023

Tuberculosis Control Manual

2017 3

Stop TBB Partnershipp 2035

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......................................................................................................... II

Stop TBB Partnershipp 2035

5~10% 2

240 8~50

5 20%

passive case findingactive case finding

6

//

2035

5~10% 2

240 8~50

5 20%

passive case findingactive case finding

6

//

2035

I

1

() /

() /

IDS

X/

X

() XX

()

()

() X

2

2 1 1 1

3

()

1

() /

() /

IDS

X/

X

() XX

()

()

() X

2

2 1 1 1

3

()

1

01

1-1 1 6 7 10 7 12

1 10

7 15 1 15

() X 1.2.3.

4.

() MTBC 2

X infiltration

100

* X

1.

2.

1.

2.

1.

2.

2

01

1-1 1 6 7 10 7 12

1 10

7 15 1 15

() X 1.2.3.

4.

() MTBC 2

X infiltration

100

* X

1.

2.

1.

2.

1.

2.

3

01

3 39 40 64 65

24

1 1

> >

()

1.

/

2. 5

3.

X

()

MDR-TB XDR-TB

()

() MDR-TB 1

4

01

3 39 40 64 65

24

1 1

> >

()

1.

/

2. 5

3.

X

()

MDR-TB XDR-TB

()

() MDR-TB 1

5

02

5

() XDR-TB 1

() 1

2

3

3

2(1)1(NAA) (2)1MTBC

1(1)

(2)

(1)(2)

6

02

5

() XDR-TB 1

() 1

7

02

()

1. 7

3-1

2. 3

1 1

()

()

1.

(1)

(2)

MDR-TB

XDR-TB 5

M. bovis BCG VICP

8

02

()

1. 7

3-1

2. 3

1 1

()

()

1.

(1)

(2)

MDR-TB

XDR-TB 5

M. bovis BCG VICP

9

03

4. 2

5. TB 6.

7. 2

A.

/

///

B.

/ 1

1

C.

HIV

3

1 1 365 30

5

1.

1.

Granulation tissue

Granulomatous change

Necrotizing granulomatous inflammation

Chronic necrotizing caseating

granulomatous inflammation

Caseous necrosis

Granuloma / granulomatous inflammation /

Langhans multinucleated giant cells Langhans

epithelial cells

(3)

A. NAAT

B. MTBC C. X

2. NAAT

3. X

10

03

4. 2

5. TB 6.

7. 2

A.

/

///

B.

/ 1

1

C.

HIV

3

1 1 365 30

5

11

03

3-2

()

1.

(1) GenoType Xpert

RMP

(2)

(3) / X/ (4) FluoroquinolonesFQ

(5) ///HIV

(6)

2. (1) 3-3

(2) (3)

() 1.

2. 3. 4.

http://www.cdc.gov.tw

()

3

/

MDR

D.

E.

TB

()

() /

()

()

() 1.

2.

12

03

3-2

()

1.

(1) GenoType Xpert

RMP

(2)

(3) / X/ (4) FluoroquinolonesFQ

(5) ///HIV

(6)

2. (1) 3-3

(2) (3)

() 1.

2. 3. 4.

http://www.cdc.gov.tw

()

3

/

MDR

13

03

()

4

MTB

2

30

CXR

CXR

X

012 6

HIVHBV

HCV

ethambutol

ethambutol

1

1

X

1

3

PZAINH

RMP

2

RMP

PZA

INH pyridoxine

Vit. B6

Flu-like syndrome

INHRMP

2

INH RMP

PZA

Rifabutin

RMPINH

SM

EMB

14

03

()

4

MTB

2

30

CXR

CXR

X

012 6

HIVHBV

HCV

ethambutol

ethambutol

1

1

X

1

15

03

() 3-4

/1

1

()

1. /

2. 2

x

3.

() TB

4

() 3-5

() 1.

2.

3.

4. () HIV 3-6

1. HIV 3// HIV

HIV

2.

3. HIV/TB

()

2

5

/

//

/ /

//

///

:

16

03

() 3-4

/1

1

()

1. /

2. 2

x

3.

() TB

4

() 3-5

() 1.

2.

3.

4. () HIV 3-6

1. HIV 3// HIV

HIV

2.

3. HIV/TB

17

03

//

//

/

1.

2. /

3. 4.

1. 7.

// /

---

() /

1.

