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Measles - possibilities of managing unsatisfactory epidemiological situation in Europe
MERVARDOVÁ, Eliška
This thesis focuses on the epidemiological situation in the incidence of measles in the Czech Republic and possibilities of influencing their unfavourable situation in Europe. Measles is a highly contagious disease of viral origin, which has a significant impact on the health of the child population in particular. The most effective protection against the measles is vaccination. The introduction of measles vaccination positively affected the epidemiological situation in the world. Priority of the WHO (World Health Organization, WHO, hereinafter) is elimination of the measles. The long term goal of the WHO and the European Centre for Disease Prevention and Control (ECDC hereinafter) was the elimination of measles in the European region by 2010. This goal was not achieved. The cause was low immunization coverage of certain population groups in several European countries. The prerequisite of achieving elimination of measles is that the vaccination coverage in the population is high. Many countries, thanks to effective vaccination strategy, succeeded in reducing the incidence of measles. In the years 2007- 2009 the historically lowest incidence, of less than 10 measles cases per million inhabitants, in the European region was achieved. In subsequent years, there was again a rise in measles morbidity. A repeated rise in cases of the disease is attributed to the expansion of social groups where vaccination coverage was inadequate in terms of achieving herd immunity. The thesis is divided into theoretical and practical part. The theoretical part is divided into four main chapters. The first chapter describes the history of measles, the origin of the name of the disease and the first mention of it. The second theoretical chapter is devoted to the clinical characteristics of measles. In subchapters it describes the clinical picture of the disease, possible complications of the disease, how the infection is diagnosed and what treatment options there are. The third chapter defines the epidemiological characteristics of the disease. The subheads are aimed at the cause of the disease, possible ways of transmission, incubation period, period of communicability, susceptibility and incidence of this disease. At last, the fourth chapter of the theoretical part desribes possible epidemiological measures, which include measles surveillance, preventive and repressive measures and vaccination. The practical part of the thesis was elaborated through quantitative research - secondary data analysis. Analysed data were obtained from the information system for reporting and recording infectious diseases EPIDAT on Regional Hygiene Station of South Bohemian Region, based in Budweis and the European Centre for Disease Prevention and Control. The data on population, in terms of age groups and individual regions, were drawn from the demographic yearbooks, which are available on the website of the Czech Statistical Office. The resulting data were subsequently processed in tabular and graphical forms in Microsoft Excel. The research objectives were: 1) to set charting trends in the incidence of measles in the Czech Republic and Central Europe over the period 2004-2013, 2) to compare the incidence of measles in the individual regions of the Czech Republic, and 3) to identify the reasons for gaps in vaccination coverage against measles in the South Bohemian Region. Based on the above stated objectives, the five research questions were defined. The results are intended to highlight the issues of possible adverse influence on the epidemiological situation in the incidence of measles in Europe. This thesis can be used as a source of information on trends in incidence, vaccine development and immunization status for measles.
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Incidence of parotitis in the South Bohemia region
MERVARDOVÁ, Eliška
The theoretical part of the bachelor thesis on the topic of Incidence of parotitis in the South Bohemian region is divided into five chapters. In these chapters the current knowledge about this disease is summarized. In the first chapter history of parotitis is described. The first mention of this disease was made as early as in the 5th century before Christ. The second chapter of this thesis deals with epidemiology of parotitis. It primarily defines clinical features of the disease. Parotitis is characterized as an acute viral inflammatory disease, accompanied by fever and the typical painful swelling of the parotid glands. The subchapters include information on the causative agent of parotitis, the source of infection, transmission, the incubation period, the period of infectiousness, susceptibility, complications, diagnosing and therapy. The third chapter is focused on the incidence of parotitis. Epidemics, mainly local, that have occurred in the Czech Republic since the introduction of routine immunizations, are mentioned here. In the Czech Republic routine immunization against parotitis was introduced in 1987. There was an epidemic in 1995-1996, when the North Moravian region was the most affected. In 2002-2003 an increased incidence in the South Bohemian region was detected. In the period of 2005-2006, the incidence of the disease increased especially in the east of the Czech Republic in Moravian regions. Since the beginning of 2010 an epidemic occurrence has been registered also in the districts of the Ústí nad Labem region. The fourth chapter deals with immunization against parotitis. Specifically, it refers to the development of vaccines, indication and dosage of used vaccines and the subsequent effectiveness of immunization. It also describes the possible side effects and circumstances for which certain persons could be either temporarily or permanently exclude from vaccination. In the last fifth chapter the system of epidemiological vigilance (parotitis surveillance), which is regulated by Decree No. 473/2008 Coll. on the epidemiological vigilance, as amended, is described. The surveillance also includes anti-epidemic measures. The main objectives of this thesis were to determine the prevalence and incidence of parotitis in the South Bohemian region over the period 2003 - 2012 in order to compare these cases in different age groups and districts of the South Bohemian region. In the practical part a secondary data analysis was carried out. The analyzed data were obtained from the system of reported infectious diseases EPIDAT in the epidemiological department of the Regional Hygiene Station of South Bohemia in České Budějovice and health statistics from the Institute of Health Information and Statistics of the CR. For the incidence rate calculation the demographic data from the Czech Statistical Office annual reports were used. The results show that parotitis in the South Bohemian region did not have an upward trend in the monitored period. The highest incidence was in 2012. Previous highs were recorded in 2006 and also in 2003. The highest incidence of parotitis was in the age group of adolescents. It was in the 15-19 year-old age group. Over the monitored period 2003-2012 an occurrence in all districts of South Bohemia was recorded. The highest number of reported cases of the disease was in the district of Tabor. This bachelor thesis could serve as a source of information on epidemiology and incidence of parotitis in South Bohemia both for professionals and the general public.
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