( 您好!臺灣時間:2021/05/12 06:10
字體大小: 字級放大   字級縮小   預設字形  


研究生(外文):Lin, Peiru
論文名稱(外文):Screening for Latent TB Infection among Occupational Employees
指導教授(外文):Ku, Chihhung
口試委員(外文):Chen, HongiChu, ChihongChang, FengyeeLin, JungchungKu, Chihhung
外文關鍵詞:screeninglatent TB infectionQFT-GIT
  • 被引用被引用:1
  • 點閱點閱:186
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
某行業因工作特性,員工時常群聚生活。在此環境下若乙名員工結核發病即容易散播結核桿菌。目前台灣臨床結核病常見之診斷工具包括:胸部X光、痰液抹片及培養,這些方法僅能診斷病發之活動性結核病患,無法及早診斷潛隱性結核感染者。而結核菌素皮膚試驗(tuberculin skin test, TST)為各國臨床上經常用來診斷潛隱性結核感染(latent TB infection, LTBI)的工具,但因為容易受到卡介苗(Bacille Calmette-Guérin, BCG)的干擾,並不適用於我國。美國食品藥物管理局(Food and Drug Administration, FDA)於2007年核准第三代診斷方法 QuantiFERON®-TB Gold In-Tube test (QFT-GIT)的使用,不僅敏感度及精確度都較TST高,且不受卡介苗干擾。本研究旨在調查某行業員工潛隱性結核感染情形及其危險因子,研究期間自99年9月1日至100年4月30日。
本研究為橫斷性研究且經人體試驗審議委員會審查通過,研究對象為某行業現職員工,收案地點選定甲、乙兩地之體檢醫院。利用結構式問卷調查結核感染相關危險因子並採集血液檢體2ml,使用QFT-GIT試驗篩檢潛隱性結核感染者。統計方法採用multiple logistic regression 之逐步分析(Stepwise)。在校正潛在干擾因素後,探討QFT-GIT篩檢結果呈現陽性的危險因子。
研究結果顯示,甲地QFT-GIT陽性率為23.3% (71/305)、乙地QFT-GIT陽性率為8.3% (56/673)。某行業員工整體QFT-GIT陽性率為13% (127/978)。本研究QFT-GIT篩檢結果呈現陽性的危險因子分別為性別(女性 vs. 男性, OR=2.66, 95%CI=1.39-5.08)、結核病史(有 vs. 無, OR=26.8, 95%CI=2.30-311.92)、工作地區(甲地 vs. 乙地, OR=3.79, 95%CI=2.35-6.10)及抽菸(有 vs. 無, OR=1.96, 95%CI=1.16-3.30)。

Based on the needs of the work, employees have to engage in congregate living. In this type of condition, once an employee progresses from tuberculosis infection to active tuberculosis, Mycobacterium tuberculosis is easily spread from one person to another. X-ray, Sputum smear and culture are currently the most common clinical diagnostic tools in Taiwan for the diagnosis of active TB, excluding latent TB infection. Tuberculin skin test (TST) is the usual clinical tool used to diagnose latent TB infection in every country; however, TST results are prone to being confounded by the Bacille Calmette-Guérin (BCG) vaccination, and therefore are not suitable in Taiwan. The Food and Drug Administration (FDA) in the United States has certified the usage of a third generation diagnostic method- QuantiFERON®-TB Gold In-Tube test (QFT-GIT) in 2007. It’s sensitivity and specificity is not only much higher than that of TST, but is also not affected by previous BCG vaccination. This study aimed to investigate the rate of latent TB infection and realize risk factors among occupational employees. The study duration was from September 1, 2010 to April 30, 2011.
This study was a cross-sectional study and had been approved by the Institutional Review Board. The study subjects were employees from an occupation. We choosed two physical examination hospitals designated hospitals A and B as our area of study. We used structural questionnaires to investigate the risk factors for latent TB infection and collected 3mls of blood specimen using QFT-GIT to screen a person for latent TB infection. Statistical analysis utilized stepwise multiple logistic regression. We discussed the risk factors for the positive results of QFT-GIT after adjusting the potential confounding factors.
The QFT-GIT positive rates were 23.3% (71/305) for hospital A, 8.3% (56/673) for hospital B and 13% for overall occupational employees. After adjustment for confounders, this study indicated that gender of women (OR=2.66, 95%CI=1.39-5.08), with TB history (OR=26.8, 95%CI=2.30-311.92), working at location A (high TB prevalence area) (OR=3.79, 95%CI=2.35-6.10) and smoking (OR=1.96, 95%CI=1.16-3.30) were associated with TB infection among occupational employees.
Our study indicated the QFT-GIT positive rate of occupational employees were elevated at higher TB incidence areas. Since these occupational employees were 24 hour clustering groups, the senior manager should enforce routine TB screening for occupational employees at higher risk areas through the use of QFT-GIT. Also we suggest performing routine follow-up for employees with TB disease history to prevent subsequent tubercle bacillus re-infection and re-activation, as well as give employees the opportunity to attend smoking cessation clinics to stop their smoking habit in order to lower infection risk after tubercle bacillus exposure. Promoting TB education during yearly physical examination to reduce TB outbreaks is also suggested.