2. () 5

M. bovis BCG

()

BCG

5

()

1

()

() VICP

() BCG

1. M. bovis BCG 2. BCG BCG

() 5 1 6

6

/

18

03

//

//

/

1.

2. /

3. 4.

1. 7.

// /

---

19

03

()

1.

2. CDC Monitor

DOT 60

()

1. 2.

3.

4. ()

() /

()

5

BO

2. A. B.

15

3.

4.

5.

(1) 2

2

(2)

X

M. bovisM. bovis BCG

3-7/E-MAIL /

/CDC Monitor

()

1.

2. NAANAAT 3.

()

1.

2. CDC Monitor 60

20

03

()

1.

2. CDC Monitor

DOT 60

()

1. 2.

3.

4. ()

() /

()

5

BO

2. A. B.

15

3.

4.

5.

(1) 2

2

(2)

X

M. bovisM. bovis BCG

3-7/E-MAIL /

/CDC Monitor

()

1.

2. NAANAAT 3.

()

1.

2. CDC Monitor 60

21

03

/X

1.

2. 2

3. 5

X

01

2

DOTS

/

14

8

/

7

X

HIV/DM/HBV/HCV

/

/////

7

2

/// 1

/

MDR

/ 1

/ /

22

03

/X

1.

2. 2

3. 5

X

01

2

DOTS

/

14

8

/

7

X

HIV/DM/HBV/HCV

/

/////

7

2

/// 1

/

MDR

/ 1

/ /

23

03

/

()

4-1

M. bovis

1.

TB

2. MTBC

/

1. /

2. M. bovis

3. M. bovis

pyrazinamide PZA

4.

1.

2.

1

/

X

Mycobacterium bovis M. bovis MTB complexMTBC

24

03

/

()

4-1

M. bovis

1.

TB

2. MTBC

/

1. /

2. M. bovis

3. M. bovis

pyrazinamide PZA

4.

1.

2.

1

/

X

Mycobacterium bovis M. bovis MTB complexMTBC

25

04

3.

10

4.

12

12 CXR

(2)

//

()

1.

2.

3. X

1.

2.

1. 10 12

2.

3.

4.

1.

DOTS14

4-3

2.

()

//

1.

(1)

(2)

(3)

2. 5

3. X

4.

1.

2.

1.

7

4-2

2. /

/

1.

2.

(1)

26

04

3.

10

4.

12

12 CXR

(2)

//

()

1.

2.

3. X

1.

2.

1. 10 12

2.

3.

4.

1.

DOTS14

4-3

2.

()

//

1.

(1)

(2)

(3)

2. 5

3. X

4.

1.

2.

1.

7

4-2

2. /

/

1.

2.

(1)

27

04

2. *

3.

4-

4

15 /

1.

(1)

(2)

15

2.

*

3.

4-

5

*

DOTS 14

8

3.

1.

2. 4-3 DOTS

14

3.

4.

() /

1.

/

X

2.

15 /

1.

(1)

(2)

15

7-3

28

04

2. *

3.

4-

4

15 /

1.

(1)

(2)

15

2.

*

3.

4-

5

*

DOTS 14

8

3.

1.

2. 4-3 DOTS

14

3.

4.

() /

1.

/

X

2.

15 /

1.

(1)

(2)

15

7-3

29

04

1. /

/

2.

/

1.

2.

3. //

4.

5.

1. /

2. /

3. X

4.

1.

2.

4-4

74 1

3.

TB

1. X

15

2.

4-6

3. TB

4. /

5. 15

6.

30

04

1. /

/

2.

/

1.

2.

3. //

4.

5.

1. /

2. /

3. X

4.

31

04

/

(3)

()

4-9

1.

X

2. 2

3.

4.

1.

)

2. DOTS

3.

4.

1.

2.

3.

4.

()

/

1. /

(1)

4-7

(2)

CXR *

2. CXR*

3. CXR

4.

*

CXR

1.

CXR

2.

infiltration

3.

1. CXR

2. CXR 3

3. 24

4. DOTS

5.

6.

1.

2.

//

(1) /

1

(2)

4-8

/

32

04

/

(3)

()

4-9

1.

X

2. 2

3.

4.

1.

)

2. DOTS

3.

4.

1.

2.

3.

4.

()

/

1. /

(1)

4-7

(2)

CXR *

2. CXR*

3. CXR

4.

