Post-conflict acute stress reactions in Kazakhstan in the aftermath of January 2022 unrests: A national survey

Background

In January 2022 Kazakhstan experienced unprecedented nationwide protests that quickly turned to violent riots. Although the number of individuals affected physically by the disturbances were cited, the emotional toll of the events remains undetermined. The aim of this study was to evaluate the comparative rates of acute stress reactions in Kazakhstan in the aftermath of the unrests.

Methods

A cross-sectional, population-based online survey was conducted one month after the start of the disturbances. The study questionnaire were completed anonymously and included the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the General Anxiety Disorder-7 (GAD-7), as well as socio-demographic and event exposure information.

Results

Of the 7021 people who initially agreed to participate, 6510 were able to complete the full survey. For a cut-off of ≥3 on the PC-PTSD-5, 14.8 % of the study participants exhibited symptoms. With a cut-off of ≥4, this percentage reduced to 4.6 %. Participants from Almaty city and Almaty region who experienced the most extensive disturbances showed a doubled prevalence compared to the national level (30.0 % for a cut-off of ≥3, and 10.1 % for a cut-off of ≥4). At the national level, the prevalence of anxiety symptoms, defined as a score of ≥10 on the GAD-7, stood at 10.9 %. This prevalence decreased to 4.2 % when considering a cut-off of ≥15.

Conclusion

Health authorities of riot-affected areas ought to be aware of the population level mental health impact of the civil conflict and consider provision of targeted interventions to mitigate the long-term consequence of these lifespan disorders, while also seeking for the peaceful resolution of the ensuing conflicts.

Epidemiology of cerebral palsy in the Republic of Kazakhstan: Incidence and risk factors

Background

There is a paucity of robust data on the incidence and causes of cerebral palsy (CP) in Central Asian countries, while this information is important for planning local healthcare services. This epidemiological study was designed to clear the gap in knowledge on both the incidence of CP and the underlying risk factors in the Republic of Kazakhstan.

Methods

This was a retrospective study that comprised two stages. At the first stage, a cross-sectional analysis of CP frequencies was performed on the basis of official statistics obtained from the Republican Center for Health Development. A study with age- and sex-matched controls was carried out at the second stage to elucidate the maternal and neonatal risk factors associated with CP.

Results

Mild variability in national CP incidence was observed, ranging from 68.7 to 83.3 per 100,000 population. A number of maternal risk factors were significantly associated with CP, including arterial hypertension, thrombocytopenia, diabetes mellitus, pathology of fetal membranes, premature rupture of membranes, and acute respiratory illness during pregnancy. Low Apgar score, gestational age, birth weight, and presence of intraventricular hemorrhage or periventricular leukomalacia were among the important neonatal risk factors.

Conclusion

There is a need for a more comprehensive prospective study to document the extent of the CP problem in Kazakhstan. In addition, a national CP registry must be envisaged to overcome the lack of essential data.

Seropositivity of SARS-CoV-2 in the Population of Kazakhstan: A Nationwide Laboratory-Based Surveillance

The data on seroprevalence of anti-SARS-CoV-2 antibodies in Kazakhstani population are non-existent, but are needed for planning of public health interventions targeted to COVID-19 containment. The aim of the study was to estimate the seropositivity of SARS-CoV-2 infection in the Kazakhstani population from 2020 to 2021. We relied on the data obtained from the results from “IN VITRO” laboratories of enzyme-linked immunosorbent assays for class G immunoglobulins (IgG) and class M (IgM) to SARS-CoV-2. The association of COVID-19 seropositivity was assessed in relation to age, gender, and region of residence. Additionally, we related the monitoring of longitudinal seropositivity with COVID-19 statistics obtained from Our World in Data. The total numbers of tests were 68,732 for SARS-CoV-2 IgM and 85,346 for IgG, of which 22% and 63% were positive, respectively. The highest rates of positive anti-SARS-CoV-2 IgM results were seen during July/August 2020. The rate of IgM seropositivity was the lowest on 25 October 2020 (2%). The lowest daily rate of anti-SARS-CoV-2 IgG was 17% (13 December 2020), while the peak of IgG seropositivity was seen on 6 June 2021 (84%). A longitudinal serological study should be envisaged to facilitate understanding of the dynamics of the epidemiological situation and to forecast future scenarios.

