Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.

STUDY OF DRIVER'S ATTITUDES TOWARDS ROAD SAFETY IN GEORGIA.

Introduction: Road traffic injuries are a global public health challenges and a leading cause of death and disability. This study examines the relationships between road traffic accident involvement, driving behaviors, and drivers' attitudes towards traffic safety in Georgia. Material and methods: Behavior of 200 Georgian drivers were reported using a self-administered questionnaire. The criteria for inclusion in the study were residency of Georgia and at least one year of driving experience. Results: A total of 200 Georgian drivers were interviewed. 59% of study participants felt that the road safety had not improved at all over the past ten years. 94% of respondents were involved in a road traffic accident as a driver. 99% of male drivers and 84% of female drivers have been fined for speeding in the last three years. 95% of males and 51% of females have experienced driving under the influence of alcohol once, and 2% of males and 43% of females have never driven under the influence of alcohol. Conclusions: The study demonstrated that alcohol consumption, using mobile phones while driving and speeding are very common among drivers in Georgia.

Study of Epidemiological Characteristics of Fatal Injuries Using Death Registry Data in Georgia.

Objective: This study aimed to evaluate epidemiological aspects of fatal injuries in Georgia. Methods: This was a retrospective, descriptive study that included all traumatic injury deaths in Georgia from January 1 to December 31, 2018. The National Center for Disease Control and Public Health of Georgia's Electronic Death Register database was utilized in this research. Results: Of the study fatal injuries, 74% (n=1489) were males. 74% (n=1480) of all fatal injuries were caused by unintentional injuries. Road traffic accidents (25%, n=511) and falls (16%, n=322) were the primary causes of mortality. During the research year, the number of Years of life lost (YLL) was associated with injuries and was increased to 58172 for both sexes (rate per 1000 population: 15.6). Most of the years were lost in the age group of 25-29 years (7515.37). Road traffic deaths accounted for 30% (17613.50) of YLL. Conclusion: Injuries are still a major public health problem in Georgia. In 2018, 2012 individuals died from injuries across the country. However, mortality and YLL rates of injury varied by age and cause of injury. To prevent injury-related mortality, it is crucial to conduct ongoing research on high-risk populations.

Epidemiological characteristics of injury in Georgia: A one-year retrospective study.

INTRODUCTION: Injury is a major health problem worldwide and a leading cause of death and disability. Disability caused by traumatic injury is often severe and long-lasting. Injuries place a large burden on societies and individuals in the community, both in cost and lost quality of life. Progress in developing effective injury prevention programs in developing countries is hindered by the lack of basic epidemiological injury data regarding the prevalence of traumatic injuries. The aim of this research was to describe the epidemiological characteristics of injury in all hospitals in Georgia. METHODS: The database of the National Center for Disease Control and Public Health of Georgia for 2018, which includes all hospital admissions, was used to identify injury cases treated in hospitals. Cases were included based on the S and T diagnosis coded of ICD-10. RESULTS: A total of 25,103 adult patients were admitted for an injury, of whom 14,798 (59%) were males and 10,305 (41%) were females, between the ages of 18 and 108 years old. The highest prevalence was among the age group 25-44 years old (n = 8654; 34%), followed by 45-64 years old (n = 6852; 27%). The main mechanism of injury was falls (n = 13,932; 55%) and exposure to mechanical forces (n = 2701; 11%). Over 1,50% (n = 379) of injuries resulted in death after hospitalization. The median hospital length of stay (LOS) was 2 days. There was a significant association between age, mechanism of injury, type of injury, performed surgical interventions, and longer LOS. CONCLUSION: Injuries are prevalent throughout the life course and cause substantial hospitalization time. This research can help focus prevention efforts can focus on the demographic and injury causes that are most prevalent.

Brain injuries: health care capacity and policy in Georgia.

BACKGROUND: Over 90% of morbidity and mortality associated with traumatic brain injury (TBI) occurs in low- and middle-income countries. Lack of reliable, high-quality data regarding TBI prevention and care hinders the ability to reduce TBI burden. We sought to identify current TBI data collection practices and capacity in Georgia, focusing on pre-hospital, hospital, and rehabilitation treatment. METHODS: The eight level I and two level II Trauma Hospitals in Georgia with the highest number of TBI admissions in 2017 were selected for study. A semi-structured survey about various aspects of TBI care was designed and semi-structured interviews of healthcare providers treating TBI patients (e.g. neurologists, neurosurgeons) were conducted based on this survey. RESULTS: Pre-hospital triage protocols were not routinely used to match patient treatment needs with hospital capacity. All hospitals provided specialist care for TBI 24 hours/day. MRI was available at only three (30%) centers, and in-hospital rehabilitation units were available in only one (10%). No center used a defined protocol for treating TBI patients and no national protocol exists. CONCLUSIONS: Even among the largest, most highly specialized hospitals in Georgia, TBI care varies in terms of diagnostic and treatment protocols. While TBI specialists are available, diagnostic equipment often is not. Gaps in pre-hospital coordination and access to rehabilitation services exist and provide areas of focus for future investment in reducing TBI burden.

Epidemiology of Traumatic Brain Injury in Georgia: A Prospective Hospital-Based Study.

PURPOSE: Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide, disproportionally affecting low- and middle-income countries (LMICs). Epidemiological characteristics of TBI at a national level are absent for most LMICs including Georgia. This study aimed to establish the registries and assess causes and outcomes in TBI patients presenting to two major trauma hospitals in the capital city -Tbilisi. PATIENTS AND METHODS: The prospective observational study was conducted at Acad. O. Gudushauri National Medical Center and M. Iashvili Children's Central Hospital from March, 1 through August, 31, 2019. Patients of all age groups admitted to one of the study hospitals with a TBI diagnosis were eligible for participation. Collected data were uploaded using the electronic data collection tool -REDCap, analyzed through SPSS software and evaluated to provide detailed information on TBI-related variables and outcomes using descriptive statistics. RESULTS: Overall, 542 hospitalized patients were enrolled during the study period, about 63% were male and the average age was 17.7. The main causes of TBI were falls (58%) and struck by or against an object (22%). The 97% suffered from mild TBI (GCS 13-15). Over 23% of patients arrived at the hospital more than 1 hour after injury and 25% after more than 4-hours post-injury. Moderate and severe TBI were associated with an increased hospital length of stay. Mortality rate of severe TBI was 54%. CONCLUSION: This study provides important information on the major epidemiological characteristics of TBI in Georgia, which should be considered for setting priorities for injury management.