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f
M
i
n
i
s
t
r
y
o
f
H
eal
t
h
,
an
d
f
r
o
m
t
h
e N
at
i
o
n
al
U
n
i
v
er
s
i
t
y
o
f
Mal
a
y
s
i
a
co
m
m
i
t
t
ee.
3.
R
ES
U
LT
S
A
ND AN
AL
Y
S
I
S
A
to
ta
l
n
u
m
be
r
of
401 H
C
W
s
w
a
s
i
n
v
ol
v
e
d i
n
t
h
i
s
s
t
u
d
y
a
s sh
o
w
n
T
ab
l
e 1
.
T
h
e
m
a
jo
r
i
ty
o
f
th
e
m
a
g
e
d be
t
w
e
e
n
20 t
o 29
-
y
ear
-
ol
d (
51.
7%
)
,
f
ol
l
o
w
e
d b
y
t
h
e
m
i
ddl
e
a
g
e
g
r
ou
p of
30 t
o 49
-
ye
a
r
-
ol
d (
39.
6%
)
,
a
n
d
s
e
n
i
or
g
r
ou
p of
H
C
W
s
(
8.
7%
)
a
g
e
d
m
or
e
t
h
a
n
50 y
e
a
r
s
.
M
os
t
of
t
h
e
m
w
e
r
e
f
e
m
a
l
e
H
C
W
s
(
78.
8%
)
.
M
or
e
t
h
an
h
al
f
(
5
4
.
9
%
)
o
f
t
h
e r
e
s
p
o
n
d
en
t
s
w
o
r
k
i
n
t
h
e al
l
i
ed
h
eal
t
h
s
ect
o
r
,
s
u
ch
as
m
ed
i
cal
as
s
i
s
t
an
t
s
,
s
t
a
f
f
n
u
r
s
es
,
s
i
s
t
e
r
s
a
n
d
m
a
t
r
on
s
,
a
n
d a
s
s
i
s
t
a
n
t
ph
a
r
m
a
c
i
s
t
s
.
O
n
l
y
a
bout
4.
2%
of
t
h
e
e
n
r
ol
l
e
d r
e
s
po
n
de
n
t
s
w
or
k i
n
t
h
e
a
d
m
in
i
s
tr
a
ti
v
e
s
ect
o
r
,
s
u
c
h
as
cl
er
k
s
an
d
ad
m
i
n
o
f
f
i
cer
s
.
T
ab
l
e
1
.
R
es
p
o
n
d
en
t
s
’
b
as
el
i
n
e ch
ar
act
er
i
s
t
i
cs
V
a
r
i
ab
l
e
V
a
l
u
e (
%
)
n
4
0
1
A
g
e
g
r
o
u
p
(y
e
a
r),
n
(%
)
2
0
-
2
9
2
0
7
(
5
1
.
7
)
3
0
-
3
9
7
7
(
1
9
.
2
)
4
0
-
4
9
8
2
(
2
0
.
4
)
>
5
0
3
5
(
8
.
7
)
G
e
n
d
e
r
,
n
(
%
)
M
a
le
8
5
(
2
1
.
2
)
F
em
a
l
e
3
1
6
(
7
8
.
8
)
J
o
b
d
e
s
c
r
i
p
t
i
o
n,
n
(
%
)
P
r
o
f
e
s
s
i
o
n
a
l
3
9
(
9
.
7
)
A
lli
e
d
H
e
a
lt
h
2
2
0
(
5
4
.
9
)
S
u
pp
or
t
s
t
a
f
f
1
2
5
(
3
1
.
2
)
A
d
m
in
is
t
r
a
t
io
n
1
7
(
4
.
2
)
W
o
r
k
p
l
ace
, n
(
%
)
M
e
d
i
cal
w
ar
d
s
7
9
(
1
9
.
7
)
S
u
r
g
i
cal
w
ar
d
s
6
0
(
1
5
.
0
)
C
l
i
n
i
c /
P
h
ar
m
acy
6
6
(
1
6
.
5
)
E
m
er
g
en
c
y
/
O
p
er
a
t
i
o
n
T
h
eat
er
1
4
0
(
3
4
.
8
)
I
n
t
en
s
i
v
e c
a
r
e u
n
i
t
s
2
2
(
5
.
5
)
A
d
m
i
n
o
ffi
c
e
3
4
(
8
.
5
)
T
h
e p
r
ev
al
en
ce o
f
L
T
B
I
am
o
n
g
t
h
e r
es
p
o
n
d
en
t
s
w
as
4
6
.
4
%
.
