Markovych I. Integral evaluation of the driving forces of the epidemic process and improvement of its control system

This dissertation is devoted to finding ways to improve epidemiological surveillance of infectious diseases and to integrating evaluation of the epidemiological safety of regions based on the study of the current state of infectious morbidity, as well as establishing the impact on its quantitative-spatial-temporal parameters of medical, demographic, social, economic and ecological transformations in Ukraine and regions during 1994 - 2015. It has been established that a decrease in the infectious disease rate has been observed in Ukraine; changes affected all age groups, and especially children aged 0 to 17, primarily due to a 41.1% reduction of their number. Acute respiratory infections and influenza, which account for up to 97% of all cases registered by the sanitary and epidemiological service, although they are classified as respiratory diseases in the sectoral statistical reporting forms of the Ministry of Health of Ukraine, had a strong influence on the formation of general infection rates. As the intensity of the epidemic process of most infections decreases the incidence of such socially significant diseases as HIV infection (Ti=46250.0%) and tuberculosis (Ti=160.8%) has increased. Due to the improvement of the diagnostic process there was an increase in the reported incidence of rotavirus infection (Td=3608.7%), Lyme disease (Td=6633.3%) and infectious mononucleosis (Ti=412.9%). The revealed unevenness of regional indicators of infectious morbidity (11% ≤Vσ≤19% for all and 10≤Vσ≤149% for individual nosologies) led to comparison of the main characteristics of epidemic surveillance and socio-hygienic monitoring that formed the basis to develop a methodology for calculating the integral index by determining the epidemic safety levels of regions and evaluate the total impact of the secondary driving forces on the epidemic process of infectious diseases (by identification of the most relevant epidemic risks), also developing a model system for epidemic risk surveillance and an algorithm for creating a single information database of the infectious disease cases to improve epidemiological surveillance, that is crucial in the context of an unstable socio-economic and environmental situation in the country.