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Mamasaliyev Nematjon Solievich, doctorof medical sciences, professor, manager of chair of therapy of faculty of improvement of doctors of the Andizhan State medical institute, Andijan State Medical Institute, Andijan, Uzbekistan.
E-mail: [email protected] Shadmanov Mirzamakhmud Alisherovich, Doctoral candidate, of the Andizhan State medical institute, Andijan State Medical Institute, Andijan, Uzbekistan.
Мirzoulugbek Mirmakhmudovich Mirsaydullayev, Doctor, of Philosophy in Medical Sciences, Andijan State Medical Institute, Andijan, Uzbekistan.
E-mail: [email protected] Usmanov Burhonjon Umarovich, assistant, of the department of therapy of faculty of improvement of doctors
of the Andizhan State medical institute, Andijan State Medical Institute, Andijan, Uzbekistan.
PECULIARITIES OF PREVALENCE OF URINARY INFECTION OF HIV-INFECTED POPULATION AND THEIR RELATIONSHIP WITH A LINE OF SOCIO-HYGIENIC FACTORS
Abstract: Epidemiological study of507 HIV-infected women (263) and male (244) sex between the ages of 20 and 69 was conducted at the regional center for AIDS prevention and control in the Andijan region. In creation of design of a research the modern WHO recommendations (2000), criteria of inclusion of clinic-epidemiological screening of the state research center of preventive medicine of the Russian Federation (2007) and experience of carrying out population researches in Andijan (2008) were used.
The most frequent HIV-associated infections of the urinary tract were observed in young people (20-29 years) of age (66.08%), in the group of 30-39 years their frequency was 31.45%, and at the age of40-59 years 19,31% (Table 2). Analysis of the frequency of HIV-associated urinary tract infection in men showed that it is highest in the group of 20-29 years (51.51%), a relatively lower prevalence is found in men 30-39 years (17.73%, p < 0.001) and > 40-50 years (11.26%, p < 0.001).
Keywords: Epidemiological study, HIV-infected persons, urinary tract infection.
Introduction. According to recent literature, it is obvi- and diagnostic process. Adequate therapy and preven-ous that not only clinical work on methodological principles tion, to a certain extent, depend both on scientifically and quality assurance mechanisms for medical care is of in- based clinical recommendations, and on high-risk poputerest to modern science and practical public health servic- lation strategies or on their results in certain population es, but also population results on the issues of improvement, groups. This is especially significant for a population of prevention and metaphylaxis of major diseases [1, 2, 3]. HIV-infected people, for studying epidemiology and
The realization of these results in practice could be- clinical manifestations of various pathologies, including
come an actual opportunity to improve the treatment urological diseases against HIV/AIDS.
Such information is practically absent in the modern literature. Undoubtedly, questions of epidemiology of an infection of a urinary tract infection at HIV of the infected persons are of special interest.
Research Aim. A study of the prevalence of urinary tract infections among HIV-infected population.
Materials and methods. Epidemiological study of 507 HIV-infected women (263) and male (244) sex between the ages of 20 and 69 was conducted at the regional center for AIDS prevention and control in the Andij an region. In creation of design of a research the modern WHO recommendations (2000), criteria of inclusion of clinic-epidemiological screening of the state research center of preventive medicine of the Russian Federation (2007) and experience of carrying out population researches in Andijan (2008) were used. During the screening, epidemiological, clinical, functional and laboratory methods were used. The questionnaire is applied to preliminary identification (WHO, 1990) where questions concerned addictions, lifestyle, a physical activity, and attempt to cope with addictions, the commitment to treatment, deliveries increased or an underweight of a body, existence of business trips "in hot spots".
In addition, to each patient the questionnaire of primary inspection of a state and stage of HIV infection consisting of 5 sections and 118 questions was filled out. Diagnosis of HIV infection/AIDS was performed on specific (blood plasma IFA on 4 generations the test - systems), to rapid tests for identification of antibodies to HIV in saliva, blood, serum and a blood plasma (agglyutinatsionny, immunofiltrational, immu-nochromatographic, and renal and chromatographic tests), to an immunoblot and methods of polymerase chain reaction and also a nonspecific method - determination of number of CD of 4 lymphocytes with keeping
Table 1. - Prevalence of urinary tract
of strategy of testing according to WHO recommendations (2001).
A strategy 3 was implemented with the involvement and direct involvement of specialists from the regional AIDS center (one test with two confirmations of a positive result).
The diagnosis of HIV-associated urinary tract infection (acute pyelonephritis, urethritis, prostate, urolithiasis, cystitis) was based on interview standards (frequent and painful urination, aching or paroxysmal pain and / or bloody urine, imperative urge and incontinence, temperature reaction with the cognition), the results of clinical, biochemical, functional and instrumental studies. The diagnosis of HIV-associated urinary tract infection was formulated according to generally accepted criteria, the verification of diagnosis in each HIV-patient was based on the analysis of clinical manifestations (typical subjective, physical symptoms and clinical syndromes), anamnestic data and complex research data.
Statistical processing of materials was carried out on a Pentium IV personal computer using standard Microsoft Excel 2007 application software. Multidimensional statistical analysis methods, rank correlation analysis (correlation coefficient r) were applied. The reliability of differences in the studied indicators was estimated using the Student's test (t): unreliable - P > 0.05, reliability low - P < 0.05, mean P < 0.01 and high P < 0.001.
Results and its discussion. We analyzed the frequency of urinary tract infection among the male and female HIV-infected population ofAndijan 20-59 years (table 1).