I
n
co
m
p
ar
i
s
o
n
,
o
f
L
T
B
I
o
ccu
r
r
en
ce i
n
be
t
w
e
e
n
t
h
e
r
e
s
pon
de
n
t
s
a
g
e
g
r
ou
ps
,
t
h
e
a
g
e
g
r
ou
p
m
e
m
be
r
of
30 t
o 39
-
y
ear
-
o
l
d
ha
ve
t
h
e
hi
ghe
s
t
p
e
r
c
e
nt
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ge
of
48.
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a
s
s
ho
w
n
i
n
T
ab
l
e 2
.
T
he
s
e
c
o
nd
hi
g
he
s
t
w
a
s
a
m
o
n
g
t
he
y
o
un
ge
s
t
a
ge
gr
o
up
m
e
m
b
e
r
s
w
i
t
h
a
pr
e
v
a
l
e
n
c
e
o
f
46.
4%
,
f
ol
l
o
w
e
d by
t
h
e
s
e
n
i
or
g
r
ou
p (
45.
7%
)
a
n
d l
e
s
s
s
e
n
i
or
g
r
ou
p (
45.
1%
)
.
T
h
e
di
f
f
e
r
e
n
c
e
s
w
e
r
e
s
i
g
ni
f
i
c
a
nt
w
i
t
h
p<
0.
01,
i
n
w
hi
c
h
t
h
e
pr
e
v
a
l
e
n
c
e
o
f
L
T
B
I
w
a
s
obv
i
ous
l
y
h
i
gh
a
m
o
ng t
h
e
y
o
u
ng
H
C
W
s
.
A
n
d
ag
ai
n
,
i
t
w
as
s
i
g
n
i
f
i
can
t
l
y
h
i
g
h
er
i
n
m
al
e co
m
p
ar
ed
t
o
f
e
m
al
e H
C
W
s
,
4
7
.
1
%
an
d
4
6
.
2
%
r
es
p
ect
i
v
el
y
.
T
ho
s
e
i
nvo
l
ve
d
a
s
he
a
l
t
h a
d
m
i
ni
s
t
r
a
t
i
o
n,
t
he
s
t
ud
y
f
o
u
nd
a
p
r
o
m
i
ne
n
t
hi
g
h
p
er
cen
t
a
g
e
o
f
L
T
B
I
o
ccu
r
r
en
ce
a
m
ong
t
h
e
m
(
70.
6%
)
c
om
pa
r
e
d t
o
ot
h
e
r
j
ob
de
s
c
r
i
pt
i
on
s
.
I
n a
d
d
i
t
i
o
n,
t
ho
s
e
w
ho
o
nl
y
w
o
r
k i
n t
he
a
d
m
i
n
of
f
i
c
e
w
e
r
e
a
l
s
o f
oun
d pos
i
t
i
ve
w
i
t
h
L
T
B
I
(
5
5.
9%
)
w
hi
c
h
i
s
t
h
e
h
i
gh
e
s
t
r
a
t
e
c
o
m
pa
r
e
d t
o
ot
h
e
r
w
or
k
s
i
t
e
or
p
l
ace.
V
a
r
ia
b
le
s
l
i
ke
a
ge
gr
o
up
s
a
nd
ge
nd
e
r
gi
ve
t
w
o
t
i
m
e
s
hi
g
he
r
r
i
s
k,
b
ut
w
e
r
e
no
t
s
i
gni
f
i
c
a
nt
(
p
>
0.
0
5
)
.
H
o
w
e
v
er
,
af
t
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ad
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u
s
t
i
n
g
f
o
r
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e an
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g
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n
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er
f
act
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t
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e s
t
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a
s s
h
o
w
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n
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ab
l
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.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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52
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T
ab
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ar
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al
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1
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J
o
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4.
D
I
SC
U
SSI
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T
h
e
s
t
u
d
y
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x
pos
e
d t
h
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t
t
h
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e
v
a
l
e
n
c
e
of
L
T
B
I
w
a
s
a
bou
t
46.
4%
a
m
ong
t
h
e
H
C
W
s
i
n
on
e
of
t
h
e
m
a
i
n go
ve
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e
nt
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t
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l
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t
w
a
s
h
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gh
e
r
c
om
pa
r
e
d
t
o G
e
r
m
a
ny
(
10.
0%
)
[
11
]
,
b
u
t
w
as
co
m
p
ar
ab
l
e
w
i
t
h t
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f
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ng
f
r
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m
S
a
u
di
A
r
a
bi
a
(
46.
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)
[
12
]
.
A
n
d
t
h
e
r
at
e
w
as
co
m
p
ar
at
i
v
el
y
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t
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o
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u
n
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S
out
h
A
f
r
i
c
a
(
56.
