RESUMO
The research aimed to assess dietary exposure to developmental toxicants (Mo, Ni, Pb) among the Armenian adult female population of reproductive age (18-49 years). Commonly consumed foods with a daily intake of more than 1 g in Armenia have been selected to assess the occurrence of Mo, Ni, and Pb. Food consumption data among the adult population in Armenia were collected in the frame of the national survey via 24-h recall method. Estimated daily intakes (EDI) and associated potential health risks for both mean and high (95 percentile) consumers were assessed based on the health-based guidance values (HBGVs). None of the EDI values for the developmental toxicants via individual food consumption exceeded the HBGVs, however, the EDI of Pb in the case of aggregate consumption of all food products exceeded HBGV of 0.5 µg/kg b.w./day, indicating possible concerns for the neurodevelopmental effects. Noticeably, the intake of Pb through some individual food items (cheese curd, beef and veal, pelmeni and khinkali, black coffee, tap water) and the aggregate consumption of all the studied foods led to a Margin of Exposure lower than 10 compared to HBGV.This study is the first one carried out on dietary exposure to developmental toxicants among women of fertile age in a Caucasus country. The outcomes prompt the need to investigate sources of Pb pollution in foods consumed in Armenia (natural or human-derived environmental pollution, as well as food contact materials, etc.) and may pave the way for similar studies in the Caucasus region.
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Oligoelementos , Adulto , Animais , Feminino , Humanos , Bovinos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Níquel/toxicidade , Níquel/análise , Molibdênio , Exposição Dietética , Armênia/epidemiologia , Chumbo , Substâncias Perigosas , Medição de Risco , Contaminação de Alimentos/análiseRESUMO
The research aimed to investigate the impact of different forms of periodontitis on patients quality of life (QoL) and anxiety. 80 patients with chronic periodontitis were involved in the study. Oral Health Impact Profile scale was used to evaluate the QoL, and Spielberger State-Trait Anxiety Inventory for the assessment of the individual and situational anxiety. The total QoL scores for chronic local and generalized periodontitis were 71.54 and 90.67, respectively. The mean scores of situational and individual anxiety scales were higher among patients with generalized chronic periodontitis. The highest QoL scores, which indicate worst quality of life, were registered among unemployed patients, those who didn't know about oral cavity hygienic means and rules, had accompanying diseases and were widowed. The results of the study indicated that periodontal diseases negatively impact an individual's QoL and anxiety level, especially in patients suffering from chronic generalized periodontitis compared to patients with local periodontitis.
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Periodontite Crônica , Humanos , Qualidade de Vida , Armênia , Ansiedade , Transtornos de AnsiedadeRESUMO
Adequate dietary iron (Fe) intake is crucial for preventing Fe-deficient anemia, a recognized global public health concern which is important in Armenia. This study aimed to analyze the intake of Fe, both heme (from animal tissues) and non-heme (more prevalent, but less efficiently absorbed), as well as the Fe dietary sources, among adults in a representative national sample in Armenia. The study was conducted on 1400 individuals aged 18-80 and above, who were enrolled from all regions of Armenia. The Fe intake was assessed through a 24 h dietary recall survey, while Fe occurrence was determined through atomic absorption spectrophotometry (AAS). The results showed a high proportion of adults with a Fe intake lower than the average requirements set by EFSA (65%, 80% and 85% of males, total females and females at fertile age, respectively). Main Fe sources were bread, fruits and vegetables; heme Fe accounted only for <5% of total Fe intake. Compared to males, females had a lower intake of all forms of Fe (p < 0.05). Significant differences were observed in the intake of different forms of Fe between regions (p < 0.05), while the age-group 36-55 years had higher intakes of total Fe. Our data call for comprehensive nutritional security strategies in order to reduce iron deficiency in Armenia, that represents a public health concern.
