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. 2012 Jan 12:12:29.
doi: 10.1186/1471-2458-12-29.

Assessing trends and predictors of tuberculosis in Taiwan

Chung-Min Liao  1 , Nan-Hung Hsieh, Tang-Luen Huang, Yi-Hsien Cheng, Yi-Jun Lin, Chia-Pin Chio, Szu-Chieh Chen, Min-Pei Ling
Affiliations

Assessing trends and predictors of tuberculosis in Taiwan

Chung-Min Liao et al. BMC Public Health. .

Abstract

Background: Variety of environmental and individual factors can cause tuberculosis (TB) incidence change. The purpose of this study was to assess the characteristics of TB trends in the period 2004 - 2008 in Taiwan by month, year, gender, age, temperature, seasonality, and aborigines.

Methods: The generalized regression models were used to examine the potential predictors for the monthly TB incidence in regional and national scales.

Results: We found that (i) in Taiwan the average TB incidence was 68 per 100,000 population with mortality rate of 0.036 person-1 yr-1, (ii) the highest TB incidence rate was found in eastern Taiwan (116 per 100,000 population) with the largest proportion of TB relapse cases (8.17%), (iii) seasonality, aborigines, gender, and age had a consistent and dominant role in constructing TB incidence patterns in Taiwan, and (iv) gender, time trend, and 2-month lag maximum temperature showed strong association with TB trends in aboriginal subpopulations.

Conclusions: The proposed Poisson regression model is capable of forecasting patterns of TB incidence at regional and national scales. This study suggested that assessment of TB trends in eastern Taiwan presents an important opportunity for understanding the time-series dynamics and control of TB infections, given that this is the typical host demography in regions where these infections remain major public health problems.

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Figures

Figure 1
Figure 1
Time-series dynamics of (a) gender-, (b) age group-, and (c) subpopulation-specific monthly confirmed TB cases in Taiwan in the period 2004-2008. The densely-populated organization is defined as the people living and working in long-term care center and nursing home for children and elderly. The faculty is defined as the people teaching and working in the school and college. (d) Time series of monthly mean, maximum, and minimum temperatures in Taiwan in the period 2004-2008.
Figure 2
Figure 2
Time series of TB incidence rate with mean temperature in (a) northern, (b) central, (c) eastern Hwa-Tung, (d) southern, (e) southern Kao-Ping, and (f) island regions, respectively. (g) Region-specific contributions of TB incidence in Taiwan.
Figure 3
Figure 3
Fitting of Poisson regression models with lagged temperature for (a) Hwalien and (d) Taitung. Fitted models with lagged temperature and age group for (b) Hwalien and (e) Taitung. Fitted models with lagged temperature, age group and gender for (c) Hwalien and (f) Taitung in the period 2004-2008. (See Table 3 for detailed models).
Figure 4
Figure 4
Comparison of monthly TB incidence rate for aborigine and expected incidence rate for (a) Hwalien and (b) Taitung based on Poisson regression model. Comparison of gender-specific monthly TB incidence rate for male and female in Hwalien (c,d) and Taitung (e,f) in the period 2004-2008.
Figure 5
Figure 5
Significant factors (p-value) on TB trends data of aborigines in (a) Hwalien and (b) Taitung. Significant factors for gender-specific TB trends data in (c) Hwalien and (d) Taitung.
Figure 6
Figure 6
Forecasted time-series dynamics of TB incidence in 2008 by Poisson regression model based on TB data in the period 2004-2007.
See this image and copyright information in PMC

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