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6SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 5 I 2022 _ISSN: 2181-1601
Scientific Journal Impact Factor (SJIF 2022=5.016) Passport: http://sjifactor.com/passport.php?id=22257
PREVALENCE ANALYSIS INCIDENCE OF ENT ORGANS IN HIV-
INFECTED CHILDREN
N. U. Narzullaev
Bukhara State Medical Institute
ABSTRACT
The material of the study was 25 sick children for 2019-2021 up to 14 years old with HIV infection. 10 sick children were examined in the emergency department and 15 sick children in the hospital. Children were examined regardless of the presence of complaints. In addition to standard research methods (general blood count, urine, bacteriological and biochemical studies), we conducted a thorough otorhinolaryngological examination in all children, and in 2 (8%) X-ray examinations. With careful observation of the child's behavior and subsequent analysis of the semiotics of the disease, it was revealed; ear pain, (16%) ear pus (32%), child restlessness (40%), poor sleep (100%), child crying (32%), nasal congestion (18%), nasal discharge (18% ) sore throat (8%) cough (8%). In 70% of patients, a symptom of Pinsa was revealed - a sick child prefers to suck on the breast opposite to the diseased ear (with right-sided otitis, he sucks the left breast, and vice versa). According to our observations, the restless behavior of the child is sometimes replaced by seeming calm.
Key words: children, HIV infection, ENT disease, research methods.
The problem of infection caused by the human immunodeficiency virus (HIV) has been studied in otorhinolaryngology in our country since the early 1990s. Identified and described diseases that are an indicator of acquired immunodeficiency syndrome (AIDS), studied the symptoms of lesions of the ear, throat and nose in HIV-infected and AIDS patients. (1,3,5)
Due to a significant increase in the number of cases of HIV infection, the likelihood of contact of an otorhinolaryngologist with HIV-infected patients is increasing. With HIV infection, various manifestations of the disease often occur with damage to the upper respiratory tract. Otorhinolaryngologists, as well as other specialists, already have to take an active part in the diagnosis, treatment of HIV-infected persons, preventive work, which, of course, will require knowledge of the features of the pathology of the ear, throat and nose in HIV infection (AIDS) (2).
The global spread of HIV infection is manifested by numerous epidemics in various regions with peculiar dynamics of development, peculiarities of transmission routes, the number of infected people, and the mortality rate among those infected (3,5).
SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 5 I 2022 _ISSN: 2181-1601
Scientific Journal Impact Factor (SJIF 2022=5.016) Passport: http://sjifactor.com/passport.php?id=22257
It is known that HIV infection from mother to child can occur before, during and after delivery. The likelihood of a baby being infected depends on many factors, including the stage of the mother's HIV infection, viral load, exposure of the fetus to infected maternal fluids during pregnancy and delivery, and breastfeeding (4,6).
A characteristic feature of the epidemiology of HIV infection in recent years has been an increase in the proportion of HIV-infected women among all infected, which may be accompanied by an increase in the number of HIV-infected children (2). ENT disease is one of the most common and dangerous childhood diseases that occurs as a complication of respiratory, bacterial, fungal and HIV infections. One of the serious complications of childhood HIV infection is the defeat of the ENT organs, where the risk of developing intracranial complications increases dramatically, leading to an unfavorable outcome of the underlying disease (1).
In retrospective analyzes of sick children with HIV infections that proceeded with lesions of the ENT organs, it occurred in 70% to 80% of cases (1.7) In this regard, we examined patients with complaints of ENT organs and found out the prevalence of ENT pathology in this contingent.
The purpose of the study was to characterize the epidemiological characteristics of ENT diseases in HIV-infected children.
Materials and research methods. For the period from May 2019 to July 2021, 25 children diagnosed with HIV infection were under our supervision. The studies were carried out on the basis of the regional children's infectious diseases hospital. The diagnosis of HIV infection was established on the basis of Order No. 480 of the Ministry of Health. In (32%) 8 children, HIV status was established upon admission to the hospital based on the results of rapid testing, followed by confirmation of the result by immune blotting.
