ANALYSIS OF VACCINATION / REVACCINATION OF BCG AND BCG-M IN VORONEZH


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Abstract

Relevance. At the present stage of development of medicine, the problem of the incidence of tuberculosis is sharply touched upon, and this applies to all layers of society, including the working-age population, which forms the basis of the growth of the economy of our country [1, 3,4,5]. Purpose. Analyze the data on the BCG / BCG-M revaccination, study the results of immunodiagnostics of children, determine the indicator of primary infection with Mycobacterium tuberculosis among the child population for the period 2018 - 2019. on the basis of VGKP No. 5. Materials and methods. An analysis of patient records of AHEC No. 5 was carried out for vaccination, revaccination of BCG or BCG-M in children for 2018 - 2019. In the course of the study, 320 outpatient records of patients aged 6-7 years were studied (180 - for the period of 2018, 140 - for the period of 2019, respectively). In the course of the study, the data of immunodiagnostics were studied. Results. It was found that in 2018. 62% (109 people) received a planned revaccination of BCG / BCG - M, in 38% (71 people) vaccination and revaccination were not carried out for various reasons, and 35% (25 people) had a medical qualification. In 2019, 70% (98 people) received a revaccination with BCG / BCG - M, 30% (42 people) were not vaccinated or revaccinated. When assessing the results of the Mantoux test (2TE) in 2018, a negative result was found in 58, 3%. Among 41, 7% (75 people), the test was positive (5 - 9 mm - 69, 3%, 10 - 14 mm - 16, 0%, 15 - 16 mm - 8, 0% hyperergic - in 5, 3%, "Bend" was observed in 1, 4% of children). Among those who had a positive Mantoux test, the absence of vaccination was found in 64.3% of cases. When assessing the results of the Mantoux test (2TE) in 2019, a negative result was found in 62.0% (86 people). Among 38, 0%, the test was positive (5 - 9 mm - 59, 3%, 10 - 14 mm - 14, 8%, 15 - 16 mm - 5, 6% hyperergic in 16, 7%, "bend" was observed in 3.6% of children). Among those who had a positive Mantoux test, the absence of vaccination was revealed in 67.8% of cases. Conclusion. From the studies conducted, it should be concluded that the refusal of vaccination / revaccination of BCG / BCG - M is still at a high level (2018 - 2019) in BUZ VO VGKP No. 5. Because of this, there is an increase in the number of positive results of tuberculin diagnostics - it characterizes a large primary infection.

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At the present stage of the development of medicine, the problem of the incidence of tuberculosis is sharply touched upon, and this applies to all layers of society, including the working-age population, which forms the basis of the growth of the economy of our country. Despite the fact that recently there has been a significant decrease in MBT infection in our state, new cases of infection are still registered, including among the child population. This is facilitated by a number of factors: the presence of risk factors, the absence of BCG / BCG-M vaccination in childhood, the duration of the source's illness, the massive bacterial excretion [2].
Vii. TARGET
Analyze the data on the BCG / BCG-M revaccination, study the data of immunodiagnostics of children, determine the indicator of primary infection with Mycobacterium tuberculosis among the child population for the period 2018-2019. on the basis of BUZ VO VGKP №5. and also to reveal a direct correlation between refusal to vaccinate with BCG / BCG - M and indicators of primary infection with Mycobacterium tuberculosis.
VIII. METHODS

