Allergic rhinitis children with obesity are more vulnerable to air pollution: a cross sectional study.

The association between air pollution, allergic rhinitis (AR), and obesity has not been studied. From 2007 to 2011, 52 obese and 152 non-obese children (7-17 years old) with AR were recruited. Pediatric-Rhinoconjunctivitis-Quality-of-Life Questionnaire (PRQLQ) and nasal peak expiratory flow (NPEF) were tested. Association between the scores and rates of the two tests and mean air pollutant concentrations within 7 days before the tests were compared. When exposed to higher concentrations of CO, PM10, and PM2.5, the rates of worse nasal discomfort were 39.4%, 44.4% and 39.3% in obese children; and 18.0%, 21.9% and 19.7% in non-obese children, respectively. Compare to non-obese children, the rates in obese children were higher for CO (odds ratio (OR) 3.54, 95% confidence interval (CI) 1.15 ~ 10.92); PM10 (OR 3.26, 95% CI 1.01 ~ 10.57) and PM2.5 (OR 3.30; 95% CI 1.03 ~ 10.54). In obese children, correlations between higher concentrations of CO, PM10, PM2.5 and higher nasal discomfort (higher PRQLQ); and correlations between higher concentrations of CO, PM10, PM2.5, NMHC (non-methane hydrocarbon) and higher nasal mucosa inflammation (lower NPEF) were noted. Obesity negatively affected AR severity when AR children experienced higher concentrations of CO, PM10, and PM2.5. Increased nasal inflammation induced by air pollutants might be the underlying mechanism.

Enhanced directly-observed treatment short-course for tuberculosis control program in mountain areas of Taiwan.

INTRODUCTION: Directly Observed Treatment Short course (DOTS) is one of the most cost-effective approaches for TB treatment. However, TB incidence rates remain high in the mountain areas of Taiwan. A lay health advisor (LHA) strategy is integrated into DOTS as an Enhanced-DOTS (E-DOTS) to provide trustworthy, culturally-specific services in mountain areas that consider the characteristics of local ethnic groups. METHODOLOGY: We recruited two Taiwanese indigenes as LHAs (one for each county) to screen close contacts in five townships of Hualien and Nantou counties from January 1, 2011 to December 31, 2013. Incidence and active finding rates of TB during the E-DOTS periods (2011-2013 for Hualien and 2012-2013 for Nantou) were compared with data when traditional DOTS was implemented (2006-2010 for Hualien and 2006-2011 for Nantou) to evaluate the effectiveness of E-DOTS using the before-and-after study design. RESULTS: Incidence rate in Hualien decreased from 393.3 in 2011 to 235.7 in 2013 per 100,000 population and from 338 in 2012 to 235.5 in 2013 in Nantou mountain area. Furthermore, the active case finding rate increased from 15.42% in 2012 to 27.38% in 2013 as compared to an average of 6.5% for CDC, Taiwan, for the specified years. TB treatment success rates were significantly improved from an average of less than 80% to an average of higher than 90% after E-DOTS was implemented. CONCLUSIONS: Our findings highlighted that the use of LHAs in E-DOTS is an effective and applicable strategy for controlling tuberculosis in the mountain areas of Taiwan.