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3«MEDICINE, SCIENCE AND EDUCATION», № 1, 2023
yflK: 614.446.33 DOI: 10.24412/1609-8692-2023-1-18-23
MPHTM: 76.33.43
ORGANIZATION OF EPIDEMIOLOGICAL SURVEILLANCE OF LISTERIOSIS IN THE ALMATY CITY
* T. Turlykozha, M. Baimuratova, A. Ryskulova, M. Sarsenbaeva
LLP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan
Summary
The annual registration of morbidity among humans and animals, the extremely negative impact of infection on the course of pregnancy and fetal development, and the registration of outbreaks of food listeriosis accompanied by high mortality make listeriosis an extremely urgent medical and veterinary problem. The most common cause of infections is food contaminated with pathogenic bacterial species of the genus Listeria, in particular L. monocytogenes. The paper analyzes outbreaks and sporadic cases of invasive listeriosis in the world and analyzes the incidence among the population of Almaty. Identification of contingents of high epidemic risk in listeriosis among the population of Almaty. It is noted that a systematic approach, including sanitary and epidemiological control of food raw materials and finished products, a properly organized technological process, and hygienic education of the population, is of crucial importance in the prevention of listeriosis.
Key words: listeriosis, outbreak of morbidity, epidemic, prevention, torch syndrome.
Introduction. The history of the study of listeriosis infection has more than a hundred years. In recent years, the medical and socio-economic significance of this problem has increased significantly. The annual registration of morbidity among humans and animals, the extremely negative impact of infection on the course of pregnancy and fetal development, the registration of outbreaks of food listeriosis, accompanied by high mortality, make listerio-sis an extremely urgent medical and veterinary problem.
The disease is characterized by a multiplicity of sources of the causative agent of infection, a variety of pathways and transmission factors, pronounced polymorphism of clinical manifestations, from mild to extremely severe cases, high mortality. Listeriosis is common in the vast majority of countries of the world, on almost all continents. In recent years, this noso-logical form has attracted attention, primarily as a food infection.
The susceptibility to listeriosis can also
be increased by previously transmitted infections, especially viral ones, the number of identified pathogens of which regularly increases [1,2].
The food quality and safety control system include: the development of a regulatory framework, the organization of laboratory control and monitoring of product quality and safety, the conduct of supervisory measures and the adoption of administrative measures [3,4]
An analysis of outbreaks and sporadic cases of invasive listeriosis, as well as a comparison of the seasons of viral and listeria infections shows that previous viral infections contribute to the disease of listeriosis due to a violation of the mucoid layer of the gastrointestinal tract in viral gastroenteritis [5,6].
The study showed that during the follow-up period from November 2018 to October 2019, clinical cases of listeriosis were distributed by diagnosis according to the age of patients. Perinatal listeriosis in most cases occurred during the winter-spring period of the
PUBLIC HEALTH
rise in the incidence of influenza, when the incidence rate of the population was above the baseline (72.2 per 10 thousand people) and above the weekly epidemic threshold. In the older age group, 4 out of 5 cases of meningitis correlated with a period of high incidence of influenza, while listeriosis pneumonia coincided with the autumn season of acute respiratory viral infections [7,8,9].
Bacteria of the genus Listeria are widely distributed in nature. These microorganisms, having broad adaptive capabilities, can inhabit both the human body and warm-blooded animals, as well as various environmental objects (soil, water, plants). However, recently several outbreaks of listeriosis have been associated with the contamination of fresh food around the world. In addition, L. monocytogenes has been found in many studies. in fresh food samples and even in some minimally processed vegetables. L. monocytogenes can contaminate fresh food if present in the growing medium (soil and water) [10,11,12].
The causative agent of listeriosis is well adapted to moist, humus-rich soils with a medium reaction close to neutral. Listeria actively reproduce in the soil in spring and autumn. Winter freezing of the soil does not adversely affect their viability [13,14].
Pregnant women, their fetuses and newborns are at the greatest risk of infection with listeriosis. Pregnant women get listeriosis 20 times more often than other healthy people, and about 35% of all registered listeriosis was observed during pregnancy. The risk of listeriosis is higher in multiple pregnancies. It is believed that listeria has a peculiar tropism to the genitourinary system of women and, especially, to the tissues of embryos [15,16,17,18].
During the current COVID-19 pandemic (2020-2021), the frequency of registrations of listeriosis of pregnant women and invasive listeriosis, occurring in the form of sepsis and/ or damage to the central nervous system, did not differ significantly from similar indicators recorded in 2018-2019. However, listeriosis sepsis combined with a severe form of a new coronavirus infection caused by SARS-CoV-2 have a high risk of mortality. The likelihood of developing listeriosis sepsis against the back-
ground of severe COVID-19 and the high risk of an unfavorable outcome require raising awareness of medical professionals in the field of diagnosis and treatment of invasive listerio-sis for the earliest possible and adequate antibacterial therapy [19,20].
