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Campbell JI, Sandora TJ, Haberer JE. A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking. BMJ Glob Health 2021; 6:e004836. [PMID: 34016576 PMCID: PMC8141435 DOI: 10.1136/bmjgh-2020-004836] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Identifying and treating children with latent tuberculosis infection (TB infection) is critical to prevent progression to TB disease and to eliminate TB globally. Diagnosis and treatment of TB infection requires completion of a sequence of steps, collectively termed the TB infection care cascade. There has been no systematic attempt to comprehensively summarise literature on the paediatric TB infection care cascade. METHODS We performed a scoping review of the paediatric TB infection care cascade. We systematically searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane and Embase databases. We reviewed articles and meeting abstracts that included children and adolescents ≤21 years old who were screened for or diagnosed with TB infection, and which described completion of at least one step of the cascade. We synthesised studies to identify facilitators and barriers to retention, interventions to mitigate attrition and knowledge gaps. RESULTS We identified 146 studies examining steps in the paediatric TB infection care cascade; 31 included children living in low-income and middle-income countries. Most literature described the final cascade step (treatment initiation to completion). Studies identified an array of patient and caregiver-related factors associated with completion of cascade steps. Few health systems factors were evaluated as potential predictors of completion, and few interventions to improve retention were specifically tested. CONCLUSIONS We identified strengths and gaps in the literature describing the paediatric TB infection care cascade. Future research should examine cascade steps upstream of treatment initiation and focus on identification and testing of at-risk paediatric patients. Additionally, future studies should focus on modifiable health systems factors associated with attrition and may benefit from use of behavioural theory and implementation science methods to improve retention.
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Affiliation(s)
- Jeffrey I Campbell
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Thomas J Sandora
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jessica E Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
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Haerana BT, Prihartono NA, Riono P, Djuwita R, Syarif S, Hadi EN, Kaswandani N. Prevalence of tuberculosis infection and its relationship to stunting in children (under five years) household contact with new tuberculosis cases. Indian J Tuberc 2020; 68:350-355. [PMID: 34099200 DOI: 10.1016/j.ijtb.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/15/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Children who inhabit the same house with tuberculosis (TB) patients are at high risk for infection and illness with TB. Nutritional status (stunting) in children is related to the child's ability to withstand MTB (Mycobacterium Tuberculosis). This study aims to estimated the prevalence of tuberculosis infection and its relationship to stunting in children (under five years) with household contact (HHC) with new TB cases. METHODS A cross-sectional design was implemented. Conducted in July 2018-April 2019 at 13 Public Health Center in Makassar City. The sample size was calculated using one sample situation-about precision formula. Samples were children under five who had contact with new diagnosed TB cases. Tuberculosis infection was measured by TST (tuberculin skin test). Logistic regression with causal model to examine TB infection relationship with stunting and covariate variable, analyzed using Stata/MP 13.0 software. RESULTS One hundred twenty-six (126) eligible children. Prevalence of tuberculosis infection was 38.10%. Frequency of stunted was 31 children (24.60%). Stunted nutritional status (aPR): 2.36, 95% CI 1.60-3.44), boys (aPR: 1.47, 95% CI 0.96-2.25), not getting BCG immunization (aPR: 1.58, 95%) CI 0.89-2.82), and high contact intensity (aPR: 2.62, 95% CI 1.10-6.22) best predicted the tuberculosis infection in children with TB case household contacts with a model contribution of 64%. CONCLUSION Stunted nutritional status (moderate and severe), boys, not getting BCG immunization, and high contact intensity are the determinants of TB infection transmission in children HHC with TB. Children under five years of age who have close contact with TB cases should be targeted for priority interventions to prevent the transmission of TB infection and progressing to TB cases.
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Affiliation(s)
- Bs Titi Haerana
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia; Department of Public Health, Universitas Islam Negeri Alauddin Makassar, Indonesia.
