Epidemiological Community and Differences of Transmissive Infections in Astrakhan Region

Abstract

Relevance. The territory of the Astrakhan region hosts natural foci of severe infections of arbovirus etiology – Crimean-Congo hemorrhagic fever (CCHF) and Astrakhan fever (spotted fever resembling the Mediterranean spotted fever, Astrakhan spotted fever (ASF). The long-term average incidence of CCHF and ASF in the Astrakhan region is to 11 and 135 times higher, respectively, than the average incidence in the Russian Federation. Aims. To present, based on epidemiological data, a comparative characterization of transmissible infections of CCHF and ASF in the Astrakhan region. Materials & Methods. The main method of the study was epidemiological. The data for 2000−2016 of primary medical documentation Ф.058/у «Emergency notification of infectious disease, food, acute occupational poisoning, unusual reaction to vaccination», federal statistical observation Ф. 2 «Information on infectious and parasitic diseases», Ф. 357/у «Epidemiological examination card of infectious disease focus», Ф. .003/у «Medical card of inpatient patient», presented by Center of hygiene and epidemiology in Astrakhan region. For retrospective epidemiological analysis, we studied the absolute and intensive morbidity indicators (per 100 ths population), by age, professional groups, and among the urban and rural population. Based on the average long-term morbidity indicators of the population, a mapping of the territory of the Astrakhan region was carried out. The influence of natural and climatic conditions on the epidemic process of CCHF and ASF was assessed by meteorological data (amount of precipitation, air temperature, etc.). Materials of long-term observation over 11 districts of Astrakhan region and Astrakhan city were analyzed, including data on the spread of Ixodid ticks, population contact with them (according to the attendance of people to treatment-and-prophylactic organizations of the region). Statistical data processing was carried out using the method of straight-line alignment of dynamic series of morbidity indicators, calculation of the average annual rate of decrease/increase. Correlation analysis was used to assess the direction and strength of the relationship between the indicators, and quantitative dependence between epidemic process characteristics. Differences between the indicators were considered to be reliable if p < 0.05. Results. During the analyzed period 151 cases of CCHF and 3951 cases of ASF were identified. By 2016. CCHF was registered in all 11 districts of the region and the area of foci covered 44,000 km2 and 44,100 km2, respectively. There are no differences significantly affecting the epidemic process of CCHF and ASF, so preventive measures are mainly aimed at controlling the vectors of the pathogens of these infections. The comprehensive study of the territory of Astrakhan region carried out in 2000–2016 revealed expansion of CCHF and ASF areal of disease (by 11.8% and 23.4% respectively) and determined the territories with the highest risk of infection, which allowed to increase and redistribute the volumes of acaricide treatments of the territories with the highest infection risk and ensure the decrease of CCHF and ASF morbidity rates. Conclusion. As a result of the comprehensive study conducted in 2000–2016 in the territory of Astrakhan region, the expansion of CCHF and ASF areal of disease was revealed (by 11.8% and 23.4% respectively) and the areas of highest infection risk were identified, which allowed to increase and redistribute the volume of acaricide treatments of the areas of highest infection risk and ensure the reduction of CCHF and ASF morbidity.