Инфекция и иммунитет. 2021;
Крымская геморрагическая лихорадка в Северо-Кавказском федеральном округе: обзор эпидемиологической ситуации и совершенствование методики прогнозирования заболеваемости
https://doi.org/10.15789/2220-7619-CHF-1827Аннотация
Данная статья посвящена анализу эпидемиологической ситуации по Крымской геморрагической лихорадке в субъектах Северо-Кавказского федерального округа (за период с 2005 по 2021 г.) и разработке нового подхода к совершенствованию эпидемиологического прогнозирования с использованием разрабатываемой «прогностической» модели. Исследование носит комплексный характер с использованием эпидемиологических методов и математической статистики. Эпидемиологический анализ проведен на основе сведений из разработанных в формате проекта баз данных по заболеваемости Крымской геморрагической лихорадкой и карт эпидемиологического обследования очага инфекционного заболевания (Ф.№357/у). «Прогностическая» модель заболеваемости разработана на основе теоремы Байеса и последовательного статистического анализа Вальда. Расчёт информативности показателей проводился по методу Кульбака. Значения климатических факторов взяты из базы данных ОИ ЦКП «ИКИ-мониторинг» Института космических исследований Российской академии наук. Полученные результаты свидетельствуют, что большинство больных Крымской геморрагической лихорадкой в течение исследуемого многолетнего периода были выявлены в Ставропольском крае (629) и Республике Дагестан (46). Единичные случаи отмечались в Кабардино-Балкарской республике (2), Карачаево-Черкесской Республикe (3) и Республике Ингушетия (2). Инфицирование возбудителем Крымской геморрагической лихорадки трансмиссивным механизмом происходило преимущественно во время ухода за сельскохозяйственными животными – 59,4 %. Отмечалось превалирование среднетяжелых форм Крымской геморрагической лихорадки (79 %), геморрагические проявления (на протяжении последних пяти лет) наблюдались почти у половины заболевших. Доля верных предварительных диагнозов при госпитализации пациентов составила 49 %. При апробации «прогностической» модели в 2021 г. на примере Ставропольского края полное точное совпадение результатов прогноза с фактическими данными получено для 11 районов (42,3 %). Ложноположительные (38,5 %) и завышенные (11,5 %) результаты на данном этапе исследования значительно не снижают прогностическую ценность модели (т.к. зачастую отражают регистрацию произошедшего случая инфицирования по месту проживания больного в другом административном районе, гиподиагностику легких форм Крымской геморрагической лихорадки в медицинских учреждениях или высокую результативность проведенных перед началом эпидемического сезона противоклещевых мероприятий в отдельных муниципальных округах). «Ложноотрицательные» результаты составили 7,7 %. Таким образом, результаты проведенного анализа свидетельствуют о необходимости повышения подготовки медицинского персонала для своевременного выявления больных Крымской геморрагической лихорадкой и усиления эффективности проводимых противоклещевых обработок. Результаты апробации «прогностической» модели подтверждают целесообразность и перспективность продолжения исследования.
Список литературы
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2. of pathological processes. Leningrad: Medicine, 1978. 294 p.
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21. Natural-Focal Viral Fevers in the South of the European Part of Russia. Crimean-Congo Hemorrhagic Fever. Problems of Particularly Dangerous Infections, 2020, no. 4, pp.75-80
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24. Platonov A.E., Avksentyev N.A., Avksentyeva M.V., Derkach E.V., Platonova O.V., Titkov A.V., Kolyasnikova N.M. Social and economic burden of five natural focal infections in the russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology, 2015, vol.8, no. 1, pp. 47–56.
25. Prislegina D.A., Dubyanskiy V.M., Kulichenko A.N.Particular dangerous arbovirus fevers in the south of Russia: improvement of monitoring with modern information technology application. Meditsina truda i ekologiya cheloveka = Occupational Health and Human Ecology, 2019, no. 4, pp. 50–58.
