核病復發的相關性研究仍需要進一步研究，以了解在結核病治療期間改善血糖控制，是否可能降低結核病復發的風險。

Background
Diabetes mellitus increases the risk of developing tuberculosis (TB), and is associated with unfavorable treatment outcomes, including treatment failure and death. It remains unclear whether diabetes also increases the risk of TB recurrence among those who had completed treatment.

Methods
We analyzed the national data from TB registry to estimate the incidence of recurrent TB recurrence rate among the 2006-2007 cohort of incident TB cases in Taiwan. Under the same cohort, we conducted a nested case-control study to investigate the association between DM status during previous anti-TB treatment and subsequent recurrence of TB.
The study population, all confirmed pulmonary TB cases reported to Taiwan TB registry during 2006 to 2007 with completing treatment outcome, was followed till December 31, 2010. Recurrent cases were defined as illnesses in patients with recurrent bacteriological or pathological confirmation of TB after having completed previous anti-TB treatment. For case-control analysis, controls were selected from the study population with 1:1 ratio to cases using incidence-density sampling and matched on time since treatment completion. Demographic and clinical characteristics of previous TB episodes were collected through retrospective medical charts review and TB registration database. We used conditional logistic regression analysis to measure the association between diabetes and recurrent TB.

Results
There were 305 (1.4%) cases of recurrent TB among the 21,939 pulmonary TB patients enrolled; two hundred and fifty one matched case-control pairs were analyzed after excluding missing information. The estimated incidence of recurrent TB among the 2006-2007 cohort was 487.6/100,000 person year (434.4-545.5/100,000). The presence of diabetes during previous TB treatment increased the risk of TB recurrence (crude OR= 1.74, 95% CI: 1.18 - 2.59). The association remained unchanged after adjusting for gender, indigenous population, alcohol consumption, smoking, cancer, end-stage of renal disease, coexisting of extra-pulmonary lesion, initial cavitation, suboptimal regimen, and directly observed therapy over 60% of treatment duration (adjusted OR= 1.84, 95% CI: 1.14-2.98).

Conclusions
The presence of diabetes mellitus was independently associated with increased risk of developing recurrent TB. To prevent recurrent TB among this population, further studies are needed to understand whether improved glycemic control during anti-TB treatment decreases the risk of recurrence.

口試委員會審定書……………………………………………………….2
Acknowledgements……………………………………………………….6
Abstract…………………………………………………………………...7
摘要………………………………………………………………….9
Chapter 1 Introduction……………………………………………………11
Chapter 2 Literature review………………………………………………13
2.1 The association between DM and risk of recurrent TB…………..13
2.1.1 Search flow…………………………………………………..13
2.1.2 Summary of findings………………………………………...14
2.2 Incidence rate of recurrent TB and associated risk factors……….18
2.2.1 Search flow…………………………………………………..18
2.2.2 Summary of findings…………………………………………19
2.3 Summary and gaps in the past studies……………………………23
2.4 Epidemiology of TB and national TB registry in Taiwan………...24
2.5 Recurrent TB in Taiwan…………………………………………..26
Chapter 3 Study objectives……………………………………………….27
Chapter 4 Materials and Methods………………………………………...28
4.1 Cohort analysis…………………………………………………...29
4.1.1 Study participants……………………………………………29
4.1.2 Data sources…………………………………………………31
4.1.3 Measurement of outcome……………………………………31
4.1.4 Statistical analysis…………………………………………...31
4.2 Nested case-control analysis……………………………………..33
4.2.1 Study participants……………………………………………33
4.2.2 Data sources………………………………………………....35
4.2.3 Measurement of main exposure and other covariates……….36
4.2.4 Sample size estimation………………………………….…...38
4.2.5 Statistical analysis…………………………………………...38
Chapter 5 Results…………………………………………………….…...40
5.1 cohort analysis: the incidence rate of recurrent TB in Taiwan........40
5.2 case-control analysis: the association between DM and recurrent TB……………………………………………………………..…..48
5.3 Stratified analysis of DM and risk of recurrent TB……….….…...51
5.4 Observed DM care pattern in case-control analysis…………..…. 55
Chapter 6 Discussion……………………………………………….……..57
6.1 Main findings……………………………………………………..57
6.2 Important differences to related studies…………………..……....58
6.3 Biological plausibility and mechanism………………….………..61
