台灣結核病流行病學重探

Abstract

The resurgence of tuberculosis (TB) in Taiwan began since 1991, with a later tremendous soar-up after 1996. The epidemiological characteristics of TB in Taiwan have two points and one emerging issue. The first is the high coverage, i.e. more than 90%, of BCG vaccination in the general population. The second is the persistent high (around three to four times that of general population) TB incidence in the aboriginal mountain townships. The interference of BCG vaccination with tuberculin skin test (TST) is important and should determine the feasibility of TST as a tool for detecting TB infection in Taiwan, when TST was increasingly used for contact investigation and treatment of latent TB infection (LTBI) during the past decade. The unusual high TB incidence in aboriginal mountain areas raises the question: whether the resurgence of TB in Taiwan could be attributed to the preponderance of TB cases in the aboriginal? What’s the major pattern of transmission links between mountain areas and their surroundings? Answers to these questions have profound implications for developing TB control strategies in Taiwan. The emerging issue pertains to the increasing number of foreign laborers from countries with high-prevalence of TB. During past decade, more than 350,000 immigrants have entered this country as workers, housewives and babysitters. The potential impact of immigrant TB needs further evaluation.