SIGNIFICANCE OF EARLY DETECTION OF ENDOCRINE DISEASES IN CHILDREN AT THE PRIMARY LEVEL

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Introduction. In the context of the reform of modern medicine, endocrine pathology is encountered not only by pediatric endocrinologists, but also by doctors of other specialties, primarily primary care doctors - pediatricians and family doctors. Currently, there is a tendency to increase the prevalence of endocrine pathologies in all age groups of the child population of Ukraine. Aim. To assess the frequency of detection of the most common endocrine diseases in children by primary care doctors and timely referral to a pediatric endocrinologist. Materials and methods. In the conditions of children's dispensaries, 4273 children aged from 0 to 18 years were consulted and examined. Children had their anthropometric indicators, the state of the thyroid gland and sex development examined. Examination of all children for the presence of endocrine pathologies and confirmation of the diagnosis was carried out on the basis of the Order of the Ministry of Health of Ukraine No. 254 of 04/27/2006 On approval of the medical care protocols for children under “Child endocrinology category. Results. Among the total number of children consulted, endocrine pathology was manifested in 36.7 % of cases. The diagnosis of first identified endocrine pathology was confirmed in 29.9 % of children. Obesity (39.9 %) takes first place among endocrine pathologies, while thyroid pathology (36.4 %), growth failure (18.3 %), and disorders of sex development (7.4 %) - second, third, and fourth place respectively. In 40% of cases disorders of sex development are combined with growth failure. It has been established that primary care doctors in 40- 50 % of cases do not perform anthropometry for children at all, the state of sex development is not evaluated in 70% of cases, which leads to untimely referral to a pediatric endocrinologist and complicates further treatment. Conclusions. There is a high percentage of children with first diagnosed endocrine pathology at the stage of primary care and their late referral by doctors to a pediatric endocrinologist, which is due to the lack of primary care physicians' assessment of anthropometric indicators of the child’s physical development, thyroid gland, and sex development.