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DOI 10.26724/2079-8334-2018-3-65-71-75 UDC 614.1:617.7
STRUCTURE, MORBIDITY AND PREVALENCE RATE OF EYE AND ADNEXA DISEASES IN UKRAINE
E-mail: 16124sk@gmail.com
Diseases of the eye and its appendages (H00-H59) in the Ukrainian population are characterized by annual growth of the severity indicators. We conducted the analysis of indicators of morbidity and prevalence of eye diseases and appendages of the eye (including glaucoma) among the population of Ukraine as a whole and of the Vinnytsia region in 2014-2016 (within the structure of the group H00-H59). In 2014-2016, the number of references to treatment- and preventive institutions for all diseases was growing steadily (from 175 654.0 in 2014 to 179 101.6 per 100 thousand of the population in 2016). The highest number of all registered disease cases (including the first registered cases) per 100 thousand of the population of Ukraine was presented in 2016 (172 692.9). The results of the analysis of eye diseases and glaucoma in Ukraine in a working age population in the structure of general morbidity in 2014-2016 suggest that this indicator is significantly lower compared to the unemployed population. We revealed an increase of the indicator of the emergence glaucoma in the Vinnytsia region, which requires a strong need in optimization of medical care to patients of the ophthalmologic profile and timely diagnostics measures. We drew up a conclusion about inadequate medical and preventive activities taken by health care institutions and a lack of attention paid by individuals to their own health.
Keywords: eye diseases, glaucoma, morbidity, prevalence, prevention.
The work is a fragment of the research project "Marketing and Pharmacoeconomic Research of Medicines and Treatment Regimens in Ukraine" (State Registration No. 0116U005801) and "Pharmacoeconomic assessment of the medicamentous therapy of common ophthalmologic and otorhinolaryngologic diseases " (State Registration No. 0114U000936).
In today's conditions of reforming the healthcare sector in Ukraine, it is difficult to overestimate the importance of public health both for the state as a whole and for individual patients, since indicators of public health reflect the progress of the society, the economic growth and the security of any civilized country [1, 12]. The trends in morbidity and prevalence of diseases in the population are considered part of the public health policy [8].
As health preservation is a prerequisite for successful implementation of the priority requirements to economic and social development of the country, the information about morbidity rates, characterizing the number of newly diagnosed diseases in the reporting year per 100 thousand individuals living in a reference area, and the prevalence - a total number of cases of particular disease in a certain group of people registered in a certain period of time, gains the special importance [5]. The social-economic and medical-organizational processes, taking place in the country, have a significant impact on the basic indicators of health of the population of Ukraine and suggests of its deterioration [5, 9].
ICD-10 (international classification of diseases) distinguishes 22 main nosology groups [4]. Eye and andexa diseases (N00-H59), characterized by annual growth of intensity indicators (prevalence, morbidity, disability) worldwide, occupy special place among the pathologies, specific for the Ukrainian population. The H00-H59 group consists of: disorders of eyelid, lacrimal system and orbit (H00-H06), disorders of conjunctiva (H10-H13), disorders of sclera, cornea, iris and ciliary body (H15-H22), disorders of lens (H25-H28), disorders of choroid and retina (H30-H36), glaucoma (H40-H42), disorders of vitreous body and globe (H43-H45), disorders of optic nerve and visual pathways (H46-H48), disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52), visual disturbances and blindness (H53-H54), and other disorders of eye and adnexa (H55-H59).
We paid special attention to glaucoma in our study, as the disease had been diagnosed in 66 million patients worldwide, including 12.5 million blind subjects [3, 11].
Glaucoma is considered worldwide an incurable disease, the progression of which can be stabilized or at least slowed down by a sustainable pharmacotherapy or surgical treatment depending on the stage and form of the disease [11]. The primary open-angle glaucoma (POAG) is usually well treated, especially in cases of early diagnostics of the disease and timely initiation of therapy, which is possible only under a condition of regular ophthalmologic examinations [2].
The purpose of the study was to study and analyze morbidity and prevalence rate of eye and adnexa diseases (in particular glaucoma) in Ukrainian population as a whole and in the population of Vinnytska oblast in 2014-2016.
Material and methods. The study involved the bibliosemantic, statistical methods, as well as the systematic approach. The study was based on the survey of health indicators of the population and the use of health care resources in Ukraine in 2014 - 2016, according to the data provided by the state enterprise "Tsentr medychnoi statystyky MOZ Ukrainy" (The Center for Medical Statistics of the Ministry of Health of Ukraine) [6-7].
