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Clinical-epidemiological impact following vaccination in rotaviral infection in infants


Author: Alsaliem Tatiana
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2021
Scientific advisers: Ala Donos
doctor habilitat, associate professor (docent)
Constantin Spînu
doctor habilitat, professor
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 9 September, 2020
Approved by NCAA on the 26 February, 2021

Abstract

Adobe PDF document – 1.02 Mb / in romanian
Adobe PDF document – 0.93 Mb / in english

Thesis

CZU 616.98:578.823.91-06:616.34-022.1-053.3(043.2)

Adobe PDF document 4.54 Mb / in romanian
129 pages

Keywords

rotaviral infection, infants, genotype, impact, vaccination

Summary

Thesis content: introduction, 4 chapters, synthesis of the obtained results, general conclusions and practical recommend ations, bibliography from 137 sources, 13 annexes, 106 pages of printed text, 41 f igures, 23 tables. The obtained results there were published in 30 scientif ic papers. Key words: rotaviral infection, infants, genotype, impact, vaccination. Study domain: ped iatrics and neonatology - 322.01. Study purpose: estimating the clinical-epidemiological impact of infant vaccination against rotaviral infection depending on the genotypes of rotaviruses identified in the Republic of Moldova.

Study objectives: 1 Study and identification of clinical-epidemiological and evolutionary features of rotaviral infection in vaccinated and unimmunized infants depending on rotavirus genotypes. 2 I d entif ication and evaluation of the particularities of the intestinal microbiota and the severity of the disease in infants depending on the application of the rotaviral vaccine. 3 Stud y and establish the correlation between hyd roelectrolytic changes in the anionic gap and clinical manifestations in infants with rotaviral infection. 4 Evaluation of the impact of the implementation of sentinel surveillance measures on the evolution of the clinical-epidemiological features of rotaviral infection in infants.

Scientific news and originality: Researches multiaspectual rotaviral infection with the application of systemic principles in acute diarrheal disease in children under one year of age; Develops an original method of early and differential diagnosis, based on Vesikari Score and metabolic acidosis, in etiologically rotaviral infection caused by different genotypes in infants; Together with the National Agency for Public Health (NAPH), it participated in the improvement of the sentinel surveillance system for rotaviral infection in infants.

The solved scientific problem: In partnership with NAPH, following the examinations performed, we researched the genotype of circulating rotaviral infection in the population of child ren und er one year of age. We realized the characteristic of the clinical - evolutionary peculiarities and the severity according to the Vesikari Score in relation to the genotypic variety of rotaviruses in vaccinated and unvaccinated child ren; Clinical - paraclinical research of patients with different genotypes has resulted in the development of early and differential diagnostic methods of rotaviral infection based on Vesikari score and metabolic acidosis in infants with rotaviral infection.

Theoretical importance consists in the theoretical argumentation of the clinical-epidemiological impact following the vaccination of infants against rotaviral infection, etiologically caused by dif f erent genotypes. The systemic approach in the stud y of rotaviral inf ection in inf ants was completed with original methods of early and differential diagnosis, in establishing the clinical -evolutionary features of the disease in vaccinated / unvaccinated, in relation to genotypic variety.

The applicative value of the study: Contributions in strengthening the training of ped iatricians and f amily med ics in d ealing with intestinal rotavirus inf ection in child ren und er 1 year of age. Development of early and differential diagnostic algorithms for rotaviral infection in infants.

The using of the scientific results: consisted in the elaboration and implementation of the National Clinical Protocol “Rotaviral I nf ection in inf ants”; capitalization and application in practice of the early diagnostic method based on the Vesikari score of the differential diagnostic method based on the evaluation of the acid-base balance and the anionic gap in rotaviral infection in infants.