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George MS, Dey RC, Kumar H, Khadka S, Singh P, Sánchez-Velazco DF, Khadka S, Manandhar S. Resurging measles in Armenia: unravelling challenges, implementing solutions. Public Health 2024; 230:e1-e2. [PMID: 38485532 DOI: 10.1016/j.puhe.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 04/16/2024]
Affiliation(s)
- M S George
- Yerevan State Medical University, Yerevan, Armenia.
| | - R C Dey
- Altai State Medical University, Barnaul, Russia.
| | - H Kumar
- Dow University of Health Sciences, Karachi, Pakistan.
| | - S Khadka
- College of Medical Sciences, Nepal.
| | - P Singh
- Faisalabad Medical University, University of Health Sciences, Faisalabad, Pakistan.
| | | | - S Khadka
- College of Medical Sciences, Nepal.
| | - S Manandhar
- Nepal Medical College, Kathmandu University, Nepal.
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Hayrumyan V, Abrahamyan A, Harutyunyan A, Libaridian L, Sahakyan S. Impact of COVID-19 on essential healthcare services at the primary healthcare level in Armenia: a qualitative study. BMC Prim Care 2024; 25:131. [PMID: 38658818 PMCID: PMC11044568 DOI: 10.1186/s12875-024-02377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The COVID-19 pandemic has presented significant global healthcare challenges, particularly impacting the continuity of essential health services in low- and middle-income countries. This study investigates the impact of the COVID-19 pandemic on the utilization and provision of essential health services in Armenia. METHODS We employed a conventional qualitative study design, conducting semi-structured in-depth interviews (n = 17) within public and private primary healthcare (PHC) facilities in Armenia in 2021. Our study participants encompassed physicians providing specialty services in PHC facilities (e.g. endocrinologists, gynecologists/obstetricians, and pediatricians), regular visitors to PHC facilities (e.g. adults with chronic diseases, parents of children), and policymakers. Thematic analysis was conducted, yielding five emergent categories: mobilization and organization of PHC services during COVID-19; PHC visits during COVID-19; worsening of chronic conditions due to the decline in PHC visits; problems with routine childhood vaccinations; and patient-provider communication challenges. RESULTS The number of in-person visits to PHC facilities declined due to adaptations in service delivery, imposed lockdown measures, and the public's fear of visiting healthcare facilities. Maternal and child health services continued with no major disruptions. PHC providers deliberately limited the number of maternal and child visits to essential antenatal care, newborn screenings, and routine childhood immunizations. Still, children experienced some delays in vaccination administration. The pandemic resulted in a notable reduction in follow-up visits and monitoring of patients with chronic conditions, thereby exacerbating their chronic conditions. Phone calls were the primary method of patient-provider communication during the pandemic. CONCLUSIONS The COVID-19 pandemic has had a profound impact on the delivery and utilization of essential healthcare services at PHC facilities, especially for those with chronic conditions who needed continuous care. Unified national-level guidance and technical capacity are needed to direct the provision of essential services at the PHC level, promote effective health communication, and implement digital platforms for the uninterrupted provision of essential care during public health emergencies.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia.
| | - Arpine Abrahamyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Arusyak Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Lorky Libaridian
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
| | - Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Baghramyan Ave, Yerevan, 0019, Armenia
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Giloyan A, Khachadourian V, Hakobyan V, Kirakosyan L, Petrosyan V, Harutyunyan T. Migraine headache and other risk factors associated with glaucoma among the adult population living in Armenia: a case-control study. Int Ophthalmol 2024; 44:188. [PMID: 38647698 DOI: 10.1007/s10792-024-03145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This study aimed to assess the association between migraine headache and glaucoma among the adult population living in Armenia. METHODS This case-control study recruited 145 cases with glaucoma and 250 controls without glaucoma and other ocular disorders except refractive error from Optomed Canada Diagnostic Eye Center in Armenia. A structured questionnaire contained questions on socio-demographics, family history of glaucoma and stroke, ocular health, smoking, migraine, and obstructive sleep apnea. The Migraine Screening Questionnaire assessed possible migraine and the Berlin Questionnaire measured obstructive sleep apnea. RESULTS The mean ages of cases and controls were 63.3 (SD = 12.3) and 39.5 (SD = 13.5), respectively. Females comprised 62.8% of cases and 69.1% of controls. A total of 17.8% of cases and 19.0% of controls had possible migraine. In the adjusted analysis older age (OR 1.17; 95% CI 1.12; 1.23), average/lower than average socio-economic status (OR 5.27; 95% CI 1.30; 21.3), and family history of glaucoma (OR 4.25; 95% CI 1.51; 11.9) were associated with high-tension glaucoma. CONCLUSION Timely case detection of glaucoma among those with average/low socio-economic status and those with family history of glaucoma could prevent further progression of the disease. Further studies to explore the relationship between migraine headache and specific types of glaucoma may be worthwhile.
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Affiliation(s)
- Aida Giloyan
- American University of Armenia, Yerevan, Armenia.
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Demirchyan A, Dudareva S, Sahakyan S, Aslanyan L, Muradyan D, Musheghyan L, Mozalevskis A, Sargsyants N, Ghukasyan G, Petrosyan V. Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: a cross-sectional study. BMJ Open 2024; 14:e080281. [PMID: 38326250 PMCID: PMC10860008 DOI: 10.1136/bmjopen-2023-080281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES This study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia. DESIGN A population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals. SETTING All administrative units of Armenia including 10 provinces and capital city Yerevan. PARTICIPANTS The study frame was the general adult population of Armenia aged ≥18 years. PRIMARY AND SECONDARY OUTCOME MEASURES The participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models. RESULTS The seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93). CONCLUSION This study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Sandra Dudareva
- Department for Infectious Disease Epidemiology, Robert Koch Institut, Berlin, Germany
| | - Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Lusine Aslanyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Diana Muradyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Lusine Musheghyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Antons Mozalevskis
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Narina Sargsyants
- National Institute of Health named after academician Suren Avdalbekyan, Yerevan, Armenia
| | - Gayane Ghukasyan
- World Health Organization Country Office in Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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Khachatryan N, Giloyan A, Paduca A, Limburg H, Petrosyan V. Nationwide Rapid Assessment of Avoidable Blindness (RAAB) in Armenia. Ophthalmic Epidemiol 2024; 31:62-69. [PMID: 36872562 DOI: 10.1080/09286586.2023.2187068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE This study aimed to estimate the prevalence and main causes of blindness and visual impairment in population aged 50 years and older in Armenia using Rapid Assessment of Avoidable Blindness (RAAB) methodology. METHODS The study team randomly selected 50 clusters (each consisting of 50 people) from all 11 regions of Armenia. Data on participants' demographics, presenting visual acuity, pinhole visual acuity, principal cause of presenting visual acuity, spectacle coverage, uncorrected refractive error (URE), and presbyopia were collected using the RAAB survey form. Four teams of trained eye care professionals completed data collection in 2019. RESULTS Overall, 2,258 people of 50 years and older participated in the study. The age- and gender- adjusted prevalence of bilateral blindness, severe and moderate visual impairment were 1.5% (95% CI: 1.0-2.1), 1.6% (95% CI: 1.0-2.2) and 6.6% (95% CI: 5.5-7.7), respectively.The main causes of blindness were cataract (43.9%) and glaucoma (17.1%). About 54.6% and 35.3% of participants had URE and uncorrected presbyopia, respectively. The prevalence of bilateral blindness and functional low vision increased with age and was the highest in participants 80 years and older. CONCLUSION The rate of bilateral blindness was comparable with findings from countries that share similar background and confirmed that untreated cataract was the main cause of blindness. Given that cataract blindness is avoidable, strategies should be developed aiming to further increase the volume and quality of cataract care in Armenia.
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Affiliation(s)
- Naira Khachatryan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Aida Giloyan
- Garo Meghrigian Institute for Preventive Ophthalmology, Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ala Paduca
- Faculty of Medicine, State University of Medicine and Pharmacy "Nicolae Testemiteanu", Chişinău, Republic of Moldova
| | - Hans Limburg
- Health Information Services, Grootebroek, The Netherlands
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
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Hoveyan J, Asatryan E, Grigoryan H, Hovsepyan S, Avagyan A, Hakobyan L, Sargsyan L, Iskanyan S, Avagyan M, Hovhannisyan S, Melnichenko I, Minasyan M, Papyan R, Manukyan N, Lazaryan A, Danelyan S, Muradyan A, Arakelyan J, Qaddoumi I, Boop F, Mkhitharyan A, Harutyunyan M, Tamamyan G, Bardakhchyan S. Trends in pediatric CNS tumors in Armenia: a multicenter retrospective study. Childs Nerv Syst 2024; 40:435-444. [PMID: 37837453 DOI: 10.1007/s00381-023-06179-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Central nervous system (CNS) tumors are the most common solid malignancies in children worldwide, including in Armenia. The current study aims to analyze epidemiological data, treatment, and outcomes of children and young adults (≤25 years) with CNS tumors in Armenia during the last 26 years. METHODS We collected data from pediatric and young adult patients treated in selected sites in Armenia from 1st January 1995 to 31st December 2020. Incidence by sex, age at diagnosis, time from first complaints to diagnosis, histopathology results, treatment strategies, complications, and overall survival (OS) rates were calculated. RESULTS The multicenter data analysis revealed 149 patients with diagnosed primary CNS tumors over 26 years. Among them, 84 (56.4%) were male. The median age at diagnosis was 7 years (range, 3 months to 25 years), and the median time from the first complaints to diagnosis was 2 months (range, 1 week to 70 months). Medulloblastomas and other embryonal tumors (47), low-grade gliomas (32), and high-grade gliomas (22) were the most commonly diagnosed malignancies. Ependymomas, craniopharyngiomas, germ cell tumors, and other malignancies were observed in 22 patients. For 26 patients, no histopathological or radiological diagnosis was available. Follow-up information was available for 98 (65.8%) patients. The 5-year OS rate for the whole study group was 67.7%. CONCLUSION Consistent with international data, embryonal tumors, and gliomas were the most commonly diagnosed CNS malignancies in Armenia. Multimodal treatment was often not available in Armenia during the study period, especially for early cases.
