“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
56
O‘ZBEKISTONDA VIRUSLI GEPATIT A: EPIDEMIOLOGIK DINAMIKA
VA PROFILAKTIK STRATEGIYALAR
Matnazarova G.S., Saidkasimova N.S., Ismoilov O.D.,
Toshkent Davlat Tibbiyot Universiteti, Epidemiologiya kafedrasi
Dolzarbligi
Virusli gepatit A (VGA) global sog‘liqni saqlash sohasida muhim ijtimoiy-
iqtisodiy va epidemiologik ahamiyatga ega bo‘lgan yuqumli kasallik sifatida dolzarb
muammo bo‘lib qolmoqda. Ushbu kasallikning keng tarqalishi, ayniqsa, o‘rtacha va
yuqori endemik mintaqalarda, shu jumladan O‘zbekiston va Rossiya Federatsiyasi
kabi davlatlarda, uning global iqtisodiyot va aholining salomatligiga ta’sirini
ta’kidlaydi. VGA nafaqat bolalar, balki katta yoshdagi shaxslar orasida ham
tarqalishi, kasallikning uzoq muddatli va og‘ir kechishi, turli klinik shakllarning
mavjudligi va boshqa etiologiyadagi jigar kasalliklari bilan kombinatsiyalanishi
uning murakkab tabiatini yanada kuchaytiradi [11,12]. Shu bilan birga, yuqori
immunogen vaktsinalarning mavjudligiga qaramay, ko‘plab mamlakatlarda,
xususan, Rossiya Federatsiyasida rejalashtirilgan emlash dasturlarining yetarli
darajada qamrovga ega emasligi VGA tarqalishini nazorat qilishda jiddiy to‘siqlarni
keltirib chiqarmoqda. O‘zbekiston o‘rtacha endemiklik darajasiga ega bo‘lsa-da,
ayrim hududlarda kasallanishning yuqori ko‘rsatkichlari qayd etilmoqda, bu esa
mahalliy sog‘liqni saqlash tizimi uchun qo‘shimcha muammolar yaratmoqda.
VGA tarixiy jihatdan qadimiy davrlardan boshlab jiddiy epidemiologik
muammo sifatida hujjatlashtirilgan bo‘lib, Xitoyda 5000 yil avvalgi yozma
manbalarda va Gippokrat tomonidan eramizdan avvalgi V asrda Tasos orolida
tasvirlangan sariqlik holatlari ushbu kasallikning uzoq tarixga ega ekanligini
ko‘rsatadi [11,12]. Zamonaviy biotexnologik yutuqlar viruslarni aniqlash va tahlil
qilish imkoniyatlarini kengaytirgan bo‘lsa-da, VGA hali ham global sog‘liqni
saqlash tizimlari uchun muhim xavf-xatar bo‘lib qolmoqda. Jahon sog‘liqni saqlash
tashkilotining (JSST) 2016 yilgi hisob-kitoblariga ko‘ra, VGA tufayli dunyo
bo‘yicha 7134 kishi vafot etgan, bu virusli gepatitdan umumiy o‘limning 0,5% ni
tashkil qiladi [13]. Ushbu kasallikning fekal-og‘iz yo‘li orqali, asosan ifloslangan
suv va oziq-ovqat orqali yuqishi uning yuqumlilik darajasini yanada oshiradi.
Globallashuv sharoitida VGA tarqalishi transmilliy xarakterga ega bo‘lib, har bir
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
57
mintaqa uchun virusning epidemiologik xususiyatlarini chuqur tushunishni talab
qiladi.
