Young Children In Taiwan Research Articles

Analyzing the Mechanisms by Which Digital Platforms Influence Family-School Partnerships among Parents of Young Children

This research delved into the correlation between digital platforms and the dynamics of family-school collaboration within the context of parents with young children in Taiwan. It also examined the roles of parental involvement, teacher-child interactions, and online communication in this model. In the context of Taiwan, a research endeavor was undertaken to elucidate the viewpoints of parents with preschool-age children concerning digital platforms and their associated determinants. A Chinese-translated questionnaire included five latent factors: digital platforms, parental involvement, teacher-child interactions, online communication, and family-school partnerships. Employing a partial least-squares technique, we conducted an in-depth examination of the survey data, focusing on the evaluation of questionnaire latent factor reliability and validity within the measurement model. Subsequently, a path analysis was conducted to examine the hypothesized assumptions in the structural model. The findings indicated significant positive effects, with digital platforms enhancing parental involvement, teacher-child interactions, and online communication, ultimately leading to stronger family-school partnerships. Statistical analyses using a robust dataset consistently confirmed the significance of these associations.

1746. RSV seasonality patterns change during 2016 to 2020 among hospitalized young children in Taiwan

Abstract Background Respiratory syncytial virus (RSV) is a common cause of hospitalizations in young children. Previous studies in Taiwan demonstrated seasonality of RSV hospitalization (RSVH) in young children was rather year-round with small peaks in spring and fall. This study aims to investigate recent seasonality patterns of RSVH in Taiwan using latest National Health Insurance (NHI) database. Methods We linked Taiwan birth cohort database to the NHI database for the years 2016-2020. Children < 5 years having hospital admission record with RSV ICD-10 coding were defined as having RSVH. To assess the correlations between RSVH with monthly average temperature/humidity, we used data from 2016-2019 (not including 2020 due to unusual RSV endemic) and by geographic region (Northern, Central, and Southern Taiwan). Results In children < 1 year, the annual RSVH incidence increased steadily from 1.32% in 2016, 1.55% in 2017, 1.60% in 2018, 1.67% in 2019, to 1.71% in 2020 (p=0.03). In contrast, for children aged 1-4 years, the annual RSVH incidence remained somewhat stable from 0.29%, 0.33%, 0.36%, 0.31% from 2016 to 2019, then substantially increased to 0.76% in 2020 (a 2.47-fold increase compared to 2019, p=0.22). Only one RSVH peak was observed per year for both age groups: in May for 2016, September for 2017-2019 and November for 2020. Temperature and RSVH showed high correlation among years 2016-2019, with correlation coefficients 0.64-0.68 and 0.64-0.66 in children aged < 1 and 1-4 years, respectively. However, RSVH only showed low to moderate correlation with humidity in both age groups. Conclusion The previously established seasonality patterns of RSVH in Taiwan were disrupted. A higher RSVH incidence for children aged 1-4 years was noted during 2020 endemic than previous years. Only one RSVH peak was observed in 2016-2020, and its correlation with temperature was high. Disclosures Ching-Hu Chung, PhD, Sanofi and AstraZeneca: Grant/Research Support Szu-Ying Tsai, n/a, Sanofi: employe Ting-Yu Yeh, n/a, Sanofi: employe

Prenatal and perinatal risk factors of food allergy in Taiwanese young children

BackgroundIn recent decades, the prevalence of food allergy (FA) in children has increased in Western countries; however, there have been only limited studies on FA, especially among young children, in Asian countries, including Taiwan. In this study, we identified prenatal and perinatal risk factors associated with FA in young children in Taiwan. MethodsFor this prospective birth cohort study, we adopted the Southern Taiwan Allergy Research Alliance (STARA)-FA questionnaire to collect data related to prenatal and perinatal risk factors and self-reported allergic symptoms in children aged 1–3 years in the well-baby clinics of 4 medical centers located in 3 cities, Chia-Yi, Tainan, and Kaohsiung, Taiwan. The STARA-FA questionnaire consisted of 99 questions to investigate the association of prenatal and perinatal risk factors with FA. ResultsWe recruited 903 young children aged 1–3 years in Taiwan. Among those, 95 (14.7%) children had allergic reactions to foods. The most common food allergens were eggs (26/95, 27.3%), milk (22/95, 23.2%), fruits (13/95, 13.7%), and seafood (12/95, 12.6%). We also found that there were 134 (14.8%) children with eczema, 86 (9.5%) with wheezing, and 240 (26.6%) with rhinitis. Children with a personal history of eczema (adjusted odds ratio [AOR], 2.48; 95% confidence interval [CI], 1.38–4.45) and a family allergy history (AOR, 2.06; 95% CI, 1.18–3.57) had a significantly increased risk of FA. Maternal peanut consumption during pregnancy was associated with a decreased risk of FA in children (AOR, 0.57; 95% CI, 0.33–0.98). ConclusionsIn this study, the prevalence of FA in a cohort of Taiwanese young children was 14.7%. Risk factors associated with FA were a personal eczema history and a family allergy history, which might serve as predictive or prevention factors for the development of FA in young children in Taiwan.

