The article is devoted to acute respiratory viral infections (ARVI) in children. ARVI take one of the leading places in a childhood morbidity structure. The article provides an overview of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» for acute respiratory infections in children. These guidelines summarize the experience of the leading world and domestic specialists, contain scientific and practical data that correspond to the most relevant trends in the management of children with this pathology. The authors present modern information on the etiology, pathogenesis, classification, clinical findings and differential diagnosis of various nosological forms of acute respiratory tract infections in the pediatric population. The general (strategic) principles of drug-free and drug treatment are discussed in detail.

Background. Delayed vaccination increases the period of vulnerability of children to vaccine preventable diseases. It is associated with higher risk of infectious morbidity and outbreaks (including previously controlled diseases).Objective. Our aim was to study the vaccination of children and its timing according to the National Immunization Schedule (NIS) in Russian Federation regions.Methods. We have performed retrospective cross sectional study. Data from 2838 maps of preventive vaccinations (form No 063/y) in children of 2015-2017 years of birth from 18 subjects of Volga and Far Eastern federal districts, as well as data from the state federal statistical monitoring forms No 6 “Information on children and adults populations vaccinated against infectious diseases" in 2016-2019 in the same subjects of Russian Federation was analyzed.Results. The proportion of children vaccinated according to the NIS varies from 8% to 87.1% (depending on the vaccine type). 51.5-94.5% of children are vaccinated timely to decreed dates according to the age criteria used in Form No 6. Whereas, more than 95% of children were considered vaccinated against infections from the NIS list (except pneumococcal infection) according to official statistics. Significant regional differences in vaccination of children and its timing were revealed.Conclusion. Significant numbers of children remains unvaccinated or are or untimely vaccinated against infections from the NIS list. At the same time, there is considerable difference between the data about vaccination and its timing received from the analysis of primary medical documentation and from the state federal statistical monitoring forms.

Обоснование. Качество оказания медицинской помощи детям является основой для реализации различных программ по сохранению здоровья матери и ребенка. Цель исследования: оценка качества помощи детям в стационарах второго и третьего уровня в различных регионах Российской Федерации. Методы. В статье обсуждаются результаты аудита стационарной помощи детям в четырех регионах Российской Федерации. Оценка качества стационарной помощи детям с помощью инструментария Всемирной организации здравоохранения была проведена в 21 больнице (из них 5 — третьего уровня, 16 — второго уровня). Результаты. Во всех участвовавших в проверке больницах регионов выявлены похожие, зачастую определяющие низкое качество особенности стационарной педиатрической помощи детям: низкая готовность к оказанию неотложной помощи в приемных отделениях, зачастую безосновательные госпитализации вследствие отсутствия четких критериев для пребывания детей в круглосуточном стационаре, крайне высокий уровень полипрагмазии и необоснованного болезненного лечения, избыточное и неадекватное применение антибактериальных препаратов и инфузионной терапии. Заключение. Идентичность проблем в различных регионах страны позволяет продумать общую стратегию их преодоления, которая, очевидно, должна, прежде всего, подразумевать образование медицинского персонала, реструктуризацию коечного фонда с увеличением коек дневных стационаров, усиление клинико-экспертной работы в больницах.

ЭПИДЕМИЯ КОРИ. РЕАЛЬНА ЛИ УГРОЗА?

Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on the management of children with acute obstructive laryngitis and epiglottitis. Croup is the most common cause of acute upper respiratory obstruction in children aged from 6 months to 6 years. Usually respiratory viruses are the pathogenic agents of the disease. The etiological factor of epiglottitis is Haemophilus influenzae type b in the vast majority of cases (> 90%). However, nowadays, epiglottitis caused by this pathogen agent is more common in adults in countries with mass immunization against hemophilic infection. This article considers in detail etiology, pathogenesis, and classification issues. Special attention is given to diagnosis, differential diagnosis, and therapy (via evidence-based approach) of acute obstructive laryngitis in children.