Ways to improve prevention of chickenpox at children of Ukraine in modern condition

Анотація

Introduction. Chickenpox (CP) in recent years has tended to steady increase in the incidence of various regions of Ukraine, especially among children. The situation regarding the incidence of PA nowadays, especially among children, determines the relevance of infection and requires the solution of problems in finding the most effective ways to prevent the population of Ukraine against CP. Purpose: to theoretically justify the introduction of the National vaccination calendar of Ukraine vaccine against CP based on the study of modern epidemiological, clinical and paraclinical features of CP in children of Kharkiv region of Ukraine. Materials and methods. The analysis of statistical data on the incidence of PA in Kharkiv region and 2780 data from case histories of children aged one month PA-18, admitted to the Kharkiv Regional Hospital of Pediatric Infectious Diseases in the last five years. The diagnosis is established on the basis of characteristic clinical manifestations. Results and discussion. During the period 2010-2014 epidemiological curve morbidity in children with CP has tended to rise with maximum performance in 2011, prevailed among patients, children who lived in the city. The largest recorded incidence in children under 15 years old, had a tendency to increase the proportion of high school age children. Among dominated diseased children attending organized children's groups (kindergartens, schools), including more than a third part of patients lived in closed children's institutions (orphanages, boarding schools, etc.). Clear seasonal disease was traced to the rise of the autumn-winter period. Monitoring the number of children with CP, admitted to hospital, also showed growth in their numbers. The reason for hospitalization were: pronounced intoxication syndrome, abundant rash on skin and mucous membranes, complicated disease, epidemiological indications. The most affected age groups were children 1-10 years. The disease ran mostly in moderately severe and severe forms. Analysis of clinical data showed that almost all children with acute illness began with symptoms of intoxication, temperature up to 38,0-400C, headache, some children had vomiting. Rash appeared mostly often by the end of the second day. Items were rash as spots 1-3 mm in diameter, round, pink with sharp edges. Subsequently, they were transformed into papules, vesicles, crusts, which were located on non-infiltrated background skin, usually separately without a tendency to merge. New elements of rash appear after 1-2 days and accompanied by fever. Almost half part of children forming vesicles recorded in the mucous membranes of the mouth, genitals and conjunctiva during 4-5 days. In hemogramma of patients revealed leukopenia, lymphocytosis. A quarter of children with CP occurred complications that are most often developed for third-eighth day of the appearance of lesions regardless of severity of clinical manifestations of the disease. The structure dominated by non-specific complications of skin lesions with the development of inflammatory diseases streptococcal and staphylococcal etiology. The structure of specific complications observed CNS with the development of meningitis, encephalitis and meningoencephalitis. Conclusions. Over the past five years in the Kharkiv region incidence of children with CP remains high with the major indices among children under 15 years. The most vulnerable are children with organized groups (especially closed children's institutions) residing in the city. There has stable tendency to increasing number of complications, particularly specific. High incidence, frequency and severity of complications dictate the need for mandatory vaccination against CP in children. First of all, in our view, it is necessary to consider compulsory vaccination of children from child care centers closed, and may in the future enter into the National calendar of vaccination of healthy children Ukraine. The use of mandatory vaccination of children against CP will significantly reduce the number of cases of children; reduce the number of complications and economic costs of treatment and rehabilitation of these patients.