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spisanie Detski i infektsiosni

Editor:
Central Medical Library ®,
MU - Sofia

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Journal "Detski i infectsiosni bolesti" (Pediatric and Infectious Diseases)

ORIGINAL PAPERS

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Vol. 5, 2013

Vol. 5, 2013, № 2

PEDIATRIC DISEASES
ORIGINAL PAPERS

J. Staykova and R. Chilingirova. Health risk assessment of children in the environmental pollution region of Kardzhali for the period 1991-2013 - Detski i infectsiosni bolesti, V. 5, 2013, No2, 3-6. (Abstract)

PEDIATRIC DISEASES
CASE REPORTS

S. Guenova, A. Stojanova-Deleva, J. Peshev, Vl. Danev and D. Mitkovski. BCG osteitis - Detski i infectsiosni bolesti, V. 5, 2013, No2, 7-11. (Abstract)

V. Velev, N. Darvenyashka, N. Naydenova and K. Vutova. Recurrence of visceral leishmaniasis in one-year-old child - Detski i infectsiosni bolesti, V. 5, 2013, No2, 12-14. (Abstract)

INFECTIOUS DISEASES
ORIGINAL PAPERS

E. Edinakova, V. Doycheva, J. Mitova, М. Vulcheva and Tz. Mintcheva. Crimean-Congo hemorrhagic fever – spread in Europe and Bulgaria - Detski i infectsiosni bolesti, V. 5, 2013, No2, 23-28. (Abstract)

M. Karcheva, I. Petrova and A. Kanova. Epidemiological study of foodborne outbreak - Detski i infectsiosni bolesti, V. 5, 2013, No2, 29-33. (Abstract)

D. Ilieva. Contemporary data on rabies in Bulgaria and the neighbouring countries - Detski i infectsiosni bolesti, V. 5, 2013, No2, 34-43.(Abstract)

M. Manova and G. Petrova. A review of literature on efficacy, safety and cost-effectiveness of rotavirus vaccines - Detski i infectsiosni bolesti, V. 5, 2013, No2, 44-50. (Abstract)

 

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PEDIATRIC DISEASES
ORIGINAL PAPERS

HEALTH RISK ASSESSMENT OF CHILDREN IN THE ENVIRONMENTAL POLLUTION REGION OF KARDZHALI FOR THE PERIOD 1991-2013 - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 3-6.
J. Staykova(1) and R. Chilingirova(2)

(1,2) Regional Health Inspectorate – Kardzhali
(1) Medical University – Sofia
Summary. More than 55 years, Kardzhali is environmental pollution region in Bulgaria due to intense emissions from mining-processing, smelter plant and processing of non-metallic minerals. The main source of pollution in those years is smelter plant (Lead and Zinc Complex), but from 2011 to 2012 lead and zinc production was gradually stopped, respectively. One of the mechanisms to assess the health risk among the population is to conduct biological monitoring, i.e. making biological materials to determine the concentration of heavy metals in them. The most vulnerable group are children. The aim of this study is to benchmark the results of the biological monitoring of children aged 9 to 14 years in the city of Kardzhali for the period 1991-2013. Biological monitoring includes determination of lead in the blood of 356 children from two schools in the city of Kardzhali (located near and far away from OCK-AD) and one in Krumovgrad (for control). According to the individual results for the period 1991-2002, when smelter plant has worked, in 71% of the children in Kardzhali values of lead in the blood are below 100 μg/l, in 24% between 100 and 200 μg/l and in 5% over 200 μg/l. In 2013, when the company ceased operation, in 92% of surveyed children the levels of lead in the blood is below 100 μg/l, in 7% from 100 to 200 μg/l and in 1% above 200 μg/l. The results indicate a link between air pollution with lead aerosols and the level of lead in the blood of children: in the intensive work of the plant during 1991-2002 in 29% of children amounts of lead in the blood is above 100 μg/l; in 2013 (when closed proceedings) only 8% of children are with lead content in the blood of more than 100 μg/l; the blood of the children in the control group demonstrated no lead content in 100% of children.
Key words: children, environmental pollution, level of load, biological monitoring
Address for correspondence: J. Staykova, Regional Health Inspectorate – Kardzhali, 2 "Gen. Vl. Stoychev" Str., 6600 Kardzhali.