Moral education in Taiwanese preschools: Importance, concepts and methods

Early childhood is a period of rapid development and growth, and regardless of physical, psychological, and social abilities, young children at this stage have great plasticity and strong imitation ability. Childhood is a critical period for individual learning; so preschool teachers must provide young children with appropriate moral education at this time. This paper is to discuss the importance of moral education for young children in Taiwan, analyze the relevant literature, and review the teaching concepts and methods of moral education. Moral education of young children is important because the ultimate goal of early childhood education is to shape the character of young children; so its content must focus on moral education, which cultivates moral values in young children. Moral education also develops an understanding of empathy and social responsibility for young children. This paper argues that preschool teachers must (1) respect young children’s moral subjectivity; (2) understand that early childhood is a critical period in which moral behavior is shaped, and (3) organize young children’s moral teaching from the concrete to the abstract. In terms of the optimal teaching methods, this paper proposes that preschool teachers use: (1) moral storytelling, (2) instructional media, (3) picture books, (4) discussion of moral issues, (5) peer learning, (6) moral narratives, (7) modeling moral behavior, (8) incorporate young children’s life experience, and (9) invite young children’s parents to participate in moral education. This study contributes to the literature on early childhood moral education and provides an insight into the praxis of moral education for young children in Taiwan.

Social Media as a Pathway to Leisure: Digital Leisure Culture among New Mothers with Young Children in Taiwan

Applying the uses and gratifications theory, we explored why new mothers with young children in Taiwan use social media for leisure and how their needs are met. Participants comprised 25 mothers aged 25 to 40 years. Data were obtained using narrative, semi-structured interviews. The results showed that the relationship between new mothers and social media in shaping their leisure lives is not additive, but interactive. Social media enables new mothers to engage in personal leisure and gain a sense of belonging. Additionally, new mothers tend to combine personal leisure with family leisure activities and rely on social media information on activities. Further, social media can also serve as a platform for mothers to obtain work achievement. The concept of goals should be considered while analyzing the relationship between users’ motivations and actions.

Compliance with orthokeratology care among parents of young children in Taiwan

ObjectivesTo evaluate compliance with orthokeratology (Ortho-K) care and its influencing factors among parents of 6–13-year-old myopic children in Taiwan. MethodsParents who are responsible for the care of the Ortho-K lenses of their myopic children were recruited through a closed Facebook peer support group to answer an online compliance questionnaire, including the wear and care behaviours and follow-up visits of Ortho-K. ResultsA total of 253 online questionnaires were analysed after excluding those with wrong information. Most participants (89.7%) were mothers and had university-level or higher education (72.3%); 67.6% of them could achieve a score equal or higher than 60% correct rate on knowledge items. In addition, 39.3% of participants had high myopia (spherical equivalent ≦ 6.0 diopters). The mean age at onset of myopia was 7.75 years for children, and 57.4% wore Ortho-K lenses for less than a year. Full compliance rate was 22.8%, as reported by fathers or mothers. The compliance rate for follow-up visits significantly increased with provision of axial length information in follow-up visits, knowledge of axial length changes as an effect of myopia control, and Ortho-K use for less than 6 months. The compliance rate for wear and care was significantly associated with high myopia in one of parents, high education level, early onset of myopia in children, knowledge of Ortho-K and myopia control, and Ortho-K use for less than 6 months. ConclusionThese results indicate the need for a comprehensive education programme for parents with young myopic children to ensure strict adherence to fitting and wear protocols and good follow-up of Ortho-K lenses.

