Medical care for children with allergic pathology in the Republic of Moldova

Abstract

Background: Allergic diseases are recognized as a globally significant public health problem. According to the World Allergy Organization, globally, by 2025, the incidence of allergic diseases will reach 2.4 billion people. A high proportion of the increase in allergic diseases occurs in children and young people. The burden of allergic diseases is expected to increase significantly in the near future as these patients become adults.

Objective: To evaluate the features of medical care for children with allergic pathology and to identify the ways for improvement it in the Republic of Moldova.

Material and methods: The assessment of the state of allergic pathology among children was established on the basis of data from the National Center for Medical Statistics, and the activities of the department of pediatric allergy of the Institute of Mother and Child over the past 20 years were analyzed. An analysis was made of scientific research in the field of pediatric allergy over the past 20 years on the basis of the Institute of Mother and Child and the Department of Pediatrics of the State Medical and Pharmaceutical University after Nicolae Testemitanu. To assess the quality of personnel training, training programs at the level of pre- and postgraduate training of doctors were evaluated.

Results. Medical care for allergic children is provided at all levels, starting with the family doctor, pediatricians and allergists of consultative polyclinics and private centers, in district hospitals and at the tertiary level — in the consultative polyclinic and the Department of Pediatric Allergy of the Institute of Mother and Child. The inpatient care unit is deployed with 25 beds and has been operating for more than 35 years. About 67% of those hospitalized are patients in need of emergency care. Education on pediatric allergy is carried out on the basis of the department of allergy, where students, resident doctors, graduate students, and doctors are trained annually in continuing education courses.

Over the past 20 years, scientific research has been carried out in the field of diagnosis and treatment of food allergies, epidemiology using the international protocol ISAC (The International Allergy and Asthma in Childhood), the study of environmental determinants, integrated management of allergic diseases, atopic dermatitis. Studies have been conducted to assess the genetic risk factors for childhood asthma using the GMDR (Generalized Multifactor Dimensionality Reduction) Software. Molecular diagnostics of food allergy is carried out and the relationship with the quality of life of parents is determined, as well as the influence of psycho-emotional factors on the evolution of asthma in children.

Conclusions: Based on the research conducted is need to develop aNational Strategy forImproving the Management of Children with Allergic Pathology, which should include sections on improving clinical management of patients, improving the healthcare system and strengthening patient, family and community knowledge. Strengthening the participation of the general public, including the government, is essential. An important component is the improvement of communication skills among medical staff, the creation of websites for professionals and patients, and the observance of the rights of the child to access free and/or compensated diagnostics and treatment of allergic diseases in children.