Methods. The study of the features of the epidemic process in listeriosis was carried out during 2021-2022 on the basis of Sanitary and epidemiological control in Almaty.
The work performed was based on the following materials:
-maps of epizootic and epidemiological examination of the focus of zoonotic infection;
-logs of registration of the material received for laboratory research; -results of bacteriological, serological and biological studies on listeriosis of the material from humans;
-logs of registration of a patient with suspected listeriosis:
The main methods were:
- epidemiological analysis;
- epizootiological analysis;
-s tatistical processing of the results obtained with the calculation of relative indicators, standard error, distribution of average long-term morbidity levels.
The study of the incidence of listeriosis and mortality was carried out using the methods of operative and retrospective epidemiological analysis based on the materials of official registration forms, laboratory research journals, acts of epidemiological investigation of foci.
Results. In our country, cases of listeri-osis continue to be registered among the population (especially among children under 14 years of age). It should be noted that over the past five years, the proportion of average forms of «listeriosis» has increased, which does not reduce the priority of studying a specific nosology. Currently, it is necessary to take into account the role of listeriosis in the genesis of torch syndrome (intrauterine infection). Thus, in the city of Almaty in 2021-2022, an analysis of the actual registration revealed a clear trend of an increase in sporadic cases by 6 times. Therefore, the study of the causes of their spread and occurrence is one of our main tasks.
Also, when analyzing laboratory studies of the risk group for zoonotic infections for 9
months of 2022 in Almaty, 827 examinations of pregnant women were conducted, of which 2.27% showed a positive result (18 cases). In comparison, for 9 months of 2021, 803 examinations of pregnant women were conducted, of which 0.62% showed a positive result (5 cases). There is a significant increase by 3.6 times, which is due to the lifting of quarantine restrictions this year, an increase in preventive examinations and an increase in laboratory diagnostics. Contact and patients with suspected listeriosis were examined in the laboratory for 9 months of 2022 in Almaty - 161 of them 15.76% (25 cases) showed a positive result [21.22].
Discussion. The most important factors contributing to the spread of listeriosis in a megalopolis are: high population of the territory by rodents, primarily epidemiologically significant objects; a large number of domestic and neglected animals; intensive and uncontrolled for the maintenance of listeria pathogens until recently, the import of food products from abroad and various regions of Kazakhstan; high migration of the population; the presence of enzootic sites where the occurrence of anthropological foci is possible; insufficient level of diagnosis of this infection.
Summing up the results of epidemio-logical surveillance based on microbiological monitoring of listeriosis, for Kazakhstan, espe-
cially in a megalopolis, the fixation and steady growth of the intestinal form of the disease in the city of Almaty remains an urgent problem.
Conclusions
1. Listeriosis is one of the infections that are constantly registered in the territory of Almaty with a tendency to increase the incidence in recent years.
2. Intestinal forms of the disease are most often registered in Almaty.
3. The most important factors contributing to the spread of listeriosis in a megalopolis are: high population of the territory by rodents, primarily epidemiologically significant objects; a large number of domestic and neglected animals; intensive and uncontrolled pathogens. listeria until recently, the import of food products from abroad and various regions of Kazakhstan; high migration of the population; the presence of enzootic sites where the occurrence of anthropological foci is possible; insufficient level of diagnosis of this infection.
4. An epizootic process is constantly operating on the territory of the city, ensuring the preservation and maintenance of the causative agent of listeriosis in the population of urban rodents.
5. The contingents of the highest epidemic risk of listeriosis infection include children aged 10-14 years, pregnant women, newborns and elderly people with impaired immune status.
ОРГАНИЗАЦИЯ ЭПИДЕМИОЛОГИЧЕСКОГО НАДЗОРА ЗА ЛИСТЕРИОЗОМ В
УСЛОВИЯХ ГОРОДА АЛМАТЫ
* Т. Турлыкожа, М. Баймуратова, А. Рыскулова, М. Сарсенбаева
ТОО Казахстанский медицинский университет «ВШОЗ» Алматы, Казахстан
Аннотация
Ежегодная регистрация заболеваемости среди людей и животных, крайне негативное влияние инфекции на течение беременности и развитие плода, а также регистрация вспышек пищевого листериоза, сопровождающихся высокой смертностью, делают листериоз чрезвычайно актуальной медицинской и ветеринарной проблемой. Наиболее частой причиной инфекций является пища, загрязненная патогенными видами бактерий рода Listeria, в частности L. monocytogenes. В статье анализируются вспышки и спорадические случаи инвазивного листериоза в мире и анализируется заболеваемость среди населения Алматы. Выявление контингентов высокого эпидемического риска по листериозу среди населения г. Алматы. Отмечается, что решающее значение в профилактике листериоза имеет системный подход, включающий санитарно-эпидемиологический контроль пищевого сырья
и готовой продукции, правильно организованный технологический процесс и гигиеническое просвещение населения.