A longitudinal cohort study of enterovirus A71 infections in young children in Taiwan

Background: Enterovirus A71 (EV-A71) is causing cyclical epidemics of fatal hand-foot-mouth disease (HFMD) in Taiwan and other Asian countries. Evidence of its incidence rates and risk factors based on longitudinal cohort studies is scarce. This study aims to investigate age-specific and cumulative incidence rates and risk factors of EV71 infections from 2006 to 2012 in northern Taiwan. Methods and materials: A total of 759 neonates born between 2006 and 2009 were recruited. Participants’ sera were collected at their 6, 12, 24, 36, 48, 60, and 72 months of age to conduct serum neutralization test. In addition, throat swabs of the participants who presented symptoms of HFMD or herpangina were collected for virus isolation and molecular tests to detect EV71 infections. Asymptomatic primary infections and reinfections were identified based on >= 4-fold rise of serum neutralizing antibody titers in consecutive sera. We calculated age-specific and cumulative incidence rates, and fitted a Cox proportional hazards model to identify risk factors of EV71 infections. Results: Among the 576 participants being followed, 127 persons (22.0%) were confirmed as with EV71 infections (70 symptomatic, 57 asymptomatic cases). Of the 127 cases, 22 (17.3%) occurred their second (n = 20) or third (n = 2) reinfections (all asymptomatic) after the primary infection. Phylogenetic analysis revealed that two distinguishable genotype B5 viruses were introduced from southern Asia to cause large-scale epidemics in Taiwan in 2008 and 2012, respectively. Age-specific incidence increased from 2.03 per 100 person-years during 0–6 months of age to 19.33 during 49–60 months of age, and reduced to 9.57 during 61–72 months of age. The cumulative incidence till 72 months of age was 31.78%. A higher number of co-residing children under 5 years old was associated with higher risk of EV71 infections (hazard ratio = 1.28, 95% CI: 1.03–1.59). Conclusion: Our results indicated incidence rates increased with age and peaked at 5 years-old, cumulative incidence rate was nearly 32% by 6 years of age, and higher number of co-residing young children was associated with higher risk of EV71 infections. This longitudinal cohort study contributes to precisely estimate incidence rates of EV71 infections via a long-term follow-up, and provides insights into clinical trial designs of EV71 vaccines.

Hospital-based surveillance of severe rotavirus gastroenteritis and rotavirus strains in young Taiwanese children

Rotavirus remains a leading cause of pediatric gastroenteritis-related hospitalization. Surveillance studies have revealed that several major rotaviral genotypes are responsible for most cases of rotavirus gastroenteritis (RVGE). This study aimed to understand the characteristics of acute gastroenteritis (AGE) caused by rotavirus in young children in Taiwan. Ten hospitals in Taiwan were subjected to prospective hospital-based AGE surveillance during 2014-2017, and children younger than 5 years old who were hospitalized due to AGE were enrolled in the study. Medical and demographic variables were recorded and analyzed, and stool specimens were collected for rotavirus identification and genotyping via real-time RT-PCR. Non-rotavirus AGE age-matched controls were enrolled. Surveillance identified 4747 young children hospitalized with AGE during this study period. The median age of these patients was 2.0 years. Rotavirus was detected in stool samples from 518 patients (10.9%). The prevalent months of RVGE in 2014, 2015, and 2017, wherein the rotavirus positivity rates exceeded 30%. The most common serotypes were G3P[8] (303/518, 58.9%) and G1P[8] (86/518, 16.6%). The percentage of G3P[8] increased from 4.9% in 2014 to 74.3% in 2016 (P<0.0001), whereas the percentage of G1P[8] decreased from 61.0% in 2014 to 22.5% in 2015 (P<0.0001). Compared with G3P[8], G1P[8] was associated with a significantly higher C-reactive protein level (P<0.05). Rotavirus remains a notable pathogenic etiology of childhood AGE and the G3P[8] serotype was dominant in Taiwan. This study highlighted the importance of rotavirus surveillance to ensure protective effectiveness against the circulating strains.