| | | | - Pandu Riono
- Department of Biostatistics, Faculty of Public Health, University of Indonesia, Indonesia
| | - Ratna Djuwita
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia
| | - Syahrizal Syarif
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia
| | - Ella Nurlaella Hadi
- Department of Health Education and Behavioral Sciences, University of Indonesia, Indonesia
| | - Nastiti Kaswandani
- Pediatric Department, RSCM Hospital, Faculty of Medicine, University of Indonesia, Indonesia
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Hamid MH, Arbab AH, Yousef BA. Bacteriological profile and antibiotic susceptibility of diabetic Foot infections at Ribat University hospital; a retrospective study from Sudan. J Diabetes Metab Disord 2020; 19:1397-1406. [PMID: 33553032 DOI: 10.1007/s40200-020-00660-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/08/2020] [Indexed: 12/19/2022]
Abstract
Purpose Diabetic foot infection (DFI) is one of the most feared complications of diabetes. In Sudan, the number of cases and the problems associated with diabetic foot infections increased in recent years. This study aimed to assess the bacteriological profile of patients with DFIs and their antibiotic susceptibility pattern. Methods A descriptive retrospective cross-sectional study was carried out at Surgery Department of Ribat University Hospital. All medical records of patients with DFIs during the period from September 2017 to February 2019 were reviewed using data collection sheet. The collected data were analyzed using Statistical Package for Social Sciences. Results Out of 250 DFI patients, 73.2% of them were males, and 86.4% of them had type 2 diabetes mellitus, and most of them suffered from diabetes for more than 10 years. Regarding culture results, 64.7% and 35.3% of the samples revealed presence of single microorganism and mixed infections, respectively. A total of 335 bacterial isolates were identified, gram-negative were more prevalent than gram-positive organisms. The most frequently isolated organisms were Proteus spp. Staphylococcus aureus, and Escherichia coli. Furthermore, antibiotic susceptibility pattern showed that imipenem, amikacin and vancomycin have the highest activity against isolated bacteria, and all isolates were found to be completely resistant to different cephalosporin drugs. Conclusion Among the studied samples, gram-negative bacteria were found to be more common in DFI patients, Proteus spp. and S. aureus were the most common microorganisms. Moreover, different isolated microorganisms showed to have different degrees of resistance and sensitivity to various antibacterial drugs.
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Affiliation(s)
- Maram H Hamid
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Al-Qasr Ave, 1111 Khartoum, Sudan
| | - Ahmed H Arbab
- Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Al-Qasr Ave, 11111 Khartoum, Sudan.,Department of Pharmacognosy, Faculty of Pharmacy, Omdurman Islamic University, Omdurman, Sudan
| | - Bashir A Yousef
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Al-Qasr Ave, 11111 Khartoum, Sudan
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Cohen A, Mathiasen VD, Schön T, Wejse C. The global prevalence of latent tuberculosis: a systematic review and meta-analysis. Eur Respir J 2019; 54:13993003.00655-2019. [PMID: 31221810 DOI: 10.1183/13993003.00655-2019] [Citation(s) in RCA: 243] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/11/2019] [Indexed: 12/18/2022]
Abstract
In 1999, the World Health Organization (WHO) estimated that one-third of the world's population had latent tuberculosis infection (LTBI), which was recently updated to one-fourth. However, this is still based on controversial assumptions in combination with tuberculin skin test (TST) surveys. Interferon-γ release assays (IGRAs) with a higher specificity than TST have since been widely implemented, but never used to estimate the global LTBI prevalence.We conducted a systematic review and meta-analysis of LTBI estimates based on both IGRA and TST results published between 2005 and 2018. Regional and global estimates of LTBI prevalence were calculated. Stratification was performed for low, intermediate and high TB incidence countries and a pooled estimate for each area was calculated using a random effects model.Among 3280 studies screened, we included 88 studies from 36 countries with 41 IGRA (n=67 167) and 67 TST estimates (n=284 644). The global prevalence of LTBI was 24.8% (95% CI 19.7-30.0%) and 21.2% (95% CI 17.9-24.4%), based on IGRA and a 10-mm TST cut-off, respectively. The prevalence estimates correlated well to WHO incidence rates (Rs=0.70, p<0.001).In the first study of the global prevalence of LTBI derived from both IGRA and TST surveys, we found that one-fourth of the world's population is infected. This is of relevance, as both tests, although imperfect, are used to identify individuals eligible for preventive therapy. Enhanced efforts are needed targeting the large pool of latently infected individuals, as this constitutes an enormous source of potential active tuberculosis.
