Cryptosporidium spp. and Eimeria spp. (Apicomplexa: Eimeriorina) of freshwater Cyprinid fish species in the Kura River basin in Azerbaijan territory.

This study aims to determine the prevalence of Cryptosporidium and Eimeria spp. oocysts in fish specimens in the river Kura. It was conducted during the 2021-2022 at two sites: Mingachevir reservoir in central Azerbaijan and in Neftchala district where the river finally enters the Caspian Sea through a delta of the Kura River estuary. The diagnosis of oocysts was performed microscopically. Fine smears from the intestine epithelial layers stained by Ziehl-Neelsen for Cryptosporidium oocysts. To identify Eimeria oocysts, each fish's faecal material and intestinal scrapings were examined directly under a light microscope in wet samples on glass slides with a coverslip. Results revealed a prevalence of Cryptosporidium and Eimeria species infections in fish hosts from both territories Rutilus caspicus, Alburnus filippi, Abramis brama orientalis and Carassius gibelio. Of 170 investigated fish specimens, 8.8% (15/170) were infected with Cryptosporidium species oocysts. Eimeria species oocysts were identified in 20.6% (35/170). The presence of Cryptosporidium and Eimeria infections in fish specimens are natural infections. However, their presence in fish species may be attributed to the age of the fish species and water pollution. This is the first report regarding the prevalence of Cryptosporidium oocysts in fish species in Azerbaijan.

Trends in cost and consumption of essential medicines for non-communicable diseases in Azerbaijan, Georgia, and Uzbekistan, from 2019 to 2021.

BACKGROUND: Access to medicines is a global priority. Azerbaijan, Georgia, and Uzbekistan have different approaches to pricing policies for pharmaceuticals. The aim of this study was to analyze recent trends in the consumption and prices of non-communicable disease (NCD) medicines in Azerbaijan, Georgia, and Uzbekistan, in the outpatient setting. METHODS: We included medicines for asthma and COPD, cancer, cardiovascular disease, diabetes, epilepsy, and mental disorders. Sales data for pharmaceutical products in community pharmacies were extracted from a commercial database. Changes in consumption and prices were analyzed across all included NCD medicines, by disease category and pharmacological group. RESULTS: Consumption of NCD medicines was highest in Georgia, at twice the levels in Azerbaijan, and four times levels in Uzbekistan. Average prices of NCD medicines, weighted by consumption, increased by 26% in Georgia, but decreased by 3% in Azerbaijan and by 0.1% in Uzbekistan. Prices increased for all disease groups in Georgia (from +13% for epilepsy medicines to +86% for cancer), varied by group in Uzbekistan (from -22% for epilepsy medicines to +47% for cancer), while changes in Azerbaijan were smaller in magnitude (from -4% for medicines for cardiovascular disease to +11% for cancer). Cancer medicines had markedly higher prices in Uzbekistan, and asthma and COPD medicines had markedly higher prices in Azerbaijan and Uzbekistan. CONCLUSIONS: Georgia showed the highest outpatient consumption of NCD medicines, suggesting the broadest access to treatment. However, Georgia also saw marked price increases, greater than in the other countries. In Georgia, where there was no price regulation, widespread price increases and increases in consumption both contribute to increasing pharmaceutical expenditures. In Azerbaijan and Uzbekistan, increases in outpatient pharmaceutical expenditures were primarily driven by increases in consumption, rather than increases in price. Comparing trends in consumption and pricing can identify gaps in access and inform future policy approaches.

The effectiveness of primary series CoronaVac vaccine in preventing COVID-19 illness: A prospective cohort study among healthcare workers in Azerbaijan, May-November 2021.

