The high burden of pediatric cystic echinococcosis in Kazakhstan: epidemiological and clinical consequences.

BACKGROUND: Cystic echinococcosis (CE) is attributable to Echinococcus granulosus metacestodes. Ultrasound examinations enable a stage-specific approach to CE management. However, this approach is not often applied in endemic areas, which include Kazakhstan. METHODS: We collected clinical and ultrasound data on CE pediatric patients seen at a national referral surgical center in Almaty, Kazakhstan, during 2015-2020. RESULTS: We included 49 patients, and 79 cysts that were all surgically treated. All but one patient carried active cysts (CE1-CE3 stages). Twenty-six (53.2%) did not receive albendazole postsurgery. Children with CE1 and CE3a cysts underwent surgery, while the use of albendazole and percutaneous drainage were advised upon by experts. CONCLUSIONS: A stage-specific approach to CE management in Kazakhstan is urgent, especially in the pediatric population. The rate of active cysts suggests continuing transmission of CE.

Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries.

The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.

Ultrasound-based evaluation of the prevalence of abdominal cystic echinococcosis in the Turkestan region of Kazakhstan.

BACKGROUND: Human cystic echinococcosis (CE) is a zoonotic disease caused by Echinococcus granulosus sensu lato. CE is known to be endemic in some parts of Central Asia. We present findings from an ultrasound-based survey to estimate the prevalence of CE in the Turkestan oblast of Kazakhstan. METHODS: In October 2019, six villages were chosen based on records from a national surveillance dataset. Inhabitants aged 5-90 y were invited to undergo a free abdominal ultrasound to screen for CE cysts. All identified cysts were staged according to the WHO-endorsed classification for CE cysts. RESULTS: A total of 2252 individuals underwent ultrasound screening. Twenty-two (0.98%) individuals had CE, with a combined total of 33 cysts: 25 (75.7%) inactive (14 CE4, 11 CE5) and 8 (24.3%) active/transitional (2 CE1, 1 CE2, 3 CE3a, 2 CE3b). One patient had a postsurgical cavity. Sixty-eight patients (3.0%) reported CE prior to surgical treatment. In 25 (36.8%) previously diagnosed patients, albendazole prophylaxis was not used. CONCLUSIONS: CE is endemic in the study region, with ongoing transmission. The number of surgically treated CE patients suggests an underestimation of the disease burden by the current surveillance system. Further studies on local CE epidemiology and the implementation of expert treatment recommendations are needed.

Effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS - retrospective analysis of data from Almaty, Kazakhstan, 2010-2015.

INTRODUCTION: According to data from the National Centre for Prevention and Control of AIDS, in the Republic of Kazakhstan, 45.8% of patients in the symptomatic stages of HIV infection are diagnosed with tuberculosis (TB) which is the cause of death in 36% of patients infected with HIV. OBJECTIVE: The aim of the study was to conduct a retrospective analysis of the effectiveness of tuberculosis (TB) chemoprophylaxis among people living with HIV in the Republic of Kazakhstan (RK) in Central Asia. MATERIAL AND METHODS: Materials and method. A retrospective analysis of patient health status was performed for each of the 648 patients (323 in the study group and 325 in the control group) during 2010-2015. Data from outpatient treatment charts were used concerning each patient infected with HIV observed at AIDS Treatment Centres. From among the 648 patients infected with HIV, 136 were receiving isoniazid in 2010, and 187 in 2011. The control group consisted of 325 people living with HIV (PLW HIV), who did not received isoniazid during observation. RESULTS: Results. The incidence of TB in patients who underwent chemoprophylaxis did not exceed 0.555/ 100,000 population in the first year of observation. Within 5 years, the TB incidence dropped to 0. In the control group, the TB incidence rate during the first year of observation was 3.262/100,000, with a decrease to 0.364 observed in 2015. Cumulated incidence rate in 2011-2015 in the study group accounted for 1.276/100,000. In the control group, the cumulative incidence was 4.3 times higher and accounted for 5.527. A significant difference in the mortality rate due to TB in the study and control groups was observed, the share of deaths due to TB in study group was 21.6% - nearly 3 times lower than in the control group (57.0%). CONCLUSIONS: Conclusions. The effectiveness of chemoprophylaxis for TB depends on biomedical, organizational and cultural factors. The presence of HIV co-infections is a special situation. Opposite to the majority of reports, in own study, no drug-resistant forms of tuberculosis were observed in relation with chemoprophylaxis with isoniazid. In the examined population, TB chemoprophylaxis reduced the incidence and cumulative incidence of TB among PLW HIV by 3.4-4.8 times. Isoniazid chemoprophylaxis decreased 4-fold the annual and cumulative mortality due to TB.

Comparative analysis of the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS treated with isoniazid.

INTRODUCTION: The epidemic of human immunodeficiency virus has had a tremendous effect on the epidemic of tuberculosis. Together with the spread of HIV, a great increase has been observed in morbidity due to tuberculosis, both in endemic countries and in those where earlier, as a result of treatment, the frequency of occurrence of tuberculosis had decreased. In 2018, the WHO data demonstrated that the EECA region was the only region worldwide where the epidemics of HIV was still rapidly increasing. The EECA region still struggles with a serious epidemic of tuberculosis. MATERIAL AND METHODS: Materials and method. The research method applied was comparative analysis of the results of own study and studies by other researchers, concerning the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS when treated with isoniazid. RESULTS: Results. In own study, it was found that primary morbidity among patients administered isoniazid significantly decreased within 5 years. Incidence rates of primary morbidity were significantly lower than among patients who had not received isoniazid. Relevant studies conducted worldwide, in many cases differed from own study with respect to both the results and approach to the problem, by country or selection of the type of patients participating in the study. However, in all studies, isoniazid was generally a safe and well-tolerated drug, without special side-effects. CONCLUSIONS: Conclusions. All studies analyzed concerning the effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS treated with isoniazid, confirmed the effectiveness of this drug. In the compared studies, applied isoniazid preventive therapy showed no difference in effectiveness according to its duration. Analyzed studies showed similar effectiveness also with respect to a decrease in mortality among patients with TB/HIV/AIDS.

