ó㳺í³÷í³ ïðèíöèïè îïòèì³çàö³¿ ñèñòåìè äèíàì³÷íîãî ñïîñòåðåæåííÿ çà ñòàíîì çäîðîâ'ÿ äèòÿ÷îãî íàñåëåííÿ

Íà îñíîâàíèè äèññåðòàöèîííîãî èññëåäîâàíèÿ íàó÷íî îáîñíîâàíû ñ ãèãèåíè÷åñêèõ ïîçèöèé ïðèíöèïû îïòèìèçàöèè äèíàìè÷åñêîãî íàáëþäåíèÿ çà ñîñòîÿíèåì çäîðîâüÿ äåòñêîãî íàñåëåíèÿ â ñèñòåìå îáùåñòâåííîãî çäîðîâüÿ.

Ïðîñòðàíñòâåííî-âðåìåííîé àíàëèç çàáîëåâàåìîñòè äåòñêîãî íàñåëåíèÿ çà 42 - ëåòíèé ïåðèîä ïîêàçàë, ÷òî çàáîëåâàåìîñòü äåòåé ñòàðøåãî äîøêîëüíîãî âîçðàñòà âûðîñëà íà 62,2 %, çà ñ÷åò áîëåçíåé îðãàíîâ äûõàíèÿ, áîëåçíåé ãëàç, áîëåçíåé àëëåðãè÷åñêîé ïðèðîäû è èíôåêöèîííûõ áîëåçíåé. Óñòàíîâëåíî, ÷òî íàèáîëüøèé ðîñò çàáîëåâàåìîñòè íàáëþäàåòñÿ â ìèêðîðàéîíàõ, ðàñïîëîæåííûõ âäîëü àâòîìàãèñòðàëåé (íà 117,5 %), è ìåíåå âûðàæåí îêîëî ïðîìûøëåííûõ ïðåäïðèÿòèé (íà 46,7 %).  ìèêðîðàéîíàõ, ðàñïîëîæåííûõ âäîëü àâòîìàãèñòðàëåé, ÷àñòü ÷àñòî áîëåþùèõ äåòåé è äëèòåëüíî áîëåþùèõ áîëüøå (ñîîòâåòñòâåííî, (ð?0,001) è (ð?0,05)).

Ïðè ïðîãíîçèðîâàíèè çàáîëåâàåìîñòè íà 2020 ãîä óñòàíîâëåíî, ÷òî íåñìîòðÿ íà ñíèæåíèå òåìïîâ ðîñòà ïîêàçàòåëåé, îæèäàåòñÿ äàëüíåéøåå óâåëè÷åíèå óðîâíÿ ñóììàðíîé çàáîëåâàåìîñòè - íà 10,7 %, óðîâíåé çàáîëåâàåìîñòè: áîëåçíÿìè àëëåðãè÷åñêîé ïðèðîäû - íà 9,4 %; èíôåêöèîííûìè - íà 22,8 %; áîëåçíÿìè ãëàç - íà 32,2 %. Íàèáîëåå èíòåíñèâíîå óâåëè÷åíèå çàáîëåâàåìîñòè ïðîãíîçèðóåòñÿ íà òåððèòîðèÿõ îêîëî ïðîìûøëåííûõ ïðåäïðèÿòèé (íà 17,2 %), â ñðàâíåíèè ñ òåððèòîðèÿìè, ðàñïîëîæåííûìè âäîëü àâòîìàãèñòðàëåé (íà 10,3 %); îäíàêî íà òåððèòîðèÿõ, ïðèëåãàþùèõ ê ïðîìûøëåííûì ïðåäïðèÿòèÿì óðîâíè è â äàëüíåéøåì áóäóò îñòàâàòüñÿ áîëåå íèçêèìè (ð?0,001).

 õîäå èññëåäîâàíèé óñòàíîâëåíà ðàçíîâåêòîðíàÿ íàïðàâëåííîñòü âîçðàñòíûõ èçìåíåíèé ïðÿìûõ è íåïðÿìûõ ïîêàçàòåëåé çäîðîâüÿ äåòåé øêîëüíîãî âîçðàñòà. Ïðè ðîñòå õðîíè÷åñêîé ïàòîëîãèè (ñ 10,2 ñëó÷àåâ íà 100 îáñëåäîâàííûõ â ìëàäøåé øêîëå äî 19,2 - â ñòàðøåé; ð?0,001), íàáëþäàåòñÿ ðîñò óäåëüíîãî âåñà äåòåé ñ âûñîêèìè õàðàêòåðèñòèêàìè ñîìàòè÷åñêîãî çäîðîâüÿ (ñîîòâåòñòâåííî, 9,2 è 12,6 %).