6.4 Strengths and limitations………………………………….………63
6.5 Clinical and public health implications…………………….……..67
6.6 Future research…………………………………………………....68
Chapter 7 Conclusion………………………………………………….….69
Figure
Figure 1 Search flow for studies associated with DM and risk of recurrent TB…………………………………………………16
Figure 2 Flowchart for the study population enrollment and nested case-control study…………………………………………...30
Figure 3 Illustration of control selection for the association study between DM and recurrent TB……………………………...34
Figure 4 Estimated incidence rate of recurrent TB, by follow-up time after completing previous anti-TB treatment…………….….43
Figure 5 Estimated incidence rate of recurrent TB, by age group and follow-up time……………………………………………….44
Figure 6 Estimated incidence rate of recurrent TB, by ethnic group and follow-up time……………………………………………….45
Figure 7 (a) Incidence of recurrent TB among indigenous population, 2006-2007; (b) Incidence of recurrent TB among non-indigenous population, 2006-2007……………….….…46
Figure 8 Estimated incidence rate of recurrent TB, by sex and follow-up time…………………………………………...….47
Figure 9 Association of DM with recurrent TB, stratified by age........52
Figure 10 Association of DM with recurrent TB, stratified by time to recurrence…………………………………………………...54
Table
Table 1 Search strategies for studies associated with DM and risk of recurrent TB……………………………………………….….15
Table 2 Summary of results for literature review about association study for DM and recurrent TB…………………………..….17
Table 3 Summary of risk factors with positive association with recurrent TB…………………………………………….…...22
Table 4 Estimated incidence rate of recurrent TB in Taiwan TB registry population, 2006-2007…………………………………...….42
Table 5 Factors associated with risk of recurrent TB………….……...49
Table 6 Glycemic control pattern among DM-TB patients during incident anti-TB treatment……………………………...…...56
Table 7 Simulation of relative risk among different under-reporting of recurrent TB to surveillance among DM and non-DM population……………………………………………....……66
References………………………………………………………….…..…70
Supplement…………………………………………………………....…..79

1.World Health Organization. Global TB control report 2011. Geneva, Switzerland. World Health Organization, 2011.
2.World Health Organization. Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response. Geneva, Switzerland: World Health Organization, 2010.
3.Murray J, Sonnenberg P, Shearer SC, Godfrey-Faussett P. Human immunodeficiency virus and the outcome of treatment for new and recurrent pulmonary tuberculosis in African patients. Am J Respir Crit Care Med. 1999;159(3):733-40.
4.Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378(9785):31-40.
5.Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4-14.
6.Roglic G, Unwin N. Mortality attributable to diabetes: Estimates for the year 2010. Diabetes Research and Clinical Practice. 2010;87(1):15-9.
7.Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med. 2008;5(7):e152.
8.Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lonnroth K, et al. The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Medicine. 2011;9(1):81.
9.Singla R, Khan N, Al-Sharif N, Ai-Sayegh MO, Shaikh MA, Osman MM. Influence of diabetes on manifestations and treatment outcome of pulmonary TB patients. Int J Tuberc Lung Dis. 2006;10(1):74-9.
10.Picon PD, Bassanesi SL, Caramori ML, Ferreira RL, Jarczewski CA, Vieira PR. Risk factors for recurrence of tuberculosis. J Bras Pneumol. 2007;33(5):572-8.
11.Maalej S, Belhaoui N, Bourguiba M, Mahouachi R, Chtourou A, Taktak S, et al. [Pulmonary tuberculosis and diabetes. A retrospective study of 60 patients in Tunisia]. Presse Med. 2009;38(1):20-4.
12.Mos-Antkowiak R. [Tuberculosis in patients with alcoholism, peptic ulcer, diabetes mellitus or mental disorders]. Pneumonol Alergol Pol. 1991;59(1-2):43-7.
13.Kameda K, Kawabata S, Masuda N. [Follow-up study of short course chemotherapy of pulmonary tuberculosis complicated with diabetes mellitus]. Kekkaku. 1990;65(12):791-803.
14.Wada M. [The effectiveness of pyrazinamide-containing six-month short course chemotherapy]. Kekkaku. 2000;75(11):665-73.
15.Zhang Q, Xiao H, Sugawara I. Tuberculosis complicated by diabetes mellitus at shanghai pulmonary hospital, china. Jpn J Infect Dis. 2009;62(5):390-1.
16.Lin S, Shen M, Sun Y. [Epidemiological characteristics of tuberculosis patients complicated with diabetes in Shanghai]. Zhonghua Jie He He Hu Xi Za Zhi. 1998;21(8):504-6.
