Analysis of the Causes and Conditions for the Formation of a High Incidence of Acute Respiratory Infections (ARI) in the Population of the Altai Krai (Part 1. Features of Long-Term and Intra-Annual Dynamics of ARI Incidence in 2011–2021)

A. I. Blokh, N. A. Pen`evskaya, N. Rudakov, O. F. Egorova, Kh. A. Manokhina, L. V. Abdrashitova, D. Saveliev
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Abstract

Relevance. The Altai Krai (AK) is among the least prosperous subjects of the Russian Federation in terms of the incidence of acute respiratory infections (ARI).Aim: to analyze the causes and conditions for the formation of a high incidence of ARI among the population of the Altai Krai based on an assessment of the long-term and intra-annual dynamics of the epidemic process in 2011–2021.Materials and methods. In the course of a retrospective epidemiological study according to the annual forms No. 2 of the state statistical observation (SOS) for 2011-2021 a comparative analysis of the incidence of ARI and community-acquired pneumonia (CAP) in various groups of the population of the AK, the Siberian federal district (SFD) and the population of the Russian Federation as a whole was carried out. Data for 2020–2021 («covid» period) was analyzed separately in comparison with the precovid period of 2011–2019. The intra-annual dynamics of the incidence of ARI and CAP in the AK were studied using the method of trend-seasonal decomposition according to the monthly forms No. 2 of the SOS.Results and discussion. It is established that in 2011–2021. the epidemic process of ARI in the AK was characterized by a higher level and rate of increase in the incidence of all population groups (adults and children, urban and rural) compared to the all-Russian and average for the Siberian Federal District; a higher proportion of children in the overall structure of ARI cases, despite the fact that the proportion of the child population did not exceed (or was even less) than in other regions; no decrease in the incidence of ARI in children in the period 2020–2021; the presence of a trend towards an increase in the incidence of ARI in both urban and rural residents in the pre-covid period; higher incidence in the rural population in 2011–2019 compared to the whole of the Russian Federation or the Siberian Federal District. A less pronounced role of the seasonal component in the registration of CAP was revealed, in comparison with ARI. In some years, an increase in the registration of CAP was observed in the spring-summer period. For 2020-2021 there was a close coincidence of the curves of the intra-annual dynamics of the registered incidence of ARI and COVID-19 among the general population, CAP and COVID-19.Conclusion. The obtained results indicate the need to study the possible impact of environmental factors, as well as the shortcomings of the etiological interpretation and differential diagnosis of some natural focal and zoonotic infections that occur with fever and respiratory symptoms on the formation of a high incidence of ARI in the Altai Territory.
阿尔泰边疆区居民急性呼吸道感染(ARI)高发病率形成的原因和条件分析(第 1 部分:2011-2021 年急性呼吸道感染发病率的长期和年度间动态特征2011-2021年急性呼吸道感染发病率的长期和年内动态特征)
相关性。目的:在评估 2011-2021 年阿勒泰边疆区人口急性呼吸道感染(ARI)发病率的长期和年内动态的基础上,分析阿勒泰边疆区人口急性呼吸道感染高发的原因和条件。在根据 2011-2021 年国家统计观察(SOS)第 2 号年表进行流行病学回顾性研究的过程中,对阿勒泰边疆区、西伯利亚联邦区(SFD)和整个俄罗斯联邦不同人群的急性呼吸道感染(ARI)和社区获得性肺炎(CAP)发病率进行了比较分析。对2020-2021年("covid "时期)的数据与2011-2019年 "precovid "时期的数据进行了对比分析。根据 SOS 第 2 号月度表格,采用趋势-季节分解法研究了 AK 地区 ARI 和 CAP 发病率的年内动态。结果表明,2011-2021 年与全俄罗斯和西伯利亚联邦区的平均水平相比,阿卡普尔科地区所有人群(成人和儿童、城市和农村)的急性呼吸道感染发病率和增长率都较高;尽管儿童人口比例没有超过(甚至低于)其他地区,但儿童在整个急性呼吸道感染病例结构中的比例较高;2020-2021 年期间,儿童急性呼吸道感染发病率没有下降;在前伏特时期,城市和农村居民的急性呼吸道感染发病率呈上升趋势;2011-2019 年期间,农村居民的发病率高于整个俄罗斯联邦或西伯利亚联邦区。与急性呼吸道感染相比,季节性因素在CAP登记中的作用并不明显。在某些年份,春夏季节的 CAP 登记量有所增加。2020-2021 年,普通人群中 ARI 和 COVID-19 登记发病率、CAP 和 COVID-19 登记发病率的年内动态曲线非常吻合。研究结果表明,有必要研究环境因素可能造成的影响,以及对阿尔泰边疆区 ARI 高发病率形成的一些伴有发热和呼吸道症状的自然病灶和人畜共患感染的病因解释和鉴别诊断的缺陷。
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