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The role of viral etiology in the development of acute gastroenteritis in children in Uzbekistan
We carried out a medical examination of women of childbear-ing age in the city Kuvasay. Studies have shown that in the group of 80 surveyed women of childbearing age, 12 is detected tachycardia, 9 — hepatomegaly, 30 girls and women — dull, thinning and hair loss, pale mucous conjunctiva, 54 — pale face, as well as in 8 — xerosis conjunctiva, 11 — angular stomatitis, 9 — cheilosis, 13 — swelling of the tongue, 16 — the phenomenon of periodontal disease, in 56 surveyed admitted functional changes in the nervous system, 9 — parotid glands, 16 — an increase in thyroid size 1-n degrees. The combination of 2 or more abnormalities found in 45 % of the surveyed girls and women of childbearing age.
In 2000-2010 yy. the Republic of Uzbekistan and the Fergana Valley incidence rates of tuberculosis have been studied. In Fergana region incidence rate it was in 2000 — 50.6 (in the country — 64.5), in 2001 — 60.0 (in the country — 72.4), in 2003 — 70.0 (in republic — 77.1). The highest rate of tuberculosis in the Fergana region made in 2010 — 67.4 (in the country — 73.5), ie, if we compare 2000 and 2010, we see that in 10 years the incidence rate increased by 16.8.
Due to the unfavourable housing situation TB was: the population — 62 %, in boarding schools — 56 %, in the receivers — 70 %, among the orphans — 67 %, among the migrants — 65 %. In connection with alcoholism tuberculosis is: the population — 61 %, in boarding — 9 %, receivers — 14 %, among the orphans — 71 %, among
the migrants — 43 %. In connection with the tobacco tuberculosis is: the population — 61 %, in boarding schools — 67 %, receivers — 71 %, among the orphans — 64 %, among the migrants — 78 %. In connection with the environmental factors of tuberculosis was: the population — 24 %, in boarding schools — 45 %, receivers — 42 %, among the orphans — 38 %, among the migrants — 35 %. In connection with the nutritional status of tuberculosis is: the population — 65 %, in boarding schools — 64 %, receivers — 62 %, among the orphans — 65 %, among the migrants — 34 %. Due to the unknown ethology was tuberculosis: the population — 28 %, in boarding schools — 31 %, receivers — 31 %, among the orphans — 25 %, among the migrants — 21 %, among the homeless — 34 %.
Conclusions:
1. Character nutritional status ofwomen of childbearing age of the rural population of Fergana region is unbalanced, due to the shortage of proteins, fats and carbohydrates. Disrupted formula of balanced nutrition.
2. For the normalization of immune parameters, anemia, iodine deficiency, vitamins, trace elements, as well as raising the level of food culture among women of childbearing age, we can recommend a diet based on traditional cooking methods, including a food additive, "Tabib-1".
3. Tuberculosis is a social and hygienic problem and requires a series of necessary preventive measures to reduce it.
References:
1. Bekbaulieva G. N. Medico-social and organizational direction of the formation of the reproductive health of the Aral Sea region and prospects of development of the population//Abstract for the degree of Doctor. - Tashkent, 2009. - P. 39.
2. Kolomiets V. M., Kolomiets J. V. Death from tuberculosis: what is it now//Proceedings of the Ninth National Congress on Diseases "Pulmonology 99" Respiratory. - M., 1999. - S. 416.
3. Nasolodin V. V., Zaytsev I. P., Zaytsev O. N. Evaluation of actual nutrition and immunological reactivity in students//Health and sanitariya. - 2005. - № 3. - P. 36-38.
4. Hozhimatov H. O. TB as a global health and social problem (brief literature review). Actual problems of ecology and health of the population in Uzbekistan//Actual problems of the humanities and natural sciences. - Moscow, 2014. - № 05(64). - S. 211-213.
5. Ermatova G. A. Actual nutrition ofwomen of childbearing age and dietary correction/doctor-graduate student//Scientific and practical journal. - Voronezh, 2011. - № 4.5(47) Russia, - S. 765-769.
Juraev Rivojiddin, Research Institute of Virology Ministry of Health of the Republic of Uzbekistan.
E-mail: saodat.us@mail.ru
The role of viral etiology in the development of acute gastroenteritis in children in Uzbekistan
Abstract: To achieve the objectives prospective epidemiological study was organized, which included a study of children under 5 years of age (from 0 to 59 months) admitted with a diagnosis of acute gastroenteritis in the Department of intestinal infections of Research Institute Virology in the period from January 1, 2013 to January 31, 2014. The study shows a significant prevalence of viral infection of bacterial infection that necessitates a change to the approach in the treatment of gastroenteritis. Featured prevalence, seasonal and age distribution, as well as the characterization of the clinical manifestations may serve as a guide for practitioners in terms of laboratory diagnostics failure.
Keywords: polymerase chain reaction (PCR), hybridization with fluorescence detection, microorganisms of the genus Shigella (Sh.spp.), Salmonella (Sal.spp.), Campylobacter (Cam.spp.), Adenoviruses group F (AdV) and RNA of group a rotavirus (RV), genotype 2 noroviruses (NoV), astroviruses (AsV).