© O.V. Kryvoviaz, O.V. Makarenko, 2018 71
All diseases H00-H59
a) Total population
1000000 100000 10000 1000 100 10 1
H00-H59 b) Urban population
160 961,90 159642,1
6 644,50 6616 20
Y/s/S
d
c) Rural population
Fig. 1. Trend in disease prevalence in Ukrainian population by disease classes
The analysis does not involve the results of the study from the Autonomous Republic of Crimea and Sevastopol (for temporary occupation) and from Luhansk and Donetsk oblasts (for the reasons of antiterrorist operation in the above territories).
a) Total population
b) Urban population
E4Î21.Î Hann 57 in. EC
2804,8
2 828,701
_
□ mm
c) Rural population Fig. 2. Trend in morbidity in Ukrainian population by disease classes
Prevalence of the disease was considered as a rate of all registered diseases in a calendar year: acute and chronic, detected in both current and previous years. The morbidity was defined as a rate of newly registered/emergence diseases in a calendar year in a given territory; in this case, we took into account all
acute and chronic diseases diagnosed for the first time during the year. We assessed the structure of diseases of the eye and appendages of the eye, including the cases of the emergence pathology.
Results and its discussion. The study of the prevalence of diseases in Ukrainian population by classes of diseases (all diseases; eye and adnexa diseases) showed that the number of references to health care facilities for all diseases in 2014-2016 was gradually increasing (from 175,654.0 in 2014 to 179,101.6 per 100 thousand population in 2016) (fig. 1a). A similar trend was observed in the survey by place of residence for urban and rural population (fig. 1b, 1c).
As for the number of eye and adnexa disease cases, it remained at the same level both for the Ukrainian population as a whole, and for urban and rural subpopulation groups (fig. 1).
The study of total morbidity of the population of Ukraine suggested of its growth in the reference period (2014-2016) as a whole and separately for urban and rural population subgroups (fig. 2). The incidence of eye and adnexa diseases, as well as prevalence of cases of this disease category remained at a constant level (fig. 2).
Table 1
Disease prevalence indicators in Ukraine and in Vinnytska oblast by reference classes in 2014-2016
Year 2014 2015 2016
Study territory Ukraine Vinnytska oblast Ukraine Vinnytska oblast Ukraine Vinnytska oblast
Disease class Number of registered disease cases per 100 thousand population
All diseases Total 175654.0 205295.4 177557.0 205917.5 179101.6 201568.6
Newly diagnosed 62654.2 71172.4 62651.3 70482.8 64242.4 68819.3
H00-H59 Total 9217.3 8870.8 9111.5 8457.6 8945.0 8633.3
Newly diagnosed 3251.7 3217.6 3271.1 3121.4 3219.8 2970.2
H40-H42 Total 601.9 851.4 606.5 809.1 609.4 853.4
Newly diagnosed 52.7 85.4 51.7 86.3 52.5 89.9
The highest number of all registered cases (including newly diagnosed diseases) per 100 thousand population in Ukraine was registered in 2016 (172 692.9). In Vinnytska oblast, the highest rate for all registered diseases (205917.5) was registered in 2015, while the number of cases of newly diagnosed diseases was the largest in 2014 (71 172.4).
The rates of registered eye and adnexa disease cases in Ukraine tended to gradual decrease (9 217.3 per 100 thousand population in 2014 versus 8 945.0 in 2016). The number of newly diagnosed eye and adnexa diseases remained at nearly the same level throughout the reference period. The indicators for Vinnytska oblast were 8 870.8, 8 457.6 and 8 633.3 in 2014, 2015, and 2016, respectively. The number of newly diagnosed diseased was steadily decreasing from 3 217.6 in 2014 to 2 970.2 in 2016 (table 1).
The number of registered glaucoma cases in Ukraine and newly diagnosed glaucoma cases in Vinnytska oblast had a positive trend. The total number of glaucoma cases in Vinnytska oblast and newly diagnosed glaucoma cases in Ukraine was unstable during 2014-2016.
The results of examination of the working-age population in the structure of total morbidity, ocular diseases and glaucoma in Ukraine for the period of 2014-2016 suggested that the morbidity rate for glaucoma in working-age people (about 21%) was significantly lower compared to the unemployed population, which was also concerted with the results of previous studies of gender-age aspects in glaucoma patients [3]. At the same time, this indicator for eye and adnexa diseases and total diseases was within 77% and 80%, respectively (fig. 3).