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Affiliation(s)
- Julieta Hoveyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia.
- Immune Oncology Research Institute, Yerevan, Armenia.
| | - Eduard Asatryan
- Division of Neurosurgery, Department of Surgery, Wigmore Hospital for Children, Yerevan, Armenia
| | - Henrik Grigoryan
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Shushan Hovsepyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Anna Avagyan
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Lusine Hakobyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Lilit Sargsyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Samvel Iskanyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Manushak Avagyan
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Saten Hovhannisyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Irina Melnichenko
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Mariam Minasyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Ruzanna Papyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Narek Manukyan
- National Center of Oncology named after V. A. Fanarjyan, Yerevan, Armenia
| | - Armine Lazaryan
- Department of Radiation Oncology, National Center of Oncology named after V. A. Fanarjyan, Yerevan, Armenia
| | - Samvel Danelyan
- Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Armen Muradyan
- Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | | | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
- Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Frederick Boop
- Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Armen Mkhitharyan
- HistoGen Pathology Center, Yerevan, Armenia
- Department of Pathology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Martin Harutyunyan
- Adult's Solid Tumor Chemotherapy Department, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Gevorg Tamamyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Samvel Bardakhchyan
- Immune Oncology Research Institute, Yerevan, Armenia
- Adult's Solid Tumor Chemotherapy Department, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
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Sahakyan S, Muradyan D, Giloyan A, Harutyunyan T. Factors associated with delay or avoidance of medical care during the COVID-19 pandemic in Armenia: results from a nationwide survey. BMC Health Serv Res 2024; 24:20. [PMID: 38178214 PMCID: PMC10768194 DOI: 10.1186/s12913-023-10483-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems throughout the world. Many patients faced delays and cancellation of care due to scaled back services, mobility restrictions, and concerns related to the risk of infection. The present study aimed to assess the prevalence of and risk factors associated with the avoidance or delay of medical care due to COVID-19 in Armenia. METHODS We conducted a cross-sectional telephone survey of 3,483 adults across Armenia. We used stratified two-stage cluster sampling to select the participants from different age groups proportionate to their size in the population. Logistic regression analysis assessed the association of risk factors with avoidance/delay of routine, urgent/emergency, and any medical care. RESULTS The mean age of the sample was 49.5 (SD = 14.8), ranging from 18 to 90. About 9.9% of the respondents avoided/delayed any type of medical care; whereas 5.5% avoided/delayed urgent/emergency care and 6.6% routine care. In the adjusted analysis, female gender and higher monthly expenditures were associated with avoidance/delay of routine medical care. Factors associated with delay/avoidance of urgent/emergency care included female gender and higher perceived threat of COVID-19. Younger age, female gender, higher perceived threat and not being vaccinated against COVID-19 were associated with avoidance/delay of any medical care in the adjusted analysis. CONCLUSION Since avoiding or delaying care might increase morbidity and mortality associated with conditions not related to COVID-19, identifying population groups that are more likely to avoid care is important. Targeting such groups with educational interventions focusing on the risks of using versus not using medical care in times of pandemic might be crucial. Ensuring the provision of in-home healthcare services for high-risk groups might help to address important medical care needs during the pandemic.
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Affiliation(s)
- Serine Sahakyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Ave, Yerevan, 0019, Armenia
| | - Diana Muradyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Ave, Yerevan, 0019, Armenia.
| | - Aida Giloyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Ave, Yerevan, 0019, Armenia
| | - Tsovinar Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Ave, Yerevan, 0019, Armenia
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Rostomian L, Chiloyan A, Hentschel E, Messerlian C. Effects of armed conflict on maternal and infant health: a mixed-methods study of Armenia and the 2020 Nagorno-Karabakh war. BMJ Open 2023; 13:e076171. [PMID: 38159954 PMCID: PMC10759127 DOI: 10.1136/bmjopen-2023-076171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
INTRODUCTION Armed conflict worldwide and across history has harmed the health of populations directly and indirectly, including generations beyond those immediately exposed to violence. The 2020 war between Armenia and Azerbaijan over Nagorno-Karabakh, inhabited by an ethnically Armenian population, provides an example of how conflict harmed health during COVID-19. We hypothesised that crises exposure would correspond to decreased healthcare utilisation rates and worse health outcomes for the maternal and infant population in Armenia, compounded during the pandemic. METHODS Following a mixed-methods approach, we used ecological data from 1980 to 2020 to evaluate health trends in conflict, measured as battle-related deaths (BRDs), COVID-19 cases, and maternal and infant health indicators during periods of conflict and peace in Armenia. We also interviewed 10 key informants about unmet needs, maternal health-seeking behaviours and priorities during the war, collecting recommendations to mitigate the effects of future crisis on maternal and infant health. We followed a deductive coding approach to analyse transcripts and harvest themes. RESULTS BRDs totalled more in the 2020 war compared with the previous Nagorno-Karabakh conflicts. Periods of active conflict between 1988-2020 were associated with increased rates of sick newborn mortality, neonatal mortality and pre-eclampsia or eclampsia. Weekly average COVID-19 cases increased sevenfold during the 2020 Nagorno-Karabakh war. Key informants expressed concerns about the effects of stress and grief on maternal health and pregnancy outcomes and recommended investing in healthcare system reform. Participants also stressed the synergistic effects of the war and COVID-19, noting healthcare capacity concerns and the importance of a strong primary care system. CONCLUSIONS Maternal and infant health measures showed adverse trends during the 2020 Nagorno-Karabakh war, potentially amplified by the concurrent COVID-19 pandemic. To mitigate effects of future crises on population health in Armenia, informants recommended investments in healthcare system reform focused on primary care and health promotion.
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Affiliation(s)
- Lara Rostomian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Araz Chiloyan
- Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Elizabeth Hentschel
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Carmen Messerlian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Massachusetts General Hospital Vincent Center for Reproductive Biology, Boston, Massachusetts, USA
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Yeraliyeva L, Issayeva A, Adenov M. COMPARATIVE ANALYSIS OF MORTALITY FROM TUBERCULOSIS AMONG COUNTRIES OF FORMER SOVIET UNION. Georgian Med News 2023:52-57. [PMID: 38325298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Mortality from tuberculosis has decreased from 11.89 deaths per 100,000 population in 1990 to 4.18 deaths per 100,000 population in Kazakhstan in 2019. Thus, the deviation was (-)35.5%. If Kazakhstan showed the above result over the 29-year period, then how are things with other republics that were part of the Soviet Union and how have the countries' economies changed? Aim - determination of the difference in 15 republics using the mortality rate from tuberculosis per 100,000 population. The study included the following countries: Ukraine, Georgia, Kazakhstan, Kyrgyzstan, Uzbekistan, Russia, Estonia, Lithuania, Latvia, Turkmenistan, Tajikistan, Belarus, Moldova, Azerbaijan, Armenia. The analysis was carried out using the Global burden of diseases database. A relatively high reduction in TB mortality was found in Kazakhstan (-3.61%). In second place is Estonia (-3.25%), in third place is Azerbaijan (-2.39%), in fourth place is Latvia (-2.16%), and the top five is closed by Georgia (-1.98%). Despite the high level of GDP, countries such as Russia (6th place in the world ranking of GDP per capita) and Ukraine (42nd place in the world ranking of GDP per capita) are not in the leading positions in reducing the burden of TB. For example, Russia is in 10th place (-0.81%) in terms of the percentage reduction in mortality from TB, and Ukraine is in last place. According to the Global Burden of Disease, Ukraine has seen an increase in TB mortality (+1.62%). The leader among the former Soviet countries in terms of spending on the healthcare system is Armenia (12.24%). In general, current public spending on health care per capita is 11.6 times lower than in OECD (Organization for Economic Cooperation and Development) member countries: in 2020 in Kazakhstan this indicator was 341.5 USD, in the OECD - on average 3 959 USD. According to WHO recommendations for sustainable development, financing of the health care system should be up to 5% of GDP, while the share of private spending should not exceed 20% of current health care spending. As the experience of developed countries shows, the level of life expectancy directly depends on the financing of the healthcare system.
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Affiliation(s)
- L Yeraliyeva
- 1National Academy of Science of the Republic of Kazakhstan, Almaty, the Republic of Kazakhstan
| | - A Issayeva
- 2University of Sussex, Brighton, United Kingdom
| | - M Adenov
- 3National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan
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10
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Martirosyan T. ON THE RESULTS OF A SYSTEMIC MULTIFACTOR ANALYSIS WITH MATHEMATICAL MODELING OF THE INDICATORS OF MEDICAL EXPERTISE OF YOUNG MALES WITH SURGICAL DISEASES IN THE REPUBLIC OF ARMENIA. Georgian Med News 2023:6-13. [PMID: 38096507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Medical aspects of the organization of replenishment of the Armed Forces with healthy and physically strong personnel are of great importance, and the deficit in the number of conscripts and their low-quality condition have become one of the main and important problems for the Armed Forces. The aim of the study was to improve the medical care of male conscripts aged 18-27 years by revealing the regularities and peculiarities of the expert assessment of surgical diseases among this category of young men on the basis of mathematical modeling. The object of the research was the study of the names of surgical profile articles, according to which these people were recognized as unfit or restricted fit for service, and the results of military medical expertise. Descriptive, social, and statistical methods were applied in the course of the study. The final stage was to conduct a systemic multifactor analysis in order to obtain a mathematical model of the process under study. The values of the influence coefficients of the mentioned indicators for 2013-2019 on the obtained mathematical models from the point of view of military-medical expertise of young men with surgical diseases both in the Republic of Armenia as a whole and in its separate regions are presented. Summarizing, it can be stated that from the point of view of military-medical expertise of young men with surgical diseases it is impossible to consider Yerevan city and the regions of RA as separate parts of the Republic of Armenia. Yerevan and the regions of the Republic of Armenia as separate parts, as they appear as a single whole according to the results of systemic multifactor analysis with mathematical modeling.