Ðåòðîñïåêòèâíûé àíàëèç ôîðìèðîâàíèÿ çäîðîâüÿ ó÷àùèõñÿ ñòàðøåé øêîëû, ïîêàçàë, ÷òî îäíîé èç ïðè÷èí ñíèæåíèÿ óðîâíÿ çäîðîâüÿ ïîäðîñòêîâ ÿâëÿåòñÿ ðàííèé âîçðàñò íà÷àëà îáó÷åíèÿ â øêîëå. Òàê, âåðîÿòíîñòü ôîðìèðîâàíèÿ íèçêîãî óðîâíÿ ñîìàòè÷åñêîãî çäîðîâüÿ ó ïîäðîñòêîâ, ïîñòóïèâøèõ â øêîëó â âîçðàñòå äî 6 ëåò â 1,63 (1,15÷2,31) ðàçà âûøå, ÷åì ó èõ ñâåðñòíèêîâ, íà÷àâøèõ îáó÷åíèå â øêîëå ïîñëå 6 ñ ïîëîâèíîé ëåò. Ðàííåå íà÷àëî îáó÷åíèÿ â øêîëå íàèáîëåå íåáëàãîïðèÿòíî äëÿ ìàëü÷èêîâ. Ó÷èòûâàÿ ðàñïðîñòðàíåííîñòü ôàêòîðà ðèñêà «íà÷àëî îáó÷åíèÿ â øêîëå ñ øåñòè ñ ïîëîâèíîé ëåò» (43,3 %) óñòàíîâëåíî, ÷òî ó êàæäîãî 5-ãî ïîäðîñòêà èç 100, óõóäøåíèå ñîñòîÿíèÿ çäîðîâüÿ ìîæåò áûòü îáóñëîâëåíî ðàííèì íà÷àëîì îáó÷åíèÿ â øêîëå.

Ïîëó÷åííûå ðåçóëüòàòû ïîçâîëèëè îïðåäåëèòü è îáîñíîâàòü ãèãèåíè÷åñêèå ïðèíöèïû äèíàìè÷íîãî íàáëþäåíèÿ çà ñîñòîÿíèåì çäîðîâüÿ äåòñêîãî íàñåëåíèÿ â ñèñòåìå îáùåñòâåííîãî çäîðîâüÿ.

Êëþ÷åâûå ñëîâà: äåòñêîå íàñåëåíèå, ôîðìèðîâàíèå çäîðîâüÿ, ñèñòåìà íàáëþäåíèÿ, çäîðîâüåôîðìèðóþùèå ôàêòîðû.

ANNOTATION

Rudnytska O.P. The hygienic principles of optimization of the system of dynamic monitoring for the children populations' health. - Manuscript.

The dissertation for the degree of Canditate of medical sciences, specialty 14.02.01 - “Hygiene and Professional Pathology” - SI “O.M. Marzeiev Institute of Public Health, NAMS of Ukraine”, Kyiv, 2016.

The differentiated prognosis of changes of the morbidity taking into account living districts of the city were developed based on the temporal-spatial analysis (42-years period of time) of the children populations' morbidity.

It was shown that the analysis of dynamic of changes of children populations' health is better to carry out on two aspects - age (for the estimation of formation of the level of children's health) and temporal (for the estimation of changes of health indicators among identical groups of children population at different periods of time).

The relation between adolescents' health and school starting age has been revealed.

The different-oriented age direction of changes of the direct and indirect indicators of children's health has been estimated: the increasing of reserve capacity of organism (direct indicator) and increasing the prevalence of chronic pathology (indirect indicator) were revealed. It means the necessary of parallel using these indicators for monitoring, as well as using of medical support of the formation of level of “healthy“ children's health.

The obtained results allowed substantiating the hygienic principles of dynamic monitoring for children populations' health for solving the issues of children preventive medicine.

Key words: children population, health formation, system of monitoring, health-related factors.

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