台灣地區阿米巴相關疾病分析

Amoebiasis-related diseases in Taiwan

目標：探討台灣各種阿米巴病發生情形與傳染病情形。方法：採用2008－2010年全民健保門診處方治療明細檔，依ICD-9-CM篩選4,275例阿米巴病相關病例，逐年分析患者性別、年齡、就診地區及就醫情形，並與傳染病通報管理系統之阿米巴痢疾病例進行比較。結果：阿米巴病相關病例好發於男性及25－44歲者，其中以阿米巴皮膚膿瘍病例數最高，且2008－2010年無膿瘍阿米巴痢疾、阿米巴肺膿瘍及其他膿瘍等阿米巴病之病例數具逐年上升趨勢（p＜0.0001）。地理分佈上，阿米巴病病例分布以台北市居冠，惟阿米巴性皮膚膿瘍86％集中於桃園縣。阿米巴痢疾境外移入病例佔總病例之42％。結論：阿米巴性皮膚膿瘍為罕見之阿米巴病，但本研究發現其病例數為阿米巴病之冠且集中於桃園縣，待未來輔以社會人口變項以進一步釐清造成此地理分布之原因。因應阿米巴痢疾之境外移入及地理分布情形，應落實旅遊返國者及外籍勞工健康篩檢，並督促相關機構進行例行檢查及環境消毒，以預防阿米巴痢疾群聚事件；並可針對高病例數之地區或易感族群進行流行病學調查。

Objectives: To analyze the current status of amoebiasis-related diseases and amoebic dysentery in the National Notifiable Disease Surveillance System (NNDSS) in Taiwan. Methods: Using 2008-2010 Details of Ambulatory Care Orders data and categorizing amoebiasis-related diseases by ICD-9-CM diagnoses, we analyzed the gender, age, and geographical distribution of the 4,275 cases we identified. Related cases were also compared with the amoebic dysentery cases obtained from the NNDSS. Results: Amoebiasis-related diseases were more common in men than in women. Most cases occurred in the 25-44 age group. Amoebic skin ulcerations were the most common amoebiasis-related diseases. A comparison of the number of cases of amoebic dysentery without abscess, amoebic lung abscess and other amoebiasis-related diseases in 2008- 2010 showed a significantly increasing trend. Geographically, most amoebiasis cases were found in Taipei City with the exception of amoebic skin ulcerations, which were concentrated in Taoyuan County. Forty-two percent of the amoebic dysentery cases identified in the NNDSS were imported. Conclusions: Although amoebic skin ulceration is a rare amoebic disease, our study found a high number of cases concentrated in Taoyuan County. Future studies that consider social and demographic variables may clarify the reasons for such a geographic distribution. To address the importation of amoebic dysentery and its geographic distribution, health screening of returning travelers and foreign workers as well as routine inspection and environmental disinfection to prevent cluster infections should be considered. Further epidemiological studies are suggested to investigate areas with a higher proportion of cases and susceptible populations.