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Heme , Estado Nutricional , Masculino , Feminino , Animais , Armênia/epidemiologia , Dieta , FerroRESUMO
Background: The natural environment of southeastern Armenia, which includes the Syunik and Vayots Dzor regions, provides a high biodiversity of flora and fauna, including ectoparasites. Currently, the fauna and ecology of gamasid ticks and their role in the circulation of tularemia in this area are unclear and incomplete. To better understand the persistence of tularemia in Armenia, an assessment of specific hosts and their vectors is needed to evaluate their role in perpetuating tularemia. Materials and Methods: Utilizing data and samples collected from 1970 to 2020, we have evaluated the species composition of gamasid ticks found on the common vole and in their nests and burrows, and identified the presence of tularemia over time. We evaluated five different geographical landscapes: semidesert, dry mountain steppe, mountain steppe, mountain forest, and high mountain in the communities and open areas of Kapan, Goris, Sisian, Meghri, and Jermuk. Results: We determined the density of gamasid ticks in southeastern Armenia over the 50-year period and isolated 20 cultures of tularemia in 12 separate years. Conclusions: It is important to regularly monitor gamasid ticks in southeastern Armenia to clarify the risk factors for the occurrence of tularemia epizootics, among both carriers and vectors, to better understand the full epidemiological picture.
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Doenças dos Roedores , Carrapatos , Tularemia , Animais , Armênia/epidemiologia , Arvicolinae , Tularemia/epidemiologia , Tularemia/veterináriaRESUMO
The purpose of the research is to study and comparatively evaluate the changes in HRV indicators in functional tests of various directions. HRV was studied in 50 elite athletes (athletics, wrestling, judo, football) , at age 20-26 years old. The research was held in the scientific research laboratory of the Armenian State Institute of Physical Culture and Sport using the hardware - software complex "Varikard 2.5.1, Iskim - 6.2. The studies were carried out in the morning, in the preparatory phase of the training process, at rest and during functional testing. In orthotest HRV was recorded at rest 5 min supine followed by 5 min standing. 20 minutes later, a treadmill test was carried out on Treadmill Proteus LTD_7560 with a gradually increasing load (1 km/h per minute) until exhaustion. The duration of test was 13-15 minutes, HRV recorded after test 5 min supine. HRV time indicators - HR(b/m), MxDMn(ms), SI (un) and frequency (spectral) indicators - TP (ms2), HF (ms2), LF (ms2), VLF(ms2) are analyzed. The degree and direction of changes in HRV indicators are connected with the different type of stress factors, their intensity and duration. The HRV time indicators in both tests change unidirectionally: sympathetic activation causes an increase in heart rate, a decrease in the variation range MxDMn and an increase in the stress index SI, with the greatest degree of shifts in the treadmill test. The spectral indicators of HRV in both tests vary in different directions. In orthotest, the vasomotor center is activated, expressed by an increase in LF wave amplitude against the background of a decrease in the HF wave, but without a significant reaction from the total power of the TP spectrum and the humoral-metabolic component VLF. With the treadmill test, there is an energy-deficient state, expressed by a sharp decrease in TP wave amplitude and all spectral indicators reflecting the activity of individual management levels of heart rhythm control. The picture of correlation links emphasizes the balanced functioning of the autonomic nervous system at rest, increased sympathetic activity and regulation centralization in orthotest, as well as an imbalance of autonomic regulation in treadmill test.
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Atletas , Esportes , Humanos , Adulto Jovem , Adulto , Frequência Cardíaca , Armênia , Sistema Nervoso AutônomoRESUMO
Mining leads to excessive heavy metal contamination of agricultural products in Armenia and can adversely impact human health. We quantify the concentrations of toxic heavy metals (lead, nickel, cadmium, and mercury) in food sampled from local markets of the capital city, Yerevan. We combine these measured concentrations with data from a diet survey of 1,195 people. The results provide an estimate of people's heavy metal intake in a typical day. The study finds that only dietary exposure to lead raises consumer safety concerns. More than 50 % of the population have daily intakes of lead that exceed the benchmark dose level (BMDL10) of 0.63 µg/kg b.w./day established by European Food Safety Authority. Moreover, risk assessment results indicate that approximately 96 % of the population has dietary exposure values for lead that exceed the threshold level, with animal products as the primary source. The lead exposure observed in sampled population has the potential to increase blood pressure on average by 0.54 mmHg, lower IQ levels by 1.2 point, and reduce lifetime earnings by $5000. The study reveals a strong need to determine the specific pathways by which lead enters the food supply, to mitigate the excess exposures, and to reduce the potential or severity of the resulting adverse health impacts.
