An ethnoveterinary study of wild medicinal plants used by the Kyrgyz farmers.

ETHNOPHARMACOLOGICAL RELEVANCE: In their centuries-old nomadic life, since their livestock was the backbone of their lives, the Kyrgyz people used a variety of wild medicinal plants for ethnoveterinary practices. However, the plants used for the treatment of livestock ailments never have been recorded, except rarely in local publications. In this study, we present the HSHR (homemade single species herbal remedy reports), their methods of preparation and application, and the livestock ailments for which these remedies were used. AIMS: The collect data from the five different high-altitude valleys of the Kyrgyz Republic on common HSHR used for the treatment of the livestock ailments and describe their preparation procedure, administration, and target animal species. MATERIALS AND METHODS: The plant species mentioned for ethnoveterinary use were collected from five different high-altitude valleys (pastures) in the Kyrgyz Republic during 2016 and 2018. Data were gathered with the help of dialog partners (experienced local shepherds, farmers and veterinarians) through semi-structured interviews. In total, 166 dialog partners were interviewed. The special characteristics of HSHR mentioned for ethnoveterinary use and practices were documented. Plant samples and voucher specimens were collected for taxonomic identification, and preserved for future reference. RESULTS: A total of 2388 HSHR referred to 66 plant species mentioned for ethnoveterinary use belonging to 27 families and 49 genera. According to the data, species of the family Asteraceae were most frequently used HSHRs in the Kyrgyz ethnoveterinary practice (599 HSHR, 25%), followed by Polygonaceae (166 HSHR, 7%), Lamiaceae (141 HSHR, 6%), Ranunculaceae (121 HSHR, 5%), Nitrariaceae (119 HSHR, 4.9%), Apiaceae (113 HSHR, 4.7%), Cupressaceae (111 HSHR, 4.6%), Urticaceae (100 HSHR, 4.2%), Gentianaceae (92 HSHR, 3.8%), Amaranthaceae (87 HSHR, 3.6%). A total of 2785 UR (use reports) were collected for the 2388 HSHR. Infection diseases (572 UR, 20.5%), parasitic diseases (531 UR, 19%), gastrointestinal disorders (523 UR, 18.77%) and wounds (522 UR, 18.74%) were almost evenly reported indications. The largest number use reports (UR) were for cattle (967 UR, 34.7%) and horses (919 UR, 33%), followed by 607 UR (21.8%) for sheep and 292 UR (10.48%) for other domestic animals, including dogs (106 UR, 3.8%), goats (103 UR, 3.69%) and donkeys (83 UR, 2.98%). CONCLUSION: In this study, we identified the folk ethnoveterinary knowledge of the HSHR used by the Kyrgyz farmers in their daily veterinary practice. All the characterized HSHR are of value to the local animal breeders. This knowledge has previously been limited to local shepherds, farmers and vets. Many of these need scientific confirmation using modern methods of phytochemistry and pharmacology.

Widespread collapse, glimpses of revival: a scoping review of mental health policy and service development in Central Asia.

PURPOSE: We aimed to map evidence on the development of mental health care in Central Asia after 1991. METHOD: We conducted a scoping review complemented by an expert review. We searched five databases for peer-reviewed journal articles and conducted grey literature searching. The reference lists of included articles were screened for additional relevant publications. RESULTS: We included 53 articles (Kazakhstan: 13, Kyrgyzstan: 14, Tajikistan: 10, Uzbekistan: 9, Turkmenistan: 2, Multinational: 5). Only 9 were published in internationally recognised journals. In the 1990's mental health services collapsed following a sharp decline in funding, and historically popular folk services re-emerged as an alternative. Currently, modernised mental health policies exist but remain largely unimplemented due to lack of investment and low prioritisation by governments. Psychiatric treatment is still concentrated in hospitals, and community-based and psycho-social services are almost entirely unavailable. Stigma is reportedly high throughout the region, psychiatric myths are widespread, and societal awareness of human rights is low. With the exception of Kyrgyzstan, user involvement is virtually absent. After many years of stagnation, however, political interest in mental health is beginning to show, along with some promising service developments. CONCLUSIONS: There is a substantial knowledge gap in the region. Informed decision-making and collaboration with stakeholders is necessary to facilitate future reform implementation.

