CHARACTERISTICS OF LETHALITY IN LEPTOSPIROSIS IN THE CHERNIVTSI REGION

Abstract

Leptospirosis is one of the greatest challenges to the public health of the Chernivtsi region among zoonotic infectious diseases.

The aim is the characteristic of lethality in leptospirosis on the example of Chernivtsi region. and determining the factors that increase its risk.

Materials and methods. The epidemiological, serological and statistical methods of research were used, the data of the State Institution «Chernivtsi Regional Laboratory Center of the Ministry of Health of  Ukraine» (2006-2016) on the morbidity and mortality rate in leptospirosis in the region, the results of the epidemiological investigation of all registered cases of leptospirosis (283 cases, in particular 32 lethal), the results of an oral interview of 157 respondents to assess the rural population’s awareness of leptospirosis were used. The etio­logy of the disease was determined by the presence of specific antibodies in the reaction of microagglutination using a non-commercial diagnostic set of strains of leptospiros.

Results and conclusions. Against the background of the tendency to decrease the incidence during the observation period in the Chernivtsi , region steady tendency towards a mortality rate has been observed. Its average rate was 11.3 % at the national level – 9.6 %, and in some years ranged from 3.6 % (2008) to 57.1 % (2016). Among fatal cases, only 59.4 % of the cases were laboratory confirmed. Among the risk factors for severe clinical course and higher mortality, it should be noted the etiological role of L. icterohaemorrhagiae, the age of patients 60 years and older, late medical treatment, late diagnosis after treatment. Among patients with a laboratory-confirmed diagnosis the antibodies to L. icterohaemorrhagiae were detected in 61.8 % of the patients with severe disease and in 63.2 % of the dead. Among all the patients, this figure was only 33.7 %. Among the patients who died, 62.5 % were persons aged 60 years and older. For medical assistance, on the 5th-10th day, 59.4 % of the people against 44.1 % approached the disease, in which the disease ended in recovery. Late appeal for medical care is due to low awareness of the population. Only one in ten among respondents from rural areas noted awareness about this infection. The coincidence of primary and final diag­noses was registered only in 3.4-23.3 % of cases. Among the patients with leptospirosis and among the deceased, rural residents (74.6 % and 65.6 % respectively) prevailed.