Epidemiology of Gastrointestinal Disease among Children and Adolescents in Kazakhstan: 2012–2019

BACKGROUND: Gastrointestinal diseases are important trigger of public health concern in pediatric population. Non treated pathologies led to chronic inflammatory processes in adulthood. AIM: With respect to the lack of international studies on epidemiology of gastrointestinal disease in pediatric population, this study was aimed at analysis of national and local incidence rates of gastrointestinal disorders among children and adolescents in Kazakhstan over the period from 2012 to 2019. METHODS: This was a retrospective cross-sectional study located on South part of Kazakhstan and based on the data obtained from the Republican Center for Health Development – the major data source on the country’s health statistics. From this, we extracted information on children (0–14 years) and adolescents (15–17 years) with gastrointestinal disease (K00-K95 International Classification of Diseases, Revision 10 codes). We calculated incidence rates for the whole country and Turkestan province. RESULTS: The national incidence of pediatric disease was characterized by relative stability, and was 7760.4 per 100,000 population in 2017. The incidence of peptic ulcers and gallbladder disease in adolescents substantially exceeded that in children. At provincial level the incidence of gastritis/duodenitis and peptic ulcers was gradually declining, while that of gallbladder disease was subjected to growth over the past years. Adolescents had higher rates of gastrointestinal disease both at national and provincial levels. CONCLUSION: The analysis of national and local incidence rates of gastrointestinal disorders among children and adolescents in Kazakhstan showed that more studies are needed to obtain in-depth understanding of risk factors associated with gastrointestinal disease in child and adolescent population of Kazakhstan, including the prevalence of Helicobacter pylori infection. Besides, a national registry on pediatric gastrointestinal disease should be envisaged to overcome the lack of essential data.

PERINATAL CARE INDICATORS IN ALMATY, KAZAKHSTAN FOR 2013-2017: A CROSS-SECTIONAL STUDY

Protection of maternity and child health is of great medical and social importance. Provision of medical care to women and children in Kazakhstan is the major task for state policy. Still, the data on epidemiological indicators of perinatal care in Kazakhstan are rather limited. This study was aimed at assessment of perinatal care indicators in Almaty, Kazakhstan Republic, over the period from 2013 to 2017. The data on demographic characteristics of study population were obtained from online platform of the Republican Center for Health Development. The analysis of perinatal indicators was carried-out on the basis of statistical reporting form No. 32. We relied on the standard statistical formulas to calculate epidemiological indicators. All statistical tests were performed in SPSS software, Version 17.0 for Windows. The crude birth rate over five years remained stable and was within the range of 25,975-26,289 per 1,000 population. The abortion rate constituted 2.018-2.272 per 1,000 population. The abortion ratio was growing until 2016 and composed 26.387 per 1,000 population. The adolescent fertility rate has dropped significantly over the past period from 4,357 per 1,000 teenage population in 2013 to 3,366 per 1,000 teenage population in 2017. The maternal mortality rate did not exceed 0.02 per 1,000 population. Maternal mortality ratio was within the range of 0.208-0.194 per 1,000 population. Incidence rate of extragenital pathology was very high and peaked in 2016 (1,010.800 per 1,000 population). Only 17.4% of women in labor were recognized as healthy based on the labor results. Effective perinatal technologies that were introduced in the Republic of Kazakhstan have demonstrated their high performance in achieving and maintaining a reasonable level of maternity and child health. This was particularly true for stable rate of general fertility and crude birth rate, and decreasing adolescent fertility rate. However, high rates of extragenital pathology indicate the need to implement national preventive programs aimed at ensuring proper monitoring over maternity health indicators.

Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan

Objectives

The lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available.

Methods

We constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization’s COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks.

Results

Over the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively.

Conclusions

Republic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.

Career intentions and dropout causes among medical students in Kazakhstan

BACKGROUND AND OBJECTIVE

The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools.

MATERIAL AND METHODS

A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011-2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire.

RESULTS

The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request.

CONCLUSIONS

Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.