台湾地区 2012-2015 年食源性疾病负担。

Disease burden from foodborne illnesses in Taiwan, 2012-2015.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Huxi Township Public Health Center, Public Health Bureau, Penghu County, Penghu, Taiwan.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2020 Sep;119(9):1372-1381. doi: 10.1016/j.jfma.2020.03.013. Epub 2020 Apr 5.

DOI:10.1016/j.jfma.2020.03.013

PMID:32268967

Abstract

BACKGROUND/PURPOSE: Foodborne disease is a global health problem. We aim to provide the first national estimate on disease burden from foodborne illnesses in Taiwan.

METHODS

We adopted the World Health Organization (WHO) Foodborne Disease Burden Epidemiology Reference Group (FERG) methodology framework, and used a hazard-based incidence approach to calculate disability-adjusted life year (DALY) lost to foodborne diseases. Estimated annual incidences and associated medical costs are based on the National Health Insurance research database. We redistributed incidence of unspecified acute gastroenteritis to specific foodborne pathogens, using reported bacteria, virus, parasite survey results in such cases as the reference. The percentage of foodborne illnesses not seeking medical attention is based on data reported from a nationwide survey.

RESULTS

During 2012-2015, 3,895,914 (90% confidence interval [CI]: 3,493,530-4,442,690) foodborne illnesses (1,445,384 sought medical care, with 50 deaths) occurred annually, which caused a total loss of 4974 (90%CI: 4671-5367) DALYs in Taiwan. The annual medical cost was NT$1.3 billion. Young (<5 years) children had the highest incidence. Among the 53% of foodborne illnesses cases with identifiable causal microorganisms, non-typhoid Salmonella, norovirus, and Vibrio parahaemolyticus were leading pathogens (annual foodborne incidence: 185,977, 157,656, and 99,351, respectively). Cases caused by non-typhoid Salmonella peaked in summer, while that caused by norovirus peaked in winter.

CONCLUSION

Foodborne illnesses cause a substantial disease burden in Taiwan. Establishment of active surveillance and investigation mechanisms for the leading foodborne pathogens is warranted.

摘要

背景/目的：食源性疾病是一个全球性的健康问题。本研究旨在提供台湾地区食源性疾病负担的首个国家估计值。

方法

我们采用世界卫生组织（WHO）食源性疾病负担流行病学参考组（FERG）的方法框架，并采用基于危害的发病率方法来计算食源性疾病导致的残疾调整生命年（DALY）损失。估计的年发病率和相关医疗费用基于全民健康保险研究数据库。我们根据报告的细菌、病毒、寄生虫调查结果，将未指明的急性胃肠炎的发病率重新分配给特定的食源性病原体。未就医的食源性疾病的比例基于全国性调查的报告数据。

结果

在 2012 年至 2015 年期间，台湾每年发生 3895914 例（90%置信区间[CI]：3493530-4442690）食源性疾病（1445384 例寻求医疗救治，其中 50 例死亡），导致台湾总共有 4974 个（90%CI：4671-5367）DALY 损失。年医疗费用为 13 亿新台币。年幼（<5 岁）儿童的发病率最高。在 53%可识别病因微生物的食源性疾病病例中，非伤寒沙门氏菌、诺如病毒和副溶血性弧菌是主要病原体（食源性疾病年发病率分别为 185977、157656 和 99351）。非伤寒沙门氏菌引起的病例在夏季达到高峰，而诺如病毒引起的病例在冬季达到高峰。