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Affiliation(s)
- T Martirosyan
- Yerevan State Medical University after Mkhitar Heratsi, Armenia
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11
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Shcherbakov OV, Aghayan SA, Gevorgyan HS, Burlak VA, Fedorova VS, Artemov GN. An updated list of mosquito species in Armenia and Transcaucasian region responsible for Dirofilaria transmission: A review. J Vector Borne Dis 2023; 60:343-352. [PMID: 38174511 DOI: 10.4103/0972-9062.374035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Canine dirofilariasis is a world-wide distributed mosquito-borne helminthiasis that has a potential zoonotic impact. This disease is a serious problem in Southern Caucasus region, including Armenia. Average extensity of Dirofilaria infection in canids in Armenia is 26.9%. At present, 77 mosquito species (Diptera: Culicidae) are presumed to have a role in the transmission of dirofilariasis. 80 species of Culicidae family mosquitoes are registered in Southern Caucasus Region, and 31 of them are described in Armenia. The following species of Culicidae can serve as vectors of Dirofilaria spp. in Armenia: Aedes vexans, Ae. caspius, Ae. albopictus, Ae. geniculatus, Culex pipiens, Cx. theileri, Cx. modestus, Anopheles maculipennis s.s., An. claviger, An. hyrcanus, An. superpictus, Coquillettidia richardi, Culiseta annulata and Uranotaenia unguiculta. We see a risk of transmission in active foci of dirofilariasis, as well as for human infection in Armenia. Comprehensive research should be conducted on detection of microfilariae in the target mosquito species and in target localities.
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Affiliation(s)
- Oleg V Shcherbakov
- Scientific Center of Zoology and Hydroeclogy; National Agrarian University of Armenia, Research Center for Veterinary and Sanitary Expertise, Yerevan, Armenia
| | - Sargis A Aghayan
- Scientific Center of Zoology and Hydroeclogy; Yerevan State University, Chair of Zoology, Yerevan, Armenia
| | | | - Vladimir A Burlak
- Laboratory of Ecology, Genetics, and Nature Protection, Tomsk State University, Tomskaya Oblast, Russia
| | - Valentina S Fedorova
- Laboratory of Ecology, Genetics, and Nature Protection, Tomsk State University, Tomskaya Oblast, Russia
| | - Gleb N Artemov
- Laboratory of Ecology, Genetics, and Nature Protection, Tomsk State University, Tomskaya Oblast, Russia
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12
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Badalian SS, Minassian VA. Establishing urogynecology subspecialty in Armenia: The Armenia project. Int Urogynecol J 2023; 34:2341-2344. [PMID: 37812214 DOI: 10.1007/s00192-023-05663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
It is well known that there are many countries in the world where Urogynecology is not an existing subspecialty, and women are not receiving appropriate care for their pelvic floor disorders (PFD). One of these countries is the Republic of Armenia. Given the lack of expertise in the field of Urogynecology in Armenia, we conducted a study on the prevalence of PFDs and the degree of bother among women of all ages across the country, which was published in 2020. This led to the creation of the International Urogynecology Association for Armenia, comprising seven physicians from different countries: five from the USA, one urogynecologist from Lebanon, and one urologist from Russia. We implemented hybrid teaching based on Zoom lectures, case presentations, journal clubs, and live visits of mentors to Armenia on a regular basis to see patients and operate with our five fellows. We introduced our fellows to research and statistics by assigning research topics for different projects. Our fellows presented evidence-based presentations and extensive literature reviews on a regular basis. Our program will continue to grow the next 2-3 years. The success of this project holds significance for governmental, public, and healthcare entities in Armenia and across the world, where this subspecialty is non-existent, in preparing future female pelvic surgeons to care for the growing needs of women with these conditions. Replicating this program in other parts of the world will compound the benefits and successes of Urogynecology care across different societies, cultures, and people around the globe.
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Affiliation(s)
- Samuel S Badalian
- Department of Obstetrics and Gynecology, Bassett Healthcare Network, 1 Atwell Road, Cooperstown, NY, 13326, USA.
- Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Vatche A Minassian
- Female Pelvic Medicine and Reconstructive Surgery, Department of OB/GYN, Brigham and Women's Hospital, Boston, MA, USA
- Obstetrics & Gynecology, Harvard Medical School, Boston, MA, USA
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13
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Kim BJ, Johnston LG, Grigoryan T, Papoyan A, Grigoryan S, McLaughlin KR. Hidden population size estimation and diagnostics using two respondent-driven samples with applications in Armenia. Biom J 2023; 65:e2200136. [PMID: 36879484 DOI: 10.1002/bimj.202200136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 03/08/2023]
Abstract
Estimating the size of hidden populations is essential to understand the magnitude of social and healthcare needs, risk behaviors, and disease burden. However, due to the hidden nature of these populations, they are difficult to survey, and there are no gold standard size estimation methods. Many different methods and variations exist, and diagnostic tools are needed to help researchers assess method-specific assumptions as well as compare between methods. Further, because many necessary mathematical assumptions are unrealistic for real survey implementation, assessment of how robust methods are to deviations from the stated assumptions is essential. We describe diagnostics and assess the performance of a new population size estimation method, capture-recapture with successive sampling population size estimation (CR-SS-PSE), which we apply to data from 3 years of studies from three cities and three hidden populations in Armenia. CR-SS-PSE relies on data from two sequential respondent-driven sampling surveys and extends the successive sampling population size estimation (SS-PSE) framework by using the number of individuals in the overlap between the two surveys and a model for the successive sampling process to estimate population size. We demonstrate that CR-SS-PSE is more robust to violations of successive sampling assumptions than SS-PSE. Further, we compare the CR-SS-PSE estimates to population size estimations using other common methods, including unique object and service multipliers, wisdom of the crowd, and two-source capture-recapture to illustrate volatility across estimation methods.
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Affiliation(s)
- Brian J Kim
- Joint Program in Survey Methodology, University of Maryland, College Park, Maryland, USA
| | - Lisa G Johnston
- Independent Consultant, LGJ Consultants, Inc., Valencia, Spain
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14
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Bisharyan M, Dallakyan A. ASSESSMENT OF THE SOCIAL AND MEDICAL ASPECTS OF SUICIDE IN THE REPUBLIC OF ARMENIA. Georgian Med News 2022:26-31. [PMID: 36427836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The objective of the article is to consider the social and medical factors which contribute to the number of suicides in the Republic of Armenia. The study covers the suicide data for the period of 2011-2020. The article provides statistical data on gender and age aspects of suicide. The paper overviews the works of contemporary authors on the social aspects of the problem. The results of the study will contribute to the further development of the effective methods to prevent suicide. ; Objective - the objective of the study was to investigate and assess the socio-medical aspects of suicide in the RA.; The subject of the study was the data on suicides in the Republic of Armenia in 2011-2020. Standard statistical methods of data analysis were used to compare the data obtained, to assess their reliability, to determine the standard statistical and mean error, reliable difference between absolute and relative values. ; The study revealed 1858 suicide cases, registered in the Republic of Armenia over 10 years. The structure analysis of the suicides by gender in the Republic of Armenia from 2011 to 2020 has shown that males predominated in the structure of suicides over the whole period. Among the motivations of suicide, the ones that deserve attention are diseases, social problems, and bereavement.; The results obtained will contribute to suicide prevention.
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Affiliation(s)
- M Bisharyan
- Scientific-practical center of forensic medicine, Ministry of Health the Republic of Armenia
| | - A Dallakyan
- Scientific-practical center of forensic medicine, Ministry of Health the Republic of Armenia
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15
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Demirchyan A, Khachadourian V, Armenian HK, Goenjian AK. The course, trajectories and predictors of depression 23 years after the 1988 Spitak earthquake in Armenia: A prospective cohort study. Psychiatry Res 2022; 313:114640. [PMID: 35598565 DOI: 10.1016/j.psychres.2022.114640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/19/2022]
Abstract
There is a scarcity of long-term studies of depression after natural disasters. This prospective epidemiologic study evaluated the course of depression and factors associated with it among survivors 23-years post-earthquake. A geographically stratified subsample of 725 adults exposed to the Spitak earthquake was assessed for depression using DSM-III-R criteria in 1991 and 2012. Additionally, an adapted CES-D-16 scale was used to assess depressive symptoms in 2012. A fitted multi-nominal logistic regression model identified predictors of different trajectories of depression. For the whole group, the rate of clinical depression dropped from 51.5% in 1991 to 31.7% in 2012. Earthquake intensity and experiencing strong fear at baseline were strongly associated with chronic (depressed at both assessments, 18.1%) and recovered (depressed only in 1991, 33.5%) depression trajectories compared with the healthy group, with odds ratios (OR) over 4.0 and 3.0, respectively. Predictors distinguishing chronic depression included earthquake-related nuclear-family deaths (OR=3.79), chronic illnesses at baseline (OR=1.24), and social support (OR=0.91). Predictors of the late-onset trajectory (depressed only in 2012, 13.5% of the cohort) included post-earthquake trauma (OR=1.42), socioeconomic status (OR=0.45), and social support (OR=0.86). The factors associated with the different trajectories of depression provide guidance for planning more effective mental health interventions after disasters.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
| | - Vahe Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Haroutune K Armenian
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Armen K Goenjian
- UCLA/Duke University National Center for Child Traumatic Stress, Department of Psychiatry and Biobehavioral Sciences, UCLA, CA, USA; Collaborative Neuroscience Network, CA, USA
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16
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Torchyan AA, Bosma H, Houkes I. Pathways to socioeconomic health differences in Armenian adolescents: The role of bullying perpetration. PLoS One 2022; 17:e0269451. [PMID: 35657823 PMCID: PMC9165766 DOI: 10.1371/journal.pone.0269451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
Bullying perpetration might be an alternative way of hierarchy formation among adolescents. It can potentially compensate for the negative health influences of low socioeconomic status (SES), rewarding this unwanted behavior. This study aimed to investigate the role of bullying perpetration in the relationship between SES and health among Armenian adolescents. A nationally representative sample of 3679 adolescents aged 11–15 years (mean = 13.1, standard deviation = 1.6) participated in the Health Behavior in School-aged Children 2013/14 survey in Armenia. Complex samples multiple logistic regression were used to estimate the associations between two SES measures (family socioeconomic position [SEP] and material well-being) and three health outcomes (perceived health status, psychosocial well-being, and psychosomatic symptoms). Bullying perpetration was not associated with less than good health or low psychosocial well-being (P > 0.05) but increased the odds of reporting high psychosomatic symptoms (P < 0.05). Perpetration did not change the SES-health gradient substantially. However, in stratified analyses, socioeconomic inequalities in health were consistently weaker among perpetrators. The largest observed difference was in the relationship between low family SEP and less than good health (OR = 3.60, 95% CI = 2.77–4.67 vs. OR = 1.80, 95% CI = 1.06–3.04), whereas the smallest difference was in the relationship between low family SEP and high psychosomatic symptoms (OR = 1.27, 95% CI = 1.03–1.56 vs. OR = 1.04, 95% CI = 0.61–1.77). Our findings suggest that bullying perpetration, as an alternative hierarchy, may be looked at as a compensatory but vicious strategy in the face of the negative health influences of low SES in Armenian adolescents. For high-SES adolescents, on the other hand, social, emotional, or psychological problems might contribute to bullying perpetration. Consequently, bullying prevention activities in Armenia should focus on both low and high-SES adolescents, considering SES-specific pathways and mechanisms.