Four years after implementation of a national micronutrient powder program in Kyrgyzstan, prevalence of iron deficiency and iron deficiency anemia is lower, but prevalence of vitamin A deficiency is higher.

BACKGROUND/OBJECTIVES: In 2009, the Ministry of Health of Kyrgyzstan launched a national Infant and Young Child Nutrition (IYCN) program which included point-of-use fortification of foods with micronutrient powders (MNP) containing iron, vitamin A, and other micronutrients. Caretakers of children aged 6-23 months were given 30 sachets of MNP every 2 months. Micronutrient surveys were conducted in 2009 and 2013. The objective of the study was to compare the prevalence of anemia and deficiencies of iron and vitamin A among children aged 6-29 months prior to the MNP program (2009) with those after full implementation (2013). SUBJECTS/METHODS: Cross-sectional national surveys were conducted in 2009 (n = 666) and 2013 (n = 2150). Capillary blood samples were collected to measure hemoglobin, iron (ferritin and soluble transferrin receptor [sTfR]) and vitamin A (retinol binding protein [RBP]) status, and inflammation status (C-reactive protein [CRP] and α-1-acid glycoprotein [AGP]). Ferritin, sTfR, and RBP were adjusted for inflammation; hemoglobin was adjusted for altitude. RESULTS: The prevalence of anemia was non-significantly lower in 2013 compared to 2009 (32.7% vs. 39.0%, p = 0.076). Prevalence of inflammation-adjusted iron deficiency (54.8% vs. 74.2%, p<0.001) and iron deficiency anemia (IDA, 25.5% vs. 35.1%, p = 0.003) were lower and the prevalence of inflammation-adjusted vitamin A deficiency was higher (4.3% vs. 2.0%, p = 0.013) in 2013 compared to 2009. CONCLUSIONS: Four years after the initiation of a national Infant and Young Child Nutrition program including the introduction of point-of-use fortification with MNP, the prevalence of iron deficiency and IDA is lower, but the prevalence of vitamin A deficiency is higher.

Effects of a large-scale micronutrient powder and young child feeding education program on the micronutrient status of children 6-24 months of age in the Kyrgyz Republic.

BACKGROUND/OBJECTIVES: To combat iron and other micronutrient deficiencies, the Ministry of Health of the Kyrgyz Republic launched a regional Infant and Young Child Nutrition (IYCN) program in 2009, which included promotion of home fortification with micronutrient powder (MNP) containing iron (12.5 mg elemental iron), vitamin A (300 µg) and other micronutrients. Every 2 months children aged 6-24 months were provided 30 sachets to be taken on a flexible schedule. The objective was to assess biochemical indicators of iron and vitamin A status among children aged 6-24 months at the baseline and follow-up surveys. SUBJECTS/METHODS: Cross-sectional representative cluster surveys were conducted in 2008 (n=571 children) and 2010 (n=541). Data collected included measurement of hemoglobin, serum ferritin, soluble transferrin receptor (sTfR), retinol-binding protein, C-reactive protein (CRP) and α1-glycoprotein acid (AGP). RESULTS: Among all children, declines were observed in the prevalence of: anemia, 50.6% versus 43.8% (P=0.05); total iron deficiency (either low ferritin or high sTfR), 77.3% versus 63.7% (P<0.01); and iron deficiency anemia, 45.5% versus 33.4% (P<0.01). Among children without inflammation as measured by CRP and AGP, similar declines were observed, but only declines in total iron deficiency and iron deficiency anemia reached statistical significance. Among all children and those without inflammation, the prevalence of vitamin A deficiency remained the same. CONCLUSIONS: One year after the introduction of home fortification with MNP, within a larger IYCN program, the prevalence of anemia, iron deficiency and iron deficiency anemia declined, but vitamin A deficiency remained unchanged.

Daily use of Sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster-randomized trial.