*

CXR

1.

CXR

2.

infiltration

3.

1. CXR

2. CXR 3

3. 24

4. DOTS

5.

6.

1.

2.

//

(1) /

1

(2)

4-8

/

33

04

/

1. MTBC/

2. M. bovis

1. 2. 1 X

3.

1. 2. 3. 4.

5. 6.

1.

2.

3.

1. 2. 3. 4. X

5.

104 12 30

33

36

43

48

67

69

70

34

04

/

1. MTBC/

2. M. bovis

1. 2. 1 X

3.

1. 2. 3. 4.

5. 6.

1.

2.

3.

1. 2. 3. 4. X

5.

104 12 30

33

36

43

48

67

69

70

35

04

/

1. 2. 3. 4.

1. / 2. 3.

4.

5.

1. 2. X 3.

4. 5. // 6. /

1. CXR 2. 2 3.

4.

1.

2. 3. 4.

5. / 6.

/

1. 10 12 2. /

3. LTBI 4. 5.

/

1. / 2. /

3.

4.

/

1. /

2. 3.

4. 74

1.

2. 3. TB 4. / 5. 15

/

6.

36

04

/

1. 2. 3. 4.

1. / 2. 3.

4.

5.

1. 2. X 3.

4. 5. // 6. /

1. CXR 2. 2 3.

4.

1.

2. 3. 4.

5. / 6.

/

1. 10 12 2. /

3. LTBI 4. 5.

/

1. / 2. /

3.

4.

/

1. /

2. 3.

4. 74

1.

2. 3. TB 4. / 5. 15

/

6.

37

04

() ()

1.

2.

3.

4.

()

1.

2. 3.

()

1. 2.

() 1.

2.

3. 4.

38

04

() ()

1.

2.

3.

4.

()

1.

2. 3.

()

1. 2.

() 1.

2.

3. 4.

39

05

5-4 DOTSDOPT

3./

5-5

()

1.

2. 2 1 1

()

1.

2.

3.

()

1.

2.

3.

4.

5.

6. EMB

7.

8. 5

9.

()

1.

2.

()

1.

2. 3 5-6

/

TB LTBI 1% LTBI

5.

()

1.

2.

3.

4.

5.

6.

App

() 5-1

()

()

() 5-2

5-3

()

1.

2.

40

05

5-4 DOTSDOPT

3./

5-5

()

1.

2. 2 1 1

()

1.

2.

3.

()

1.

2.

3.

4.

5.

6. EMB

7.

8. 5

9.

()

1.

2.

()

1.

2. 3 5-6

/

TB LTBI 1% LTBI

5.

()

1.

2.

3.

4.

5.

6.

App

() 5-1

()

()

() 5-2

5-3

()

1.

2.

41

05

7

EMB 3

1% LTBI TB

10

5-7

()

()

1.

5-10

2. 10-15

3. 15-20

()

5-8

()

() 5-9

()

1. 16

2. 8

()

42

05

7

EMB 3

1% LTBI TB

10

5-7

()

()

1.

5-10

2. 10-15

3. 15-20

()

5-8

()

() 5-9

()

1. 16

2. 8

()

43

05

7 26 39 43-46 48

DR-TB RMP RR-TB RMP /

MDR-TB INH RMP

/XDR-TB fluoroquinolone

3 capreomycinkanamycinamikacin

1 96 5 1

MDR-TB

2013 RR-TB

MDR-TB

RR-TB

44

05

7 26 39 43-46 48

DR-TB RMP RR-TB RMP /

MDR-TB INH RMP

/XDR-TB fluoroquinolone

3 capreomycinkanamycinamikacin

1 96 5 1

MDR-TB

2013 RR-TB

MDR-TB

RR-TB

45

06

MDR-TB

MDR-TB

/

()

MTBC (+)

INHRIF

MTBC (+)

INHRIF

MDR-TB

MDR-TB 24

6-2MDR-TB

7

6-2

1. ( 4) 2. RR-TBMDR-TB

3.

4. 80 1 1( 365 30)

BOXDR

MDR-TBXDR-TB1.

2.

