Unmet need for contraception among married women in the Kyrgyz Republic using the datasets from the 2006, 2014 and 2018 Multiple Indicator Cluster Survey: a cross-sectional study.

BACKGROUND: Since the beginning of the family program in 1998, the proportion of married women who used contraception has fluctuated. An unmet need for contraception among women in Kyrgyzstan drastically increased from 2006 (1.1%) to 2014 (19.1%), and remained unchanged until 2018 (19.0%). This study aims to re-investigate the prevalence of an unmet need for contraception from 2006 to 2018 in a comprehensive manner, and examine the factors associated with an unmet need for contraception among married women over the course of 12 years in the Kyrgyz Republic. METHODS: This is a cross-sectional study using secondary data that derived from the Multiple Indicator Cluster Survey (MICS). The study employed three datasets from the MICS 2006, 2014, and 2018. The study included a total of 9,229 women aged 15-49 who were married and fecund, and whose status of the met/unmet need for contraception could be identified. Logistic regression was employed to estimate the relationship of an unmet need for contraception with independent factors. A P value < 0.05 was set as statistically significant. RESULTS: The prevalence of an unmet need for contraception was 19.9% in 2006, 20.4% in 2014, and 22.5% in 2018. Across 12 years, all reversible-contraceptive methods for women constantly declined. Although intrauterine devices were the prominent contraceptive method of usage among Kyrgyz women, the trend of usage drastically decreased over time. Factors associated with unmet need for contraception included women's age, area of residence, mother tongue of household head, age of husband, and number of children ever born. CONCLUSION: The unmet need for contraception among married Kyrgyz women slightly increased, and the trend of modern contraceptive usage declined from 2006 to 2018, particularly the use of pills, injections, and intra-uterine devices. Comprehensive sexual health education for young people and youth-friendly services should be promoted. An effective and reliable supply chain of contraceptive commodities should be prioritized and strengthened. Regular supportive supervision visits are essential to improve the knowledge and skills of healthcare providers to be able to provide intrauterine device service as a contraceptive choice for Kyrgyz women.

Knowledge, attitudes, and practices (KAP) towards seasonal influenza and influenza vaccine among pregnant women in Kyrgyzstan: A cross-sectional study.

Influenza is an acute respiratory disease of global importance due to its pandemic potential. Pregnant women are more susceptible to severe illness and adverse outcomes of influenza, and vaccination is the most effective preventive measure for mother and infant. The coverage rate of influenza immunization in Kyrgyzstan is below national targets, despite the World Health Organization's (WHO) recommendation to prioritize pregnant women for vaccination. This study sought to understand drivers and barriers to influenza vaccine uptake in pregnant women in Kyrgyzstan. A knowledge, attitudes, and practices (KAP) survey was administered from December 2018 to March 2019 to 1,193 pregnant women aged 18 and older attending public health institutions in Kyrgyzstan. Multivariate regression analysis was used to determine the association between variables and outcomes of interest.Nearly half (56.2 %) of the 1,193 participants expressed willingness to be vaccinated during their current pregnancy. Participants with only a high school education had a significantly greater intention for vaccination (95 % CI: 1.4-3.2, p < 0.005) in the multivariate analysis compared to participants with university degrees. Participants with underlying health conditions had a higher intention of being vaccinated (95 % CI: 1.2-1.9, p < 0.005). The main reason for vaccine refusal was the belief that influenza vaccines could have adverse effects on the fetus (28.4 %); belief that vaccines could harm their pregnancy (24.3 %); and concern about vaccine effectiveness (10.6 %).These findings are important as they can inform targeted strategies and policy updates to facilitate influenza vaccine implementation and improve uptake among pregnant women in Kyrgystan, and may support strengthening of national influenza vaccine programs in other countries in Central Asia.

New approach for tuberculosis contact tracing implemented in the two regions of Kyrgyz Republic during 2017-2018.

INTRODUCTION: Tuberculosis (TB) contact investigation as a proved approach for finding new TB cases, is not fully performed in Kyrgyzstan. In 2018, the country started aligning the National Guidelines for tracking contacts with the WHO recommendations by expanding the definition for TB index cases to all close contacts, regardless of their TB risk status. METHODOLOGY: This cross-sectional census aimed to determine the active case detection changes among TB contacts after implementation of a new TB tracing strategy using the National Surveillance data. We compared populations in Chui and Issyk-Kul regions of Kyrgyzstan who had contacts with TB index cases before (2017) and after (2018) strategic changes for the rates of indexes, contacts, screened contacts, and detected TB among screened contacts. RESULTS: New TB tracing strategy resulted in increased numbers of indexes (21%) and contacts (36%). Though the smaller number of contacts (1730 vs. 1590) have been screened in 2018, the proportion of TB diagnosed was substantially higher (95% CI: 0.024-0.005; p = 0.002) in 2018 vs. 2017. The mean numbers of TB contacts per-one-index-case also has increased dramatically by 117% (1.8 vs. 3.9) in Chui and by 43% (3.0 vs. 4.3) in Issyk-Kul regions (95% CI: 3.20-3.37; p < 0.001 and 95% CI: 2.97-3.09; p < 0.001, respectively) between 2018 and 2017. CONCLUSION: Extending new tracing approach to other regions of Kyrgyzstan will increase the number of identified contacts, leading to better TB control in the country and prevention of more severe TB development among the unidentified contacts.