17.Mboussa J, Monabeka H, Kombo M, Yokolo D, Yoka-Mbio A, Yala F. [Course of pulmonary tuberculosis in diabetics]. Revue de pneumologie clinique. 2003;59(1):39-44.
18.He GX, Xie YG, Wang LX, Borgdorff MW, van der Werf MJ, Fan JH, et al. Follow-up of patients with multidrug resistant tuberculosis four years after standardized first-line drug treatment. PLoS One. 2010;5(5):e10799.
19.Crofts JP, Andrews NJ, Barker RD, Delpech V, Abubakar I. Risk factors for recurrent tuberculosis in England and Wales, 1998-2005. Thorax. 2010;65(4):310-4.
20.Millet JP, Orcau A, de Olalla PG, Casals M, Rius C, Cayla JA. Tuberculosis recurrence and its associated risk factors among successfully treated patients. J Epidemiol Community Health. 2009;63(10):799-804.
21.Dobler CC, Crawford AB, Jelfs PJ, Gilbert GL, Marks GB. Recurrence of tuberculosis in a low-incidence setting. Eur Respir J. 2009;33(1):160-7.
22.Glynn JR, Murray J, Bester A, Nelson G, Shearer S, Sonnenberg P. High rates of recurrence in HIV-infected and HIV-uninfected patients with tuberculosis. J Infect Dis. 2010;201(5):704-11.
23.Crampin AC, Mwaungulu JN, Mwaungulu FD, Mwafulirwa DT, Munthali K, Floyd S, et al. Recurrent TB: relapse or reinfection? The effect of HIV in a general population cohort in Malawi. AIDS. 2010;24(3):417-26.
24.Golub JE, Durovni B, King BS, Cavalacante SC, Pacheco AG, Moulton LH, et al. Recurrent tuberculosis in HIV-infected patients in Rio de Janeiro, Brazil. AIDS. 2008;22(18):2527-33.
25.Datiko DG, Lindtjorn B. Tuberculosis recurrence in smear-positive patients cured under DOTS in southern Ethiopia: retrospective cohort study. BMC public health. 2009;9:348.
26.Thomas A, Gopi PG, Santha T, Chandrasekaran V, Subramani R, Selvakumar N, et al. Predictors of relapse among pulmonary tuberculosis patients treated in a DOTS programme in South India. Int J Tuberc Lung Dis. 2005;9(5):556-61.
27.Driver CR, Munsiff SS, Li J, Kundamal N, Osahan SS. Relapse in persons treated for drug-susceptible tuberculosis in a population with high coinfection with human immunodeficiency virus in New York City. Clin Infect Dis. 2001;33(10):1762-9.
28.Aber VR, Nunn AJ. [Short term chemotherapy of tuberculosis. Factors affecting relapse following short term chemotherapy]. Bulletin of the International Union against Tuberculosis. 1978;53(4):276-80.
29.Pulido F, Pena JM, Rubio R, Moreno S, Gonzalez J, Guijarro C, et al. Relapse of tuberculosis after treatment in human immunodeficiency virus-infected patients. Arch Intern Med. 1997;157(2):227-32.
30.Tam CM, Chan SL, Kam KM, Goodall RL, Mitchison DA. Rifapentine and isoniazid in the continuation phase of a 6-month regimen. Final report at 5 years: prognostic value of various measures. Int J Tuberc Lung Dis. 2002;6(1):3-10.
31.A controlled trial of six months chemotherapy in pulmonary tuberculosis. Second report: results during the 24 months after the end of chemotherapy. British Thoracic Association. The American review of respiratory disease. 1982;126(3):460-2.
32.Noertjojo K, Tam CM, Chan SL, Chan-Yeung MM. Extra-pulmonary and pulmonary tuberculosis in Hong Kong. Int J Tuberc Lung Dis. 2002;6(10):879-86.
33.Hawken M, Nunn P, Gathua S, Brindle R, Godfrey-Faussett P, Githui W, et al. Increased recurrence of tuberculosis in HIV-1-infected patients in Kenya. Lancet. 1993;342(8867):332-7.
34.Johnson JL, Okwera A, Vjecha MJ, Byekwaso F, Nakibali J, Nyole S, et al. Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis. Int J Tuberc Lung Dis. 1997;1(5):446-53.
