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Objective: This research aims to update knowledge on the regional and national sickness burden attributable to cystic echinococcosis (CE) from 1990 to 2019, as well as epidemiology and disease control, with a particular emphasis on the People's Central Asian Regions. Methods: We calculated the morbidity, mortality, and disability-adjusted life years at the global, regional, and national levels for CE in all central Asian countries from 1990 to 2019, and we analyzed the association between GDP per capita and the disease burden of CE. Results: In 2019, the three greatest numbers of CE cases were recorded in Kazakhstan [23986; 95% uncertainty interval (UI); 19796; 28908]; Uzbekistan (41079; 18351; 76048); and Tajikistan (10887; 4891; 20170) among all 9 countries. The three countries with the greatest ASIR of CE were estimated to be Kazakhstan (127.56; 95% UI: 105.34-153.8), Uzbekistan (123.53; 95% UI: 58.65-219.16), and Tajikistan (121.88; 58.57-213.93). Kyrgyzstan, Tajikistan, and Uzbekistan had the biggest increases (125%, 97%, and 83%, respectively) in the number of incident cases of CE, whereas Georgia, Kazakhstan, and Armenia saw the largest decreases (45%, 8%, and 3%, respectively). Conclusion: To reduce the illness burden caused by CE, our findings may help public health professionals and policymakers design cost-benefit initiatives. To lessen the impact of CE on society, it is suggested that more money be given to the region's most endemic nations. Echinococcosis, cystic, negative health effects, life-years lost due to disability, rate of occurrence as a function of age, rate of death as a function of age.
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Equinococose , Humanos , Equinococose/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Anos de Vida Ajustados por Deficiência , Adolescente , Adulto Jovem , Efeitos Psicossociais da Doença , Ásia Central/epidemiologia , Idoso , Criança , Uzbequistão/epidemiologiaRESUMO
OBJECTIVE: To evaluate the current state of neurosurgical care in Central Asia, identify the challenges and advancements, and propose recommendations to improve neurosurgical capabilities and access in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. METHODS: A comprehensive review of the neurosurgical infrastructure, availability of neurosurgeons, technological advancements, and healthcare policies in the five Central Asian countries. Analysis included published literature, healthcare reports, and expert opinions to assess the state of neurosurgical care and identify areas for improvement. RESULTS: Significant variation in neurosurgical care was observed across the region. Kazakhstan showed notable advancements, including an increased number of neurosurgeons and progress in specialized fields such as vascular neurosurgery and brain tumor management. Other countries, like Uzbekistan, Tajikistan, and Kyrgyzstan, made strides in improving neurosurgical care but still faced substantial challenges. Common issues included a shortage of neurosurgeons, limited facilities, and inadequate access to modern technology. The lack of research data further highlighted the need for urgent intervention. CONCLUSIONS: To enhance neurosurgical care in Central Asia, a multipronged approach involving targeted investments, policy reforms, international collaborations, and knowledge sharing is recommended. This includes establishing specialized neurosurgical training programs and fellowships, investing in infrastructure and technology, fostering international collaborations for training and research, introducing early neurosurgery education in medical schools, improving access to online education resources, and promoting telemedicine for consultations and follow-up care. These measures are necessary to expand access to essential neurosurgical care and improve outcomes in the regions.
