EVALUATION OF THYROID DISEASE DETECTION AMONG FEMALE POPULATION WITH BREAST PATHOLOGIES IN KVEMO KARTLI REGION (GEORGIA).

AIM OF THE STUDY: to investigate the prevalence of thyroid diseases in women, 35-65 of ages diagnosed with breast pathology in the Kvemo Kartli region and to assess the epidemiological situation; The objectives of the study: to promote the early detection and prevention of thyroid cancer in the Kvemo Kartli region; to reduce the morbidity and mortality rates of breast and thyroid diseases; to evaluate the access and/or barriers to healthcare services to optimize women's health and health care needs. Cross-sectional (prevalence) research was held in several medical institutions in Rustavi with a high number of patients. Consequently, only 103 (53%) of the respondents among the female population with breast pathologies (n=194) in Kvemo Kartli underwent thyroid examination. 169 (87%) of respondents were not informed that early detection of thyroid diseases at breast pathologies is of great importance. Breast cancer was reported in 49 (25%) of respondents, 40 (83%) of respondents belonged to the age category of 50-65 years. Only 18 (37%) of respondents with breast cancer underwent thyroid examination. Respondents utilizing the insurance packages are twice as likely to pass thyroid examination. Most patients were referred for thyroid screening by mammologists (54%) endocrinologists (32%) and family doctors (14%).The women with breast diseases in Kvemo Kartli should be exposed to timely diagnosis and treatment of thyroid diseases by screening; ensuring early detection and prevention of breast and thyroid cancers by eliminating barriers to accessing medical services and early detection of breast and thyroid diseases.

INFLUENCE OF VARIOUS FACTORS ON THE VITAMIN D LEVELS IN MENOPAUSAL WOMEN LIVING IN KVEMO KARTLI.

The aim of the study was to study the level of vitamin D in menopausal women living in Kvemo Kartli region; to determine the relationship between various factors and vitamin D deficiency; to formulate recommendations about efficient preventive activities based on epidemiologic study results. Research methods and materials: Cross-sectional (prevalence) research was conducted in three different medical institutions in Rustavi with a high number of patients. The study population involved women aged 47-54 years who had not received vitamin D supplements or other food supplements in the last 2 months. The research was conducted using standard questionnaire, which revealed various factors affecting the level of vitamin D, as well as Demographic characteristics. Half of the study population underwent blood vitamin D screening in late autumn, the other half in spring. The study showed that 24% of the menopausal women involved in our study, living in Kvemo Kartli had adequate levels of vitamin D (≥30 ng/ml), and 76% of the women had vitamin D deficiency/insufficiency in the blood. The majority -90% of those diagnosed with vitamin D deficiency are urban residents, 77% of respondents with adequate levels of vitamin D in the blood do physical work. At the same time, none of the respondents working in the open space and ethnically Azerbaijani and examined in the fall had a deficiency of vitamin D in their blood. A statistically significant correlation was found between the risk factors, we had assessed and the presence of vitamin D deficiency: Correlation Between the season of determining the level of vitamin D in the blood and the level of vitamin D, in particular, the chance of having a deficiency of vitamin D in the blood in spring is 11 times higher than in autumn (odds ratio (OR) =11.3 95% CI (1.4-90.6); Correlation Between the type of work (less physical activity) and vitamin D deficiency (OR) = 3.5 95% CI (1.1-12.6), 77% of respondents with adequate levels of vitamin D in the blood do physical type of work. work with less physical activity); Correlation between dress style (closed garments and headscarves) and vitamin D deficiency (OR) = 8.0 95% CI (1.0 -64.1). Considering the correlation with the above-mentioned issues related to vitamin D deficiency, special attention should be paid to different factors contributing to vitamin D deficiency/ insufficiency in menopausal women, such as the degree of exposure to the sun and various aspects related to it, evaluation and prevention of vitamin D deficiency prevalence.

NEURAL TUBE DEFECTS AND MICRONUTRIENTS DEFICIENCY PREVALENCE IN GEORGIA.