2022 yilda AQShning Florida shtatida VGA, invaziv meningokokk kasalligi
(IMD) va mpoxning bir vaqtda tarqalishi qayd etildi, bu esa ushbu kasalliklarning
sinergetik xususiyatlarini va ularning tarqalishiga ta’sir qiluvchi ijtimoiy-
demografik omillarni tahlil qilish zaruriyatini ko‘rsatdi [14]. Florida shtatida VGA
tarqalishi (153 holat) asosan genotip IA bilan bog‘liq bo‘lib, Markaziy Floridada
mart-iyun oylarida eng yuqori darajaga chiqdi. IMD (44 holat) Neisseria
meningitidis serogrup C bilan, mpox esa (2845 holat) global epidemiyaning bir
qismi sifatida Janubiy Floridada avgust oyida cho‘qqisiga yetdi [14]. Ushbu
epidemiyalar, ayniqsa, erkaklar o‘rtasida jinsiy aloqa qiluvchi shaxslar (MSM)
orasida yuqori tarqalish ko‘rsatdi, bunda OIV infeksiyasi mpox holatlarida (52%)
VGA (21%) va IMD (34%) ga nisbatan yuqori foizni tashkil etdi [14]. Ushbu
guruhlarda VGA va IMDning tarqalishi 1997–2005 va 2016–2017 yillarda
Yevropada, shuningdek, 2017–2018 yillarda AQShda qayd etilgan epidemiyalar
bilan o‘xshashliklarni ko‘rsatadi [15-20]. Bu holatlar yuqori xavfli guruhlar uchun
maqsadli emlash dasturlari va profilaktik choralar zarurligini ta’kidlaydi [21-24].
Tadqiqot maqsadi
O‘zbekistonda virusli gepatit A kasalligining epidemiologik dinamikasini
tahlil qilish va uning tarqalishiga ta’sir qiluvchi asosiy omillarni aniqlash.
Tekshiruv usullari va materiallari
Tadqiqot 2008–2023 yillardagi O‘zbekiston Respublikasi bo‘yicha rasmiy
statistik ma’lumotlar, 300 ta VGA bilan kasallangan bemorlarning kasallik tarixlari
va 300 ta epidemik o‘choqlarda o‘tkazilgan epidemiologik tekshiruv xaritalariga
asoslanadi. Tahlil jarayonida kasallanishning ko‘p yillik dinamikasi, mintaqaviy
tarqalishi va ijtimoiy-epidemiologik omillar tizimli ravishda o‘rganildi.
Olingan natijalar
O‘zbekistonda 2008–2023 yillar davomida virusli gepatitlar orasida VGA
yetakchi o‘rinni egallab, umumiy kasallanishning 97,9% ni tashkil etdi, keyingi
o‘rinda VGB (1,4%), VGC (0,4%), VGD (0,1%) va VGE (0,2%) turadi [22]. VGA
kasalligining o‘rtacha ko‘p yillik intensiv ko‘rsatkichi 100 ming aholiga nisbatan
100,1 ni tashkil etdi. Kasallanish dinamikasi nomutanosib bo‘lib, 2009 yilda 136,7,
2010 yilda 107,7, 2011 yilda 114,5, 2012 yilda 100,6, 2013 yilda 112,3, 2014 yilda
119,9, 2016 yilda 81, 2017 yilda 119,7, 2018 yilda 99,8, 2019 yilda 79,9, 2020 yilda
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
58
33,2, 2021 yilda 21,8, 2022 yilda 82,8 va 2023 yilda 162 ni tashkil etdi [22]. 2020
yildagi keskin pasayish COVID-19 pandemiyasi davrida qo‘llanilgan qat’iy karantin
choralariga bog‘liq bo‘lib, aholining sanitariya-gigiena qoidalariga rioya qilishi va
ijtimoiy izolyatsiya kasallanishni sezilarli darajada kamaytirdi.
VGA kasalligi mintaqaviy jihatdan nomutanosib taqsimlangan bo‘lib,
Namangan, Sirdaryo va Navoiy viloyatlarida eng yuqori ko‘rsatkichlar, Toshkent,
Farg‘ona va Andijon viloyatlarida respublika o‘rtacha ko‘rsatkichidan bir oz yuqori,
Xorazm, Buxoro, Qashqadaryo viloyatlari va Qoraqalpog‘iston Respublikasida esa
nisbatan past ko‘rsatkichlar qayd etildi [22]. Ushbu farqlar quyidagi omillarga
bog‘liq:
1.
Vaktsinatsiya qamrovi
: 1 yoshdan 14 yoshgacha bo‘lgan bolalar
orasida, ayniqsa, uyushgan jamoalarda (maktablar, bog‘chalar), VGA ga qarshi
vaktsinatsiya darajasi yetarli emas.
2.
Ichimlik suvi sifati
: Aholining toza va sifatli ichimlik suvi bilan
ta’minlanish darajasi hududlar bo‘yicha turlicha.
3.
Sanitariya-gigiena sharoitlari
: Maktab va bog‘chalarda shaxsiy
gigiena qoidalariga rioya qilish uchun zarur infratuzilmaning yetishmasligi.
