National prevalence of breastfeeding in Taiwan.

The objectives of this study were to describe the national prevalence of breastfeeding during hospitalization and at 1 and 3 months after delivery in Taiwan. A stratified proportional probability sampling method was used, with a total of 2079 mothers participating in the postal questionnaire. The prevalence of exclusive and partial breastfeeding (to any degree) was 17.9% and 47.0% during hospitalization, 22.3% and 48.4% at 1 month, and 16.7% and 17.4% at 3 months, respectively. There were significant regional variations in the rate of breastfeeding, with the highest rates demonstrated for Taipei City. Prevalence of breastfeeding in this study was generally higher than previously reported; however, a decline of more than 50% was noted between 1 and 3 months. In addition, the rates of exclusive breastfeeding were low. The results suggest the need to increase breastfeeding duration and encourage exclusive breastfeeding in Taiwan. Regional variations in prevalence of breastfeeding merit further study.     

Prevalence of skin diseases among schoolchildren in Magong, Penghu, Taiwan: a community-based clinical survey.

BACKGROUND/PURPOSE: Skin diseases are common in children. Epidemiologic studies of skin diseases in schoolchildren performed by direct inspection by dermatologists are limited in Taiwan. The current study surveyed the prevalence of selected childhood dermatoses in Magong City, Penghu, the largest offshore island of Taiwan. METHODS: A cross-sectional study was carried out in June 2005, in which a total of 3273 children aged 6-11 years living in Magong were examined by at least two board-certified dermatologists, with regard to the point prevalence of acne, ephelides, atopic dermatitis, warts, keloids, vitiligo, fungal infections, alopecia areata and psoriasis. The skin of the scalp, face, neck, trunk and extremities were inspected; that of the breast, genitalia and feet were skipped for privacy. RESULTS: Acne vulgaris was found at the age of 7 in both genders, with comedones being the earliest manifestation. The overall prevalence of acne was 17.3% (95% CI, 16-18.6%). Ephelides were frequently observed in the children (prevalence rate, 15.24%; 95% CI, 14-16.47%). The prevalence of atopic dermatitis was 4.33% (95% CI, 3.63-5.03%), with more boys affected than girls (1.49:1) (p = 0.03). The prevalence of warts on the hands was 2.81% (95% CI, 2.24-3.38%). Keloids were identified in seven boys and four girls, accounting for 0.33% of the children (95% CI, 0.13-0.53%). Three children had vitiligo (prevalence rate, 0.09%; 95% CI, 0-0.19%). The prevalence of fungal infection including tinea nigra, tinea versicolor and tinea corporis was 0.24% (95% CI, 0.07-0.41%). Neither alopecia areata nor psoriasis was identified. CONCLUSION: Compared with our previous study in Kaohsiung County using similar methodology, the point prevalence of atopic dermatitis and ephelides was significantly higher whereas that of fungal infection was lower in Penghu. Unexpectedly, tinea nigra was not rare in Penghu.     

Factors influencing the prevalence and severity of dysmenorrhoea in young women

Factors influencing the prevalence and severity of dysmenorrhoea were assessed longitudinally in a representative sample of young women born in 1962. The prevalence of dysmenorrhoea was lower (P less than 0.01) at 24 years of age than at 19 years of age. At 24 years of age, 67% of the women still experienced dysmenorrhoea; 10% reported dysmenorrhoea which limited daily activity. The severity of dysmenorrhoea (linear analogue scale) was lower (P less than 0.001) at 24 years of age (3.4, SD 2.8) than at 19 years (4.1, SD 3.2). The prevalence and severity of dysmenorrhoea were reduced (P less than 0.05) in women who were parous in 1986 and nulliparous in 1981, but was unchanged in women who were still nulliparous or women who had had a miscarriage or abortion. Dysmenorrhoea was reduced (P less than 0.001) in oral contraceptive users. The severity of dysmenorrhoea was significantly associated with the duration of menstrual flow, menarcheal age and cigarette smoking. The severity of dysmenorrhoea was not associated with age as an isolated factor, nor with height, weight, length of menstrual cycle or frequency of physical exercise.     

Trends in asthma mortality in Taiwan, 1981-2000.