目錄 I
表目錄 III
圖目錄 IV
摘要 V
Abstract VII
第一章 緒言 1
第一節 研究背景及重要性 1
第二節 研究動機 11
第三節 研究目的 12
第四節 研究假設 13
第二章 文獻探討 14
第一節 結核感染(病)篩檢之盛行率探討 14
第二節 結核感染(病)之危險因子探討 18
第三章 材料與方法 24
第一節 研究設計 24
第二節 研究族群及對象 25
第三節 研究架構 26
第四節 研究工具-問卷調查 27
第五節 研究工具-診斷方法 29
第六節 統計方法 30
第四章 結果 31
第一節 QuantiFERON檢驗結果之陽性率 31
第二節 基本人口學 32
第三節 醫藥狀況 35
第四節 自覺症狀 37
第五節 生活型態 39
第六節 居住環境 41
第七節 工作環境 43
第八節 QFT-GIT(+)的危險因子 45
第五章 討論 46
第一節 某行業員工潛隱性結核感染率之比較 46
第二節 某行業員工潛隱性結核感染之危險因子 47
第三節 其他文獻之危險因子 55
第四節 研究限制 60
第六章 結論與建議 61
第七章 參考文獻 63

1.(1979). "Trial of BCG vaccines in south India for tuberculosis prevention." Indian J Med Res 70: 349-363.
2.(1989). "Research towards global control and prevention of tuberculosis with an emphasis on vaccine development. A Fogarty International Center Workshop, Bethesda, Maryland, 3-5 November 1987. Proceedings." Rev Infect Dis 11 Suppl 2: S335-490.
3.(1999). "Fifteen year follow up of trial of BCG vaccines in south India for tuberculosis prevention. Tuberculosis Research Centre (ICMR), Chennai." Indian J Med Res 110: 56-69.
4.Aktas, E., F. Ciftci, et al. (2009). "Peripheral immune response in pulmonary tuberculosis." Scand J Immunol 70(3): 300-308.
5.Andersen, P., T. M. Doherty, et al. (2007). "The prognosis of latent tuberculosis: can disease be predicted?" Trends Mol Med 13(5): 175-182.
6.Andersen, P., M. E. Munk, et al. (2000). "Specific immune-based diagnosis of tuberculosis." Lancet 356(9235): 1099-1104.
7.Arcavi, L. and N. L. Benowitz (2004). "Cigarette smoking and infection." Arch Intern Med 164(20): 2206-2216.
8.Baker, M., D. Das, et al. (2008). "Tuberculosis associated with household crowding in a developed country." J Epidemiol Community Health 62(8): 715-721.
9.Bang, D., A. B. Andersen, et al. (2010). "Recurrent tuberculosis in Denmark: relapse vs. re-infection." Int J Tuberc Lung Dis 14(4): 447-453.
10.Banu, S., A. Hossain, et al. (2010). "Pulmonary tuberculosis and drug resistance in Dhaka central jail, the largest prison in Bangladesh." PLoS One 5(5): e10759.
11.Barnes, P. F., B. Samten, et al. (2009). "Progress in understanding the human immune responses to Mycobacterium tuberculosis." Tuberculosis (Edinb) 89 Suppl 1: S5-9.
12.Bates, M. N., A. Khalakdina, et al. (2007). "Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis." Arch Intern Med 167(4): 335-342.
13.Beggs, C. (2000). "ENGINEERING THE CONTROL OF AIRBORNE PATHOGENS ", from http://www.efm.leeds.ac.uk/CIVE/MTB/CBB-paper1.pdf.
14.Black, G. F., R. E. Weir, et al. (2002). "BCG-induced increase in interferon-gamma response to mycobacterial antigens and efficacy of BCG vaccination in Malawi and the UK: two randomised controlled studies." Lancet 359(9315): 1393-1401.
15.Bodenmann, P., P. Vaucher, et al. (2009). "Screening for latent tuberculosis infection among undocumented immigrants in Swiss healthcare centres; a descriptive exploratory study." BMC Infect Dis 9: 34.
16.Boelaert, J. R., M. S. Gomes, et al. (2003). "Smoking, iron, and tuberculosis." Lancet 362(9391): 1243-1244.
17.Bowman, C., W. Bowman, et al. (2006). "U.S. Navy and Marine Corps conversion rates for tuberculosis skin testing (1999-2002), with literature review." Mil Med 171(7): 608-612.
18.Buff, A. M., S. J. Deshpande, et al. (2008). "Investigation of Mycobacterium tuberculosis transmission aboard the U.S.S. Ronald Reagan, 2006." Mil Med 173(6): 588-593.
