Epidemiological features of biliary atresia in Taiwan, a national study 1996-2003.
OBJECTIVE
The incidence of biliary atresia (BA) varies among different countries. It is supposed to be higher in Asian countries than in Western countries; however, the incidence of BA in Taiwan has not been well investigated. The aim of this study was to analyze the epidemiological characteristics and the incidence of BA in Taiwan.


METHODS
National Health Insurance (NHI) was implemented in Taiwan in 1995, and covers most of the population (>99%). We use the NHI database to investigate the epidemiological features of BA and compare Taiwan's annual BA incidence with that of other countries.


RESULTS
We identified 327 new BA cases during the period from 1996 to 2003. The overall incidence of BA was 1.46 cases per 10 000 live births (0.89-1.90 per 10 000). The estimation was 1.32-1.65 per 10 000 after adjustment for the misdiagnosis rate. The peak incidence occurred in 2002 (1.90 per 10 000), accompanying Taiwan's dengue fever epidemic in 2002. The 5-year overall survival rate during 1999-2003 was higher than that during 1996-1998 (74.8% vs 61.1%, P = 0.014).


CONCLUSIONS
Taiwan has the second-highest incidence of BA reported in world literature. Viral infection outbreaks remain a potential candidate as a cause of BA. The management of BA has been improving, with a better 5-year overall survival rate.
Tiao
Mao-Meng
MM
Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Tsai
Shang-Shyue
SS
Kuo
Hsin-Wei
HW
Chen
Chao-Long
CL
Yang
Chun-Yuh
CY
D001656:Biliary Atresia / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000706:statistics & numerical data; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000706:statistics & numerical data; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome