ASSOCIATION OF QUALITY OF LIFE WITH LIVER FIBROSIS AMONG PATIENTS TREATED FOR HEPATITIS C IN GEORGIA.

A seroprevalence survey was conducted in 2015 in Georgia among adults aged ≥18 years. This survey data was used to estimate anti-HCV seroprevalence in Georgia at 7.7% and HCV RNA prevalence at 5.4%. Treatment adherence, recovery and quality of life are interrelated, however, there are limited data on the role of successful antiviral treatments in changing the quality of life (QOL) of patients in Georgia. A questionnaire assessed the QOL for patients involved in the hepatitis C elimination program. Patient responses were analyzed to estimate the magnitude of any association between quality of life with the degree of liver fibrosis and various laboratory parameters. Liver fibrosis status was measured by the FIB4 score and liver elastography. We recruited 378 eligible adult participants who were beneficiaries of the hepatitis C elimination program (HCV RNA-positive) before the start of antiviral treatment. Of the surveyed individuals, 283 (77.5%) were males; the median age was 47 years (range 20 to 83). Almost 30% of participants had advanced liver fibrosis. The following factors were associated with advanced liver fibrosis: older age (PR=7.05; 95% CI:3.93-12.65), general weakness (PR=5.88; CI:2.23-15.45) and insomnia (PR=3.5, CI:1.37-9.19). Muscle pain (PR=2.75, CI:1.91-3.96) and abdominal pain (PR=3.23, CI:2.19-4.77) were more common among participants with a high FIB4 score; these patients were also more likely to report that liver disease affects family life (PR=4.23, CI:2.94-6.09). This study suggests that advanced liver fibrosis is associated with poorer QOL, an association that has been noted by research elsewhere in Europe. Given that the Georgian experience appears to be similar to other European countries, public health interventions to improve QOL may be expedited by collaboration with regional neighbors.

KNOWLEDGE RELATED TO HIV/TB/HCV AMONG PRIMARY HEALTH CARE WORKERS AND THE INTEGRATED SCREENING IN KVEMO KARTLI REGION.

Integration of TB/HIV/HCV screening into primary health care has been implemented in Georgia since 2018. The aim of the program is to strengthen TB, HIV/HCV screening and early detection capabilities in the primary health care, as early detection and treatment are considered to be the most effective strategies to prevent these infections. The goal of the study was to evaluate and compare the baseline and follow-up knowledge about TB, HIV and HCV infectious among primary health care workers in Kvemo Kartli Region. The study instrument was a self-administered questionnaire. A total of 459 primary HCWs from Kvemo Kartli region were surveyed. The proportion of HCWs correctly knowing MDR TB definition increased from 34.6% to 82.8% and this difference was statistically significant (p<0.01). Nurses were less informed about HIV infection. Only 70.7% of them knew modes of HIV transmission, while 89.3% of physicians answered this question correctly (p<0.001). An assessment of knowledge among primary health care workers (PHC) providers is important, as they represent the first level of community contact with health care. The post-test after the training showed significant improvement in knowledge among trained HCWs. Follow-up knowledge and practice surveys are needed to understand the long-term impact of training on the rate screening referrals by PHC providers.

KNOWLEDGE OF GEORGIAN POPULATION TOWARDS AIR POLLUTION AND HEALTH EFFECTS OF LEAD CONTAMINATION.

The goal of this study was to assess the level of knowledge about air pollution and the health effects of lead exposure among the population of Georgia. In 2019, a project entitled "Protect Environment" was conducted by the National Center for Disease Control and Public Health and the Health Research Union. The online survey was carried out using a Facebook advertisement, which included the title, body text, the banner, and a link to the questionnaire. The target population was the entire country and the language used was Georgian. We collected information on knowledge about health problems caused by polluted air, diverse environmental pollutants (such as the smoke of burning leaves, cigarette butts and smoke, effects of lead), and the effectiveness of a face mask to filter pollutants. Finally, we assessed awareness of the informational website www.air.gov.ge. The study was conducted over 3 days among 349 respondents in October 2019. Most (90.3%) of the respondents correctly answered the question related to air pollution causing different types of diseases, a similar proportion were concerned about the impact of environmental pollution and the impact of exposure to lead (76.8%). These findings indicate the importance of promoting educational websites that provide detailed information about various contaminants, as well as different preventive measures to mitigate environmental pollution. This study provides important information about the level of awareness among the Georgian population regarding air pollution and lead poisoning, research which is still very nascent. These findings should inform the development of educational campaigns to raise awareness about air pollution.

