Experience in Providing Medical Assistance to the Population of the Amur Region Exposed to the Effects of the Flood

Medical assistance to individuals residing in the flooded areas of the region was delivered on a priority basis throughout the health care institutions on the territorial-division principle, at the temporal accommodation sites, further on - long-term stay centers, 24-hours a day. Determined was the amount of means for specific prophylaxis, immunized was the contingent under risk, stocked up were pharmaceutical preparations, medical products and consumables. Therewith, carried out therapeutic, medical-preventive operations turned out to be on-time and sufficient for providing essential complex of medical assistance to the exposed population in the devastated areas

Prevention of the Infectious Disease Dissemination in Temporal Accommodation Sites during the Large-Scale Flood in the Amur Region

Abnormal rainfall flooding in the Amur Region formed premises for aggravation of epidemiological situation on acute enteric infections. Despite the organized strict control over compliance with applicable sanitary-epidemiological regulations at the temporal accommodation sites, a cluste of enterovirus infection occurred in one of them. On-time performed anti-epidemic measures made it possible to avoid distribution of the infection among the evacuated population and its dissemination outside the territory of that temporal accommodation site. Displayed are the data on operational experience of the Rospotrebnadzor institutions in the Amur Region in managing prophylactic and anti-epidemic activities aimed at the prevention of occurrence and distribution of the infectious diseases among the population evacuated from areas exposed to flood and placed in temporal accommodation sites

Реализация противоэпидемических мероприятий по профилактике пневмококковых инфекций в зонах паводкового наводнения в Приамурье

The aim of this study was to analyze CAP epidemiology and morbidity in the Amur region, to evaluate anti-epidemic measures for prevention of pneumococcal infections in flooded areas and medical and socioeconomic benefits of vaccination of children with risk factors for pneumococcal disease. Material and methods. Common morbidity of pneumonia was analyzed in the Amur region. To evaluate clinical and epidemiological efficacy of pneumococcal vaccination with PCV13 in 2014–2017, 5,000 children aged 2 to 5 yrs with high risk of pneumococcal infection were involved into a special follow-up programme. Clinical, epidemiological, social, hygienic, economic and statistical analyses were used. Results. The total incidence of pneumonia in population of the Amur region reached the peak value (897.3 per 100,000) in 2009; this was associated with influenza pandemic. CAP incidence decreased by 43.8% in 2010–2014. Morbidity of CAP had certain age-related and seasonal differences and was closely related to morbidity of acute respiratory viral infection. Results of microbiological monitoring of CAP pathogens in the Amur region were also discussed. Morbidity of pneumonia and acute respiratory infections decreased in 2014 in 69.4% of children vaccinated with PCV13. Morbidity of CAP reduced by 2,014 cases in 2014 that prevented economic loss of 94 billion RUB. Conclusion. Clinical and economic monitoring of CAP and pneumococcal vaccination with PCV13 in the Amur region have significant medical and socioeconomic efficacy.Пневмококковые инфекции в целом и внебольничная пневмония (ВП) в частности являются одной из важнейших проблем здоровья человека и общества в России. Особая зона и условия риска формирования ВП на территории Дальневосточного региона созданы паводковым наводнением в бассейне реки Амур летом 2013 г., обусловившим необходимость организации неотложных противоэпидемических мер и мероприятий по их профилактике. Цель исследования – анализ эпидемиологических особенностей заболеваемости ВП населения Амурской области (АО) и организации противоэпидемических мероприятий по профилактике пневмококковых инфекций в зонах паводкового наводнения в Приамурье, медицинской и социально-экономической эффективности вакцинации детей с факторами риска заболевания. Материалы и методы. Проведен анализ динамики показателей заболеваемости населения всеми формами пневмоний на территории АО. В разработанную программу мониторинга и клинико-эпидемиологической оценки эффективности вакцинации с использованием антипневмококковой вакцины «Превенар-13» (ПКВ-13) включены дети (n = 5 000) в возрасте 2–5 лет с факторами риска возникновения пневмококковой инфекции. Программой мониторинга предусматривается комплекс клинических методов обследования и наблюдения в динамике (2014–2017) с использованием методов клинико-эпидемиологического, социально-гигиенического, экономического и статистического анализа. Результаты. Уровень заболеваемости населения всеми формами пневмоний на территории АО достиг своего пикового значения (897,3 на 100 тыс. населения) в 2009 г., что было связано с пандемией гриппа. В 2010–2014 гг. произошло снижение заболеваемости на 43,8 %. Отмечены отчетливые возрастные и сезонные особенности динамики ВП, установлена их тесная корреляционная связь с острыми респираторными вирусными инфекциями (ОРВИ). Представлены результаты микробиологического мониторинга возбудителей ВП на территории АО. По результатам анализа использования ПКВ-13 показано, что в 2014 г. заболеваемость ОРВИ и пневмонией снизилась у 69,4 % детей, привитых пневмококковой вакциной. В 2014 г. за счет снижения заболеваемости населения ВП на 1 014 случаев предотвращен экономический ущерб в размере 94 млн руб. Заключение: в результате реализации Программы клинико-эпидемиологического мониторинга и профилактики ВП с использованием ПКВ-13 на территории АО отмечен высокий уровень медицинской и социально-экономической эффективности

