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Epidemiology and Vaccinal Prevention

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Vol 17, No 5 (2018)
View or download the full issue PDF (Russian)
https://doi.org/10.31631/2073-3046-2018-17-5

CONFERENCE

5-16 2020
Abstract

The article presents an analysis of theoretical generalizations in epidemiologists at all stages of its development and development. It is shown that the components that make up the content of the subject of epidemiology have evolved in the understanding of their essence, in particular, causality, the mechanism of development and epidemiological manifestations. Representations and terminology about the content and essence of the subject have changed: from the epidemic, to the epidemic process, and, finally, to the population level of organization of pathology and human health (morbidity and public health). The greatest scientific discussions and intellectual struggle of opinions passed through the whole history of science. The concepts that prevailed in the ancient world, the Middle Ages, in the 20th century and theoretical generalizations in epidemiology of the modern period are presented. Problems were revealed and directions for further research in the field of theory and practice of epidemiology were suggested.

17-24 1769
Abstract

The development of theoretical concept is based on previous knowledge. In this article we have presented historical aspect of epidemiology of healthcare-associated infections (HAIs), because without these events the modern theoretical scientific basis for the prevention of HAIs would not be possible. The modern concept will be presented in the second part of article.

25-30 986
Abstract

The article presents the basic positions of managing the vaccine prevention risks on the population level. The science-based necessity of transition from the assessment of the effectiveness of mass vaccinal prevention in terms of incidence rates to managing potential risks of vaccine prevention. The prospects for further development of this methodology were determined.

31-37 1272
Abstract

This article is devoted to both theoretical and practical aspects of modern epidemiology of infectious diseases associated with the improvement of pre-epidemic diagnostics and the need for its implementation in the system of risk-based surveillance. The authors summarized and systematized the current data on the factors of epidemiological risk as well as suggested methodological approaches to identify and assess the prerequisites and precursors of complication of the epidemiological situation. In addition, they took into consideration the existing problems of pre-epidemic diagnosis and ways to solve them.

38-44 898
Abstract

Background. In recent decade, skin cancers are considered as a serious threat to the population health. Goal. Assessment of the dynamics of indicators characterizing the epidemiological manifestations of melanoma and other skin cancers among the population of the Altaiskiy krai in 2007–2016, as well as making a forecast for the next ten-year period.

Materials and methods. The general and standardized melanoma and other skin cancers incidence (mortality) rates of the Altaiskiy krai population for the period 2007– 2016 have been calculated. A component analysis of the dynamic changes in morbidity during the studied period was carried out. The risk of development to 75, 85 years old and throughout life of the studied cancers was assessed for a residents of the Altaiskiy krai. The nonlinear extrapolation method was used to calculate the predicted values for the next ten years. Results. The melanoma and other skin cancers incidence rates in the population of Altaiskiy krai in the study period were 5.7 (95% CI 5.4 – 6.0) and 63.4 (95% CI 62.4 – 64.4) per 100 th population and tended to increase (5.2 and 3.1% per year, respectively), which was due to both demographic processes (42.1 and 68.6% respectively), and activation of risk factors (80.6 and 66.7%, respectively). The risk of melanoma and other skin cancer over a lifetime for a resident of the Altaiskiy krai was 0.37 and 4.12%, respectively.

Conclusion. Thus, the revealed unfavorable tendencies to the growth of melanoma and other skin cancers morbidity rates in Altaiskiy krai during the studied period testify to the need to improve preventive measures and surveillance.

45-53 2268
Abstract

Relevance. Measles and rubella have been known to humanity for centuries. These two infections have a number of similarities. However, despite all the similarities and a single elimination program, it is not possible to achieve the same results by the level of the incidence of these infections. Goal. Identify common features and differences in the manifestations of the epidemic process of measles and rubella at the present stage and formulate a hypothesis on their explanation.

Materials and methods. Methods of retrospective epidemiological analysis of morbidity were used: Evaluation of the statistical significance of the differences in indicators with the Student’s test. To compare the rate of decrease in the incidence of measles and rubella their exponential approximations using the method of least squares were used. To process the research data, the Microsoft Excel program was used.