AWARENESS AND ATTITUDE TOWARDS COVID-19 AMONG STUDENTS OF MEDICAL UNIVERSITIES IN TBILISI, GEORGIA.

On December 31st, 2019, a disease, now known as COVID-19, caused by novel coronavirus was detected in Wuhan, China. Since then, new cases of COVID-19 emerge all over the world each day, having a fatal outcome chiefly in those who belong to high risk groups. In order to prevent the disease spread, health regulations have been brought in by the authorities. They have become obligatory to follow in numerous countries, including Georgia, which confirmed its first case in Tbilisi on February 26. During the pandemic, it is crucial for people, especially health care workers to have access to reliable information regarding the disease and its spread. One of the most important groups in this field are the medical students. The purpose of this study was to evaluate awareness and attitude towards COVID-19 among medical students in Tbilisi, Georgia. An online survey was conducted using Google forms and posted in Facebook groups. There were 18 questions in total and the language used was Georgian. All questions were marked as "required" to encourage completion. In total, 178 participants completed the questionnaire from 4 different medical universities of Tbilisi. Answers were compared to a study done locally among the Georgian population regarding knowledge and attitude towards COVID-19, as well as a survey conducted among Iranian medical students concerning the same topic. Our results showed that majority of participants had a high degree of knowledge about the coronavirus transmission, high proportion of students reported practicing social distancing, however some students struggled with distinguishing between coronavirus and influenza. This is the first study estimating COVID-19 knowledge among medical students in Georgia, however it needs further research to assess the situation in other medical universities and attain a larger sample to see a more accurate picture. It would also be interesting to conduct an updated version of the survey, in order to evaluate whether there has been an increase in awareness about this subject.

KNOWLEDGE RELATED TO THE NOVEL CORONAVIRUS (SARS-COV-2) AMONG GEORGIAN POPULATION.

Georgia confirmed its first case of SARS-COV-2 infection on February 26, 2020. Despite the government's proactive measures during the early stages of the epidemic, number of new infections of SARS-COV-2 is increasing and by March 31, a total of 110 cases have been reported. Limited understanding about epidemics can lead to panic and disrupt public health efforts to contain transmission. Thus, it is very important to understand the perceptions of the population regarding the disease and perceived level of government preparedness to fight against the spread of infection. This study reports results of a survey designed to understand attitudes and knowledge regarding SARS-COV-2 virus among Georgian population, including health care workers (HCWs). The online survey was conducted using a Facebook advertisement. The target was the whole country and the language used was Georgian. We collected information on demographic data, knowledge of symptoms and transmission modes of coronavirus, perceived differences between coronavirus and influenza, availability of antiviral medication and vaccination. We also included questions to capture the Georgian population's perceptions about government preparedness to combat the new coronavirus. The survey was open for three days (March 2-4, 2020). 5228 participants completed the survey. Of these, 40.3% were 25-45 years old and 58.2% were female. 20.7% of respondents had university degree and 10.3% were HCWs. For 25.8% of respondents, COVID-19 and influenza are the same diseases; 10.9% did not know if they are different. The majority correctly identified the transmission route and symptoms (96.9% and 98.0%, respectively). Regarding physical distancing, 13.2% indicated they would attend public events if needed even if they had COVID-19 symptoms. 19.1% think that Georgia is ready for COVID 19 epidemic, while according to 55% the county is not ready, but HCWs are trying hard to respond to this challenge properly. For 18% response is inadequate. There was no difference in knowledge between HCWs, non-HCWs and unemployed. 20% of HCWs as well as other study subjects believe that SARS-COV-2 vaccine and medications do exist but are simply not available in Georgia. One in five Georgians believe that there is a vaccine and medication to treat coronavirus, but that it is not available in the country. Given that information regarding coronavirus is changing very rapidly, the need to reach people with time-sensitive educational messages as well as prevention strategies is vital. Three months have elapsed since discovery of the novel coronavirus causing severe acute respiratory syndrome and classified as SARS-COV-2.