Medico-social effectiveness of biological monitoring of iodine deficiency status (IDS) among women of reproductive age in Kazakhstan.

INTRODUCTION: Iodine deficiency is one of the most important public health problems in the world. It mostly affects pregnant women and children. The lack of iodine leads to an increase in the numbers of perinatal mortality and mental retardation. MATERIAL AND METHODS: In 2012-2014, a survey was carried out of 2,342 women, of whom 2284 were analyzed for salt to measure the content of iodine, and 2,242 women of reproductive age had their urine samples analyzed by the cerium-arsenite method based on the Sandell-Kolthoff reaction. Determination of the medical and social effectiveness of biological monitoring of IDS was carried out in 3 stages. RESULTS: The study revealed that in the eastern Kazakhstan region the relative risk (RR) of overall prevalence of iodine deficiency among women was 1.1 times higher (95% ID: 0.35-3.61; Z statistic = 0.192) among household respondents (≤15mkg/kg). In the Pavlodar region, the RR of the prevalence of total iodine deficiency is 0.5 times higher in households where the salt was not sufficiently iodized. In the Zhambyl region the RR of the iodine deficiency prevalence was about twice as high due to insufficient iodized salt. CONCLUSIONS: The introduction of biological monitoring of IDS among women, especially pregnant women, may positively affect the detection of the risk limits for the birth of infants with reduced mental abilities or other diseases during pregnancy, using timely targeted preventive measures to exclude factors that affect the spread of IDS.

Cystic Echinococcosis of the Bone in Kazakhstan.

Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease.

Volatile oil composition of Carthamus Tinctorius L. flowers grown in Kazakhstan.

INTRODUCTION: Carthamus tinctorius L. is commonly known as Safflower. C. tinctorius extracts and oil are important in drug development with numerous pharmacological activities in the world. This plant is cultivated mainly for its seed which is used as edible oil. For a long time, C. tinctorius has been used in traditional medicines as a purgative, analgesic, antipyretic and an antidote to poisoning. It is a useful plant in painful menstrual problems, post-partum haemorrhage and osteoporosis. OBJECTIVE: The subject of this study is the seeds of Kazakhstan species of 'Akmai' safflower, collected in the flowering stage in Southern Kazakhstan. Volatile oil was carry out to study the component composition of Kazakhstan 'AkMai' safflower flowers. MATERIALS AND METHOD: Pale yellow oily extracts were obtain by varying the process parameters. The volatile oil obtained by hydrodistillation of the petals Carthamus tinctorius L. was analyzed by gas chromatography/mass spectrometry (GC/MS). The yield of the oil was 0.175 % (v/w). 20 compounds representing 99.81% of the oil were characterized. The volatile oil was found to be rich in undecanoic acid, octane, 2-nonen -1-ol, hexadecanal, dodecanal, dec-2-en-1-ol, nonanoic acid, tetradecanoic acid, 2 pentadecanone, 6,10,14-trimethyl, 1,2-benzenedicarboxylic acid, isobutyl-beta-phenylpropionate, 1.3-cyclohexadiene, myrtenoic acid, octadecanoic acid, heneicosanoic acid, 2(3H)-furanone, 4,4-dipropylheptane, hexcosane,1-eicosanol, as well as heptocosane. RESULTS: Volatile oil from the flowers of the Kazakhstan safflower species 'Ak-Mai' were investigated by GC/MS which allowed the detection of 20 compounds. Biologically active complex of the flower of the Kazakhstan safflower species 'Ak-Mai' was released for the first time by using this oil.

Human health cost of hydrogen sulfide air pollution from an oil and gas Field.

Introduction and objective. The Karachaganak oil and gas condensate field (KOGCF), one of the largest in the world, located in the Republic of Kazakhstan (RoK) in Central Asia, is surrounded by 10 settlements with a total population of 9,000 people. Approximately73% of this population constantly mention a specific odour of rotten eggs in the air, typical for hydrogen sulfide (H2S) emissions, and the occurrence of low-level concentrations of hydrogen sulfide around certain industrial installations (esp. oil refineries) is a well known fact. Therefore, this study aimed at determining the impact on human health and the economic damage to the country due to H2S emissions. Materials and method. Dose-response dependency between H2S concentrations in the air and cardiovascular morbidity using multiple regression analysis was applied. Economic damage from morbidity was derived with a newly-developed method, with Kazakhstani peculiarities taken into account. Results.Hydrogen sulfide air pollution due to the KOGCF activity costs the state almost $60,000 per year. Moreover, this is the reason for a more than 40% rise incardiovascular morbidity in the region. Conclusion. The reduction of hydrogen sulfide emissions into the air is recommended, as well as successive constant ambient air monitoring in future. Economic damage evaluation should be made mandatory, on a legal basis, whenever an industrial facility operation results in associated air pollution.