EPIDEMIOLOGICAL PECULIARITIES OF GAS- TROESOPHAGEAL REFLUX DISEASE OCCUR- RENCE AMONG CHILDREN IN LVIV REGION

The aim of the study was to identify and analyze the epidemiology of gastroesophageal reflux disease (GERD) among children under 14 years old in Lviv region. A retrospective analysis of the epidemiology of GERD among children of Lviv region during 2013-2016 years was conducted. There were following criteria for inclusion in the study: 1) children under 14 years old, diseased with GERD, who were living during the time of the study in Lviv and Lviv region 2) voluntary informed consent to participate in the study was received. There were follow- ing eexclusion criteria: 1) children over 14 years old, 2) children from other regions of Ukraine. 3) refusal from participation in the study at any stage. All children were divided into groups according to their gender, age and place of residence, as well as according to different years of observation. According to the results, there is tendency of in- creasing of the general GERD morbidity in children from Lviv region from 0.66 cases per 1000 children in 2013 to 1.15 cases per 1000 children in 2016 (growth rate Tpr = + 66.67%). The highest level of GERD was registered in Starosambirskyi district- 7.40 cases/1 thousand people (2014), and as for cities - in Chervonograd - 5,15 cases/1 thousand people (2016). The incidence of GERD is high- er in girls than in boys during all years of observation. The incidence of GERD decreases in the group of chil- dren under 6 years, while it increases in the group of children 7-14 years old. In summary, the overall incidence of GERD among children in the Lviv region is increasing, which is more pronounced in urban settlements. According to the prevalence of GERD there are following "territories of risk": Starosambirsky, Skolivsky, Sokalsky and Busky districts; Chervonograd and Morshyn cities. The level of primary and general morbidity in GERD is higher in girls than in boys. The highest incidence was noted in school- age children than in pre-schoolers in all areas of Lviv region and during all years of observation. The average percentage of coverage by monitor- ing of children with GERD ranged from 48.46 ± 3.10% in 2013 to 77.45 ± 1.93% in 2016. The coverage by the monitoring of children with GERD in cities was 1.25- 2.32 times higher than in rural areas. 100 % coverage of monitoring of children with GERD was observed in Morshyn city only during all years of observation and in Drohobych, Mykolaiv, Peremyshlyany, Yavoriv districts, Drohobych city during most years of observation; over 80% - in Busk, Zolochiv, Sokal districts, Lviv and Cher- vonograd cities during most years of observation. Com- paring diagrams with data of the monitoring of the GERD morbidity during the last year of the study with the dia- grams of the general morbidity and according to the re- sults of the above-mentioned analysis, it is possible to determine the unfavorable territories as for the further forecasting of the growth of the incidence of GERD among children. Following districts Skole, Busk and Zhovkva belongs to such territories, since they are char- acterized by high level of morbidity and low coverage of monitoring during all period of study. Starosambirsky, Sokalsky and Kamianka-Buzsky districts can be consid- ered as territories of high risk of GERD morbidity. Rela- tively favorable are the Turka, Yavoriv and Mykolaiv districts. The results of current study coincide with global data on the rapid increase in the incidence and spreading of GERD, including pediatric population.