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Chumbo , Metais Pesados , Animais , Humanos , Chumbo/análise , Armênia , Estresse Financeiro , Metais Pesados/análise , Cádmio/análiseRESUMO
PTE contamination of soils remains one of the global environmental concerns. The ways of detecting and monitoring PTE concentrations in soils varies including traditional field sampling accompanied by sample preparation and chemical analysis and state of the art visible and near-infrared (Vis-NIR) spectroscopic approaches. Among the different Machine Learning (ML) to extract soil information from spectra and to explore the relationship between spectral reflectance data and soil PTE content PLSR method is a well-established one to construct a soil PTE estimation model. This study aimed to explore the relationship of soil PTE geochemical and VIS-NIR spectroscopy characteristics in agricultural soils near Cu-Mo mine area in Armenia. PLSR method is applied to identify the links between the spectra and agricultural soil Ti, V, Cr, Mn, Fe, Co, Ba, Pb, Zn, Cu, Sr, Zr and Mo contents to reveal the potential of VIS-NIR spectroscopy in ex-situ monitoring of Kajaran soils. The results show that different portions of VIS-NIR spectra are responsible for Ti (1100-1200 nm, 2350-2500 nm), V (350-500 nm, 700-750 nm, 1000-1100 nm, 1400-2500 nm), Cr (1300-1400 nm, 1900-2100 nm) and Ba (450-500 nm, 600-800 nm, 1050-1700 nm, 2000-2100 nm, 2350-2400 nm) estimations through PLSR correspondingly. However, among the studied PTEs Ti and V, which shows significant negative correlations in VIS-NIR spectra registered at around 400-600 nm and 850-1150 nm regions, are remarkable and promising with the PLSR estimation results using VIS-NIR spectra Ti (R2Test = 0.74), V (R2Test = 0.71). This study shows that VIS-NIR spectroscopy has a high potential for the estimation of at least several PTE in soils and PLSR modelis reliable for deriving information from there.
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Poluentes do Solo , Solo , Solo/química , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Armênia , Poluentes do Solo/análise , Aprendizado de Máquina , Monitoramento Ambiental/métodosRESUMO
INTRODUCTION: Childhood cancer (CC) is a leading cause of death among children aged 0-19 years worldwide. Each year, 400,000 new cases of CC are diagnosed globally. Given the between-country differences in CC incidence rates, types and trends, this study aimed to identify possible risk factors for CC in Armenia. METHODS: We used a case-control study design and enrolled participants from the only specialized pediatric hematology and oncology center in Armenia. Cases included patients ≤ 14 years old diagnosed and treated with a malignant disease between 2017 and 2020 in the centre. Controls included patients diagnosed and treated in the center during the same period for a non-malignant disease. We conducted telephone interviews with mothers of cases and controls. Independent risk factors of cancer were identified using multivariable logistic regression analysis. RESULTS: Overall, 234 participants (117 cases, 117 controls) were included in the study. Based on the fitted model, maternal usage of folic acid during pregnancy was protective against CC, almost twice decreasing its odds (OR = 0.54; 95% CI: 0.31-0.94). On the contrary, experiencing horrifying/terrifying event(s) during pregnancy (OR = 2.19; 95% CI: 1.18-4.07) and having induced abortions before getting pregnant with the given child (OR = 2.94; 95% CI: 1.45-5.96) were associated with higher odds for a child to develop cancer. CONCLUSION: Despite the limited sample size of the study, significant modifiable risk factors for CC in Armenia were identified, all of which were linked to the period of pregnancy. The data from this study adds to the limited information available from etiological CC research throughout the world, and it will increase understanding of CC risk factors in settings with small populations and low resources. Although these findings may be helpful for future research, they should be taken with caution unless validated from further larger-scale studies.
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Neoplasias , Feminino , Gravidez , Humanos , Criança , Adolescente , Estudos de Casos e Controles , Neoplasias/epidemiologia , Neoplasias/etiologia , Armênia/epidemiologia , Fatores de Risco , Ácido FólicoRESUMO
The main goal of this study is to compare the concentrations of anionic synthetic surfactants (ASS) in drinking and surface waters in Armenia and to explore possible relationship with diseases of the skin and digestive system. Surfactants are widely employed in numerous field of the economy, are in contact with the entire population throughout life and can be harmful to human health.The samples of drinking and surface waters (n = 144) were collected in Kotayk province to analyze ASS concentrations, physicochemical parameters and phytotoxic activity. The prevalence of diseases was analyzed for different population groups. ASS concentrations in surface waters were significantly higher in summer compared to spring (p = 0.006). In drinking water, concentrations were also higher in summer, but not significantly. In surface waters, ASS levels were 2.4-3 times higher compared to drinking (p = 0.03) and exceeded the permissible limit by 1.4-2.9 times in summer and fall. No phytotoxic activity and differences in both classes of diseases and age groups were revealed. The determination of ASS in both surface and drinking waters with the same trend showed their interrelation to a certain extent. This study provides important information for future research and action which will contribute to the sustainable development of local communities.