Background: Healthcare workers (HCWs) have suffered considerable morbidity and mortality during the COVID-19 pandemic. Few studies have evaluated the CoronaVac vaccine effectiveness (VE), particularly in Eastern Europe, where the vaccine has been widely used. Methods: We conducted a prospective cohort study among HCWs in seven hospitals in Baku, Azerbaijan between May 17 and November 30, 2021, to evaluate primary series (two-dose) CoronaVac VE against symptomatic SARS-CoV-2 infection. Participants completed weekly symptom questionnaires, provided nasopharyngeal swabs for SARS-CoV-2 RT-PCR testing when symptomatic, and provided serology samples at enrollment that were tested for anti-spike and anti-nucleocapsid antibodies. We estimated VE as (1 - hazard ratio)*100 using a Cox proportional hazards model with vaccination status as a time-varying exposure, adjusting for hospital and previous SARS-CoV-2 infection status. Results: We enrolled 1582 HCWs. At enrollment, 1040 (66%) had received two doses of CoronaVac; 421 (27%) were unvaccinated. During the study period, 72 PCR-positive SARS-CoV-2 infections occurred; 36/39 (92%) sequenced samples were classified as Delta variants. Primary series VE against COVID-19 illness was 29% (95% CI: -51%; 67%) for the entire analysis period. For the Delta-only period (July 1-November 30, 2021), primary series VE was 19% (95% CI: -81%; 64%). For the entire analysis period, primary series VE was 39% (95% CI: -40%; 73%) for HCWs vaccinated within 14-149 days and 19% (95% CI: -81%; 63%) for those vaccinated ≥150 days. Conclusions: During a period in Azerbaijan characterized by mostly Delta circulation, VE point estimates suggested that primary series CoronaVac protected nearly 1 in 3 HCWs against COVID-19, but 95% confidence intervals were wide, with lower bounds that crossed zero, reflecting the limited precision of our VE estimates. Our findings underscore the need to consider booster doses for individuals who have received the primary series of CoronaVac.

The Prevalence of Gastroesophageal Reflux Disease in Azerbaijan: A Population-Based Cross-sectional Study.

BACKGROUND/AIMS: The prevalence of gastroesophageal reflux disease in Azerbaijan has not been evaluated before. The aim of our study was to determine the prevalence of gastroesophageal reflux disease based on the validated reflux questionnaire. MATERIALS AND METHODS: A total of 1026 individuals from 7 regions of Azerbaijan were included in the cross-sectional study conducted via face-to-face administration of the validated Mayo Clinic's gastroesophageal reflux disease questionnaire. Gastroesophageal reflux disease was diagnosed if an individual had heartburn and/or regurgitation occurring at least once a week. RESULTS: The prevalence of gastroesophageal reflux disease in Azerbaijan was 22.7% with significant female predominance (26.1% vs. 15.3%; P < .0001). Gastroesophageal reflux disease was prevalent in 17% of those aged below 35 years; 22.7% of those in the age range 36-55 years, and 38.5% of those who are above 56 years, which, accordingly, indicates that gastroesophageal reflux disease becomes significant as age increased (P < .0001). Male respondents younger than 35 years had much lower rates of gastroesophageal reflux disease than in older groups (5.7% vs. 22.7%, P < .0001), whereas in females older than 55 years, age was a significant factor for increasing gastroesophageal reflux disease symptoms (22.6% vs. 50%, P < .001). Reflux was observed in 18.1% of normal-weight respondents (body mass index 18.6-24.9), 25.6% of overweight (body mass index 25-29.9), and 30.4% of obese ( body mass index > 30) individuals (P = .001). Regarding marital status, the prevalence was the lowest in the single subjects' group (17%), close to average in the married group (23.8%), and the highest (41.7%) in divorced/widowed cases (P = .003). Stress significantly affected the gastroesophageal reflux disease distribution, affecting 59.4% of all respondents (P < .004). CONCLUSION: Gender, body mass index, increased age, marital status, and stress were precipitating factors of gastroesophageal reflux disease. Socioeconomic diversity, along with lifestyle/habits, did not play a crucial role in the gastroesophageal reflux disease prevalence distribution.

[Nutrition of pregnant. Comparative analysis based on data from a survey of residents of Russian Federation and the Republic of Azerbaijan (on the example of Astrakhan and Baku)].

