[MONITORING AND EVALUATION OF EFFECTIVENESS OF INFECTIOUS CONTROL IN STOMATOLOGICAL ORGANIZATIONS OF THE KYRGYZ REPUBLIC].

The paper highlights the issues of monitoring and assessing the state of infection control conducted over four years of research in order to prevent infections associated with the provision of medical dental care to the population of the republic. The results are presented at baseline and periodically in order to predict and scientifically substantiate preventive measures. The studies were carried out in dental organizations using the "Evaluation sheet of the state of infection control in dentistry" which included 31 criteria for seven functional and organizational blocks by the method of direct observation of existing practices, interviewing medical staff, discussion of causal relationships between processes and phenomena (qualitative assessment) and the method calculating a numerical expression of the percentage between existing and expected compliance with infection control requirements (quantification). As a result of the fourth Monitoring and Evaluation, indicators of compliance with infection control requirements showed a significant increase, both in general - by 37.2% (2.4 times compared to the baseline monitoring and evaluation), and in the functional blocks of the infection control system. The growth rate was 116.5%, the rate of increase was 16.5% (p<0.05). However, the indicators remain low, which requires further improvement of the system of measures for the prevention of infections associated with the provision of dental care to the population.

[The classifier of surgical operations and manipulations in system of medical services financing in the Kyrgyz Republic].

The health care reforms in the Kyrgyz Republic are directed to develop hospital financing system. In 2003 the system of clinical-cost groups was introduced. The surgical clinical-cost groups are organized on the basis of existing classifier "The Surgical Operations and Manipulations", which is not revised since its approval in 1997, that resulted in distortion of statistical information. Hence, need in development and implementation of modern reference book is obvious. The purpose of the study is to comparatively analyze international classifiers of surgical operations and manipulations, to evaluate their accordance to clinical practice in the Kyrgyz Republic and to develop new national classifier to be applied in the Kyrgyz Republic. The actually applied national classifier of Surgical Operations and Manipulations includes 2181 types of surgical interventions, 250 (12%) out of which have no accurate formulation (for example "The other types of brain surgeries"). In addition, 453 (21%) surgical operations are not applied. The detailed analysis of such international classifiers as the International Classification of Diseases-10 Procedure Coding System (ICD-10-PCS), the Australian Classification of Health Interventions (ACHI), the NOMESCO Classification of Surgical Procedures (NCSP), Nomenclature of Health Services, the Russian Nomenclature of Health Services (RNHS) was implemented. The systematization of analyzed data permitted to determine the Russian classifier "Nomenclature of medical services" as the most optimal for implementation in the Kyrgyz Republic. The obtained and analyzed data made it possible for the Ministry of Health of the Kyrgyz Republic to proceed activities related to development of new classifier of surgical interventions on the basis of the Nomenclature of Medical Services of the Russian Federation.

[The condition of post-vaccination immunity to diphtheria and tetanus in population of the Republic of Kyrgyzstan].

The serologic epidemiological analysis of intensity of anti-diphtheria and anti-tetanus post-vaccination population immunity in the Republic of Kyrgyzstan was carried out. The presence of immune defense was determined in 453 residents by detecting IgG to diphtheria and tetanus by enzyme-linked immunosorbent assay using test system RIDASCREEN Diphtherie IgG and RIDASCREEN Tetanus IgG (Germany, R-Biopharm). It was established that the level of antibodies depends on the age of individuals. The highest immune defense against diphtheria is present in adult population aged 20-29 years (100%) and 30 years and older (100%). The lowest level is detected in the group of children of 1-4 years old and is up to 30.6%. The proportion of individuals with protective titer of antibodies ≥ 0.10 for diphtheria was 88.5%. The population intensity of post-vaccination tetanus immunity high antibody titers were established in age groups of 15-19 years (92.9%), 20-29 years (93.3%) and 30 years and older (94.8%). There is relationship between level of antibody titers and the age. Thus, in children age group of 5-9 years, high level of protection was established, that amounted up to 60.4%, in adolescents of 10-14 years old this indicator was 40%, and the lowest level in children aged of 1-4 years old was 39.6%.