TEMPORAL TRENDS OF CERVICAL CANCER MORTALITY IN GEORGIA, 2011-2018.

Cervical cancer is the fifth most common cancer diagnosed in Georgia, after breast, thyroid, colorectal, and uteri cancers. During 2015-2018 cervical cancer incidence composed 17.9, 19.6, 15.0 and 14.3 per 100000 female population accordingly. The study aims to describe cervical cancer (CC) mortality in Georgia during the period of 2011 and 2018. Descriptive analysis was conducted using mortality data during the period of 2011-2018 from the National Statistics Office of Georgia. To estimate time trends of CC mortality study period was divided into two groups - 2011-2014 and 2015-2018 years. For data analysis, descriptive statistics was performed, in which the mortality rates, age-specific mortality rates per 100,000 female population and other statistical measurements - median, the first quartile (Q1), the third quartile (Q3), and interquartile range (IQR) of age at death from Cervical cancer were estimated. Statistical analysis was completed by using the programs of EpiInfo version 7 and Statistical Package of the Social Science (SPSS) version 23 for Windows. The statistical significance tests - p value, and 95% of Confidence Interval (95% CI) were used in order to estimate statistical reliability of the results. The number of annual deaths varied between 121 and 185 cases that composed variation of mortality rates from 6.1 to 9.5 per 100,000 women. According to the 95% of CI the difference between mortality rates according to calendar years is not statistically significant. Mean mortality rates for the periods 2011-2014 and 2015-2018 were 7.1(SD=0.7) and 8.7 (SD=0.5) accordingly and presented a slight increase. Taking into consideration that during 2005-2010 annual number of registered deaths from cervical cancer in Georgia was quite low and varied between 50 and 60, it is likely that this increase is related to the improvement in registration and is not a true increase. Therefore, the second period (2015-2018) of the study represents more real data, then the first (2011-2014). Cervical cancer mortality increases with age, which indicates that advanced age is a predictor factor. The age effects for almost all calendar years included in analysis (2011-2018) presented an increasing trend with age from 25 to 59, while a moderate decrease was shown within the age group from 60-64 to 65-69 and over 80 years of old. The median age of deaths from CC fluctuated inconsistently between 57 and 62 years; Interquartile range in different calendar years composed: 47-67, 52-72, and 52-67 years. Comparatively stable median age of deaths, indicates that, there is no tendency of cervical cancer early mortality reduction. The study revealed a slight increase in CC mortality, which could be related to the improvement of death registration.

ASSESSMENT OF THE LEVEL OF KNOWLEDGE OF MEDICAL PERSONNEL IN DIARRHEA AND HEMOLYTIC-UREMIC SYNDROME.

Survey have been conducted among medical professionals to test knowledge level of HUS and diarrheal diseases and to identify predictor variables for better knowledge. Cross-sectional survey have been conducted among medical personnel at different clinics in Tbilisi and in regions of Georgia. Participants were selected from different clinics in Tbilisi and in three biggest regional cities (Zugdidi, Batumi and Kutaisi) of Georgia. A total of 12 clinics were selected from them 6 were in Tbilisi and 2 at each regional cities. Clinics were selected based on their ability to provide services for gastrointestinal diseases, infectious diseases and kidney diseases. Data were entered into electronic database and analyzed using R v3.3.2. Descriptive statistics and methods of multivariate analysis were used for data analysis. 366 medical personnel have been interviewed. 73% (267) were females and 27% (99) males. Mean age was 40.8, IQR (27-52). A total of 64% (235) participants were from clinics located in Tbilisi. In multivariate analysis background in infectious diseases, female sex and having more than 10 years of medical experience were significantly associated with the total knowledge score of diarrheal diseases (p<0.05). High total knowledge score of HUS was detected among pediatricians (p<0.05). Trainings has been recommended for medical specialists to increase knowledge of diarrheal diseases and HUS to be able to identify those condition and to provide timely medical support for patients.