The study of the structure of registered disease cases in Ukraine in terms of patient residence shows steady little prevalence of urban population over rural in 2014-2016 for both total patients and those newly diagnosed the disease (fig. 4).
HOO-59
All diseases
xoo
21,58 21,50 '21,76
20,00
43.00
60.00
SO.00
Fig. 3. Comparative description of the proportion of working-age population in the structure of total morbidity, ocular diseases and glaucoma in Ukraine in 2014-2016
a) Total b) Newly diagnosed
Fig. 4. Trends in the structure of registered disease cases in Ukraine in 2014-2016 for urban and rural population
Note: D all diseases; H- H00-59; ISI- H40-42.
The study of morbidity and prevalence of diseases (in particular, ocular) in the urban and rural population of Ukraine and the Vinnytska oblast is one of the integral components of healthcare reform strategy development.
In the course of the study, we established growing rates of morbidity and prevalence of all diseases in the Ukrainian population. At the same time, the study presented no significant changes in the eye and adnexa disorder indicators.
Age analysis showed a significant prevalence of the proportion of working-age people in the structure of total morbidity for total diseases, as well as for eye and adnexa diseases. At the same time, this indicator for individuals with glaucoma had the opposite trend, which may be explained, to a certain extent, by special features of this pathology, which is typical, mostly, for individuals of the older and elderly age.
Differences in the quantitative ratio of urban and rural population (predominance of urban population) suggest of a difference in the quality of diagnostics, treatment and health survey of patients, polyclinic care, lacking medical staff and diagnostic equipment at district ophthalmologic offices.
Also, we revealed growing rate of newly diagnosed glaucoma in Vinnytska oblast, preconditioning the urgent need in optimization of medical care to patients of ophthalmologic profile, as well as in timely diagnostics of the disease.
The obtained data on the trends in prevalence and morbidity may be accounted for bad demographic situation both in Ukraine and in some regions of the country (including Vinnytska oblast) and unstable social-economic condition of the state. Therefore, we can assert an inadequate medical and preventive efforts taken by healthcare institutions on the background of insufficient attention paid by individuals to their own health.
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ISSN2079-8334. Ceim Meduu,UHU ma dio^ii. 2018. № 4 (66)
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СТРУКТУРА ТА Р1ВЕНЬ ЗАХВОРЮВАНОСТ1 ТА ПОШИРЕНОСТ1 ХВОРОБ ОКА ТА ЙОГО ПРИДАТКОВОГО АПАРАТУ В УКРА1Ш Кривов'яз О.В., Макаренко О.В., Томашевська Ю.О., Очеретнюк А. С.
Захворювання ока та його придаткового апарату (Н00-Н59) у населення Укра!ни характеризуются щорiчним зростанням штенсивних показникiв. В структурi групи Н00-Н59 був проведений аналiз показниюв захворюваност та поширеност хвороб ока та його придаткового апарату (зокрема глаукоми) серед населення Украши в цшому та Вшницько! област у перюд 2014-2016 рр. Протягом 2014-2016 рр. юльюсть звернень у лiкувально-профiлактичнi заклади з приводу усiх хвороб поступово зростала (з 175654,0 у 2014 р. до 179101,6 на 100 тис. населення у 2016 р.) Найвищу юльюсть уах зареестрованих захворювань (в т.ч. вперше зареестрованих випадюв) на 100 тис. населення в Укра!ш було зареестровано у 2016 р. (172692,9). Результати анайзу частки населення працездатного вiку в структурi загально! захворюваностi, очних хвороб та глаукоми в Украш за перюд 2014-2016 рр. свщчать про те, що частота захворюваносп на глаукому серед оаб працездатного вiку (близько 21 %) е суттево нижчою порiвняно з непрацюючим населенням. Для хвороб ока та його придаткового апарату i уах захворювань цей показник знаходиться в межах 77 % та 80 % вщповщно. Виявлено збшьшення показника вперше виявлено! глаукоми у Вшницьюй обласи, що диктуе потребу в оптимiзацil надання медично! допомоги хворим офтальмологiчного профшю та необхiднiсть проведення своечасно! дiагностики. Зроблено висновок про неналежну л^вально-профшактична дiяльнiсть закладiв охорони здоров'я та недостатню увагу, що придiляеться населенням власному здоров'ю.
Ключовi слова: хвороби ока, глаукома, захворювашсть, поширенiсть, профшактика.
Стаття надiйшла 20.05.18 р.