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Affiliation(s)
- Armen A. Torchyan
- Department of Family and Community Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
- Faculty of Health, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - Hans Bosma
- Faculty of Health, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Inge Houkes
- Faculty of Health, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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17
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Avetyan D, Hakobyan S, Nikoghosyan M, Ghukasyan L, Khachatryan G, Sirunyan T, Muradyan N, Zakharyan R, Chavushyan A, Hayrapetyan V, Hovhannisyan A, Mohamed Bakhash SA, Jerome KR, Roychoudhury P, Greninger AL, Niazyan L, Davidyants M, Melik-Andreasyan G, Sargsyan S, Nersisyan L, Arakelyan A. Molecular Analysis of SARS-CoV-2 Lineages in Armenia. Viruses 2022; 14:v14051074. [PMID: 35632815 PMCID: PMC9142918 DOI: 10.3390/v14051074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 12/11/2022] Open
Abstract
The sequencing of SARS-CoV-2 provides essential information on viral evolution, transmission, and epidemiology. In this paper, we performed the whole-genome sequencing of SARS-CoV-2 using nanopore and Illumina sequencing to describe the circulation of the virus lineages in Armenia. The analysis of 145 full genomes identified six clades (19A, 20A, 20B, 20I, 21J, and 21K) and considerable intra-clade PANGO lineage diversity. Phylodynamic and transmission analysis allowed to attribute specific clades as well as infer their importation routes. Thus, the first two waves of positive case increase were caused by the 20B clade, the third peak caused by the 20I (Alpha), while the last two peaks were caused by the 21J (Delta) and 21K (Omicron) variants. The functional analyses of mutations in sequences largely affected epitopes associated with protective HLA loci and did not cause the loss of the signal in PCR tests targeting ORF1ab and N genes as confirmed by RT-PCR. We also compared the performance of nanopore and Illumina short-read sequencing and showed the utility of nanopore sequencing as an efficient and affordable alternative for large-scale molecular epidemiology research. Thus, our paper describes new data on the genomic diversity of SARS-CoV-2 variants in Armenia in the global context of the virus molecular genomic surveillance.
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Affiliation(s)
- Diana Avetyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
- Correspondence: (D.A.); (A.A.)
| | - Siras Hakobyan
- Bioinformatics Group, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia;
- Armenian Bioinformatics Institute, Yerevan 0014, Armenia;
| | - Maria Nikoghosyan
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
- Bioinformatics Group, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia;
| | - Lilit Ghukasyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
| | - Gisane Khachatryan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
| | - Tamara Sirunyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
| | - Nelli Muradyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
| | - Roksana Zakharyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
| | - Andranik Chavushyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Davidyants Laboratories, Yerevan 0054, Armenia
| | - Varduhi Hayrapetyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
| | - Anahit Hovhannisyan
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
- Laboratory of Evolutionary Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia
| | - Shah A. Mohamed Bakhash
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98102, USA; (S.A.M.B.); (K.R.J.); (P.R.); (A.L.G.)
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Keith R. Jerome
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98102, USA; (S.A.M.B.); (K.R.J.); (P.R.); (A.L.G.)
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Pavitra Roychoudhury
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98102, USA; (S.A.M.B.); (K.R.J.); (P.R.); (A.L.G.)
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Alexander L. Greninger
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98102, USA; (S.A.M.B.); (K.R.J.); (P.R.); (A.L.G.)
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Lyudmila Niazyan
- NORK Infection Clinical Hospital, MoH RA, Yerevan 0047, Armenia; (L.N.); (M.D.)
| | - Mher Davidyants
- NORK Infection Clinical Hospital, MoH RA, Yerevan 0047, Armenia; (L.N.); (M.D.)
| | - Gayane Melik-Andreasyan
- National Center of Disease Control and Prevention, Ministry of Health RA, Yerevan 0025, Armenia; (G.M.-A.); (S.S.)
| | - Shushan Sargsyan
- National Center of Disease Control and Prevention, Ministry of Health RA, Yerevan 0025, Armenia; (G.M.-A.); (S.S.)
| | - Lilit Nersisyan
- Armenian Bioinformatics Institute, Yerevan 0014, Armenia;
- SciLifeLab, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 17177 Solna, Sweden
| | - Arsen Arakelyan
- Laboratory of Human Genomics, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia; (L.G.); (G.K.); (T.S.); (N.M.); (R.Z.); (A.C.); (V.H.)
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan 0051, Armenia; (M.N.); (A.H.)
- Bioinformatics Group, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia;
- Armenian Bioinformatics Institute, Yerevan 0014, Armenia;
- Correspondence: (D.A.); (A.A.)
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18
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Jrbashyan N, Yeghiazaryan N, Sikder A, Nallasamy S, Reid MW, Ohanesian R, Lee TC, Espinoza J. Pattern and prevalence of eye disorders and diseases in school-aged children: findings from the Nationwide School Sight Sampling Survey in Armenia. BMJ Open Ophthalmol 2022; 7:e000899. [PMID: 35265749 PMCID: PMC8860128 DOI: 10.1136/bmjophth-2021-000899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022] Open
Abstract
ObjectiveThis study aims to identify the prevalence of eye disorders and their causes among secondary schoolchildren aged 6–15 years old in Armenia, based on analysis of the Nationwide School Sight Sampling Survey.Methods and AnalysisA two-stage proportionate stratified cluster sample was designed for the survey. 22 600 students were screened for visual acuity in schools; 5944 of them were selected for analysis as a nationally representative sample. Those with 20/40 or worse vision were referred to photoscreening and rapid ophthalmic assessment in schools and then were provided with vouchers for free comprehensive eye examination in eye clinics. Data were collected through data collection forms and analysed using SPSS V.23.ResultsWhile majority of the children (85%) had normal vision, 15% had a visual acuity ≤20/40. The prevalence of vision impairment (VI) in at least one eye was 9.7% and blindness in at least one eye was 0.05%. The prevalence of abnormal vision and VI was higher among girls and older children. VI was more prevalent in urban areas. The most common diagnoses were myopia (60%), astigmatism (33.7%), hyperopia (29.5%) and strabismus (3.8%).ConclusionMajority of the vision abnormalities and VI among schoolchildren are a result of refractive error and are treatable. Our results highlight the importance of regular eye examinations for schoolchildren to detect and prevent VI. Raising awareness among parents, school staff and children about eye health is vital.
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Affiliation(s)
- Nairuhi Jrbashyan
- Armenian EyeCare Project, Yerevan, Armenia
- Yerevan State University, Yerevan, Armenia
| | | | - Abu Sikder
- Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Sudha Nallasamy
- Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Mark W Reid
- Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Roger Ohanesian
- Armenian EyeCare Project, Yerevan, Armenia
- Department of Ophthalmology, UC Irvine, Irvine, California, USA
| | - Thomas C Lee
- Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA
- Surgery, USC Keck School of Medicine, Los Angeles, California, USA
| | - Juan Espinoza
- Pediatrics, Children's Hospital of Los Angeles, Los Angeles, California, USA
- Pediatrics, USC Keck School of Medicine, Los Angeles, California, USA
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19
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Hayrumyan V, Harutyunyan A, Torosyan A, Grigoryan L, Sargsyan Z, Bazarchyan A, Petrosyan V, Dekanosidze A, Sturua L, Kegler MC, Berg CJ. Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial. BMJ Open 2022; 12:e055396. [PMID: 35131832 PMCID: PMC8823221 DOI: 10.1136/bmjopen-2021-055396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Given high prevalence of smoking and secondhand smoke exposure in Armenia and Georgia and quicker implementation of tobacco legislation in Georgia versus Armenia, we examined correlates of having no/partial versus complete smoke-free home (SFH) restrictions across countries, particularly smoking characteristics, risk perceptions, social influences and public smoking restrictions. DESIGN Cross-sectional survey study design. SETTING 28 communities in Armenia and Georgia surveyed in 2018. PARTICIPANTS 1456 adults ages 18-64 in Armenia (n=705) and Georgia (n=751). MEASUREMENTS We used binary logistic regression to examine aforementioned correlates of no/partial versus complete SFH among non-smokers and smokers in Armenia and Georgia, respectively. RESULTS Participants were an average age of 43.35, 60.5% women and 27.3% smokers. In Armenia, among non-smokers, having no/partial SFHs correlated with being men (OR=2.63, p=0.001) and having more friend smokers (OR=1.23, p=0.002); among smokers, having no/partial SFHs correlated with being unmarried (OR=10.00, p=0.001), lower quitting importance (OR=0.82, p=0.010) and less favourable smoking attitudes among friends/family/public (OR=0.48, p=0.034). In Georgia, among non-smokers, having no/partial SFHs correlated with older age (OR=1.04, p=0.002), being men (OR=5.56, p<0.001), lower SHS risk perception (OR=0.43, p<0.001), more friend smokers (OR=1.49, p=0.002) and fewer workplace (indoor) restrictions (OR=0.51, p=0.026); among smokers, having no/partial SFHs correlated with being men (OR=50.00, p<0.001), without children (OR=5.88, p<0.001), daily smoking (OR=4.30, p=0.050), lower quitting confidence (OR=0.81, p=0.004), more friend smokers (OR=1.62, p=0.038) and fewer community restrictions (OR=0.68, p=0.026). CONCLUSIONS Private settings continue to lack smoking restrictions in Armenia and Georgia. Findings highlight the importance of social influences and comprehensive tobacco legislation, particularly smoke-free policies, in changing household smoking restrictions and behaviours. TRIAL REGISTRATION NUMBER NCT03447912.