Results. In the pre-vaccination period, the incidence of measles was 4.6 times higher than rubella. For major infections in this period characterized by a pronounced cyclic morbidity, while the intervals between cyclical rises for measles are shorter, and the amplitude of cycles is higher. As the population was vaccinated, the incidence of these infections decreased, while the rate of decline in the incidence of rubella was higher than that of measles. Also, a faster decrease in morbidity and smoothing of the cyclicity, a transition to older age groups, a gradual exit from the incidence of younger age groups confirm that the rubella has a contact number less then measles.

Conclusion. The current level of population immunity is sufficient to eliminate rubella in a relatively short time. For measles, which has greater contagiousness and a contact number, and is more demanding for population immunity, this level is not enough. As a consequence, rubella shows better «manageability» in immunization than measles.

54-59 2512
Abstract

Chicken pox in the Russian Federation in recent years has maintained a consistently high level of rating in the structure of infectious diseases and the magnitude of economic damage from infectious diseases.

Purpose: was to assess the epidemiological features of chicken pox in adults over 18 years in the Voronezh region.

Methods. Materials the study was of the form of Federal state statistical supervision over 2006 – 2017 years. The method of retrospective epidemiological analysis was used. Statistical data processing was performed using Microsoft Excel.

Results. In recent years, in the Voronezh region there has been an increase in the incidence and hospitalization of adults diagnosed with varicella. In persons older than 18 years, more severe course and complications were observed. Cases of varicella were reported as an infection related to medical care. The sources of infection for nosocomial cases were pregnant women and healthcare professional.

Conclusions. In order to prevent introduction and spread of chicken pox in medical organizations of the region it is necessary to consider the immunization of contingents at risk. It requires the introduction of a permanent statistical monitoring of individuals with a diagnosis of «Shingles».

60-70 2717
Abstract

The diphtheria carriage is a asympthomatic colonization of oro- and nasopharynx by toxigenic and nontoxigenic Corynebacterium diphtheriae. The carriage of toxigenic strains prevents a complete eradication of diphtheria infection in spite of mass toxoid immunization. The contamination by toxigenic diphtheria bacteria leads to the carriage if the person has a protective level of diphtheria antitoxin. Contamination with the toxigenic and nontoxigenic leads to the carriage if the person has no protection to the bacterial colonization factors. Some of them are surface protein structures and may serve as components of the future vaccines against diphtheria bacteria colonization.

71-77 1270
Abstract

Objective. The frequency of diagnosing intrauterine infections is increasing every year. assessment of the frequency of intra-amniotic infection of the fetus using the standard case definition.

Subject and methods: a study, conducted in one of the maternity hospitals of St. Petersburg, included 110 newborn children with an established diagnosis of intra-amniotic infection. To clarify the diagnosis, we have applied the probable and confirmed standard definitions of the case.

Results: a study showed that the diagnosis of intraamniotic infection was consistent with the standard case definition in 30.9% of cases.

Conclusion:  the introduction of standard case definitions will make it possible to unify the registration and notification of the intrauterine infections by different specialists in all types of healthcare settings and will allow a unified approach to identification of the intrauterine infections, both in maternity hospitals and in the neonatal units of children's hospitals.

78-88 1112
Abstract

This review analyzes the methodological reasons for the heterogeneity of the results of the evaluation of the epidemiological effectiveness of vaccine prophylaxis of tick-borne encephalitis (TBE) using indicators such as the efficiency coefficient (COEF) and the efficiency index (IEF), and their discrepancy with similar indicators of the immunological effectiveness of vaccines. It is shown that the calculation of COEF and IEF according to official statistical reporting is illegal in connection with the emergence of systematic errors of selection due to the impossibility of retrospective formation of compared groups of vaccinated and unvaccinated, comparable in risk of infection and disease. In addition, COEF and IEF do not allow to compare the efficiency of vaccination in different areas in physical and monetary units.

Based on the analysis of the literature data on immunogenicity of modern vaccines against TBE, protective titer of antibodies and results of field tests of vaccine efficacy in the conditions of total coverage of the population with vaccinations, the authors conclude that the third generation vaccines against TBE protect against disease 95–98% of persons attacked by ticks. Algorithm for calculating the number of preventable cases of TBE diseases is proposed for a comparative evaluation of the effectiveness of vaccination as an anti-epidemic measure in different areas.