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Água Potável , Poluentes Químicos da Água , Humanos , Monitoramento Ambiental , Armênia , Tensoativos/toxicidade , Tensoativos/análise , Poluentes Químicos da Água/toxicidade , Poluentes Químicos da Água/análiseRESUMO
Health behavior theories have been effectively used for studying populations' awareness, attitudes, and beliefs related to COVID-19 preventative behaviors. The aim of this study was to explore the factors associated with the intention to get vaccinated against COVID-19 in the Armenian population using the Health Belief Model (HBM) as a framework. We applied stratified two-stage random sampling to conduct a telephone survey of 3,483 adults in 2021. The multi-domain survey instrument included questions on socio-demographic characteristics, COVID-19-related knowledge, COVID-19 susceptibility, severity and self-efficacy beliefs, sources of information on COVID-19, COVID-19 vaccination practice, and its benefits and barriers. We performed bivariate and hierarchical multivariate regression analysis with the entry of variables in blocks. In total, about 12% of the sample (n = 393) was vaccinated against COVID-19. Of 2,838 unvaccinated participants, about 53% (n = 1516) had an intention to get vaccinated. The final hierarchical logistic regression model containing socio-demographic characteristics, knowledge about COVID-19, and HBM constructs explained 43% of the variance in the intention to get vaccinated against COVID-19. Participants' age, employment status, average monthly expenditures, perceived threat, benefits, perceived barriers, self-efficacy, and cues to action were significant and independent predictors of the intention to get COVID-19 vaccination. This study confirmed the utility of the HBM in highlighting drivers of an important health-protective behavior in the context of pandemics. Health policy makers, communication specialists, and healthcare providers should particularly stress the effectiveness and safety of the vaccines in their efforts to increase vaccination rates and focus on unemployed and low-income population groups.
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COVID-19 , Adulto , Humanos , Armênia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Vacinação , Comunicação , IntençãoRESUMO
BACKGROUND: There are an estimated 460,000 Armenians in the United States, and more than half live in California. Armenian-Americans are generally represented within the 'White' or 'Some Other Race' race categories in population-based research studies. While Armenians have been included in studies focused on Middle-Eastern populations, there are no studies focused exclusively on Armenians due to a lack of standardized collection of Armenian ethnicity in the United States or an Armenian surname list. To fill this research gap, we sought to construct and evaluate an Armenian Surname List (ASL) for use as an identification tool in public health and epidemiological research studies focused on Armenian populations. METHODS: Data sources for the ASL included the California Public Use Death Files (CPUDF) and the Middle Eastern Surname List (MESL). For evaluation of the ASL, the California Cancer Registry (CCR) database was queried for surnames with birthplace in Armenia and identified by the MESL. RESULTS: There are a total of 3,428 surnames in the ASL. Nearly half (1,678) of surnames in the ASL were not identified by the MESL. The ASL captured 310 additional Armenian surnames in the CCR than the MESL. CONCLUSIONS: The ASL is the first surname list for identifying Armenians in major databases for epidemiological research.
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Etnicidade , Saúde Pública , Humanos , Armênia/epidemiologia , Sistema de Registros , Coleta de DadosRESUMO
PURPOSE: Congenital stromal corneal dystrophy (CSCD) is a rare congenital, dominantly inherited disorder characterized by diffuse stromal opacification associated with mutations in the decorin gene ( DCN ). As only 5 families with genetically confirmed CSCD have been reported, the identification of a novel pedigree provides the opportunity to better characterize the phenotype and genetic basis. METHODS: An Armenian family with individuals in 4 consecutive generations demonstrated clinical features consistent with CSCD. Consented individuals underwent slit lamp examination, optical coherence tomography, and confocal microscopy. Genomic DNA was collected from saliva and all coding and adjacent intronic regions of DCN were sequenced. In silico analysis was performed for identified mutation(s). Excised corneal tissue underwent light, electron microscopic, and immunohistochemical evaluation. RESULTS: Affected individuals demonstrated bilateral, diffuse, panstromal corneal opacification. Three of the 6 individuals diagnosed with CSCD underwent genetic analysis; all demonstrated a novel heterozygous frameshift deletion in exon 8 of DCN (p.His317Thrfs*11), predicted to cause a 33 amino acid truncation and to be damaging and disease causing by SIFT and MutationTaster. Light and electron microscopic examination of an excised cornea demonstrated increased corneal thickness, stromal scarring, keratocyte loss, and an irregularity of lamellar collagen spacing and fibril formation. Immunofluorescent examination demonstrated increased DCN immunostaining, predominantly in the widened interlamellar spaces. CONCLUSIONS: We report only the sixth pedigree with genetically confirmed CSCD, associated with a novel DCN frameshift mutation. The clinical evaluation, multimodal imaging, and histopathologic assessment in this family with CSCD broaden our understanding of this rare corneal disease.
