sazogadoebrivi

janmrTelobis
epidzedamxedvelobis
sistemis gacnoba
miznebi
• sazogadoebrivi janmrTelobis
epidzedamxedvelobis gansazRvra
• epidzedamxedvelobis monacemebis
gamoyenebis areebi
• epidzedamxedvelobis sistemis dagegmvis
etapebis aRwera
• epidzedamxedvelobis sxvadasxva
saxeebis aRwera
• laboratoriis rolis aRwera
epidzedamxedvelobaSi
midgoma
danergva:
sazogadoebriv rogor
janmrTelobaSi akeTebT amas?
Carevis
Sefaseba:
rogor
risk faqtorebis muSaobs?
gamovlena:
ra aris mizezi?

epidzedamxedveloba:
ra warmoadgens
problemas?

problema reagireba
 sazogadoebrivi janmrTelobis sistemis
epidzedamxedvelobis gansazRvreba
 sazogadoebrivi janmrTelobis epidzedamxedveloba
warmoadgens janmrTelobis Sesaxeb arsebuli
monacemebis uwyvet Segrovebas, analizs,
interpretacias da gavrcelebas
 es aris meqanizmi romelsac sazogadoebrivi janmrTelobis
saagentoebi iyeneben TavianTi sazogadoebebis
janmrTelobis mdgomareobis gasakontroleblad. misi
daniSnulebaa, rom am saagentoebs qondeT faqtebi,
romelze dayrdnobiTac isini dasaxaven saTanado
prioritetebs, dagegmaven programebs da daiwyeben
qmedebas, rom daexmaron da daicvan sazogadoebrivi
janmrTeloba
 sazogadoebrivi janmrTelobis
epidzedamxedveloba
 sistematiuri
 uwyveti
 Segroveba
 analizi
 interpretacia
 janmrTelobis Sesaxeb arsebuli monacemebis
gavrceleba
 epidzedamxedvelobis monacemTa kavSiri
sazogadoebrivi janmrTelobis praqtikasTan
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis daniSnuleba
 sazogadoebrivi janmrTelobis statusis
Sefaseba
 sazogadoebrivi janmrTelobis sistemis
qmedebebis dawyeba
 sazogadoebrivi janmrTelobis
prioritetebis gansazRvra
 programebis Sefaseba
epidzedamxedveloba

informacia qmedebisTvis
 sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
 monacemTa analizi
 monacemTa interpretacia
 monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba

monacemTa Segroveba
 monacemTa analizi
 monacemTa interpretacia
 monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 monacemTa wyaroebi
Setyobinebas daqvemdebarebuli
daavadebebi
laboratoriuli nimuSebi
mosaxleobis bunebrivi dinamikis
Canawerebi
reestrebi
mimoxilviTi kvlevebi
administraciul monacemTa sistemebi
monacemTa sxva wyaroebi
 Setyobinebas daqvemdebarebuli
daavadebebi – saerTaSoriso da
adgilobrivi
 janmo – 6+
 aSS – 60+
 saqarTvelo – 70+ (m.S. 12 gansakuTrebiT saSiSi
da masTan gaTanabrebuli daavadebebi)

