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UDC 616.853-053.2-07-085.21 DOI: 10.22141/2224-0713.1.87.2017.96541
O. Sukhonosova
Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
Comparison of prevalence, incidence and disability from nervous diseases and epilepsy among children of the Kharkiv region and Ukraine
Abstract. The article presents the results of comparison of prevalence, incidence and disability from nervous diseases and epilepsy among children of the Kharkiv region of Ukraine and Ukraine as a whole and the results are compared with global figures. In 2015 in Ukraine 407 618 cases of diseases of nervous system were registered in children from 0 to 17 years of age, that is 53.53per 1000 children, the average value for 5years is 459 300 children (58.354 %o), in the Kharkiv region 36 494children (86.28 %) were diagnosed with diseases of nervous system, 5-year average is 39 883 children (94.476 %c). The prevalence of epilepsy in Ukraine amounts to 25 695 children (3.21 %), higher than the prevalence of cerebral palsy or neuroinfections, the average value for 5 years is 24667children (3.144 %). In the Kharkiv region the number is 1 451 children (3.43 %c), 5-year average is 1 340 children (3.21 %c). The incidence of diseases of the nervous system in children in Ukraine amounts to 140 494children (18.45 %c), an average over 5years is 159 215children (20.29 %c), in the Kharkiv region the number is 11 871 children (28.07 %c), an average is 13 795 children (33.068 %c). The incidence of epilepsy in children in Ukraine is 3 306 children (0.43 %c), the average value for 5 years is 3 569children (0.454 %c). In Kharkiv region the incidence is 252persons (0.53 %c), an average is 201.2 children (0.468 %c). In Ukraine, over the past 5years there has been a tendency to reduce the prevalence and incidence of diseases of the nervous system in children, while in the Kharkiv region in 2014—15 there is an increase of these indicators, which is connected, apparently, with the migration of the population. In the structure of disability of children under the age of 18 in Ukraine diseases of the nervous system come second, amounting to 29 684 children (37.1 per 10 000 children), the proportion is 17.6 %, in the Kharkiv region this number is 1 770 (41.8per 10 000 children). Thus, the presented results of the work allowed to analyze a group of children under 18 years of age with diseases of the nervous system, to determine a number of epidemiological indicators for the Kharkiv region, to assess first of all, the place and importance of epilepsy, to compare data obtained with all-Ukrainian data for optimization of medical care for children. Keywords: children; incidence;prevalence; disability; nervous system diseases; epilepsy
М1ЖНАРОДНИЙ НЕВРОЛОГ1ЧНИЙ ЖУРНАЛ
INTERNATIONAL NEUROLOGICAL JOURNAL |
МЕЖДУНАРОДНЫЙ НЕВРОЛОГИЧЕСКИЙ ЖУРНАЛ ОРИГШАЛЬШ ДОСЛЩЖЕННЯ /ORIGINAL RESEARCHES/
Background
The health for all policy framework for the European Region (WHO "Health 21", "Healthy Start in Life") provides for health improvement for all infants, young children and pre-school age children in the region by 2020. 11 medical interventions that WHO has classified the most cost-effective include prevention of noninfectious diseases and disabilities. In 2015 in Ukraine 13 267 123 cases of all diseases were registered in children from 0 to 17 years of age, that is 1742.3 per 1000
children, 407 618 of them were diseases of nervous system, which is 53.53 per 1000 children. However, nervous system diseases is one of the main causes of disability among children and have a share of17 %. Epilepsy holds the 1st place among the diseases of the nervous system for disability reasons.
The aim of this work is to compare prevalence, incidence and disability from nervous diseases and epilepsy among children of the Kharkiv region of Ukraine and Ukraine as a whole and to compare the results with global figures for optimization of medical care.
© «International Neurological Journal», 2017 © <^жнародний невролопчний журнал», 2017
© Publisher Zaslavsky O.Yu., 2017 © Видавець Заславський О.Ю., 2017
For correspondence: Olga Sukhonosova, Candidate of Medical Sciences, PHD, Associate Professor at the Department of Neurology and Child Neurology, Kharkiv Medical Academy of Postgraduate Education, Amosova st., 58, Kharkiv, 61176, Ukraine; e-mail: [email protected] Для кореспонденцп: Сухоносова Ольга Юрпвна, кандидат медичних наук, доцент кафедри неврологи та дитячо'1' неврологи, Харгавська медична академия послядипломноТ освiти, вул. Амосова, 58, м. Харгав, 61000, Украша; е-mail: [email protected]
Materials and methods
For comparative analysis we used the data for the last 5 years. The provided data are specified with the forms of the reporting under health care questions approved by the Order ofthe Ministry of Health of Ukraine of 07/10/2007 No. 378 in coordination with the State Statistics Committee of Ukraine.