7%
)
[
1
3]
,
T
a
i
w
a
n
(
88.
8%
)
[
14]
,
a
nd
C
hi
na
(
56.
7%
)
[
15]
.
A
no
t
he
r
s
t
ud
y d
i
s
c
o
ve
r
y
w
a
s
a
b
o
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t
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gh p
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e
va
l
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nc
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f
L
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B
I
a
m
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g H
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t
w
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ppor
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m
por
t
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or
T
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I
[1
6
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-
[
1
9]
.
H
o
w
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er
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e s
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f
a
vo
ur
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[2
0
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[
21]
.
L
T
B
I
w
a
s
f
oun
d t
o be
h
i
g
h
e
r
a
m
ong
m
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l
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t
h
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n
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e
m
a
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C
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o
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oppos
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t
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n
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r
[2
2
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-
[
24]
.
I
t a
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k
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m
ila
r
a
c
r
os
s
t
h
e
j
ob de
s
c
r
i
pt
i
on
[
25
]
.
A
nd
f
o
r
t
hi
s
s
t
ud
y
,
he
a
l
t
h a
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m
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t
p
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ev
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t
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f
T
B
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n
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ec
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i
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n
[2
6
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-
[
27]
.
5.
CO
NCL
U
S
I
O
N
T
h
i
s i
s
t
he
o
nl
y
s
t
ud
y t
ha
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ve
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l
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hi
g
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B
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m
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g
no
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-
c
li
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ic
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l H
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ad
m
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s
t
r
at
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e s
t
a
f
f
.
T
h
ey
al
s
o
n
eed
t
o
h
av
e g
o
o
d
k
n
o
w
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g
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d
k
n
o
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p
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A
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NO
W
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231
R
EF
ER
EN
C
ES
[
1]
W
o
r
ld
H
e
a
lth
O
r
g
a
n
iz
a
tio
n
,
“
G
l
oba
l
t
u
be
r
c
ul
os
i
s
r
e
por
t
,”
G
en
ev
a
,
201
3.
[
2]
M
ack
U
.
,
M
ig
lio
r
i
G
.
B
.
,
S
es
t
er
M
.
,
et
al
.
,
“
La
n
g
e
fo
r
th
e
TB
N
E
T.
LT
B
I
: la
te
n
t tu
b
e
r
c
u
lo
s
is
i
n
f
e
c
tio
n
o
r
la
s
tin
g
i
m
m
une
r
e
s
pons
e
s
t
o M
.
T
ube
r
c
u
l
os
i
s
?
A
T
B
N
E
T
c
ons
e
ns
us
s
t
a
t
e
m
e
nt
,”
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u
r R
e
sp
i
r J
.
,
vo
l
.
33
,
pp
.
956
-
73
,
200
9.
[
3]
P
an
S
.
C
.
,
C
he
n Y
.
C
.
,
W
a
n
g
J
.
Y
.
,
e
t a
l.
,
“
T
u
b
er
cu
l
o
s
i
s
i
n
H
eal
t
h
car
e W
o
r
k
er
s
:
A
M
a
t
c
he
d C
oho
r
t
S
t
u
dy
i
n
T
ai
w
an
,”
P
L
oS O
ne
,
vo
l.
10
, p
p
.
e
014
50
47
,
20
15
.
[
4]
O
'
H
ar
a N
.
N
.
,
R
o
y
L
.
,
O
'
H
ar
a
L
.
M
.
,
e
t a
l.
,
“
H
eal
t
h
car
e W
o
r
k
er
P
r
ef
er
en
ces
f
o
r
A
ct
i
v
e T
u
b
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cu
l
o
s
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s
C
as
e F
i
n
d
i
n
g
P
r
og
r
a
m
s
i
n S
out
h A
f
r
i
c
a
:
A
B
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t
-
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or
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t
S
c
a
l
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C
hoi
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m
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nt
,”
P
L
oS
O
ne
,
v
o
l.
10
,
pp.
e
01
33
304
,
20
15
.
[
5]
Jo
sh
i
R
.
, R
e
i
n
go
l
d A
.
L
.
,
M
en
zi
es
D
.
,
P
a
i
M
.
,
“
T
ube
r
c
ul
os
i
s
a
m
ong
he
a
l
t
h
-
car
e w
o
r
k
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s
i
n
l
o
w
-
a
nd m
i
ddl
e
-
i
n
co
m
e
c
o
u
n
tr
ie
s
: a
s
y
s
t
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m
a
tic
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v
ie
w
,”
P
L
oS
M
e
di
c
i
ne
,
v
o
l
.
3
, p
p
.
e
49
4
,
2
006
.