19.Cardona, P. J. (2010). "Revisiting the natural history of tuberculosis. The inclusion of constant reinfection, host tolerance, and damage-response frameworks leads to a better understanding of latent infection and its evolution towards active disease." Arch Immunol Ther Exp (Warsz) 58(1): 7-14.
20.CDC (1995). "Screening for Tuberculosis and Tuberculosis Infection in High-Risk Populations Recommendations of the Advisory Council for the Elimination of Tuberculosis " MMWR 44(RR-11): 18-34.
21.CDC (2000). "Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection." MMWR 49(RR-6): 1-54.
22.CDC (2010). "Decrease in Reported Tuberculosis Cases --- United States, 2009." MMWR 59(10): 289-294.
23.CDC. (2010). "The Difference Between Latent TB Infection and Active TB Disease." from http://www.cdc.gov/tb/publications/factsheets/general/LTBIandActiveTB.pdf.
24.CDC (2010). "Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium tuberculosis Infection --- United States, 2010." MMWR 59(RR-5).
26.Chan, P. C., L. M. Huang, et al. (2009). "It is time to deal with latent tuberculosis infection in Taiwan." J Formos Med Assoc 108(12): 901-903.
27.Charalambous, S., A. D. Grant, et al. (2008). "Contribution of reinfection to recurrent tuberculosis in South African gold miners." Int J Tuberc Lung Dis 12(8): 942-948.
28.Cheng, S. H., K. B. Walker, et al. (1993). "Monocyte antimycobacterial activity before and after Mycobacterium bovis BCG vaccination in Chingleput, India, and London, United Kingdom." Infect Immun 61(10): 4501-4503.
29.Chiang, C. Y., C. J. Hsu, et al. (2002). "Pulmonary tuberculosis in the Taiwanese prison population." J Formos Med Assoc 101(8): 537-541.
30.Chiang, C. Y., J. Suo, et al. (2002). "Screening for pulmonary tuberculosis among military conscripts in Taiwan." J Formos Med Assoc 101(12): 841-845.
31.Choi, C. M., C. I. Kang, et al. (2006). "The role of TST in the diagnosis of latent tuberculosis infection among military personnel in South Korea." Int J Tuberc Lung Dis 10(12): 1342-1346.
32.Ciftci, F., E. Tozkoparan, et al. (2004). "The incidence of tuberculosis in the armed forces: a good reflection of the whole population." Int J Tuberc Lung Dis 8(8): 965-968.
33.Clark, M., P. Riben, et al. (2002). "The association of housing density, isolation and tuberculosis in Canadian First Nations communities." Int J Epidemiol 31(5): 940-945.
34.Colditz, G. A., T. F. Brewer, et al. (1994). "Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature." JAMA 271(9): 698-702.
35.Crofts, J. P., N. J. Andrews, et al. (2010). "Risk factors for recurrent tuberculosis in England and Wales, 1998-2005." Thorax 65(4): 310-314.
36.DA (2008). Supplemental guidance for the Army Latent Tuberculosis Infection (LTBI) Surveillance and Control Program.
38.de Souza, J. N. and M. R. Bertolozzi (2007). "The vulnerability of nursing workers to tuberculosis in a teaching hospital." Rev Lat Am Enfermagem 15(2): 259-266.
39.den Boon, S., S. W. van Lill, et al. (2005). "Association between smoking and tuberculosis infection: a population survey in a high tuberculosis incidence area." Thorax 60(7): 555-557.
40.Diel, R., R. Loddenkemper, et al. (2010). "Evidence-based comparison of commercial interferon-gamma release assays for detecting active TB: a metaanalysis." Chest 137(4): 952-968.
41.DiStasio, A. J., 2nd and D. H. Trump (1990). "The investigation of a tuberculosis outbreak in the closed environment of a U.S. Navy ship, 1987." Mil Med 155(8): 347-351.
42.DoN (2009). Tuberculosis control program.
43.Dong, B., N. Ge, et al. (2001). "[Social economical status, behaviors and environment as the risk factors of tuberculosis in Chengdu China]." Zhonghua Liu Xing Bing Xue Za Zhi 22(2): 102-104.
44.Dong, B., N. Ge, et al. (2001). "[Smoking and alcohol consumption as risk factors of pulmonary tuberculosis in Chengdu: a matched case-control study]." Hua Xi Yi Ke Da Xue Xue Bao 32(1): 104-106.
45.Dye, J. A. and K. B. Adler (1994). "Effects of cigarette smoke on epithelial cells of the respiratory tract." Thorax 49(8): 825-834.
46.Eisenhut, M., S. Paranjothy, et al. (2009). "BCG vaccination reduces risk of infection with Mycobacterium tuberculosis as detected by gamma interferon release assay." Vaccine 27(44): 6116-6120.
47.Escombe, A. R., C. C. Oeser, et al. (2007). "Natural ventilation for the prevention of airborne contagion." PLoS Med 4(2): e68.