saqarTvelos Sesaxeb monacemebi moyvanilia Semdegi wyaros mixedviT: Surveillance

and Control of Communicable Diseases: Guidelines for Public Health Services in Georgia;
Section 4 Notification and Reporting. Prepared by: Ministry of Labor, Health and Social
Affairs of Georgia National Center for Disease Control With technical support provided by:
Partners for Health Reformplus Curatio International Foundation; October 2004.
 Setyobinebas daqvemdebarebul
daavadebaTa epidzedamxedveloba
 Setyobineba gaTvaliswinebulia normatiuli brZanebiT
 eqimebi, klinikebi, saavadmyofoebi da laboratoriebi
atyobineben sazjandacvis raionul samsaxurebs
 xdeba miRebuli Setyobinebebis gadaxedva da Cveulebriv
adgilobrivi an regionaluri sazogadoebrivi jandacvis
warmomadgenlobebi axdenen Semdgom reagirebas
 saswrafo an agregirebuli (jamuri) Setyobinebebi igzavneba
jandacvis zemdgom samsaxurebSi (mag.: nacionaluri)
 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
laboratoriuli nimuSebi
 mosaxleobis bunebrivi dinamikis Canawerebi
 reestrebi
 mimoxilviTi kvlevebi
 administraciul monacemTa sistemebi
 monacemTa sxva wyaroebi
 salmonelozi
30
aSS, 1970-2000
100,000 mosaxleze Setyobinebuli SemTxvevebi

25 ilinoisSi
dabinZurebuli
pasterizebuli rZiT
20
gamowveuli afeTqeba

15

10

0
1970 1975 1980 1985 1990 1995 2000
wyaro: CDC. Summary of notifiable diseases. 2000 .
 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
 laboratoriuli nimuSebi

mosaxleobis bunebrivi dinamikis Canawerebi

 reestrebi

 mimoxilviTi kvlevebi

 administraciul monacemTa sistemebi

 monacemTa sxva wyaroebi

 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
 laboratoriuli nimuSebi

 mosaxleobis bunebrivi dinamikis Canawerebi

reestrebi
 mimoxilviTi kvlevebi

 administraciul monacemTa sistemebi

 monacemTa sxva wyaroebi

 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
 laboratoriuli nimuSebi

 mosaxleobis bunebrivi dinamikis Canawerebi

 reestrebi

mimoxilviTi kvlevebi
 administraciul monacemTa sistemebi

 monacemTa sxva wyaroebi

 mSobiaroba sakeisro kveTiT
aSS, 1970-1992
30

25
procenti

20

15

10

0
74

92
80
70

78

82
72

86

88
76

84

90
19

19
19

19
19

19
19

19

19
19

19

19
weli
wyaro: National Hospital Discharge Survey (NHDS)
 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
 laboratoriuli nimuSebi

 mosaxleobis bunebrivi dinamikis Canawerebi

 reestrebi

 mimoxilviTi kvlevebi

 administraciul monacemTa sistemebi

 monacemTa sxva wyaroebi

 monacemTa wyaroebi
 Setyobinebas daqvemdebarebuli daavadebebi
 laboratoriuli nimuSebi

 mosaxleobis bunebrivi dinamikis Canawerebi

 reestrebi

 mimoxilviTi kvlevebi

 administraciul monacemTa sistemebi

monacemTa sxva wyaroebi

 epidzedamxedvelobisTvis saWiro
sxva monacemTa wyaroebi
 vaqcinebis gverdiTi movlenebis saregistracio sistema
 farmakologiuri samsaxuri
 samedicino Canawerebi
 administraciuli monacemTa sistemebi
 dabadebis/gardacvalebis mowmobebi
 garemos monitoringis sistemebi
 cxovelebi/veqtorebi
 individebi
 policiis Canawerebi
 epidzedamxedvelobis
Setyobinebis formebiT
Segrovebuli monacemebi
 saidentifikacio informacia
 demografiuli informacia
 klinikuri informacia
 informacia eqspoziciis/risk faqtoris Sesaxeb
 im piris Sesaxeb informacia, vinc gascems
Setyobinebas
 kontaqtebis Sesaxeb arsebuli informacia
 epidzedamxedvelobis saxeebi
epidzedamxedveloba

populaciaze sayrdeni
mibmuli bazebiT

aqtiuri pasiuri aqtiuri pasiuri

 populaciaze mibmuli
epidzedamxedveloba
gansazRvreba

epidzedamxedveloba, romelic
zogadad dafuZnebulia geografiul
sazRvrebSi moqceul populaciaze
 populaciaze dafuZnebuli
epidzedamxedveloba
maxasiaTeblebi