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Affiliation(s)
- Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arusyak Harutyunyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Lilit Grigoryan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Alexander Bazarchyan
- MOH National Institute of Health Named After Academician Suren Avdalbekyan, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ana Dekanosidze
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Lela Sturua
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Michelle C Kegler
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, George Washington University, Washington, District of Columbia, USA
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Muradyan A, Mardian M, Mkrtchyan S, Sekoyan E. [PECULIARITIES OF RELATIONSHIP BETWEEN SOME PHYSIOLOGICAL INDICATORS OF PHYSICAL HEALTH AMONG THE POPULATION OF ARMENIA]. Georgian Med News 2021:118-124. [PMID: 34749335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
It is not so easy to understand the essence of the definition of physical health, although this phrase consists of two words that have an important semantic meaning, that is, "health" is a generalized characteristic, and "physical" is related to the physical capabilities of a person. The purpose of this study was to study the relationship between some physiological indicators of the physical health of the Armenian population. A cross - sectional study of 2000 residents aged 11 to 79 years (men n=429, average age - 33.7±13.2 and women n=1171, average age-34.6±12.1) of the Republic of Armenia was conducted. Physiological indicators (wellness and its component indicators-body composition, endothelium and stress resistance (stress scores) and) were measured using the Mutiscan BC-OXi PLUS Version 2.9 RU monitoring system to study indicators with acceptable reproducibility and a significant difference in values. Studies of the general sample showed that among the population of Armenia, the indicators of endothelium and wellness are within the normal range, the indicator of body composition is slightly below the norm, and the indicator of stress resistance is on the border between the norm and the violation. The average indicators of stress resistance, endothelium and wellness are significantly higher in women compared to men and a reliable direct proportional relationship of average strength between the indicators of stress resistance-wellness, endothelium-wellness and body composition-wellness in both groups are revealed. It was found that the correlation infrastructure (according to Spearman and Pearson) of the above indicators is subject to significant changes depending on gender, while the level of these indicators (in points) in the studied samples is significantly less susceptible to changes.
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Affiliation(s)
- A Muradyan
- 1Armenian State Institute of Physical Culture and Sport, Department of physical rehabilitation; Armenia
| | - M Mardian
- Yerevan State Medical University, 2Department of public health and health organization, Armenia
| | - S Mkrtchyan
- Yerevan State Medical University, 3Department of ENT diseases, Armenia
| | - E Sekoyan
- Yerevan State Medical University, 4Department of ehabilitation, physiotherapy and sports medicine, Armenia
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Chekijian SA. Emergency systems in the Republic of Armenia: country in crisis or land of opportunity. Eur J Emerg Med 2021; 28:337-338. [PMID: 33899774 DOI: 10.1097/mej.0000000000000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sharon A Chekijian
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Oberkanins C, Pagava K, Babikyan D, Korinteli IA, Phagava H, Hayrapetian H, Kriegshäuser G, Sarkisian T. ALPHA- AND BETA-GLOBIN GENE MUTATIONS IN GEORGIA AND ARMENIA. Georgian Med News 2021:124-128. [PMID: 34628392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Georgia and Armenia are situated at the northern rim of the thalassemia belt and bordering to countries with a known high prevalence of thalassemias. In this study we assessed the carrier frequency and potential spectrum of alpha- and beta-globin mutations among 202 and 190 unselected Georgian and Armenian subjects, respectively. We found four alpha-globin mutations (-3.7del, -4.2del, anti-3.7 triplication, poly-A2) in 9 Armenians (4.74%) and 4 Georgians (1.78%). The heterozygous beta-globin codon 8 [-AA] mutation was detected in one individual from Armenia only. Overall, carrier frequencies seem to be low in both countries, supporting the notion that thalassemias are not a major health problem there.
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Affiliation(s)
| | - K Pagava
- 2Tbilisi State Medical University, Department of Child & Adolescent Medicine, Georgia
| | - D Babikyan
- 3Center of Medical Genetics and Primary Health Care, Yerevan, Armenia; 4Yerevan State Medical University, Department of Medical Genetics, Armenia
| | - I A Korinteli
- 2Tbilisi State Medical University, Department of Child & Adolescent Medicine, Georgia
| | - H Phagava
- 5Tbilisi State Medical University, Department of Epidemiology & Biostatistics, Georgia
| | - H Hayrapetian
- 3Center of Medical Genetics and Primary Health Care, Yerevan, Armenia; 4Yerevan State Medical University, Department of Medical Genetics, Armenia
| | - G Kriegshäuser
- 6IHR LABOR, Medical Diagnostic Laboratories, Vienna, Austria; 7Clinical Institute of Medical and Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - T Sarkisian
- 3Center of Medical Genetics and Primary Health Care, Yerevan, Armenia; 4Yerevan State Medical University, Department of Medical Genetics, Armenia
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Paul P, Arra B, Hakobyan M, Hovhannisyan MG, Kauhanen J. The determinants of under-5 age children malnutrition and the differences in the distribution of stunting-A study from Armenia. PLoS One 2021; 16:e0249776. [PMID: 34038415 PMCID: PMC8153414 DOI: 10.1371/journal.pone.0249776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
Stunting undermines economic growth by perpetuating the vicious cycle of poverty and labour market performance. Studies have captured the trend in stunting and present distributional evidence of policy effects in the country contexts. We identify the determinants of U5 (under 5 years of age) malnutrition for the poor and the Nonpoor and compare the distribution of stunting at four time points (2000, 2005, 2010 and 2015) over a 15-year period between different groups of population. Further, we decompose the gap in malnutrition into causes of differences in stunting between worse-off and better-off socioeconomic groups of the population and estimate the magnitude of distributional differences in stunting between two socioeconomic groups. We also present the inequality trend over time that provides insights into the dynamicity of the effect of different determinants on stunting at different time points. Using 35,490 observations from Armenian Demographic and Health Survey Data [four waves: Year2015,9533; Year2010,8644; Year2005,8919; Year2000,8334], we apply regression-based decomposition method and inequality measures to identify the determinants of malnutrition and distribution of stunting between and within socioeconomic groups. Although the proportional difference in prevalence of stunting between worse-off and better-off children of 13 months and above are reduced by 9.5% in 2015 compared to 2000, the association between socioeconomic position and stunting is statistically significant among children aged 13 months and above in 2000, as well as among children of 36 months and above in 2015. This study demonstrates that the less of socioeconomic distribution of the population, but rather more of the effect from in-country region and settlement of residence are significantly associated with stunting. The approach of our analysis is potentially also a useful tool to generate evidence for decision making towards achieving SDGs 2.2. We conclude that development in childhood is not independent from the distributional effect of region specific development initiatives. Understanding the regional characteristics and resources allocated for the maternal and child health is the necessity to address stunting.