According to the data obtained, the surveyed population has a rather high (41.02%) prevalence of HIV-associated urinary tract infection and large differences in the incidence of it in men and women, in whom it is significantly higher.
infection among HIV-infected people
Surveyed population groups HIV-infected patients without urinary tract infection HIV-infected patients with urinary tract infection Total
n % n % n %
1 2 3 4 5 6 7
HIV-infected men (1) 195 79.60 50 20.40 245 100.00
HIV-infected women (2) 104 39.69 158 60.31 262 100.00
In general. the overall HIV-infected population 299 58.98 208 41.02 507 100.00
1 2 3 4 5 6 7
Statistics of differences in the t-test (p) p < 0.05 -
p < 0.01 -
p < 0.001 2-1
In the literature, mainly data on the epidemiology of especially important, in social adaptation of the operated
urinary tract infection among HIV-negative populations are presented, the results of which are certainly valuable for understanding the epidemiology of HIV-associated urinary tract infection in modern conditions, but there are no differences in sex.
As can be seen from Table 1, every fifth HIV-infect-ed man has urinary tract infection, and among HIV-infected women they are more often more than 3 times (p < 0.001). This, too, confirms the need to further develop aspects of improving the methods of early detection and prevention of this pathology.
In our opinion, the epidemiological and preventive making treatment tactics not less, than surgical, can make a contribution to effectiveness of treatment and that is
HIV patients.
The analysis of frequency of the HIV-associated infection of an uric path in various age groups, in surveyed by HIV-infected population showed rather big differences of prevalence of HIV-associated of an infection of urinary in separate age groups. The most frequent HIV-associated infections of the urinary tract were observed in young people (20-29 years) ofage (66.08%), in the group of30-39 years their frequency was 31.45%, and at the age of40-59 years 19,31% (Table 2). Analysis ofthe frequency ofHIV-associ-ated urinary tract infection in men showed that it is highest in the group of 20-29 years (51.51%), a relatively lower prevalence is found in men 30-39 years (17.73%, p < 0.001) and > 40-50 years (11.26%,p < 0.001), (Table 3).
Table 2.- Prevalence of urinary tract infection in different age groups of the HIV-infected population
Age group HIV-infected patients without urinary tract infection HIV-infected patients with urinary tract infection Total
n % n % n %
20-29 years (1) 58 33.92 113 66.08 171 100.00
30-39 years (2) 170 68.55 78 31.45 248 100.00
40-59 years (3) 71 80.69 17 19.31 88 100.00
Statistics of differences in the t-test (p) p < 0.05 2-3
p < 0.01 1-2
p < 0.001 1-3
Table 3.- Prevalence of urinary tract infection in different age groups of male HIV-population
Age group HIV-infected patients without urinary tract infection HIV-infected patients with urinary tract infection Total
n % n % n %
20-29 years (1) 16 48.49 17 51.51 33 100.00
30-39 years (2) 116 82.27 25 17.73 141 100.00
40-59 years (3) 63 88.73 8 11.26 71 100.00
Statistics of differences in the t-test (P) p < 0.05 2-3
p < 0.01 1-2
p < 0.001 1-3
Further, one of the main objectives of this study was ferent age groups of the HIV-infected female population to study the prevalence of urinary tract infection in dif- (Table 4).
Table 4.- Prevalence of urinary tract infection in different age groups of the HIV population of women
Age group HIV-infected patients without urinary tract infection HIV-infected patients with urinary tract infection Total
n % n % n %
20-29 years (1) 45 32.61 93 67.39 138 100.00
30-39 years (2) 46 42.99 61 57.01 107 100.00
40-59 years (3) 13 76.48 4 23.52 17 100.00
Statistics of differences in the t-test (P) p < 0.05 2-3
p < 0.01 1-2
p < 0.001 1-3
The highest incidence of urinary tract infection, exceeding that of men, was characterized by the age group of women 20-29 years old (67.39%), compared to 1.2 (57.01%, p < 0.05) and 3.2 times (23.52%, p < 0.001), age groups of30-39 years and 40-59 years, respectively, were of lesser prevalence.
Analysis of incidence rates of the surveyed populations indicates that the peak of the prevalence of HIV-associated urinary tract infections, decreasing with age, falls on the age group of 20-29 years. The findings indicate the need for further monitoring of these epi-demiological indicators in prospective studies, as well as coordinated actions of medical structures and AIDS prevention centers in the Ferghana Valley region.
Conclusions:
1. In the HIV-positive population of the population, a high prevalence of infections of the urinary tract was found (41.2%). In women, HIV-associated urinary tract infections are 3 times more common than men (60.31% and 20.40%, respectively).
2. There are significant differences in the epidemiological indicators of HIV-associated urinary tract infections in different age groups. The most commonly HIV-associated urinary tract infections are observed in HIV-infected patients aged 20-29 (66.08%) and 30-39 years (31.45%), relatively less often, at the age of 40-59 years (19.31%).
References:
1. Bachou H., Tylleskär T., Downing R., Tumwine J. K. Severe malnutrition with and without HIV-1 infection in hospitalised children in Kampala, Uganda: differences in clinical features, haematological findings and CD4+ cell counts // Nutrition Journal.- 2006.- Oct. l6.- P. 5-27.
2. Czaja C. A., Schole D., Hooton T. M., Stamm W. E. Population-based epidemiologic analysis of acute pyelonephritis // Clinical Infectious Diseases.- 2007.- Aug 1;45(3).- P. 273-80.
3. Esposito S., Noviello S., Leone S. Catheter-associated urinary tract infections: epidemiology and prevention // Le Infezioni in Medicina.- 2008.- Sep 16(3).- P. 130-43.