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Distrofias Hereditárias da Córnea , Humanos , Decorina/genética , Decorina/metabolismo , Armênia , Distrofias Hereditárias da Córnea/genética , Mutação , Linhagem , Análise Mutacional de DNARESUMO
The Kura-Araxes (KA) cultural phenomenon (dated to the Early Bronze Age, c. 3500/3350-2500 BCE) is primarily characterised by the emergence of a homogeneous pottery style and a uniform 'material culture package' in settlements across the South Caucasus, as well as territories extending to the Ancient Near East and the Levant. It has been argued that KA societies practised pastoralism, despite a lack of direct examination of dietary and culinary practices in this region. Here, we report the first analyses of absorbed lipid residues from KA pottery to both determine the organic products produced and consumed and to reconstruct subsistence practices. Our results provide compelling evidence for a diversified diet across KA settlements in Armenia, comprising a mixed economy of meat and plant processing, aquatic fats and dairying. The preservation of diagnostic plant lipid biomarkers, notably long-chain fatty acids (C20 to C28) and n-alkanes (C23 to C33) has enabled the identification of the earliest processing of plants in pottery of the region. These findings suggest that KA settlements were agropastoral exploiting local resources. Results demonstrate the significance of applying biomolecular methods for examining dietary inferences in the South Caucasus region.
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Arqueologia , Indústria de Laticínios , História Antiga , Arqueologia/métodos , Dieta , Ácidos Graxos , ArmêniaRESUMO
INTRODUCTION: Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties.Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic. STUDY OBJECTIVE: This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers. METHODS: This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients. RESULTS: Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score -3.26; P value <.01) or as an EMS physician (z-score -2.76; P value <.01) as well as being at least 30 years old (z-score -2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%). CONCLUSION: Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.
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COVID-19 , Serviços Médicos de Emergência , Incidentes com Feridos em Massa , Ferimentos por Arma de Fogo , Humanos , Adulto , COVID-19/epidemiologia , Armênia/epidemiologia , Estudos Transversais , Pandemias , SARS-CoV-2RESUMO
This article focuses on develop the model of psychophysiological bases of well-being, for what Psychophysiological features of well-being of Armenian' student was investigated. For diagnosis of well-being was used the WHOQOL-1. The indicators of functional state were registered the indicators of heart rate variability. All student participated in anonymous research. The purpose of our study is to identify the relationship of students Psychological Wellbeing with physiological indicators as an indicator of physical health. The sample consisted of 140 voluntary respondents from different HEI (High Education Institute) from Armenia (45% female), aged 18-25 years (median age 22, 4), who participated in anonymous research. In the first stage, the students answered WHOQOL2. After the questions of the questionnaire Measuring Quality of Life, the functional indicators were registered in the laboratory "Sport Cab" of Armenian State Institute of Physical Culture and Sport. To identify the relationship between the indicators of functional state (physiological indicators) and the components of well-being of the students in the RA, a Pearson correlation analysis was performed. Psychological well-being was positively correlated with tension indicators and High Frequencies indicators. Negative correlations were found between almost all other indicators and psychological components of well-being. More interesting are those facts that no reliable links have been found between the "physiological indicators" of well-being and social relations. The obtained correlations between the studied indicators of psychological well-being and physiological indicators allow us to consider the indicators of the cardiovascular system not only as factors of physical health, but also as components of psychological well-being.
