Registration Number
0219U004431,
0118U000357
, R & D reports
Title
Epidemiology, pathogenesis and clinical manifestations of Lyme disease (borreliosis) in its endemic regions of Ukraine, including Ternopil region; improvement of its diagnosis, treatment, rehabilitation and prevention.
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Head
Andreychyn Mykhaylo,
Registration Date
10-07-2019
Organization
Horbachevsky Ternopil State Medical Academy
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Report on research work (intermediate): 78 p., 16 figures, 10 tables, 51 sources. Lyme borreliosis, B. BURGDORFERI SENSU LATO (B. BURGDORFERI SENSU STRICTO, B. AFZELII AND B. GARINII), B MIYAMOTOI, granulocytic anaplasmosis MAN WITH Lyme borreliosis, erythema migrans, forest workers, students Ternopil State Medical University, ixodid ticks , IMMUNOGLOBULINS, THERMOGRAPHY, POLYMERASE CHAIN ??REACTION. The object of the research is the workers of forest enterprises of Ternopil, Zhytomyr, Zakarpattia, Khmelnytsky, Volyn, Chernivtsi and Chernihiv regions; students of the Ternopil State Medical University named after. AND I. Gorbachevsky; schoolchildren, patients with Lyme borreliosis with predominant skin impairment, cardiovascular and musculoskeletal system, patients with tuberculosis; Ixod mites, selected from patients and from the environment. The purpose of the work is to investigate the etiological structure of Lime borreliosis (B. afzelii, B. burgdorferi sensu stricto and B. garinii) from inhabitants of a number of regions of Ukraine; to study the features of clinical manifestations of Lyme borreliosis in patients with skin diseases, nervous, cardiovascular and musculoskeletal systems, and the frequency of acute and chronic infections in adults and children in different regions of Ukraine; to investigate the ixod mites of regions isolated from humans and the environment for the infection with the major species B. burgdorferi and B. miyamotoi, A. phagocytophilum. Methods of research: clinical (physical, questionnaires); epidemiological; Laboratory (PCR: DNA of major species of Borrelia burgdorferi, Borrelia miyamotoi, Anaplasma phagocytophilum (in material from patients, in mites), ELISA: IgM and IgG antibodies to the major species of Borrelia burgdorferi in the material from patients: blood serum, synovial fluid, interleukins of different groups ; western blot method: IgM and IgG to the antigens of the major species of Borrelia burgdorferi in serum of patients); statistical At the 1st and 2nd stage of the research, it was found that in the serological study in the ELISA test, antibodies of at least one class of IgM and / or IgG to B. burgdorferi sensu lato (B. burgdorferi sensu stricto, B. afzelii and B. garinii) (positive or intermediate the results were detected in 146 (43.1%) of the working forest enterprises of Ternopil, 58 (58.0%) of Zhytomyr, 61 (43.3%) of Transcarpathian, 60 (40.0%) of Khmelnytsky, 72 (48.9%) Volyn, 21 (22.8%) of Chernivtsi, 55 (45.8%) of Chernihiv regions; in 25 (25.2%) patients with tuberculosis and in 29 (27.6%) patients of the rheumatologic department of Ternopil municipal communal hospital №2 and 44 (21.9%) - Ternopil regional skin and venereal dispensary. In the second stage, research has revealed the presence of antibodies of the IgM and / or IgG class to the B. burgdorferi sensu lato complex (B. burgdorferi sensu stricto, B. afzelii and B. garinii) (positive or intermediate findings) by immunoblotting method (EUROLINE Borrelia RN- AT) in 121 (83.5%) of 145 working forestry farms with preliminary positive and interim results using the immune enzyme method of Ternopil, 51 (87.9%) out of 58 Zhytomyrska, 38 (62.3%) out of 61 Transcarpathian, 55 (91.7%) out of 60 Khmelnytsky, 64 (88.9%) out of 72 Volyn, 20 (95.2%) out of 21 Chernivtsi, 48 (87.3%) out of 55 Chernihiv oblasts and 19 (76.0 %) of 25 cases Rh on tuberculosis, indicating the need for a two-stage serum diagnosis of Lyme borreliosis. The analysis of student awareness of Ternopil State Medical University (TDMU) regarding Lime borreliosis, which revealed insufficient knowledge about the clinical manifestations of Lime borreliosis in the interviewed students. The presence of endemic natural cells of human granulocytic anaplasmosis (GAL) in the territory of the western region of Ukraine, including those associated with Lymborolysis, has been analyzed, which determines the high probability of infection of the population as a monoinfection of GAL and several tartar zoonoses in various variations and requires an integrated approach to diagnosis. , treatment and prevention of these infections In residents of Ternopil region DNA of A. phagocytophilum was detected in real time in blood serum 9 (7.6%) from 118 patients, in which 4 of the patients were ill with sarcoidosis of the lungs, 2 patients suffered from diseases of the locomotor system and had a sharp Lyme -boreillosis manifested by migratory erythema, 1 patient was treated for diseases of the cardiovascular system. Infection of a part of ticks, selected from inhabitants of Ternopil region, B. burgdorferi sensu lato, has been confirmed. From 243 ticks, taken from the body surface of children who were bitten by ticks, for 6 months. In 2018, 66 (27.2%) were infected. Among them, B. burgdorferi sensu lato DNA was detected in 67 (58.2%) mites, A. phagocytophilum was found in 33 (28.7%), B. miyamotoi in 4 (3.5%), B. burgdorferi sensu lato together with A. phagocytophilum - in 10 (8.7%), B. miyamotoi together with A. phagocytophilum - in 1 (0.9%) mite. The fact of their infection with B. miyamotoi and A. phagocytophilum is established for the first time. The low percentage of medical treatment for both mite removal and migratory erythema or other symptoms, lack of sufficient information about this disease and non-use of preventive measures in case of tick mite require an increase in the level of sanitary and educational work on Lime borreliosis among the surveyed population of Ukraine.
Product Description
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Івахів Олег Любомирович
Іщук Інна Станіславівна
Андрейчин Михайло Антонович
Васильєва Наталія Аврумівна
Грищук Леонід Андрійович
Завіднюк Наталя Григорівна
Запорожан Степан Йосипович
Качор Василь Олексійович
Кліщ Іван Миколайович
Климнюк Сергій Іванович
Копча Василь Степанович
Лепявко Андрій Андрійович
Никитюк Світлана Олексіївна
Ничик Наталя Анатоліївна
Павлишин Галина Андріївна
Подобівський Степан Степановичс
Сміян Світлана Іванівна
Федонюк Лариса Ярославівна
Шкільна Марія Іванівна
Ярема Надія Іванівна
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2020-04-02
