[Trends in the incidence of mental and behavioral disorders during the COVID-19 pandemic in Penza Oblast]

OBJECTIVE

An analysis of the trend of overall and primary incidence of mental and behavioral disorders, including those caused by the use of psychoactive substances, in different age groups during the COVID-19 pandemic in Penza Oblast.

MATERIAL AND METHODS

The data were obtained from statistical report №12 for Penza Oblast. These included the overall and primary incidence of mental and behavioral disorders (MBD), as well as substance use-related MBD (MBDSUR), as calculated per 100.000 people for the period 2015 to 2022. The period 2015 to 2019 was the reference period and 2020 to 2022 was the pandemic period. The calculation was carried out by age groups: children (0-14 years), adolescents (15-17 years), adults (over 18 years), adults over working age (from 55 years for women and from 60 years for men). Statistical processing of the results included regression analysis, calculation of incidence forecast for 2023-2025, and assessment of the significance of the changes using the t-criterion.

RESULTS

The decrease in the overall incidence of MBD in adults was highly deterministic (R2=0.82; p=0.012) and significant between 2017-2018 (p=0.009), 2018-2019 (p=0.001) and 2019-2020 (p=0.004). High determination with a logarithmic trend line was characteristic of almost all models, except for the primary incidence of MBD in children and overall incidence of MBDSUR in adults over working age, including after 2020. Among adolescents, the overall incidence of MBDSUR decreased significantly from 2015 to 2022 (p=0.042).

CONCLUSION

There was no significant increase in the incidence of MBD, including MBDURS, during the pandemic. At the same time, there was a trend towards the decrease in adults, as well as the increase in the primary incidence of MBD in children and the overall incidence of MBDSUR in adults over working age, which determines the need for further identification of risk factors and development of specific rehabilitation measures for patients in these groups.

[Dynamics of morbidity in the elderly according to the class of eye and its appendage diseases in the Arkhangelsk region.]

The article describes the trends in the primary morbidity of the elderly by the class of eye disease and its accessory apparatus (H00-H59) in the Arkhangelsk region of Russian Federation from 2018 to 2021, analyzes the features of morbidity by gender, age, form of medical care, nosology according to the Territorial Fund of Compulsory Medical Insurance of the Arkhangelsk region (TFOMS AR), n=418 196. The indicators of primary morbidity of eye diseases in the elderly have a general negative trend, increasing in 2019 during the COVID-19 pandemic. In men, the dynamics of morbidity over five years is lower than in women. Primary morbidity is higher in the group of 70-79 years than in other age groups in relative and absolute values. 90% of primary diagnoses were made during outpatient admission, 6% in a round-the-clock hospital. Among nosologies, the leading ones are lens diseases (H25-H28) - 41,9% and glaucoma (H40-H42) - 20,6%. The data obtained can be used to organize preventive measures, for example, drawing up a plan for medical examination and dispensary observation of the elderly population, as well as to assess sensory deficits when analyzing the level of functionality in the elderly with a comprehensive geriatric assessment.

[THE AGE-RELATED FEATURES OF THE MORBIDITY OF THE POPULATION IN THE CONTEXT OF THE COVID-19 PANDEMIC]

The COVID-19 pandemic has led to changes in all medical and demographic indicators, including changes in the incidence of the population. The article provides an analysis of the age characteristics of the primary morbidity of the population in the conditions of the COVID-19 pandemic. A pattern has been determined: the highest rates of primary morbidity in the conditions of the COVID-19 pandemic (for 2020) were determined in the age group older than working age. It was in this group that the highest incidence rates of COVID-19 were established. On the contrary, a comparative analysis of the primary morbidity of children (0-14 years old) in Russia as a whole in the «pre-pandemic» year (2019) and in the conditions of the COVID-19 pandemic (2020) showed a decrease in the level of this indicator by 13.9% (from 172455.1 to 148537.7 per 100 thousand population, р < 0.05). Among the child population, 1208.3‱ cases of COVID-19 were registered. Thus, in the Central Federal District, the indicators of primary morbidity of children were lower than the general.