48.Ferrara, G., B. Bleck, et al. (2008). "Mycobacterium tuberculosis induces CCL18 expression in human macrophages." Scand J Immunol 68(6): 668-674.
49.Ferrara, G., M. Losi, et al. (2009). "Exploring the immune response against Mycobacterium tuberculosis for a better diagnosis of the infection." Arch Immunol Ther Exp (Warsz) 57(6): 425-433.
50.Fine, P. E. (1995). "Variation in protection by BCG: implications of and for heterologous immunity." Lancet 346(8986): 1339-1345.
51.Foote, F. O. (2006). "A tuberculosis event on a Navy assault ship." Mil Med 171(12): 1198-1200.
52.Franchi, A., L. Richeldi, et al. (2007). "Room size is the major determinant for tuberculin conversion in health care workers exposed to a multidrug-resistant tuberculosis patient." Int Arch Occup Environ Health 80(6): 533-538.
53.Franken, W. P., J. F. Timmermans, et al. (2007). "Comparison of Mantoux and QuantiFERON TB Gold tests for diagnosis of latent tuberculosis infection in Army personnel." Clin Vaccine Immunol 14(4): 477-480.
54.Freeman, R. J., J. D. Mancuso, et al. (2010). "Systematic review and meta-analysis of TST conversion risk in deployed military and long-term civilian travelers." J Travel Med 17(4): 233-242.
55.Furuya, H., M. Nagamine, et al. (2009). "Use of a mathematical model to estimate tuberculosis transmission risk in an Internet cafe." Environ Health Prev Med 14(2): 96-102.
56.Geng, Y., S. M. Savage, et al. (1995). "Effects of nicotine on the immune response. I. Chronic exposure to nicotine impairs antigen receptor-mediated signal transduction in lymphocytes." Toxicol Appl Pharmacol 135(2): 268-278.
57.Ginns, L. C., P. D. Goldenheim, et al. (1982). "T-lymphocyte subsets in smoking and lung cancer: Analysis of monoclonal antibodies and flow cytometry." Am Rev Respir Dis 126(2): 265-269.
58.Golub, J. E., S. Bur, et al. (2006). "Delayed tuberculosis diagnosis and tuberculosis transmission." Int J Tuberc Lung Dis 10(1): 24-30.
59.Gulati, M., D. J. Liss, et al. (2005). "Risk factors for tuberculin skin test positivity in an industrial workforce results of a contact investigation." J Occup Environ Med 47(11): 1190-1199.
60.Hagiwara, E., K. I. Takahashi, et al. (2001). "Cigarette smoking depletes cells spontaneously secreting Th(1) cytokines in the human airway." Cytokine 14(2): 121-126.
61.Hamid Salim, M. A., E. Declercq, et al. (2004). "Gender differences in tuberculosis: a prevalence survey done in Bangladesh." Int J Tuberc Lung Dis 8(8): 952-957.
62.Hart, P. D. and I. Sutherland (1977). "BCG and vole bacillus vaccines in the prevention of tuberculosis in adolescence and early adult life." Br Med J 2(6082): 293-295.
63.Hauck, F. R., B. H. Neese, et al. (2009). "Identification and management of latent tuberculosis infection." Am Fam Physician 79(10): 879-886.
64.Horna-Campos, O. J., A. Bedoya-Lama, et al. (2010). "Risk of tuberculosis in public transport sector workers, Lima, Peru." Int J Tuberc Lung Dis 14(6): 714-719.
65.Horna-Campos, O. J., E. Consiglio, et al. (2011). "Pulmonary tuberculosis infection among workers in the informal public transport sector in Lima, Peru." Occup Environ Med 68(2): 163-165.
66.Hudelson, P. (1996). "Gender differentials in tuberculosis: the role of socio-economic and cultural factors." Tuber Lung Dis 77(5): 391-400.
67.Hussain, H., S. Akhtar, et al. (2003). "Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan." Int J Epidemiol 32(5): 794-799.
68.Hutton, M. D., W. W. Stead, et al. (1990). "Nosocomial transmission of tuberculosis associated with a draining abscess." J Infect Dis 161(2): 286-295.
69.Ijaz, K., J. A. Dillaha, et al. (2002). "Unrecognized tuberculosis in a nursing home causing death with spread of tuberculosis to the community." J Am Geriatr Soc 50(7): 1213-1218.
70.IUATLD. (2008). "Tobacco and Tuberculosis." from http://www.tobaccofreeunion.org/content/en/8/.
71.Jackson, M. M. (1996). "Pulmonary tuberculosis in a homeless person." Am J Infect Control 24(4): 294-298.
72.Janele, D., T. Lang, et al. (2006). "Effects of testosterone, 17beta-estradiol, and downstream estrogens on cytokine secretion from human leukocytes in the presence and absence of cortisol." Ann N Y Acad Sci 1069: 168-182.
73.Jasmer, R. M., P. Nahid, et al. (2002). "Clinical practice. Latent tuberculosis infection." N Engl J Med 347(23): 1860-1866.