Investigating the Aesthetic Domain of the “Early Childhood Education and Care Curriculum Framework” for Young Students in Taiwan

Aesthetic education is fundamental to young children’s holistic development and future lives. The development of aesthetic sensibility has been promoted in early childhood education in various countries and is an important issue in Taiwan’s current educational practice. This paper aims to examine the aesthetic domain of the Early Childhood Education and Care Curriculum Framework, promulgated by the Taiwan’s Ministry of Education, highlighting the importance of aesthetic education for young children in Taiwan. The objective of this research study is to better understand the aesthetic education of Taiwan’s young children, and provide insight for preschool teachers who implement aesthetic education. The findings are as follows: (1) the goals of aesthetic domain in the curriculum framework is to help young children enjoy aesthetic experience and artistic creation, and develop rich imagination, and respond to feelings and preferences for artistic creation of young children; (2) the aesthetic domain includes the development of “exploration and awareness”, “performance and creation”, and “response and appreciation”; (3) the learning aspect of the aesthetic domain is divided into two parts: “affection” and “artistic media”; (4) teachers should also pay attention to appropriate arts and cultural activities so the young children can experience their own local culture. If preschool teachers open their eyes and ears, they can guide young children to share in the beauty and joy of life. This paper provides discourses of preschool teachers who design an aesthetic education curriculum and offers practical, concrete suggestions that can support the aesthetic education of young children in Taiwan.

Effects of Daily Parenting Uplifts on Well-being of Mothers with Young Children in Taiwan

Focusing on mothers with young children, the aim of this study was to understand their daily experiences and the effects of parenting uplifts on mothers’ well-being. This study comprised two parts: In Study 1, we examined and analyzed the daily hassles and uplifts that mothers experience. Two hundred and six married, full-time working mothers with young children were interviewed using Target Complaints instrument. Family was found to be the dominant domain in which both daily hassles and uplifts were experienced. We then compared the intensity of hassles and uplifts among the domains; the intensity for family-based uplifts was the strongest. In Study 2, we further investigated Study 1 findings and examined the effects of parenting uplifts on mothers’ well-being. Three hundred and thirty-six couples filled out questionnaires. We found that parenting uplifts were positively associated with the mothers’ life satisfaction. Finally, the actor–partner interdependence model (APIM) revealed that fathers’ parenting uplifts influenced the mothers’ life satisfaction.

Aesthetic Education for Young Children in Taiwan: Importance and Purpose

Since broadening the aesthetic experience for young children is an element of early childhood education, aesthetic education is important at this stage. By reading and analyzing related studies, this article aims to give preschool teachers a better understanding of the importance and purpose of aesthetic education in early childhood so young children can receive the appropriate aesthetic education in Taiwan.

Daily Intake Estimation for Young Children's Ingestion of Residential Dust and Soils Contaminated with Chlorpyrifos and Cypermethrin in Taiwan.

We estimated the daily intakes of chlorpyrifos and cypermethrin via ingestion of indoor dust and outdoor soils using the Stochastic Human Exposure and Dose Simulation Model on a probabilistic approach for Taiwanese young children. Variables for the estimation, such as concentration, ingestion rate, and body weight, were adopted from previous studies. Monte Carlo simulation was performed with 1,000,000 iterations to simulate a single daily intake, which was shown in terms of percentage of the Acceptable Daily Intake (ADI) of either insecticide. The daily intakes are minimal with a 99% probability, but go up steeply at the 99.9th percentile (13.1% and 20.0% of the ADIs of chlorpyrifos and cypermethrin, respectively). The sensitivity analysis indicates that concentration is the most determinant variable for daily intake estimation, suggesting that high intakes may occur when insecticide concentrations are elevated. Compared to the data of daily intakes via dietary ingestion of vegetables derived from a previous study, the estimated non-dietary intakes are negligible until reaching the highest percentile. Consequently, the non-dietary ingestion exposure to either insecticide is commonly low for young children in Taiwan’s homes, unless high contamination (e.g., indoor insecticide application) occurs in the environment. Care has to be taken to avoid high contamination indoors.

Immigrant Mothers’ Knowledge of Medication Safety and Administration for Young Children

The goals of this paper are to compare immigrant (Southeast Asian and Chinese) and non-immigrant (Taiwanese) mothers’ knowledge of medication safety and administration for children, and to reveal how the accessibility of medical resources could affect immigrant mothers’ medication administration. The medication knowledge and communication ability of immigrants are suggested to be insufficient, which could be the main reason for medication errors. When medical resources can be accessed easily, immigrant mothers’ medication errors may be reduced. A survey with stratified sampling was used. Data were gathered from 643 participants with young children in Taiwan. A researcher-designed questionnaire was used to solicit participants’ responses concerning medication preservation and medication administration. Southeast Asian mothers need the help of doctors or family members; they frequently administer suppositories to febrile children, store children’s medication in the fridge, and pay less attention to the expiry date. Chinese immigrant mothers tend to let children take Chinese medicine, give previously prescribed drugs to sick children, give other children’s medication to sick children, and buy medicines at a pharmacy without a doctor’s prescription. When the participants spend more than 31 minutes travelling to the nearest clinic, they are more likely to misuse medication, such as giving previously prescribed drugs to a sick child, and combining medication with Chinese medicine. The findings of this study suggest that the medication knowledge and administration habits of immigrant and non-immigrant mothers differ. The parents of young children take sick children to seek proper medical treatment when they are able to easily access medical resources.