BACKGROUND AND PURPOSE: The prevalence and mortality rates of asthma in many countries have increased in the past 2 decades. The purpose of this study was to determine the trends of asthma mortality in Taiwan from 1981 through 2000. METHODS: Data from the National Health Statistics for Taiwan identifying asthma [International Classification of Disease (ICD)-9 code 493] as the underlying cause of death were collected. Age-specific and age-adjusted mortality rates of asthma were calculated and the 20-year trends were analyzed. RESULTS: The crude mortality rate of asthma decreased from 8.17 to 4.53 per 100,000 general population, and the age-adjusted mortality rate decreased from 8.17 to 2.37 per 100,000 during the 20-year period. This trend of decreasing mortality was most obvious for age groups older than 35 years, i.e., from 4.05 to 1.20 per 100,000 in those aged 35 to 54 years and from 47.43 to 13.44 per 100,000 in those aged 55 to 74 years. The mortality rate for asthma in those aged 15 to 34 years remained the same, around 0.40 to 0.35 per 100,000 population. For those below 15 years of age, the mortality rates for asthma fluctuated between 0.30 and 0.10 per 100,000 population. CONCLUSIONS: The mortality rate of asthma has steadily decreased in Taiwan in the past 20 years, especially in the age groups above 35 years.     

Factors influencing the prevalence and severity of dysmenorrhoea in young women

Summary. Factors influencing the prevalence and severity of dysmenorrhoea were assessed longitudinally in a representative sample of young women born in 1962. The prevalence of dysmenorrhoea was lower ( P <0.01) at 24 years of age than at 19 years of age. At 24 years of age, 67% of the women still experienced dysmenorrhoea; 10% reported dysmenorrhoea which limited daily activity. The severity of dysmenorrhoea (linear analogue scale) was lower (P<0·001) at 24 years of age (3·4, SD 2.8) than at 19 years (4.1, SD 3.2). The prevalence and severity of dysmenorrhoea were reduced (P<0.05) in women who were parous in 1986 and nulliparous in 1981; but was unchanged in women who were still nulliparous or women who had had a miscarriage or abortion. Dysmenorrhoea was reduced (P<0.001) in oral contraceptive users. The severity of dysmenorrhoea was significantly associated with the duration of menstrual flow, menarcheal age and cigarette smoking. The severity of dysmenorrhoea was not associated with age as an isolated factor, nor with height, weight, length of menstrual cycle or frequency of physical exercise.     

Job and life satisfaction among remote physicians in Taiwan.

To determine the nature and current level of job and life satisfaction among remote physicians in Taiwan, 115 physicians practicing in 31 aboriginal townships and on 3 offshore islands were interviewed through a mail survey. Out of 95 respondents, 93% were male. The average age was 46.0 years, and 82% of the physicians practiced only primary care. About half of the respondents had not received any residency training prior to their beginning practice. Physicians aboriginal areas and on offshore islands appear to be moderately satisfied with their jobs and with their lives in general. In aggregate, the areas of greatest job satisfaction included their contacts with other physicians and their relationships with other health care workers. Areas of least satisfaction included physicians' salary/income and their opportunities for promotion in the future. Most respondents felt that the greatest causes of work stress were the realities of medical practice and the time pressures. Areas of least stress included clinical competence/interpersonal relations and anxieties about the future. In aggregate, the areas of lowest life satisfaction included the physicians' incomes and the lack of leisure activities. It is suggested that a family practice residency training course prior to practice and access to continuing medical education programs are urgently needed for remote physicians in Taiwan. On the other hand, economic incentives seem to be the best strategy to increase the job and life satisfaction of these physicians.     

Contraceptive prevalence among young women in Nigeria.

In almost all societies in the world there is an increase in sexual activity among young persons (10-24 years). There is a need for contraceptive use among them to prevent high risk unintended pregnancies. This study was carried out to determine the contraceptive prevalence among young women in Nigeria. The study population was 832 young women between the ages of 15 and 24 years. Only 11.1% of the respondents had ever used contraceptives although 63.2% of them had had sexual intercourse. Contraceptive usage was significantly higher (p<0.05) among the single sexually active women (38.5%) than among the married women (7.7%). Only 7.3% of respondents are currently using a contraceptive method. The main methods in use were condoms and pills. There is an unmet need for contraceptives among young women in Nigeria. It is necessary to improve these young women's abilities to protect themselves against unwanted pregnancies.     

The evolving national birth prevalence of Down syndrome in Taiwan. A study on the impact of second-trimester maternal serum screening

