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.

Comparative Analysis of Clinical and Laboratory Data in Children with Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 in the Republic of Kazakhstan.

Background and Objectives: Data with more severe mutations of the SARS-CoV-2 virus, compared with the original wild-type strain of COVID-19 disease, were reported worldwide. The study aims to describe the clinical and laboratory manifestations of a multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 in the Republic of Kazakhstan and to compare the severity of the disease depending on the time of the circulating variant of SARS-CoV-2 virus. Material and methods: A retrospective, multicentre, nationwide study of 89 children with MIS-C who received inpatient treatment from August 1, 2020, to December 1, 2021. The patients were allocated into two groups: 1(2020) - 45 children and 2 (2021) - 44 children. Study periods were characterized by the circulation of different strains of the SARS-CoV-2 virus. Results: In children with MIS-C in 2021, acute renal failure, disseminated intravascular coagulation syndrome, and shock were statistically more frequently found, which led to fairly common admittance to the intensive care unit. When comparing laboratory data, the children with MIS-C in 2021 had higher values of inflammation markers: ferritin, procalcitonin, erythrocyte sedimentation rate, leukocytes, and neutrophils. Furthermore, these children had a lower level of lymphocytes than children with MIS-C in 2020. Conclusions: MIS-C is a severe, life-threatening systemic disease characterized by multiple organ damage and important inflammatory changes in laboratory parameters. A more aggressive clinical course of MIS-C in 2021 may be associated with the emergence of new SARS-CoV-2 strains.