Evidence regarding the association between body mass index (BMI) and mortality in TB patients is limited and inconsistent. We investigated the effect of BMI on TB-specific and non-TB-specific mortality in TB patients. All adult Taiwanese with TB in Taipei, Taiwan, during 2011 to 2012 were included in this retrospective cohort study. Multinomial logistic regression was used to evaluate associations of BMI with cause of death in TB patients. Of the 1608 eligible patients, 83.6% (1345) were successfully treated, 3.3% (53) died of TB-specific causes, and 13.1% (210) died of non-TB-specific causes. Mean age was 64.6 years, and 67.5% of patients were male. After controlling for potential confounders, underweight was significantly associated with higher risks of all-cause mortality (adjusted odds ratio [AOR], 1.66; 95% confidence interval [CI], 1.21-2.30), TB-specific mortality (AOR, 2.14; 95% CI, 1.18-3.89), and non-TB-specific mortality (AOR, 1.58; 95% CI, 1.11-2.25) during TB treatment, while overweight was not. When gender differences on the association of BMI with mortality were considered, underweight only significantly increased risks of TB-specific (AOR, 2.37; 95% CI, 1.19-4.72) and non-TB-specific mortality (AOR, 1.58; 95% CI, 1.05-2.37) during treatment in male patients, but not female subjects.T he present findings indicate that underweight was associated with higher risks of TB-specific and non-TB-specific mortality during TB treatment, particularly in male patients.

Background: The tuberculosis reporting enquiry system was launched in Taiwan in 2001. Tuberculosis has been categorized as the third most important notifiable disease in Taiwan and the time required for reporting has been shortened to 7 days. Methods: A total of 114,827 cases were reported using the Taiwan enquiry system between 2002 and 2006; of these, 26,027 (22.7%) were finally diagnosed as not being tuberculosis, 7,005 (8.2%) were diagnosed as extra-pulmonary tuberculosis and 3,677 (3.2%) were not a first-time diagnosis of tuberculosis, and these cases were hence excluded. Diagnosis time was defined as the length of time between the first medical examination (including chest radiography, sputum smear or sputum culture) to the diagnosis of PTB; treatment time was defined as the period from the diagnosis of PTB to the initiation of treatment. Using the cut-off at the 75^th percentile, a period of longer than 9 days was defined as a diagnosis delay and a period of longer than 2 days as a treatment delay. Multiple logistic regression analysis was applied to analyze the risk factors associated with these delays. Results: During the five-year study period, among the 78,118 new PTB patients reported in Taiwan, the mean diagnosis and treatment times were 12 and 5 days and the median times 1 day and 0 days, respectively. In total, 24.9% of the new PTB patients' diagnosis time delays were longer than 9 days and 20.3% of the patients' treatment time delays were longer than 2 days. The main factors associated with diagnosis delay included age, reporting year, living with family and a positive sputum culture (p < 0.0001); the risk factors significantly associated with treatment delay were increased age, an aboriginal ethnic background, a positive sputum culture and diagnosis at a non-medical center (p < 0.0001). Conclusion: The Taiwan TB reporting enquiry system has successfully increased the confirmed PTB reporting rate from 64.4% to 71.5%. Greater age and a positive sputum culture were both found to significantly increase both diagnosis and treatment delays; treatment delay is also significantly affected by the patient having an aboriginal ethnic background and being diagnosed at a non-medical center.

Alcohol consumption is a significant public health issue worldwide. The rat model and epidemiological studies have both reported conflicting results about the effects of alcohol on the kidneys. We aimed to explore the relationships between alcohol consumption and chronic kidney disease. Data from the National Health Interview Survey, the National Health Insurance research database, and the National Deaths Dataset were used. Standardized in-person interviews were executed in 2001, 2005, and 2009 to obtain the demographic characteristics of study population. The participants were followed up until 2013. The primary outcome was new-onset chronic kidney disease. We analyzed 45,200 adults older than 18 years (50.8% men and 49.2% women), and the overall mean (SD) age was 42.73 (16.64) years. During the 8.5 (3.5) years of follow-up, new-onset chronic kidney disease was recognized in 1535 (5.5%), 292 (2.7%), and 317 (4.9%) non-drinking, social-drinking, and regular-drinking participants, respectively. The participants who were social and regular drinkers had a significantly decreased risk of chronic kidney disease incidence (social drinking: adjusted hazard ratio (HR), 0.85; 95% confidence interval (CI), 0.74–0.97; p = 0.018; regular-drinking: AHR, 0.85; 95% CI, 0.74–0.98; p = 0.024), with baseline demographics and comorbidities adjusted. In conclusion, social and regular drinkers had decreased risk of chronic kidney disease when compared with non-drinkers.