Introduction
According to the World Health Organization, diarrhea remains a significant cause of the morbidity and mortality among children in developing countries [1]. Despite ongoing efforts, from
diarrhea die each year more than 1.3 million children under the age of 5 years [1; 2]. The etiological structure of infectious diarrhea is different in different parts of the globe, but still remains the dominant bacteria and viruses [3; 4]. To carry out effective preventive
Section 5. Medical science
measures and the adoption of policies to combat diarrheal diseases, it is important to study the structure of the etiological causes of acute gastroenteritis in children under 5 years.
The aim of this study was to investigate the etiological structure of diarrheal diseases and the role in the development of viral etiology of acute gastroenteritis in children in the Republic of Uzbekistan, the description of the epidemiology and clinical characteristics of pathogens.
Materials and methods
To achieve the objectives prospective epidemiological study was organized, which included a study of children under 5 years of age (from 0 to 59 months) admitted with a diagnosis of acute gastroenteritis in the Department of intestinal infections of Research Institute Virology in the period from January 1, 2013 to January 31, 2014. All data is entered into an electronic database and subsequently processed by the statistical program SPSS 16.
The etiological transcript was carried out using the test system "AmpliSens® OCI screen-FL" intended for the detection and differentiation of DNA microorganisms of the genus Shigella (Sh. spp.), Salmonella (Sal. spp.) And thermophilic Campylobacter (Cam. spp.), Adenoviruses group F (AdV) and RNA of group a rotavirus (RV), genotype 2 noroviruses (NoV), astrovi-ruses (AsV) by polymerase chain reaction (PCR), hybridization with fluorescence detection. A similar test system was used to study Podkolzin et al., 2015 [5].
Results
In total during the study period in the Department of intestinal infections in 1050 patients received. All 1050 stool samples were tested for the presence of pathogens and 7 825 (78.6 ± 1.4 %) patients, one or more agents (Table 1) has been identified. The bulk of the pathogens viruses accounted for 667 cases (80.8 ± 1.5 %), while the bacteria were much smaller proportion of established cases — 177 (21.5 ± 3.1 %). The most common rotavirus was 41.1 ± 2.4 %, then followed by norovirus 32.6 ± 2.5 %, astroviruses and adenovirus were less widespread viral pathogens and constituted 12.9 ± 2.9 % and 12.7 ± 2.9 %, respectively. Among the most common bacterial infection have been established Salmonella and Shigella (6.2 ± 2.8 % and 5.7 ± 2.8 %, respectively).
Among the cases with established etiology mono infection was observed in 595 cases (72.1 ± 1.8 %). In the remaining 230 cases (27.9 ± 3.0 %) infection was observed by two or more agents. The most frequently noted as mono infection rotavirus 82.3 ± 1.8 % and norovirus 67.0 ± 2.2 %. Astroviruses and adenoviruses met as mono infection about a third of cases. Bacterial infection occurs mainly in combination with other infections ranging from 51.3 % to 95.0 %. Combination rotavirus the most frequent among mixed infection with norovirus (12.8 ± 3.2 %), followed by a combination of rotavirus and adenovirus (3.5 ± 3.5 %). The combination of other infections has not more than 3 %, the combination of bacterial infection is not higher than 1 %.
Table 1. - The detection of infectious pathogens in children with
It should be noted that hospitalizations for acute gastroenteritis were observed throughout the year, with the vast majority of cases (84 %) were observed during the period from June to November. Negotiability peak is in August, the minimum number of references pointed out in February. With regard to entities that seasonal distribution is less clear (Fig. 1). Since rotavirus had a pronounced fall-winter active of the peak in the month of October, and the minimum level in June. A similar, but less pronounced distribution noted in astroviruses. Norovirus, on the contrary, observed mostly between April and July months. Adenovirus was observed more pronounced in the winter-spring period. Bacterial infections have approximately the same seasonal distribution. The growing number of bacterial infections began in late spring, during the summer continued to grow, reaching a peak in August, then decline observed during the autumn.
The bulk of cases falls on the age of 2 years, by the end of the second year oflife is celebrated more than 80 % (from 65 % to 94 %) of all cases, with about half of the cases of ill before the age of 1 year. Cases diseases under the age of 3 months is less than 3 %.
Discussion
Total etiologic agent was identified in 78.6 %, which is typical for the use of molecular-genetic methods of diagnosis [6]. Among all hospitalized cases in 63.5 % of cases, the cause of acute gastroenteritis contact viral infection has been established, and only 17 %, cause bacterial installed. Among the etiologic agents identified in 41.1 % of cases, contact was established rotavirus. This fully corresponds with the data of supervision of rotavirus infection in Europe, America and Asia [7], including neighboring Tajikistan, where the rate of rotavirus infection was 39 %. A similar level was detected in 44 % of Russia [8]. The second most common cause of diarrhea in our study was the Norovirus infection (32.6 %). This is consistent with numerous publications, pointing to a significant incidence (6-48 %) noroviruses in children with acute gastroenteritis [9]. Occurrence astroviruses and adenoviruses was approximately the same and amounted to 12.7 % and 12.9 %, respectively. According to the World Literature astroviruses and adenoviruses prevalence ranging from 5 % to 16 % globally [10; 11; 12], our results fit into the frame. Bacterial infections occupy a much smaller role in the occurrence of gastroenteritis and did not exceed 17 %. However, this is consistent with reported prevalence of these agents in the world [3; 13; 14].