PEDIATRIC DISEASES
CASE REPORTS

BCG OSTEITIS - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 7-11.
S. Guenova(1), A. Stojanova-Deleva(2), J. Peshev(1), Vl. Danev(1) and D. Mitkovski(3)

(1) Department of General and Clinical Pathology, Medical University – Plovdiv
(2) Department of Pediatrics, Medical University – Plovdiv
(3) Department of Pediatric Surgery, Medical University – Plovdiv
Summary. BCG osteitis (BCGOST) is the most common late vaccinal complication – 0.39 per 1 000 000 newborns. It involves shins, thighs, vertebrae, sternum and ribs. We present a case of BCG rib osteitis in one-year-old boy. The child was vaccinated on the third day after birth with no further local reactions. At the age of one year and a month a tumor of the IX rib left location was found. Tuberculous etiology was proved after surgical extirpation, frozen, histological investigation and cultivation on Lowenstein-Jensen. One month long treatment with tuberculostatics was administered and in spite of parents refusal of long lasting therapy one year later the child is in a perfect health.
Key words: BCGOST, BCG vaccine, osteitis, rib
Address for correspondence: S. Guenova, Department of General and Clinical Pathology, Medical University – Plovdiv

 

RECURRENCE OF VISCERAL LEISHMANIASIS IN ONE-YEAR-OLD CHILD - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 12-14.
V. Velev, N. Darvenyashka, N. Naydenova and K. Vutova

Department of Infection diseases, Parasitology and Tropucal medicine, Medical University – Sofia
Summary. We present a case of one-year old child treated from local visceral leishmaniasis in Bulgaria. Disease occurred at the end of March 2009, and the child was treated with antimony preparations only ten days, then the treatment was stopped. 6 months later, the child had disease reccurrence with immunosuppression, at the background of which also acute bronchitis developed.
Key words: local visceral leishmaniasis, return disease, treatment
Address for correspondence: V. Velev, Department of Infection diseases, Parasitology and Tropucal medicine, Medical University – Sofia

 

INFECTIOUS DISEASES
ORIGINAL PAPERS

CRIMEAN-CONGO HEMORRHAGIC FEVER – SPREAD IN EUROPE AND BULGARIA - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 23-28.
E. Edinakova, V. Doycheva, J. Mitova, М. Vulcheva and Tz. Mintcheva

Department of Epidemiology, Medical University – Sofia
Summary. Crimean-Congo hemorrhagic fever is an acute viral disease manifested by common toxic infectious syndrome, followed by bleeding, which can be extended to all organs, including the skin and mucous membranes. The virus is transmitted by infected ticks, their smudging or through contaminated blood of a patient in contact with broken skin and mucous membranes. It is characterized by natural areas, seasonality, high mortality, affecting mainly certain professional groups. Crimean-Congo hemorrhagic fever infection is endemic in Bulgaria. It is described for the first time in 1952. During the period 1954-1955 in the region of Shumen (northeastern Bulgaria) epidemic is registered with 305 ill. For the last 50 years in the country have been very sporadic cases and small outbreaks. Most diseased are in the region of Burgas – 309, followed by 305 – Shumen. Morbidity (100 000 in Bulgaria) of Crimean-Congo hemorrhagic fever in the periods 1953-1970, 1971-1990, in 1991-2012 is from 0,09%ооо - 3,51%ооо for the first period, from 0,03%ооо – 0,4%ооо for the second period and 0,02%ооо-0.66%ооо in 2002. For the entire period the lowest incidence was between 1971 to 1990. Period 1953 to 2012. there are 1447 registered people infected with Crimean-Congo hemorrhagic fever in Bulgaria. Endemic areas are Shumen, Veliko Tarnovo, Pazardzhik, Haskovo, Kardzhali, Burgas, Stara Zagora, Yambol, Plovdiv.
Key words: Crimean-Congo hemorrhagic fever, epidemiological analysis, geographical distribution
Address for correspondence: E. Edinakova, Department of Epidemiology, Medical University – Sofia

 

EPIDEMIOLOGICAL STUDY OF FOODBORNE OUTBREAK - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 29-33.
M. Karcheva(1), I. Petrova(2) and A. Kanova(2)