35.Mallory KF, Churchyard GJ, Kleinschmidt I, De Cock KM, Corbett EL. The impact of HIV infection on recurrence of tuberculosis in South African gold miners. Int J Tuberc Lung Dis. 2000;4(5):455-62.
36.El Sahly HM, Wright JA, Soini H, Bui TT, Williams-Bouyer N, Escalante P, et al. Recurrent tuberculosis in Houston, Texas: a population-based study. Int J Tuberc Lung Dis. 2004;8(3):333-40.
37.Lopez-Cortes LF, Marin-Niebla A, Lopez-Cortes LE, Villanego I, Rodriguez-Diez M, Pascual-Carrasco R. Influence of treatment and immunological recovery on tuberculosis relapses in HIV-infected patients. Int J Tuberc Lung Dis. 2005;9(12):1385-90.
38.Benator D, Bhattacharya M, Bozeman L, Burman W, Cantazaro A, Chaisson R, et al. Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial. Lancet. 2002;360(9332):528-34.
39.Jee SH, Golub JE, Jo J, Park IS, Ohrr H, Samet JM. Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean men and women. Am J Epidemiol. 2009;170(12):1478-85.
40.Selassie A, Pozsik C, Wilson D, Ferguson P. Why Pulmonary Tuberculosis Recurs: A Population-based Epidemiological Study. Annals of Epidemiology. 2005;15(7):519-25.
41.Hamilton CD, Stout JE, Goodman PC, Mosher A, Menzies R, Schluger NW, et al. The value of end-of-treatment chest radiograph in predicting pulmonary tuberculosis relapse. Int J Tuberc Lung Dis. 2008;12(9):1059-64.
42.Crampin AC, Mwaungulu JN, Mwaungulu FD, Mwafulirwa DT, Munthali K, Floyd S, et al. Recurrent TB: relapse or reinfection? The effect of HIV in a general population cohort in Malawi. AIDS. 2010;24(3):417-26.
43.Lambert M-L, Hasker E, Deun AV, Roberfroid D, Boelaert M, Van der Stuyft P. Recurrence in tuberculosis: relapse or reinfection? The Lancet Infectious Diseases. 2003;3(5):282-7.
44.de Boer AS, Borgdorff MW, Vynnycky E, Sebek MM, van Soolingen D. Exogenous re-infection as a cause of recurrent tuberculosis in a low-incidence area. Int J Tuberc Lung Dis. 2003;7(2):145-52.
45.Bang D, Andersen AB, Thomsen VO, Lillebaek T. Recurrent tuberculosis in Denmark: relapse vs. re-infection. Int J Tuberc Lung Dis. 2010;14(4):447-53.
46.Magana-Arachchi DN, Perera AJ, Senaratne V, Chandrasekharan NV. Patterns of drug resistance and RFLP analysis of Mycobacterium tuberculosis strains isolated from recurrent tuberculosis patients in Sri Lanka. Southeast Asian J Trop Med Public Health. 2010;41(3):583-9.
47.Wang JY, Lee LN, Lai HC, Hsu HL, Liaw YS, Hsueh PR, et al. Prediction of the tuberculosis reinfection proportion from the local incidence. J Infect Dis. 2007;196(2):281-8.
48.Glynn JR, Yates MD, Crampin AC, Ngwira BM, Mwaungulu FD, Black GF, et al. DNA fingerprint changes in tuberculosis: reinfection, evolution, or laboratory error? J Infect Dis. 2004;190(6):1158-66.
49.Bandera A, Gori A, Catozzi L, Degli Esposti A, Marchetti G, Molteni C, et al. Molecular epidemiology study of exogenous reinfection in an area with a low incidence of tuberculosis. Journal of clinical microbiology. 2001;39(6):2213-8.
50.Taiwan centers for disease control. Taiwan Tuberculosis Control Report 2008. Centers for Disease Control, Department of Health, R.O.C. (Taiwan) 2008; http://www2.cdc.gov.tw/public/data/9411674871.pdf. Access date: June 8, 2012
51.Lo HY, Yang SL, Chou P, Chuang JH, Chiang CY. Completeness and timeliness of tuberculosis notification in Taiwan. BMC public health. 2011;11:915.
52.Chiang CY, Enarson DA, Yu MC, Bai KJ, Huang RM, Hsu CJ, et al. Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study. European Respiratory Journal. 2006;28(5):980-5.
53.Lin TP, Suo J, Lee CN, Lee JJ, Yang SP. Short-course chemotherapy of pulmonary tuberculosis in pneumoconiotic patients. The American review of respiratory disease. 1987;136(4):808-10.