1. Study design
We carried out a study and analysis of the outpatient records of patients of AHKP No. 5 for vaccination, revaccination of BCG or BCG-M in children for 2018 - 2019. In the course of the study, 320 outpatient records of patients aged 6-7 years were studied (180 - for the period of 2018, 140 - for the period of 2019, respectively). Also, a survey was conducted of the parents of those children who were not vaccinated / revaccinated for any reason. In the course of the study, the data of immunodiagnostics of these groups were studied, the risk factors for the development of the disease were studied. Statistical data were processed using the Student's t-test with calculating the mean value, standard deviation, the differences were considered significant at p≤0.05.
2. Eligibility criteria
This study involved all patients who were registered with a pediatrician in a polyclinic at their place of residence (BUZ VO VGKP No. 5). The data (outpatient cards) of patients for 2018 - 2019 were studied. at the time of revealing marks of vaccination / revaccination of BCG / BCG - M, as well as the results of tuberculin diagnostics (Mantoux test). The age group was taken from 6 to 7 years.
3. Conditions
The study was attended by BUZ VO VGKP No. 5 of Voronezh, on the basis of which there were: collection, analysis of the information received.
4. Duration of research
This study was part of a large-scale study and processing of statistical data on the basis of this institution, which took 3 years and 8 months and continues to the present.
5. Description of the medical intervention
No medical interventions have been performed on patients. The study of documentation (outpatient cards), as well as archive data was made.
6. The main outcome of the study
"True point" - indicators of vaccination / revaccination of BCG / BCG - M, justification for refusal of the procedure, as well as indicators of tuberculin diagnostics in BUZ VO VGKP No. 5, reflecting the social significance of this disease in the region.
7. Additional study outcomes
The reasons for the medical withdrawal were identified, which directly affect the statistics regarding vaccination / revaccination of BCG / BCG - M.
8. Analysis in subgroups
For the study, two groups of patients were created, the data of which were studied for the period of 2018 and 2019, respectively. The criteria were the age of 6 - 7 years (since it is during this period that BCG is revaccinated). After the study of the indicators, a comparative analysis of the data of the two groups was carried out.
9. Methods of registration of outcomes
Studied statistical data of patients. Registration of outcomes was carried out manually, data analysis was carried out in the MicrosoftExel program.
10. Statistical analysis
Statistical data were processed using the Student's t-test with the calculation of the mean, standard deviation, differences were considered significant at p≤0.05.
IX. RESULTS
Objects (participants) of the study: outpatient records of patients of BUZ VO VGKP No. 5 in the amount of 180 (2018) and 140 (2019).
The main results of the study: in 2018, the following results were obtained. Among the studied group, it was found that 62% (109 people) received a planned revaccination of BCG / BCG - M, 38% (71 people) were not vaccinated or revaccinated for various reasons, and 35% (25 people) had a medical withdrawal and vaccination was scheduled for a later date. Among the group of persons with a medical withdrawal from revaccination, it was revealed: at the time of revaccination, 80% had acute diseases / exacerbations of chronic foci of infection, 12% - patients with forms of primary immunodeficiency, 8% - patients with complicated reactions to the previous administration of BCG vaccine ( lymphadenitis, keloid scar). The remaining 65% (46 people) did not have a medical challenge and were not vaccinated due to parental refusal. From the collected anamnesis, it was found that in the maternity hospital, the parents were fully informed about the need, benefit and safety.

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About the authors

Svetlana Lagutina

Author for correspondence.
Email: svlagutina97@mail.ru
ORCID iD: 0000-0003-3730-5265
Russian Federation

Pavel Chizhkov

Email: qooleer@yandex.ru
ORCID iD: 0000-0002-5626-0579
Russian Federation

References

  1. Васильева И.А, Белиловский Е.М., Борисов С.Е., Стерликов С.А. Заболеваемость, смертность и распространенность как показатели бремени туберкулеза в регионах ВОЗ, странах мира и в Российской Федерации 2 Часть Заболеваемость и распространенность туберкулеза // Журнал Туберкулез и болезни легких .- 2017, Т 95, № 6.-С.9-21
  2. Великая О. В., Савельев В. В., Лушникова А. В. Структура впервые выявленного туберкулеза легких в Воронежской области// Современные проблемы науки и образования. 2019. №2. С. 123
  3. Великая О.В. , Стогова Н.А., Мартышова О.С., Николаев В.А., Лушникова А.В., Хорошилова Н.Е. Исходы туберкулезного менингита у детей и подростков в практике педиатра //Вопросы практической педиатрии. 2017. Т 12. № 2. С. 19-25.
  4. Гельцер Б.И., Шахгельдян К.И., Кривелевич Е.Б., Медведев В.И., Ермолицкая М.З. Некоторые подходы к оценке эффективности региональной фтизиатрической службы //Туберкулез и болезни легких. 2017. № 12. С. 28-34.
  5. Мартышова О.С., Великая О.В., Лушникова А.В., Хорошилова Н.Е. Исходы туберкулезного менингита у детей и подростков в зависимости от своевременности диагностики // Системный анализ и управление в биомедицинских системах. 2018 . Т. 17. № 1. С. 214-218 .

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