26. Prislegina D.A., Dubyanskiy V.M.,Maletskaya O.V., Kulichenko A.N.,Vasilenko N.F., Manin E.A.,Kovalchuk I.V.
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36. Trukhachev V.I., Tokhov Yu.M., Lutsuk S.N., Dylev A.A. Tolokonnikov V.P., Dyachenko Yu. V. Distribution and ecological characteristics of Hyalomma ixodid ticks in the ecosystems of the Stavropol region. Iug Rossii: ekologiia, razvitie = South of Russia: ecology, development, 2016, vol. 11, no. 2, pp. 59–69.
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41. Mostafavi E., Chinikar S., Bokaei S., Haghdoost A. Temporal modeling of Crimean-Congo hemorrhagic fever in eastern Iran. Int. J. Infect. Dis., 2013, vol. 17, no. 7, pp. 524–528.
42. Vescio F.M., Busani L., Mughini-Gras L., Khoury C., Avellis L., Taseva E., Rezza G., Christova I. Environmental correlates of Crimean-Congo haemorrhagic fever incidence in Bulgaria. BMC Public Health, 2012, no. 12, 1116 p.
43. Yigit G.K. An example of tick-Crimean Congo hemorrhagic fever (CCHF) in Eflani district, Karabuk, Turkey. Scientific Research and Essays, 2011, vol. 6, no. 11, pp. 2395–2402.
Russian Journal of Infection and Immunity. 2021;
CRIMEAN-CONGO HEMORRHAGIC FEVER IN THE NORTH CAUCASIAN FEDERAL DISTRICT: OVERVIEW OF THE EPIDEMIOLOGICAL SITUATION AND IMPROVEMENT OF MORBIDITY FORECASTING METHOD
https://doi.org/10.15789/2220-7619-CHF-1827Abstract
This article is dedicated to analyzing epidemiological situation of Crimean-Congo hemorrhagic fever in the subjects of the North Caucasian Federal District (from 2005 to 2021) and developing a new approach to improve epidemiological forecasting by using an in-progress «prognostic» model. The study is comprehensive, using epidemiological methods and mathematical statistics. The epidemiological analysis was carried out based on information from the databases on the incidence rate for Crimean-Congo hemorrhagic fever presented as a project and maps of infectious disease focus epidemiological examination. The «prognostic» morbidity model is developed based on Bayes' theorem and Wald's sequential statistical analysis. The factors information calculation was carried out by using by the Kullback method. The value of climatic factors was retrieved from the database of the Center for Collective Use «IKI-monitoring» of the Space Research Institute of the Russian Academy of Sciences. The data obtained indicate that the majority of patients with Crimean-Congo hemorrhagic fever within the studied long-term period in the Stavropol Territory (629) and the Republic of Dagestan (46) were revealed. Isolated cases in the Kabardino-Balkarian Republic (2), the Karachay-Cherkess Republic (3) and the Republic of Ingushetia (2) were noted. Infection by the Crimean-Congo hemorrhagic fever causative agent via the transmission mechanism occurred mainly during the care after farm animals in 59.4 per cent. The prevalence of moderate forms of Crimean-Congo hemorrhagic fever (79 per cent) was noted, with hemorrhagic manifestations (over the last five years) observed almost in half of the patients. The proportion of correct preliminary diagnoses during patient hospitalization was 49 per cent. While testing the «prognostic» model in 2021 particularly in the Stavropol Territory, a complete exact coincidence for predicted and the actual data was obtained for 11 districts (42.3 per cent). False positive (38.5 per cent) and overestimated (11.5 per cent) data at this stage of the study do not significantly reduce the predictive value of the model (since they often reflect registered infection case that occurred at the patient's place of residence in another administrative region, underdiagnoses mild forms of Crimean-Congo hemorrhagic fever in medical institutions or high efficiency of preventive measures against ticks measures carried out before the beginning of the epidemic season in individual municipal districts). «False negative» results were 7.7 per cent. Thus, the results of the analysis evidence about a need to improve the training of medical personnel for the timely detection of patients with Crimean-Congo hemorrhagic fever and to enhance the effectiveness of preventive measures against ticks. The results of testing the «prognostic» model confirm the feasibility and hold promise to continue the study
References
1. Gubler E.V. Computational methods for analysis and identification
2. of pathological processes. Leningrad: Medicine, 1978. 294 p.