OBJECTIVES: The aim of the present study was to determine whether the liberal use of second-trimester maternal serum screening in Taiwan started in 1994 had a measurable impact on birth prevalence of infants with Down syndrome (DS) in the past decade. METHODS: We based our study on the databases of 'National Birth Defect Registration and Notification System', 'Amniocentesis in Pregnant Women', and 'Demographic Fact Book' in Taiwan. Collected data included total registered birth number, the registered number of stillbirths, the registered numbers of live births and of DS stillbirths affected with DS, amniocentesis rates each year in pregnant women aged 35 or more, and the age distribution of pregnant women in Taiwan. The live birth rate of and total birth rate of fetuses affected with DS, and the rates of live birth and stillbirth to total birth with DS, were analyzed year by year, in order to understand the change of birth rate of infants affected with DS between 1993 and 2001. Those with isolated cleft palate (ICP) were also analyzed as internal control variable. Confidence interval of live birth rate of infants with DS under Poisson distribution was calculated. Chi-square test for trend in binomial proportions was performed to see if there is an increasing (or decreasing) trend in the proportion of incidence of fetuses affected with DS. The difference was statistically significant if a p value was <0.05. RESULTS: A total of 1 331 616 deliveries were collected during the study period, including 840 cases of DS confirmed by karyotyping study. A marked decrease in the live birth rates of case with DS occurred in 1994-95, from 0.63 per 1000 births to 0.23 per 1000 births. There was a crossover from more live births with DS to more stillbirths with DS during 1994 to 1996 after the implementation of second-trimester maternal serum screening for DS in 1994. In 1993, 76.9% of births diagnosed with DS were born alive, compared to 32.5% in 2001 (p < 0.001). CONCLUSIONS: The policy of prenatal diagnosis program including amniocentesis for pregnant women aged 35 or more and the liberal application of maternal serum screening for DS in younger women was responsible for the marked decrease in the live births affected with DS in Taiwan from 1993 to 2001.     

Higher prevalence of goiter in endemic area of blackfoot disease of Taiwan.

Blackfoot disease is an endemic peripheral vascular disorder which is confined to a limited land area on the southwest coast of Taiwan. It has long been related to the consumption of high levels of arsenic found in the artesian well water. Humic substances have also been extracted from the well water and have been reported as a possible source of environmental goitrogen. The purpose of this study was to examine whether the prevalence of goiter is increased in the blackfoot disease-endemic area. This study covered all the children in the elementary schools of Putai and Peimen. They were divided into two groups according to the location of schools in the endemic area or non-endemic area of blackfoot disease. Thyroid enlargement was examined by palpation as recommended by the World Health Organization. Thyroid antibodies and hormones were determined in school children with a goiter and age-sex-matched normal control children using particle agglutination methods and radioimmunoassays, respectively. Aspiration cytology was done in cases with a nodular goiter. In total 4,567 school children were examined, including 2,306 males and 2,261 females. One hundred and twenty school children (2.63%) had a goiter of grade I or above. The prevalence of goiters in school children from the endemic area was higher than that from the non-endemic area (3.44 vs 2.08%, p less than 0.01). The prevalence of goiters in females from the endemic area was higher than that from the non-endemic area (4.65 vs 2.69%, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)     

Latex allergy and latex-fruit syndrome among medical workers in Taiwan.

BACKGROUND AND PURPOSE: Latex allergy is a serious occupational health problem among medical workers, but there are few data regarding its incidence and clinical characteristics in Taiwan. No data on the latex-fruit syndrome in Taiwan have been reported. This study investigated the prevalence of both latex allergy and latex-fruit syndrome, and risk factors for the development of latex allergy among medical workers. METHODS: A total of 302 medical workers who had daily contact with latex gloves during work at three hospitals in central Taiwan were interviewed and screened by questionnaire to detect allergic reactions to latex. Those with a history of immediate allergic reaction to latex gloves were screened for specific IgE antibodies against latex. Subjects whose screening results were positive were considered to have immediate latex allergy. Latex-fruit syndrome was defined as a clinical condition that manifested as immediate allergic reactions to both latex and fruit. RESULTS: Twenty-six (8.6%) medical workers had immediate allergic reactions to latex. The severity of latex allergy was correlated to the serum level of latex-specific IgE. Seven subjects with latex allergy (26.9%) had latex-fruit syndrome. Risk factors for development of latex allergy among medical workers were latex glove-related hand dermatitis, fruit allergy, preexisting atopic disease, hospital employment for more than 2 years, and total exposure to latex gloves of more than 9,000 hours. CONCLUSION: Latex allergy is an underrecognized occupational health problem in Taiwan. Early identification of medical workers at high risk is important so that they can be advised to use non-latex gloves as early as possible to prevent further sensitization to latex proteins.     

Occupational exposure and respiratory morbidity among asbestos workers in Taiwan.