4.
Aholining bilim saviyasi
: Kasallikning yuqish yo‘llari va profilaktik
choralari to‘g‘risida aholining ma’lumot darajasi, sanitariya madaniyati va sog‘lom
turmush tarziga rioya qilish darajasi.
5.
Ijtimoiy omillar
: Bolalar muassasalari xodimlari va o‘qituvchilarning
profilaktik tadbirlarni amalga oshirishdagi faoliyati.
Virusli gepatit B (VGB) kasalligi esa 2000-yillardan boshlab yangi tug‘ilgan
chaqaloqlarga qarshi rejalashtirilgan emlash dasturlari tufayli uzluksiz pasayish
tendensiyasini ko‘rsatmoqda. Ushbu dasturlar bolalar orasida kasallanishni 4
baravar, 1991–2001 va 2002–2023 yillar o‘rtacha ko‘rsatkichlarini solishtirganda
esa 23 baravar kamaytirdi [22].
Xulosa
O‘zbekistonda VGA kasalligi yuqori epidemiologik ahamiyatga ega bo‘lib,
uning tarqalishini nazorat qilish uchun kompleks yondashuv talab qilinadi.
Rejalashtirilgan vaktsinatsiya dasturlarini kengaytirish, toza ichimlik suvi bilan
ta’minlash, sanitariya-gigiena sharoitlarini yaxshilash va aholining sog‘liq haqidagi
bilimlarini oshirish orqali kasallikning tarqalishini sezilarli darajada kamaytirish
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
59
mumkin. Ushbu chora-tadbirlar nafaqat iqtisodiy samaradorlikni oshiradi, balki
aholining umumiy salomatligini mustahkamlashga xizmat qiladi.
Foydalanilgan adabiyotlar ro‘yxati.
[1]. Tekay F. Hakkari Devlet Hastanesine Başvuran 0-14 Yaş Grubu
Çocuklarda Hepatit A Sıklığı. Dicle Tıp Dergisi. 2006; 33(4): 245-7.
[2]. Arvas G, Kaya B, Berktaş M. The seroprevalance of Acute Hepatitis A
in 0-18 Age Group Children who Applied to Iğdır State Hospital. J Pediatr İnf. 2011;
5: 129-31.
[3].Melnick JL. Properties and classification of hepatitis A virus. Vaccine
1992; 10 Suppl 1: S24-S26 [PMID: 1335653 DOI: 10.1016/0264-410x(92)90536-
s]
[4]. World Health Organization. Hepatitis A. [cited 19 January 2021]. In:
World Health Organization [Internet]. Available from:
room/fact-sheets/detail/hepatitis-a
[5],Sander AL, Corman VM, Lukashev AN, Drexler JF. Evolutionary Origins
of Enteric Hepatitis Viruses. Cold Spring Harb Perspect Med. 2018 Dec
03;8(12) [
[6].
Ergon C, Abacıoğlu H. Hepatit Virüsleri. Ed. Başustaoğlu CA.Baskı,
Tıbbi Mikrobiyoloji. Ankara, Atlas Kitapçılık, 2010; 645-648.
[7].Ланган RC, Гудбред ЭйДжей. Гепатит А. Известный врач. 1 октября
2021 г.; 104 (4): 368–374. ИДМ: 34652109
[8]. Cooksley WG. What did we learn from the Shanghai hepatitis A
epidemic? J Viral Hepat 2000; 7 Suppl 1: 1-3 [PMID: 10870174 DOI:
10.1046/j.1365-2893.2000.00021.x]
[9].Koff RS. Feinstone SM, Kapikian AZ, Purcell RH. Hepatitis A: detection
by immune electron microscopy of a virus like antigen associated with acute illness
[Science 1973;182:1026-1028].
[10].Melnick JL. Properties and classification of hepatitis A virus.
Vaccine
1992; 10 Suppl 1: S24-S26 [PMID:
1335653
DOI:
10.1016/0264-410x(92)90536-
s
]
[11].REFERENCES Fonseca JC. [History of viral hepatitis]. Rev Soc Bras
Med Trop 2010; 43: 322-330 [PMID: 20563505 DOI: 10.1590/s0037-
86822010000300022]
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
60
[12].Martin NA. The discovery of viral hepatitis: a military perspective. J R
Army Med Corps 2003; 149: 121-124 [PMID: 12929519 DOI: 10.1136/jramc-149-
02-04]
[13].Информационный бюллетень ВОЗ от 20 июля 2023 года.