3.

monitor

72RMPMDR-TB

MDR/XDR

1.24RR-TBMDR-TB(MDR-TB)

2.()3

3.XDR24XDR

monitor1

1. 24RR-/MDR-/XDR-TB2. MDR

3. MDR-TBMDR-TBunique4MDR-TB8

5/

5

1. monitor(monitor.cdc.gov.tw)/Table/Alert INH+RMP

2. GenoTypeRR-/MDR/XDR-TBMDR

3. 4. 10MDRXDR

(Xpert)RMP

DR-TB

DR-TB 6-1

6-1 RR-/MDR-/XDR-TB

46

06

MDR-TB

MDR-TB

/

()

MTBC (+)

INHRIF

MTBC (+)

INHRIF

MDR-TB

MDR-TB 24

6-2MDR-TB

7

6-2

1. ( 4) 2. RR-TBMDR-TB

3.

4. 80 1 1( 365 30)

BOXDR

MDR-TBXDR-TB1.

2.

3.

monitor

72RMPMDR-TB

MDR/XDR

1.24RR-TBMDR-TB(MDR-TB)

2.()3

3.XDR24XDR

monitor1

1. 24RR-/MDR-/XDR-TB2. MDR

3. MDR-TBMDR-TBunique4MDR-TB8

5/

5

1. monitor(monitor.cdc.gov.tw)/Table/Alert INH+RMP

2. GenoTypeRR-/MDR/XDR-TBMDR

3. 4. 10MDRXDR

(Xpert)RMP

DR-TB

DR-TB 6-1

6-1 RR-/MDR-/XDR-TB

47

06

RR-TB/MDR-TB/XDR-TB

New

Previously treated patients

RelapseTreatment after loss to

follow-up patientsTreatment after failure

(other previously treated patients)

(patients with unknown history of TB

treatment)

Chronic case

fluoroquinolone

MDR-TB 24

24 RR-/MDR-TB

MDR-TB (

)

DR-TB

6-4

6-4DR-TB

RR-

/MDR-TB

TB

RR-/MDR-TB

TB

RR-/MDR-TB

()

()

/

6-3

6-3RR-/MDR-/XDR-TB

(MDR-TB)

(RR-/MDR-/XDR-TB)

DR-TB

DR-TB

[1

2]

1.2.//

1.RR-/MDR-TBRR-/MDR-TB2.(-)

(MDR-TB)

DR-TB

48

06

RR-TB/MDR-TB/XDR-TB

New

Previously treated patients

RelapseTreatment after loss to

follow-up patientsTreatment after failure

(other previously treated patients)

(patients with unknown history of TB

treatment)

Chronic case

fluoroquinolone

MDR-TB 24

24 RR-/MDR-TB

MDR-TB (

)

DR-TB

6-4

6-4DR-TB

RR-

/MDR-TB

TB

RR-/MDR-TB

TB

RR-/MDR-TB

()

()

/

6-3

6-3RR-/MDR-/XDR-TB

(MDR-TB)

(RR-/MDR-/XDR-TB)

DR-TB

DR-TB

[1

2]

1.2.//

1.RR-/MDR-TBRR-/MDR-TB2.(-)

(MDR-TB)

DR-TB

49

06

() 2015 1 1MDR-TB( 6-2)

Cured.

30

Treatment completed

Died

Treatment failed

- 1 2

- 3

- fluoroquinolone

- 4

lost to follow -up

2

1. 8 2. 30

3. 30 4.

() 2015 1 1MDR-TB 6-3)

Cured.

12

5 30

1

3 30

Treatment completed

X(

6

RMP

isoniazidethambutolpyrazinamide

streptomycin 3()

6-1MDR-TB()

X

[] 1 1 6 1

[] 1 3 1

30

50

06

() 2015 1 1MDR-TB( 6-2)

Cured.

30

Treatment completed

Died

Treatment failed

- 1 2

- 3

- fluoroquinolone

- 4

lost to follow -up

2

1. 8 2. 30

3. 30 4.

() 2015 1 1MDR-TB 6-3)

Cured.

12

5 30

1

3 30

Treatment completed

X(

6

RMP

isoniazidethambutolpyrazinamide

streptomycin 3()

6-1MDR-TB()

X

[] 1 1 6 1

[] 1 3 1

30

51

06

4.

/

()

1. / 24 RR-TB

MDR-TB

6-3

2. /monitor (monitor.cdc.gov.tw)/Table/Alert INH+RMP

3. ////DR-TB

()

1.

2.

3.