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Affiliation(s)
- Pavitra Paul
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- * E-mail:
| | - Bhanu Arra
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | | | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Goenjian AK, Steinberg AM, Walling D, Bishop S, Karayan I, Pynoos R. 25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression. Psychol Med 2021; 51:976-988. [PMID: 31931901 PMCID: PMC8161430 DOI: 10.1017/s0033291719003891] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/29/2019] [Accepted: 12/06/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors. METHODS At 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate-severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS (1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1-22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses. CONCLUSION Post-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
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Affiliation(s)
- Armen K. Goenjian
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
- Collaborative Neuroscience Network, Garden Grove, CA, USA
- Psychiatric Outreach Program, Armenian Relief Society, Long Beach, CA, USA
| | - Alan M. Steinberg
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
| | - David Walling
- Collaborative Neuroscience Network, Garden Grove, CA, USA
| | - Sheryl Bishop
- School of Nursing, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Ida Karayan
- Psychiatric Outreach Program, Armenian Relief Society, Long Beach, CA, USA
| | - Robert Pynoos
- Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles, Los Angeles, CA, USA
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25
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Kuhls K, Moskalenko O, Sukiasyan A, Manukyan D, Melik-Andreasyan G, Atshemyan L, Apresyan H, Strelkova M, Jaeschke A, Wieland R, Frohme M, Cortes S, Keshishyan A. Microsatellite based molecular epidemiology of Leishmania infantum from re-emerging foci of visceral leishmaniasis in Armenia and pilot risk assessment by ecological niche modeling. PLoS Negl Trop Dis 2021; 15:e0009288. [PMID: 33872307 PMCID: PMC8055006 DOI: 10.1371/journal.pntd.0009288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 03/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is re-emerging in Armenia since 1999 with 167 cases recorded until 2019. The objectives of this study were (i) to determine for the first time the genetic diversity and population structure of the causative agent of VL in Armenia; (ii) to compare these genotypes with those from most endemic regions worldwide; (iii) to monitor the diversity of vectors in Armenia; (iv) to predict the distribution of the vectors and VL in time and space by ecological niche modeling. METHODOLOGY/PRINCIPAL FINDINGS Human samples from different parts of Armenia previously identified by ITS-1-RFLP as L. infantum were studied by Multilocus Microsatellite Typing (MLMT). These data were combined with previously typed L. infantum strains from the main global endemic regions for population structure analysis. Within the 23 Armenian L. infantum strains 22 different genotypes were identified. The combined analysis revealed that all strains belong to the worldwide predominating MON1-population, however most closely related to a subpopulation from Southeastern Europe, Maghreb, Middle East and Central Asia. The three observed Armenian clusters grouped within this subpopulation with strains from Greece/Turkey, and from Central Asia, respectively. Ecological niche modeling based on VL cases and collected proven vectors (P. balcanicus, P. kandelakii) identified Yerevan and districts Lori, Tavush, Syunik, Armavir, Ararat bordering Georgia, Turkey, Iran and Azerbaijan as most suitable for the vectors and with the highest risk for VL transmission. Due to climate change the suitable habitat for VL transmission will expand in future all over Armenia. CONCLUSIONS Genetic diversity and population structure of the causative agent of VL in Armenia were addressed for the first time. Further genotyping studies should be performed with samples from infected humans, animals and sand flies from all active foci including the neighboring countries to understand transmission cycles, re-emergence, spread, and epidemiology of VL in Armenia and the entire Transcaucasus enabling epidemiological monitoring.
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Affiliation(s)
- Katrin Kuhls
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
- Research Platform Data Analysis & Simulation, Leibniz Centre for Agricultural Landscape Research (ZALF), Müncheberg, Germany
| | - Olga Moskalenko
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
| | - Anna Sukiasyan
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
- Research Institute of Epidemiology, Virology and Medical Parasitology after A.B. Alexanyan, Ministry of Health, Yerevan, Armenia
- Eurasia International University, Yerevan, Armenia
| | - Dezdemonia Manukyan
- Research Institute of Epidemiology, Virology and Medical Parasitology after A.B. Alexanyan, Ministry of Health, Yerevan, Armenia
| | - Gayane Melik-Andreasyan
- Research Institute of Epidemiology, Virology and Medical Parasitology after A.B. Alexanyan, Ministry of Health, Yerevan, Armenia
- National Center of Disease Control and Prevention, Ministry of Health,Yerevan, Armenia
| | - Liana Atshemyan
- Research Institute of Epidemiology, Virology and Medical Parasitology after A.B. Alexanyan, Ministry of Health, Yerevan, Armenia
| | - Hripsime Apresyan
- Yerevan State Medical University after Mkitar Herats, Yerevan, Armenia
| | - Margarita Strelkova
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector-borne Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anja Jaeschke
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | - Ralf Wieland
- Research Platform Data Analysis & Simulation, Leibniz Centre for Agricultural Landscape Research (ZALF), Müncheberg, Germany
| | - Marcus Frohme
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
| | - Sofia Cortes
- Division of Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, Wildau, Germany
- Global Health & Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ara Keshishyan
- Research Institute of Epidemiology, Virology and Medical Parasitology after A.B. Alexanyan, Ministry of Health, Yerevan, Armenia
- National Center of Disease Control and Prevention, Ministry of Health,Yerevan, Armenia
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26
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Kantner AC, van Wees SH, Olsson EMG, Ziaei S. Factors associated with measles vaccination status in children under the age of three years in a post-soviet context: a cross-sectional study using the DHS VII in Armenia. BMC Public Health 2021; 21:552. [PMID: 33743623 PMCID: PMC7981943 DOI: 10.1186/s12889-021-10583-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The resurgence of measles globally and the increasing number of unvaccinated clusters call for studies exploring factors that influence measles vaccination uptake. Armenia is a middle-income post-Soviet country with an officially high vaccination coverage. However, concerns about vaccine safety are common. The purpose of this study was to measure the prevalence of measles vaccination coverage in children under three years of age and to identify factors that are associated with measles vaccination in Armenia by using nationally representative data. METHODS Cross-sectional analysis using self-report data from the most recent Armenian Demographic Health Survey (ADHS VII 2015/16) was conducted. Among 588 eligible women with a last-born child aged 12-35 months, 63 women were excluded due to unknown status of measles vaccination, resulting in 525 women included in the final analyses. We used logistic regression models in order to identify factors associated with vaccination status in the final sample. Complex sample analyses were used to account for the study design. RESULTS In the studied population 79.6% of the children were vaccinated against measles. After adjusting for potential confounders, regression models showed that the increasing age of the child (AOR 1.07, 95% CI: 1.03-1.12), secondary education of the mothers (AOR 3.38, 95% CI: 1.17-9.76) and attendance at postnatal check-up within two months after birth (AOR 2.71, 95% CI: 1.17-6.30) were significantly associated with the vaccination status of the child. CONCLUSIONS The measles vaccination coverage among the children was lower than the recommended percentage. The study confirmed the importance of maternal education and attending postnatal care visits. However, the study also showed that there might be potential risks for future measles outbreaks because of delayed vaccinations and a large group of children with an unknown vaccination status.
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Affiliation(s)
- Annabell C Kantner
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Sibylle Herzig van Wees
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
- Karolinska Institutet, Department of Global Public Health, K9 Global folkhälsa, K9 GH Stålsby Lundborg Hanson, SE-171 77, Stockholm, Sweden
| | - Erik M G Olsson
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Shirin Ziaei
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden.
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Grabsky A. [; RETROSPECTIVE CLINICAL EPIDEMIOLOGICAL STUDY OF PREVALENCE OF URINARY STONE DISEASE IN THE REGIONS OF ARMENIA]. Georgian Med News 2020:19-26. [PMID: 32965244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Morbidity of USD is constantly rising in Armenia as well as in the world and this tendency is rising on its own. The prevalence for 100,000 of population has grown from 252,1 in 1990 to 519.6 in 2014. If in 1990 the incidence of USD was 52.6 new cases per 100,000 of population, in 2014 the incidence grew to 196.2 new cases. We have analyzed data of 793 patients, who were examined and treated at "Izmirlyan" Medical Center from 2006 to 2013 with the diagnosis of USD. The stones were removed by a medical expulsion technique as well as surgically by ESWL, URS, PNL, laparoscopy or open surgery. Chemical analysis of stone shows that 49,56% patients had calcium oxalate stones, 7,19% - uric acid stones, 0,76% - carbonate stones, 0,38% - phosphate stones, 0,26% - cystine stone and 41,6% - Mixed stones. The stone distribution by chemical composition in patients from Yerevan is the following: 52,3% - calcium oxalate stones, 5,9% - uric acid stones, 1,05% - carbonate stones, 0,42% - phosphate stones, 40,33% - mixed stones. The stone type largest percentage by regions of Armenia: oxalate stones in Armavir region of Armenia - 58,4%; uric acid stones in Tavush and Sunik regions - 25% and 17,6%; mixed stones in Lori and Vayots-Dzor regions. In conclusion we can say that in a small country like Armenia USD is one of the most widespread diseases with different stone composition, depending on the region, as far as the landscape of the country varies from 380 to 4100 m above sea level and climate ranges from hot subtropical to cold high-land. CaOx stones are seen most frequently throughout Armenia, the percentage of these stone ranged from 31,25% to 58,4%, with a medium value of 49,56%. Next largest group is represented by mixed stones, which mostly consist of CaOx again and uric acid stones, which, of interest, constitutes more stone burden in absolute figures compared to pure uric acid stones.
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Affiliation(s)
- A Grabsky
- Yerevan State Medical University after Mkhitar Heratsi; "Izmirlian" Medical Center, Yerevan, Armenia
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Markosyan T, Sargsyan K, Kharatyan S, Elbakyan H, Hakobyan V, Simonyan L, Voskanyan H, Shirvanyan A, Stepanyan T, Khachatryan M, Karapetyan M, Avagyan A, Mcvey WR, Weller R, Keen J, Risatti GR. The epidemiological status of African swine fever in domestic swine herds in the Tavush Province region, Armenia. REV SCI TECH OIE 2020; 38:751-760. [PMID: 32286569 DOI: 10.20506/rst.38.3.3024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
KEEN The factors associated with the spread and persistence of African swine fever (ASF) in the Caucasus region remain to be fully identified. It is assumed that large naive populations of domestic free-ranging and wild pigs are critical to disease transmission and maintenance. Nonetheless, 11 years since its epidemic introduction into the region in 2007, ASF virus (ASFV) is still circulating, suggesting that an endemic cycle has been established based on contact between free-ranging domestic pigs and wild pigs, and that native Ornithodoros ticks probably serve as reservoirs for the virus. Therefore, research is required to gather information on the epidemiological status of ASF in the Caucasus region, focusing particularly on understanding modes of ASFV spread and persistence in this new virus environment. The authors established an ASFV survey targeting domestic pigs in the Tavush province of northern Armenia, an area of the country considered to be at high risk of disease incursion/occurrence. All tested samples collected for this survey were negative for ASF. The probability of observing no reactors by antibody enzyme-linked immunosorbent assay in a sample of this size (n = 1,506) from a population with an estimated disease prevalence of 1% is very low (< 0.0001). Therefore, it is possible but very unlikely for ASFV to be present among domestic pigs in the Tavush province region.
