Vol 22, No 6 (2017)
- Year: 2017
- Articles: 6
- URL: https://ogarev-online.ru/1560-9529/issue/view/2447
- DOI: https://doi.org/10.17816/EID.226
Articles
EVALUATION OF THE CLINICAL AND ECONOMIC EFFECTIVENESS OF INTERFERON-GAMMA IN THE TREATMENT OF TUBERCULOSIS
Abstract
Tuberculosis worldwide is a serious problem for the health system and for society. Despite the fact that in recent years there has been a tendency to the decline in the incidence of tuberculosis, it remains to be one of the socially significant infections in the Russian Federation. Significant difficulties in the treatment of tuberculosis include the overcoming of the drug resistance of mycobacteria to the existing therapy, as well as the available limitations of the resources of the healthcare system in the Russian Federation. In this regard, there is a need to find additional opportunities to improve the effectiveness of the treatment and clinical and economic evaluation of existing treatment regimens. Interferon-gamma is an effective preparation for the management of tuberculosis. As a result of the pharmacoeconomic analysis, the administration of interferon-gamma (Ingaron) contributed to an increase in the quality of life by 2.1 QALY, and in terms of an addition to the therapy will be accompanied by savings of the budget of the Russian Federation up to 284 million rubles, or up to 27.3% of funds for the treatment of patients from this group.
Epidemiology and Infectious Diseases. 2017;22(6):276-280
276-280
PREVALENCE RATE AND IMPACT OF ADDICTIVE DISORDERS ON THE COURSE OF HIV-INFECTION IN IN-PATIENTS
Abstract
Aim of the study. To make an analysis of the prevalence rate and the impact of addictive disorders on the course of HIV-infection and evaluate the efficacy of the antiretroviral therapy. Methods and Materials. The retrospective analysis of medical records of HIV-positive patients, examined by the narcologist in the S.P. Botkin Clinical Infectious Diseases Hospital during the period of from September to November in 2014 and 2016. Results. Half of the patients (576 out of 1164 patients, 49.5%) treated in HIV-infection hospital required consultation of narcologist. In 2014 and 2016 men were more prevalent among such patients (73% and 76% accordingly), with a trend toward the involvement of older patients. Most prevalent narcological pathology among HIV-positive patients was opioid dependence (48% and 45% accordingly). Despite an increase of absolute numbers of narcologist’s consultations in 2016 the only group in which the relative gain from 17% to 26% was observed there was a group of patients suffered both opioid dependency and chronic alcoholism simultaneously. According to our data odds ratio for starting antiretroviral therapy in the hospital were higher in women and in patients with remission of chronic alcoholism. Percentage of patients who started antiretroviral therapy was insufficient - 30% among patients discharged after the complete in-hospital stay. Conclusion. The pattern of HIV epidemic among patients with addictive disorders does not differ from the general HIV-positive population. The gain in percentage of patients with comorbidity such as opioid dependency with alcohol abuse was observed. Patients manifested the alcohol abuse at the time of admission have lower chances to begin to receive ARVT comparing to those who were in remission.
Epidemiology and Infectious Diseases. 2017;22(6):281-288
281-288
PHARMACOECONOMIC JUSTIFICATION FOR THE INCLUSION OF VACCINATION AGAINST VARICELLA IN THE REGIONAL CALENDAR OF PREVENTIVE VACCINATIONS ON THE EXAMPLE OF THE PENZA REGION
Abstract
The article presents the pharmacoeconomic rationale for the inclusion of vaccination against varicella in the regional calendar of preventive vaccinations on the example of the Penza region. Varicella remains one of the most common infectious diseases in the studied region and in the Russian Federation as a whole. With the limited amount of budget funds allocated for the program of vaccination, it is necessary to assess their economic efficiency. For the economic evaluation, there was developed the algorithm of calculations contained in the software based on MS Excel in order to get the result when you change the source of regional data. As a result of calculations, the vaccination in the Penza region was revealed to be a profitable investment. The sustainability of the two-time vaccination of a cohort of children aged 1 year against the Varicella held in 2016, will come in for 2018, and further savings (prevented damage) will increase steadily. By the end of 2029, “net economic benefit” will be about 246.5 million rubles, the damage prevented would exceed the cost of the vaccination of a cohort of 6 times.