 reprezentatuli (warmomadgenlobiTi)
 dafuZnebulia sazogadoebrivi janmrTelobis
arsebul sistemaze
 iSviaTi daavadebebis aRmoCenis albaToba
gazrdilia
 sayrdeni bazebiT
epidzedamxedveloba
gansazRvreba

epidzedamxedveloba, romelic
dafuZnebulia arCeul populaciur jgufebze
da asaxavs am jgufebis maxasiaTeblebs
 sayrdeni bazebiT
epidzedamxedveloba
maxasiaTeblebi
 monawileoben arCeuli eqimebi an dawesebulebebi

 xdeba amorCeuli daavadebebis Setyobineba

 maRali xarisxis monacemebis Segroveba

 ar aris reprezentatuli (warmomadgenlobiTi)

 xSirad gamoiyeneba farTod gavrcelebuli

daavadebebisTvis/mdgomareobebisTvis, rodesac
 SemTxvevaTa srulyofili danaTvalis codna ar aris mniSvnelovani
 calkeuli SemTxvevis dros ar xdeba sazogadoebrivi janmrTelobis
mxridan reagireba
 populaciaze mibmuli da sayrdeni
bazebiT epidzedamxedvelobis Sedareba
populaciaze
mibmuli sayrdeni bazebiT
Setyobinebis
yvela arCeuli
wyaroebi
warmomadgenlobiToba ki (Teoriulad) ar aris aucilebeli

monacemTa xarisxi SeiZleba iyos cudi kargi

iSviaTi, mZime xSiri

saukeTesoa…
daavadebebisTvis daavadebebisTvis
 epidzedamxedvelobis
pasiuri da aqtiuri sistemebi
 pasiuri - inicirebulia pirveladi
janmrTelobis samedicino personalis mier

 aqtiuri - inicirebulia sazogadoebrivi

janmrTelobis sistemis mier
 aqtiuri da pasiuri sistemebiT
Setyobinebuli SemTxvevebis
raodenoba/100 eqimze, monros sagrafo
(niu iorki) 1980-81 w

daavadeba aqtiuri pasiuri Tanafardoba

hepatiti 78 27 2.9
wiTela 11 8 1.4
wiTura 7 3 2.3
salmonelozi 44 9 4.9
sul 140 47 2.9
 janmrTelobis departamentis miaxloebiTi
xarjebi aqtiur da pasiur
epidzedamxedvelobaze,
vermonti, 1981 weli
aqtiuri pasiuri
qaRaldi $ 114 $ 80
fosta 185 48
telefoni 1,947 175
personali
mdivani 3,000 2,000
eqTnebi 14,025 0
St. laboratoria 700 500
HBIG da ISG 10,890 8,250
sul $30,861 $11,053
 pasiuri sistema -
maxasiaTeblebi
 martivi
 nebayofilobiTi
 naklebad damtvirTavi
 naklebi samuSaoa sazogadoebrivi janmrTelobis
samsaxurebisaTvis

 Setyobinebis mowodebis araregularoba

 SesaZloa, ar iyos reprezentatuli (warmomadgenlobiTi)
 SesaZlebelia ar iyos drouli
 SeiZleba ver moaxdinos afeTqebebis /tendenciis aRmoCena
 aqtiuri sistema -
maxasiaTeblebi
 pasiuri sistemis reprezentatulobis
(warmomadgenlobiTobis) validurobis dadgena
 uzrunvelyofs ufro srulyofil Setyobinebas
 SeiZleba iyos gamoyenebuli specifikur kvlevebTan
erTad
 SeiZleba iyos gamoyenebuli xanmokle drois periodSi
 saWiroebs ufro met resursebs
 sindromuli da droebiTi
epidzedamxedveloba
 sindromuli epidzedamxedveloba – daavadebis
nacvlad fokusirdeba erT simptomze an simptomebis
jgufze