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Neurocirurgia , Procedimentos Neurocirúrgicos , Humanos , Neurocirurgia/educação , Ásia Central , NeurocirurgiõesRESUMO
Background and objective: The potential impact of gut health on general physical and mental well-being, particularly in relation to brain function, has led to a growing interest in the potential health advantages of prebiotics, probiotics, and synbiotics for the management of ASD. A comprehensive meta-analysis and systematic review was conducted in order to evaluate the effectiveness and protection of many drugs targeted at manipulating the microbiota in the treatment of ASD. Methods: The present study employed a comprehensive examination of various electronic databases yielded a total of 3,393 records that were deemed possibly pertinent to the study. RCTs encompassed a total of 720 individuals between the ages of 2 and 17, as well as 112 adults and participants ranging from 5 to 55 years old, all of whom had received a diagnosis of ASD. Results: Overall, 10 studies reported Autism-Related Behavioral Symptoms (ARBS). Regarding the enhancement of autism-related behavioral symptoms, there wasn't a statistically significant difference between the intervention groups (combined standardized mean difference = -0.07, 95% confidence interval: -0.39 to 0.24, Z = 0.46, p = 0.65). We observed that in the patients with ASD treated with probiotic frontopolar's power decreased significantly from baseline to endpoints in beta band (Baseline: 13.09 ± 3.46, vs. endpoint: 10.75 ± 2.42, p = 0.043, respectively) and gamma band (Baseline: 5.80 ± 2.42, vs. endpoint: 4.63 ± 1.39, p = 0.033, respectively). Among all tested biochemical measures, a significant negative correlation was found between frontopolar coherence in the gamma band and TNF-α (r = -0.30, p = 0.04). Conclusion: The existing body of research provides a comprehensive analysis of the developing evidence that indicates the potential of probiotics, prebiotics, and synbiotics as therapeutic therapies for ASD. Our findings revealed that those there was no significant effect of such therapy on autism-related behavioral symptoms, it has significant effect on the brain connectivity through frontopolar power in beta and gamma bands mediated by chemicals and cytokines, such as TNF-α. The psychobiotics showed no serious side-effects.
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Medical ethics have traditionally encountered resistance in medical education, with doubts regarding their necessity during preclinical years. Concerns include the practical application of theoretical ethics and favoring the learning of ethics through observation and imitation. Furthermore, ethics courses often focus on codes and regulations and neglect the promotion of moral reasoning and decision-making skills. Therefore, enhancing ethical researcher-training modules is essential for advancing instructional methods and promoting a unified and interactive learning atmosphere. A 3-week course was conducted using the values exchange (VX) online platform to assess the effectiveness of the VX system in involving students and its impact on their perceptions of the importance of research ethics. Accordingly, a blended course was provided as an optional course to the students, and a qualitative course evaluation survey was administered at the end of the course. Sixty-one medical students participated in a pilot-blended research ethics program and the majority (93%) reported a positive learning experience. The course was preferred over traditional classroom-based courses by 80% of the respondents, with 77% reporting increased interest and motivation to study Research Ethics. Over half of the students (57%) reported that the course stimulated their thinking and changed their perspectives on handling medical research issues. Some students (20%) reported improvements in their social and information technology skills. The VX platform was able to meet the expectations of both faculty and students, and fulfilled all dimensions of the Health Professions Learning Environment Conceptual Framework. The VX platform provides an interactive and effective simulated learning environment that promotes ethical research aligned with the Health Professions Learning Environment Framework and fosters core competencies, such as ethical reasoning, decision-making, and cultural respect. Medical schools are encouraged to implement VX to enhance the teaching of research ethics.
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Estudantes de Medicina , Humanos , Estudos Transversais , Saúde Pública , Internet , Currículo , Ética MédicaRESUMO
The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress. Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress. Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
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Doenças Cardiovasculares , Etnicidade , Adolescente , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Humanos , Quirguistão/epidemiologia , Grupos MinoritáriosRESUMO
BACKGROUND: To date, there is no data available of health literacy of the population in Kazakhstan. This study was aimed to assess the health literacy of the rural population for the development of the targeted health education programs. METHODS: The adapted HLS-EU-Q47 survey was carried out among 1650 respondents aged 18-76 from rural settlements in Almaty region of Kazakhstan in 2013. The health literacy competences to assess, understand, appraise and apply health information on healthcare, disease prevention and health promotion were measured. The associations between the health literacy competencies and demographic and socio-economic characteristics were shown through a multiple linear regression analysis. RESULTS: The overall health literacy rate of the rural population of Almaty region was problematic and inadequate. With regards to their age, sex, social and economic characteristics, the health literacy competencies differ according to health literacy domain. Respondents with low education level or perceived social status had respectively low health literacy scores, especially in appraising and applying information of disease prevention. CONCLUSION: Low educated people and with lower income have lower health literacy in comparison to respondents with higher education level and higher income. Respondents with higher health literacy have higher rate of self-assessed health.