Results
The number of the children's population in Kharkiv region from 2011 to 2015 is specified in table 1.
Table 1. The number of the children's population in Kharkiv region from 2011 to 2015
Comparative dynamics of epilepsy prevalence among the children's population (0—17) of Kharkiv region and Ukraine is presented in fig. 2.
2011 year 2012 year 2013 year 2014 year 2015 year
Kharkiv region 415 618 413 718 416 442 418 984 422 956
3.5 3.4 3.3 3.2 3.1 3 2.9 2.8 2.7
3.43
3.24 3.25 „
2011 2012 2013 2014 ■ Kharkiv region ■ Ukraine
2015
The prevalence of the disease is the number of all registered cases in a certain population. In Ukraine among the children's population (0—17 years) 407 618 children with diseases of the nervous system are registered that makes 53.53 cases per 1000 children's population. Diseases of the nervous system in children occupy the 8th rank place and have a specific weight of 3.1 among all diseases among children. As the prevalence of diseases of the nervous system in children Kharkiv region ranks the 1st among 27 territorial units of Ukraine, generally due to functional disorders, vegetative dysfunctions.
Comparative dynamics of diseases prevalence of a nervous system among the children's population (0—17 years) of Kharkiv region and Ukraine is presented in fig. 1.
The prevalence of epilepsy in Ukraine is 25 695 children (3.21 %), exceeding the prevalence of cerebral palsy, neuroinfections. Kharkiv region takes the 14th place among all regions of Ukraine on prevalence of epilepsy, not exceeding the general indicator
Figure 2. Comparative dynamics of epilepsy prevalence among the children's population (0-17 years) of Kharkiv region and Ukraine from 2011 to 2015
The research conducted in various countries give an epilepsy prevalence rates from 1.5 in Japan, 2.3 in Norway per 1000 people to 6.0 in Great Britain, 6.7 in the USA.
Disease incidence is a frequency of appearaning new, firstly revealed cases in the population this year. The incidence of diseases of the nervous system in children aged 0-17 years in Ukraine is 140 494 children (18.45 %). Diseases of the nervous system in children occupy 10th ranking place and have a specific weight of 1.48 among all diseases of the children's population. By the number of nervous system diseases in children Kharkiv region ranks the 1st in Ukraine.
Comparative dynamics of nervous system incidence among the children's population (0-17 years) of Kharkiv region and Ukraine is presented in fig. 3.
Figure 1. Comparative dynamics of diseases prevalence of a nervous system among the children's population (0-17 years) of Kharkiv region and Ukraine from 2011 to 2015
50 40 30 20 10 0
41.77
36.68
31.22
27.6 28.07
I1 28 20.29 19.03 Ig.*;
tm
2011 2012 2013 2014 2015 ■ Kharkiv region i Ukraine
Figure 3. Comparative dynamics of nervous system incidence among the children's population (0-17 years) of Kharkiv region and Ukraine from 2011 to 2015
The incidence of epilepsy in Ukraine among children aged 0—17 years is 0,43 % (3 306 children). As the incidence of epilepsy among children's population (0—17 years), Kharkiv region occupies the 17th place among all regions of Ukraine.
Comparative dynamics of epilepsy incidence among the children's population (0—17 years) of Kharkiv region and Ukraine is presented in fig. 4.
0.6 0.5 0.4 0.3 0.2 0.1 0
0.54
0.48
0.46 0.45 0.45 0.43 0.41 0.43
2011 2012 2013 2014 ■ Kharkiv region ■ Ukraine
2015
38,1 %
30,4 %
%
13,9 %
I Congenital anomalies I Diseases of the nervous system Disorders of mentality and behavior Another cases
Figure 5. The disability reasons among the children's population of Ukraine
Figure 4. Comparative dynamics of epilepsy incidence among the children's population (0-17 years) of Kharkiv region and Ukraine
In the world, the incidence of epilepsy ranges from 11 to 134 per 100 000 population.
In 2015 in Ukraine 153 547 disabled children were registered (201.6 per 10 000 children), 151 125 disabled children were registered in 2014 (199), 168 280 disabled children were registered in 2013 (210.6), 167 059 disabled children were registered in 2012 (209.6), 166 164 disabled children were registered in 2011 (207.6 per 10 000 children).