 droebiTi epidzedamxedveloba – uwyvetis nacvlad

droebiTi epidzedamxedveloba, romelic Cveulebriv
mimdinareobs movlenamde, mis ganmavlobaSi an
movlenis Semdeg; Cveulebriv isic sindromulia da eZebs
bioterorizmTan dakavSirebul movlenebs
 sindromebi,
11 seqtembris Semdgomi sindromuli
epidzedamxedveloba,
niu iorki
 kvamlis an mtvris inhalacia
 sasunTqi sistemis daavadebebis gamwvaveba
 SfoTva
 diarea/gastroenteriti
 zeda an qveda respiratoruli traqtis infeqcia cxelebiT
 sefsisi an aratravmuli Soki
 gamonayari cxelebiT
 meningiti, encefaliti, encefalopaTia
 botulizmis msgavsi sindromi
 auxsneli gardacvaleba, anamnezSi cxelebiT
 sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
monacemTa analizi
 monacemTa interpretacia
 monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 epidzedamxedvelobis
monacemebis analizi
 calkeul SemTxvevaTa Setyobinebebis
mimoxilva
 aRwerilobiTi–yvelaze xSiria
 dro
 adgili
 adamiani

 rTuli statistikuri analizi

 aberaciebis aRmosaCenad dro-mwkrivebis analizi
 dro-sivrcis klasterireba
sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
 monacemTa analizi
monacemTa interpretacia
 monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 ra SeiZleba iyos SemTxvevebis
raodenobis zrdis mizezi?
 incidentobis WeSmariti zrda
 Setyobinebis procedurebis cvlileba /epidzedamxedvelobis
sistemaSi ganxorcielebuli cvlileba
 SemTxvevis gansazRvrebis cvlileba
 diagnostikis gaumjobeseba
 momatebuli cnobadoba
 samedicino momsaxurebisadmi gazrdili xelmisawvdomoba
 axali eqimi, intensiuri Terapiis ganyofileba, an klinika –
SesaZlebelia iyos gazrdili mimarTvianoba, diagnostika, an
Setyobineba xdebodes regularulad
 laboratoriuli an diagnostikuri Secdoma
 jgufuri Setyobineba
 cvlileba mniSvnelSi
 wlebis mixedviT salmonelozis
Setyobinebuli maCveneblebi, 1965–1997
30
ilinoisSi
kontaminirebuli
Setyobinebuli SemTxvevebi 100,000

25 pasterizebuli rZiT
gamowveuli afeTqeba
20
mosaxleze

15

10

0
1967 1972 1977 1982 1987 1992 1997
 SeZenili imunodeficitis sindromis (Sidsi)
Setyobinebuli SemTxvevebi kvartalebis mixedviT,
SeerTebuli Statebi, 1984–1995
Setyobinebuli SemTxvevebi

SemTxvevebis gamovlenisTvis
zedamxedvelobis gafarToeba

weli (kvartali)
 sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
 monacemTa analizi
 monacemTa interpretacia
monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 epidzedamxedvelobis monacemebis
gavrceleba
visTvis miwodeba?
 sazogadoebrivi janmrTelobis warmomadgenlebi
 mTavrobis warmomadgenlebi
 klinicistebi / laboratoriis personali (Semtyobineblebi)
 sazogadoeba

rogor?
 Sida moxsenebebi
 janmrTelobis organizaciebis publikaciebi (mag.: epidbiuleteni)
 pres-relizebi
 epidzedamxedvelobis monacemebis Sejameba/angariSebi
 samedicino/epidemiologiur JurnalebSi arsebuli statiebi
 sazogadoebrivi janmrTelobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
 monacemTa analizi
 monacemTa interpretacia
 monacemTa gavrceleba
monacemTa kavSiri qmedebasTan
 monacemTa kavSiri
qmedebasTan
 afeTqebis gamokvleva
 daavadebis kontroli
 vaqcinacia/profilaqtika
 mizezis likvidacia