Until 2015, systematic statistical data on micronutrient deficiency was not available in Georgia, to provide developing national strategy. In the same year, the National Centre for Disease Control and Public Health of Georgia (NCDC) in collaboration with the USA CDC launched the project "Strengthening surveillance of micronutrient deficiency in Georgia". In 2015 we did choose sentinel surveillance approach. For setting nutrition surveillance system 8 sentinel sites (2 sites in each region/children and pregnant health facilities) in four regions of Georgia (Tbilisi, Kakheti, Achara, and Samegrelo) were selected, using the criteria of geographical, social, ethnical, urban/rural, and religion. Also, existing information about malnutrition and dietary habits from the above mentioned regions. The project protocols was approved by the Institutional review board (IRB) at the NCDC and by the Research Review Committee and Ethical review committee of the US CDC. As a result of surveillance system functioning (2016-2019) we reviled that, about 36% out of 1021 studied children U2 (12-23 months) were anemic, 74% of them were identified as iron deficient. Hemoglobin was tested among 963 pregnant women and about 21% of them were found anemic, 57% were iron deficient, and 28% tested positive for folate deficiency. Neural tube defects (NTDs) prevalence per 1000 live births registered in sentinel sites was high 3.7. Our results show that anemia and iron deficiency are prevalent among both pregnant women and children of the specified age group in Georgia. Additionally, folate deficiency was quite common during the1st trimester of pregnancy. Our findings will inform public health policy decision makers to take relevant decisions on required interventions, such as health education, distribution of relevant supplements, and food fortification.

DIETARY HABITS OF SCHOOL-AGE CHILDREN IN TBILISI.

Study Goal was to determine dietary habits in school-aged children. Sampling of children was conducted in two stages. In the first stage, five schools in Nadzaladevi district of city Tbilisi were randomly selected. On the second stage the study groups from the appropriate school-aged students (10-14 years old children) were also randomly selected. All student participants filled out standardized and adopted questionnaires suggested by the American Academy of family physicians. Data were analyzed by using EpiInfo 7th version. Statistical analyses looked at correlations between criteria of unhealthy diet (such as morning without breakfast, frequent consumption of non-alcoholic beverages and fast food products) and overweight/obesity. A Body Mass Index (BMI) was calculated by using CDC tool. 175 children with ages of 10-14 years (47% boys) were included and interviewed. Half of the children noted that they love or like fast food products. 10% - visits fast food places 2-3 times a week together with a family. 11% - visits fast food places 5 times a week and even more. 34% - do not start morning with breakfast; 15% - eat only twice a day; 26% - add salt to their dishes; 58% - drink non-alcoholic beverages every day or many times during a week; 24% - are overweight; 29% suffer from obesity; 25% noted that fast food places are located near schools. Very weak correlation was found between unhealthy diet (morning without breakfast, frequent consumption of non-alcoholic beverages and fast food products) and overweight/obesity. According to study results, dietary habits of school-age children in Tbilisi is unhealthy; to improve nutritional habits is essential: (1) promote consumer (students, parents and teachers) awareness on a healthy diet, (2) educate children, adolescents and adults about nutrition and healthy dietary practices, (3) encourage to raise awareness about the salt consumption in recommended doses in children.

[Epidemiology of endemic goiter in Racha region].

1.034 inhabitants (270 men, 459 women and 305 children) were examined in Racha region (North-western Georgia) on endemic goiter at the age from 1 to 75. The investigated population was selected by randomized method. Diagnostic criteria for the evaluation of the degree of endemic goiter were based on the data of palpation and ultrasonography. In children iodine excretion by urine was also determined. Obtained data were analyzed by means of computer program Epi info-6. Prevalence of endemic goiter in examined population was 62,4% (45,2% in men, 72,1% in women and 62,9% in children). The highest spreading of the endemic goiter is noticed in the 21-30 year age group among women (78,8%). The main form of endemic goiter in Racha region is euthyroid diffuse goiter (56,1%). High index of spreading of endemic goiter in Racha region is caused by iodine deficiency along with irrational feeding and genetic factors.