title: Incidence and risk factors associated with acute mountain sickness in children trekking on Jade Mountain, Taiwan.
abstract: BACKGROUND
  Acute mountain sickness (AMS) is a pathophysiological symptom complex that occurs in high-altitude areas. The incidence of AMS on Jade Mountain, the highest peak in Taiwan (3952 m), has been reported to be ∼36%. There is a lack of data in children trekking at altitude in Taiwan. The purpose of this study was to determine the incidence, risk factors and symptoms of AMS in children trekking on Jade Mountain, Taiwan.
  
  
  METHODS
  This prospective cohort study included a total of 96 healthy non-acclimatized children aged 11-12 years who trekked from an elevation of 2600-3952 m in 3 days. The Lake Louise AMS score was used to record symptoms associated with AMS.
  
  
  RESULTS
  AMS were reported in 59% of children trekking on Jade Mountain over a 3 day period. AMS incidence increased significantly with increasing altitude. The most common AMS symptom was headache, followed by fatigue or weakness, difficulty sleeping, dizziness or lightheadedness and gastrointestinal symptoms. Children who had experienced upper respiratory infection (URI) within the 7 days before their trek tended to have a greater risk for development of AMS. AMS incidence did not significantly differ according to gender, recent acute gastroenteritis, menstruation and body mass index.
  
  
  CONCLUSIONS
  The incidence of AMS in children trekking on Jade Mountain is greater than that observed in adults, and was associated with altitude and recent URI.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Taiwan Wilderness Medical Association, Taiwan.
authors.forename: Cheng-Wei
authors.initials: CW
authors.lastname: Chan
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yin-Chou
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chiu
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Taiwan Wilderness Medical Association, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan, Department of Emergency Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
authors.affiliation: Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yu-Jr
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Taiwan Wilderness Medical Association, Taiwan, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan, Altitude Research Center, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA, mountainwangsh@gmail.com.
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Taiwan Wilderness Medical Association, Taiwan, Department of Emergency Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Tai-Yi
authors.initials: TY
authors.lastname: Hsu
authors.affiliation: Taiwan Wilderness Medical Association, Taiwan, Department of Emergency Medicine, Taiwan Adventist Hospital, Taipei, Taiwan and Department of Physical Education, National Taitung University, Taitung, Taiwan.
authors.forename: Kuo-Feng
authors.initials: KF
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Te-Fa
authors.initials: TF
authors.lastname: Chiu
mesh_terms: D000208:Acute Disease; D000531:Altitude; D000532:Altitude Sickness / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D005260:Female; D006261:Headache; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014195:Travel
keywords: Acute mountain sickness; Jade mountain; Taiwan; children at high altitude; upper respiratory infection