(1)

(2) /

(3) DOTS-plus

(4)

4.

Died

Failed

12 5 2 2

3 1

Defaulted 2

RMP

()

1. 6-1

/

XDR-TB

2. (DOTS-plus)

DOTS-Plus

/ DOTS-plus 5

1 1 2

2

3. ( 6-2)

(1)

/ 3

(2) 6

/

/

(3) 6

3/

52

06

4.

/

()

1. / 24 RR-TB

MDR-TB

6-3

2. /monitor (monitor.cdc.gov.tw)/Table/Alert INH+RMP

3. ////DR-TB

()

1.

2.

3.

(1)

(2) /

(3) DOTS-plus

(4)

4.

Died

Failed

12 5 2 2

3 1

Defaulted 2

RMP

()

1. 6-1

/

XDR-TB

2. (DOTS-plus)

DOTS-Plus

/ DOTS-plus 5

1 1 2

2

3. ( 6-2)

(1)

/ 3

(2) 6

/

/

(3) 6

3/

53

06

1. MTBC

2. MTBC 3. 12

()

MDR-TB /

MDR-TBMDR-TB RR-TB 3

6-3 6-4

1

MDR-TBMDR-TB 1

/ 6-5

DOTS-plus

RMP

DOTS-plus 5

DOTS-Plus

DOTS-plus/

DOTS-Plu

/ DOTS-Plus (DOTS)

6-6

( 6-7)

/

/

/

6-7

1) DR-TB 24

()

1.

2. 2 1

()

6-4

X LTBI

MDR-TB

MDR-TB

X

( 3

X

1

1.

2

2. DR-TB

2

3.

LTBI

RR-TB

RR-TB

X ( 3

X

LTBI

96 5 1

( 6-1)

DOTS-plus

() RMP

()

/-

() MDR-TBMDR-TBMDR-TB

54

06

1. MTBC

2. MTBC 3. 12

()

MDR-TB /

MDR-TBMDR-TB RR-TB 3

6-3 6-4

1

MDR-TBMDR-TB 1

/ 6-5

DOTS-plus

RMP

DOTS-plus 5

DOTS-Plus

DOTS-plus/

DOTS-Plu

/ DOTS-Plus (DOTS)

6-6

( 6-7)

/

/

/

6-7

1) DR-TB 24

()

1.

2. 2 1

()

6-4

X LTBI

MDR-TB

MDR-TB

X

( 3

X

1

1.

2

2. DR-TB

2

3.

LTBI

RR-TB

RR-TB

X ( 3

X

LTBI

96 5 1

( 6-1)

DOTS-plus

() RMP

()

/-

() MDR-TBMDR-TBMDR-TB

55

06

()

/

()

RR-/MDR-TB

24

RR-/MDR-TB

RR-/MDR-TB

MDR-TB

XDR-TB

XDR-TB 24

XDR-TB

6-2 2)

6-8

()

() / ()

1. 1 11 1

2. 2 3 1

1

() /

1. 1 2. 1 X

() /

() /

() / X 3 13

56

06

()

/

()

RR-/MDR-TB

24

RR-/MDR-TB

RR-/MDR-TB

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XDR-TB

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()

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1

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57

06

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MDR-TBRR-TB

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RR-/MDR-TB

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24

MDR-TB

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DOTS-plus

MDR-TBRR-TB

6-2

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58

06

() 3-5 mL

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() 5%~10%

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RR-/MDR-TB

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24

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MDR-TBRR-TB

DOTS-plus

MDR-TBRR-TB

6-2

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59

07

Acid-fast bacilli

AFB smear

microscopy

13025C 24

Culture Solid

media & Liquid

media

13026C

21

56

Nucleic acid

amplification tests

NAAT

12182C 1~7

Identification ID

13013C

7

immunochromatiogra-

phic test, ICT

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13015C 28

28

()

3

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1.5mL

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() M. bovis BCG

()

60

07

Acid-fast bacilli

AFB smear

microscopy

13025C 24

Culture Solid

media & Liquid

media

13026C

21

56

Nucleic acid

amplification tests

NAAT

12182C 1~7

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13013C

7

immunochromatiogra-

phic test, ICT

Drug susceptibility

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13015C 28

28

()

3

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M. bovis BCG

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() M. bovis BCG

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61

07

/

3

5

M. bovis BCG

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/

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1

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()

62

07

/

3

5

M. bovis BCG

/

/

> > >

1

()

() () BO 2%

3

()

() ()

() () /

()

63

07

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65

08

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69

08

(5)

(6)

1.

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() WHO 2035

()

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3.

4.

()

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4.

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70

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4.

(2)

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71

08

/ /

16.

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3.

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15.

16.

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6.

12.

13.

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7.

1~19

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4.

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(2)

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1.

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4.

1.

2.

3.

4.

5.

19._______

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6. 7.

MDRRMP

(1) 3 (2) 6

(3) 3

8.

3.

6.MDR

7.

8.

9.

14.

15.

16.

19.______

3. 8.

72

08

/ /

16.

19.______

4.

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:

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2.

1.

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17.

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5.

3.

10.

11.

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16.

19.______

6.

12.

13.

19.______

7.

1~19

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4.

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(2)

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2.

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4.

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3.

4.

5.

19._______

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(1) 3 (2) 6

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8.

3.

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7.

8.

9.

14.

15.

16.

19.______

3. 8.

73

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75

08

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76

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77

08

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08

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87

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1

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1

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2

3

8

TB /

RR/MDRTB

48-72 HIV/TNF- inhibitor///

/

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>

() 10-4

10-5

2

2

() LTBI

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TB

/

TB LTBI

88

10

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12 X

4. LTBI/

3

X

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1

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1

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2

3

8

TB /

RR/MDRTB

48-72 HIV/TNF- inhibitor///

/

5mm

10mm

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LTBI Mitogen-

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>

() 10-4

10-5

2

2

() LTBI

10-6

() 10-7 3

TB

/

TB LTBI

89

10

5

5

1.

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3. LTBI 3 LTBI

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2. /LTBI

10-8

3. 5

DR-TB

RR/MDR/

XDR/TDR-TB

1. RR-TB /MDR-TB 1 DR-TB

3 X

2. 1 X DR-TB 2 DR-TB

2 LTBI

3. MDR-TB TB

MDR-TB TB

MDR-TB

4. MDR/XDR TB

MDR-TB

10-9

X DR-TB

2 DR-TB 2

/ 4

4/

////

1.

2.

/

/

1.

2.

1.

2.

1.

2.

3. LTBI

4.

1.

2.

3. LTBI

4.

/

90

10

5

5

1.

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3. LTBI 3 LTBI

1. 30 () TST

2. /LTBI

10-8

3. 5

DR-TB

RR/MDR/

XDR/TDR-TB

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3 X

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2 LTBI

3. MDR-TB TB

MDR-TB TB

MDR-TB

4. MDR/XDR TB

MDR-TB

10-9

X DR-TB

2 DR-TB 2

/ 4

4/

////

1.

2.

/

/

1.

2.

1.

2.

1.

2.

3. LTBI

4.

1.

2.

3. LTBI

4.

/

91

10

()

1. 3

2.

()

1064

1269

() 4

1.

2.

3.

4.

A>B>C(A)(A)

(B)(C)

C

B

A

ex: 20

ex: 30

40

3

1.

(1) (2)

aerosol- generating

procedures

(3)

2.

N95 ()

3.

/

4.

2 X

5.

1.

2. /

/

/

1.

2. /

/

TB

X

LTBI

92

10

()

1. 3

2.

()

1064

1269

() 4

1.

2.

3.

4.

A>B>C(A)(A)

(B)(C)

C

B

A

ex: 20

ex: 30

40

3

93

10

6

5 MDR/XDRTB

5

5

MDR

X

1. TB/MDR TB /XDR TB

2. TB/MDR TB 3. TB/MDR TB

* 10-210-3-110-3-2 10-9

Monitor: Alert

https://monitor.cdc.gov.tw/stoptb/Alert.aspx?funid=1

>PersonalView>

30

30 X MTBC 5 1 3 TST

4

() TB 10-10

() ) 10-11

() 10-1210-13

() 10-1410-15

() >>

>>

() 10-16

() 10-17

() 10-18

() 10-19

5 MDR/XDR

3

2

94

10

6

5 MDR/XDRTB

5

5

MDR

X

1. TB/MDR TB /XDR TB

2. TB/MDR TB 3. TB/MDR TB

* 10-210-3-110-3-2 10-9

Monitor: Alert

https://monitor.cdc.gov.tw/stoptb/Alert.aspx?funid=1

>PersonalView>

30

30 X MTBC 5 1 3 TST

4

() TB 10-10

() ) 10-11

() 10-1210-13

() 10-1410-15

() >>

>>

() 10-16

() 10-17

() 10-18

() 10-19

5 MDR/XDR

3

2

95

10

latent TB infectionLTBI

1.

