Epidemiology of Tuberculosis in Taiwan and Challenges Ahead

Cheng-Yi Lee1,2, Jo-Shan Wang3, Ding-Ping Liu1,2,Shiang-Lin Yang1, Shiang-Yun Huang1

2014 Vol.30 NO.6

Correspondence Author: Shiang-Yun Huang

  • 1.Epidemic Intelligence Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan.
  • 2.Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
  • 3.Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taiwan.

Abstract:

       Tuberculosis (TB) is the most fatal communicable disease and also prevailing public health threats in Taiwan. Evaluation of various TB indicators is essential for TB control and national strategy formulation.

       The incidence and mortality rate of TB in Taiwan revealed a declining trend during the period from 2005 to 2012. As for demographics, elder male is the majority affected, and the decline trend among young adults population is slower than elderly. In 2012, implementation rate of national DOTS (directly observed treatment, short-course) program reached to 96%, and the Level A was 85%. Regarding treatment outcomes, success rate among those less than 50 years-old reached to WHO goals of 85%. Drug-resistance rate among retreatment cases was higher than new cases, however, multidrug resistance rate among retreatment cases showed decreasing trend. In recent years, the majority TB cluster events were reported in campus and high-density-population institutions. TB incidence in aboriginal villages in 2012 was 3.6 times higher than national levels, however, comparing to 2005, it had decreased by 34%.  

        In brief, the control of TB in Taiwan showed preliminary progress, but still faces challenges ahead, which included WHO revised definitions and reporting framework for tuberculosis, aging population, difficult to follow-up among young adults, cluster events across jurisdictions, management of TB/HIV confection, foreign labors, foreign-born citizens and frequent international travel and trade, for instance. 

Keywords:tuberculosis, incidence, mortality, aboriginal villages, treatment outcomes, drug resistance, HIV/T