(1)Department of Epidemiology, Parasitology and Tropical Medicine, Medical University – Pleven
(2)Regional Health Inspection – Pleven
Summary. Food-borne illnesses are acute infectious diseases that occur with intoxication and
gastrointestinal symptoms. Infections are resulting from the consumption of contaminated food. The aim of the study was to explore the epidemiological characteristics of an outbreak occurring after consumption of food in the city of Pleven. We performed a retrospective epidemiological study. Eleven patients were affected, with gastrointestinal symptoms. Microbiological testing of fecal samples from eight hospitalized patients did not find isolation of pathogenic enteric bacteria. Workers in the food item (47 individuals) were examined microbiologically. Laboratory investigations included stool analysis and culture which are negative. All 47 samples of nasal swabs were examined and four strains of Staphylococcus aureus were isolated. Ten samples from the production environment from food outlets were taken and sent for testing in Regional Directorate of Food Safety as well as three samples of prepsred food. In one of them coagulasepositive staphylococci were isolated. The analysis of the epidemiological study does not allow for definite statement on the probable source of infection, leading to the occurrence of foodborne outbreak.
Key words: food toxicoinfection, food-borne outbreaks, Staphylococcus aureus
Address for correspondence: M. Karcheva, Department of Epidemiology, Parasitology and Tropical Medicine, Medical University – Pleven, email: milena_karcheva@abv.bg

 

CONTEMPORARY DATA ON RABIES IN BULGARIA AND THE NEIGHBOURING COUNTRIES - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 34-43.
D. Ilieva

National Reference Laboratory “Rabies and monitoring the effectiveness of the vaccination”,
NDRVMI – Sofia
Summary. It is studied the epidemiological situation in respect of rabies in neighbouring countries. During 2013 Romania, Serbia and Macedonia are categorized with high risk of transmission of rabies. With low level and risk of rabies are some regions in Greece and Bulgaria. In connection with monitoring of rabies in our country during 2012 total of 797 diagnostic samples were investigated – 21 samples from suspect animals and 776 samples from wildlife (456 foxes and 320 jackals). The effectiveness of oral vaccination against rabies in Bulgaria was evaluated with 3 tests: age determination, seroprevalence and tetracycline detection. The data show, that junior foxes (J) were 25.5% and adult foxes (А)-74,5%. 91,3% from the adult foxes (А) and 8.7% from the junior foxes (J) were Elisa Ab positive. Tetracycline positive were 85% from the adult foxes (A) and 15% from the junior foxes (J). There are analyzed the data from the oral vaccination against rabies in Bulgaria compared with oral campaigns in neighbouring countries.
Key words: rabies, oral vaccination, monitoring, wildlife

Address for correspondence: D. Ilieva, National Reference Laboratory “Rabies and monitoring the effectiveness of the vaccination”, NDRVMI – Sofia, e-mail: emd@mail.orbitel.bg

 

A REVIEW OF LITERATURE ON EFFICACY, SAFETY AND COST-EFFECTIVENESS OF ROTAVIRUS VACCINES - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No2, 44-50.
M. Manova and G. Petrova

Pharmaceutical Faculty, Medical Univertisty – Sofia
Summary. The goal of the current work was to summarize published studies on the efficacy, safety and cost-effectiveness of the vaccines against rotavirus infections. We searched the data bases with medical literature PubMed and Scopus with key words rotavirus vaccines, efficacy, safety and cost-effectiveness. Six multicenter, randomized, real life clinical studies were selected for the vaccines safety, efficacy and 9 studies for their cost-effectiveness. The studies show that the vaccines are effective, safe and costeffective for the society and benefit the health care systems. No Bulgarian pharmacoeconomic analysis of the vaccines is present, but literature evidences suppose that the vaccines will be also effective with acceptable level of safety and cost-effective for the Bulgarian population.
Key words: Rotavirus infections, vaccination, efficacy, safety
Address for correspondence: M. Manova, Pharmaceutical Faculty, Medical Univertisty – Sofia

 

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Vol. 5, 2013, № 1

PEDIATRIC DISEASES
ORIGINAL PAPERS

M. Krasteva. Dose-dependent effect of exogenous surfactant used in the treatment of full-term newborns with congenital pneumonia - Detski i infectsiosni bolesti, V. 5, 2013, No1, 3-9. (Abstract)