2.

13

LTBI

HIV

10

100

LTBI

Tuberculin Skin TestTSTInterferon-gamma

release assayIGRA

5 5 TST IGRA

1 1 TST 3 2 TST

1 TST 2 TST

3

10 mm BCG 5mm

IGRA QuantiFERON-TB Gold In-Tube test QFT-GIT TB antigen Nil 0.35 IU/ml 25% Nil

T-SPOT.TB testT-Spot>8 spots QFT-GIT 10-18

MTBC 5 13 90 IGRA

MTBC 90 IGRA

10 12

1.

2. 3.

4.

//

1. //

2.

1. / 2.

3.

4. TB 5. LTBI

6.

96

10

latent TB infectionLTBI

1.

2.

13

LTBI

HIV

10

100

LTBI

Tuberculin Skin TestTSTInterferon-gamma

release assayIGRA

5 5 TST IGRA

1 1 TST 3 2 TST

1 TST 2 TST

3

10 mm BCG 5mm

IGRA QuantiFERON-TB Gold In-Tube test QFT-GIT TB antigen Nil 0.35 IU/ml 25% Nil

T-SPOT.TB testT-Spot>8 spots QFT-GIT 10-18

MTBC 5 13 90 IGRA

MTBC 90 IGRA

10 12

1.

2. 3.

4.

//

1. //

2.

1. / 2.

3.

4. TB 5. LTBI

6.

97

11

11-

3-1 11-3-2

()

LTBI

DOPT 11-4DOPT

/

() LTBILTBI

directly

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() 11-5-1 11-5-2

1. 2.

(1)

(2)

(3)

(4) DOPT 3HP DOPT ()

INH

12 X

INH

INH

INH

LTBI

LTBI

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1.

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X

Isoniazid TST IGRA

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LTBI

() isoniazid

() rifampicin ()

10-1

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LTBI 11-2-1 5 11-2-2

5

9 isoniazid9H isoniazid 9 270

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98

11

11-

3-1 11-3-2

()

LTBI

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/

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directly

observed preventive therapyDOPT

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1. 2.

(1)

(2)

(3)

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INH

12 X

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INH

INH

LTBI

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1.

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12 X

() TST IGRA 3 8-12

() LTBI 12

X

Isoniazid TST IGRA

12 X

LTBI

() isoniazid

() rifampicin ()

10-1

() 11-1 X

LTBI 11-2-1 5 11-2-2

5

9 isoniazid9H isoniazid 9 270

3 isoniazid+rifapentine3HP isoniazid

rifapentine 12

99

11

1.

1

11-6

2.

(congenital tuberculosis)

LTBI

11-6

prophylaxis

5

prophylaxis 3

LTBI

IGRA

LTBI IGRA IGRA

IGRA

LTBI

LTBI

LTBI

NTM

LTBI

prophylaxis

LTBI

3

5

1. RMP+PZA 2

2. INH+RMP 3

LTBI LTBI

()

LTBI

1. LTBI

2.

3. LTBI LTBI

() DOPT

/

()

1-2

100

11

1.

1

11-6

2.

(congenital tuberculosis)

LTBI

11-6

prophylaxis

5

prophylaxis 3

LTBI

IGRA

LTBI IGRA IGRA

IGRA

LTBI

LTBI

101

11

X

LTBI

LTBI

11

LTBI

LTBI DOPT

IGRA

monitor.cdc.gov.tw

chrome

LTBI

Table

Alert

IDS

Table

Alert

www.cdc.gov.tw >

102

11

TST/IGRA LTBI

isoniazid

rifampicin

INH

prophylaxis TST

RZ 2 HR 3

LTBI 1-2/

DOPT

/

103

11

() 2

() 2 1 365 1

()

()

() 40

P.S.

3

() 2

() probable cluster

()

BO

1

1

104

11

() 2

() 2 1 365 1

()

()

() 40

P.S.

3

() 2

() probable cluster

()

BO

1

1

105

12

2.

