Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014
Epidemiological Features of Japanese Encephalitis in Taiwan from 2000 to 2014
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DOI：
10.4269/ajtmh.16-0330
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Chen, Kow-Tong
中科院分区：
文献类型：
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作者：
Chang, Yu-Kang;Chang, Hsiao-Ling;Chen, Kow-Tong
1968年台湾实施全国疫苗接种计划后，乙型脑炎发病率急剧下降。然而，乙脑病例仍在发生。本研究的目的是评估台湾乙脑的流行病学和疫苗接种政策。我们分析了2000至2014年间台湾疾病控制中心(台湾疾控中心)报告的乙脑病例。在15年的研究期间，共有4474例病例报告给台湾疾控中心。在这些个案中，379宗(8.5%)列为证实个案，4,095宗(91.5%)列为怀疑个案。乙脑发病率从0.59/100万人到1.61/100万人不等，并在2007年达到高峰。男性乙脑发病率高于女性(1.37/100万比0.84/100万；P=0.03)。40-59岁的患者比20岁以下的患者发病率更高(1.82vs0.23；P<；0.001)。居住在台湾东部地区的患者乙脑发病率最高(P<；0.001)。与未接种乙脑疫苗的患者相比，接种4剂乙脑疫苗的患者死亡和/或住院的风险较低(调整后的优势比：0.26；95%可信区间：0.08~0.90；P=0.04)。乙脑在台湾仍然是一个公共卫生问题，为了在台湾消灭乙脑，有必要通过诊断测试来监测乙脑，以确定最佳的疫苗接种方案，并对成人实施乙脑疫苗强化接种。
The incidence of Japanese encephalitis (JE) decreased sharply after the national vaccination program was implemented in Taiwan in 1968. However, cases of JE still occur. The purpose of this study was to assess the epidemiology and vaccination policy for JE in Taiwan. We analyzed the data on JE cases reported to the Taiwan Centers for Disease Control (Taiwan CDC) between 2000 and 2014. During the 15-year study period, a total of 4,474 cases were reported to the Taiwan CDC. Of these, 379 (8.5%) were classified as confirmed cases, and 4,095 (91.5%) were classified as suspected cases. The incidence of JE ranged from 0.59 to 1.61 per 1,000,000 people and peaked in 2007. Men had a higher incidence of JE than women (1.37 versus 0.84 per 1,000,000; P = 0.03). Patients who were 40-59 years of age had a higher incidence than did patients younger than 20 years (1.82 versus 0.23; P < 0.001). Patients who lived in the eastern region of Taiwan had the highest incidence rate of JE (P < 0.001). Compared with those who were not vaccinated with the JE vaccine, patients who received four doses of JE vaccine had a lower risk of suffering from death and/or hospitalization (adjusted odds ratio: 0.26; 95% confidence interval: 0.08-0.90; P = 0.04). JE is still a public health problem in Taiwan, and monitoring JE via diagnostic testing to determine the best vaccination program along with enforcing JE vaccine boosters for adults is necessary to eliminate JE in Taiwan.