Performance differences between verbally talented preschoolers and their regular counterparts in storytelling

The primary purpose of this study was to compare language and narrative skills of both talented and regular young children in Taiwan. The participants were asked to tell a story based on images in children’s picture books. Twelve children, who participated in a screening session designed to identify young talented children for the Enrichment Program for Cultivating Problem Solving Abilities and Multiple Intelligences for Talented Preschoolers (PSMIGP program), were divided into a verbally talented group (VT) and a regular group (RE). The stories told by the participants were tape-recorded, transcribed, and coded using the Child Language Data Exchange System (CHILDES). The results indicated that the verbally talented children demonstrated their linguistic talents at as young as four years of age. In telling a story, they used more clauses and more words that were different to complete the task. In addition, they used more modifiers (i.e. adjectives and adverbs) and employed more conjunctions that were more complex. However, there were no differences between the two groups in mean length of utterance (MLU) and type-token ratios (TTRs). This paper presents a discussion on the implications of this study and offers suggestions for future research.

Hepatic damage caused by coxsackievirus B3 is dependent on age-related tissue tropisms associated with the coxsackievirus-adenovirus receptor

Coxsackievirus B (CVB) and enterovirus 71 (EV71) are important causes of severe enteroviral diseases in neonates or young children in Taiwan. CVB can cause fulminant hepatitis, myocarditis or meningoencephalitis. This study was designed to explore the role of coxsackievirus-adenovirus receptor (CAR) in the pathogenesis of CVB3-infected hepatocytes via in vitro and mice studies. CVB3 (CVB3/2630) was isolated from liver tissue of a neonate with fulminant hepatitis. Cell lines A549, HeLa, HEp2 and Huh-7 were maintained in Dulbecco's modified Eagle's medium. Mice progeny 1 or 7 days old were used in the experiments. Viremia was noted in 7-day-old ICR mice 2 h after intraperitoneal injection. The highest viral titers were detected in blood, liver and spleen. Histopathological studies of the liver demonstrated polymorphonuclear cell infiltration, massive hepatic cell necrosis and apoptosis. CAR was expressed more in liver than in other tissues. Expression of CAR decreased with mouse age. Anti-CAR monoclonal antibody prevented infection of Huh-7 cells from CVB3. Furthermore, anti-CAR monoclonal antibody pretreatment can reduce mortality and decrease the level of liver enzymes in CVB3-infected mice. These findings indicate that CAR plays an important role in the initiation of CVB infections and is closely associated with hepatotropism and age-specific susceptibility.

Probiotic supplement use among young children in Taiwan: a prospective cohort study.

ObjectivesThe objective of this study is to provide details on probiotic supplement use among young children in Taiwan.Participants and MethodsThis study is based on the Taiwan Birth Cohort Study database. We used questionnaires to collect information on probiotic supplement use among young children from birth to 18 months of age, while also considering their demographic characteristics and other covariates. Low-birth-weight infants, preterm infants, those with birth defects, and those with caregivers who returned incomplete questionnaires were excluded. The final valid sample comprised 16,991 cases.ResultsApproximately half the children received probiotic supplements before the age of 18 months. Only 6.3% of the children received probiotic supplements during the two periods of birth to 6 months and 7 to 18 months. Firstborn children, native mothers, mothers with higher educational levels, higher family income, and parents who lead healthy lifestyles were positively related to probiotic supplement use among children. Young children who were breastfed, with eczema, or with gastrointestinal tract problems were significantly positively associated with probiotic supplement use.ConclusionThe findings show that probiotic supplement usage among young children is associated with a more socially advantaged circumstance and certain child health factors, such as eczema, diarrhea, and constipation. Parents might use probiotic supplements for prevention or treatment of child diseases. The findings of this research could serve as a baseline for future studies, and provide insight into probiotic supplement use behavior for health professionals caring for infants and young children.