Ovarian Malignancies Frequency in the Female Population from the Bryansk Region Living in Conditions of Radioactive, Chemical and Combine Contamination (2000-2020)

Background: Radioactive contamination and chemical pollution of the environment can affect the processes of carcinogenesis, including the formation of malignant neoplasms of the ovaries in women. We used the data of official state statistics for 2000–2020 to test the hypothesis about the effect of radioactive contamination (following the Chernobyl disaster) and chemical pollutants on the incidence of ovarian malignancies in the female population of the Bryansk region. Methods: A variety of statistical approaches were used to estimate the incidence of ovarian malignancies, including the Shapiro–Wilk test, Mann–Whitney U test, Spearman’s rank correlation test and linear regression. Results: We did not establish statistically significant differences in the frequency of primary morbidity of women with malignant neoplasms of the ovaries, regardless of the environmental conditions of living. Furthermore, no significant correlations were found between the frequency of primary morbidity of ovarian malignancies, both with the level of contamination by Cesium-137 and Strontium-90, and air pollution with volatile organic compounds, carbon monoxide, sulfur dioxide and nitrogen oxides. A statistically significant increase in the long-term trend in the frequency of ovarian malignant neoplasms was revealed in the areas of chemical pollution (p = 0.02), however, in other territories, no statistically significant regularities were established. The forecast of the frequency of newly diagnosed malignant neoplasms of the ovaries on average in the Bryansk region shows an increase of 12.4% in 2020 in comparison with the real data for 2020, while the largest increase in predicted values is recorded in the territories of radioactive contamination (by 79.6%), and the least in the combined territories (by 6.9%). Conclusions: The results obtained indicate the need for further work to understand the trends in the presence/absence of independent and combined effects of pollutants and the growth of oncogynecological pathology from the perspective of assessing the distant and regional metastasis, histological and immunohistochemical profile of a specific malignant ovarian neoplasm with levels of environmental contamination.

[The morbidity of diseases of skin and subcutaneous cellular tissue in population of the Republic of Bashkortostan]

The diseases of skin and subcutaneous tissue are an actual medical and social problem. The purpose of study was to analyze dynamics of incidence and prevalence of diseases of skin and subcutaneous tissue in population of the Republic of Bashkortostan in 2008-2017. The average rates of incidence and prevalence of these diseases in the Republic of Bashkortostan were significantly higher than relevant data in the Russian Federation and Volga federal district. In the Republic of Bashkortostan the study established increase in incidence rate of atopic dermatitis (primary morbidity increased up to 18.6%, total morbidity increased up to 20.2%) and psoriasis (total morbidity increased up to 3%). The low level of dispensary observation of patients with dermatitis in the medical organizations of the Republic of Bashkortostan was established. In 2017 full coverage with dispensary observation was established in case of children aged 0-14 years with discoid lupus erythematosus. The low level of dispensary observation of children with atopic dermatitis (42%) and adults with psoriasis (30.6%) was established. The study demonstrated necessity of further studying of total and primary morbidity of diseases of skin and subcutaneous tissue and also indices of dispensary observation of patients according nosologies and age groups, identification of corresponding risk factors, development and implementation of measures improving medical care at all stages of its rendering.

[The main trends in primary morbidity of population in the subjects of the Russian Federation in 2008-2017]

The analysis of primary morbidity is the most important indicator of detection of population health in every single subject of the Russian Federation in whole Russia. This approach also permits to monitor impact of economic and social processes on the national level. The article presents analysis of primary morbidity in the subjects of the Russian Federation in 2008-2017. The trends are established, the rates of increase and decrease of primary morbidity in every particular subject of the Russian Federation are calculated. The subjects with significant increase of particular classes of diseases according ICD-10 were identified. During last decade, the indices of primary morbidity increased on the whole up to 0.9%. The decrease was registered only in the Central and Privolzhskiy Federal Okrugs (4.3% and -1.6% correspondingly. In the rest of Federal Okrugs increase was registered. The highest level of primary morbidity was registered in the Nenets Autonomous Okrug and the lowest level in the Kabarda-Balkar Republic. Ib 2017, the Altai Kray became a leader in registration of primary morbidity of neoplasms and diseases of endocrine system and the Pensa oblast took the lead in registration of primary morbidity of diseases of cardiovascular system. In 2017, the highest level of morbidity of diseases of respiratory system was registered in the Chukchi Autonomous Okrug and of diseases of ear and mastoid bone in the Republic of North Ossetia - Alania. The increase of morbidity in the mentioned classes of diseases in the particular subjects of the Russian Federation requires consideration of leading specialists and corresponding development of measures concerning morbidity stabilizing.