Poor nutrition of the expectant mother leads to an unfavorable course of pregnancy and a number of serious deviations in the development of the child. Therefore, a multifaceted study of the actual nutrition of a pregnant woman is relevant, including the identification of trends associated with geographical, ethnic, and family characteristics. The study was aimed at conducting a comparative analysis of the nutrition of pregnant women from two cities, Astrakhan (Russian Federation) and Baku (Republic of Azerbaijan), by means of a questionnaire. Material and methods. In the course of a voluntary anonymous survey in 2022, 432 women aged 18-50 years old in the II trimester of pregnancy, living in Baku (n=280, group 1) and Astrakhan (n=152, group 2) have been interviewed. The answers of the respondents were analyzed in terms of eating habits, frequency of intake and food repertoire. Results. An analysis of the nutrition of pregnant women from both cities showed that it is unbalanced in terms of a set of products. Significant violations of the diet were noted in women from both studied groups, for example, a reduction in its multiplicity to two times a day (in group 1 - 2.5% and in group 2 - 7.2%). When conducting a comparative analysis of the nutrition of expectant mothers using the Pearson χ-square contingency coefficient, it was found that the groups had no significant differences in the consumption of milk and dairy products, meat and meat products, fish and seafood. Meat and meat products were used daily by no more than 31% of the surveyed, milk and dairy products - 43%, about half of pregnant women didn't consume fish and seafood. A relationship was established between the frequency of fruit consumption and the city of residence of pregnant women, in Baku women consumed fruits more often. In both groups, the abuse of confectionery and sugar was noted, some women already suffered from diabetes (5.4% from Astrakhan and 0.7% from Baku). Digestive pathology was detected in group 1 - in 11.2% (17), in group 2 - in 29.3% (79) of pregnant women. When conducting a comparative analysis of the frequency of consumption of undesirable products (mayonnaise, sauces, chips, carbonated drinks), it turned out that the groups were homogeneous, no connection with the city of residence was established. During pregnancy, 40.1 and 45.0% of women from 1 and 2 groups, respectively, took vitamin-mineral complexes. The level of vitamin D in the blood serum was determined by 29.6 and 6.8% of the respondents, respectively. A comparative analysis of the content of vitamin D in blood serum, determined respectively in 29.6 and 6.8% of respondents, showed that the groups of subjects were homogeneous, no connection of vitamin D level with the city of residence was found. Conclusion. In general, all the peculiarities of pregnant women's nutrition identified in the course of the survey can lead to an imbalance in the diet in terms of nutrient content, a deficiency of complete proteins, vitamins, and trace elements with excessive consumption of carbohydrates. When conducting a comparative analysis, it was possible to identify differences in the diet of pregnant women, relating only to the consumption of fruits - some respondents from Astrakhan consumed fruits less than once a week. Common unfavorable factors for pregnant women of both groups were the abuse of "undesirable" products, flour products and sugar, as well as the lack of involvement of women in the examination to assess the body's vitamin D supply and the rare prescription of vitamin-mineral complexes by specialists to correct micronutrient deficiencies.

TP53 Codon 72 Polymorphism and the Risk of Colorectal Cancer in an Azerbaijani Population.

BACKGROUND: We aimed to evaluate the association between the TP53 Arg72Pro gene polymorphism and risk of colorectal cancer in an Azerbaijani population. METHODS: A total of 141 patients with colorectal cancer and 150 gender- and age-matched controls were involved in the study. The genotypes of the TP53 gene Arg72Pro polymorphism were detected by polymerase chain reaction-based restriction fragment length polymorphism analysis. RESULTS: We found that the heterozygous genotypes Arg/Pro (odds ratio, 1.128; 95% CI, 0.657-1.937) and mutant Pro/Pro (odds ratio, 1.274; 95% CI, 0.648-2.504) were more frequent in colorectal cancer patients compared to healthy controls. The frequency of the mutant Pro allele (odds ratio, 1.122; 95% CI, 0.809-1.554) was revealed in 47.5% of colorectal cancer patients and in 44.7% of healthy controls. There was no association observed between TP53 Arg72Pro polymorphism and risk of colorectal cancer in an Azerbaijani population (P > .05). CONCLUSION: Our findings indicate a lack of relationship between TP53 Arg72Pro polymorphism and risk of colorectal cancer. Furthermore, we have found no statistical differences in the frequency of genotype and allele by sex, age, histological grade, tumor stage, smoking status, and alcohol consumption in this study.

The current epidemiology of leishmaniasis in Turkey, Azerbaijan and Georgia and implications for disease emergence in European countries.

