DETERMINANTS OF VACCINE HESITANCY AMONG PARENTS IN KYIV.

OBJECTIVE: The aim: Assess of the determinants of vaccine hesitancy among parents regarding their children in Kyiv, Ukraine. PATIENTS AND METHODS: Materials and methods: Direct interview with survey on parents' attitudes and behaviors regarding their children's immunization. Vaccination hesitancy was determined with the median of responses and by self-reported question. The study was conducted among parents, whose children were patients at Children's hospitals, attend schools and kindergarten in Kyiv, Ukraine. RESULTS: Results: The median of vaccine hesitancy was 14,2% of 797 parents in Kyiv. The results show that 81.5% of parents with university degree agree that vaccination of their child is important for the health of others in the community, whereas only 67% (p≤0.05) of people who graduated from high school supported this view. The only reason to vaccinate their child is so they can enter daycare or school was marked by only 4.5% of parents with university education background and 15.3% of people who graduated from high school (p≤0,05). CONCLUSION: Conclusions: Vast majority of interviewed parents think that vaccines are important for their children; meanwhile only half of the parents fully trust the current National Immunization Schedule and fully agree that question of child vaccination is their responsibility. Consulting pediatricians and GPs are associated with more parental confidence than other medical workers. Main source of negative information about vaccines is the Internet, but some part of parents who received negative information indicates health care workers as a source of this information. Majority of parents thinks that their religion is compatible with vaccines.

PREVENTIVE EXAMINATIONS OF CHILDREN IN DIFFERENT COUNTRIES: SIMILARITIES AND DIFFERENCES.

OBJECTIVE: The aim: The aim of this study was to compare, analize and establish differences the recommendations for well-child visits and screenings till the age of 5 years in different countries . PATIENTS AND METHODS: Materials and methods: The comparative analysis of the data from governmental recommendations for pediatricians from Germany, Ukraine and Poland is conducted. It was used the guideline for medical care for a child under 3 years (The Order №149) and for a healthy child from 4 to 18 years (The Order №434) in Ukraine, the book «Kinderuntersuchungsheft¼ in Germany and child's examination book «Ksiazeczka zdrowia dziecka¼ in Poland. RESULTS: Results: The number of visits to children by the doctors in Ukraine is 1.5-2 times higher than in other countries and the nurses visit are absent in Germany. The neonatal screening for genetic and metabolic diseases, updated in 2021 in Ukraine, corresponds to such screenings in other countries. Physical examination is performed in accordance with WHO standards in Ukraine, while in Poland and Germany the growth references are specially developed for the pediatric population. There was a difference in the age of hearing screening, examination of the hip joints, tactics for assessing vision by a pediatrician. The use of vitamin D, fluoride, iodine and vitamin K is recommended in Poland and Germany from the birth, while in Ukraine only vitamins are used. CONCLUSION: Conclusions: It was found that the differences and similarities in preventive program in Ukraine, Poland and Germany. The results of this study may be useful for improving primary pediatric care.

A COMPARATIVE STUDY OF LIPID PROFILE AND LEPTIN RESISTANCE IN CHILDREN WITH METABOLIC SYNDROME DEPENDING ON HYPERTENSION IN KYIV.

OBJECTIVE: The aim: To compare lipid metabolism and leptin levels among the children with and without hypertension to identify associated risk factors for the course of metabolic syndrome in children. PATIENTS AND METHODS: Materials and methods: This observational, cross-sectional study recruited children from the Rheumocardiology Department of Children's Clinical Hospital No 6 in Kyiv, with metabolic syndrome, identification of waist-to-height ratio, leptin level, homeostasis model assessment of insulin resistance and lipid profile. The main group included 41 children with metabolic syndrome and hypertension and the control group included 40 children with metabolic syndrome without hypertension. Statistical data analysis was performed using the MedStat 2.6.2. package. RESULTS: Results: A total of 81 children aged 10 to 17 with metabolic syndrome were examined. The group of children with hypertension had significantly lower high-density lipoprotein cholesterol (0.85±0.04) than children without hypertension (0.94±0.03), with p < 0.05. Leptin resistance was detected in 65.2% of children with hypertension and 35.3% of children with normal blood pressure (p < 0.01). CONCLUSION: Conclusions: Children with metabolic syndrome and hypertension had a significantly higher body mass index and waist circumference as opposed to children with normal blood pressure. In the lipid profile high-density lipoprotein cholesterol was significantly lower in hypertensive children. There was no reliable difference in other lipid profile indicators between the two groups, but there was an upward trend of them in group with hypertension. Leptin resistance is also significantly higher in hypertensive children.

Clustering patterns of metabolic syndrome: A cross-sectional study in children and adolescents in Kyiv.

Objective: The aim: to identify subgroups by cluster analysis according parameters: original homeostatic model of insulin resistance (HOMA-1 IR), updated computer model of insulin resistance (HOMA-2 IR), ß-cell function (%B) and insulin sensitivity (%S) for the prognosis of different variants of metabolic syndrome in children for more individualized treatment selection. Patients and methods: The observational cross-sectional study on 75 children aged from 10 to 17 with metabolic syndrome according to the International Diabetes Federation criteria was conducted at the Cardiology Department of Children's Clinical Hospital No.6 in Kyiv. HOMA-1 IR was calculated as follows: fasting insulin (µIU/ml) × fasting glucose (mmol/L)/22.5. HOMA-2 IR with %B and %S were calculated according to the computer model in [http://www.dtu.ox.ac.uk]. All biochemical analysis were carried out using Cobas 6000 analyzer and Roche Diagnostics (Switzerland). The statistical analysis was performed using STATISTICA 7.0 and Easy R. The hierarchical method Ward was used for cluster analysis according the parameters: HOMA-1 IR, HOMA-2 IR, %B and %S. Results: Four clusters were identified from the dendrogram, which could predict four variants in the course of metabolic syndrome such that children in cluster 1 would have the worst values of the studied parameters and those in cluster 4 - the best. It was found that HOMA-1 IR was much higher in cluster 1 (6.32 ± 0.66) than in cluster 4 (2.19 ± 0.13). HOMA-2 IR was also much higher in cluster 1 (3.80 ± 0.34) than in cluster 4 (1.31 ± 0.06). By the analysis of variance using Scheffe's multiple comparison method, a statistically significant difference was obtained between the laboratory parameters among the subgroups: HOMA-1 IR (p < 0,001), glucose (p < 0.001), insulin (p < 0,001), HOMA-2 IR (p < 0.001), %B (p < 0.001), %S (p < 0.001), TG ( p = 0.005) and VLDL-C (p = 0.002). Conclusions: A cluster analysis revealed that the first two subgroups of children had the worst insulin resistance and lipid profile parameters. It was found positive correlation between HOMA-1 IR, HOMA-2 IR, %B and %S with lipid metabolism parameters TG and VLDL-C and negative correlation between %B and HDL-C in children with metabolic syndrome (MetS).The risk of getting a high TG result in the blood analysis in children with MetS was significantly dependent with the HOMA-2 IR >2.26.