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Nº 1 (2017)
- Ano: 2017
- Artigos: 15
- URL: https://journals.eco-vector.com/2226-6976/issue/view/6696
Articles
Incidence of infectious diseases among children in the Orenburg Region: Main challenges and possible solutions
Resumo
Objective. To analyze the incidence of infectious diseases among children in the Orenburg Region in 2015. Materials and methods. The author has used data from the state reports «On the state sanitary and epidemiological wellbeing of the population in the Orenburg Region» for the period 2013-2015, data from annual statistical reports (Form № 2), and those of the Federal Service of State Statistics in the Orenburg Region. The clinical features of infectious diseases are presented by extracts from case histories. Results. Respiratory tract diseases, enteric viral infections, and varicella have a lead in the structure of infectious diseases in children. In viral infections, the activity of the epidemic process is maintained by the pediatric population, whose proportion is as high as 70% in the age structure of morbidity in the period of an epidemic rise. Conclusion. Involvement of infants in the epidemic process necessitates monitoring of the circulation of pathogens and prevention.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):4-9
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The incidence of pyoseptic infections in newborns, puerperas, and patients from surgical hospitals in the Nizhny Novgorod Region in 2014-2015 and measures for its prevention
Resumo
Objective. To carry out an epidemiological analysis of the incidence of pyoseptic infections (PSIs) in the hospitals of Nizhny Novgorod and its region. Materials and methods. The data available in the 2014-2015 governmental reports «On the sanitary and epidemic wellbeing of the population in the Nizhny Novgorod Region» were analyzed. Results. Nosocomial infections (NIs) were registered in 308 cases in the maternity hospitals of the Nizhny Novgorod Region; in 179 cases (including 95 neonatal PSI cases) in the children’s hospitals and departments, and in 413 cases in surgical hospitals and departments. The incidence rate of neonatal PSIs was 7.5 per 1,000 live births in the maternity hospitals and 5.0 per 1,000 live births in the obstetric departments. That of NIs was 12.0 per 1,000 live births. The proportion of bacteriologically confirmed neonatal PSIs was 95.5%. Conclusion. This study allows one to formulate some risk factors for hospital epidemic ill-being and, as a result, the emergence of PSI cases.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):10-14
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Specific features of the spread of HIV infection among persons who inject drugs in the Republic of Tajikistan
Resumo
Objective. To identify the characteristics of the spread of HIV infection, hepatitis C, and syphilis among PWID in Tajikistan for the further elaboration and improvement of prevention programs on their counteraction. Subjects and methods. The survey covered 2,200 respondents from 10,466 PWID registered in the Republic of Tajikistan. Results. The specific features of the spread of HIV infection among PWID are a lack of self- motivation for safe and healthy lifestyles, risky injecting and sexual behaviors, poor knowledge of preventive methods and measures, and insufficient HIV testing coverage. Conclusion. The results of evaluating the behavior of PWID should be kept in mind when planning preventive measures in the framework of the country’s ongoing counteraction to HIV epidemic.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):15-19
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The results of influenza immunoprophylaxis in the 2015-2016 epidemic season
Resumo
The analysis of the incidence of influenza in the Russian Federation over the last 20 years have shown that influenza immunization leads to substantially reduced morbidity rates, the prevention of complications, and lower death rates. The paper gives the results of monitoring the epidemiological situation of influenza in the 2015-2016 epidemic season and analyzes the efficiency of immunization with Russian vaccines against influenza in the population of the Russian Federation within the National Immunization Calendar in the 2015-2016 epidemic season. There was a low incidence rate (2.7% of cases) and the severe course of the disease was absent in the people vaccinated against influenza. Influenza-related deaths were mainly due to delayed care-seeking and concomitant chronic diseases in the victims. The Russian influenza vaccines «Grippol®», «Grippol®plus», «Savigripp®», and «Ultrix®» were found to be highly effective and safe.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):20-28
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Alanine aminotransferase activity and its clinical significance in patients with chronic hepatitis B
Resumo
The incidence of chronic hepatitis B (CHB) in Russia is not decreasing, despite the ongoing vaccination of the population. The relevance of chronic hepatitis is due to the risk of outcomes, such as cirrhosis and primary cancer of the liver, the prevention of which requires timely antiviral therapy. The leading criterion for the therapy is the high serum concentration of hepatitis B virus (HBV) DNA whereas the significance of the activity of alanine aminotransferase (ALT) is discussed. Objective. To identify the clinical significance of the level of ALT activity in patients with CHB. Subjects and methods. During the investigation, more than 250,000 patients were tested for serum hepatitis B surface antigen (HBsAg). ALT activity was identified in the persons who had been found to have HBsAg. Qualitative and quantitative assessments of HBV DNA were made in HBsAg-positive individuals. Groups of patients with different ALT activities and viral load were studied. Non-invasive assessment of liver fibrosis was carried out in CHB patients with normal ALT activity. Results. The prevalence of HBsAg in the Moscow Region amounted to 4.1%. Serum HBV DNA was detected in 63.3% of the HBsAg-positive examinees and a high viral load was found in 20.0%. High ALT levels were observed more often in males and patients older than 30 years. The combination of ALT activity > 2 N and viremia > 20,000 IU/ml suggests that the course of CHB is active and requires etiotropic therapy. Normal ALT activity levels and viremia < 20,000 IU/ml do not rule out the active course of CHB in HBsAg-positive patients.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):29-33
