Эпидемический процесс острых кишечных вирусных инфекций на современном этапе

Abstract

В статье приведены результаты ретроспективного эпидемиологического анализа заболеваемости острыми кишечными инфекциями в Одесском регионе за период 1998-2011 гг. Показана ведущая роль ротавирусной инфекции в структуре гастроэнтероколитов, сезонный подъем заболеваемости сопровождался достоверно более частым выявлением ротаантигена в фекалиях больных. Как ротавирусными, так другими установленными и неустановленными гастроэнтероколитами преимущественно болеют дети до 3 лет. В последние годы отмечен неуклонный рост заболеваемости ОКИ, преимущественно, вирусной этиологии.

The paper presents the results of a retrospective epidemiological analysis of the incidence of acute intestinal infections in Odessa region for the period of 1998-2011. The work used the state statistical month reports and annual incidence of DCI and RVI in Odessa and its region. There was shown a leading role of rotavirus in the structure of gastroenterocolites; seasonal rise in incidence was accompanied by significantly more frequent detection of rotaantigene in the faeces of patients. It can be difficult to establish the etiology of the pathogen due to late presentation of patients, incomplete laboratory examination, and inaccessibility of virological investigations for many hospitals. When one of the etiologic agents is found, studies for other agents have been conducted; patients often have mixed infections, which remain unidentified. In Odessa RVI has been recorded since 1995. Every year the rate of the morbidity is increasing, which is associated with improved diagnostic capabilities against AIVI. During the period analyzed 90 adults fell ill with RVI according to the official registration in Odessa (2.99 %); children from 0 to 14 years old - 2920 (97.01 %) of them from 0 to 2 years old - 2192 (72.82 %), from 3 to 6 years old - 624 (20.73 %), from 7 to 14 yo - 104 (3.46 %). RVI incidence among adult population ranged from 0 (2004 and 2008) to 5.94 (in 2001), making on an average, 0.64 ± 0.73 per 100 thousand of population. Whereas among children aged 0 to 14 years old, it was 3.25 (2002) to 388.02 (2011), on an average, 125.51 ± 68.74 and was significantly higher than among the adult population (t = 3.70; p = 0.002). The highest incidence was in the group of children of 0-2 years old, ranging in some years from 14.24 (2002) to 1777.82 (2011) and making to an average 588.10 ± 310.29 per 100 thousand of population, significantly exceeding the level of morbidity in all age groups (Student's t ratio averaged 3.73, p = 0.002). In the group of children aged 3 to 6 years old, the incidence ranged from 2.69 (1997) to 342.48 (2011), making on an average 113.38 ± 60.08. In the group of 7 to 14 years old, the incidence ranged from 0 RVI (1995, 1998) to 27.39 (2001), reaching an average of 6.97 ± 4.13 per 100 thousand of population. Thus, the incidence of RVI in the population of Odessa during the study period ranged from 0.67 (2002) to 54.13 (2011), reaching on an average 18.20 ± 9.55. Seasonal rise in the incidence of RVI started in December and lasted until April, which was typical of this infection. Increased incidence was also observed in the summer months - July and August, which was likely due to the swimming season and the water factor in the spread of infection and was confirmed reliably by more frequent detection of RA in seawater. In cold weather, route of transmission was mainly contact-household, which was associated with frequent carriage of RVI among adults, including decreed groups. Seasonal factors on the whole caused 81.33 % per annum, including water factor - 19.63 % due to the duration of the bathing season. A comparison of the average detection rotaantigene from December to May and from June to November was made. It is established that during the periods of seasonal incidence rises in RVI, the proportion of positive results for the presence of RA was significantly higher (t = 6.67; p ≤ 0.001) and was, on an average, 53.22 ± 5.79 % than in the periods of recession (34.90 ± 4.65 %). Both rotavirus and other established and nonestablished gastroenterocolites mainly affects children under 3 years old. In recent years there has been a steady increase in the incidence of acute intestinal infections, predominantly of viral etiology.

У статті наведено результати ретроспективного епідеміологічного аналізу захворюваності на гострі кишкові інфекції в Одеському регіоні за період 1998-2011 рр. Показано провідну роль ротавірусної інфекції в структурі гастроентероколітів. Сезонний підйом захворюваності супроводжувався достовірно частішим виявленням ротаантигену у фекаліях хворих. Як ротавірусними, так іншими гастроентероколітами встановленої і невстановленої етіології переважно хворіють діти до 3 років. В останні роки відзначено неухильне зростання захворюваності ГКІ, переважно, вірусної природи.