Epidemiology and Infectious Diseases. 2017;22(6):288-294
288-294
RABIES. ACTUAL ISSUES
Abstract
The article gives an analysis of domestic and foreign literature reports, as well as the author’s own experience in the problem of rabies. There are presented facts on the etiology, pathogenesis, epidemiology of rabies. Details of the features of the clinical and laboratory diagnosis and the issues of treatment and prevention are considered. An algorithm for management patients with suspected rabies is suggested.
Epidemiology and Infectious Diseases. 2017;22(6):295-305
295-305
RISK FACTOR: THEORY AND PRACTICE IN THE APPLICATION IN EPIDEMIOLOGICAL STUDIES
Abstract
The category “risk factor” is widely used in the clinical epidemiological studies. To date, a large number of applied studies on the specific characteristics of risk factors for individual nosological forms has been published. At the same time, there is a minimum of publications concerning dealing with a general pattern concerning the theoretical basis for the application of this epidemiological category. In connection with this, the purpose of this report is the theoretical presentation and justification for the use in the epidemiological studies of the category “risk factor”. The authors give an epidemiological definition to this term. The risk factor is any property or feature of the human population, any impact on it, which increases the probability of a negative effect on the incidence and/or its consequences on the prevalence of any epidemiological phenomenon. The article considers the main variants of grouping risk factors and their detailing by various classification criteria (external and internal factors, managed and unmanaged factors). The need to study the complex impact of risk factors, especially in combination and/or comorbidity diseases, is shown. The authors gave an epidemiological interpretation of the risk-related concepts: “risk determinant” and “risk marker”, the areas of correct application of these terms in clinical epidemiological studies are indicated. A proposal was made to use the term “determinant of risk” only in those cases when the investigated factor has a high degree of evidence of causality with the event being studied and is not disputed by other specialists. Examples of the substitution of the concepts “risk factor” and “risk marker” are given. There is marked the situation in which clinical and epidemiological studies mask real risk factors. In conclusion, the authors indicate to the evident level of designation and identification of risk factors as a necessary condition for the success of anti-epidemic measures and the adoption of adequate management decisions in the epidemiological surveillance system.
Epidemiology and Infectious Diseases. 2017;22(6):306-310
306-310
ENHANCED INVESTIGATION OF ETIOLOGY OF DISEASES DURING THE SHIGELLOSIS OUTBREAK WITH FATAL OUTCOMES AMONG CHILDREN
Abstract
The outbreak of shigellosis caused by Shigella. flexneri 2a which affected a total of 42 persons was revealed by epidemiological analysis and microbiological testing in a nursing home for disabled children with a severe pathology of the nervous system. At the same time, four fatal cases among children were registered. The main purpose of our study was to perform an enhanced investigation to find potentially novel etiological agent among affected persons especially in cases with fatal outcome. We applied a broad range of commercial kits based on the nucleic acid amplification techniques as well as bacteriological methods for etiological diagnosis. Additionally, several S. flexneri 2a isolates and revealed bacterial pathogens were subjected to pulsed-field gel electrophoresis (PFGE) and Whole Genome Sequencing (WGS) for expanded genetic characterization as well as demonstration of their clonality and the presents/absence of unusual pathogenic determinants. Genetic relationship between viral pathogens was characterized by Sanger sequencing of phylogenetically informative regions. Epidemiological data and lab testing allowed considering the generalized herpes simplex virus type 1 infection (HSV-1) to be a possible cause of fatal cases.
Epidemiology and Infectious Diseases. 2017;22(6):311-319
311-319