Leishmania spp. are sand fly-borne protozoan parasites causing leishmaniasis in humans and animals. The aim of the study was to analyse the epidemiology of leishmaniasis in Turkey, Azerbaijan and Georgia from 2005 to 2020 and evaluate the associated risk for disease emergence in European countries. It is based on an analysis of WHO and OIE reported cases between 2005 and 2020, a review of scientific articles published in SCOPUS between 2009 and 2020 and a questionnaire survey to public health and veterinary authorities in these countries. Endemic Leishmania spp. include L. infantum in the three countries, L. major in Azerbaijan and Turkey and L. tropica and L. donovani in Turkey. Leishmaniasis is reported in humans, animals and sand flies and incidence is spatially and temporarily variable. In the southern Caucasus and particularly in Georgia, reported incidence of human visceral leishmaniasis by L. infantum remains high. However, whilst Georgia experienced a gradual decrease from >4.0 cases per 100,000 population in 2005-09 to 1.13 cases per 100,000 population in 2020, the period with highest incidence in Azerbaijan, which ranged between 0.40 and 0.61 cases per 100,000 population, was 2016-2019, and no cases have so far been reported for 2020. Visceral leishmaniasis in the Southern Caucasus affects mostly young children from deprived urban areas and its closely associated to canine leishmaniasis. Turkey reported cases of visceral leishmaniasis between 2005 and 2012 and in 2016 only, and incidence ranged between 0.02 and 0.05 per 100,000 population. In contrast, the reported annual incidence of cutaneous leishmaniasis in Turkey was much greater and peaked at 7.02 cases per 100,000 population in 2013, associated to imported cases from cutaneous leishmaniasis endemic Syria. Leishmaniasis by L. infantum in Azerbaijan and Georgia represents a regional public and animal health challenge that requires support to improve diagnosis, treatment and control. The unprecedented rise of cutaneous leishmaniasis and the spread of L. tropica and L. donovani in Turkey is an important risk factor for their emergence in Europe, especially in Mediterranean countries where competent vectors are widespread.

Nagorno-Karabakh conflict: Mental health repercussions and challenges in Azerbaijan.

The Armenia-Azerbaijan Nagorno-Karabakh conflict has made many Azerbaijanis internally displaced (IDP), missing, wounded, disabled, or killed. The war and its aftermath have drastically impacted the mental health of these populations, leading to depression, anxiety, and stress-related psychosomatic illnesses such as dissociative disorder. However, their access to medical and psychological services is limited. Intervention in terms of policy making, healthcare services, information systems, and social support is required to promoting social integration and facilitate accessibility to mental healthcare. National and international organisations, foreign aids, and media support can contribute to this end. The psychological effects of the war on children, healthcare shortage associated with COVID-19, accommodation and welfare problems, limited access to vaccination, technology, and educational opportunities, dangerous explosive remnants, as well as isolation and marginalisation of the IDPs can all be challenges facing the mental health of these populations. Organising programs such as support groups to share wartime experience, resilience promotion, psychosocial support for healthcare providers, religious identification, integral COVID-19 management, beside accommodation and education support are recommended to enhance the condition of these Azerbaijani populations.

Factors associated with early uptake of COVID-19 vaccination among healthcare workers in Azerbaijan, 2021.

INTRODUCTION: We evaluated uptake and factors associated with COVID-19 vaccination among health workers (HWs) in Azerbaijan. RESULTS: Among 1575 HWs, 73% had received at least one dose, and 67% received two doses; all received CoronaVac. Factors associated with vaccination uptake included no previous COVID-19 infection, older age, belief in the vaccine's safety, previous vaccination for influenza, having patient-facing roles and good or excellent health by self-assessment. CONCLUSION: These findings could inform strategies to increase vaccination uptake as the campaign continues.

The monitoring of Francisella tularensis in surface water of East Azerbaijan province, Iran.

BACKGROUND: Francisella tularensis could be disseminated through arthropod bites and exposure to infected animals, water, and aerosols. Water sources that are contaminated with rodent excrement could be a source of contamination; therefore, an analysis of water samples is an appropriate method to investigate the routes of dissemination. Since an outbreak occurred in one of the villages in East Azerbaijan. The current study aimed to investigate the Francisella isolation in the different water samples from East Azerbaijan, Iran. Sampling was carried out in East Azerbaijan province. Forty-six specimens of surface water were collected. Filtration, culture, and inoculation of the water sample into NMRI (Naval Medical Research Institute) inbreed mice were performed. DNA was extracted from filtered water samples, different organs of inoculated mice, and bacterial isolates and was tested by TaqMan real-time PCR by targeting ISFtu2 and fopA genes. Despite the unsuccessfulness in isolation of F. tularensis, molecular test results indicate the presence of bacteria in surface water. The highest rate of F. tularensis (ten from 46 water samples, 21.7%) was detected from injected mice based on molecular methods. Despite the high efforts of researchers to isolate Francisella spp. in Iran, in recent years, and also the evidence that shows the presence of this bacterium in different parts of the country, the culture was not successful again in this study and the molecular method still is recommended to identify the possible sources of Francisella spp.