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Structure of syphilis and gonococcal infection morbidity in different phases of the epidemic cycle
Resumo
Objective. To analyze the involvement of different social groups (by gender, age, and place of registration) in the spread of syphilis and gonorrhea at different stages of the epidemic. Materials and methods. Based on the statistical data available in the Irkutsk Region over 1988-2013, the investigators conducted a retrospective epidemiological study of the incidence of syphilis and gonorrhea in various social groups. The average incidence rates were compared at different stages of the epidemic cycle. Results. The incidence rates of syphilis and gonorrhea in the general population amounted to 232 and 292 per 100,000 population during in the epidemic rise (1993-1997), 125 and 155 in the decline phase (2005-2009), and 66 and 78 in 2013, respectively. Both infections were more often registered among women and the rural population in the rise phase. The highest incidence rates of syphilis and gonorrhea were recorded in the age group of 18-19 years in the rise phase and in the group of 20-29 years in the decline phase. Conclusion. The same generation born in the late 1970s to early 1980s participated most actively in the formation of risk groups at the beginning of the epidemic and during the period of declining incidence.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):34-39
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Risk factors for the probable development of invasive candidiasis in the HIV-infected
Resumo
Objective. To identify risk factors for and probability of developing of invasive candidiasis (IC) in patients with HIV infection. Subjects and methods. A case-control study was conducted in a specialized department of the Perm Regional Clinical Hospital for Infectious Diseases in 2012-2014. A case group included 43 patients with the confirmed diagnosis of IC; a control group consisted of 59 patients without IC. The groups were matched for sex, age, residence, stage of HIV infection, counts of CD lymphocytes, and the absence of antiretroviral therapy. Results. The HIV-infected patients with IC were significantly more frequently observed to have factors, such as oropharyngeal candidiasis and tuberculosis, intensive care unit stay, prior gastrointestinal surgery and mechanical ventilation, active psychoactive substance dependence, stay in prison places, and the lack of a permanent job. To predict the development of IC in the HIV-infected, it is advisable to use at least three of the nine identified signs, the totality of which is characterized by the highest sensitivity (88.3%) and specificity (98.3%). Conclusion. The identified factors can be used for the prediction of a risk for IC in HIV-infected patients, for timely examination, early diagnosis, and adequate therapy.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):40-45
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Herpesvirus infection in patients with juvenile arthritis
Resumo
Based on the data available in the Russian and foreign literature over the last 10 years, the authors consider the role of herpesvirus infection as trigger and/or pathogenetic factors leading to the development of autoimmune processes, juvenile arthritis (JA) in particular. Herpesviruses are pantropic and widely distributed in the human population. The spectrum of the clinical manifestations of herpesvirus infection is very diverse in children: it depends on the localization of the pathological process, its extent, the patient’s immune system, and the antigenic type of the virus. According to the present-day concepts, JA is a heterogeneous group of chronic joint diseases with different etiopathogenesis and immunogenetic origin, nosology, and controversial prognosis. JA includes juvenile rheumatoid arthritis (juvenile idiopathic arthritis) and juvenile spondyloarthritis. The prevalence of JA in different countries ranges from 0.05 to 0.6% and its incidence does from 2 to 19 cases per 100,000 children under 16 years of age. The review discusses the influence of different endogenous and environmental factors on the development and progression of rheumatoid arthritis and the role of the genetically determined and secondary defects in immunoregulatory mechanisms, which lead to rapid transformation of an acute physiological inflammatory response to chronic progressive inflammation. It describes the current theories explaining the development of pathological autoimmune processes, such as the theory of genetic predisposition, the theory of immune dysregulation, the theory of network regulation, and the infection theory (including the relationship to the course of herpesvirus infection). The types of viral and bacterial infections and their impact on the development of severe clinical forms of JA are considered. The paper presents the modern concepts of pharmacotherapy for arthritis, juvenile idiopathic arthritis in particular. It describes the possible effects of biological agents on the reactivation of latent viral infections. Whether antiviral drugs can be used in children and should be administered in different stages and clinical types of JA is discussed.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):46-53
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Role of vitamin D in anti-infective immunity
Resumo