In the structure of children's disability aged up to 18 years the1st place is taken by congenital anomalies (malformations) of 51 195 children (64.1 per 10 000 children) (specific weight of 30.4 %), the 2nd place is occupied by diseases of the nervous system of 29 684 children (37.1 per 10 000 children) (specific weight of 17.6 %), the 3rd place is taken by disorders of mentality and behavior of 23 337 children (29.2 on 10 000 children) (the specific weight of 13.9 %). From year to year the growth rate of children's disability has been noted, in particular disability related to congenital anomalies (malformations).
The dynamics of disability indicators due to nervous system diseases and epilepsy among children (aged 0—17 years) of Kharkiv region from 2011 to 2015 is presented in the fig. 6.
According to the rate of children's disability Kharkiv region takes the seventh place in Ukraine and the first place in the number of children whose disability is connected with epilepsy.
For the first time in 2015, 2160 children were recognized as disabled due to diseases of the nervous system. The indicator per 10 000 children makes 2.8, specific weight is 12.5.
Figure 6. The dynamics of disability indicators due to nervous system diseases and epilepsy among children (aged 0-17 years) of Kharkiv region for 2011 to 2015
There were 2028 children who were recognized as disabled due to diseases of the nervous system in 2014 (the indicator per 10 000 children makes 2.7), specific weight is 12.5. In 2013 year there were 2439 children who were recognized as disabled due to diseases of the nervous system (the indicator per 10 000 children makes 3.1), specific weight is 13.3. There were 2432 children who were recognized as disabled due to diseases of the nervous system in 2012 (the indicator per 10 000 children makes 3.1), specific weight is 13.4. In 2011 year there were 2579 children who were recognized as disabled due to diseases of the nervous system (the indicator per 10 000 children makes 3.2), specific weight is 13.8.
Dynamics of primary disability indicators due to diseases of a nervous system and epilepsy among the children's
Diseases of the nervous system ■ Epilepsy
Figure 7. Dynamics of primary disability indicators due to diseases of a nervous system and epilepsy among the children's population (0-17years) of Kharkiv region from 2011 to 2015
population (0—17 years) of Kharkiv region from 2011 to 2015 is presented in fig. 7.
According to indicators of primary disability in children with diseases of a nervous system Kharkiv region takes the 21st place, and the 13th place according to epilepsy.
According to the European Academy of Childhood Invalidity in Central and Eastern Europe the percentage of children with disabilities is 2.5 %. Taking into account children population in Ukraine it makes about 200 thousand disabled children. Comparing these estimates with reports of the Center for Health Statistics of the Ministry of Health of Ukraine (153 547 children with disabilities in 2015), we can speak about under-diagnosis of disabling diseases in young children and a problem of accessible health care.
Conclusions
Thus, the presented results of the work allowed to analyze a group of children under 18 years of age with diseases of the nervous system, to determine a number of epidemiological indicators for the Kharkiv region, to assess first of all, the place and importance of epilepsy, to compare data obtained with all-Ukrainian data. This will bring in subsequent comparative characteristics and more in-depth study of the problem in
Ukraine. However, statistical data do not allow to diagnose a form of the disease, to evaluate age and gender composition of patients. Neither it is possible to evaluate the appointment of anticonvulsant therapy and its effectiveness in epilepsy and determine the type of the disease and its prognosis. Therefore, completion of a register of patients with epilepsy is one of the most important tasks enabling us to improve patient care, patients' medical and social prognosis and helping to prevent severe consequences of the disease and disability of patients.
Conflict of interests. Not declared.
References
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Received 12.01.2017 ■
Сухоносова О.Ю.
