EDITORIALS
ORIGINAL ARTICLES
Background. Monitoring of documented vaccination is one of the indicators of the epidemiological supervision quality of preventive vaccination. It is crucial for epidemical situation prevention. Objective. The aim of the study is to estimate immunization and immunization coverage levels according to National Immunization Schedule (NIS) for children population in Russia. Methods. Immunization rates were estimated according to preventive vaccination cards (form №063/y) and children development cards (form №112/y) among children aged from 6 months to 15 years in 8 towns of Russia. Immunization was determined by the ratio of people who has fully performed all the vaccines from NIS (version of the year 2014), while immunization coverage – by the ratio people who has received at least one dose of corresponding vaccine. Results. The study has included data from 2,687 vaccinated children. The highest levels of immunization and immunization coverage were against tuberculosis (98.1% each), hepatitis B (85.9% and 96.5%), measles, mumps and rubella (84.4% and 93.9%). Immunization against diphtheria, pertussis and tetanus significantly differed from their immunization coverage (60.5% and 94.9%), as well as for poliomyelitis (65.0% and 94.9%). Relatively low immunization and immunization coverage levels were observed for pneumococcal infection (27.6% and 47.1%) and influenza (5.8% and 30.5%). The increase in the immunization level with age was observed for all vaccines, except pneumococcal vaccine. Conclusion. Immunization and immunization coverage against infections included in NIS vary significantly. The highest immunization and immunization coverage levels for all age groups were revealed for tuberculosis vaccine, and the lowest — for influenza vaccine.
Background. The prevalence of various allergic diseases has increased worldwide in recent decades. Allergy diagnosis in children should be economically optimal and as sparing as possible, while ensuring the high quality of medical care. Objective. The aim of the study is to develop optimal algorithms for analysis of sensitization profile in children with allergy family history, or suspected allergy, or atopy phenotype. Methods. Complete examination of 153 children aged from 1 to 17 years 11 months was performed. Children were divided in 4 groups according to the presence and characteristics of complaints, the presence of allergic disease. Sensitization was determined via the “gold standard” of allergy diagnosis — the ImmunoCap method (Phadia, Sweden), and the results of skin testing. Results. 97 (63.4%) children have shown sensitization to various allergens. We have revealed seasonal manifestation of allergy in children to various allergens: Fagales in 89-92% of cases, grasses in 68-72% of cases, weeds in 39-57% of cases. Complaints of all-year manifestations of allergic rhinitis were revealed in 24% of cases to cat dandruff, complaints of coughing and/or bronchospasm — in 100% of cases to birch pollen and in 35% of cases to house dust. The sensitization analysis has revealed strong correlations with confirmed statistical significance between pollen allergen sensitization classes in groups of different plants. Conclusion. Optimal algorithms for sensitization diagnosis in children living in Moscow agglomeration were developed according to the obtained results and revealed correlations.
Background. Nowadays there is a need to revise the Russian list of risk factors of hearing loss and deafness based on their study according to the evidence-based medicine and the analysis of the audiology service capabilities. Moreover, audiologic screening system for newborns and infants should be revised in every region to identify the reasons of mismatch with international standards and to find ways of its efficacy improvement. Objective. The aim of the study is to increase the efficacy of Russian program of all-round newborns and infants hearing screening. Methods. This study consisted of two parts. 1) The first stage of audiological screening audit on the example of 78 medical institutions in Saint-Petersburg. The availability and correct function of hearing research equipment, specialists’ qualifications, study technique and conditions, documents and results transmitting accuracy were estimated. 2) Updating the list of risk factors of hearing loss. The prevalence rate of these factors in Russian population according to the literature and official statistics was studied. Evaluation of predictive significance of risk factors was based on retrospective data in the cohort of 393 children born in 2012 (280 with hearing loss, 113 healthy) examined in National Research Centre for Audiology and Hearing Rehabilitation at the age of 0–4 years. Results. The first stage of audiological screening audit has shown that only 14% of included institutions fully meet the criteria of its effective implementation. The following problems were revealed: purchase and renewal of equipment, its timely adjustment, ensuring the continuity of screening stages, specialists training, compliance with methodology and study conditions, results documentation. We were able to increase by 8.5% (close to targeted indicator) the coverage of newborns with first stage of audiological screening as well as to increase the rate of children at the diagnostic stage from 33% to 51%, due to the results of this audit and methodological assistance to the institutions. According to the analysis of prognostic significance and prevalence of risk factors of hearing loss and deafness in Russian population of newborns, it is necessary to perform full hearing examination regardless of the results of newborns and infants hearing screening with the following risk factors: 1) cases of persistent child hearing loss in the family; 2) syndromes associated with hearing loss; 3) auricle, ear canal and dentofacial anomalies; 4) congenital infection (cytomegalovirus, rubella, syphilis, toxoplasmosis); 5) stay in newborns intensive care unit for more than 2 days; 6) prematurity of 32 weeks or less; birth weight less than 1500 g; 7) hyperbilirubinemia in perinatal period (exchange blood transfusion; total bilirubin level when exchange blood transfusion is needed); 8) usage of ototoxic drugs; 9) severe perinatal damage to the central nervous system, neurodegenerative diseases; 10) ambiguous reaction to sounds, developmental delay. Conclusion. Maintenance of all-round newborns hearing screening algorithm will allow us to avoid the diagnosis delay, to start the rehabilitation earlier and further to significantly increase the efficacy of modern high-tech methods for correcting hearing disorders in children. We have to check the presence of risk factors of hearing loss and deafness in every child. Timely referral of children with risk factors for the second stage of audiological screening, diagnosis and correction of hearing disorders creates conditions for normal child oral-aural development.
SHORT REPORT
NEWS
JUBILEE
FROM THE UNION OF PEDIATRICIANS OF RUSSIA
ISSN 2500-3089 (Online)