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Badalian SS, Sagayan E, Simonyan H, Minassian VA, Isahakian A. The prevalence of pelvic floor disorders and degree of bother among women attending primary care clinics in Armenia. Eur J Obstet Gynecol Reprod Biol 2020; 246:106-112. [PMID: 32006916 DOI: 10.1016/j.ejogrb.2020.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the prevalence of various Pelvic Floor Disorders (PFD) and the degree of symptom bother in a convenience sample of Armenian women in the Republic of Armenia. METHODS Fifty women ages 20-85 years from each Armenian region (Marz) were included in the study. The survey included the validated Armenian version of the Global Pelvic Floor Bother Questionnaire (PFBQ) and general questions on demographics and comorbidities related to these disorders. RESULTS A total of 540 women (90%) attending primary care clinics completed the validated PFBQ questionnaire. Initial analysis showed that the PFBQ score was significantly higher in older women, and those with higher vaginal parity and BMI. Women with prior hysterectomy (37.1+22.4) and prior pelvic prolapse or anti-incontinence surgeries (40.6+21.6) had significantly higher PFBQ scores than women without prior surgeries (18.8+20,0 and 19.4+19.7) and were associated with an increased odds of developing pelvic prolapse symptoms and obstructed defecation. CONCLUSIONS PFD symptoms were observed to be common and significantly correlated with demographic characteristics and self-reported comorbidities in Armenian women. We need to start promoting proper training of physicians in Female Pelvic Medicine and Reconstructive Surgery.
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Affiliation(s)
| | - Elena Sagayan
- Kaiser Permanente Medical Center, Pleasantville, California, USA
| | | | - Vatche A Minassian
- Brigham and Women's Hospital, Harvard Medical School, Massachusetts, USA
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Hovhannesyan K, Sahakyan S, Davtyan K, Gasparyan S, Sarkisyan T, Reid AJ. Epidemiology and management of familial Mediterranean fever in Armenia: national audit from 1999 to 2018. Clin Exp Rheumatol 2019; 37 Suppl 121:154-155. [PMID: 30873950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/11/2019] [Indexed: 06/09/2023]
Affiliation(s)
| | - Serine Sahakyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Karapet Davtyan
- FMD K & L, Yerevan, and TB Research and Prevention Center NGO, Yerevan, Armenia
| | | | - Tamara Sarkisyan
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
| | - Anthony John Reid
- Operational Research Unit, Operational Centre Brussels, Médecins sans Frontières, Luxembourg
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Bacci A, Hodorogea S, Khachatryan H, Babojonova S, Irsa S, Jansone M, Dondiuc I, Matarazde G, Lazdane G, Lazzerini M. What is the quality of the maternal near-miss case reviews in WHO European Region? Cross-sectional study in Armenia, Georgia, Latvia, Republic of Moldova and Uzbekistan. BMJ Open 2018; 8:e017696. [PMID: 29654004 PMCID: PMC5898291 DOI: 10.1136/bmjopen-2017-017696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES The maternal near-miss case review (NMCR) cycle is a type of clinical audit aiming at improving quality of maternal healthcare by discussing near-miss cases. In several countries this approach has been introduced and supported by WHO and partners since 2004, but information on the quality of its implementation is missing. This study aimed at evaluating the quality of the NMCR implementation in selected countries within WHO European Region. DESIGN Cross-sectional study. SETTINGS Twenty-three maternity units in Armenia, Georgia, Latvia, Moldova and Uzbekistan. ASSESSMENT TOOLS A predefined checklist including 50 items, according to WHO methodology. Quality in the NMCR implementation was defined by summary scores ranging from 0 (totally inappropriate) to 3 (appropriate). RESULTS Quality of the NMCR implementation was heterogeneous among different countries, and within the same country. Overall, the first part of the audit cycle (from case identification to case analysis) was fairly well performed (mean score 2.00, 95% CI 1.94 to 2.06), with the exception of the 'inclusion of users' views' (mean score 0.66, 95% CI 0.11 to 1.22), while the second part (developing recommendations, implementing them and ensuring quality) was poorly performed (mean score 0.66, 95% CI 0.11 to 1.22). Each country had at least one champion facility, where quality of the NMCR cycle was acceptable. Quality of the implementation was not associated with its duration. Gaps in implementation were of technical, organisational and attitudinal nature. CONCLUSIONS Ensuring quality in the NMCR may be difficult but achievable. The high heterogeneity in results within the same country suggests that quality of the NMCR implementation depends, to a large extent, from hospital factors, including staff's commitment, managerial support and local coordination. Efforts should be put in preventing and mitigating common barriers that hamper successful NMCR implementation.
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Affiliation(s)
- Alberta Bacci
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Stelian Hodorogea
- State Medical and Pharmaceutical University "N. Testemitanu", Chisinau, Moldova
| | | | | | - Signe Irsa
- Pauls Stradins Clinical University Hospital, Riga, Latvia
| | | | | | | | - Gunta Lazdane
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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Armenia, Maldives, Sri Lanka and Kyrgyzstan certified malaria-free. Wkly Epidemiol Rec 2017; 92:573-7. [PMID: 28960947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Fazeli Moghadam E, Tadevosyan A, Fallahi E, Goodarzi R. Nutritional factors and metabolic variables in relation to the risk of coronary heart disease: A case control study in Armenian adults. Diabetes Metab Syndr 2017; 11:7-11. [PMID: 27339795 DOI: 10.1016/j.dsx.2016.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/06/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Dietary factors can affect the coronary heart disease (CHD). Results of previous studies on the association between the diet and CHD are not consistent in different countries. There were no data on this association in Armenia. OBJECTIVE Aims of this case-control study were to evaluate the association between nutritional factors and CHD among Armenians in Yerevan. METHODS During 2010 and 2011, we randomly selected 320 CHD patients with a diagnosis of CHD less than 6 months and 320 subjects without CHD (≥30years old) from the hospitals and polyclinics in Yerevan. Dietary intakes with 135 food items over the previous 12 months were evaluated using a semi-quantitative food frequency questionnaire. RESULTS After adjusting for some CHD risk factors higher intakes of polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA) were associated with a reduced risk of CHD, while this association was not witnessed for saturated fatty acids (SFA). In addition, findings indicated an inverse relation between vitamins (E, B6 and B12, folic acid) and fiber with CHD. In this population, smoking, hypertension, and metabolic syndrome (MetS) were significantly more common among patients with CHD. CONCLUSION The intake of vitamins E, B6 and B12, folic acid, PUFA, MUFA and fiber appeared to be predictors of CHD, independently of other risk factors.
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Affiliation(s)
| | - Artashes Tadevosyan
- DSC Public Health Department, Yerevan State Medical University, Yerevan, Armenia
| | - Ebrahim Fallahi
- Nutrition Department, Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Reza Goodarzi
- Imam Hospital of Borujerd, Lorestan University of Medical Sciences and Health Services, Borujerd, Iran.
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Atoyan S, Hayrapetyan H, Sarkisian T, Ben-Chetrit E. MEFV and SAA1 genotype associations with clinical features of familial Mediterranean fever and amyloidosis in Armenia. Clin Exp Rheumatol 2016; 34:72-76. [PMID: 27791951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/26/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Familial Mediterranean fever (FMF) is a hereditary periodic disease characterised by recurrent attacks of fever and serositis. The most devastating complication of FMF is amyloidosis (AA) affecting mainly the kidneys. Aim of the study is to search for correlations between the MEFV genotype and the SAA polymorphisms with the clinical manifestations of FMF and the occurrence of amyloidosis in a large cohort of Armenian patients. METHODS Information about the MEFV mutations, SAA polymorphisms and FMF clinical features, were obtained for 1017 FMF patients, from the database of the Center of Medical Genetics in Yerevan. For identifying probable correlation between the MEFV and SAA genotype and clinical features of FMF, regression logistic analyses were conducted between the genotype and phenotype of the patients. RESULTS Patients homozygous for M694V were highly associated with all the clinical features of FMF and its complications - proteinuria and amyloidosis. None of the SAA1 polymorphisms had any correlation with FMF clinical features. However, homozygosis for SAA1 α/α polymorphism was associated with proteinuria and amyloidosis whereas carrying the β/β polymorphism was found to be protective for amyloidosis. CONCLUSIONS The SAA1 α allele is strongly associated with amyloidosis in FMF patients. This observation is valid in inflammatory diseases other than FMF too. SAA1 polymorphism has no effect on the clinical features of FMF. M694V homozygosis is highly associated withal typical features of FMF and with amyloidosis. FMF course in Armenia is similar to that in Middle Eastern countries where FMF disease is common.
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Affiliation(s)
- Stepan Atoyan
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
| | | | - Tamara Sarkisian
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
| | - Eldad Ben-Chetrit
- Rheumatology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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Khachadourian V, Armenian H, Demirchyan A, Melkonian A, Hovanesian A. A post-earthquake psychopathological investigation in Armenia: methodology, summary of findings, and follow-up. Disasters 2016; 40:518-533. [PMID: 26578424 DOI: 10.1111/disa.12166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The post-earthquake psychopathological investigation (PEPSI) was designed to probe the short-and long-term effects of the earthquake in northern Armenia on 7 December 1988 on survivors' mental and physical health. Four phases of this study have been conducted to date, and, overall, more than 80 per cent of a sub-sample of 1,773 drawn from an initial cohort of 32,743 was successfully followed during 2012. This paper describes the methodology employed in the evaluation, summarises previous findings, details the current objectives, and examines the general characteristics of the sample based on the most recent follow-up phase outcomes. Despite a significant decrease in psychopathology rates between 1990 and 2012, prevalence rates of post-traumatic stress disorder and depression among study participants in 2012 were greater than 15 and 26 per cent, respectively. The paper also notes the strengths and limitations of the study vis-à-vis future research and highlights the importance and potential practical implications of similar assessments and their outcomes.
