OPTIMIZATION OF EPIDEMIOLOGICAL SUPERVISION FOR ACUTE INTESTINAL INFECTIONS IN UKRAINE
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Keywords

epidemiological surveillance, risk factors, prognosis, shigellosis, salmonellosis, diarrhegenic escherichiosis

How to Cite

Malysh, N. G., Chemych, M. D., & Kuzmenko, O. V. (2019). OPTIMIZATION OF EPIDEMIOLOGICAL SUPERVISION FOR ACUTE INTESTINAL INFECTIONS IN UKRAINE. Eastern Ukrainian Medical Journal, 7(1), 28-38. Retrieved from https://eumj.med.sumdu.edu.ua/index.php/journal/article/view/6

Abstract

Introduction. Acute intestinal infections nowadays remain a burning problem for many countries of the world, especially with middle and low income, in spite of improved sanitary and hygienic conditions of living and drinking water quality. Therefore, the system of epidemiological surveillance of acute intestinal infections needs to be improved.

Purpose. The paper presents the results of studies on the dynamics of the incidence of schigellosis, salmonellosis, diarrhegenic escherichiosis, demographic statistics and indicators of sanitary-hygienic monitoring for the period 2001-2017 in the Sumy region. Epidemiological and statistical methods of research, multivariate analysis were applied.

Discussion. It was established that in the investigated period incidence rates for shigellosis decreased from 42.3 per 100 thousand population to 0.5, salmonellosis increased 13.0 to 17.7, diarrhegenic esherihiosis – varied at 3.70–2.20. At the same time, the population of the region has decreased from 1317.8 thousand people in 2001 to 1104.5 thousand in 2017, the population density decreased from 55.3 (persons per km2) to 46.3, the natural population movement decreased from -11.1 % to ‑8.6, migratory movement  ̶ from -5.2 % to -0.7, the prevalence of diseases of the digestive system has increased from 13004.0 per 100 thousand people to 17124.89. It has been established that in those examined for prophylactic purposes, the frequency of isolation of shigella and salmonella decreased from 146.5 and 20.7 per 100 thousand to 0, enteropathogenic Coli Bacilli  ̶ from 671.4 to 24.9. Results of sanitary-hygienic monitoring of food and drinking water showed that the frequency of detection of "non-standard" samples of water was 8.1 %, meat products – 5.2 %, milk and dairy products – 4.3 %, sugar and confectionery products  ̶ 5.6 %, eggs  ̶ 4.2 %. The frequency of separation of sanitary and indicative microflora from equipment, the hands of workers in public catering facilities was 4.7 %, food enterprises and enterprises for the production of confectionery creamy products 3.4 % and 1.03 %, respectively, dairies – 1.6 %. In the course of statistical analysis, with the help of Statistica applications, the dependence of the morbidity on the influence of risk factors was established and presented as a linear multivariate regression equation. Using predictive values of risk factors, with the use of regression equations, predictive values of morbidity were obtained for the most significant forms of acute intestinal infections. In 2018–2020, an increase in the incidence of shigellosis, salmonella, diarrhegenic escherichiosis is expected. Among the risk factors, the greatest impact will be provided by the increase in population density, the prevalence of diseases of the digestive system, migration of the population, "non-standard" microbiological indicators of meat and meat products.

Thus, identifying risk factors for epidemic situation and using a mathematical model to predict the development of the epidemic process of acute intestinal infections, taking into account demographic indicators and socio-hygienic monitoring data can be an important part of the system for improving epidemiological surveillance.

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