Taoyuan Centre

Personnel

• Dr Chun-Chieh Kao

Why was Taoyuan selected for ISAAC?

In Taiwan, there was limited literature to disclose the prevalence, severity, and seasonal variations of allergic diseases, especially the seasonal variations in a large-scale survey in recent years. The aim of the present study was to use the ISAAC protocol to investigate the prevalence, severity, demographic and seasonal variations of asthma and other allergic diseases in Taiwan in a county sample of school children aged 6-7 years and 13-14 years. Besides, we also wanted to know the prevalence and severity about Taiwanese aborigines in Taoyuan County of Taiwan (Taoyuan Center).

Our experience of ISAAC

The ISAAC Phase Three parents-administered translated questionnaire for children aged 6 to 7 years, was used for children in the first grade in the elementary school. The same questionnaire, with some changes to fit with ISAAC Phase Three recommended version for children aged 13 to 14 years, was used for children in the eighth grade in the junior high school. The ISAAC standard questionnaire consisted of three main sections, each involving questions relating to the prevalence and severity of wheezing, rhinitis, and eczema respectively. These questionnaires had been validated in previous studies. The questions concentrated mainly on past and current wheezing episodes, frequency of wheezing attacks, sleep disturbance and speech limitation during attacks, acute severe wheezing episodes, exercise-induced wheezing, night-time cough unrelated to respiratory infection and a doctor’s diagnosis of asthma. The core questionnaires for rhinitis and eczema followed a similar format. As all the schoolchildren and parents speak Mandarian fluently in Taiwan, they were given to answer a Chinese version of the questionnaire despite a small number of Aborigine in the Taoyuan County of Taiwan. The Chinese version of the questionnaire had been back-translated as a validity check, according to defined guidelines. We opted to add several questions about seasonal variations of asthma to explore the connection with asthma and hospital admissions for asthma.

Sampling and Data Collection

The studied area was Taoyuan County, northern Taiwan, and grade 1 or grade 8 children were recruited. According to ISAAC protocol, school was the sampling unit and twenty-five schools were stratified cluster selected from 10 districts in Taoyuan County . The eighth-grade children (aged 13-14 years) filled the questionnaires during class hours under the supervision of their class teacher, and first-grade children (aged 6-7 years) took the questionnaires home to have it filled in by their parents or guardian and returned it within a week. For children who missed the school during our visit, a questionnaire was given another day. This study protocol, sampling method, data had submitted to ISAAC and permission was obtained (area code 113003).

A total of 6771 questionnaires were supposed to be collected between May and June of 2002 and 6483 questionnaires were returned with a total response rate of 95.7% (92.7% in the younger age group, and 99.1% in the older children). Excluding 21 due to ineligible age and 275 due to missing answers in the diagnosed questions on either asthma, rhinitis, or eczema, a total of 6187 school children were included for this study. Our results had been published in the Journal of Pediatric Allergy and Immunoloy(PAI).

We gratefully acknowledge all members in the work team from Taipei center and Lishin hospital in Taoyuan center. We wish to thank all parents, children and school staff who participated in the surveys and also our fieldworkers team for their enthusiasm and effort thoughout each study.