The study is devoted to the issue of expanding the diagnostic algorithm for the growth hormone deficiency (GHD) in children on the platform of combining the methods of clinical medicine, medical epidemiology and medical geography. The Geographic information systems (GIS) methods were used in the course of clinical observation and GHD prevalence analysis in children in various parts of the Odessa region in the period from 2012 to 2020 (t = 8 years) with the constant inclusion of new patients. In total, 92 children were included in the study; the ratio of boys to girls is 3:1. The prevalence of GHD (t = 8 years) was 19.7 cases per 100,000 children. There were no regional features of the clinical presentation of GHD in children of the Odessa region. In most cases, the disease was idiopathic, congenital, isolated, with a predominance of the peak GH level in 2 stimulation tests in the range of 7-10 ng / ml. The greatest prevalence of DHD (35,8 per 100 000 children) was found in the Foreststeppe zone of the Odessa region , which has a number of territorial geophysical features, according to local GIS data. These include hydrogeological anomalies, altered magnetic and gravitational fields, pinpoint increases in the content of uranium, radon, radium, mercury, lead and deficiencies in the content of Zn, Co, Mo. In the central part of the Forest-steppe zone (Ananyevsky district), a steady 4,7 times excess of the average regional prevalence the GHD in children was noted (93,4 per 100 000 children). Local GIS data and materials of the epidemiological study permit to define this territory as a GHD-associated zone. The possibility of using the GIS method to improve the diagnosis of GHD based on increasing diagnostic alertness and improving medical management was established.
K ey wor d s: geographic information systems, growth hormone deficiency, diagnostics, epidemiology.
Aryayev M.L., Biryukov V.S., Senkivska L.I.PDF URL