臺灣博碩士論文加值系統

中 文 摘 要
目前台灣，因社會結構的轉變，人力需求及推向國際化等因素，促使來台之外籍人士，包括勞工、教師、家庭看護工及新娘等日益增加。依行政院衛生署2000年公佈之統計分析，來台的外籍人士接受10種的健康檢查共發現13,424人不合格，其中「腸內寄生蟲檢查」這一項，有12,353人不合格，佔不合格者的92.02﹪，是所有檢查項目中最高的。
基於此，本研究針對1997至2001年間，至高雄醫學大學附設醫院作「身體健康檢查」之外籍人士寄生蟲檢查結果，依其國籍、性別、年齡及職業，加以分析探討。
本研究共檢查4,445件來自17個國家外籍人士的糞便檢體及血液抹片。血液抹片檢查結果，未發現任何寄生蟲之感染。糞便檢查結果，感染寄生蟲的有420件，陽性率為9.44﹪（420/4,445）。依寄生蟲的種類，有蠕蟲類9種和原蟲類7種，蠕蟲類中以鉤蟲（Hookworm）和鞭蟲（Trichuris trichiura）的陽性率較高，其陽性率分別為1.84﹪（81/4,445）及1.68﹪（75/4,445）。而原蟲類中陽性率較高者為人芽囊原蟲（Blastocystis hominis）1.19﹪（53/4,445）和哈氏阿米巴（Entameba hartmani）1.15﹪（51/4,445）。就國籍而言，以來自柬埔寨、越南和印尼這三個國家的陽性率較高。就性別而言，其中女性檢體陽性率11.40﹪（312/2,738）顯著高於男性檢體陽性率6.33﹪（180/1,707）（p<0.005）。就年齡而言，以19歲以下及60歲以上的檢體陽性率較高，但以20至29歲的檢體陽性數最多。就職業而言，以外籍新娘檢體陽性率15.3﹪（216/1,414）為最高。
痢疾阿米巴是法定傳染病之一，14件陽性檢體中，7件是來自外籍新娘和家庭看護工，她們深入家庭的生活，將會危及其照護與共同生活中的家人，值得有關單位注意，在防疫上，應有其因應對策。

Abstract
Recently , due to the changes of social structure , the demand of human resources and the attempt of internationalization of our country , a lot of foreign workers such as laborers , teachers and nursing care helpers , and brides had been imported to Taiwan . According to the statistic analysis made by the Department of Health , Executive Yuan in 2000 , there were 13,424 foreign workers failed to one or more items of physical examinations in 10 items .Among them the highest failure rate , 92.02% or 12,353 workers , was found in the item of intestinal parasitic infection .
From 1997 to 2001 , totally , 4,445 stool samples and 4,445 blood samples collected from 17 countries had been examined at Kaohsiung Medical University Hospital . Their nationality , sex , age and occupation were also analyzed .
All blood samples examined showed negative for blood parasites . The result of stool examination revealed that 9.44% or 420 samples were positive for one or more species of intestinal parasites , among 9 species of helminths found from 420 samples , the higher infection rates were 1.84%(81/4,445) for Hookworm and 1.68%(75/4,445) for Trichuris trichiura respectively , and among 7 species of protozoa , the higher rates were 1.19%(53/4,445) for Blastocystis hominis and 1.15%(51/4,445) for Entameba hartmani respectively . According to the nationality , the higher rates were found in Combodia (21.4%) , Vietnam (16.2%) and Indonesia (12.9%) . The infection rate in males was 6.33%(108/1,707) and 11.40%(312/2,738) in females , which is significantly higher (p<0.005) than that of males . According to the age group , the higher positives rates were found in under 19 years old and in above 60 years old , but the highest positive rate was seen in between 20 and 29 years old . The higher infection rates 15.3% (216/1,414) was seen in foreign brides .