89-95 1328
Abstract

In modern conditions, the study, development of methods for the prevention of imported infections after international travel is an urgent problem in many countries of the world. In 2017, the world has committed more than 1322 million international trips, in Russia – 39.6 million trips abroad. The factors influencing the growth in the number of international trips made are singled out. The structure of imported infectious diseases in 380 children and 1580 adult patients hospitalized in Moscow's Infectious Clinical Hospital № 1 between 2009 and 2016 after arriving from foreign countries is given. Objective: to analyze some modern approaches to the prevention of imported infectious diseases. The modern classification of categories of travelers is given. Examples of studies conducted in different countries indicate the important role of pre-travel consultations for the prevention of imported infections. The analysis of the risks of development of certain infectious diseases in travelers has been carried out. Modern algorithms of vaccination before journeys are considered. Attention is drawn to the need to develop centers for medicine in Russia, which will help provide practical health care in the prevention of imported infections.

96-99 964
Abstract

The health of servicemen has always been one of the main factors playing a decisive role in the battle. The level of development of medical knowledge of military doctors plays an enormous role in maintaining the health of the personnel of the troops, together with their proper improvement. Sanitary losses of troops during the wars of the XIX-XX centuries have always been huge and depended mainly on infections, including wound infections, which many times exceeded the number of deaths during battles. Infectious complications of wounds of different genesis remain one of the most difficult problems of surgery in both peaceful and wartime. It should be noted, that Louis Pasteur was the first who spoke about infectious diseases at infectious diseases in 1862, and already in 1865, on the basis of Pasteur's experiments, the English surgeon Joseph Lister suggested using carbolic acid to fight infected wounds. These works laid the foundation of antiseptics, contributing to significant success in surgery. At the present time, new microorganisms have come to replace the classical pathogens of infectious diseases, contributing to the development of infectious complications, an increase in the duration of treatment and lethality.

PRACTICAL ASPECTS OF EPIDEMIOLOGY AND VACCINE PREVENTION

100-105 1043
Abstract

Squamous cell carcinoma of the head and neck organs occupies the 5th place in the structure of oncological morbidity in the world. The mortality from this pathology has not changed for several decades, despite significant successes and achievements in modern clinical oncology. In article are explored and analyzed: the etiological role of human papillomavirus (HPV) in the development of oropharyngeal cancer; sexual and age specific features of HPV-associated cancer, various methods of predictive diagnosis, specific prevention. Conclusions: papillomavirus infection is the main cause of the sharp and continuing increase in the incidence of oropharyngeal cancer, mainly among men in many countries of the world; vaccination has positive expectations in the prevention of the incidence of oropharyngeal cancer.

106-110 877
Abstract

The history of association between HPV and cancer, risk factors, pathogenesis, diagnostics, treatment and prophylaxis of anal intraelithelial neoplasia (AIN) and squamous-cell anal cancer are discussed in this article. Although these conditions are rare, they may become some of the main health hazards in certain groups of patients, such as HIV-infected patients, patients with history of other HPV-related malignancies, patients practicing anal sexual intercourse and patients receiving systemic immunosuppressive therapy. A collaboration of different specialists is necessary in order to develop effective prophylactic measures for HPV-associated malignancies of anal region. There are no estabilished methods for AIN treatment. The use of ointments and local destruction are the most researched treatment methods. Vaccination is already developed as a prophylactic measure. However, a more thorogh research of HPV types in russian population is necessary prior to its wide implementation. Preliminary data favors the use of polivalent vaccines in russian population.

111-116 973
Abstract

Background. Vaccination is considered by the world community as the main measure of the fight against pneumococcal infection [1–3]. Immunization of children has been carried out since the end of 2014.  Goals. To study the compliance of the vaccination scheme against pneumococcal infection in young children and its influence on vaccination efficacy.

Methodology. Evaluation of the compliance of the vaccination schedule against pneumococcal infection and the impact on morbidity in young children was carried out under the conditions of epidemiological observational descriptive and analytical («cohort») researches. Expert assessment is made of medical records of 52 patients, and 200 electronic medical cards and 200 cards of prophylactic vaccination in children were born in of 2015 and 2016.

Results. The high importance of adherence to the vaccination scheme against pneumococcal infection was established not only in the prevention of disease and also in reducing carriage of S. pneumoniae. The greatest effect of pneumococcal immunization was observed in children who received the first vaccination before the age of 6 months and with a completed course of vaccination.

Conclusion. Timeliness of immunization of young children against pneumococcal infection is a significant factor in ensuring preventive efficacy of immunization.



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ISSN 2073-3046 (Print)
ISSN 2619-0494 (Online)