3. Gubler E.V., Genkin A.A. Application of statistical non-parametric
4. criteria in medico-biological investigations. Leningrad: Medicine, 1973.
5. p.
6. Vasilenko N.F., Manin E.A., Maletskaya O.V., Volynkina A.S., Prislegina D.A., Semenko O.V., Kulichenko A.N.The modern condition of CrimeanCongo haemorrhagic fever natural focus in the Russian Federation.
7. Journal of microbiology, epidemiology and immunobiology, 2019,
8. no. 4, , pp. 46–52 .
9. Volynkina A.S., Kotenev E.S., Lisitskaya Ya.V., Maletskaya O.V., Shaposhnikova L.I., Kulichenko A.N.Epidemiological Situation on Crimean Hemorrhagic Fever in the Russian Federation in 2016, and Prognosis for 2017. Problems of Particularly Dangerous Infections, 2017, no. 1, pp. 24–28.
10. Volynkina A.S., Maletskaya O.V., Skudareva O.N., Tishchenko I.V., Vasilenko E.I., Lisitskaya Ya.V., Shaposhnikova L.I., Kolosov A.V., Rostovtseva D.V., Vasilenko N.F., Dubyansky V.M., Prislegina D.A., Yatsmenko E.V., Kulichenko A.N. Analysis of Epidemiological Situation on Crimean Hemorrhagic Fever in the Russian Federation in 2020 and Prognosis for 2021. Problems of Particularly Dangerous Infections, 2021, no. 1, pp. 17–22.
11. Dubyanskiy V.M., Prislegina D.A., Kulichenko A.N. Risk-oriented model for predicting epidemiological situation with Crimean-Congo hemorrhagic fever (on the example of Stavropol region). Analiz riska zdorov'yu = Health Risk Analysis, 2018,no. 1, pp. 13–21.
12. Dubyanskiy M.A., Kenzhebaev A., Stepanov V.M., Asenov G.A.,
13. Dubyanskaia L.D.Prognostication of plague epizootic activity in Sub-Aral and KyzylkumAreas. Nukus: Karakalpakstan, 1992. 240 r.
14. Kulichenko A.N., Prislegina D.A. Climatic prerequisites for changing activity in the natural Crimean-Congo hemorrhagic fever focus in the South of the Russian Federation.
15. Russian Journal of Infection and Immunity, 2019, vol. 9, no. 1, pp. 162–172.
16. Kulichenko A.N., Maletskaya O.V.,
17. Prislegina D.A., Vasilenko N.F., Semenko O.V.,Gaziyeva A.YU.,Ashibokov U.M.Epidemiological situation on natural focal infectious diseases in the Southern and North Caucasian federal districts in 2019. Analytical review. Stavropol, 2020. 96 p.
18. Kulichenko A.N., Maletskaya O.V., Prislegina D.A., Makhova V.V.,
19. Taran T.V.,Vasilenko N.F., Ashibokov UM. Epidemiological situation on natural focal infectious diseases in the Southern and North Caucasian federal districts in 2020. Analytical review. Stavropol, 2021. 91 p.
20. Maletskaya O.V., Taran T.V., Prislegina D.A., Dubyansky V.M., Volynkina A.S., Semenko O.V., Vasilenko N.F., Tarasov M.A., Tsapko N.V.
21. Natural-Focal Viral Fevers in the South of the European Part of Russia. Crimean-Congo Hemorrhagic Fever. Problems of Particularly Dangerous Infections, 2020, no. 4, pp.75-80
22. Onishchenko G.G., Efremenko V.I., Beyer A.P. Crimean-Congo hemorrhagicfever.Moscow: GOU VUNMTS, 2005. 269 r.
23. On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020:State report. Moscow: Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 2021. 256 p.