Entamoeba histolytica is one of notifiable infectious diseases , that may be infected by person to person without delay . Among 14 positives of Entamoeba histolytica , 7 positives including 6 brides and 1 nursing care helper , may spread this disease by their close contact to the family members . This notifiable parasitic disease may influence the strategy of national public health policy and its endemicity . Our government should pay more attention to this kind of communicable disease .

目 錄
中文摘要
英文摘要
誌謝
緒論
研究背景…….……………………………………….1
外籍勞工的定義及職業類別的規範………..………4
感染法定傳染病外籍人士處置原................6
研究目的..….…………………………………….…8
研究方法和材................................9
結果……………….………………………………..13
討論………………….…………………………..…25
結語與建議………………………………………….30
圖表………………………………….……..……..31
參考文獻…………………………………………….48

參考文獻
1、 Stafford EE,Sudomo M , Marsri S , Brown RJ : Human parasitoses in Bali , Indonesia.Southeast Asian J Trop Mub Med Pub Hlth 11 : 319~23 , 1980.
2、 Stafford EE , Dennis DT , Masri S , Sudomo M : Intestinal and blood prasites in the Torro Valley , Centeal Sulawesi , Indonesia . Southeast Asian J Trop med pub Hlth 11 : 468-72 , 1980 .
3、 Cross JH , Clarke MD , Cole WC , Lien JC , Partono F , Joesoef A , Kosin EH : prasitology survey in northern Sumatra , Indonesia . J Trop Med Hyg 79 : 123~131 , 1976 .
4、 Kasvya S , Khamboonruang C , Amano K , Murase T , Araki H , Kato Y , Kumada Y , Koyamoa A , Higuchi M , Nakamura J , Tomida K , Makino S : Intestinal parasitic infection among schoolchildren in Chiang Mai , northern Thailand : an analysis of the present situation . J Trop Med Hyg 92 : 360~364 , 1989 .
5、 Upatham ES , Viyanant V , Brockelman WY , Kurathong S , Lee P , Chindaphol U : Prevalence , incidence , intensity and associated morbidity of intestinal helminthes in South Thailand . Int J Parasitol 19 : 217~228 , 1989 .
6、 Hasegawa H , Miyagi I , Toma T , Kamimura K , Nainggolan IJJ , Tumewu-Wagei M , Mandagi-Waworuntu HG , Kapojos FX , Runtuwene J , Paath-Runtupalit C , Syafruddin : Intestinal parasitic infections in Likupang , North Sulawesi , Indonesia . Southeast Asian J Trop Med Pub Hlth 23 : 219~227 , 1992 .
7、 Mangali A , Sasabone P , Syafruddin , Abadi K , Hasegawa H , Toma T , Kamimura K , Miyagi I : Intestinal parasites in Campalagian district , South Sulawesi , Indonesia . Southeast Asian J Trop Med Pub Hlth 24 : 313~320 , 1993 .
8、 Fan PC , Peng HW : Parasite infections among foreign laborers in Taiwan with special emphasis on Opisthorchis viverrini . Chinese J Parasitol 6 : 21~27 , 1993 .
9、 Lo CT , Lee KM : Intestinal parasitic infections among the laborers from four Southeast Asian countries . Chinese J Parasitol 6 : 41~46 , 1993 .
10、 Yen CM , Tsen LT , Leu SN , Chung LY , Hsieh HC , Chen ER : Investigation on the parasites of alien laborers in Kaohsiung . Kaohsiung J Med Sci 11:390~397 , 1995 .
11、 Lee JD , Wang JJ , Leu SN , Tsen LT , Chung LY , Chen ER , Yen CM : Investigation on the parasitic infections in alien laborers in Kaohsiung from Aug 1994 to June 1995 . Chinese J Parasitol 9 : 35~42 , 1995 .
12、 Lo CT , Lee KM , Lee KF : Intestinal parasites among the Southeast Asian laborers in Taiwan during 1993~1994 . Chinese Medical 57 : 401~404 , 1996 .