74.Jensen, P. A., L. A. Lambert, et al. (2005). "Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005." MMWR Recomm Rep 54(RR-17): 1-141.
75.Jeon, K., S. H. Ji, et al. (2008). "Boosted reaction on two-step tuberculin skin test among military personnel in South Korea, a setting with an intermediate burden of tuberculosis and routine bacille Calmette-Guerin vaccination." J Korean Med Sci 23(3): 402-405.
76.Jiamjarasrangsi, W., S. Bualert, et al. (2009). "Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand." Int J Tuberc Lung Dis 13(4): 454-459.
77.Juan Carlos Palomino, Sylvia Cardoso Leão, et al. (2007). Tuberculosis 2007 From basic science to patient care.
78.Katsenos, S., M. Nikolopoulou, et al. (2010). "Interferon-gamma release assay clarifies the effect of bacille Calmette-Guerin vaccination in Greek army recruits." Int J Tuberc Lung Dis 14(5): 545-550.
79.Kinoshita, S., M. Ohmori, et al. (2007). "[Outbreaks of tuberculosis in facilities used by an unspecified number of people near a train station - problems regarding tuberculosis in urban areas ]." Kekkaku 82(10): 749-757.
80.Kline, S. E., L. L. Hedemark, et al. (1995). "Outbreak of tuberculosis among regular patrons of a neighborhood bar." N Engl J Med 333(4): 222-227.
81.Kondo, A., N. Oketani, et al. (2002). "[An outbreak of pulmonary tuberculosis probably due to exogenous reinfection at a nursing home for the elderly]." Kekkaku 77(5): 401-408.
82.Konstantinos, A. (2010). " Diagnostic tests -Testing for tuberculosis." Australian Prescriber(33): 12-18.
83.Kunimoto, D., E. Der, et al. (2009). "Use of the QuantiFERON-TB Gold test to confirm latent tuberculosis infection in a Canadian tuberculosis clinic." Int J Tuberc Lung Dis 13(6): 726-730.
84.Kusner, D. J. (2005). "Mechanisms of mycobacterial persistence in tuberculosis." Clin Immunol 114(3): 239-247.
85.Lalvani, A. (2007). "Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy." Chest 131(6): 1898-1906.
86.Lalvani, A. and M. Pareek (2010). "Interferon gamma release assays: principles and practice." Enferm Infecc Microbiol Clin 28(4): 245-252.
87.Lalvani, A., A. A. Pathan, et al. (2001). "Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells." Lancet 357(9273): 2017-2021.
88.Lamar, J. E., 2nd and M. A. Malakooti (2003). "Tuberculosis outbreak investigation of a U.S. Navy amphibious ship crew and the Marine expeditionary unit aboard, 1998." Mil Med 168(7): 523-527.
89.Leung, C. C., T. H. Lam, et al. (2007). "Lower risk of tuberculosis in obesity." Arch Intern Med 167(12): 1297-1304.
90.Li, Y., G. M. Leung, et al. (2007). "Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review." Indoor Air 17(1): 2-18.
91.Lienhardt, C., K. Fielding, et al. (2003). "Risk factors for tuberculosis infection in sub-Saharan Africa: a contact study in The Gambia." Am J Respir Crit Care Med 168(4): 448-455.
92.Lienhardt, C., K. Fielding, et al. (2005). "Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa." Int J Epidemiol 34(4): 914-923.
93.Liu, J., V. Tran, et al. (2009). "BCG vaccines: their mechanisms of attenuation and impact on safety and protective efficacy." Hum Vaccin 5(2): 70-78.
94.Lonnroth, K., B. G. Williams, et al. (2008). "Alcohol use as a risk factor for tuberculosis - a systematic review." BMC Public Health 8: 289.
95.MacIntyre, C. R., N. Kendig, et al. (1997). "Impact of tuberculosis control measures and crowding on the incidence of tuberculous infection in Maryland prisons." Clin Infect Dis 24(6): 1060-1067.
96.Madretsma, S., L. M. Wolters, et al. (1996). "In-vivo effect of nicotine on cytokine production by human non-adherent mononuclear cells." Eur J Gastroenterol Hepatol 8(10): 1017-1020.
97.Maini, R., E. W. St Clair, et al. (1999). "Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group." Lancet 354(9194): 1932-1939.
98.Mancuso, J. (2010). "Tuberculosis in the US Military." from http://wrair-www.army.mil/templates/TropMed/11-Mancuso-MTb-WRAIRTropMed.pdf.
99.Mancuso, J. D., S. K. Tobler, et al. (2010). "Active tuberculosis and recent overseas deployment in the U.S. military." Am J Prev Med 39(2): 157-163.
100.Marcy, T. W. and W. W. Merrill (1987). "Cigarette smoking and respiratory tract infection." Clin Chest Med 8(3): 381-391.
