Understanding public interest and needs in health policies through the application of social network analysis on a governmental Facebook fan page.

BACKGROUND: This study analyzed the interactions between agencies, policies, and the interest of the public using a social network analysis. METHODS: Open data on the 2017 Facebook fan page of the Ministry of Health and Welfare (MoHW) in Taiwan, including 18,193 messages, were analyzed by conducting a social network analysis, NodeXL (Network Overview, Discovery and Exploration for Excel), creating visualized explorations using size volumes to present the degree of strength between agencies and policies to further calculate the network centrality indicators of agencies and policies. RESULTS: Agencies of the "Social and Family Affairs Administration" and "Health Promotion Administration" contributed the most policy posts. The policy of "Physical and mental health promotion" entailed the most agencies to be involved. The "Department of Nursing and Health Care" received the largest public response, for which "Long-term care" received the most public interest. CONCLUSIONS: A social network analysis of fan page of Taiwan's top level health government agency can reveal the government's most emphasized core policies, the strength of correlations between agencies and policies, and provide an understanding of public interest toward the policies.

Seroepidemiology of dengue virus infection among adults during the ending phase of a severe dengue epidemic in southern Taiwan, 2015.

BACKGROUND: A severe dengue epidemic occurred in 2015 which resulted in over 22,000 laboratory-confirmed cases. A cross-sectional seroprevalence study was conducted during the ending phase of this epidemic to evaluate the true incidence of dengue virus (DENV) infection and the level of herd immunity. METHODS: Adult residents in three administrative districts with high dengue incidence were recruited; workers in two districts with intermediate dengue incidence were also recruited for comparison. DENV-specific IgM and IgG were tested using commercial enzyme-linked immunosorbent assays. DENV RNA was detected using commercial quantitative real-time reverse transcriptase polymerase chain reaction assay. Univariate and multivariate logistic regressions were performed to identify risk factors for recent and past DENV infection. RESULTS: The overall seroprevalence of anti-DENV IgM and IgG in 1391 participants was 6.8 and 17.4%, respectively. The risk of recent DENV infection increased with age, with the elderly having the highest risk of infection. Living in areas with high incidence of reported dengue cases and having family members being diagnosed with dengue in 2015 were also independent risk factors for recent DENV infection. One sample was found to have asymptomatic viremia with viral load as high as 105 PFU/ml. CONCLUSIONS: Comparing the seroprevalence of anti-DENV IgM with the incidence of reported dengue cases in 2015, we estimated that 1 out of 3.7 dengue infections were reported to the surveillance system; widespread use of rapid diagnostic tests might contribute to this high reporting rate. The results also indicate that the overall herd immunity remains low and the current approved Dengvaxia® is not quite suitable for vaccination in Taiwan.

National health data linkage and the agreement between self-reports and medical records for middle-aged and older adults in Taiwan.

BACKGROUND: Characteristics associated with acceptance of dataset linkages and health data linkage data quality were analyzed. METHODS: Participants from the 2011 Taiwan Longitudinal Study on Aging were asked to link their epidemiological data with concurrent and future medical claim datasets. Characteristics associated with acceptance of data linkage, data consistency, under-reporting, and over-reporting of disease conditions were identified. RESULTS: Among the 3727 respondents, 3601 (96.6%) accepted data linkage. Middle-aged adults with worse functional health accepted data linkage. Older adults (65+) with better health behavior and social support were more likely to accept data linkage. Consistency between self-reports and medical data was very good to satisfactory (Kappa = 0.80 and 0.67, respectively, for diabetes and hypertension). Comorbidities were common risk factors resulting in inconsistency between self-reports and medical data (OR = 1.58 and 1.27, respectively, for diabetes and hypertension). Living alone was another risk factor resulting in inconsistency for diabetes. Male, older, and not living alone were other risk factors resulting in inconsistencies for hypertension. Under-reporting of illness was associated with poor health and older age. Over-reporting of illness was associated with better health and younger age. DISCUSSION: The findings suggest different adjustment methods for middle-aged versus older respondents when considering self-report data validity.

On Temporal Patterns and Circulation of Influenza Virus Strains in Taiwan, 2008-2014: Implications of 2009 pH1N1 Pandemic.

BACKGROUND: It has been observed that, historically, strains of pandemic influenza led to succeeding seasonal waves, albeit with decidedly different patterns. Recent studies suggest that the 2009 A(H1N1)pdm09 pandemic has had an impact on the circulation patterns of seasonal influenza strains in the post-pandemic years. In this work we aim to investigate this issue and also to compare the relative transmissibility of these waves of differing strains using Taiwan influenza surveillance data before, during and after the pandemic. METHODS: We make use of the Taiwan Center for Disease Control and Prevention influenza surveillance data on laboratory-confirmed subtyping of samples and a mathematical model to determine the waves of circulating (and co-circulating) H1, H3 and B virus strains in Taiwan during 2008-2014; or namely, short before, during and after the 2009 pandemic. We further pinpoint the turning points and relative transmissibility of each wave, in order to ascertain whether any temporal pattern exists. RESULTS/FINDINGS: For two consecutive years following the 2009 pandemic, A(H1N1)pdm09 circulated in Taiwan (as in most of Northern Hemisphere), sometimes co-circulating with AH3. From the evolution point of view, A(H1N1)pdm09 and AH3 were able to sustain their circulation patterns to the end of 2010. In fact, A(H1N1)pdm09 virus circulated in six separate waves in Taiwan between summer of 2009 and spring of 2014. Since 2009, a wave of A(H1N1)pmd09 occurred every fall/winter influenza season during our study period except 2011-2012 season, when mainly influenza strain B circulated. In comparing transmissibility, while the estimated per capita weekly growth rates for cumulative case numbers (and the reproduction number) seem to be lower for most of the influenza B waves (0.06~0.26; range of 95% CIs: 0.05~0.32) when compared to those of influenza A, the wave of influenza B from week 8 to week 38 of 2010 immediately following the fall/winter wave of 2009 A(H1N1) pdm09 was substantially higher at r = 0.89 (95% CI: 0.49, 1.28), in fact highest among all the waves detected in this study. Moreover, when AH3 or A(H1N1)pdm09 exhibit high incidence, reported cases of subtype B decreases and vice versa. Further modeling analysis indicated that during the study period, Taiwan nearly experienced at least one wave of influenza epidemic of some strain every summer except in 2012. DISCUSSION: Estimates of R for seasonal influenza are consistent with that of temperate and tropical-subtropical regions, while estimate of R for A(H1N1)pdm09 is comparatively less than countries in Europe and North America, but similar to that of tropical-subtropical regions. This offers indication of regional differences in transmissibility of influenza virus that exists only for pandemic influenza. Despite obvious limitations in the data used, this study, designed to qualitatively compare the temporal patterns and transmissibility of the waves of different strains, illustrates how influenza subtyping data can be utilized to explore the mechanism for various influenza strains to compete or to circulate, to possibly provide predictors of future trends in the evolution of influenza viruses of various subtypes, and perhaps more importantly, to be of use to future annual seasonal influenza vaccine design.