INVESTIGATION OF ALCOHOL DEHYDROGENASE (ADH3) GENE POLYMOPHISM IN PATIENTS WITH CHRONIC ALCOHOLIC PANCRATITIS IN AZERBAIJAN POPULATION.

The aim of the study is to determine the single nucleotide polymorphism of the ADH3 gene, which is involved in the development of chronic alcoholic pancreatitis in the Azerbaijani population. Seventy patients (51 with chronic alcoholic pancreatitis, 19 with chronic non-alcoholic pancreatitis) and 90 healthy individuals (55 smokers and 35 non- drinkers) were included in the study. Genomic DNA was isolated from venous blood based on the kit protocol. Genotypes were determined on agarose gel using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) methods. To study the specificity of the ADH3 gene polymorphism in alcohol-dependent people, genotypes and alleles were compared in patients with chronic alcoholic pancreatitis (CAP) and "practically healthy " alcohol abusers. It was found that in both groups, the ADH3*1/ADH3*2 genotype predominates. It was also found that in the Azerbaijani population the frequency of ADH3*1 and ADH3*2 alleles is equally divided. From the data obtained, it can be clearly stated that the correlation of the ADH3*1 allele of the ADH3 gene polymorphism with an increased risk of the disease is not detected (p=0.876). When comparing genotypes and alleles in patients with chronic pancreatitis of non-alcoholic origin and non-drinkers, the predominance of the heterozygous ADH3*1 gene in both groups was also revealed without statistical significance (p=0.777). In the Azerbaijani population, the association between the polymorphism of the ADH3 gene genotypes and the development of CAP was not revealed. The predominance of the ADH3*1/ADH3*2 genotype explains the low incidence of both CAP and alcohol-dependent people in the Azerbaijani population.

[Prevalence of age-related macular degeneration of retina among rural and urban population of the western region of Azerbaijan]. / Rasprostranennost' vozrastnoi makulyarnoi degeneratsii setchatki sredi sel'skogo i gorodskogo naseleniya Zapadnogo regiona Azerbaidzhana.

PURPOSE: To compare the prevalence rates of age-related macular degeneration (AMD) of retina among the rural and urban populations. MATERIAL AND METHODS: The study was conducted at the National Centre of Ophthalmology named after the Academician Zarifa Aliyeva, which in 2016 provided specialized ophthalmic care to the population of the western region of the Azerbaijan Republic - the Ganja-Gazakh economic region. Three types of settlements were determined among administrative units of the region: big city; small towns; rural settlements within the administrative regions. All patients were examined by specialists of the mobile ophthalmologic team using complex diagnostic methods. RESULTS: According to patient data, the prevalence rate of AMD among people aged 60 years and older was not high and varied within the interval of 0.2‰ in the Gadabay district to 1.0‰ in the Goranboy district with statistically significant inter-regional differences. General prevalence rate changed within the interval of 1.0‰ in the Gadabay district to 3.1‰ in the Goranboy district, also with statistically significant inter-regional differences. Comparison of the prevalence rate of this pathology among the population of a big city, small towns and rural settlements aged 40-49 years confirms the validity of the null hypothesis. According to our survey, gender differences in the prevalence rates of AMD among the population were not statistically significant (p>0.05). CONCLUSION: Comparative assessment of the prevalence rates of age-related macular degeneration of retina among rural and urban populations confirms its high risk in rural settlements. According to patient statistics, the prevalence rate of AMD in the available data is many times lower than its actual prevalence (≥60‰). Significant increase in AMD risk is observed in individuals aged 50 years and older in rural settlements, and 60 years and older in cities.

Cryptosporidium spp. infections in livestock and wild animals in Azerbaijan territory.

Cryptosporidium is an intracellular protozoan parasite, globally distributed and capable of infecting various vertebrate species, including humans as well as domestic and wild animals. Cryptosporidium is increasingly gaining attention as a human and an animal pathogen mainly due to its dominant involvement in worldwide waterborne outbreaks. The present paper reviews the current knowledge and understanding of Cryptosporidium spp. in terrestrial and water animals in Azerbaijan.