Seasonal fluctuations vary considerably, which may be an indirect reference point for practitioners and will reduce the frequency of unjustified use of antibiotics, which in practice are used in more than 90 % of cases.
Thus, the study shows a significant prevalence ofviral infection of bacterial infection that necessitates a change to the approach in the treatment of gastroenteritis. Featured prevalence, seasonal and age distribution, as well as the characterization of the clinical manifestations may serve as a guide for practitioners in terms of laboratory diagnostics failure.
acute gastroenteritis in children less than 5 years (N = 1050)
Pathogen Total Mono infection Mixed infection
n % (SE) n % (SE) n % (SE)
Rotavirus A 432 41.1 (2.4) 352 81.6 (2.1) 80 18.4 (4.3)
Norovirus 2 342 32.6 (2.5) 229 67.0 (3.1) 113 33.0 (4.4)
Astrovirus 133 12.7 (2.9) 38 28.4 (7.3) 95 71.6 (4.6)
Adenovirus F 135 12.9 (2.9) 45 33.6 (7.0) 90 66.2 (5.0)
Salmonella spp. 60 5.7 (3.0) 22 37.1 (10.3) 38 62.9 (7.8)
Shigella spp. 65 6.2 (3.0) 31 48.7 (9.0) 34 51.3 (8.6)
Campylobacter spp. 44 4.2 (3.0) 4 7.8 (13.4) 40 92.2 (4.3)
Medical and biological assessment of the fluoride content of bottled water
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Fig. 1. Seasonal distribution of acute gastroenteritis among children under the age of 5 years, depending on the pathogen
References:
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5. Podkolzin A. T. et al. The Comparative Characteristic of Sets of Reagents for Identification of Antigens of Rotaviruses Used on the Territory of Russia//Klin Lab Diagn. - 2015. - 60(6): 48-52.
6. Amar C. F. et al. Detection by PCR of eight groups of enteric pathogens in 4,627 faecal samples: re-examination of the English case-control Infectious Intestinal Disease Study (1993-1996)//Eur J Clin Microbiol Infect Dis. - 2007. - 26(5): 311-323.
7. Mirzayeva R., et al. Rotavirus burden among children in the newly independent states of the former union of soviet socialist republics: literature review and first-year results from the rotavirus surveillance network//J Infect Dis. - 2009. - 200, Suppl 1: 203-214.
8. Podkolzin A. T. et al. Hospital-based surveillance of rotavirus and other viral agents of diarrhea in children and adults in Russia, 2005-2007//J Infect Dis. - 2009. - 200, Suppl 1: 228-233.
9. Iturriza-Gomara M. et al. Rotavirus genotypes co-circulating in Europe between 2006 and 2009 as determined by EuroRotaNet, a pan-European collaborative strain surveillance network//Epidemiol Infect. - 2011. - 139(6): 895-909.
10. Langley J. M. Adenoviruses//Pediatr Rev. - 2005. - 26(7): 244-249.
11. Walter J. E. and Mitchell D. K. Role of astroviruses in childhood diarrhea//Curr Opin Pediatr. - 2000. - 12(3): 275-279.
12. Amaral M. S. et al. The prevalence of norovirus, astrovirus and adenovirus infections among hospitalised children with acute gastroenteritis in Porto Velho, state of Rondonia, western Brazilian Amazon//Mem Inst Oswaldo Cruz. - 2015.
13. Tran A. et al. Prevalence of rotavirus, adenovirus, norovirus, and astrovirus infections and coinfections among hospitalized children in northern France// J Clin Microbiol. - 2010. - 48(5): 1943-1946.
14. Amaral M. S. et al. The prevalence of norovirus, astrovirus and adenovirus infections among hospitalised children with acute gastroenteritis in Porto Velho, state of Rondonia, western Brazilian Amazon//Mem Inst Oswaldo Cruz. - 2015. - 110(2): 215-221.
Zokirkhonova Shahzoda, Tashkent State Dental Institute, Researcher of the Department of hospital dental therapeutics E-mail: Zokirhonova@gmail.com
Medical and biological assessment of the fluoride content of bottled water
Abstact: It has been established that the fluoride content ofbottled water with concentration of 0.7-1.0 mg/L is not toxic,
it does not cause irritation action to the skin and mucous membranes of the eyes, has no cumulation and sensitizing properties.
Bottled water containing fluoride concentration of 0.7 and 1.0 mg/l, can be attributed to non-toxic and low- hazard products. Keywords: bottled water, toxicology, food safety.