A. Ilieva and R. Kolarov. Application of nutrinidrink mf in children with surgical diseases in the maxillofacial region - Detski i infectsiosni bolesti, V. 5, 2013, No1, 10-14. (Abstract)

A. Loukova. Self-management and prevention of alcohol poisoning in children - Detski i infectsiosni bolesti, V. 5, 2013, No1, 15-18. (Abstract)

Z. Spasova, G. Tsolova, A. Manolova, P. Dimitrov and E. Teolova. Child road traffic injuries in Europe - Detski i infectsiosni bolesti, V. 5, 2013, No1, 19-25. (Abstract)


INFECTIOUS DISEASES
ORIGINAL PAPERS

T. Petkova, S. Pachkova and A. Decheva. M-typing of Streptococcus pyogenes strains and implications for Streptococcal vaccine development - Detski i infectsiosni bolesti, V. 5, 2013, No1, 26-31. (Abstract)

G. Popov and К. Plochev. Treatment of acute non-АBСDE hepatitis with Transmetil - Detski i infectsiosni bolesti, V. 5, 2013, No1, 32-37. (Abstract)

M. Dimitrova, M. Doneva and G. Petrova. Budget impact analysis of immunodeficiency additive therapy with human normal immunoglobulin for subcutaneous application - Detski i infectsiosni bolesti, V. 5, 2013, No1, 38-43. (Abstract)

 

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PEDIATRIC DISEASES
ORIGINAL PAPERS

DOSE-DEPENDENT EFFECT OF EXOGENOUS SURFACTANT USED IN THE TREATMENT OF FULL-TERM NEWBORNS WITH CONGENITAL PNEUMONIA - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 3-9.
M. Krasteva
Neonatology Unit, Department of Obstetrics and Gynecology, UMHAT “Sv. Georgi” -- Plovdiv
Summary: The aim of the present study was to establish the dose-dependent effect of exogenous surfactant applied as part of the complex treatment of full-term newborns with congenital pneumonia. Twenty-four term newborns with congenital pneumonia have been studied and have been divided into two groups according to the dose of exogenous surfactant insufflation at the time of conventional ventilation, 100 mg/kg -- first group and 200 mg/kg -- second group, respectively. The need for surfactant administration in the first 6 hours after birth was observed in 53.8% of the newborns in the first group and in 63.6% for the second group. A dose of 200 mg/kg exogenous surfactant significantly improves oxygen saturation after insufflation, reduces the need for a second dose of the drug and shortens the duration of treatment with oxygen, but does not affect the duration of mechanical ventilation, hospital stay and the outcome of the child. Higher concentration of the surfactant used in the treatment of term newborns with congenital pneumonia significantly improves pulmonary oxygenation and reduces the need for oxygen supplementation.
Key words: exogenous surfactant, full-term newborns, congenital pneumonia
Address for correspondence: M. Krasteva; Neonatology Unit, Department of Obstetrics and Gynecology, UMHAT “Sv. Georgi” – Plovdiv

 

APPLICATION OF NUTRINIDRINK MF IN CHILDREN WITH SURGICAL DISEASES IN THE MAXILLOFACIAL REGION - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 10-14.
A. Ilieva and R. Kolarov
Specialized Hospital for Maxillofacial Surgery, MU -- Sofia
Summary: Poor nutrition in children with surgical illnesses worsens their normal development and quality of life. The purpose of this clinical surveillance was to examine the impact of the special meals for medical needs NutriniDrink MF in patients suffering from childhood from surgical diseases in the maxillofacial region (MFR). Twenty patients (children aged 3-18 years) divided into 2 groups were examined for a period of 9 months. Changes in body weight, upper and lower dyspeptic syndrome and general condition were evaluated during the follow-up. The three flavors of the medical food offered for sale on Bulgarian market were well-tolerated, with the most rapid response being observed in children with inflammatory diseases in MFR. Sustained increase in body weight in children with fractures and congenital malformations, no allergic reactions or other complications were observed during treatment and after discontinuation. Children with and without accompanying diseases responded equally well to therapy.
Key words: NutriniDrink MF, malnutrion, maxillofacial region, Alagille syndrome
Address for correspondence:A. Ilieva  Specialized Hospital for Maxillofacial Surgery, MU – Sofia; e-mail: ialbena@yahoo.com