[14].Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease,
and Mpox, Florida, USA, 2021–2022 Timothy J. Doyle, Megan Gumke, Danielle
Stanek, Joshua Moore, Brian Buck, Timothy Locksmith, Kelly Tomson, Sarah
Schmedes, George Churchwell, Shan Justin Hubsmith, Baskar Krishnamoorthy,
Karalee Poschman, Brandi Danforth, Daniel Chacreton; the outbreak investigation
team
[15].Cotter SM, Sansom S, Long T, Koch E, Kellerman S, Smith F, et al.
Outbreak of hepatitis A among men who have sex with men: implications for
hepatitis
A
vaccination
strategies.
J
Infect
Dis.
2003;187:1235–40.
https://doi.org/10.1086/374057
[16].Stene-Johansen K, Tjon G, Schreier E, Bremer V, Bruisten S, Ngui SL,
et al. Molecular epidemiological studies show that hepatitis A virus is endemic
among active homosexual men in Europe. J Med Virol. 2007;79:356–65.
https://doi.org/10.1002/jmv.20781
[17].Ndumbi P, Freidl GS, Williams CJ, Mårdh O, Varela C, Avellón A, et
al.; Members of the European Hepatitis A Outbreak Investigation Team. Hepatitis
A outbreak disproportionately affecting men who have sex with men (MSM) in the
European Union and European Economic Area, June 2016 to May 2017. Euro
Surveill.
2018;23:1700641.
[18].Werber D, Michaelis K, Hausner M, Sissolak D, Wenzel J, Bitzegeio J,
et al. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM),
Berlin, November 2016 to January 2017—linked to other German cities and
European countries. Euro Surveill. 2017;22:30457
[19] Foster MA, Hofmeister MG, Albertson JP, Brown KB, Burakoff AW,
Gandhi AP, et al. Hepatitis A virus infections among men who have sex with men—
eight U.S. states, 2017–2018. MMWR Morb Mortal Wkly Rep. 2021;70:875–8.
https://doi.org/10.15585/mmwr.mm7024a2
[20].Latash J, Dorsinville M, Del Rosso P, Antwi M, Reddy V, Waechter H,
et al. Notes from the field: increase in reported hepatitis A infections among men
“JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN
UZBEKISTAN” JURNALI
VOLUME 03, ISSUE 06, 2025. JUNE
ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869
61
who have sex with men— New York City, January–August 2017. MMWR Morb
Mortal Wkly Rep. 2017;66:999–1000. https://doi.org/10.15585/ mmwr.mm6637a7
[21].Bozio CH, Blain A, MacNeil J, Retchless A, Weil LM, Wang X, et al.
Meningococcal disease surveillance in men who have sex with men—United States,
2015–2016.
MMWR
Morb
Mortal
Wkly
Rep.
2018;67:1060–3.
https://doi.org/10.15585/mmwr.mm6738a4
[22]. Folaranmi TA, Kretz CB, Kamiya H, MacNeil JR, Whaley MJ, Blain
A, et al. Increased risk for meningococcal disease among men who have sex with
men in the United States, 2012–2015. Clin Infect Dis. 2017;65:756–63.
https://doi.org/ 10.1093/cid/cix438
[23].Kava CM, Rohraff DM, Wallace B, Mendoza-Alonzo JL, Currie DW,
Munsey AE, et al. Epidemiologic features of the monkeypox outbreak and the
public health response— United States, May 17–October 6, 2022. MMWR Morb
Mortal Wkly Rep. 2022;71:1449–56. https://doi.org/10.15585/ mmwr.mm7145a4
[24]. Blackburn D, Roth NM, Gold JAW, Pao LZ, Olansky E, Torrone EA,
et al. Epidemiologic and clinical features of mpox in transgender and gender-diverse
adults—United States, May–November 2022. MMWR Morb Mortal Wkly Rep.
2022;71:1605–9. https://doi.org/10.15585/ mmwr.mm715152a1
[25]. Centers for Disease Control and Prevention. Mpox: 2022 U.S. map &
case
count
[cited
2022
Dec
27].
https://www.cdc.
gov/poxvirus/mpox/response/2022/us-map.html