 gavrcelebis meqanizmis gawyveta

 programebis Seqmna da samizneebze mimarTva

(ganaTleba, riskis Semcireba da sxva)
 meTodikebis, normebis SemuSaveba
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi dinamikis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
wiTelas Setyobinebuli SemTxvevebi dawyebis
TariRis mixedviT,
almaata, yazaxeTi,
2004 wlis ianvari - 2005 wlis marti
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi dinamikis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 110
botulizmi (alimentaruli)
aSS, 1980-2000
100

laboratoriulad dadasturebuli SemTxvevebi*

90
ilinoisSi Semwvari xaxviT gamowveuli saxelmwifo Setyobinebas daqvemdebarebuli
afeTqeba daavadebebis zedamxedvelobis sistemis (NNDSS)
80 monacemebi

texasSi kangaucleli, RumelSi Semwvari kartofiliT

70
fermentirebuli Tevzis/zRvis gamowveuli afeTqeba
60 produqtebiT gamowveuli afeTqeba

50
Setyobinebuli SemTxvevebi

40

30

20

10
weli
0
1980 1985 1990 1995 2000

*Statis epidemiologebis da Statis sazogadoebrivi jandacvis laboratoriebis direqtorebis yovelwliuri

mimoxilvis monacemebi
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi dinamikis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 poliomieliti: msoflioSi SemTxvevebis raodenoba
da oraluri vaqciniT mocva, 1980-2001 ww.

70000 100
SemTxvevbis raodenoba

90
60000

vaqciniT mocva (%)

80
50000 70
60
40000
50
30000
40

20000 30
20
10000
10
0 0
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000
SemTxvevebi uzrunvelyofa

10
-
wyaro: janmo-s kontrolirebadi daavadebebi: monitoringis sistema, 2002 wlis globaluri reziume.
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi dinamikis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 aSS-Si da mis sazRvrebs gareT dabadebulTa
Soris dafiqsirebuli tuberkulozis SemTxvevebis
raodenobebis Sedareba, aSS, 1991-2001
(dajgufebuli RerZuli diagrama)

20,000
SemTxvevebis raodenoba

15,000

10,000

5,000

0
1991 1993 1995 1997 1999 2001
aSS-Si
U.S.-born
dabad. Foreign-born
sazRvargareT dabadebuli
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi dinamikis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
A hepatitis maCvenebeli, 1996

0 - 3.26
3.27 - 4.74
100,000 mosaxleze 4.75 - 17.24
17.25
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
daavadebis bunebrivi mimdinareobis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 Cutyvavila,
aSS, 1988-1995

vaqcinaciis
35 SemoReba

30
S et yo bi nebu l i
25
S emTx vevebi / 20
100,000 15
mo s ax l ez e 10

5
0

wel i
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi mimdinareobis aRwera
hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 yivanaxvelas afeTqeba,
aSS, 1985
r ao d eno ba
i ns i d ens i 100,000-z e
60 600
SemTxvevebi
Cases
50 insidensi
Incidence
500
40 400
30 300
20 200
10 100
0 0
<1 1-4 5-9 10-19 20-49 50+
as aki (wl ebi )
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi mimdinareobis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
infeqciuri agentebis cvlilebebis monitoringi
 samedicino praqtikaSi cvlilebebis aRmoCena
 penicilinisa da tetraciklinisadmi plazmidebiT gamowveuli
rezistentobis tendencia
aSS, 1988-1997
12
PPN
10
G
TRNG
PPNG & TRNG
8
procenti

0
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 weli

SeniSvna: "PPNG" (penicilinazas warmomqmneli) da "TRNG" (tetraciklinisadmi rezistentuli)

