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Značaj primene definicije slučaja za unapređenje epidemiološkog nadzora nad hepatitisima B i C / The importance of introducing case definitions for improving epidemiological surveillance of hepatitis B and C

<p>Adekvatni nadzor nad zaraznim bolestima predstavlja aktuelni izazov ne samo kod nas već i u razvijenim zemljama. Savremeni epidemiolo&scaron;ki nadzor nad zaraznim bolestima zasniva se na odgovarajućim definicijama slučaja. Njihova osnovna funkcija je olak&scaron;avanje prepoznavanja određenih bolesti i njihovo registrovanje na jednoobrazan način. Definisanje slučajeva zaraznih bolesti nije jednostavno, jer uključuje kliničke, epidemiolo&scaron;ke i laboratorijske parametre, uz istovremeno očekivanje visoke senzitivnosti i specifičnosti. Ciljevi istraživanja su bili da se utvrdi primenljivost definicija slučaja hepatitisa B i C na Klinici za infektivne bolesti Kliničkog centra Vojvodine, te da se utvrdi senzitivnost i specifičnost primenjenih definicija slučaja hepatitisa B i C. Uz postojeći dijagnostički algoritam Klinike za infektivne bolesti Kliničkog centra Vojvodine, uvedena su tri seta definicija hepatitisa B i C: Evropskog centra za prevenciju i kontrolu bolesti (ECDC) iz 2008. i 2012.godine kao i američkih Centara za kontrolu bolesti (CDC) iz 2012. godine. Istraživanje je sprovedeno na Klinici za infektivne bolesti Kliničkog centra Vojvodine i tokom 12 meseci, u skladu sa predloženim definicijama slučaja, identifikovano je 150 ispitanika obolelih od hepatitisa B i C. Utvrđene su sledeće činjenice: preporučene definicije slučaja su primenljive u Republici Srbiji za laboratorijske i kliničke kriterijume, dok uključivanje epidemiolo&scaron;ke povezanosti u definicije slučaja ima malo praktičnog značaja za prijavljivanje hepatitisa; definicije slučaja koje uključuju i obavezno prisustvo kliničkih kriterijuma (najče&scaron;će definicije verovatnog slučaja) imaju nisku senzitivnost, a visoku specifičnost, kao posledica prisustva infekcije i u odsustvu bilo kakvih kliničkih manifestacija; definicije slučaja koje se zasnivaju samo na laboratorijskim kriterijumima imaju maksimalnu senzitivnost i specifičnost.</p> / <p>Adequate surveillance of communicable diseases is the actual challenge, not only in our country but also in developed countries. Modern epidemiological surveillance of communicable diseases is based on the appropriate case definitions. Their main purpose of them is to facilitate the recognition of certain diseases and their registration in a uniform manner. Case definition of communicable diseases is not easy, because it involves clinical, epidemiological and laboratory parameters, along with the expectated high sensitivity and specificity.The objectives of the study were to determine the applicability of the casedefinitions for hepatitis B and C in the Clinic for Infectious Diseases of the Clinical Center of Vojvodina and to determine the sensitivity and specificity of the applied definition of cases of hepatitis B and C. In addition to existing diagnostic algorithm of the Clinic for Infectious Diseases, three sets of hepatitis B and C case definitions were introduced: the European Centre for Disease Prevention and Control in 2008 and 2012 as well as the US Centers for Disease Control in 2012. The study was conducted at the Clinic for Infectious Diseases Clinical Center of Vojvodina over 12 months, and in accordance with the proposed case definitions, 150 patients suffering from hepatitis B and C were identified. We found following facts: recommended case definitions are applicable in the Republic of Serbia for laboratory and clinical criteria, while the inclusion of epidemiological connection between the case definition has little practical significance for reporting hepatitis; case definitions that include the obligatory presence of clinical criteria (most common definition of probable cases) have low sensitivity and high specificity, as a result of the presence of infection in the absence of any clinical manifestations; case definitions that are based solely on laboratory criteria showed maximum sensitivity and specificity.</p>

Identiferoai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)100362
Date02 February 2017
CreatorsDakić Zoran
ContributorsĐurić Predrag, Fabri Milotka, Dragovac Gorana, Kocić Biljana, Turkulov Vesna, Dugandžija Tihomir, Petrović Vladimir
PublisherUniverzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad
Source SetsUniversity of Novi Sad
LanguageSerbian
Detected LanguageUnknown
TypePhD thesis

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