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Qualidade de Vida , Estudantes , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Masculino , Armênia , Estudantes/psicologia , Inquéritos e Questionários , EscolaridadeRESUMO
The increased antiretroviral therapy (ART) coverage of patients in the absence of routine genotyping tests and in the context of active labor migration highlight the importance of HIV-1 drug resistance (DR) surveillance in Armenia. We conducted a two-phase pretreatment DR (PDR) study in 2017-2018 (phase I; 120 patients) and 2020-2021 (phase II; 133 patients) according to the WHO-approved protocol. The analysis of HIV-1 genetic variants showed high degrees of viral diversity, with the predominance of A6. The prevalence of any PDR was 9.2% in phase I and 7.5% in phase II. PDR to protease inhibitors was found only in 0.8% in phase II. PDR to efavirenz and nevirapine was found among 5.0% and 6.7% of patients in phase I, and 6.0% and 6.8% of patients in phase II, respectively. The prevalence of PDR to nucleoside reverse-transcriptase inhibitors decreased from 5.0% in phase I to 0.8% in phase II. In addition, we identified risk factors associated with the emergence of DR-male, MSM, subtype B, and residence in or around the capital of Armenia-and showed the active spread of HIV-1 among MSM in transmission clusters, i.e., harboring DR, which requires the immediate attention of public health policymakers for the prevention of HIV-1 DR spread in the country.
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Fármacos Anti-HIV , Infecções por HIV , Soropositividade para HIV , HIV-1 , Minorias Sexuais e de Gênero , Humanos , Masculino , Gravidez , Feminino , HIV-1/genética , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Prevalência , Homossexualidade Masculina , Armênia/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Organização Mundial da Saúde , Genótipo , MutaçãoRESUMO
OBJECTIVE: Leukemia represents a serious public health concern as the incidence is increasing worldwide. In this study we aimed to describe the epidemiological profile of acute lymphoblastic (ALL) and myeloid (AML) leukemia, identify disease clusters and find association with possible risk factors. METHODS: Data on leukemia cases were provided by the National Institute of Health of the Republic of Armenia for the period of 2012-2018. Age-standardized incidence rate was calculated using Segi World Population. SaTScan purely spatial analysis was applied to find leukemia clusters. To find association between leukemia and agricultural and mining activities and demographic data Poisson regression model was used. RESULTS: During the studied period 259 new cases of ALL and 478 AML were recorded. The age-standardized incidence rate was 1.5 and 1.9 per 100,000 inhabitants with male to female ratio of 0.97 and 1.1 for ALL and AML, respectively. No significant changes in ALL or AML incidence trends were found. For ALL significant cluster encompassing Shirak, Lori, Tavush and Armavir provinces of Armenia was identified, while Kotayk and Ararat was provinces with the highest incidence of AML. We found significant positive association of ALL with crop density, while no elevated risk estimates were found between AML and exposure variables. CONCLUSION: Altogether, our results suggested that acute leukemias incidence in Armenia follows the pattern described for developing countries.
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Leucemia Mieloide Aguda , Pesquisa , Feminino , Masculino , Humanos , Incidência , Armênia/epidemiologia , Fatores de Risco , Leucemia Mieloide Aguda/epidemiologiaRESUMO
INTRODUCTION: The coronavirus disease (COVID-19) has led to millions of deaths around the world. The indirect effects of the pandemic, include disruption of routine immunization services. METHODOLOGY: We conducted a retrospective review to assess the impact of the pandemic on routine immunization in Yerevan and the vaccinations against COVID-19 in Armenia. We compared the number of administered doses of DPT/VHB/HIB/IPV1,2,3, Pneumococcal1,2,3, Rotarix1,2, and MMR1 vaccines in target groups in 2020 and 2021 and the total vaccination coverage in 2019, 2020, and 2021. We also analyzed the number of COVID-19 vaccines administered in Armenia from 17 May 2021 to 6 February 2022. RESULTS: There was a decline in the number of administered doses of vaccines at the beginning of the pandemic due to restrictive quarantine measures: 16 ± 4.5 (95% CI, 11.8-20.2), p < 0.05, during the second wave 18 ± 2.6 (95% CI, 15.6-20.4), p < 0.05 and during the interruption due to COVID-19 vaccine delivery 16 ± 7.4 (95% CI, 9.1-22.9), p < 0.05. There was no significant decrease in the number of vaccinations during the first, third, and fourth pandemic waves (p > 0.05) Overall, the COVID-19 vaccination process was slow and only 30% of the population were vaccinated. CONCLUSIONS: The COVID-19 pandemic led to disruptions in the routine immunization process, but there was no significant decrease in the total vaccine coverage due to rapid scaling up of the vaccination services and catch-up vaccinations. Thus, the restrictions imposed during the pandemic did not affect the overall progress of vaccination.