[
6]
M
ir
ts
k
h
u
la
v
a
V
.
,
W
h
i
t
ak
er
J
.
A
.
,
K
ip
ia
n
i M
.
,
e
t a
l.
,
“
D
e
t
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r
m
i
na
nt
s
of
t
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r
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t
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w
or
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s
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n t
he
c
o
unt
r
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of
G
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or
g
i
a
,”
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n
f
e
c
t
C
ont
r
ol
H
os
p E
pi
de
m
i
ol
,
v
o
l.
36
, p
p
.
52
2
-
8
,
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[
7]
C
hu H
.
,
S
hi
h C
.
J
.
,
L
ee Y
.
J
.
,
et
a
l
.
,
“
R
i
s
k
o
f
t
u
b
er
cu
l
o
s
i
s
am
o
n
g
h
eal
t
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car
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w
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r
k
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s
i
n
an
i
n
t
er
m
ed
i
at
e
-
bur
de
n
c
o
u
n
tr
y
: a
n
a
tio
nw
i
de
po
pul
a
t
i
on
s
t
udy
,”
T
he
J
our
n
al
of
I
nf
e
c
t
i
o
n
,
vo
l
.
69
,
pp.
52
5
-
32
,
20
14
.
[
8]
Al
-
Z
a
m
el
F
.
A.
,
“
D
e
t
e
c
t
i
on a
nd di
a
g
nos
i
s
of
M
y
c
oba
c
t
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um
t
ube
r
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s
,”
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xp
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t
R
evi
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O
f
A
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t
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f
ect
i
ve
T
he
r
apy
,
v
o
l/is
s
u
e
:
7(
9)
, p
p
.
10
99
-
1
08
,
20
09.
[
9]
D
ie
l R
.
,
Go
le
tti D
.
,
F
er
r
ar
a
G
.
,
et
a
l.
,
“
In
t
e
rf
e
ro
n
-
g
a
m
m
a r
el
e
as
e a
s
s
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y
s
f
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t
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e d
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ag
n
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s
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f
l
at
en
t
M
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co
b
act
er
i
u
m
t
u
b
er
cu
l
o
s
i
s
i
n
f
ect
i
o
n
:
a s
y
s
t
e
m
at
i
c r
ev
i
e
w
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d
m
et
a
-
an
al
y
s
i
s
,”
T
he
E
ur
ope
an R
e
s
p
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r
at
or
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our
n
al
,
vo
l
.
37
, p
p
.
88
-
99
,
2
01
1.
[
1
0]
L
ig
h
te
r
F
.
J
.
,
S
u
r
et
t
e A
.
M
.
,
“
P
e
r
f
o
r
m
an
ce o
f
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n
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f
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g
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m
m
a r
el
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d
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en
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t
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t
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on
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ur
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pr
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g
na
nc
y
,”
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s
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ri
c
s
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nd
G
y
ne
c
ol
o
gy
,
vo
l
.
1
19
, p
p
.
10
88
-
95
,
20
12
.
[
1
1]
N
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us
A
.
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c
ha
bl
on A
.
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r
ei
s
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er
A
.
M
.
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e
t a
l.
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m
a
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er
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s
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v
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,”
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ccu
p
M
ed
T
o
xi
co
l
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v
o
l
.
9
, p
p
.
9
,
20
14.
[
1
2]
B
a
l
k
h
y H
.
H
.
,
M
ille
r
T
.
L
.
,
Al
i
S
.
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e
t a
l.
,
“
C
o
m
p
l
i
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ce w
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t
h
p
o
s
t
ex
p
o
s
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r
e s
cr
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n
g
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d
t
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eat
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t
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l
at
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t
t
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o
s
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s
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n
f
ect
i
o
n
am
o
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g
h
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car
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k
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n
a t
er
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r
y
c
a
r
e
h
o
s
p
ita
l
in
S
a
u
d
i A
r
a
b
ia
,”
I
nf
e
c
t
C
on
t
r
ol
H
os
p
E
pi
de
m
i
ol
,
v
o
l.
35
, p
p
.
17
6
-
81
,
20
1
4.
[
1
3]
v
an
R
i
e A
.
,
M
cC
ar
t
h
y
K
.
,
S
c
o
tt L
.
,
e
t a
l.
,
“
P
r
ev
al
en
ce,
r
i
s
k
f
act
o
r
s
an
d
r
i
s
k
p
er
cep
t
i
o
n
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f
t
u
b
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l
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s
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s
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n
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ect
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o
n
a
m
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m
ed
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cal
s
t
u
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s
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9]
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3]
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,”
B
MC
In
f
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s Di
se
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,
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l
.
10
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