State of the problem of infectious diseases with fecal-oral transmission mechanism in Southern Ukraine

Keywords: acute intestinal infections, intensity, diagnosis, sentinel epidemiological surveillance

Abstract

The purpose  of the study is to establish the causes of high incidence of infectious diseases with fecal-oral mechanism in the south of Ukraine.

Methods. Epidemiological analysis, descriptive-analytical, virological, bacteriological, serological and statistical.

Results. In a comparative study of the manifestations of the epidemic process of infectious diseases with fecal-oral transmission mechanism revealed evolutionary changes and a high level of its intensity, both in Ukraine and in the North-Western Black Sea region, which include Mykolaiv, Odessa and Kherson regions. In general, the share of acute intestinal infections with an established pathogen decreased by 1.2 times, dysentery by 3 times, acute intestinal infections with unidentified pathogen and rotavirus infection by 1.2 and 1.8 times, respectively. Significantly higher (t = 13.61; p <0.001) level of acute intestinal infections among the population of the region (506.63 ± 29.64)  о/оооо compared to the general indicators in the country (268.03 ± 11.39)  о/оооо. There is a pronounced downward trend in the incidence of shigellosis, as in the state (from 4.31 о/оооо in 2010 to 1.97 о/оооо in 2018), and in the region (from 9.02о/оооо in 2010 to 2.39 о/оооо in 2018). The region has a tendency to increase the incidence of salmonellosis (from 17.60 о/оооо in 2010 to 20.28 о/оооо in 2018), and a stable low level incidence of yersiniosis, both among the population of Ukraine (0.22 ± 0.20)  о/оооо, and - the region (0.31 ± 0.04) о/оооо. There was a steady increase in the incidence of rotavirus infection, both in the country (from 14.71 о/оооо in 2010 to 31.30 о/оооо in 2018), and and region (from 20.92 о/оооо in 2010 to 36.36  о/оооо in 2018), with two periodic rises (in 2014 and 2017). At this time in the territory of Odessa region there was a change in the dominant genotype of rotavirus (in 2013 (G4P[8] - (58.80 ± 4.87)  %, in 2014 there were three genetic variants: G2P [4] [32] 0 ± 4.59)  %, G4P[8] (31.0 ± 4.56)  % and G1P [8] (30.1 ± 4.52)  %, in 2017 G1P[8] dominated [66, 7 ± 4.91)  % On the territory of Odessa region there is a constant change of the dominant rotavirus genes: G1P[8], G3P[8] and G4P[8], which is accompanied by a cyclical (2-3 years) rise in the incidence of rotavirus infection among children under 5 years (r = 0.68; p <0.01), which is associated with the natural formation of the "susceptible layer".

Conclusions.  In the period 2010-2018 there was an increase in the intensity of acute intestinal infections epidemic process both in Ukraine and in the North-Western Black Sea region, where the proportion of morbidity was almost 1/5 of the national and was significantly higher (p <0,001). The etiological structure of acute intestinal infections with a deciphered pathogen is shown on the example of Odessa region, in children the "displacement" of pathogenic bacterial pathogens by opportunistic pathogens and rotaviruses is revealed. A comprehensive approach to diagnosis, as well as the use of modern PCR research methods increases the effectiveness of etiological diagnosis of acute intestinal infections pathogens. On the example of the region it is shown that when applying both bacteriological method and multiplex PCR the etiology of acute intestinal infections was deciphered in (89.78 ± 2.36)  % of cases, including (18.66 ± 1.74)  % of samples were detected 2-3 pathogens.. During the period of patrol epidemiological surveillance for rotavirus infection in the Odessa region in children with acute intestinal infections children found 15 different G [P] -combinations of rotaviruses, of which four main: G1P[8], G3P[8], G4P[8] and G2P[4]. With the dominance of the G1P[8] genotype the epidemic process of rotavirus infection was characterized by a stable course, while the increase in the proportion of G4P[8] was accompanied by a significant increase in its intensity.  To optimize the epidemiological surveillance of infectious diseases with fecal-oral transmission mechanism, we consider it necessary to introduce patrol epidemiological surveillance in some areas of the country with the selection of indicator populations (children, the elderly) and areas (territories), with the creation of reference centers.

Author Biographies

O. V. Kozishkurt, Odessa National Medical University

Doctor of medical sciences, MD, PhD, Associate Professor, Head of the Department of General and Clinical Epidemiology and Biosafety, Odessa National Medical University

M. I. Holubiatnykov, Odessa National Medical University

Doctor of medical sciences, professor of the Department of General and Clinical Epidemiology and Biosafety of Odessa National Medical University

S Doan, Odessa National Medical University & International European University

doctor of medical sciences, professor, Professor of the Department of General and Clinical Epidemiology and Biosafety of Odesa National Medical University & Vice-Rector for Research and Teaching and Postgraduate Education International European University

O. M. Ivanko, Ukrainian Military Medical Academy

Lt Col MS, MD, associate professor,  Head of the Research Institute Military medicine Problems of Ukrainian  Military  Medical  Academy

K. O. Talalayev, Odessa National Medical University

MD, PhD, Associate Professor, Vice-rector of Odesa national medical university

A. I. Savchuk, Odessa National Medical University

Doctor of medical sciences, professor Childrens infectious diseases department of Odessa National Medical University

V. R. Haydey, Odessa National Medical University

Doctor of medical sciences, professor, professor of Childrens infectious diseases department of Odessa National Medical University

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Published
2022-06-30
How to Cite
Kozishkurt, O. V., Holubiatnykov, M. I., Doan, S., Ivanko, O. M., Talalayev, K. O., Savchuk, A. I., & Haydey, V. R. (2022). State of the problem of infectious diseases with fecal-oral transmission mechanism in Southern Ukraine. Ukrainian Journal of Military Medicine, 3(2), 55-65. https://doi.org/10.46847/ujmm.2022.2(3)-055
Section
Military preventive medicine

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