[The Medical Social Efficiency of Joint Confinement of Mother and Child in Place of Imprisonment]

The article, on the basis of the results of study of 2016, analyzes a comparative medical social effect of conjoint and separate residing of mother and child in the Children's Homes of the Penal Enforcement System. The materials of study consisted of original observations while working in the given system, data of reports of the Federal Penitentiary Service of Russia concerning medical care of women and children in 2011-2015 and data of address requests to the Children's homes under correctional facility in 2013 and 2015. The experience of functioning of the Children's homes of penitentiary system is summarized. The positive effect of conjoint keeping to indices of coverage with breast feeding is established. The coverage of natural and mixed feeding amounted to 65% in Children's Homes, including 83% in Children's Homes with conjoint residing of mother and child in Children's Homes and in other Children's Homes -- 43% (p<0.05). In 2015, a single refusal of child by condemned mother occurred in Children's Homes, while in 2013 there were 4 of such refusals (p<0.05). In Children homes with extended department of conjoint residence primary morbidity of children made up to 1,679‰ and in comparison, group -- 2014‰ that is reliably higher (p<0.05). According data of primary morbidity occurred decreasing of pool of diseases of respiratory organs from 1,002 to 872 per 1,000 children due to brining into operation of dormitory of conjoint residence of mother and child. This occurrence resulted in decreasing per 12% of number of hospitalizations by emergency indications. The conjoint residence of condemned mother and newborn results in harmonious growth, physical, neuropsychic development of child and also in development of motherhood feelings that is an important factor of re-socialization of the condemned woman. It is proposed to introduce normatively obligatory conjoint residence of mother and child in Children's homes of the Penal Enforcement System.

[The Analysis of Morbidity of Urban Population Older than Able-Bodied Age in Russia]

The aging of population ia an important social, economic and medical problem. The purpose of study is evaluating of morbidity of urban population older than able-bodied age in the Russian Federation in 2010-2014.The article presents the results of studying of primary and total morbidity of urban population older than able-bodied age according classes of diseases in the Russian Federation in 2010-2015. The analysis was applied to morbidity of narcological disorders and particular valuable diseases in population older than able-bodied age and residing in city.

[Effect of anthropo-technogenic load on medico-social aspects of primary morbidity and disability of population.]

Population aging is a global social phenomenon that affects the most important health indicators of the population. The older generation is particularly vulnerable in the current conditions of urbanization and the associated environmental situation. The comprehension of indicators of disability and morbidity of the population, the study of the factors that determine the negative processes of health damage, taking into account regional features of these processes are necessary for the planning of preventive measures. In the age structure of the primary disability of the adult population in the Voronezh region elderly disabled people make up 53,3%, middle and young people with disabilities are less - 30,1 and 16,6%, respectively. These indicators are higher than the average Russian. The results of non-carcinogenic risk and primary morbidity analysis in population of Levoberezhniy district of Voronezh under permanent anthropotechnogenic load have presented. It has been established that non-carcinogenic risk coefficients were bigger that acceptable level (HQ>1) by for nitrogen dioxide, acrylonitrile, acrolein, 1,3-butadiene, copper oxide, chromium+6. Unacceptable level of non-carcinogenic risk is typical for respiratory organs pathology, pathologies of cardiovascular system and endocrine system. Analysis of the primary morbidity of these nosological forms shows their high distribution in adult population morbidity. Under rehabilitation measures in patients with respiratory organs diseases, circulatory system and endocrine system diseases it is necessary to consider anthropotechnogenic load and relationship between agents and disease development.