ANALYSIS OF HEALTH DYNAMICS IN CHILDREN AND ADOLESCENTS BASED ON THE RESULTS OF REGULAR MEDICAL CHECK-UPS

The article deals with the issues of health in children and adolescents aged 7–17 years. The objective of this study is to analyze health experience in school-age children and adolescents based on regular medical check-up results. According to regular medical check-up results, 15,192 schoolchildren were examined in 2015, including 12,649 children aged 7–14 years and 2,543 children aged 15–17 years. In 2020, health of 18,708 schoolchildren was assessed, including 14,861 children aged 7 to14 years and 3,847 children aged 15 to 17 years. The authors analyze dynamics of distribution of children into health groups, and age-related incidence of school-related diseases. In children and adolescents of different age, eye disorders occupy first place in the rank of prevalent school-related diseases; the events are followed by musculoskeletal diseases, nervous and GIT diseases, progressing with age, including scoliosis. Percentage of healthy children without the signs of a school-related abnormality at school is reducing. In the majority of cases, pathological abnormalities are found in 15–17-year-old adolescents. Key words


RELEVANCE
Monitoring of health in children and adolescents, prevention of chronic diseases and functional deviations at the stage of school education is a high-priority task faced by any country [1][2][3].At present, various social-hygienic, psychological and technical environmental factors produce an unfavorable effect on many children and adolescents [4][5][6][7].A number of children and adolescents with health deviations and need in rehabilitation is constantly increased due to the intensive education process [8][9][10][11][12].
Analysis of regular medical check-up results enables to reveal certain age groups of children and adolescents requiring intensive prophylaxis and clinical care to prevent and decrease the risk of school-related diseases [13][14][15].

OBJECTIVE OF THE STUDY
To examine the health of children and adolescents of school age based on the regular medical check-up results.

PATIENTS AND METHODS
We compared distribution of children and adolescents into health groups and incidence of school-related diseases among them in 2015 and 2020.Distribution of schoolchildren aged РОССИЙСКИЙ ВЕСТНИК ГИГИЕНЫ | 3, 2021 | RBH.RSMU.PRESS schoolchildren aged 15 to 17 years, speech abnormalities were reduced as compared with 7-to 14-year-olds.
According to the results of regular medical check-ups held in 2020, 3,847 adolescents aged 15 to 17 years underwent medical and preventive care.The care-related data are presented in table 3.
Table 3 shows that based on the results of regular medical check-ups held in 2020, among 3,847 15-17-year-old adolescents with visual organ pathology, 28.13% needed to wear corrective glasses (including 17.03% of young women and 11.1% of young men).Some of the adolescents were hospitalized to achieve the objectives of an examination, therapeutic and surgical treatment, whereas 4.26% of them were referred for health resort treatment.
According to the results of a regular medical check-up, all schoolchildren with other health abnormalities were under a regular medical check-up and sent for rehabilitation to specialized doctors.

DISCUSSION OF RESULTS
According to the research, children and adolescents with health group 2 prevail among other schoolchildren of different age both in 2015, and 2020.Schoolchildren with chronic diseases in the compensatory stage (health group 3) are ranked second and constitute 20 to 30% of all those examined, irrespective of age.The value of absolutely healthy children and adolescents (health group 1) remains low.Some authors state that the dynamics is associated with increased neuropsychic load, hypodynamia, disrupted daily routine and nutrition, and longterm use of gadgets both in learning, and for playing various computer games [8,13].
Our researches have shown that eye disorders, musculoskeletal diseases, nervous and GIT diseases, including scoliosis, progressing with age, are the most frequently found 7-14 years and 15-17 years into groups is associated with the requirement of the regional healthcare department to regular medical check-ups of schoolchildren.
According to regular medical check-up results, 15,192 schoolchildren were examined in 2015, including 12,649 children aged 7-14 years and 2,543 children aged 15-17 years.In 2020, health of 18,708 schoolchildren was assessed, including 14,861 children aged 7 to 14 years and 3,847 children aged 15 to 17 years.
The obtained data were subjected to statistical analysis using StatSoft Statistica 7.0.The groups were compared using Fisher's test, with statistical significance р value of 0.05 or less.

RESULTS
Distribution of schoolchildren into health groups depending on their age and the year of observation is presented in table 1.
Table 1 shows that specific gravity of children with health groups 1 and 2 is decreased with age, whereas a number of schoolchildren with health groups 3 and 4 is increased.
In 2020, a number of schoolchildren with health group 1 aged 7 to 14 years increased, and a number of children and adolescents with health group 3 decreased by a percentage as compared with 2015.Moreover, 2020 is a year of children and adolescents with health group 5.
Incidence of school-related diseases is presented in table 2. School-related diseases are health problems in children aged 7 to 17 years resulting from academic overload, learning process and diet violation, and stress.
Table 2 shows that eye disorders occupy first place in the rank of prevalent school-related diseases in children and adolescents of the analyzed age groups both in 2015, and in 2020; the events are followed by musculoskeletal diseases, nervous and GIT diseases, progressing with age, including scoliosis.Trials of other authors confirm the data [6,14].In V 0 0 0.9 0.9 Note.Significant differences at р <0,05, *-significant differences in the registration frequency of children belonging to health groups 1 and 2 within one observation period, ** -significant differences in the registration frequency of children belonging to health groups 1 and 3 within one observation period.The trial results confirm the previous data about high incidence of school-related diseases among children and adolescents, emergence of children with health groups 3 to 5, and their insufficient preventive mitigation.In our opinion, outpatient pediatricians need a closer cooperation with the Center of Children's Health to render medical and preventive aid to schoolchildren.Apart from finding diseases and analyzing the structure at different age, the Center employees carry out considerable preventive work associated with implementation of healthy lifestyles in a family and prevention of school-related disorders among schoolchildren, their parents and teachers.
We believe that administration of schools, education and healthcare departments need to adopt a strategy aimed at the implementation of 'Health Saving Educational and Health-Improving Technologies in Educational Establishments' taking into account suggestions of the leading domestic hygienists [15,16].School health workers need to regularly speak at teacher-parent meetings devoted to sensible nutrition, physical education and methods of prevention of school-related diseases cooperating with doctors from children's outpatient clinics.

CONCLUSION
Percentage of healthy children with no signs of the examined school-related abnormality at school is reduced.Pathological abnormalities are mainly found in 15-17-year-old adolescents.The obtained results show that children and adolescents must obtain intensive preventive and therapeutic aid as soon as they go to school, and not during the teen years only.
Doctors and teachers at schools need to cooperate and implement health-saving educational and health-improving technologies at schools and actively participate in joint parental involvement medical and pedagogical programs aimed at prevention of school-related diseases.

Table 1 .
Distribution of children and adolescents aged 7-17 years into health groups (2015 and 2020)

Table 2 .
[3,6,ence of school-related diseases in children and adolescents based on regular medical check-up results (per 1,000 of those examined) in children and adolescents at school.This was confirmed by other authors[3,6,14].Concern on schoolchildren's health and emerging trends in their health impairment with age was brought up in a number of reports during the VII Congress of School and University Medicine held on October 21-22, 2021.
Note*.The differences between the groups of children and adolescents aged 7 to 14 years and 15 to 17 years within one period of observation are statistically significant (р < 0.05).RUSSIAN BULLETIN OF HYGIENE | 3, 2021 | RBH.RSMU.PRESS events