Epidemiology of acute otitis media among young children: A multiple database study in Taiwan

Acute otitis media (AOM) is a common complication of upper respiratory tract infection (URTI) among children. The purpose of this study was to evaluate the epidemiology of AOM among young children in Taiwan, including the age incidence and seasonality by combining multiple databases. Two country-based questionnaire survey studies had been conducted to evaluate the experience of otitis media (OM) among young children: one in 2007 and the other between 2005 and 2010. The number of OM cases (5% of population younger than 7 years) in 2005 and annual visiting rates for URTI from 2005 to 2010 obtained from the National Health Insurance Research Database of Taiwan were collected and comprised the third database. The fourth database comprised ambulatory visits of children with OM to a medical center in central Taiwan between 2005 and 2010. Data from a total of 1099 questionnaires were entered into Database I in 2007, and data from 9705 questionnaires between 2005 and 2010 comprised Database II. There were 86,702 children (younger than 7 years, representing 5% of the whole population for this age group) retrieved from Database III in 2007, and 5,904 cases of OM in children between 2005 and 2010 in a hospital. In Database I, 7.46% children experienced at least one episode of AOM compared with 9.21% in Database II for children aged 5 years and younger. In Database III, 13.2% children younger than 7 years had AOM in 2005. The peak season of AOM among children was from March to May (Databases III and IV). AOM was thought to be a very common disease among children; however, this comparative analysis showed that the overall prevalence of AOM among children younger than 5 years was only 20%, much lower than in other countries. AOM was more prevalent during the spring season, and still was similarly common after age 2 years.

Incidence rates of enterovirus 71 infections in young children in Taiwan, 2008–09

Incidence rates of enterovirus 71 infections in young children in Taiwan, 2008–09

Stage of adoption for preventive behaviour against passive smoking among pregnant women and women with young children in Taiwan

This study assessed the applicability of the transtheoretical model to prevent exposure to passive smoking among pregnant women and women with young children in Taiwan. We examined whether women in different stages of change had different knowledge, processes of change, decisional balance and self-efficacy. Although previous studies have found a positive association between the presence of children and a mother's readiness to prevent exposure to passive smoking, a few studies have systematically examined the mothers' stage of adoption for preventive behaviour against passive smoking. A cross-sectional survey based on self-reported data was conducted in 2005-2006. A total of 315 women was recruited from perinatal and paediatric clinics at four hospitals. The transtheoretical model measures included knowledge, stages of change, processes of change, decisional balance and self-efficacy towards passive smoking. Of the 315 women in the study, 17·1% were at the precontemplation stage, 7·9% were at the contemplation/preparation stage and 74·9% were at the action/maintenance stage. Women at the action/maintenance stage scored the highest in knowledge, process of change, pros of decisional balance and self-efficacy, followed by the women at the contemplation/preparation stage and the women at the precontemplation stage. This study supported the applicability of the transtheoretical model theory for adoption of preventive behaviour against passive smoking among pregnant women and women with young children. Nurses could educate pregnant women and women with young children to adopt preventive behaviours against passive smoking using stage-matched intervention strategies, targeting the transtheoretical model constructs, to promote behavioural change.

Gender and geographic differences in developmental delays among young children: Analysis of the data from the national registry in Taiwan

Although developmental delays are not uncommon in children, the incidence is seldom assessed, and the reported prevalence varies widely. In Taiwan, the government mandates the reporting of suspected cases. Using the national registry data, we conducted a study to estimate the incidence and prevalence of developmental delays in young children in Taiwan and to assess the gender and geographic differences. According to the law, each city and county in Taiwan needs to establish a reporting and referral center. The Department of Interior constructed a surveillance system on the basis of these centers and publishes the registry data annually. We analyzed the data from 2003 to 2008. From 2003 to 2008, 73,084 new cases were registered, and the incidence was 5.7–11.1 per 1000 person-year under 3 years of age and 7.9–11.4 per 1000 person-year at 3–5 years of age. The estimated prevalence was 8.6–16.6 per 1000 under 3 years of age and 26.2–47.6 per 1000 at 3–5 years of age. The average age at reporting decreased from 3.4 years in 2003 to 3.1 years in 2008. In addition, we found that boys had higher incidence than girls all through the years. Rural areas had higher incidence than urban areas, except for 2003.