Tsai Pui-Jen
The Center for General Education, Aletheia University, New Taipei, Taiwan.
Glob J Health Sci. 2013 Feb 15;5(3):101-14. doi: 10.5539/gjhs.v5n3p101.
On the main island of Taiwan, a higher risk of scrub typhus infection has been reported in endemic clusters in Southeastern Taiwan and in mountainous township areas. However, research on health care problems associated with scrub typhus in Taiwanese ethnic peoples is limited. This study employs spatial analysis of areal data to determine spatial features related to scrub typhus and the four main Taiwanese ethnicities: Hoklo, Hakka, Mainlander, and aboriginal communities, respectively.
We used a GWR spatial method to analyze the local regressed relationships between scrub typhus incidence and ethnic community percentage in 349 townships in Taiwan, and the subsequent spatial regressed resultants and local parameter estimates were compared between two periods of 2004 and 2008 by kappa statistics.
In the GWR models, the spatial regressed relationships of scrub typhus incidences and the Hoklo communities showed significant and negative parameter estimates in numerous locations, showing clusters in Southeastern and Southwestern Taiwan, and areas of the central and southern mountainous townships. Both Hakka and Mainlander communities in the mountainous townships showed less-regressed clusters with scrub typhus prevalence. However, clusters of Aboriginal populations were positively correlated with scrub typhus in highly infected mountainous areas and in Southeastern Taiwan. The kappa value results and the comparisons of local parameter estimates in the 349 townships in Taiwan between 2004 and 2008 indicated that the incidence of scrub typhus in the Hoklo communities was substantial, in the Hakka communities was fair, in the Mainlander communities was slight, and in the aboriginal communities was moderate, respectively.
The aboriginal communities have been closely associated with higher risks of scrub typhus in the mountainous townships and in the southeastern portion of Taiwan.
在台湾主岛，台湾东南部的地方性疫源地集群以及山区乡镇地区已报告有较高的恙虫病感染风险。然而，关于台湾原住民中与恙虫病相关的医疗保健问题的研究有限。本研究采用区域数据的空间分析方法，分别确定与恙虫病以及台湾四大主要族群（闽南人、客家人、外省人、原住民社区）相关的空间特征。
我们使用地理加权回归（GWR）空间方法分析台湾349个乡镇恙虫病发病率与族群社区百分比之间的局部回归关系，并通过kappa统计量比较2004年和2008年两个时期的后续空间回归结果及局部参数估计值。
在GWR模型中，恙虫病发病率与闽南人社区的空间回归关系在许多地点显示出显著的负参数估计值，在台湾东南部和西南部以及中部和南部山区乡镇地区呈现聚集现象。山区乡镇的客家人和外省人社区与恙虫病患病率的回归聚集较少。然而，在感染严重的山区和台湾东南部，原住民群体的聚集与恙虫病呈正相关。2004年至2008年台湾349个乡镇的kappa值结果及局部参数估计值比较表明，闽南人社区恙虫病发病率高，客家人社区发病率中等，外省人社区发病率低，原住民社区发病率中等。
在山区乡镇和台湾东南部，原住民社区与较高的恙虫病风险密切相关。