Blastocystis in the faeces of children from six distant countries: prevalence, quantity, subtypes and the relation to the gut bacteriome.

BACKGROUND: Blastocystis is a human gut symbiont of yet undefined clinical significance. In a set of faecal samples collected from asymptomatic children of six distant populations, we first assessed the community profiles of protist 18S rDNA and then characterized Blastocystis subtypes and tested Blastocystis association with the faecal bacteriome community. METHODS: Stool samples were collected from 244 children and young persons (mean age 11.3 years, interquartile range 8.1-13.7) of six countries (Azerbaijan 51 subjects, Czechia 52, Jordan 40, Nigeria 27, Sudan 59 and Tanzania 15). The subjects showed no symptoms of infection. Amplicon profiling of the 18S rDNA was used for verification that Blastocystis was the most frequent protist, whereas specific real-time PCR showed its prevalence and quantity, and massive parallel amplicon sequencing defined the Blastocystis subtypes. The relation between Blastocystis and the stool bacteriome community was characterized using 16S rDNA profiling. RESULTS: Blastocystis was detected by specific PCR in 36% (88/244) stool samples and was the most often observed faecal protist. Children from Czechia and Jordan had significantly lower prevalence than children from the remaining countries. The most frequent subtype was ST3 (49%, 40/81 sequenced samples), followed by ST1 (36%) and ST2 (25%). Co-infection with two different subtypes was noted in 12% samples. The faecal bacteriome had higher richness in Blastocystis-positive samples, and Blastocystis was associated with significantly different community composition regardless of the country (p < 0.001 in constrained redundancy analysis). Several taxa differed with Blastocystis positivity or quantity: two genera of Ruminococcaceae were more abundant, while Bifidobacterium, Veillonella, Lactobacillus and several other genera were undrerrepresented. CONCLUSIONS: Asymptomatic children frequently carry Blastocystis, and co-infection with multiple distinct subtypes is not exceptional. Prevalence and quantity of the organism clearly differ among populations. Blastocystis is linked to both faecal bacteriome diversity and its composition.

Helicopter Emergency Medical Services in East Azerbaijan province: Assessment of patients' outcome.

BACKGROUND: In this study, we aimed to evaluate the outcomes of patients transported by Helicopter Emergency Medical Services in East Azerbaijan Province. METHODS: This retrospective cross-sectional study was conducted on patients transported by the HEMS centre of Tabriz from August 2014 to March 2017. Records of the centre were used to collect data. Statistical analysis was performed by SPSS software version 20; the statistical significance level was considered below 0.05. RESULTS: In this study, 268 patients were transferred to Tabriz hospitals by 167 missions performed. The mean age of patients was 34.26±19.43, and 173 (65%) patients were male. The most common reason for call-out was the need for professional care (91.4%). The target of the majority of missions was on countryside routes. The mean distance of destinations was about 99.13±35.9 Kms, with a mean transference time of 54.68±14.17 minutes, while the mean estimated ground route time was 86.38±26.26 minutes. The most prevalent diagnosis was trauma; The Glasgow Coma Scale (GCS) and vital signs of the majority of patients were above 13 and stable, respectively. About 98 percent of patients received fluid therapy, and 71 percent were immobilized, and only 6 percent needed intubation. Also, 28 percent of patients needed Intensive Care Unit (ICU), 56 percent of whom passed away later. CONCLUSION: Our results suggest that Tabriz HEMS missions have reduced the patient transport time and also made the mortality rate closer to international standards.

Association between body mass index and patient-reported-outcome questionnaire scores (CAT™, ACT™, mMRC dyspnoea scale, IPAQ) in Ukraine, Kazakhstan and Azerbaijan: results of the CORE study.