 

SELF-MANAGEMENT AND PREVENTION OF ALCOHOL POISONING IN CHILDREN - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 15-18.
A. Loukova
Toxicology Clinic, MHATEM “Pirogov” -- Sofia
Summary: The self-management is an intervention directed to forming a personal, purposeful, con­se­cu­tive and deliberate control to the behaviour and the emotions without foreign intervention. In the framework of alcohol poisoning in children the aim is to implement an active psychological defense and a prompt attitude towards drinking refusal. Our study presents some scientific evidences, basic tendency and algorithm of treatment.
Key words: self-management, poisoning, children, alcohol
Address for correspondence:A. Loukova; Toxicology Clinic, MHATEM “Pirogov” – Sofia; 1606 Sofia; tel. 02/9154409

 

CHILD ROAD TRAFFIC INJURIES IN EUROPE - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 19-25.
Z. Spasova, G. Tsolova, A. Manolova, P. Dimitrov and E. Teolova
National Center of Public Health and Analyses -- Sofia
Summary: Road traffic traumatism is among the leading causes for death and disability of children. The present paper provides a review of the current literature on the problem of child road traffic injuries in Europe, reveals the main risk factors and gives preventive strategies. A review of the state of road traumatism in Europe has been made with a special focus on the situation in Bulgaria. Good preventive practices have been given that could be applied in our country as well.
Key words: road traffic traumatism, children, Europe, Bulgaria, preventive measures
Address for correspondence:Z. Spasova; National Center of Public Health and Analyses – Sofia; tel. 02/8056381; e-mail: Z.Spassova@ncpha.government.bg

 

INFECTIOUS DISEASES

ORIGINAL PAPERS

M-TYPING OF STREPTOCOCCUS PYOGENES STRAINS AND IMPLICATIONS FOR STREPTOCOCCAL VACCINE DEVELOPMENT - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 26-31.
T. Petkova(1), S. Pachkova(2) and A. Decheva(3)
(1)Department of Epidemiology, Parasitology and Tropical Medicine, Medical University -- Pleven, (2)Department of Microbiology, Virology and Medical Genetics, Medical University -- Pleven, (3)NRL Pathogenic Cocci, Diphtheria and Anaerobic Infections, NCIPD -- Sofia
Summary: Typing based on the M-protein, the major virulence and immunological determinant of group A streptococcus (Streptococcus pyogenes, or GAS), has been the most widely used method. Available epidemiological data have pointed at the development of GAS vaccine candidates. Several vaccine candidates have shown promise, however, only 26-valent M-protein-based vaccine, has recently reached clinical trials. The aim of this study was to perform M-typing of GAS strains, isolated from children with sporadic forms of acute streptococcal tonsillopharyngitis, and determine the vaccine coverage of isolates with experimental GAS vaccine. This prospective study was carried out in Pleven in the period September 2010-September 2012. For the duration of the study 1332 children with acute tonsillopharyngitis were examined. Lancefield group of the isolated streptococci in pure culture was determined using the latex agglutination test Slidex Strepto Plus (BioMerieux-France). Of the isolated GAS, identification of M- and T-serotype was carried out by conventional methods. Serotyping showed circulation of 20 M-types in Pleven region, dominated by M25 (24.4%), M12 (11.3%) and M8 (11.3%). Theoretical experimental vaccine coverage was defined as the proportion of isolates in the region that were contained in the 26-valent M-protein-based GAS vaccine. Ten (50%) of the isolated M-types were included in the vaccine, however, the most common serotypes, M25 and M8, were not covered by the vaccine. The results of this study suggest that the experimental vaccine would provide mid-level coverage in Bulgaria, like in Asia and the Middle East. However, there were significant differences in M-type distribution by region, therefore, alternative formulations of the vaccine would be needed for different regions of the world.
Key words: Streptococcus pyogenes, M-serotypes, Streptococcus group A vaccines
Address for correspondence:T. Petkova; Department of Epidemiology, Parasitology and Tropical Medicine, Medical University – Pleven; tel. тел. 064/884 269;  e-mail: tanja_1973@abv.bg

 

