The COVID-19 pandemic and mental health in Kazakhstan.

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

Study of seroprevalence of SARS-CoV-2 in Kazakhstan.

This study aimed to analyse the seroprevalence of SARS-CoV-2 in Kazakhstan. This is a cross-sectional study of adult population in Kazakhstan for the period from October 2021 to May 2022. For the study, 6 720 people aged 18 to 69 were recruited (from 17 regions). The demographic data were collected and analysed. Gender was evenly distributed (males 49.9%, females 50.1%). Women exhibited a higher seroprevalence than men (IgM 20.7% vs 17.9% and IgG 46.1% vs 41.5%). The highest prevalence of IgM was found in the age group of 30-39. However, the highest prevalence of IgG was detected in the age group of 60-69. The seroprevalence of IgG increased across all groups (from 39.7% in 18-29 age groups to 53.1% in 60-69 age groups). The odds for a positive test were significantly increased in older age groups 50-59 (p < 0.0001) and 60-69 (p < 0.0001). The odds of a positive test were 1.12 times higher in females compared to males (p = 0.0294). The odds for a positive test were significantly higher in eight regions (Astana, Akmola, Atyrau, Western Kazakhstan region, Kostanai, Turkestan, Eastern Kazakhstan region, and Shymkent) compared to Almaty city. The odds of a positive test were three times higher in Astana and the Western Kazakhstan region than in Almaty city. In urban areas, the odds of a positive test were 0.75 times lower than in rural areas (p < 0.0001). The study's results showed an adequate level of seroprevalence (63%) that exceeds the essential minimum of herd immunity indicators in the country. There was significant geographic variability with a higher prevalence of IgG/IgM antibodies to SARS-CoV-2 in rural areas.

Foregoing medicines in the former Soviet Union: changes between 2001 and 2010.

Pharmaceutical costs dominate out-of-pocket payments in former Soviet countries, posing a severe threat to financial equity and access to health services. Nationally representative household survey data collected in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine were analysed to compare the level of population having to forego medicines in 2001 and 2010. Subgroup analysis was conducted to assess differences between populations of different economic status, and rural and urban populations. A substantial proportion of the population did forego medicines in 2010, from 29.2% in Belarus to 72.9% in Georgia. There was a decline in people foregoing medicines between 2001 and 2010; the greatest decline was seen in Moldova [rate ratio (RR)=0.67 (0.63; 0.71)] and Kyrgyzstan [RR=0.63 (0.60; 0.67)], while very little improvement took place in countries with a higher Gross National Income (GNI) per capita and greater GNI growth over the decade such as Armenia [RR=0.92 (0.87; 0.96)] and Georgia [RR=0.95 (0.92; 0.98)]. Wealthier, urban populations have benefited more than poorer, rural households in some countries. Countries experiencing the greatest improvement over the study period were those that have implemented policies such as price controls, expanded benefits packages, and encouragement of rational prescribing. Greater commitment to pharmaceutical reform is needed to ensure that people are not forced to forego medicines.