Background: Injecting drug users (IDUs) in Taiwan contributed significantly to an HIV/AIDS epidemic in 2005. In addition, studies that identified risk factors of HCV/HIV co-infection among IDUs were sparse. This study aimed to identify risk factors of HCV/HIV co-infection and HCV mono-infection, as compared with seronegativity, among injecting drug users (IDUs) at a large methadone maintenance treatment program (MMTP) in Taipei, Taiwan. Methods: Data from enrollment interviews and HCV and HIV testing completed by IDUs upon admission to the Taipei City Hospital MMTP from 2006–2010 were included in this cross-sectional analysis. HCV and HIV testing was repeated among re-enrollees whose HCV or HIV test results were negative at the preceding enrollment. Backward stepwise multinomial logistic regression was used to identify risk factors associated with HCV/HIV co-infection and HCV mono-infection. Results: Of the 1,447 IDUs enrolled, the prevalences of HCV/HIV co-infection, HCV mono-infection, and HIV mono-infection were 13.1%, 78.0%, and 0.4%, respectively. In backward stepwise multinomial regression analysis, after controlling for potential confounders, syringe sharing in the 6 months before MMTP enrollment was significantly positively associated with HCV/HIV co-infection (adjusted odds ratio [AOR]=27.72, 95% confidence interval [CI] 13.30–57.76). Incarceration was also significantly positively associated with HCV/HIV co-infection (AOR=2.01, 95% CI 1.71–2.37) and HCV mono-infection (AOR=1.77, 95% CI 1.52–2.06), whereas smoking amphetamine in the 6 months before MMTP enrollment was significantly inversely associated with HCV/HIV co-infection (AOR=0.44, 95% CI 0.25–0.76) and HCV mono-infection (AOR=0.49, 95% CI 0.32–0.75). HCV seroincidence was 45.25/100 person-years at risk (PYAR; 95% CI 24.74–75.92/100 PYAR) and HIV seroincidence was 0.53/100 PYAR (95% CI 0.06–1.91/100 PYAR) among re-enrolled IDUs who were HCV- or HIV-negative at the preceding enrollment. Conclusions: IDUs enrolled in Taipei MMTPs had very high prevalences of HCV/HIV co-infection and HCV mono-infection. Interventions such as expansion of syringe exchange programs and education regarding HCV/HIV prevention should be implemented for this high-risk group of drug users.

Background Health-related quality of life (HRQOL) is widely used as an indicator of health status. However, few studies have examined predictors of HRQOL among injection drug users (IDUs). We investigated factors associated with HRQOL among IDUs in Taiwan. Methods In this cross-sectional study, recruited IDUs completed an HRQOL-related interview at methadone clinics in Taipei during 2012–2013. Multiple linear regression was used to identify factors associated with HRQOL. Results Of 802 eligible participants, 85.4% were male; mean (SD) age was 44.7 (8.7) years. Mean scores for physical, psychological, social, and environmental HRQOL were 13.2, 11.8, 12.5, and 12.5, respectively. In multivariate analysis, social support was significantly associated with better HRQOL in all domains (β = 0.56, 0.87, 0.83, and 0.64, respectively), while obtaining most income from temporary jobs or other noncriminal sources was significantly associated with worse HRQOL in all domains (β = −1.00, −1.03, −1.15, and −1.22, respectively). Receiving methadone treatment was associated with good physical and psychological HRQOL (β = 1.47 and 0.79, respectively), while history of drug overdose (β = −0.40 and −0.53, respectively), history of cutaneous abscess (β = −0.45 and −0.53, respectively), and human immunodeficiency virus (HIV) positivity (β = −0.41 and −0.58, respectively) were associated with lower physical and psychological HRQOL. Male sex (β = −0.64 and −0.70, respectively) and a greater number of incarcerations (β = −0.11 and −0.12, respectively) were associated with poor social and environmental HRQOL. Conclusion Poor HRQOL was associated with a number of factors among IDUs at methadone clinics in Taipei, Taiwan. To improve HRQOL in this population, future programs should focus on IDUs with a history of drug overdose. In addition, methadone programs and social support should be integrated to improve HRQOL among this socially marginalized population.

Participatory technology assessment often holds sessions for experts to inform laypersons about scientific controversies. However, few studies examine how these laypersons perceive experts and make policy recommendations. The purpose of this study was to examine interactions between experts and laypersons in two consensus conferences in Taiwan to find illuminating illustrations. Quantitative and qualitative methods were employed to understand the cases. We found that in each of the two consensus conferences, on average the level of laypersons’ science literacy in terms of content was improved and their attitudes toward scientific controversies changed. Expert lectures were perceived as the most important element in influencing participants’ knowledge learning and attitude changes. However, in exchanging views with experts, laypersons could not only identify biases, normative positions, and personal preferences in experts’ seemingly objective talks, but could also raise reflective, worthy viewpoints that were not articulated by the experts. Implications of the findings to research and practices of participatory technology assessment were discussed. 科技相關的公共政策, 經常落入科技專家或利益團體的獨斷控制, 不利於民眾參與, 明顯違背民主政治的基本理念。丹麥型的公民共識會議, 以審議民主為本, 針對有重大爭議的科技政策, 提供專家和一般民眾較民主、較平等的對話機制, 以聽取民眾於知情理性公開討論下, 所形成的共識意見。本研究以2004年於台灣舉辦的代理孕母公民共識會議和產前篩檢與檢測公民共識會議為例, 深入分析一般民眾和專家之間的互動, 民眾科技知能和態度的變化, 特別是專家歧見下, 民眾如何看待這些意見並形成他們的看法。本研究關注專家和一般民眾之間的溝通權力和地位的不對等。本研究發現, 民眾與專家對話後, 不但能分辨專家的歧見和偏見, 亦能提出超越專家盲點的見解。過程中, 民眾對科技的理解, 有明顯的轉變, 民眾認為這些轉變受專家演講影響最大, 而民眾的團體討論也有相當的影響力。此外, 專家對科學的理解也需要並且也應該有機會被轉變, 但事實如何, 如何促進, 值得後續研究努力