From Big Medical Encyclopedia

NOZOGEOGRAFIYA (grech, nosos a disease + geographia zemleopisany) — the section of medical geography studying geographical spread of diseases of the person.

Studying of geography of diseases is conducted from 18 century. The term «nozogeogra-fiya» is offered A. Miihry in 1856. Scientific bases of N. as independent direction began to develop after issue of the capital guides to medical geography of Buden (J. Ch. Boudin, 1857) and A. Girsha (1860 — 1864). In the same time in Russia the attempt to create nozogeografichesky about-in was made. In the USSR for a long time the term «nozogeografiya» was applied as a synonym of medical geography and only at the beginning of the 60th 20 century N. was allocated as the independent direction of medical geography.

The big contribution to development of the theory and methods H. to the USSR was brought by E. N. L of avlovskiya, V. N. Beklemishev, P. A. Petrishcheva, N. G. Olsufyev, A. A. Shoshin, A. D. Lebedev, B. K. Vershinsky, etc. Numerous expeditions of E. N. Pavlovsky in 1930 — 1940 established that the geography of transmissible and natural and focal diseases is closely connected with geography of carriers and animals — tanks of causative agents of these diseases.

N.'s problems include identification of areas of separate diseases (see. Nozoareal ) and opening of patterns of their education, studying of a role natural and socio-economic factors in geographical spread of diseases of the person, drawing up nozogeografichesky cards.

In the USSR methodological base of development of a problem of geography of diseases of the person is the materialistic understanding of unity of an organism and the environment (natural and socio-economic factors). Emergence and characteristic geographical spread of diseases is defined by so-called nozokompleks — a combination of internal causes of a human body and environmental factors. The disease of the person in the medico-geographical plan is considered as result of disturbance of balance between an organism and the environment. It can develop under the influence of exogenous factors if their force and duration of action exceed compensatory opportunities of a healthy organism. On the other hand, protective forces of an organism at genetic disorders, inborn defects of development, etc. are insufficient to support a homeostasis even in the conditions of usual action of environmental factors. The structure but-zokompleksov a mnogokomponentna, in it can prevail either internal causes, or natural and social and economic. Seasonal, cyclic and other type variability of separate components of the environment predetermines dynamics of nozokompleks.

The main object of studying of N. is the area of a certain disease. N. studied a long time only monoetiologichny, hl. obr. infectious and invasive, the diseases which are rather easily differentiated from other diseases.

Due to the general progress of a nosology, improvement of diagnostic methods and implementation of mathematical methods of the analysis of system an area of a disease — the geographical environment appeared a vozkhmozhnost of studying also of N. of nek-ry noninfectious, usually polietiologichny diseases, such as biogeochemical an endemia (e.g., a local craw, Kashin's disease — Beck, etc.), malignant new growths, cardiovascular diseases, etc. Relevance of studying of geography of malignant tumors found the expression in allocation in 1973 of new discipline within nozo-geography — an onkogeografiya.

Information basis of H. make medical - biol, factors and geographical characteristics of the environment. The N operates with statistical materials about existence and frequency of the studied diseases among the population of this area, terms of their identification and features a wedge, currents, uniform lists of focuses of the disease, registration of cancer, coronary heart disease and other medico-statistical data. Valuable information is given by purposeful medical examinations or selective inspections of certain groups of the population. In foreign countries because of incompleteness a dignity. statistics preference is quite often given to data on mortality from this or that disease (frequency, age structure etc.).

From geographical characteristics of the environment features of a vegetable cover, etc. are considered as the most important climatic, soil, hydrological, faunistic.

The analysis of bonds between medical - biol, factors and characteristics of the geographical environment is carried out by two main methods: cartographic and mathematical. The first consists in comparison of cards with medical - biol, and geographical information (the interfaced analysis of cards of different type); by results of the interfaced analysis the nozogeografichesky cards which are of quite often independent value for health care are designed. Mathematical methods (a steam room and multiple correlation, the regression and datalogical analysis, etc.) allow to define extent of communication between spread of a disease and environmental factors (natural and social and economic).

