| Abstract [eng] |
Aim: to estimate the actual prevalence of diarrhea and risk factors in the population of Lithuania. Methods: the investigation of prevalence was conducted by choosing 10 respondents every month from the ten administrative territories. 120 respondents from every territory within twelve month of the investigation, 1200 respondents in total. Self reported “diarrhea” was defined as >=3 loose stools during the last 24 hours, and lasted > 24 hours. For the collection of the data the questionnaire method was used. The collected data was analyzed using EpiData 2.1., SPSS 11.0. ir WinPepi 1.55 software. The prevalence of diarrhea episodes was expressed in percentage points, the precision was evaluated at the confidence intervals (CI) of 95%, the comparison of categorical data was made using χ2 test and Fisher‘s exact test. The level of significance equal to α=0,05, p<0,05 was used – the difference was concluded to be significant statistically. The Mantel trend test and linear regression method was used to evaluate the trend of acute gastrointestinal infections. Results: the trends analysis of acute diarrhea illnesses within the period 1995-2005 has shown that the overall illness number of salmonellosis, yersiniosis, campylobacteriosis, rotavirus infection and other unspecified gastrointestinal infections was increasing. The sharp drop tendency of shigellosis illness was observed. 5% of respondents have had the diarrhea within the period of last four weeks. The differences between the respondents living in the city and the country side were not observed. The significant difference was observed while comparing the prevalence of diarrhea among the genders: the prevalence was as twice as larger among the men (7,8%) than among the women (4,2%). While comparing the respondents according to their education, the largest prevalence was observed within the group with the university education (11,6%) and the smallest prevalence level within the group having the secondary or high-school education (1,3%). High significance level was observed while evaluating the seasonality of diarrhea episodes – it is especially notable in the period of October-December. Prevalence of the most important consumption risk factors in the population was following: milk (92,6%), meat (95,7%), poultry (79,8%), eggs (84,6%), fruits and vegetables (96,2%). Analysis of the risk factors revealed the significance of the following risk factors: purchase of milk and its products in the market-place (PRR=3,66, PI 95% 1,42-9,42, p=0,026), purchase of eggs in the market-place (PRR=3,45, PI 95% 1,91-6,24, p<0,001), consumption of raw eggs (PRR=3,97, PI 95% 1,33-11,85, p=0,043), unwashed hands before the preparation of food (PRR=3,45, PI 95% 1,91-6,24, p<0,001), and unwashed hands after the contact with the raw meat products (PRR=3,20, PI 95% 1,54-6,67, p=0,006). The analysis of the information collected revealed that daily activities were limited in 40% cases and some 6% have approached for the medical aid services. The same analysis showed that only 2% of the respondents have been tested using microbiological methods and hospitalized, while 11% have been subscribed for the antimicrobial treatment. Conclusions: diarrhea is the important public health issue in Lithuania. The information collected by the registration of acute gastrointestinal infections does not represent the real epidemic situation. The likely prevalence of diarrhea in Lithuania is not less 5%, which extrapolated for the whole population sums up to at least 170 000 cases per year. Only 11-12% of cases are reported according official statistics. Taking into account the prevalence of diarrhea and the growing trends of acute gastrointestinal infections in Lithuania, the surveillance system as well as risk factors must be evaluated and the national control program of these infections must be prepared. |