24. Platonov A.E., Avksentyev N.A., Avksentyeva M.V., Derkach E.V., Platonova O.V., Titkov A.V., Kolyasnikova N.M. Social and economic burden of five natural focal infections in the russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology, 2015, vol.8, no. 1, pp. 47–56.
25. Prislegina D.A., Dubyanskiy V.M., Kulichenko A.N.Particular dangerous arbovirus fevers in the south of Russia: improvement of monitoring with modern information technology application. Meditsina truda i ekologiya cheloveka = Occupational Health and Human Ecology, 2019, no. 4, pp. 50–58.
26. Prislegina D.A., Dubyanskiy V.M.,Maletskaya O.V., Kulichenko A.N.,Vasilenko N.F., Manin E.A.,Kovalchuk I.V.
27. Crimean-Congo hemorrhagic fever in the Stavropol region: contemporaryclinical and epidemiological
28. aspects and new approach to forecasting of morbidity.
29. Infectious Diseases: News, Opinions, Training, 2018, no. 3, pp. 49–56.
30. Smirnova S.E.Crimean-Congo hemorrhagic fever (etiology, epidemiology, laboratory diagnostics).M.: ATiSO, 2007.
31. p.
32. Tokhov Yu.M.,Degtyarev D.Yu., Dubyanskiy V.M.
33. Ixodid ticks (morphology, medical significance, population regulation). Stavropol: IP Svetlichnaya S.G., 2015. 84 p.
34. Tokhov Yu.M., Chumakova I.V., Lutsuk S.N., Dyachenko Yu.V.,
35. Kotenev E.S., Zaitsev A.A. Ticks as the reservoir of contagious diseases in the Stavropol territory. Vestnik veterinarii = Newsletter of Veterinary Science, 2013, no. 2,pp. 19–21.
36. Trukhachev V.I., Tokhov Yu.M., Lutsuk S.N., Dylev A.A. Tolokonnikov V.P., Dyachenko Yu. V. Distribution and ecological characteristics of Hyalomma ixodid ticks in the ecosystems of the Stavropol region. Iug Rossii: ekologiia, razvitie = South of Russia: ecology, development, 2016, vol. 11, no. 2, pp. 59–69.
37. Shestopalov N.V., Shashina N.I., Germant O.M., Pakskina N.D., Tsarenko V.A., Verigina E.V., Boyko L.S. Information letter «Natural and focal infections, which agents are passed by ixodic ticks, and their nonspecific preventive measures in the Russian Federation (according to 01.01.2019)».Dezinfektsionnoe Delo = Disinfection Affairs, 2019, no.1 (107), pp. 37–44.
38. Cherkasskii B.L. Risk in Epidemiology. Moscow:
39. Practical medicine, 2007. 480 p.
40. Ansari H., Shahbaz B., Izadi S., Zeinali M., Tabatabaee S.M., Mahmoodi M., Holakouie Naieni K., Mansournia M.A. Crimean-Congo hemorrhagic fever and its relationship with climate factors in southeast Iran: a 13-year experience. J. Infect. Dev. Ctries., 2014, vol. 8, no. 6, pp. 749–757.
41. Mostafavi E., Chinikar S., Bokaei S., Haghdoost A. Temporal modeling of Crimean-Congo hemorrhagic fever in eastern Iran. Int. J. Infect. Dis., 2013, vol. 17, no. 7, pp. 524–528.
42. Vescio F.M., Busani L., Mughini-Gras L., Khoury C., Avellis L., Taseva E., Rezza G., Christova I. Environmental correlates of Crimean-Congo haemorrhagic fever incidence in Bulgaria. BMC Public Health, 2012, no. 12, 1116 p.
43. Yigit G.K. An example of tick-Crimean Congo hemorrhagic fever (CCHF) in Eflani district, Karabuk, Turkey. Scientific Research and Essays, 2011, vol. 6, no. 11, pp. 2395–2402.