BACKGROUND: The overweight/obese population (evaluated by a body mass index, BMI) represents a global health problem and contributes to the development of various chronic diseases. In this epidemiological study we evaluated this relationship by analyzing patient-reported questionnaires related to respiratory function, physical activity and BMI. METHODS: In 2013-2015, adult residents of selected cities were enrolled to this study in: Ukraine (M/F: 403/561), Kazakhstan (M/F = 348/597) and Azerbaijan (M/F: 389/544). Height was measured using a vertical measuring board, and body weight was measured by using portable digital scales. All participants were interviewed using CAT™, mMRC scale and IPAQ; respondents who also reported wheezing or whistling chest sounds during the previous 12 months additionally ACT™. RESULTS: 45.4% of respondents in Ukraine, 47.6% in Kazakhstan and 54.9% of respondents in Azerbaijan were found to be overweight/obese (BMI ≥ 25 kg/m2). The mean CAT™ total score among this population versus those respondents with a normal weight was 5.2 versus 3.6 (Ukraine, p < 0.001), 4.2 versus 2.9 (Kazakhstan, p < 0.001) and 5.9 versus 4.3 (Azerbaijan, p < 0.001). The number of respondents without airflow limitations (mMRC score 0) among overweight/obese respondents versus normal weight respondents was 298 (68.2%) versus 456 (86.7%) in Ukraine, 261 (58.1%) versus 387 (78.2%) in Kazakhstan and 343 (67.1%) versus 345 (82.3%) in Azerbaijan. The ACT™ total score between overweight/obese respondents and normal weight respondents was not statistically different. IPAQ showed a tendency towards a higher proportion of "low activity" results (compared to "moderate" and "high") in the overweight/obese subgroup (24.7% vs. 23.8% in Kazakhstan, 18.5% vs. 14.6% in Azerbaijan), and in Ukraine this difference was significant (12.4% vs. 5.2%, p < 0.001). CONCLUSION: CAT™ and mMRC are widely used tools for respiratory function assessment. Despite CAT™ scores being close to a normal value (< 5), the relationship of both CAT™ and mMRC scores with being overweight/obese was demonstrated in the general adult population of three CIS countries. IPAQ may also be a useful instrument for measuring activity level however, more objective studies are required to evaluate the relationship between BMI and physical activity.

Working towards development of a sustainable brucellosis control programme, the Azerbaijan example.

Brucellosis caused by Brucella abortus and Brucella melitensis is endemic in the Republic of Azerbaijan but a complex mix of fiscal, political and technical constraints has impeded regulatory authority decision making for adoption of a sustainable national control programme. This paper reports a series of epidemiologic studies of the disease in animals and humans which we conducted between 2009 and 2020. A preliminary study and a subsequent larger study using vaccination of all non-pregnant female sheep and goats of breeding age and all females between 3 and 8 months with conjunctival Rev1 vaccine both recorded significant reduction in small ruminant seroprevalences. A case control study of winter pasture flocks found many case and control farmers used raw milk to make dairy products for sale, ate fresh cheese and sold dairy products in unregulated markets. Almost all farmers expressed willingness to pay a portion of the costs associated with elimination of brucellosis from their flocks. A pilot human study in 2009 led to a large study in 2017 which recorded an overall seroprevalence of 8.1% in humans. Persons in farm related occupations were at greater risk than urban persons and males were more likely to be seropositive than females. Risk factors included keeping small ruminants, using raw milk cheese and slaughtering animals whereas having heard education information about brucellosis and vaccinating against brucellosis were protective.

Age and sex adjusted prevalence and annual incidence of multiple sclerosis in East-Azerbaijan, Iran.

BACKGROUND: Incidence and prevalence of multiple sclerosis (MS) is postulated to be rising in recent decades. Therefore, updating and completing the information of patients is essential, especially in high population areas. East-Azerbaijan is the largest and most populous province in the northwest of Iran. This study aimed to determine the prevalence and annual incidence of MS from 2008 to 2017 in East-Azerbaijan. METHODS: We evaluated the data of all patients who had registered at the MS center in the university hospital. The data include nearly all MS patients in the East-Azerbaijan region, because it is the only referral site in the area. All of the reported rates were calculated in 100,000 of the total population. RESULTS: By the end of 2017, the number of MS patients was 2995 (residing in the, with 769 (25.67%) men and 2226 (74.32%) women. The prevalence rate was 75.72/100,000 (95 % CI: 73.06-78.48), 38.2 in men (95% CI: 35.5-41.0), and 114.61 for women (95% CI: 109.9-119.4), with a female to male (F/M) ratio of 3:1. The mean annual incidence rate was 7.63/100,000 (95% CI: 5.6-9.3), and this rate was higher in women than men. During the nine years, the incidence rate increased. The patients' mean age was 32.33 ± 8.92, with a peak prevalence in 25-29 years for both genders. In this study, 13.9% of patients had a positive MS family history. CONCLUSIONS: This study showed a high prevalence of MS in the region. There is a significant increase in the incidence of MS during the nine years in East-Azerbaijan. The increment of incidence was more prominent in women. Also, considering the increasing incidence rate, it is concluded that the risk of MS is increasing in this region.