101.Marie de Perio, T. N., M. Groenewold (2010). Screening for Latent tuberculosis Infection Among Immigration Facility Employees — Illinois, 2009
102.Mateos, F., J. H. Brock, et al. (1998). "Iron metabolism in the lower respiratory tract." Thorax 53(7): 594-600.
103.Mazurek, G. H., J. Jereb, et al. (2005). "Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States." MMWR Recomm Rep 54(RR-15): 49-55.
104.Mazurek, G. H., M. J. Zajdowicz, et al. (2007). "Detection of Mycobacterium tuberculosis infection in United States Navy recruits using the tuberculin skin test or whole-blood interferon-gamma release assays." Clin Infect Dis 45(7): 826-836.
105.McElnay, C., C. Thornley, et al. (2004). "A community and workplace outbreak of tuberculosis in Hawke's Bay in 2002." N Z Med J 117(1200): U1019.
106.Mellencamp, M. A. (1996). "Effects of ethanol consumption on susceptibility to pulmonary and gastrointestinal factors." Alcohol Clin Exp Res 20(8 Suppl): 192A-195A.
107.Menzies, D., A. Fanning, et al. (2000). "Hospital ventilation and risk for tuberculous infection in canadian health care workers. Canadian Collaborative Group in Nosocomial Transmission of TB." Ann Intern Med 133(10): 779-789.
108.Millet, J. P., A. Orcau, et al. (2009). "Tuberculosis recurrence and its associated risk factors among successfully treated patients." J Epidemiol Community Health 63(10): 799-804.
109.Muecke, C., M. Isler, et al. (2006). "The use of environmental factors as adjuncts to traditional tuberculosis contact investigation." Int J Tuberc Lung Dis 10(5): 530-535.
110.Mulder, C., E. Klinkenberg, et al. (2009). "Effectiveness of tuberculosis contact tracing among migrants and the foreign-born population." Euro Surveill 14(11).
111.Nardell, E. A. (1998). "The role of ventilation in preventing nosocomial transmission of tuberculosis." Int J Tuberc Lung Dis 2(9 Suppl 1): S110-117.
112.Nechaeva, O. B., E. V. Aref'eva, et al. (2007). "[Recurrent tuberculosis in the Sverdlovsk Region]." Probl Tuberk Bolezn Legk(1): 42-46.
113.Neyrolles, O. and L. Quintana-Murci (2009). "Sexual inequality in tuberculosis." PLoS Med 6(12): e1000199.
114.Nolan, C. M., A. M. Elarth, et al. (1991). "An outbreak of tuberculosis in a shelter for homeless men. A description of its evolution and control." Am Rev Respir Dis 143(2): 257-261.
115.Nyendak, M. R., D. A. Lewinsohn, et al. (2009). "New diagnostic methods for tuberculosis." Curr Opin Infect Dis 22(2): 174-182.
116.Ouyang, Y., N. Virasch, et al. (2000). "Suppression of human IL-1beta, IL-2, IFN-gamma, and TNF-alpha production by cigarette smoke extracts." J Allergy Clin Immunol 106(2): 280-287.
117.Pai, M., K. Gokhale, et al. (2005). "Mycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing." JAMA 293(22): 2746-2755.
118.Pai, M., A. Zwerling, et al. (2008). "Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update." Ann Intern Med 149(3): 177-184.
119.Pakasi, T. A., E. Karyadi, et al. (2009). "Malnutrition and socio-demographic factors associated with pulmonary tuberculosis in Timor and Rote Islands, Indonesia." Int J Tuberc Lung Dis 13(6): 755-759.
120.Palmer, C. E. and M. W. Long (1966). "Effects of infection with atypical mycobacteria on BCG vaccination and tuberculosis." Am Rev Respir Dis 94(4): 553-568.
121.Richeldi, L., M. Losi, et al. (2009). "Performance of tests for latent tuberculosis in different groups of immunocompromised patients." Chest 136(1): 198-204.
122.Riley, R. L., C. C. Mills, et al. (1962). "Infectiousness of air from a tuberculosis ward. Ultraviolet irradiation of infected air: comparative infectiousness of different patients." Am Rev Respir Dis 85: 511-525.
123.Ritz, N., W. A. Hanekom, et al. (2008). "Influence of BCG vaccine strain on the immune response and protection against tuberculosis." FEMS Microbiol Rev 32(5): 821-841.
124.Roden, A. C., M. T. Moser, et al. (2004). "Augmentation of T cell levels and responses induced by androgen deprivation." J Immunol 173(10): 6098-6108.
125.Roth, J. (2009). "Evolutionary speculation about tuberculosis and the metabolic and inflammatory processes of obesity." JAMA 301(24): 2586-2588.
126.Sadatsafavi, M., N. Shahidi, et al. (2010). "A statistical method was used for the meta-analysis of tests for latent TB in the absence of a gold standard, combining random-effect and latent-class methods to estimate test accuracy." J Clin Epidemiol 63(3): 257-269.