The literature data on the osseous and extraosseous effects of vitamin D, its pleiotropic mechanism of involvement in metabolic processes are analyzed. The paper reviews studies confirming the extraosseous (pleiotropic) effect of vitamin D and describes the pathogenetic ways of realizing the above effects. The anti-inflammatory and immunomodulatory properties of vitamin D as a factor of nonspecific protection in infections of various genesis (viral and bacterial) allow it to be used for the prevention and treatment of tuberculosis, hepatitis C, influenza A, acute respiratory infections, chronic rhinosinusitis, and pneumonia. A relationship of vitamin D to cardiovascular and kidney diseases, immune and nervous system disorders, and aging is considered in terms of the data of current studies. There are data on vitamin D provision in the pediatric population of the Russian Federation and on the normal serum levels of the active vitamin D metabolite 25(OH)D; a stepwise dosage regimen of vitamin D as cholecalciferol for prevention is given. Further studies in this area will be able to reconsider approaches to the therapy of infectious diseases and their prevention from birth to adulthood, by applying the physiological mechanisms of immune regulation.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):54-57
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Combined antiretroviral drugs containing lamivudine and zidovudine for the treatment of HIV infection
Resumo
The paper presents the results of a clinical trial comparing two first-line antiretroviral therapy (ART) regimens including combined drugs containing lamivudine and zidovudine. Objective. To compare the efficacy and safety of the brand-name drug combivir (AZT/3TC) and the generic drug dizaverox (AZT/3TC), by using the conventional comparison criteria. Subjects and methods. The investigation enrolled 61 patients: Group 1 included 32 patients receiving dizaverox (AZT/3TC); Group 2 consisted of 29 patients taking combivir (AZT/3TC). The groups were matched for age, sex, and clinical characteristics of HIV infection. All the patients had not previously received ART, had indications for therapy initiation; after the use of antiretroviral drugs they were followed up during 24 weeks. In this period, the investigators evaluated the clinical and immunological efficacy of the drugs and the severity of adverse events during their development. All the patients underwent a standard examination within the scheduled time and, if necessary, an additional in-depth examination. Results. With the comparable immunological efficacy of the drugs, the rate and amount of an increment in the number of CD4 lymphocytes were significantly higher in Group 1 than in Group 2 (230 and 144.5 cells/pl, respectively). At 24 weeks, the proportion of patients with suppressed HIV activity was also significantly higher in Groupl than in Group 2 (86.4% and 75%, respectively). In both groups, adverse events were recorded in 85% of the patients; anemia and hypercholesterolemia were most common; cytopenia, various gastrointestinal disorders, and hyperglycemia were encountered. The therapy was discontinued because of adverse reactions in 5 (15.6%) and 8 (27.6%) patients in Groups 1 and 2, respectively. Conclusion. The results of the study showed that the combined drugs taken for 24 weeks by HIV-infected patients who have not previously received ART have comparable clinical, immunological, and virological effects. At the same time, immunological and virological improvements occurred significantly faster and more substantially and adverse events developed less frequently in Group 1 patients.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):58-65
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Evidence-based medicine: the history of approaches to making decisions
Resumo
Evidence-based medicine represents a new approach to medical practice, which has evolved over the centuries. Different definitions of evidence-based medicine are presented in historical perspective. The periodization of development of this approach involves an empirical period, the period of the Enlightenment, a transitional period, and a modern period. The key events of each period and the role of well-known physicians in these are described.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):66-71
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The formation of scientific epidemiology in Russia in the 18th century
Resumo
In Russia, scientific medicine appeared and developed rapidly in the 18th century. Among the physicians who contributed to the development of Russian medicine, the disciples of Russian hospital schools, who vigorously fought the epidemics of plague, smallpox, and other epidemic diseases, played a great role. It was during this historical period when in Russia the teaching of contagionists came into contention in the struggle against the miasma theory. The study of their works written in the footsteps of controlling epidemic diseases gives every reason to believe that scientific epidemiology as an integral part of Russian scientific medicine began to take shape in the second half of the 18th century. As a historical argument in favor of the latter statement, the authors give an analysis of the events occurred 245 years ago during the 1770-1772 plague epidemic in Moscow.
Epidemiology and Infectious Diseases. Current Items. 2017;(1):72-76
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In memory of Professor Irina Lvovna Shakhanina
Epidemiology and Infectious Diseases. Current Items. 2017;(1):77-77
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Information on infectious and parasitic diseases in January-December 2016
Epidemiology and Infectious Diseases. Current Items. 2017;(1):78-81
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O.V. Kovalishena, V.V. Shkarin, N.V. Saperkin, M.M. Khramtsov. Epidemiology of infectious diseases M.M. Khramtsov, O.V. Kovalishena, V.V. Shkarin, N.V. Saperkin. Infectious diseases and epidemiology
Epidemiology and Infectious Diseases. Current Items. 2017;(1):82-85
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