To determine the prevalence of asbestos-related lung disease and the impairment of lung function among asbestos workers, we conducted a cross-sectional health survey of 459 workers in 33 asbestos-related factories in Taiwan. Each worker was asked about his medical and occupational history and was given a medical examination, chest roentgenogram and pulmonary function test. Manufacturing processes included production of asbestos cements, textiles, friction materials and insulation products. Exposure assessments were based on asbestos sampling and counting using a phase contrast microscope. The average age of the participants in the study was 41.6 years. They had an average of 8.1 years of dust exposure, with a range of one to 42 years. The majority had a cumulative asbestos exposure of less than 20 fiber years/mL. No case of asbestos-related lung disease was found during our investigation. No roentgenogram showed unequivocal changes of asbestosis. However, a multiple linear regression analysis of the pulmonary function test showed that both FVC and FEV1 decreased significantly with an increasing cumulative dose of exposure after controlling for age, height and smoking effects during analysis. FEV1/FVC and FEF25-75% were not affected by exposure dose. The absence of asbestosis and other asbestos-related lung diseases may be due to an inadequate induction time of asbestos exposure and a possible healthy selection of workers. We conclude that among workers in Taiwan, there is a significant effect on the respiratory system, especially pulmonary function, due to asbestos exposure.     

Epidemiologic study of carcinoma in situ of the cervix

From 1950 to 1979, 1,248 cases of cancer in situ were treated in the Department of Gynecology, Cancer Institute Hospital, Tokyo. Detailed data were obtained from 585 of the patients by interview. Many patients had had their first sexual experience at an early age. Many had had more than two sexual partners, and there was a large discrepancy between the age at first sexual intercourse and at first marriage. The above factors seem to be related to the development of cancer in situ.     

Epidemiologic study of extra-uterine pregnancy. Apropos of 375 cases

From a retrospective study over 11 years of 375 ectopic pregnancies, the authors have analyzed the epidemiological factors that could account for a very sensible and regular increase of the frequency of this gravidic accident. If a past history of tubal infection is usually considered as a major cause, in this series, we must mainly consider the abnormal frequency of the use of a modern contraceptive method at the time of the ectopic pregnancy, found in 32% of the cases. The place and the role of intra-uterine devices are discussed since a coil was associated with an ectopic pregnancy in 22.5% of the patients while the notion of a previous usage does not seem to be a predisposing factor: approximately only 2% of these patients had resorted to it. A hormonal contraception in progress may also lead to a late diagnosis, especially in patients using mini and micro-pills (8% of ectopic pregnancies). Finally, the advantages of conservative tubal surgery contingent on an earlier diagnosis are kept in mind by the authors because of the persistence of a high recurrence rate on the contralateral side, even after salpingectomy.     

Traditional fertility regulation among the Yoruba of southwestern Nigeria. I. A study of prevalence, attitudes, practice and methods

This study was conducted among Yoruba women and traditional healers with the aim of identifying and describing the practice, preparation, and administration of traditional contraceptives. The data were obtained in 1990 from a random sample of 1,400 women of childbearing age and 42 traditional healers in Nigeria's Oranmiyan area, using questionnaires and in-depth interviews. Findings revealed that knowledge of the traditional contraceptives is nearly universal among the Yoruba population, and the traditional contraceptive prevalence rate is 7.1 percent. The use of traditional contraceptives was significantly more common among uneducated women and among women aged 20 to 29 years old. Findings also revealed the existence of four main varieties of traditional contraceptive devices, the methods of preparation of the traditional contraceptives, varieties of herbal and animal products used, methods of administration, and taboos against usage. The easy accessibility of traditional medical practitioners and the belief that traditional contraceptive devices are devoid of complications, especially among those experienced with modern contraceptive devices, were the main reasons women cited for patronizing the traditional practitioners. The paper concludes with policy implications for family planning programmers in Nigeria.     

Epidemiologic study of trichomoniasis in normal women

The prevalence of trichomonas vaginalis in a relatively unselected group of 4341 30-45 year old white women from Washington County, Maryland, was examined in Papanicolaou stained smears prepared by the self-administered irrigation smear method. 14.5% of the 4290 satisfactory smears were classified as positive for T. vaginalis. This may have been underestimated since over 1/2 of the group showed few parasites. 2.7% of the total (20% of the positive group) had heavy infestations. There was an insignificant increase between 30-34 and 40-45 year old women (13.6%-15.2%). There was a negative association between the amount of schooling and incidence of infection. Married women had 1/2 the infection incidence of widowed or never married women and one-third the incidence of divorced or separated women, a a pattern which differs from other reports. However, symptomatic unmarried women may have responded to the survey in greater numbers than symptomatic unmarried women, biasing the results. There was a significantly higher incidence of trichomoniasis among women married several times than among women married only once. There was a correlation between age at first marriage and infection incidence. The use of intravaginal contraceptive agents may have an effect on the trichomonads. There was no correlation with religion or size of household. Inverse correlations were noted between income, occupation of husband, crowding and sanitary facilities and trichomoniasis infection with an exception being the low frequency among farm women. Moderate and heavy cigarette smokers had higher infection rates than light and nonsmokers, and there was a high association of trichomoniasis with abnormal cytologic findings. These were all consistent with a venereal mode of transmission.