TREATMENT OF ACUTE NON-АBСDE HEPATITIS WITH TRANSMETIL - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 32-37.
G. Popov and К. Plochev
Clinic of Infectious Diseases, MМА -- Sofia
Summary: Hepatitis А, B, C, D and E viruses are well defined hepatotropic agents that cause the relevant to them types of viral hepatitis. To date, acute viral hepatitis caused by other viruses, rickettsia and bacteria have been met more often in the clinical practice. In this retrospective study we have analyzed 208 patients with non-ABCDE hepatitis, hospitalized in the Clinic of Infectious Diseases at the Military Medical Academy, Sofia, for the period January 01, 2004-December 31, 2012. Diagnostic criteria for non-ABCDE hepatitis were: clinical and clinical-laboratory data for acute viral hepatitis and negative serological markers for HAV, HВV, HCV, HEV and HDV. Depending on clinical features we have examined patients with serological markers for EBV, CMV, VZV, HSV, C. burneti, R. conori, P. epidemica, B. burgdorferi, C. trachomatis et pneumoniae, M. pneumoniae, Parvovirus, Morbillivirus and Enterovirus with ELISA test. One hundred twenty-four (124) patients were treated with S-Adenosyl-L-Metthionine (Transmetil) scheduled 500 mg i.v., 2 times daily for 7 days, followed by 2 weeks of oral treatment. Eighty-four (84) patients constituted the control group, treated with common hepatoprotective therapy. Of all 208 investigated patients, 121 (58%) were male and 87 (42%) female, with mean age 42 +/- 6. Indexes for cytolysis (AST, ALT) and intrahepatic cholestasis (total bilirubin, АР and GGT) were studied during a dynamic follow-up. The assessment of clinical and biochemical indices were accomplished before initiation of treatment with Transmetil, and at week 2, 4 and 8 after treatment initiation (together with observation in the control group). Statistically reliable decrease of total bilirubin, AST, ALT, АР and GGT in the group treated with Transmetil was observed at the second week of treatment (р < 0.01). At the end of the treatment, the percentage decrease of cholestatasis enzymes was two times higher in the group treated with Transmetil.
Key words: non-ABCDE hepatitis, treatment, Transmetil
Address for correspondence:G. Popov;  Clinic of Infectious Diseases, MМА – Sofiaтел. 0888-517-529; e-mail: popovg@abv.bg

 

BUDGET IMPACT ANALYSIS OF IMMUNODEFICIENCY ADDITIVE THERAPY WITH HUMAN NORMAL IMMUNOGLOBULIN FOR SUBCUTANEOUS APPLICATION - DETSKI I INFECTIOSIOSNI BOLESTI, V. 5, 2013, No1, 38-43.
M. Dimitrova, M. Doneva and G. Petrova
Faculty of Pharmacy, Medical University -- Sofia
Summary: Hypogammaglobulinemia is an inconstant immunodeficiency disease with reduction of almost all types of gamma-immunoglobulins. Patients with hypogammaglobulinemia experience recurrent infections of the upper and lower airway tract -- sinusitis, otitis, bronchitis, pneumonia. Moreover, there is a high risk of non-Hodgkin B-cell lymphoma among adults and juvenile rheumatoid arthritis among children. These patients should be treated with replacement therapy with human normal immunoglobulin but this treatment should be performed in hospital or ambulatory setting. The goal of the current study was to calculate the budget impact of the replacement therapy with human normal immunoglobulin for subcutaneous application. The cost of therapy with subcutaneous route of application have been compared with the cost of therapy with other intravenous human immunoglobulins, with the expenditure calculated per patient for one year. Two scenarios were performed -- one for the cost of replacement therapy for children with average weight 40 kg and the second one -- for cost of replacement therapy for adults with average weight 70 kg. The pharmacoeconomic analysis showed that the cost of therapy with subcutaneous immunoglobulin was lower than that with intravenous immunoglobulin and, therefore, if introduced to practice, would lead to direct savings for the National Health Insurance Fund and some other direct and indirect savings, related to the route of application.
Key words: hypogammaglobulinemia, subcutaneous application, human normal immunoglobulin
Address for correspondence:M. Dimitrova; Faculty of Pharmacy, Medical University – Sofia; Str Dunav ) 2;
1000-Sofia.

 

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Last update: 11.03.2014