Хармвська мелична акалем1я п1слядипломноI осв1ти, м. Харюв, Укра'на
Пор1вняння поширеносп, захворюваност та ¡нвал1дносп з нервових хвороб i ешлепсм серед дитячого населення ХарювськоТ облает й УкраТни
Резюме. У статт надаш результата зютавлення поширеносп, захворюваноси та швалщноси з нервових хвороб i епшепсп серед дитячого населення Харивськш обласи й Украши i по-рiвняння отриманих результаив i3 свгговими показниками. В 2015 рощ серед дитячого населення 0—17 роив в Украш за-реестровано 407 618 дитей iз хворобами нервово! системи, що становить 53,53 випадку на 1000 дитячого населення, середнш показник за 5 роив — 459 300 дитей (58,354 %с), в Харивськш обласп — 36 494 дитини (86,28 %с), середнш показник — 39 883 дитини (94,476 %с). Поширешсть епшепсп в Укра!ш
становить 25 695 випадив (3,21 %с) та перевищуе поширешсть дитячого церебрального парал1чу, нейрошфекцп, середнш показник за 5 роив — 24 667 випадив (3,144 %с), в Харивськш обласи — 1451 випадок (3,43 %с), середнш показник — 1340 випадив (3,21 %с). Захворювашсть дггей на хвороби нервово! системи в Украт становить 140 494 випадки (18,45 %с), середнш показник за 5 роив — 159 215 дггей (20,29 %с), в Харивськш обласи — 11 871 дитина (28,07 %с), середнш показник — 13 795 дитей (33,068 %с). Захворювашсть на епшепсш в Украш в дитей становить 3306 випадив (0,43 %с), середнш показник за
5 роюв — 3569 дггей (0,454 %с), в Харк1вськ1й област1 — 252 ди-тини (0,53 %с), середнш показник — 201,2 дитини (0,468 %с). В Укра'М за остант 5 рок1в вщзначаеться тенденцы до зниження поширеноси та захворюваност1 на хвороби нервово! системи в дитей, а в Харк1вськ1й област1 в 2014—2015 рр. спостерггаеться збшьшення цих показниив, що пов'язано, мабуть, з мпращею населення. У структур1 швалщноси д1тей в1ком до 18 роив в Украш хвороби нервово! системи займають 2-ге м1сце та становлять 29 684 випадки (37,1 на 10 000 дитей), питома вага — 17,6 %, в Харивсьий обласп — 1770 (41,8 на 10 000 дитей). Таким
чином, надаш результати роботи дозволили проан^зувати групу дiтей до 18 роив с захворюваннями нервово! системи, визначити ряд епiдемiологiчних показниив по Харивсьий областi, оцшити в першу чергу мiсце i значення епшепсп, пор1в-няти отриманi дат з загальноукрашськими. Це в подальшому дозволить провести порiвняльнi характеристики i бшьш по-глибленi дослщження проблеми по всш Украш для оптимiзацii надання медично! допомоги дiтям.
Ключовi слова: дiти; захворюванiсть; поширенiсть; швалщтсть; нервовi хвороби; епшепсш
Сухоносова О.Ю.
Харьковская медицинская академия последипломного образования, г. Харьков, Украина
Сопоставление распространенности, заболеваемости и инвалидности по нервным болезням и эпилепсии среди детского населения Харьковской области и Украины
страненности и заболеваемости болезнями нервной системы у детей, а в Харьковской области в 2014—15 гг. наблюдается увеличение этих показателей, что связано, по-видимому, с миграцией населения. В структуре инвалидности детей в возрасте до 18 лет в Украине болезни нервной системы занимают 2-е место и составляют 29 684 случая (37,1 на 10 000 детей), удельный вес — 17,6 %, в Харьковской области — 1770 (41,8 на 10 000 детей). Таким образом, представленные результаты работы позволили проанализировать группу детей до 18 лет с заболеваниями нервной системы, определить ряд эпидемиологических показателей по Харьковской области, оценить в первую очередь место и значение эпилепсии, сравнить полученные данные с общеукраинскими. Это в последующем позволит провести сравнительные характеристики и более углубленные исследования проблемы по всей Украине для оптимизации оказания медицинской помощи детям. Ключевые слова: дети; заболеваемость; распространенность; инвалидность; нервные болезни; эпилепсия
Резюме. В статье представлены результаты сопоставления распространенности, заболеваемости и инвалидности по нервным болезням и эпилепсии среди детского населения Харьковской области и Украины и сравнение полученных результатов с мировыми показателями. В 2015 году среди детского населения 0—17 лет в Украине зарегистрировано 407 618 лиц с болезнями нервной системы, что составляет 53,53 случая на 1000 детского населения, в Харьковской области — 36 494 ребенка (86,28 %с). Распространенность эпилепсии в Украине составляет 25 695 случаев (3,21 %с) и превышает распространенность детского церебрального паралича, нейроинфекции, в Харьковской области — 1451 случай (3,43 %с). Заболеваемость болезнями нервной системы у детей в Украине составляет 140 494 случая (18,45 %с), в Харьковской области — 11 871 случай (28,07 %с). Заболеваемость эпилепсией в Украине у детей составляет 3306 случаев (0,43 %с), в Харьковской области — 252 случая (0,53 %с). В Украине за последние 5 лет отмечается тенденция к снижению распро-