13、 行政院衛生署：外籍勞工健康管理面面觀。衛生報導33:18~21,1993.
14、 Sapero JJ , Lawess DK : The “MIF” Stain-presevation technic for the identification of intestinal protozoa . Am J Jrop Med Hyg , 123:613~9 , 1953 .
15、 Blagg W , Schlegel EL , Mansour NS , Khalaf GI : A new concentration technic for the demonstration of protozoa and helminth eggs in feces . Am J Trop Med Hyg , 4:23~29 , 1995 .
16、 林益卿，楊佩玉，洪偉洲，洪錫慶，王嘉慶：外籍勞工腸道寄生蟲感染率之調查 公共衛生雜誌 24（4）：251~257，1998。
17、 Wang LC : Parasitic infections among Southeast Asian laborers in Taiwan : a long term study . Epidemiol Infect 120 : 81~86 , 1998 .
18、 Fan PC , Chung WC ,Chen ER . Current status of imported parasitic infection among foreign workers in Northern Taiwan (1999~2000) . Kaohsiung J Med Sci , 17(10):503~8 , 2001 .
19、 許須美：外勞與國內防疫問題。疫情報導 12（11）：339~355，1986。
20、 行政院衛生署疾病管制局：受聘僱外籍勞工國外健康檢查不合格情形。疫情監視摘要報導 4（37）：675，1998。
21、 Giacometti A , Cirioni O , Fiorentini A , Fortuna M , Scalise G : Irritable Bowel Syndrome in patient with Blastocystis hominis infection . Eur J Clin Microbiol Infect Dis 18 : 436~139 , 1999 .
22、 Cheng HH , Huang YH , Huang MJ , Huang WP , Tsai MH , chen HC , Lan WS , shin JW :Epidemiologic survey of Blastocystis hominis infection among alien laborers in southern Taiwan . Proceedings of The Sixth Asian-Pacific Congress for Parasitic Zoonoses , Taipei Taiwan , 81~94 , 2000 .
23、 Lee JD , Wang JJ , chung LY , Chang EE , Lai Lc , Chen ER , Yen CM . A survey on the intestinal parasites of the school children in Kaohsiung county . Kaohsiung J Med Sci , 16(9):452~8 , 2000 .
24、 Maleewong W , Intapan P , Wongwajana S , Sitthithaworn P , Pipitgool V , Wongkham C , Daenseegaew W : Prevalence and intensity of , Opisthorchis viverrini in rural community near the Mekong River on the Thai-Laos border in Northeast Thailand . J Med Assoc Thailand 75 : 231~235 , 1992.
25、 Haswell-Elkins MR , Sithithaworn P , Mairiang E , Elkins DB ,Wongratacheewin S , Kaewakes S , Mairiang P : Immune responsiveness and parasite-specific antibody levels in human hepatobiliary disease associated with Opisthorchis viverrini infection . Clin Exp Immunol 84:213~218 , 1991 .
26、 Elkins DB , Haswell-Elkins MR , Mairiang E , Mairiang P , Sithithaworn P , Kaewakes S , Rhudisawasdi V , Uttaravichien T : A high freguency of hepatobililary disease and suspected cholangiocarcinoma associated with heavy Opisthorchis viverrini infection in a small community in northeast Thailand . Trans Roy Soc Trop Med Hyg 84 : 715~719 , 1990
27、 Chen ER : Current status of Clonorchiasis in Taiwan . Proceedings of the 10th International Congress of Parasitology . Vancouver (Canada) , Aug 4-9 , pp613~618 , 2002 .
28、 Peng HW , Chao HL , Fan PC : Imported Opisthorchis viverrini and parasite infections from Thai laborers in Taiwan . J Helminthol 67 : 102~106 , 1993 .
29、 Fan PC : Review on imported parasites from foreign laborers in Taiwan . Chinese J Parasitol 12 : 35~49 , 1999 .