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A healthy workforce is vital for the sustainable social and economic development of any country. Assuring occupational health and safety (OHS) depends not only on the passing of quality working legislation and inspection of workplaces, but also on preparation of qualified specialists on OHS. Aimed at assessing of relevance of the content of training at Central Asian universities to the needs in prevention of risks of accidents and injuries and promotion of a preventive culture in the workplace, and finding out how they are compliant with the recommendations of the Mainstreaming occupational safety and health into the education (2010), we examined curricula of 20 medical and non-medical universities across Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.The analysis of training programs showed that education in OHS and preparation of qualified specialists in Central Asiana countries is up-to-date and tailored to local needs for prevention of risks of accidents and injuries and promotes the notion of a preventive culture in the workplace.
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Currículo/estatística & dados numéricos , Educação Profissionalizante/estatística & dados numéricos , Saúde Ocupacional/educação , Ásia Central , Educação Profissionalizante/métodos , Humanos , Saúde Ocupacional/estatística & dados numéricos , UniversidadesRESUMO
INTRODUCTION: In the Global Strategy on Human Resources for Health: Workforce 2030, the World Health Organization (WHO) called for the promotion of decent working conditions for health care workers (HCWs) in all settings. The Central Asian countries (CACs) are low- and middle-income countries with economies past transition and with implemented health care reforms that touch HCWs and occupational health and safety (OHS) at large. THE AIM: of the present article is to highlight some challenges in OHS regulation and to highlight some of the latest studies on biological health risks to HCWs in CACs. MATERIALS AND METHODS: The article reviews 18 journal articles in Russian and 3 journal articles in English published since 2004, 3 dissertations, 10 national statistical sources and profiles, and 5 books. RESULTS: OHS management systems in CACs are built on the principle of responding to insurance cases, not their prevention. Most labor law standards are declarative in nature because many employers ignore labor protection requirements. There has been no study since 2000 on the working conditions, the physical and chemical health risks or the effects of working conditions, mental and physical loads on the health of HCWs. A few studies were found on work-related infectious diseases (viral hepatitis, HIV and tuberculosis) of HCWs in Kyrgyzstan and Kazakhstan. The latest studies showed a high prevalence of viral hepatitis B, C and G and of HIV infection in HCWs in Kyrgyzstan, with much lower rates in Kazakhstan. CONCLUSIONS: The traditional OHS approach used in soviet times has proven insufficient in CACs with developing market economies. OHS and the health of HCWs in Central Asia is insufficiently studied. The available data indicate a low level of attention to the health of HCWs. Serious studies on OHS in health care settings in this region are needed.
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Pessoal de Saúde , Saúde Ocupacional , Ásia Central/epidemiologia , Países em Desenvolvimento , Regulamentação Governamental , Humanos , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Saúde Ocupacional/legislação & jurisprudência , Saúde Ocupacional/normas , Saúde Ocupacional/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/etiologia , Traumatismos Ocupacionais/prevenção & controle , RiscoRESUMO
BACKGROUND: In the period of transition from a centralized economy to the market economy, occupational health services in Kyrgyzstan have survived through dramatic, detrimental changes. It is common for occupational health regulations to be ignored and for basic occupational health services across many industrial enterprises and farms to be neglected. OBJECTIVE: The aim of this study was to demonstrate the present situation and challenges facing occupational health services in Kyrgyzstan. FINDINGS: The transition from centralized to the market economy in Kyrgyzstan has led to increased layoffs of workers and unemployment. These threats are followed by increased workload, and the health and safety of workers becomes of little concern. Private employers ignore occupational health and safety; consequently, there is under-reporting of occupational diseases and accidents. The majority of enterprises, especially those of small or medium size, are unsanitary, and the health status of workers remains largely unknown. The low official rates of occupational diseases are the result of data being deliberately hidden; lack of coverage of working personnel by medical checkups; incompetent management; and the poor quality of staff, facilities, and equipment. Because Kyrgyzstan is a mountainous country, the main environmental and occupational factor of enterprises is hypoxia. Occupational health specialists have greatly contributed to the development of occupational medicine in the mountains through science and practice. CONCLUSIONS: The enforcement of existing strong occupational health legislation and increased financing of occupational health services are needed. The maintenance of credible health monitoring and effective health services for workers, re-establishment of medical services and sanitary-hygienic laboratories in industrial enterprises, and support for scientific investigations on occupational risk assessment will increase the role of occupational health services in improving the health of the working population.