Ключевые слова: листериоз, вспышка заболеваемости, эпидемия, профилактика, torch-синдром.
АЛМАТЫ ЦАЛАСЫ ЖАГДАЙЫНДА ЛИСТЕРИОЗГА ЭПИДЕМИОЛОГИЯЛЬЩ ЦАДАГАЛАУДЫЦ ¥ЙЫМДАСТЫРЫЛУЫ
*Т. Турлыкожа, М. Баймуратова, А.Рыскулова, М. Сарсенбаева
«^ДСЖМ» ^азакстанды; медицина университетi ЖШС Алматы, ^азакстан
Туй1ндеме
Адамдар мен жануарлар арасындагы аурушацдыкты жыл сайын тiркеу, инфекцияньщ жYктiлiк пен урыктыц дамуына ете жагымсыз эсерi жэне жогары eлiммен бiрге жYретiн тагамды; листериоздыц ершуш тiркеу листериозды ете eзектi медициналы; жэне ветеринарлык проблемага айналдырады. Инфекциялардыц ец кеп тараган себебi - Listeria тукымдас бактериялардыц патогендi тYрлерiмен ластанган тагам, атап айтканда L. monocytogenes. Макалада элемдегi инвазиялы; листериоздыц eршуi мен спорадикалы; жагдайлары жэне Алматы тургындары арасында сыркаттанушылы; талданады. Алматы каласыныц тургындары арасында листериоз бойынша жогары эпидемиялы; кауш контингенттерi аныкталады. Листериоздыц алдын алуда тамак шикiзаты мен дайын eнiмдi санитарлык-эпидемиологиялы; бакылауды, д^рыс уйымдастырылган технологиялы; процестi жэне халыкты гигиеналы; окытуды камтитын жYЙелi тэсiл шешушi мэнге ие екендiгi атап етшедь
Tyrnndi свздер: листериоз, аурудыц вршу1, эпидемия, алдын алу, torch синдромы.
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Conflict of interest. All authors declare that there is no potential conflict of interest requiring disclosure in this article.
Contribution of the authors. All authors have made an equal contribution to the development of the concept, implementation,processing of results and writing of the article. We declare that this material has not been published before and is not under consideration by other publishers.
Financing. Absent.
Information about the authors
Corresponding author. Turlykozha Tokzhan Adilkhankyzy, LLP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: [email protected] , ORCID https://or-cid.org/0000-0002-2990-085X.
ЭДЕБИЕТТ1К ШОЛУЛАР
Baimuratova Mayrash Aushatovna - candidate of Medical Sciences, Associate Professor of the Department of Public Health and Social Sciences», LLP Kazakhstan's Medical University «KSPH» , Almaty, Kazakhstan, E-mail: [email protected] , ORCID https://orcid.org/0000-0003-0219-7874.
Ryskulova Alma-Gul Rakhimovna- candidate of Medical Sciences, Associate Professor, Head of Department of Population Health and Social Sciences, LLP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan, E-mail: [email protected], ORCID https://orcid.org/0000-0003-4768-4799.
Sarsenbaeva Maira Zamanbekovna - candidate of Medical Sciences, senior lecturer, LLP Kazakhstan's Medical University, «KSPH», Almaty, Kazakhstan, E-mail: maira.sarsenbaeva@ mail.ru, ORCID https://orcid.org/0000-0002-0921-2224.
Article submitted: 13.03.2023 Accepted for publication: 28.03.2023
УДК: 614.2+616.36-003.826-071 DOI: 10.24412/1609-8692-2023-1-23-30
МРНТИ: 76.29.34.
КЛИНИЧЕСКИ ЗНАЧИМЫЕ ФАКТОРЫ РИСКА НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ
(обзор литературы)
* М. Азнабакиева, Е. Авдеева, Ф. Башатова, К. Гусеинов, Т. Каримов,
Ж. Маюкова, А. Имаматдинова
НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова», г. Алматы, Казахстан
Аннотация
В настоящее время неалкогольная жировая болезнь печени (далее - НАЖБП) является самым распространенным заболеванием печени, поразившим около четверти населения мира. Знание основных факторов риска НАЖБП, позволит вовремя диагностировать и, что немаловажно, предотвратить прогрессирование заболевания. Используя литературный анализ, изучив раннее проведенные исследования, посвященные этой теме, нами были выделены основные факторы риска неалкогольной жировой болезни печени: ожирение (90%), сахарный диабет 2 типа, генетические мутации, возраст, пол, а также образ жизни пациента. На основании всех данных, нами был сделан вывод о том, что вклад каждого фактора риска НАЖБП по отдельности неоценим, так как он варьируется в зависимости от сопутствующих заболеваний и географического положения.
Ключевые слова: неалкогольная жировая болезнь печени (НАЖБП), факторы риска, ожирение, сахарный диабет, метаболически ассоциированная жировая болезнь печени (МАЖБП).
