jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2019-11-1-41-45jofin-849Research ArticleОригинальное исследованиеOriginal ResearchКЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА СЕРОЗНЫХ МЕНИНГИТОВ У ДЕТЕЙ ХМЕЛЬНИЦКОЙ ОБЛАСТИ (ПОДОЛЬСКИЙ РЕГИОН, УКРАИНА): ЧЕТЫРНАДЦАТИЛЕТНЕЕ ЭПИДЕМИОЛОГИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL-EPIDEMIOLOGICAL CHARACTERISTICS OF ASEPTIC MENINGITIS IN CHILDREN OF KHMELNITSKYI REGION (PODILSKYI REGION, UKRAINE): FOURTEEN-YEAR EPIDEMIOLOGICAL OBSERVATIONПыпаЛ. В.PypaL. V.

MD, PhD, DSci, Professor, Head of the Department of Pediatrics, Faculty of Postgraduate Education

СвистильникР. В.SvistilnikR. V.

MD, PhD, Assistant, Department of Neurology and Neurosurgery, Faculty of Postgraduate Education

ЛисицаЮ. Н.LysytsiaYu. N.

Assistant, Department of Pediatrics, Faculty of Postgraduate Education

РоманчукК. Ю.RomanchukK. Yu.

MD, PhD, Assistant, Department of infectious diseases with the course of epidemiology;

21000, Vinnytsia, Khmelnytskyi shosse st., 96;

tel: 432-51-12-33

ОдарчукИ. В.OdarchukI. V.

Assistant, Department of Pediatrics, Faculty of Postgraduate Education

Винницкий национальный медицинский университет им. Н.И. Пирогова.УкраинаVinnytsia National Pyrogov Memorial Medical University.Ukraine2019300320191114145Copyright © Пыпа Л.В., Свистильник Р.В., Лисица Ю.Н., Романчук К.Ю., Одарчук И.В., 20192019Пыпа Л.В., Свистильник Р.В., Лисица Ю.Н., Романчук К.Ю., Одарчук И.В.Pypa L.V., Svistilnik R.V., Lysytsia Y.N., Romanchuk K.Y., Odarchuk I.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/849

Цель – проанализировать этиологическую структуру, эпидемиологические особенности, социально-демографические профили и характер развития осложнений со стороны ЦНС при серозных менингитах у детей Хмельницкой области за период 2004–2017 гг.Материалы и методы. Проведен проспективный анализ 208 случаев серозного менингита у детей, из которых 138 мальчика и 70 девочек. Этиологию заболевания определяли путем исследования ликвора методом ПЦР. Осложнения со стороны ЦНС диагностировали на основе клинической картины и методом КТ или МРТ. Для проведения анализа полученных данных использовался аналитический метод.Результаты. Наибольший сезонный рост заболеваемости приходится на период с августа по октябрь и составляет 65,6% с пиком в сентябре (24,0%). Клиническая картина характеризовалась среднетяжелым течением в 71,2% случаев и тяжелым течением – в 28,8%. В 100% случаев заболевание начиналось с лихорадки, головной боли (83,6%), рвоты (76,9%), боли в животе с расстройствами стула (6,2%), эпилептических припадков (0,9%). Средний уровень цитоза составлял 269,4 ± 196,7 клеток в мм3с преобладанием лимфоцитов, а средний уровень белка в ликворе составлял 73 ± 36 мг/дл. Этиологический фактор был установлен у 18 (8,6%) пациентов.Выводы. Главным возбудителем остается энтеровирус, который определялся в 72,2% случаях. Второе место заняли вирусы герпеса (22,2% случаев), третье место занял вирус паротита (5,6% случаев) (из этиологически определенных). В большинстве случаев заболевание заканчивалось полным выздоровлением, однако у 47 (22,6%) пациентов наблюдались осложнения. Распространенность серозного менингита среди детей Хмельницкой области составила 6,2 на 100 тыс. детского населения в соотношении между мужским и женским полом – 2:1.

Aim of work – to analyze the etiological structure, epidemiological structure, social-demographic features and the nature of the development of complications of the central nervous system in aseptic meningitis in children in Khmelnitskyi region for the period 2004-2017.Materials and methods. It was conducted a prospective analysis of 208 cases of aseptic meningitis in children of whom 138 people were boys and 70 people were girls. The etiology of the disease was determined by studying cerebrospinal fluid using PCR method. Complications of the central nervous system were diagnosed on the basis of the clinical picture and CT or MRI scans. The analytical method was used to conduct the analysis of the received data.Results. The highest seasonal increase of the incidence was from August to October and it was 65.6% with its peak in September (24.0%). The clinical picture was characterized by a moderate trend in 71.2% of cases and in 28.8% by a severe course. In 100% of cases the disease began with a fever, headache (83.6%), vomiting (76.9%), abdominal pain with diarrhea (6.2%), epileptic seizures (0.9%). The average level of cytosis was 269.4±196.7 cells/mm3with a predominance of lymphocytes and the average protein level in cerebrospinal fluid was 73 ± 36 mg/dl. The etiological factor was established in 18 (8.6%) patients.Conclusions. Enterovirus remains to be the main pathogen which was determined in 72.2% of cases. The second place was taken by herpes viruses (22.2% of cases), the third place was given to the mumps virus (5.6% of cases) (in etiologically verified cases). In most cases the disease ended in complete recovery but in 47 (22.6%) patients the complications were observed. The prevalence of aseptic meningitis among children in Khmelnitskyi region was 6.2 per 100,000 children, and males outnumbered females by a 2:1 ratio.

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The authors declare that there are no conflicts of interest present.