Б01 10.26724/2079-8334-2018-4-66-75-80 УДК 616.53-002.25-07:616.153.94-07
СТРУКТУРА И УРОВЕНЬ ЗАБОЛЕВАЕМОСТИ И РАСПРОСТРАНЕННОСТИ ЗАБОЛЕВАНИЙ ГЛАЗА И ЕГО ПРИДАТОЧНОГО АППАРАТА В УКРАИНЕ Кривовяз Е.В., Макаренко О. В., Томашевская Ю.А., Очеретнюк А. С.
Заболевания глаза и его придаточного аппарата (Н00-Н59) у населения Украины характеризуются ежегодным ростом интенсивных показателей. В структуре группы Н00-Н59 был проведен анализ показателей заболеваемости и распространенности болезней глаза и его придаточного аппарата (в частности глаукомы) среди населения Украины в целом и Винницкой области в период 2014-2016 гг. В течение 2014-2016 гг. количество обращений в лечебно-профилактические учреждения по поводу всех болезней постепенно росло (с 175654,0 в 2014 до 179101,6 на 100 тыс. населения в 2016). Наивысшее количество всех зарегистрированных заболеваний (в т.ч. впервые зарегистрированных случаев) на 100 тыс. населения в Украине было зарегистрировано в 2016 г. (172692,9). Результаты анализа доли населения трудоспособного возраста в структуре общей заболеваемости, глазных болезней и глаукомы в Украине за период 2014-2016 гг. свидетельствуют о том, что частота заболеваемости глаукомой среди лиц трудоспособного возраста (около 21 %) существенно ниже по сравнению с неработающим населением. Для болезней глаза и его придаточного аппарата и всех заболеваний этот показатель находится в пределах 77 % и 80 % соответственно. Выявленное увеличение показателя впервые выявленной глаукомы в Винницкой области диктует необходимость в оптимизации оказания медицинской помощи больным офтальмологического профиля и необходимость проведения своевременной диагностики. Сделан вывод о ненадлежащем уровне лечебно-профилактической деятельности учреждений здравоохранения и недостаточном внимании, уделяемом населением собственному здоровью.
Ключевые слова: болезни глаза, глаукома, заболеваемость, распространенность, профилактика.
Рецензент Голованова I.A.
ФУНКЦ1ОНУВАННЯ NO-СИНТАЗИ В ЛЕИКОЦИТАХ ПЕРИФЕРИЧНО1 КРОВ1
У ХВОРИХ НА ACNE VULGARIS
E-mail: lavrykgal@gmail.com
Висв^лено роль стафшокоюв у naToreHe3i вугрово! хвороби. Пролiферацiя умовно-патогенно! мжрофлори шюри посилюе вившьнення медiаторiв запалення i сприяе розвитку запального процесу. Ктроген оксид виконуе як прозапальну, так i протизапальну роль у мехашзмах розвитку запалення. Вивчено змши активност ендотелiальноi' та шдуцибельно! jVO-синтаз лейкоциив кровi хворих на вугрову хворобу до та тсля лжування. Встановлено, що при формах акне, спричиненого як Staphylococcus aureus так i Staphylococcus epidermidis (планктонна та плiвкоутворююча), достовiрно зростае актившсть ендотелiальноi' iзоформи NO-синтази щодо контрольних значень. Зафксовано зростання у деюлька десятюв разiв iндуцибельноi' NO-синтази лейкоцитiв периферично! кровi у всiх хворих, з пустул яких видшено плiвкоутворюючi i планктонш форми стафiлококiв. Пiсля проведеного курсу лжування акне, ускладненого пролiферацiею S. aureus (планктонна та плiвкоутворююча форма), достовiрно знижуеться активнiсть iндуцибельноi' iзоформи NO-синтази вiдносно контрольного рiвня. Змши в активност NO-синтази можна використовувати як маркерний показник у динамщ розвитку acne vulgaris та ефективност терапп.
Ключов! слова: acne vulgaris, лейкоцита, eNOS, iNOS, Staphylococcus aureus. Staphylococcus epidermidis
Дождження e фрагментом НДР «Обгрунтування мониторингу дiагностики, стратегiя профшактики та стандартизащя методiв л^вання кровотеч (шлунково-кишковий тракт) № державно'1 реестраци: 0115U000042.
Серед захворювань шюри вугрова хвороба (acne vulgaris) е одним з найпоширешших запальних, хрошчних, рецидивуючих захворювань пшосебоцейного комплексу з локатзащею на
© Г.С. Лаврик, О.П. Корншчук, 2018