The material of the study was 25 sick children for 2019-2021 up to 14 years old with HIV infection. 10 sick children were examined in the emergency department and 15 sick children in the hospital. Children were examined regardless of the presence of complaints. In addition to standard research methods (general blood count, urine, bacteriological and biochemical studies), we conducted a thorough otorhinolaryngological examination in all children, and in 2 (8%) X-ray examinations.
With careful observation of the child's behavior and subsequent analysis of the semiotics of the disease, it was revealed; ear pain, (16%) ear pus (32%), child restlessness (40%), poor sleep (100%), child crying (32%), nasal congestion (18%), nasal discharge (18%) sore throat (8%) cough (8%). In 70% of patients, a symptom of Pinsa was revealed - a sick child prefers to suck on the breast opposite to the diseased ear (with right-sided otitis, he sucks the left breast, and vice versa). According to our observations, the restless behavior of the child is sometimes replaced by seeming calm.
SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 5 I 2022 _ISSN: 2181-1601
Scientific Journal Impact Factor (SJIF 2022=5.016) Passport: http://sjifactor.com/passport.php?id=222ff7
We believe that the doctor should pay attention to weakness at high body temperature in a child, since it may be the result of depression of the nervous system. We observed this symptomatology in the clinic of acute otitis media in children under 3 years old only in 5 children (20%).
By age, sick children are divided into 4 groups: 1st group from 1 to 3 years; 2nd group from 3 years to 6 years; 3rd group from 6 years to 12 years; 4th group from 12 years old to 14 years old.
The incidence of acute otitis media in boys is somewhat higher (25%), compared with girls (20.4%) at the same time, catarrhal otitis media occurs twice as often as acute suppurative otitis media (30.9% and 14.5 %) respectively. The incidence of tonsillitis and rhinosinusitis in the 1st group of boys is slightly higher (16%) compared to girls (8% and 12%), while acute laryngitis occurs in boys (8%) and girls (12%), respectively, acute pharyngitis this group was not observed.In the second group, the incidence of acute otitis media in boys and girls was almost the same, but acute catarrhal otitis media occurs almost 5 times more often than acute suppurative otitis media 31.3% and 6.2%, respectively. The incidence of acute tonsillitis in boys and girls was almost the same (12% and 12%, respectively). In this group, acute laryngitis and pharyngitis were not observed.
Rhinosinusitis occurs in boys (8%), and in girls 16%, respectively. The incidence of acute otitis media in the 3rd group of children was the highest (46.3%), boys were sick more often than girls (28.2% and 18.1%), respectively.
The incidence of acute tonsillitis in this group was more common among boys (16%) than girls (16% and 8%), respectively. Acute rhinosinusitis fell ill almost the same (12% and 12%), respectively, boys (12%) and girls (8%) fell ill with acute pharyngitis.
In the 4th group, the incidence of acute otitis media was also higher in boys than in girls. (17.6%-10.2%), and tonsillitis occurs in boys (12%), in girls (16%), rhinosinusitis in boys (16%), girls (8%), pharyngitis occurs in boys (8% ), in girls (12%), respectively.
We also compared the results of detection of ENT pathology in the emergency department and in the hospital. The frequency of registration of ENT pathology in the emergency department was significantly lower than that in the hospital, although all patients examined in the hospital had already passed through the emergency department. This is due, first of all, to the absence of a permanent ENT doctor in the admissions department, where the pediatrician is forced to see many children a day and does not always pay attention to ENT pathologies.
SCIENTIFIC PROGRESS VOLUME 3 I ISSUE 5 I 2022 _ISSN: 2181-1601
Scientific Journal Impact Factor (SJIF 2022=5.016) Passport: http://sjifactor.com/passport.php?id=222ff7
Conclusion. Thus, the incidence of ENT organs in HIV-infected children averages 70-80%, at the same time, the admission department does not pay due attention to the presence of ENT pathology in them, adequate therapy is not prescribed, which contributes to the development of a chronic condition or various intracranial complications, which can eventually lead to disability of varying degrees. Findings:
1. Acute inflammation of the ENT organs in HIV-infected children occurs in 70% to 80% of cases.
2. In children's infected hospitals, it is necessary to allocate the staff of a pediatric otorhinolaryngologist for the mandatory examination of all HIV-infected incoming patients in order to prevent possible secondary development of intracranial complications.
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