Factors affecting the use of anti-malaria preventive measures among Taiwan immigrants returning to malaria-endemic regions.

The aim of this study was to investigate the predictors of anti-malaria preventive measures (AMPMs) among Taiwan immigrants returning to their country of origin using the Health Belief Model (HBM). Between March and May 2011, all permanent immigrants originating from malaria-endemic countries, attended by either the Taipei or Tainan Immigrant Service Center, Taiwan, and who reported a history of returning to their country of origin within the preceding year during the malarious season in their country of origin were enrolled in the study. Complete information was collected from 316 immigrants, with a response rate of 87% (316/364). The mean age of the subjects was 38.1 years (SD = 9.9). The majority (70%) of participants did not receive travel information through a pre-travel consultation; more than 40% reported that they did not use measures to prevent insect bites. Multiple regression analyses revealed that Chinese proficiency, travel consultation before travel, lower perceived susceptibility to malaria, higher perceived severity of malaria infection, higher perceived benefit for taking measures, and higher self-efficacy for taking measures significantly predicted the use of AMPMs during the return to their country of origin (R(2) = 0.20; F = 50.42; P < 0.001). A high proportion of immigrants were not using appropriate AMPMs when they returned to their country. Educational approaches should be targeted toward immigrants who return to visit their country of origin.

Epidemiological features of intestinal infection with Entamoeba histolytica in Taiwan, 2002-2010.

Amebiasis remains an important public health problem worldwide, and immigration and an increase in international travel have affected the incident cases of the disease. The purpose of this study was to assess the prevalence of Entamoeba histolytica in Taiwan between 2002 and 2010. We analyzed data from surveillance programs run by the Centers for Disease Control, Taiwan (Taiwan CDC), and only laboratory-confirmed cases were analyzed. In total, 1796 cases with E. histolytica infections were included in our analysis. Among them, 788 (44%) of the cases were imported, and 1008 (56%) were locally acquired. The average annual incidence rate of E. histolytica infections was 0.49 and 9.26 per 100,000 for local patients and immigrants/foreign workers from endemic countries, respectively. The annual incidence of E. histolytica infections among immigrants/foreign workers was significantly higher than among Taiwanese who had not traveled abroad (P < 0.0001). Travelers to E. histolytica-endemic areas (e.g., Southeast countries) had a higher risk acquiring an E. histolytica infection. This study emphasized that E. histolytica infection is an important intestinal infectious disease in Taiwan. The risk of infection with E. histolytica for travelers was higher for those with destinations in South and Southeast Asia. To control E. histolytica infections in Taiwan, a sensitive surveillance system needs to be established, and the amebiasis-screening program for immigrants/foreign workers from endemic countries should be enforced.

Updated diagnosis and treatment of childhood tuberculosis.

BACKGROUND: Childhood tuberculosis (TB) accounts for a significant proportion of the global tuberculosis disease burden. However, current and previous efforts to develop better diagnostic, therapeutic, and preventive interventions have focused on TB in adults, and childhood TB has been relatively neglected. The purpose of this review is to provide an update on the diagnostic and therapeutic recommendations for childhood TB with an emphasis on intrathoracic disease. DATA SOURCES: The literature from a range of sources was reviewed and synthesized to provide an overview of the contemporary approaches for the diagnosis and treatment of childhood TB. RESULTS: This review summarizes the clinical, radiological, bacteriological, and immunological approaches to diagnose TB infection and disease in children. In addition, we summarize the updated guidelines for the treatment of TB in children. CONCLUSIONS: The development of better diagnostic and therapeutic methods for childhood TB remains a significant challenge. As the strategies for diagnosis and treatment of childhood TB continue to improve and the knowledge base increases, the implementation of these strategies will be crucial.

Childhood tuberculosis: epidemiology, diagnosis, treatment, and vaccination.

Despite the existence of a government-run tuberculosis (TB) control program, the current nationwide burden of TB continues to be a public health problem in Taiwan. Intense current and previous efforts into diagnostic, therapeutic, and preventive interventions have focused on TB in adults, but childhood TB has been relatively neglected. Children are particularly vulnerable to severe disease and death following infection, and children with latent infections become reservoirs for future transmission following disease reactivation in adulthood, thus fueling future epidemics. Additional research, understanding, and prevention of childhood TB are urgently needed. This review assesses the epidemiology, diagnosis, treatment, and relevant principles of TB vaccine development and presents efficacy data for the currently licensed vaccines.

The absence of endemic malaria transmission in Taiwan from 2002 to 2010: the implications of sustained malaria elimination in Taiwan.

The purpose of this study was to assess the epidemiology of malaria in Taiwan between 2002 and 2010. We analyzed data reported as part of surveillance programs run by the Taiwan Centers for Disease Control (Taiwan CDC). Malaria cases were diagnosed by blood films, polymerase chain reaction, or rapid diagnostic tests. The risk of re-establishment of malaria transmission in Taiwan was assessed. A total of 193 malaria cases were included in our analysis. All of the cases were associated with importation. One hundred and fifty-eight cases (82%) were diagnosed within 13 days from the start of symptoms/signs, and 44% of these cases were acquired in Africa and 42% were acquired in Asia. Plasmodium falciparum was responsible for the majority (49%) of these cases. Travel to an endemic area was associated with the acquisition of malaria. The malaria importation rate was 2.77 per 1,000,000 travelers (range, 1.35-5.74). The reproductive number under control (R(c)) was 0. No endemic transmission of malaria in Taiwan was identified. This study suggests that maintaining a vigilant surveillance system, environmental management, vector-control efforts, and case management are needed to prevent outbreaks and sustain the eradication of malaria in Taiwan.

The association between enterovirus 71 infections and meteorological parameters in Taiwan.

BACKGROUND: Enterovirus 71 (EV71) infections are a significant cause of neurological disorder and death in children worldwide. Seasonal variations in EV71 infections have been recognized, but the mechanisms responsible for this phenomenon remain unknown. The purpose of this study was to examine the relationship between meteorological parameters and EV71 infection. METHODS AND FINDINGS: We analyzed the number of EV71 infections and daily climate data collected in Taiwan between 1998 and 2008 and used Poisson regression analysis and case-crossover methodology to evaluate the association between weather variability and the incidence of EV71 infection. A total of 1,914 EV71-infected patients were reported between 1998 and 2008. The incidence of EV71 infections reflected significant summertime seasonality (for oscillation, p<0.001). The incidence of EV71 infections began to rise at temperatures above 13°C (r(2) = 0.76, p<0.001); at temperatures higher than approximately 26°C (r(2) = 0.94, p<0.05), the incidence began to decline, producing an inverted V-shaped relationship. The increase in the incidence with increasing relative humidity was positive and linear (r(2) = 0.68, p<0.05). EV71 infection was most highly correlated with temperature and relative humidity in the period that likely preceded the infection. CONCLUSION: Our study provides quantitative evidence that the rate of EV71 infection increased significantly with increasing mean temperature and relative humidity in Taiwan.