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Affiliation(s)
- Adam Cohen
- Dept of Pathology, St Olavs Hospital, Trondheim, Norway.,Both authors contributed equally
| | - Victor Dahl Mathiasen
- International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.,Dept of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.,Both authors contributed equally
| | - Thomas Schön
- Division of Microbiology and Molecular Medicine, Dept of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Dept of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Kalmar, Linköping University, Linköping, Sweden
| | - Christian Wejse
- Dept of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark .,Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.,Center for Global Health, Aarhus University (GloHAU), Aarhus, Denmark
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Sayyahfar S, Davoodzadeh F, Hoseini R, Rahimzadeh N, Otukesh H. Comparison of tuberculin skin test and interferon gamma release assay for diagnosis of latent tuberculosis infection in pediatric candidates of renal transplantation. Pediatr Transplant 2018; 22. [PMID: 29388291 DOI: 10.1111/petr.13148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2017] [Indexed: 02/04/2023]
Abstract
IGRA has been approved as an alternative in vitro test to diagnose Mycobacterium TB infection. This study aimed to assess the diagnostic value of TST in comparison with QFT assay to detect LTBI among Iranian children candidate for renal transplantation. This cross-sectional study was performed on 31 children who were candidate for renal transplantation admitted to Ali Asghar Children's Hospital and Rasoul Akram Hospital, Tehran, Iran, from 2013 to 2014. TST and QFT were performed for all patients. QFT was negative in all patients, while TST was positive only in one case. Both tests results were negative in 30 patients, yielding an accuracy rate of 96.7% for TST to diagnose LTBI when compared to QFT. In conclusion, compared to QFT, TST is still a valuable diagnostic tool with high accuracy rate for diagnosis of LTBI in children candidates for renal transplantation and can still be used as an accurate test for screening Mycobacterium TB infection.
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Affiliation(s)
- Shirin Sayyahfar
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ali Asghar Children Hospital, Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | | | - Rozita Hoseini
- Department of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Rahimzadeh
- Department of Pediatrics, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Otukesh
- Department of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
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Badie F, Arshadi M, Mohsenpoor M, Gharibvand SS. Drug Resistance Pattern of Mycobacterium tuberculosis Isolates From Patients Referred to TB Reference Laboratory in Ahvaz. Osong Public Health Res Perspect 2015; 7:32-5. [PMID: 26981340 PMCID: PMC4776274 DOI: 10.1016/j.phrp.2015.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 10/12/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives Tuberculosis remains one of the top three infectious disease killers. The prevalence of multidrug-resistant tuberculosis (MDR-TB) has increased substantially in the past 20 years. When drug resistance is not detected, MDR-TB patients cannot access life-saving treatment; this puts their communities at risk of ongoing MDR-TB transmission. We aimed to determine the patterns of resistance to antituberculosis drugs among Mycobacterium tuberculosis isolates from Khuzestan province in Iran. Methods A total of 850 clinical specimens from patients suspected of active TB were cultured in 2015. Drug susceptibility testing to the first line antiTB drugs for culture positive MTB was performed on Lowenstein–Jensen medium using the proportion method. Results Of 850 cultured specimens, 272 (32%) were culture positive for mycobacteria. Of 64 MTB isolates that were analyzed by the proportion method, 62 (96.8%) were pan-susceptible and two (3.1%) were MDR. Conclusion An important way to prevent the emergence of MDR and XDR TB, and the principles of full implementation of the strategy is directly observed treatment, short-course (DOTS). The efficient diagnosis and timely treatment of MDR-TB patients can prevent disease transmission, reduce the risk of drug resistance developing, and avoid further lung damage.
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Affiliation(s)
- Fereshteh Badie
- West Ahwaz Health Center, Ahwaz Jundishapoor University Of Medical Science, Ahwaz, Iran
| | - Maniya Arshadi
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Mohsenpoor
- TB Reference Laboratory, Ahwaz Jundishapoor University Of Medical Science, Ahwaz, Iran
| | - Soodabeh S Gharibvand
- West Ahwaz Health Center, Ahwaz Jundishapoor University Of Medical Science, Ahwaz, Iran
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Alavi SM, Bakhtiyariniya P, Albagi A. Factors associated with delay in diagnosis and treatment of pulmonary tuberculosis. Jundishapur J Microbiol 2015; 8:e19238. [PMID: 25861434 PMCID: PMC4385251 DOI: 10.5812/jjm.19238] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/27/2014] [Accepted: 08/27/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Early treatment of pulmonary tuberculosis (PTB) is necessary for a successful tuberculosis (TB) control program. OBJECTIVES The objective of this study was to determine total treatment delay and its associated factors among PTB patients in Ahvaz. PATIENTS AND METHODS A retrospective study was performed among newly diagnosed PTB cases registered in 2010 at the Ahvaz health center. Total treatment delay was defined as the time interval between the onsets of cough to the initiation of anti-TB treatment. Tuberculosis diagnosis and treatment was based on the national TB program (NTP). Data analysis was performed using the SPSS software by chi-square and Fisher's exact test with odds ratio (OR) and 95% confidence interval (CI). RESULTS The mean age of the patients was 38.9 ± 12.3 years; 83 were male and 56 were female. Of the 139 smear positive PTB cases, 91 (65.5%) cases had received delayed-treatment. The mean time between onset of symptoms, diagnosis and treatment was 73 days (median: 48 days, range: 4-570 days). Female gender (OR (95% CI): 2.9, 1.03-8.23, P = 0.02), smoking (OR (95% CI): 0.49, 0.22-0.96, P = 0.04) and receiving immunosuppressive drugs (OR (95% CI): 8.18, 1.09-75.31, P < 0.05) were associated with longer delayed time. CONCLUSIONS Delayed diagnosis and treatment of tuberculosis appears to be the main problem in the TB control program of the region. Delayed time is significantly associated with female gender, smoking and immunosuppressive drugs.
