International Medical Journal, Vol. 21., Iss. 3, 2015, P. 77−80.
CLINICAL EPIDEMIOLOGICAL MONITORING OF ANTIDIPHTHERIA NONSPECIFIC IMMUNE PROTECTION IN CHILDREN ON THE STAGES OF HEPATITIS A
V. N. Karasin Kharkiv National University, Ukraine
The aim of this research was determining and analysis of indices of cellular and humoral immunity (CHI) as well as application of the research results in practice of epidemic supervision for individualization of tactics of immunization of children who survived hepatitis A (HA). Our study involved 405 children of basic group (sick and survived HА) aged 1−14 who were treated at Kharkiv Child's Regional Clinical Infectious Hospital No. 8. The study was conducted in dynamics, namely during hospitalization, on discharge and 6 months after the disease. The control group consisted of 146 healthy age−matched children. The level of titles of specific antibodies to diphtheria, maintenance of T−cell, Т−helper−cell, T−suppressor−cell, concentrations of immunoproteins of class A (IgA), class M (IgМ) and class G (IgG) in the peripheral blood were determined. The degree of immune disorders (DID) was analyzed using the adapted methodology of determination of disorders of heterospecific immunity by Karaulov A. V. The values of index in limits (1.0?33.0) % corresponded to grade 1 of immune disorders; (33.1?66.0) % −− 2I, and over 66.0 % −− grade 3. To make a hysteresisogram (a standard reflection of formula of disorders of the immune system (FDIS) of patients) the coefficient of diagnostic value of Kj was used. Analysis of disorders CHI demonstrated that the degree of the disorders and their variety depended on the stage of epidemic supervision. The most meaningful disorders were distinguished at the level of humoral immunity in the age−matched groups of children aged 7−10 (IIIIgA+ −− increase in the level of serum immunoprotein more than by 30.0 %) and aged 11−14 (IIIIgA+М+ −− increase of the level of immunoprotein more than by 30.0 %), while in those aged 1−6 disorders of CHI were characterized by grade 2−1 changes. Thus, it should be noted that depending on the age of children the stage of disorders also differed. If in children aged 1−6 minimum changes were registered on the first stage of the clinical epidemiological monitoring, simultaneously with the changes of CHI in patients aged 1−6, the proportion of children with the level of antidiphtheria immunity also changed (only titles over 1:80 were considered) within the limits (25.0?5.0) %. In the senior age group (11−14), in contrast to children aged 1−6 on the 3rd stage of the clinical epidemiological monitoring only grade 1 disorders of CHI were registered, that demonstrates clinical epidemiological heterogeneity of children and confirms a requirement in age−dependent individualization of tactics of forming of artificial immunity in a remote period after HА, that must be taken into account at a re−vaccination.
Key words: children, hepatitis A, cellular and humoral immunity.