Sesabamisad N. gonorrhoeae plazmidebis saSualebiT aris penicilinisadmi da tetraciklinisadmi
rezistentuli.
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis gamoyeneba
 problemis masStabis Sefaseba
 epidemiebis aRmoCena/problemis gansazRvra
 sakontrolo RonisZiebebis Sefaseba
 dagegmvis xelSewyoba
 daavadebis geografiuli gavrcelebis gansazRvra
 daavadebis bunebrivi mimdinareobis aRwera
 hipoTezebis Seqmna, kvlevis stimulacia
 infeqciuri agentebis cvlilebebis monitoringi
samedicino praqtikaSi cvlilebebis aRmoCena
 perinataluri Sidsis insidensi
aSS, 1985-ivnisi 2000*
PACTG 076

USPHS -is monacemebi

500 zidovudinis gamoyenebasTan
SemTxvevebis

400 dakavSirebiT
oba

81%
Cases

300
daqveiTeba
ofen
No.od

200
ra

100
0

Half Year of Diagnosis

diagnostikis naxevarwledi
*Setyobinebuli 12 Tvis ganmavlobaSi
 axali epidzedamxedvelobis sistema
saWiroa?
SesaZlo gamarTlebebi
 daavadeba garkveuli adgilisTvis mniSvnelovania an
savaraudod iqneba aseTi
 epidzedamxedveloba, romelic saWiroa prevenciuli da/an
sakontrolo RonisZiebebis Casatareblad, maTze monitoringis
gansaxorcieleblad da Sesafaseblad
 epidzedamxedveloba, romelic saWiroa fonuri insidensis
dasadgenad, radganac mosalodnelia prevenciuli/sakontrolo
RonisZiebebis ganxorcieleba
 daavadeba axalia da saWiroa misi aRmocenebis modelis,
klinikuri speqtris, risk jgufebis da masze zemoqmedebis
moxdenis SesaZleblobis ukeT Seswavla
 arsebuli monacemebi da alternatiuli wyaroebi ar aris sakmarisi
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
 SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analizuri midgomis Seqmna da testireba
 informaciis gavrcelebis meqanizmis Camoyalibeba
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 epidzedamxedvelobaSi prioritetebis
daweseba
 janmo-s interesi
 sxva samTavrobo organizaciis interesi
 daavadebis incidentoba
 daavadebis simZime
 sikvdilianoba
 letaloba
 kontagiozuroba
 afeTqebebis albaToba
 socialur-ekonomikuri zegavlena
 sazogadoebis mier riskis aRqma (SeSfoTeba)
 prevenciis SesaZlebloba (mag.: vaqciniT)
 sazogadoebrivi janmrTelobis sistemis mxridan
saswrafo reagirebis saWiroeba
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analitikuri midgomis Seqmna da testireba
 gavrcelebis meqanizmis Seqmna
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 gaxseneba:
sazogadoebrivi janmrTeliobis
sistemis epidzedamxedvelobis
mimdinareoba
 monacemTa Segroveba
 monacemTa analizi
 monacemTa interpretacia
 monacemTa gavrceleba
 monacemTa kavSiri qmedebasTan
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
 SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analizuri midgomis Seqmna da testireba
 informaciis gavrcelebis meqanizmis Camoyalibeba
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
 SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analizuri midgomis Seqmna da testireba
 informaciis gavrcelebis meqanizmis Camoyalibeba
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
 SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analizuri midgomis Seqmna da testireba
 informaciis gavrcelebis meqanizmis Camoyalibeba
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 savele testireba
 axali epidzedamxedvelobis sistemis an axali
instrumentebis gamoyenebis da aTvisebis
SesaZleblobebis Sesafaseblad
 monacemTa Segrovebis procedurebSi an garkveuli
kiTxvebis SinaarsSi sirTuleebis aRmosaCenad
 am testis Sedegad miRebuli informaciis analizisas
informaciasTan dakavSirebuli problemebis
dasadgenad
 sxvadasxva saxis midgomebis Sedarebis da gamocdis
xelSesawyobad
 epidzedamxedvelobis sistemis
dagegmvis etapebi
 miznebis dadgena
 SemTxvevis gansazRvrebebis Seqmna
 monacemTa wyaros an monacemTa Segrovebis
meqanizmis gansazRvra (sistemis saxe)
 monacemTa Segrovebis instrumentis Seqmna
 savele-testebis meTodi
 analizuri midgomis Seqmna da testireba
 informaciis gavrcelebis meqanizmis Camoyalibeba
 analizisa da interpretaciis gamoyenebis uzrunvelyofa
 sazogadoebrivi janmrTelobis
epidzedamxedvelobis informaciuli cikli
sazogadoebrivi
janmrTelobis janmrTelobis
sistema warmomadgeneli