127.Sanchez, A., B. Larouze, et al. (2009). "Screening for tuberculosis on admission to highly endemic prisons? The case of Rio de Janeiro State prisons." Int J Tuberc Lung Dis 13(10): 1247-1252.
128.Sauzullo, I., M. Lastilla, et al. (2009). Utility of QuantiFERON-TB Gold in–tube for tuberculosis screening in Italian Air Force personnel.
129.Schablon, A., M. Harling, et al. (2010). "Risk of latent TB infection in individuals employed in the healthcare sector in Germany: a multicentre prevalence study." BMC Infect Dis 10: 107.
130.Shah, S. A., S. A. Mujeeb, et al. (2003). "Prevalence of pulmonary tuberculosis in Karachi juvenile jail, Pakistan." East Mediterr Health J 9(4): 667-674.
131.Sherman, D. R., M. Voskuil, et al. (2001). "Regulation of the Mycobacterium tuberculosis hypoxic response gene encoding alpha -crystallin." Proc Natl Acad Sci U S A 98(13): 7534-7539.
132.Shigematsu, I. and M. Minowa (1985). "Indoor infection in a modern building." Tokai J Exp Clin Med 10(4): 407-413.
133.Shimouchi, A., S. Koda, et al. (2007). "[Survey on nosocomial infection of tuberculosis in nursing homes for elderly in Osaka City]." Kekkaku 82(3): 179-184.
134.Slama, K., C. Y. Chiang, et al. (2007). "Tobacco and tuberculosis: a qualitative systematic review and meta-analysis." Int J Tuberc Lung Dis 11(10): 1049-1061.
135.Small, P. M. and P. I. Fujiwara (2001). "Management of tuberculosis in the United States." N Engl J Med 345(3): 189-200.
136.Smith, B., M. A. Ryan, et al. (2002). "Tuberculosis infection among young adults enlisting in the United States Navy." Int J Epidemiol 31(5): 934-939.
137.Stevenson, C. R., N. G. Forouhi, et al. (2007). "Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence." BMC Public Health 7: 234.
138.Styblo, K., J. Meijer, et al. (1969). "[The transmission of tubercle bacilli: its trend in a human population]." Bull World Health Organ 41(1): 137-178.
140.Suzuki, S., K. Nakabayashi, et al. (1997). "[Tuberculosis in the crew of a submarine]." Nihon Kyobu Shikkan Gakkai Zasshi 35(1): 61-66.
141.Szabo, G. (1997). "Alcohol's contribution to compromised immunity." Alcohol Health Res World 21(1): 30-41.
142.Teixeira, H. C., C. Abramo, et al. (2007). "Immunological diagnosis of tuberculosis: problems and strategies for success." J Bras Pneumol 33(3): 323-334.
143.Toyota, M. (2003). "[Environmental factors relating to a mass outbreak of tuberculosis in a junior high school]." Kekkaku 78(12): 733-738.
144.Valway, S. E., S. B. Richards, et al. (1994). "Outbreak of multi-drug-resistant tuberculosis in a New York State prison, 1991." Am J Epidemiol 140(2): 113-122.
145.Vergne, I., J. Chua, et al. (2005). "Mechanism of phagolysosome biogenesis block by viable Mycobacterium tuberculosis." Proc Natl Acad Sci U S A 102(11): 4033-4038.
146.Verver, S., R. M. Warren, et al. (2005). "Rate of reinfection tuberculosis after successful treatment is higher than rate of new tuberculosis." Am J Respir Crit Care Med 171(12): 1430-1435.
147.Villarino, M. E. and M. Clairy (2001). "Tuberculosis due to environment, biology, or both?" Chest 120(5): 1435-1437.
148.Vinton, P., S. Mihrshahi, et al. (2009). "Comparison of QuantiFERON-TB Gold In-Tube Test and tuberculin skin test for identification of latent Mycobacterium tuberculosis infection in healthcare staff and association between positive test results and known risk factors for infection." Infect Control Hosp Epidemiol 30(3): 215-221.
149.Vynnycky, E. and P. E. Fine (2000). "Lifetime risks, incubation period, and serial interval of tuberculosis." Am J Epidemiol 152(3): 247-263.
150.Wang, P. D. (2009). "Gender Differences in the Epidemiology of Tuberculosis in Taipei City,1998~2005." Taiwan J Fam Med 19(2): 102-111.
151.Weiss, G., G. Werner-Felmayer, et al. (1994). "Iron regulates nitric oxide synthase activity by controlling nuclear transcription." J Exp Med 180(3): 969-976.
152.WHO (1996). "Groups at Risk: WHO Report on the Tuberculosis Epidemic, 1996." Global Tuberculosis Program, Geneva.
153.WHO. (2002). "Gender and Tuberculosis." from http://whqlibdoc.who.int/gender/2002/a85584.pdf.
154.WHO (2004). "Weekly epidemiological record." No.4(79): 25-40.