3.

4. 21

()

() 12-4

()

()

LTBI X 6 1

1 2

10 5

/

10

10

12-112-2

()

IGRA/TST

IGRA/TST LTBI

()

X

()CO2

CO21000ppm

()

HIV

()

()

1. 12-3

2. X

3. 2 //

4. / 12-1 12-2

()

Nucleic Acid Amplification Test NAAT

()

1.

106

12

2.

3.

4. 21

()

() 12-4

()

()

LTBI X 6 1

1 2

10 5

/

10

10

12-112-2

()

IGRA/TST

IGRA/TST LTBI

()

X

()CO2

CO21000ppm

()

HIV

()

()

1. 12-3

2. X

3. 2 //

4. / 12-1 12-2

()

Nucleic Acid Amplification Test NAAT

()

1.

107

12

- BO

CO2

LTBI

2

3

LTBI

LTBI

LTBI

IGRA IGRA LTBI

LTBI

LTBI LTBI LTBI

6 CXR 1

2

12-1

12-2

12-3

12-4

BO 1.2.

;LTBI

10

?

1. 2

2. 10

3.

1.

2. 10

108

12

- BO

CO2

LTBI

2

3

LTBI

LTBI

LTBI

IGRA IGRA LTBI

LTBI

LTBI LTBI LTBI

6 CXR 1

2

12-1

12-2

12-3

12-4

BO 1.2.

;LTBI

10

?

1. 2

2. 10

3.

1.

2. 10

109

12

WHO

Tuberculosis and air travel Guidelines for prevention and control WHO

13-1

/

13-2

MDRTB

1

14

MDR

MDR

2

-

110

12

WHO

Tuberculosis and air travel Guidelines for prevention and control WHO

13-1

/

13-2

MDRTB

1

14

MDR

MDR

2

-

111

13

2

2

/

3

8

//

3

3

A. MTBC X B. X MDR

Focal point

Focal point

1

/ /

13-4

A4 13-3

1. 2

2.

3.

1.

2.

1. 2 2

2.

3.

4. 5.

13-5

112

13

2

2

/

3

8

//

3

3

A. MTBC X B. X MDR

Focal point

Focal point

113

13

/

3

() /

1. 3 (1)

A. MTBC X

B. X MDR (2) 3

(3) 8

2.

3.

X

13-6

4.

3

5. 8 40

()

Focal point

()

1. 2.

3.

(1) 2 5

(2)

(3)

114

13

/

3

() /

1. 3 (1)

A. MTBC X

B. X MDR (2) 3

(3) 8

2.

3.

X

13-6

4.

3

5. 8 40

()

Focal point

()

1. 2.

3.

(1) 2 5

(2)

(3)

115

13

()

(Bacille Calmette et Guerin)

65 70

Tokyo172

5 ( 5-8 ) 1

(NIIS)

116

13

()

(Bacille Calmette et Guerin)

65 70

Tokyo172

5 ( 5-8 ) 1

(NIIS)

117

14

()/

()/

1.( 14-4)

2.( 14-5)

3.

()

()

()

1.

2.

3. 1 1

()/

1.

1 1

2.

3.

(/

//)

()

1.

2.

()

(NIIS)

( 14-1)

()

X

()

()(6 )

()(

)

() 6

() 2500

( 14-2-1)

( 14-3)

3

(6B/DTaP-Hib-IPV12MMR/

)

()

118

14

()/

()/

1.( 14-4)

2.( 14-5)

3.

()

()

()

1.

2.

3. 1 1

()/

1.

1 1

2.

3.

(/

//)

()

1.

2.

()

(NIIS)

( 14-1)

()

X

()

()(6 )

()(

)

() 6

() 2500

( 14-2-1)

( 14-3)

3

(6B/DTaP-Hib-IPV12MMR/

)

()

119

14

15

14-8

()

NIIS

(

)

( 14-6)

()

()/

()

()

()()

( 14-2-1)( 14-2-2)

()() 3

9 1

() 104

14-7

()

NIIS

()/

/

() 1

()//

()

()

() 116

120

14

15

14-8

()

NIIS

(

)

( 14-6)

()

()/

()

()

()()

( 14-2-1)( 14-2-2)

()() 3

9 1

() 104

14-7

()

NIIS

()/

/

() 1

()//

()

()

() 116

121

14

122

14

I