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Affiliation(s)
- Seyed Mohammad Alavi
- Health Research Institute, Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Seyed Mohammad Alavi, Health Research Institute, Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-6133387724, E-mail:
| | - Pejman Bakhtiyariniya
- Khuzestan Health Center, Tuberculosis Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Albagi
- Khuzestan Health Center, Tuberculosis Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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Haghdoost AA, Afshari M, Baneshi MR, Gouya MM, Nasehi M, Movahednia M. Estimating the annual risk of tuberculosis infection and disease in southeast of iran using the bayesian mixture method. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15308. [PMID: 25593722 PMCID: PMC4270654 DOI: 10.5812/ircmj.15308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/10/2013] [Accepted: 02/22/2014] [Indexed: 01/29/2023]
Abstract
Background: Tuberculosis is still a public health concern in Iran. The main challenge in monitoring epidemiological status of tuberculosis is to estimate its incidence accurately. Objectives: We used a newly developed approach to estimate the incidence of tuberculosis in Sistan, an endemic area in southeast of Iran in 2012-13. Patients and Methods: This cross-sectional study was conducted on school children aged 6-9 years. We estimated a required sample size of 6350. Study participants were selected using stratified two-stage cluster sampling method and recruited in a tuberculin skin test survey. Indurations were assessed after 72 hours of the injection and their distributions were plotted. Prevalence and annual risk of tuberculosis infection (ARTI) were estimated using the Bayesian mixture model and some traditional methods. The incidence of active disease was calculated using the Markov Chain Monte Carlo technique. Results: We assumed weibull, normal and normal as the best distributions for indurations due to atypical reactions, BCG (Bacillus Calmette–Guérin) reactions and Mycobacterium tuberculosis infection, respectively. The estimated infection prevalence and ARTI were 3.6% (95%CI: 3.1, 4.1) and 0.48%, respectively. These estimates were lower than those obtained from the traditional methods. The incidence of active tuberculosis was estimated as 107 (87-149) per 100000 population with a CDR of 54% (40%-68%). Conclusions: Although the mixture model showed slightly lower estimates than the traditional methods, it seems that this method might generate more accurate results for deep exploration of tuberculosis endemicity. Besides, we found that Sistan is a high endemic area for tuberculosis in Iran with a low case detection rate.
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Affiliation(s)
- Ali Akbar Haghdoost
- Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Mahdi Afshari
- Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
- Corresponding Author: Mahdi Afshari, Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran. Tel/Fax: +98-3412263725, E-mail:
| | - Mohammad Reza Baneshi
- Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Mohammad Mehdi Gouya
- Center for Infectious Disease Control, Ministry of Health and Medical Education, Tehran, IR Iran
| | - Mahshid Nasehi
- Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
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Hsiao HH, Chu NS, Tsai YF, Chang CS, Lin SF, Liu TC. Trimethoprim/sulfamethoxazole-related acute psychosis in the second course of treatment after a stem cell transplant: case report and literature review. EXP CLIN TRANSPLANT 2013; 11:467-8. [PMID: 24128138 DOI: 10.6002/ect.2013.0119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The case report describes a woman who has an acute psychosis episode during the second course of trimethoprim/sulfamethoxazole therapy, after having an allogeneic hematopoietic stem cell transplant that favored a dose-related effect of this adverse effect.
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Affiliation(s)
- Hui-Hua Hsiao
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Review on Epidemiology, Diagnosis, Occupational Hazards and Management of Pulmonary Tuberculosis in Elderly: A Guide for General Physicians Working in the Health Network Setting, Khuzestan, Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.6677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Childhood Tuberculosis in Kermanshah, Iran, During 10 Years. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2013. [DOI: 10.5812/pedinfect.9140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gholamali G, Jafar A. Tuberculin Skin Test Size after Prolong Time of Bacille Calmette Guérin Vaccination. JOURNAL OF MEDICAL SCIENCES 2008. [DOI: 10.3923/jms.2009.46.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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