155.WHO. (2005). "Risk factors for TB-Smoking." from http://apps.who.int/tb/surveillanceworkshop/status_analysis/smoking.htm.
156.WHO (2006). "The Global Plan to Stop TB 2006-2015."
157.WHO (2008). "The global burden of disease: 2004 update."
158.WHO (2009). "10 facts about tuberculosis."
159.WHO (2010). "Estimated epidemiological burden of TB, all forms, 1990–2008 ".
160.WHO (2010). "Global Health Observatory (GHO) -Health-related Millennium Development Goals 6: Combat tuberculosis (Mortality)."
161.WHO (2010). "The Global Plan to Stop TB 2011-2015."
162.WHO (2010). Global tuberculosis control 2010.
163.WHO (2010). "Global tuberculosis control: a short update to the 2009 report."
164.WHO. (2010). "World TB Day." from http://www.stoptb.org/events/world_tb_day/.
165.Winje, B. A., F. Oftung, et al. (2008). "Screening for tuberculosis infection among newly arrived asylum seekers: comparison of QuantiFERONTB Gold with tuberculin skin test." BMC Infect Dis 8: 65.
166.Winje, B. A., F. Oftung, et al. (2008). "School based screening for tuberculosis infection in Norway: comparison of positive tuberculin skin test with interferon-gamma release assay." BMC Infect Dis 8: 140.
167.Wood, R., S. Johnstone-Robertson, et al. (2010). "Tuberculosis transmission to young children in a South African community: modeling household and community infection risks." Clin Infect Dis 51(4): 401-408.
168.Wu, X., Q. Li, et al. (2009). "Latent tuberculosis infection amongst new recruits to the Chinese army: comparison of ELISPOT assay and tuberculin skin test." Clin Chim Acta 405(1-2): 110-113.
169.Yagi, T., Y. Sasaki, et al. (1999). "[Tuberculosis microepidemic in a commuter bus]." Kekkaku 74(6): 507-511.
170.Yamamoto, Y., H. Saito, et al. (1991). "Sex differences in host resistance to Mycobacterium marinum infection in mice." Infect Immun 59(11): 4089-4096.
171.內政部. (2011). "內政統計通報--99年底人口結構分析." from http://sowf.moi.gov.tw/stat/week/list.htm.
172.行政院衛生署 (2009). 歷年法定傳染病統計概況.
173.行政院衛生署疾病管制局 (2004). 結核菌檢驗手冊: 102-103.
174.行政院衛生署疾病管制局 (2006). "某醫院外包司機罹患肺結核及其家庭聚集感染事件." 疫情報導 22(4).
175.行政院衛生署疾病管制局 (2006). "結核病十年減半全民動員計畫."
176.行政院衛生署疾病管制局. (2007). "人口密集機構傳染病防治及監視作業注意事項." from http://www.cdc.gov.tw/public/Attachment/95251120571.pdf.
177.行政院衛生署疾病管制局 (2008). "結核病診治指引-第三版."
178.行政院衛生署疾病管制局 (2009). "台灣結核病防治年報2009."
179.行政院衛生署疾病管制局. (2009). "結核病防治工作手冊 -第二版." from http://www.cdc.gov.tw/lp.asp?CtNode=1540&CtUnit=842&BaseDSD=7&mp=230.
180.行政院衛生署疾病管制局 (2011). 地區年齡性別統計表--結核病.
181.行政院衛生署疾病管制局. (2011). "結核病統計資料查詢." from http://nidss.cdc.gov.tw/SingleDisease.aspx?Pt=s&Dc=1&Dt=3&disease=010.
182.行政院衛生署統計室 (2010). 98年死因統計完整統計表.
183.行政院衛生署疾病管制局 (2008). 台灣結核病再治個案之流行病學監測及預後之存活分析.
184.李龍騰. (2006). "認識結核病." from http://health.edu.tw/health/upload/tbteaching_kb/20060613155117_file1.pdf.
185.法務部統計處 (2011). 矯正統計.
186.洪珮玲 (2006). 醫療保健人員結核桿菌感染之調查研究.
187.國防部軍醫局. (2010). "國軍人員體格檢查作業." from http://mab.mnd.gov.tw/web/03job/05checkup_1.htm.
188.陳建甫, 徐美菁, et al. (2008). "疫苗的原理及最新發展." 基層醫學 23(6): 178-183.
189.楊慶輝 and 盧進德 (2008). "診斷潛伏性結核的最新進展." 內科學誌 19: 115-120.
190.衛生署疾病管制局. "卡介苗(BCG)預防接種." from http://www.cdc.gov.tw/ct.asp?xItem=5692&CtNode=1519&mp=230.
191.衛生署統計處. (2011). "結核病防治工作成果表." from http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=11851&class_no=440&level_no=2.
192.鍾金湯 and 劉仲康 (2004). "卡密特[Albert Calmette]--卡介苗的發明人." 科學發展 378: 34-41.

第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