Факторы риска осложненного течения коклюша и методы их коррекции на амбулаторном этапе с учетом современных тенденций специфической иммунизации

Abstract. A two-stage study aimed at revealing risk factors for pneumonia-complicated whooping cough and methods of correction of these factors at the ambulatory stage was conducted. At the first stage, the probable risk factors for pneumonia-complicated whooping cough were identified, as well as the main epidemiological data, by retrospective study of 423 case histories of children admitted with whooping cough in the Children’s city Hospital number 3, Novosibirsk, in 2011-2017. The maximum number of cases of pertussis and the maximum percentage of complicated course was registered in children of the first three months of life. An increase in cases of whooping cough in older children was recorded. As risk factors for pneumonia were identified: absence of vaccination and concomitant pathology of the central nervous system. Considering that these factors are often interdependent, the need for a second phase of the study appeared. At the second stage, 784 outpatient cards of children observed in outpatient clinics in Novosibirsk were analyzed with a study of current trends in vaccination in conditionally healthy children and children with CNS pathology. As a result, we revealed a positive tendency expressed in a decrease in the number of unjustified medical exemption in the structure of the reasons for the lack of vaccination in children with central nervous system pathology. At the same time, there was an increase in the role of refusals from vaccination both in patients suffering from CNS diseases and in healthy children. Consequently, it is necessary to modernize the existing national vaccination calendar with the inclusion of vaccination of pregnant women and revaccination of children at school age, as well as to actively educate health workers and the population to reduce the total number of pertussis diseases and the number of cases complicated by pneumonia.