Evaluation of tuberculosis epidemic situation in Ukraine and possible scenarios for its prognosis

The work is aimed at the assessment of the epidemiological situation of tuberculosis (TB) in Ukraine and the development of possible scenarios of outlooks incidence of this infection in the short and medium term perspective. It is established that the epidemic situation of tuberculosis in Ukraine is an emergency. This fact is indicated by the following parameters: since 1995 more than 1% of the population has been suffering from TB (460 219 patients were registered in tuberculosis institutions in 2011), and the intense morbidity indicator was 68.1 per 100 thousand people in 2012, what was twice as much as the epidemic threshold (30.0 per 100 thousand of population). A strong inverse statistical correlation (rank correlation coefficient ranges from 7836 to 8718) between the incidence of TB and human development index (HDI) has been proved in the countries of the WHO European Region. The major factor contributing to the spread of TB in Ukraine is one of the lowest rates of HDI in Europe, which in 2010 was 0.725 in Ukraine (the 43d place among 51 countries in the WHO European Region, and at the same time the 8th place by TB incidence). The prognosis of TB morbidity in Ukraine has two possible scenarios: an optimistic scenario (there is a statistical tendency to moderate decrease in the incidence of TB) and a pessimistic one (a gradual increase in the incidence of TB, which can be associated with the negative tendencies of the global crisis and European development). In Ukraine, a severe statistical tendency to the increase of intensive indicators of TB associated with HIV infection stands in favor of the latter scenario

THE INFLUENCE OF CHRONIC KIDNEY DISEASE ON SEXUAL FUNCTION OF WOMEN

The article describes the current view on hormonal changes in women of reproductive age, pre- and postmenopause with chronic kidney disease (CKD), including sexual and reproduction function disturbances, menstrual cycle changes, infertility and miscarriage, as well as the influence of renal replacement therapy (RRT) on sexual and reproductive function. Menstrual cycle changes characterized as anovulation and amenorrhea. The lack of LH peaks and absence of estradiol changes according to menstrual cycle phase, hypoestrogenemia, hyperprolalactinemia are the basis of hormonal disfunction. Results of experimental studies have shown renoprotective effect of estrogens by influencing the synthesis and release of vasoactive substances, cytokines and other growth factors that are responsible for the functional abnormalities of mesangial cells, and preventing the action of transforming growth factor β-1 (TGF-β-1), which plays a role in the process of glomerulosclerosis

ULTRASOUND FEATURES OF THE THYROID GLAND IN PATIENTS WITH TYPE 1 DIABETES DEPENDING ON THE KIDNEY FUNCTION

Introduction. Thyroid dysfunction is a common endocrine disorder among patients with chronic kidney disease (CKD), but there is still no clear understanding of sonographic characteristics of the thyroid gland (TG) in patients with diabetes-related CKD. Aim. The aim of the study was to identify sonographic features of the TG in patients with type 1 diabetes (T1D) and CKD. Patients and methods. A cross-sectional study included 173 patients with T1D, divided into subgroups based on renal function, and 39 healthy controls. Clinical assessment included evaluation of serum levels of creatinine, glycated hemoglobin (HbA1c), antithyroid antibodies, estimated glomerular filtration rate (eGFR) with subsequent stratification by stages of CKD, as well as ultrasound examination of the TG using a standard technique. Results. Patients with T1D without CKD had the lowest median of the TG left lobe volume (p=0.009) compared to the control group; meanwhile, there were no differences with other subgroups of patients. Patients with T1D who had underwent kidney transplantation had the highest prevalence of thyroid nodules (42.9%) (χ2=5.0, p=0.025 compared to individuals with T1D without CKD). There were no differences in the frequency of ultrasound signs of thyroiditis in T1D patients with different CKD stages, as compared to the control group (χ2=3.8, p=0.274). Conclusion. The present study has obtained new data on sonographic features of the TG in patients with T1D complicated by CKD

ANALYSIS OF SUBSEQUENT DISEASE CASES IN ESTIMATION OF COST OF ILLNESS OF ROTAVIRUS INFECTION

The aim of the work. Evaluation of subsequent cases of rotavirus infection (RVI) using retrospective epidemiological data and mathematical and computer modeling. Materials and Methods. The information basis for the analysis was the retrospective epidemiological data of monthly RVI morbidity inUkraine from 2010 to 2016, methods of mathematical and computer modeling. Results and Discussion. Using the developed software, probabilities of RVI in different age groups and the expected number of primary and subsequent cases of disease for newborns in the first five years of life were determined. The highest probability of the disease was observed in children in the age of 1-2 years, which is consistent with world trends. Despite the fact that in the world it was decided to take into account the first few cases of RVI, the results of computer simulations showed that the number of primary cases significantly dominates the number of subsequent cases in the morbidity of RVI among children under five years of age in Ukraine. Conclusions. The obtained modeling results are of great importance when carrying out a pharmacoeconomic study of specific prevention of RVI among children of Ukraine, since it has been shown that the costs of treatment of the first case of illness should be taken into account and subsequent disease cases, as much less likely, can be neglected