The characteristic complex of diseases is inherent in the population of certain geographical districts that gave the grounds to speak about its specific nozoprofil. So, pathology of inhabitants of the equatorial Africa is characterized by existence of a number of the tropical diseases which were any more not found anywhere (a tsetse-fly disease, a loasis, etc.).

Nozoprofil of the population of various countries and geographical districts undergoes continuous changes. In the second half of 20 century spread of many infectious and invasive diseases considerably decreased, and nek-ry of them are successfully liquidated (e.g., diphtheria). At the same time the frequency of a number of diseases, napr, malignant new growths, caries of teeth, diabetes, tends to growth. Changes in spread of diseases took place also in the past. In the past at various steps of development human about-va the N is engaged in features of geographical spread of diseases historical. She widely uses data of paleontology and materials of archaeological researches. Historical N. promotes deeper understanding of evolution of diseases and allows to develop long-term forecasts of changes in spread of diseases.

Important patterns of N. Ustanovleno are revealed that geographical spread of diseases of the person differs by the size, a form and structure of a nozoareal. Features of nozoareal are defined by numerous factors of the geographical environment. One of the investigations of it is geographical and ecological variability of eurysynusic diseases. So, the amoebic invasion on the site of an area with a temperate climate is shown preferential in the form of an asymptomatic carriage, and in tropics — in the form of acute amoebic dysentery. Geographical variability of diseases can reflect distinctions of living conditions of the activator or a carrier (in case of infectious diseases) or living conditions of people, such as type of food and caloric content of food, type of dwellings and settlements, working conditions, etc. (in case of noninfectious diseases).

Knowledge of these patterns allows to predict possible spread of diseases in the low-made habitable territories at their development, and also change of prevalence of diseases at implementation of various economic actions — the so-called nozo-geographical forecast.

Researches on N. with success are used in practice of health care of the USSR during the planning of anti-epidemic and preventive actions (e.g., on a trass of construction of the Baikal-Amur Mainline), and also during the planning of placement of medical institutions, specialization of various health services depending on nozoprofilya the population, etc.

For coordination of researches on N. in the Soviet Union in 1954 the Commission of medical geography Geographical about-va the USSR is created. Results nozo geographical researches were discussed at I (1962), II (1965) and III (1968) all-Union meetings on medical geography and on the XXII International geographical congress (Moscow, 1976).

A series survey and analytical nozokart by diseases with a natural ochagovost in the USSR to both separate infectious and parasitic diseases is published (atlases Africa, 1968; Transbaikalia, 1967; Tajikistan, 1968, etc.).

See also Geography medical .

Bibliography: Beklemishev V. N. Some principles of a nozogeografiya of the obligate and transmissible diseases affecting the person Medical parazitol., t. 28, No. 6, page 648, 1959; Geografiya of natural and focal diseases of the person in connection with problems of their prevention, under the editorship of P. A. Petrishcheva and N. G. Olsufyev, M., 1969; Zabolotny D. K. Chosen works, t. 1 — 2, Kiev, 1956 — 1957; Lebedev A. D. and Raich Je. L. The bases of medical geography, in book: Medical geography, under the editorship of Je. L. Raich, etc., page 10, M., 1976; Lysenko A. Ya. and Semashko I. N. Geografiya of malaria (a medico-geographical sketch of the most ancient disease), in book: Medical geography, 1966, under the editorship of A. D. Lebedev, page 25, M., 1968, bibliogr.; Pavlovsky E. N. A natural ochagovost of transmissible diseases in connection with landscape epidemiology of zooantroponoz, M. — L., 1964, bibliogr.; Sh about sh and A. A N. The main objectives and methods of studying of geography of diseases (nozogeografiya), in book: Geographical Saturday., under the editorship of E. N. Pavlovsky, Saturday. 14, page 130, M. — L., 1961; M and at J. M of The ecology of human diseases, v. 1—2, N. Y., 1958 — 1961.

A. Ya. Lysenko.