54.Taiwan centers for disease control. Treatment guidelines for tuberculosis (結核病診治指引-第二版). Centers for Disease Control, Department of Health, R.O.C. (Taiwan); 2006 [May 22, 2012]; http://www2.cdc.gov.tw/ct.asp?xItem=7138&ctNode=78&mp=230. Access date: June 8, 2012
55.World Health Organization. Treatment of Tuberculosis: guidelines for national programmes. Geneva, Switzerland. World Health Organization, 2009.
56.Bloss E, Chan PC, Cheng NW, Wang KF, Yang SL, Cegielski P. Increasing directly observed therapy related to improved tuberculosis treatment outcomes in Taiwan. The International Journal of Tuberculosis and Lung Disease. 2012;16(4):462-7.
57.Jasmer RM. Recurrent Tuberculosis in the United States and Canada: Relapse or Reinfection? American Journal of Respiratory and Critical Care Medicine. 2004;170(12):1360-6.
58.Panjabi R, Comstock GW, Golub JE. Recurrent tuberculosis and its risk factors: adequately treated patients are still at high risk. Int J Tuberc Lung Dis. 2007;11(8):828-37. Epub 2007/08/21.
59.Yang C-H, Yang S-Y, Shen M-H, Kuo H-S. The changing epidemiology of prevalent diagnosed HIV infections in Taiwan, 1984–2005. International Journal of Drug Policy. 2008;19(4):317-23.
60.Control CfD. Taiwan Tuberculosis Control Report 2010. Centers for Disease Control, Department of Health, R.O.C. (Taiwan); 2010 [May 22, 2012]; Available from: http://www.cdc.gov.tw/ct.asp?xItem=32159&ctNode=1947&mp=1. Access date: June 8, 2012
61.Vree M, Huong NT, Duong BD, Sy DN, Van LN, Hung NV, et al. Survival and relapse rate of tuberculosis patients who successfully completed treatment in Vietnam. Int J Tuberc Lung Dis. 2007;11(4):392-7.
62.Yamashiro S, Kawakami K, Uezu K, Kinjo T, Miyagi K, Nakamura K, et al. Lower expression of Th1-related cytokines and inducible nitric oxide synthase in mice with streptozotocin-induced diabetes mellitus infected with Mycobacterium tuberculosis. Clinical and experimental immunology. 2005;139(1):57-64.
63.Martens GW, Arikan MC, Lee J, Ren F, Greiner D, Kornfeld H. Tuberculosis susceptibility of diabetic mice. American journal of respiratory cell and molecular biology. 2007;37(5):518-24.
64.Vallerskog T, Martens GW, Kornfeld H. Diabetic mice display a delayed adaptive immune response to Mycobacterium tuberculosis. Journal of immunology. 2010;184(11):6275-82.
65.Stalenhoef JE, Alisjahbana B, Nelwan EJ, van der Ven-Jongekrijg J, Ottenhoff TH, van der Meer JW, et al. The role of interferon-gamma in the increased tuberculosis risk in type 2 diabetes mellitus. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 2008;27(2):97-103.
66.Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabetic medicine : a journal of the British Diabetic Association. 1997;14(1):29-34.
67.Rayfield EJ, Ault MJ, Keusch GT, Brothers MJ, Nechemias C, Smith H. Infection and diabetes: the case for glucose control. The American journal of medicine. 1982;72(3):439-50.
68.Yu MC, Bai KJ, Chang JH, Lee CN. Tuberculosis incidence and mortality in aboriginal areas of Taiwan, 1997-2001. Journal of the Formosan Medical Association = Taiwan yi zhi. 2004;103(11):817-23.
69.Lo HY, Suo J, Chang HJ, Yang SL, Chou P. Risk Factors Associated With Death in a 12-Month Cohort Analysis of Tuberculosis Patients: 12-Month Follow-up After Registration. Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health. 2011.
70.Horne DJ, Royce SE, Gooze L, Narita M, Hopewell PC, Nahid P, et al. Sputum monitoring during tuberculosis treatment for predicting outcome: systematic review and meta-analysis. Lancet Infect Dis. 2010;10(6):387-94.
71.Leung CC, Lam TH, Chan WM, Yew WW, Ho KS, Leung GM, et al. Diabetic control and risk of tuberculosis: a cohort study. Am J Epidemiol. 2008;167(12):1486-94.