ЭПИДЕМИОЛОГИЯ ВИЧ-ИНФЕКЦИИ В АМУРСКОЙ ОБЛАСТИ

The HIV infection prevalence rate suggests that in the Russian Federation the number of new cases of infection continues to grow. The retrospective epidemiological analysis of HIV infection in the Amur region was performed during a 5-year period from 2013 to 2017. The study included evaluation of incidence and prevalence rates, morbidity and mortality patterns. A positive HIV status has 0,14% of the region population. In 2017, the HIV-incidence rate equaled to 10,97‰00. Similar incidence rates were registered during 2015 and 2016. During 2013–2017 annual growth of HIV-prevalence that reached its peak in 2017 and exceeded the previous year’s rate at 18,3±0,65% (p=0,001) was registered. The highest HIV prevalence was detected at age from 30 to 39 years (45%). Among the HIV-positive people, sexual transmission route was dominant and during 2017 and totaled to 87%. Among people living with HIV registered for outpatient treatment, the most frequent stages of the disease (representing 97,7% of all clinical forms) were subclinical stage diagnosed in 251,3‰ [95% CI 232,2–270,3] and second stage (of secondary manifestations) totaled to 216,1‰ [95% CI 191,5–240,5]. This indicates on the development of the concentrated stage of HIV infection in the Amur region. Epidemiologic features of infection spread in the Amur region derives not only from active cross-border movements of citizens, but also from the specifics of demography processes.Цель работы: оценка состояния и тенденций развития эпидемического процесса ВИЧ-инфекции в Амурской области за последние пять лет (2013–2017). Материалы и методы. Проведен ретроспективный эпидемиологический анализ заболеваемости ВИЧ-инфекцией в Амурской области за 5 лет, с 2013 по 2017 год, изучены показатели инцидентности, превалентности, структуры заболеваемости и смертности. Результаты. Положительный ВИЧ-статус имеет 0,14% лиц от общей численности населения области. В 2017 году заболеваемость составила 10,97‰00, в том же диапазоне находились показатели 2016 и 2015 годов (10,80‰00 и 10,99‰00 соответственно). 2013–2017 годы характеризуются ежегодным ростом пораженности, достигая максимума в  2017 году, превышая показатель предшествующего года на 18,3±0,65% (p=0,001), а максимальный удельный вес пораженности ВИЧ-инфекцией приходился на возрастную группу от 30 до 39 лет (45%). Среди инфицированных лиц доминирует половой путь передачи, в 2017 году на него пришлось 87%. Среди лиц с ВИЧ-инфекцией, находящихся на диспансерном учете, доминировали стадии субклинических 251,3‰ [95% ДИ 232,2–270,3] и вторичных проявлений 216,1‰ [95% ДИ 191,5–240,5], составляя 97,7% от общего числа всех клинических форм. Это свидетельствует о реализации в Амурской области концентрированной стадии эпидемии ВИЧ-инфекции. Заключение. Эпидемические особенности распространения инфекции в  Амурском регионе обусловлены активными трансграничными перемещениями граждан.    </p

Epidemiological Surveillance over HIV-infection Including Patients Co-infected with HIV and Viral Hepatitis in the Far Eastern Federal District

Relevance. HIV-infection continues to be one of the unsolved issues of modern healthcare. In the Russian Federation, an annual increase in the number HIV-infected people including co-infected with HIV and viral hepatitis is registered. This is associated with common transmission mechanisms of the diseases. Objective: to conduct a retrospective analysis of the main HIV-infection epidemiological indices that included prevalence of viral hepatitis B and C among people living with HIV in the Far Eastern Federal district during years 2006–2018. Materials and methods: the conducted retrospective epidemiological analysis was based on evaluation of materials provided by AIDS prevention and control regional centers as well as in the official statistical data form № 61 «Data on HIVinfected contingents». Analysis of the obtained data included parametric and nonparametric statistics. Results. A deterioration of the epidemic situation concerning HIV-infection with and without viral hepatitis B and C was registered in the Far Eastern Federal district. The fraction of HIV-positive people aged 40 years and older increased up to 24.68 ± 0.26% in 2018. Feminization of HIV-infected population was observed. The fraction of HIV-positive women increased from 32.30 ± 0.50 % in 2006 to 36.82 ± 0.29% in 2018. The fraction of sexual transmission mechanism of the HIV has increased during the observed period of time and totaled 40.60 ± 0.30% in 2018. This fact plays a significant part in the spread of HIV in the Far Eastern Federal district. Conclusion. The revealed tendencies indicate a necessity of changing the preventive measures strategy against HIV

ENTEROBACTERIACAE, PRODUCING ESBLS AND METALLO-β-LACTAMASE NDM-1, ISOLATED IN HOSPITALS OF BALTIC REGION COUNTRIES

Abstract. We studied the prevalence of K. pneumoniae and E. coli resistance to extended spectrum cephalosporins and carbapenems, isolated from patients of eight hospitals in St-Petersburg from January to May, 2012. Prevalence of cephalosporin resistant isolates varied in different hospitals: E. coli – from 7,8 to 50%, K. pneumoniae – from 25,4 to 88,4%. Isolates produced extended spectrum beta-lactamases СТХ-М, mainly СТХ-М-1, also СТХ-М-2 and СТХ-М-9. Twenty two carbapenem-resistant K. pneumoniae strains (also resistant to other antimicrobials) were isolated in three hospitals. MALDI-TOF MS showed that carbapenem resistance was caused by carbapenemase. Carbapenemases of all isolates belonged to metallo-β-lactamases according to results of the ROSCO Diagnostica tests. The gene coding production of New Delhi metallo-β-lactamase (blaNDM-1) were detected in all strains. Our data confirmed that the main cephalosporin resistance mechanism of E. coli и K. pneumoniae in Baltic region (including Russia, St-Petersburg) is CTX-M-1 production. For the first time in Russia K. pneumoniae strains  producing metallo-β-lactamases NDM-1 were isolated in several hospitals of St-Petersburg