monacemebi informacia
Setyobineba

Sefaseba analizi da
interpretacia

ukukavSiri
gadawyvetileba
qmedeba
 “daavadebis Sesaxeb
informaciis Segrovebis,
analizis da gavrcelebis mizani
am daavadebis kontrolia.
monacemTa Segrovebam da
analizma ar unda waiRos
resursebi, Tu maT ar moyveba
garkveuli qmedeba”
 laboratoria
epidzedamxedvelobaSi
“swori da drouli laboratoriuli
informacia gaxda is safuZveli,
romelzedac agebulia amJamindeli
daavadebis mkurnalobis, prevenciis
da kontrolis programebi”
laboratoriebi SeiZleba CarTuli
iyvnen bevr samuSaoSi:
 nimuSebis aReba
 nimuSebis damuSaveba
 nimuSebis transportireba
 nimuSebis kvleva
 Sedegebis Cawera (xeliT an eleqtronulad)
 Sedegebis Setyobineba
 gamomgzavn dawesebulebaSi
 sazogadoebrivi janmrTelobis samsaxurebSi
 Stamebis gamoyofis/identifikaciis tendenciebis
analizi
laboratoriebi SeiZleba CarTuli
iyos bevr doneze
 periferia (mag.: janmrTelobis centri,
ambulatoria)
 Suamdebare (raionuli/regionuli laboratoria)
 nacionaluri (mag.: meningitis referaluri
laboratoria)
 saerTaSoriso (poliomielitis saerTaSoriso
laboratoria)
 laboratoriuli samsaxuris
saWiroeba
daavadebaze reagirebis procesis yvela stadiaze laboratoriuli
samsaxuri saWiro elementia
 epidemiebis aRmoCena da dadastureba

 endemuri daavadebebis epizedamxedveloba (tuberkulozi,

malaria)
 daavadebis eliminacia (daavadebisgan gaTavisufleba) da
eradikacia (aRmofxvra)

agreTve

 axali agentebis aRmoCena

 antibaqteriuli rezistentobis epidzedamxedveloba
 laboratoriis funqciebis magaliTi
epidzedamxedvelobis dros
aReba
martivi testebi
damuSaveba + P P P P P P
transportireba
aReba
damadasturebeli testebi
Sedegebis Setyobineba I I
damuSaveba + transportireba
gamokvlevaSi CarTva
specializirebuli testebi
saerTaSoriso lab-Si transportireba
Sedegebis Setyobineba P = periferia
gamokvlevaSi CarTva
swavleba
C I = Suamdebare
C = centraluri

maRali specifikis mqone testebi

Sedegebis Setyobineba
gamokvlevaSi CarTva saerTaSoriso laboratoriebi
swavleba
 “kargi epidzedamxedveloba
aucileblad ar uzrunvelyofs swori
gadawyvetilebebis miRebas,
magram is amcirebs araswori
gadawyvetilebebis miRebis
albaTobas”
 literatura
 Overview of Public health Surveillance –
presentation by Richard C. Dicker, 2005

 Principles and practices of Public Health

surveillance, Steven M. Teutsch. R. Elliott Churchill

 Updated guidelines for Evaluating Public Health

Surveillance Systems, MMWR, June27, 2001