BACKGROUND: Iron-deficiency anemia is widespread among young children in the Kyrgyz Republic, and there is an urgent need to identify an effective intervention to address this significant public health problem. OBJECTIVE: To test the effectiveness of a 2-month intervention with daily home fortification of complementary food using micronutrient powder (Sprinkles) in reducing anemia among children 6 to 36 months of age in the Kyrgyz Republic. METHODS: In this cluster-randomized, community-based effectiveness trial conducted in three regions of the Kyrgyz Republic, 24 clusters of children aged 6 to 36 months were randomly assigned to two groups. The intervention group (12 clusters, n = 1,103) received 60 sachets of micronutrient powder (12.5 mg elemental iron), which were taken as one sachet daily for 2 months. The control group (12 clusters, n = 1,090) did not receive micronutrient powder until after the study period. Blood hemoglobin concentration was assessed at the start and end of the intervention. RESULTS: From baseline to follow-up, the mean hemoglobin concentration in the intervention group increased by 7 g/L, whereas it decreased by 2 g/L in the control group (p < .001). The prevalence of anemia (hemoglobin < 110 g/L) in the intervention group decreased from 72% at baseline to 52% at follow-up, whereas it increased from 72% to 75% in the control group (p < .001). Compliance with the intervention was high, with children consuming on average 45 of the 60 sachets given. CONCLUSIONS: A course of 60 Sprinkles micronutrient powder sachets taken daily for 2 months is effective in improving hemoglobin levels and reducing the prevalence of anemia among young children in the Kyrgyz Republic.

The current salt iodization strategy in Kyrgyzstan ensures sufficient iodine nutrition among school-age children but not pregnant women.

OBJECTIVE: Although goitre and cretinism were brought under control in Kyrgyzstan during the 1960s by centrally directed iodized salt supplies, iodine-deficiency disorders (IDD) had made a comeback when the USSR broke up in 1991. Upon independence, Kyrgyzstan started developing its own salt processing industry and by 2001 the Government enacted a law on IDD elimination, mandating universal salt iodization (USI) at 25-55 mg/kg. The present study aimed to evaluate the effectiveness of the USI strategy on the iodine consumption, iodine status and burden of IDD in the population of Kyrgyzstan. DESIGN: A national, population-representative survey during autumn 2007 collected household salt and urine samples of school-age children and pregnant women for quantitative iodine measurements. Thyroid volume was measured by ultrasound. RESULTS: The median iodine content in household salt was 11.2 mg/kg; 97.9 % of salt samples were iodized, but only 39.5 % had >or=15 mg iodine/kg. The median urinary iodine concentration (UIC) of 114 microg/l in children did not differ from the UIC of 111 microg/l in pregnant women. Thyroid volume in pregnant women increased with the duration of pregnancy. Strong relationships existed between salt iodine levels and the UIC values in children and women. CONCLUSIONS: The iodine nutrition status of the Kyrgyz population is highly responsive to household salt iodization. Although the results in children suggest adequate iodine nutrition, the iodine consumption among pregnant women did not assure their dietary requirements. In-depth analysis of the survey data suggest that excess iodine intake is not likely to become a public health concern in Kyrgyzstan when the salt supply meets agreed standards.

[Hygienic evaluation of work conditions and morbidity parameters among workers engaged into oil and gas extraction in Kyrgyz Republic].

The article covers hygienic evaluation of work conditions and morbidity parameters among workers engaged into oil and gas extraction in Kyrgyz Republic. Work conditions are characterized by physical, chemical and psychophysiologic occupational hazards that, if long-lasting, could promote formation of occupational diseases. Results of the study helped to specify prophylactic measures.

Epidemic diphtheria in the Kyrgyz Republic, 1994-1998.

The Kyrgyz Republic experienced a widespread diphtheria epidemic during 1994-1998. National diphtheria surveillance and vaccination coverage information were used to describe the course of the epidemic. The epidemic began in August 1994, reached a peak in 1995 with 704 cases (incidence rate: 15.4/100,000 population) and 30 deaths, and declined to an incidence rate of 4.0/100,000 during the first 8 months of 1998. Age-specific incidence was highest in 1995 among persons 15-19 and 20-29 years old. Three rounds of mass vaccination with tetanus and diphtheria toxoids for adult use (Td) were conducted; reported coverage was 69% in 1995 and >95% in 1996 and 1997. Reported routine vaccination coverage with three doses of diphtheria toxoid by age 12 months increased from 62% in 1989 to 98% in 1997. Mass vaccination of the adult population with Td and improvements in childhood vaccination coverage played a major role in controlling the epidemic.