ROLE OF VIRAL PATHOGENS IN INFANTS WITH SYSTEMIC INFECTION AT THE NEWBORN INTENSIVE CARE UNITS IN GEORGIA.

In Georgia, causative agents among infants with systemic infections are generally not identified and "neonatal sepsis" is usually diagnosed and treated without determining the etiology. The objective of this study was to estimate the role of viral pathogens (Herpesviridae and Enteroviruses) among neonates with generalized infections. A cross-sectional study was performed among neonates younger than <8 weeks admitted to a neonatal intensive care unit (NICU) at the two largest pediatric hospitals in Tbilisi, Georgia. Laboratory tests were performed by consensus and then by type-specific PCR methods. A total of 187 infants were recruited from the NICUs; most participants (74.9%) were of normal birth weight at admission to the NICU and half (51.3%) were younger than 7 days of age. Almost all babies (91.4%) were treated with a broad-spectrum antibiotic despite a lack of microbe identification. While the overall mortality rate of infants with a systemic infection was 21.9 %, neonatal outcomes were more favorable when the infection was due to enteroviruses (2.9% mortality rate) compared to a herpesvirus infection (16.1% mortality rate). Multivariate analyses identified independent predictors associated with neonatal mortality. These included etiology of infection, APGAR score and the type of delivery. Our investigation suggests that viral pathogens play a substantial role in systemic infections among NICU infants. Utilizing molecular-based testing in these cases could improve both the clinical management and outcomes of neonates with generalized infections.

KNOWLEDGE, ATTITUDE TOWARD DISEASE AND PRACTICE SURVEY ON DIABETES IN GARDABANI DISTRICT.

In 2014-2016, the Georgia Red Cross Society (GRCS) implemented a project to improve diabetes prevention, detection and care in rural Georgia, namely in the Gardabani district. The KAP survey was conducted to determine current levels of knowledge, attitudes and practices regarding diabetes among the general population in the Gardabani district. We compared current findings with baseline results from a 2014 survey to identify trends. A cross sectional study design with multi-stage random sampling was used to select participants. Data were collected at households through face-to-face individual interviews using a specially designed questionnaire. In total, 716 individuals were surveyed, the majority of whom (98.9%) were aware of diabetes. Most respondents (85.3%) believed that diabetes can be prevented and correctly identified measures of diabetes prevention. Compared to the previous survey, the level of knowledge regarding risk factors, symptoms and complication of diabetes had improved significantly. Knowledge of diabetes prevention correlated positively with individuals having a higher education level (62.6% vs. 50.8%; p=0.05), higher family income (62.2% vs. 53.5%; p=0.03) and residing in rural settlements (58.6% vs. 25%; p<0.001). Knowledge of diabetes management was significantly associated with type of residence (rural 50.3% vs. urban 28.4%; p<0.001) and family income (high family income 52.3% vs. low family income 45.5%; p=0.05). Respondents identifying GRCS as a source of information tended to have a higher awareness of diabetes prevention and management. Knowledge of diabetes has significantly improved among the general population of the Garabani district from 2014 to 2016. The development and implementation of similar public health programs to increase the level of awareness and knowledge about diabetes is required in other parts of Georgia to improve control and management of the disease throughout the country.