ESTIMATION OF RISK OF CONTRACTING DIPHTHERIA IN CHILDREN WITH DIABETES TYPE 1

Realizing the great importance of active prevention of infectious diseases, it is clear that each epidemic, even caused by one and the same microbe has individual characteristics, depending on the nature of the microbe, features of real human environment, space and time. Clarification of these individual features is a priority of the active epidemiologist, not interested in counting the victims of the epidemic, to protect people from danger. According to the Order of Ministry of Health of Ukraine N 595 from 16.09.2011, the “Schedule vaccination in Ukraine” [www.portal.rada.gov.ua/] list of contraindications to vaccination was considerably reduced, particularly regarding autoimmune and endocrine pathology (diabetes, etc.). Retrospective analysis of the incidence of diphtheria in the USSR from 1965 to 1976 years shows a decline 987 times, thanks to routine vaccination against diphtheria. So we, epidemiologists, consider it appropriate to analyze clinical indicators of immune protection of children with diabetes type 1 and assess their risks of disease of diphtheria to restore in modern medicine good, long-term experience of Soviet medicine. The aim of the study was to analyze the risks of contracting diphtheria for type 1 diabetes children depending on the number of diphtheria vaccinations and duration of diabetes.

Materials and methods. There were examined 105 children and adolescents in Kharkov and Kharkov region aged 1–18 years, patients with diabetes type 1 that are on permanent replacement insulin therapy under the supervision at the State Establishment “Institute of Child and Adolescents Health NAMS of Ukraine”. The control group comprised 71 healthy children.

Results and discussion. The analysis of the risk of contracting diphtheria patients with diabetes mellitus type 1 depending on the number of vaccinations against diphtheria and duration of diabetes mellitus type 1 was performed. Assessment of risk of contracting diphtheria in different schedule is considered an indicator of the relative risk, which is counted as ratio of certain categories of diphtheria protection. It was found that the number of vaccinations against diphtheria affects the risk of developing diphtheria children with diabetes type 1. Assessing the influence of diabetes mellitus duration on risk of contracting diphtheria showed significant differences (P<0.01). Only one group of children who suffer from diabetes type 1 contracted diphtheria within less than 1 year. Their data of risk is 8.21 (4.41–12.01) times higher than those for healthy children.

Conclusions. Consequently, the number of vaccinations significantly affect the risk of contracting diphtheria among children with type 1 diabetes mellitus. Children who suffer from diabetes mellitus type 1 less than during a year are at risk in the presence of 1–2 revaccinations.