Surveillance Metrics of SARS-CoV-2 Transmission in Central Asia: Longitudinal Trend Analysis.

BACKGROUND: SARS-CoV-2, the virus that caused the global COVID-19 pandemic, has severely impacted Central Asia; in spring 2020, high numbers of cases and deaths were reported in this region. The second wave of the COVID-19 pandemic is currently breaching the borders of Central Asia. Public health surveillance is necessary to inform policy and guide leaders; however, existing surveillance explains past transmissions while obscuring shifts in the pandemic, increases in infection rates, and the persistence of the transmission of COVID-19. OBJECTIVE: The goal of this study is to provide enhanced surveillance metrics for SARS-CoV-2 transmission that account for weekly shifts in the pandemic, including speed, acceleration, jerk, and persistence, to better understand the risk of explosive growth in each country and which countries are managing the pandemic successfully. METHODS: Using a longitudinal trend analysis study design, we extracted 60 days of COVID-19-related data from public health registries. We used an empirical difference equation to measure the daily number of cases in the Central Asia region as a function of the prior number of cases, level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: COVID-19 transmission rates were tracked for the weeks of September 30 to October 6 and October 7-13, 2020, in Central Asia. The region averaged 11,730 new cases per day for the first week and 14,514 for the second week. Infection rates increased across the region from 4.74 per 100,000 persons to 5.66. Russia and Turkey had the highest 7-day moving averages in the region, with 9836 and 1469, respectively, for the week of October 6 and 12,501 and 1603, respectively, for the week of October 13. Russia has the fourth highest speed in the region and continues to have positive acceleration, driving the negative trend for the entire region as the largest country by population. Armenia is experiencing explosive growth of COVID-19; its infection rate of 13.73 for the week of October 6 quickly jumped to 25.19, the highest in the region, the following week. The region overall is experiencing increases in its 7-day moving average of new cases, infection, rate, and speed, with continued positive acceleration and no sign of a reversal in sight. CONCLUSIONS: The rapidly evolving COVID-19 pandemic requires novel dynamic surveillance metrics in addition to static metrics to effectively analyze the pandemic trajectory and control spread. Policy makers need to know the magnitude of transmission rates, how quickly they are accelerating, and how previous cases are impacting current caseload due to a lag effect. These metrics applied to Central Asia suggest that the region is trending negatively, primarily due to minimal restrictions in Russia.

Parts Unknown: Risk Factors of Intimate Partner Violence in Azerbaijan, Kyrgyzstan, Tajikistan, and Moldova.

Extant research has argued that there are variations in predictors of intimate partner violence (IPV) across nations and it is necessary to examine country-specific correlates of IPV. Much remains unknown about factors that affect risk of IPV in transitional countries. Specifically, we explore risk factors for IPV among four former nations of the Soviet Union-Azerbaijan, Kyrgyzstan, Tajikistan, and Moldova-with data from the nationally representative Demographic and Health Surveys. Rates of physical abuse were similar within Tajikistan (18.96%) and Moldova (18.38%), while Kyrgyzstan (20.62%) had the highest prevalence and Azerbaijan (9.29%) had the lowest prevalence. In contrast, the prevalence of sexual abuse was very similar across the four countries and was much lower (between 1.00% and 3.50%) than cross-national estimates of physical abuse. Findings suggest that many of the same risk factors of IPV in developing and developed nations influence risk of IPV in transitional nations. Across the four former Soviet nations included in analyses, the experience of controlling behaviors, husband's alcohol use, and witnessing IPV or experiencing abuse during childhood were all significantly associated with risk of physical and sexual abuse later in life. Indeed, the intergenerational transmission of violence may be a cross-national phenomenon. In addition, equality in decision making did not have an effect on risk of physical and sexual violence, except for risk of physical abuse in Moldova. This may be due to the historical context of these nations. Taken together, findings suggest that country context may influence individual risk factors of IPV.