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Affiliation(s)
- Vahe Khachadourian
- Research Associate at the College of Health Sciences, American University of Armenia, Armenia
| | - Haroutune Armenian
- Professor at the Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, United States
| | - Anahit Demirchyan
- Senior Research Specialist at the College of Health Sciences, American University of Armenia, Armenia
| | | | - Ashot Hovanesian
- Chief Executive Officer at Synergy International Systems, United States
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Balayan AZ. [CLINICAL FEATURES DURING THE ACUTE CHOLECYSTITIS IN THE OLDER AGE GROUP OF PATIENTS]. Eksp Klin Gastroenterol 2016:60-64. [PMID: 30280556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
One of the most popular abdominal diseases is an acute cholecystitis. that’s why is very actual in acute cholecystitis the study of clinical features in the older age group of patients in improving of preoperative diagnosis and adequate option of treatment. In the research were involved 1273 patients, wiich were the patients during 2007-2014 years in Medical center of Yerevan, department of Laporacopic surgery, who suffered from acute cholecystitis. Research findings from the data analysis allows us to assume that the characteristics of the older age group of patients during the acute cholecystitis are difficult to do some surgical intervention and it needs very clever prediction for treatment.
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Ben-Chetrit E, Hayrapetyan H, Yegiazaryan A, Shahsuvaryan G, Sarkisian T. Familial Mediterranean fever in Armenia in 2015: some interesting lessons. Clin Exp Rheumatol 2015; 33:S15-S18. [PMID: 26487400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Eldad Ben-Chetrit
- Rheumatology Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.
| | | | - Anna Yegiazaryan
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
| | | | - Tamara Sarkisian
- Center of Medical Genetics and Primary Health Care, Yerevan, Armenia
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Truzyan N, Crape B, Grigoryan R, Martirosyan H, Petrosyan V. Increased risk for multidrug-resistant tuberculosis in migratory workers, Armenia. Emerg Infect Dis 2015; 21:474-6. [PMID: 25695488 PMCID: PMC4344258 DOI: 10.3201/eid2103.140474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To understand use of tuberculosis (TB) services for migrant workers, we conducted a cross-sectional census of 95 migrant workers with TB from Armenia by using medical record reviews and face-to-face interviews. Prolonged time between diagnosis and treatment, treatment interruption, and treatment defaults caused by migrant work might increase the risk for multidrug-resistant TB.
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Schweitzer A, Krause G, Pessler F, Akmatov MK. Improved coverage and timing of childhood vaccinations in two post-Soviet countries, Armenia and Kyrgyzstan. BMC Public Health 2015; 15:798. [PMID: 26285702 PMCID: PMC4545703 DOI: 10.1186/s12889-015-2091-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Timing of childhood vaccinations has received close attention in many countries. Little is known about the trends in correctly timed vaccination in former Soviet countries. We examined trends in vaccination coverage and correct timing of vaccination in two post-Soviet countries, Armenia and Kyrgyzstan, and analyzed factors associated with delayed vaccinations. METHODS We used data from the Demographic and Health Surveys; the surveys were conducted in 2000 (n = 1726), 2005 (n = 1430) and 2010 (n = 1473) in Armenia and in 1997 (n = 1127) and 2012 (n = 4363) in Kyrgyzstan. We applied the Kaplan-Meier method to estimate age-specific vaccination coverage with diphtheria, tetanus and pertussis (DTP) vaccine and a measles-containing vaccine (MCV). A Cox proportional hazard regression with shared frailty was used to examine factors associated with delayed vaccinations. RESULTS Vaccination coverage for all three doses of the DTP vaccine increased in Armenia from 92 % in 2000 to 96 % in 2010. In Kyrgyzstan, DTP coverage was 96 % and 97 % in 1997 and 2012, respectively. Vaccination coverage for MCV increased from 89 % (Armenia, 2000) and 93 % (Kyrgyzstan, 1997) to 97 % (Armenia, 2010) and 98 % (Kyrgyzstan, 2012). The proportion of children with correctly timed vaccinations increased over time for all examined vaccinations in both countries. For example, the proportion of children in Armenia with correctly timed first DTP dose (DTP1) increased from 46 % (2000) to 66 % (2010). In Kyrgyzstan, the proportion of correctly timed DTP1 increased from 75 % (1997) to 87 % (2012). In Armenia, delays in the third DTP dose (DTP3) and MCV vaccinations were less likely to occur in the capital, whereas in Kyrgyzstan DTP3 and MCV start was delayed in the capital compared to other regions of the country. Also, in Armenia living in urban areas was associated with delayed vaccinations. CONCLUSIONS Vaccination coverage and timing of vaccination improved over the last years in both countries. Further efforts are needed to reduce regional differences in timely vaccinations.
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Affiliation(s)
- A Schweitzer
- Helmholtz Centre for Infection Research, Braunschweig, Germany.
| | - G Krause
- Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - F Pessler
- Helmholtz Centre for Infection Research, Braunschweig, Germany.
- TWINCORE Centre for Experimental and Clinical Infection Research, Hannover, Germany.
| | - M K Akmatov
- Helmholtz Centre for Infection Research, Braunschweig, Germany.
- TWINCORE Centre for Experimental and Clinical Infection Research, Hannover, Germany.
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Strelkova MV, Ponirovsky EN, Morozov EN, Zhirenkina EN, Razakov SA, Kovalenko DA, Schnur LF, Schönian G. A narrative review of visceral leishmaniasis in Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, the Crimean Peninsula and Southern Russia. Parasit Vectors 2015; 8:330. [PMID: 26077778 PMCID: PMC4474452 DOI: 10.1186/s13071-015-0925-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 06/01/2015] [Indexed: 11/10/2022] Open
Abstract
There is an extensive body of medical and scientific research literature on visceral leishmaniasis (VL) in the Caucasus, Central Asia, the Crimean Peninsula and the southern part of The Russian Federation that is written in Russian, making it inaccessible to the majority of people who are interested in the leishmaniases in general and VL in particular. This review and summary in English of VL in what was Imperial Russia, which then became the Soviet Union and later a number of different independent states intends to give access to that majority. There are numerous publications in Russian on VL and, mostly, those published in books and the main scientific journals have been included here. The vast geographical area encompassed has been subdivided into four main parts: the southern Caucasus, covering Armenia, Azerbaijan and Georgia; Central Asia, covering Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan; the Crimean Peninsula and the northern Caucasus, which is part of The Russian Federation. Only rare cases of VL have been recorded in the northern Caucasus and Crimean Peninsula. In the other countries mentioned, human VL has been more intense but epidemics like those associated with L. donovani in India and East Africa have not occurred. For most of the countries, there are sections on the distribution, clinical aspects, the causative agent, the reservoirs and the vectors. Serological surveys and research into therapy are also covered. Recent studies on VL in Uzbekistan covered the application of serological, biochemical and molecular biological methods to diagnose human and canine VL, to identify the leishmanial parasites causing them in Uzbekistan and neighbouring Tajikistan and the epidemiology of VL in the Namangan Region of the Pap District, Eastern Uzbekistan. More recently, two studies were carried out in Georgia investigating the prevalence of human and canine VL, and the species composition of phlebotomine sand flies and their rates of infection with what was probably L. infantum in Tbilisi, eastern Georgia and Kutaisi, a new focus, in western Georgia. Though published in English, summaries of this information have been included where relevant to update the parts on VL in Uzbekistan and Georgia.
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Affiliation(s)
- Margarita V Strelkova
- The Sechenov First Moscow State Medical University, Martsinovsky Institute of Medical Parasitology and Tropical Medicine, Moscow, Russia.
| | - Evgeny N Ponirovsky
- The Sechenov First Moscow State Medical University, Martsinovsky Institute of Medical Parasitology and Tropical Medicine, Moscow, Russia.
| | - Evgeny N Morozov
- The Sechenov First Moscow State Medical University, Martsinovsky Institute of Medical Parasitology and Tropical Medicine, Moscow, Russia.
| | - Ekaterina N Zhirenkina
- The Sechenov First Moscow State Medical University, Martsinovsky Institute of Medical Parasitology and Tropical Medicine, Moscow, Russia.
| | - Shavkat A Razakov
- The Isaev Research Institute of Medical Parasitology, Samarqand, Uzbekistan.
| | - Dmitriy A Kovalenko
- The Isaev Research Institute of Medical Parasitology, Samarqand, Uzbekistan.
| | - Lionel F Schnur
- The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
| | - Gabriele Schönian
- The Institute of Microbiology and Hygiene, Charite University Medicine, Hindenburgdamm 30, D-12203, Berlin, Germany.
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Affiliation(s)
- Marina Ohanyan
- Family Medicine Department, Yerevan State Medical University after Mkhitar Hratsi & Co-president, Family Medicine Academic Society, Yerevan, Republic of Armenia. E-mail:
| | - Armine Danielyan
- Family Medicine Department, Yerevan State Medical University after Mkhitar Hratsi, Yerevan Ohanyan, Republic of Armenia
| | - Kevork Hopayian
- Suffolk, UK, and Honorary Senior Lecturer, School of Medicine, University of East Anglia, Norwich, UK
| | - Bob Mash
- Professor and Head of Division, Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa. E-mail:
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Laube GF, Sarkissian A, Nazaryan H, Spartà G, Sanamyan A, Babloyan A, Leumann E, Gaspert A. Native kidney biopsies in Armenian and Swiss children: high prevalence of amyloidosis in Yerevan and of IgA nephropathy in Zurich. Virchows Arch 2014; 466:77-83. [PMID: 25380969 DOI: 10.1007/s00428-014-1681-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/02/2014] [Accepted: 10/27/2014] [Indexed: 11/30/2022]
Abstract
The spectrum of pathology in native kidney biopsies varies considerably between different countries. Based on similar biopsy policy and joint workup, biopsy data of native kidneys of children in Yerevan (Armenia) and Zurich (Switzerland) were compared over a period of two decades (1993-2002 and 2003-2012). A total of 487 renal biopsies in Yerevan (EVN), n = 253; median age 11.2 years (range 0.8-18; 56 % males) and in Zurich (ZRH), n = 234; median age 8.7 years (range 0.1-18; 61 % males) were analyzed. Biopsies from EVN were locally analyzed by light microscopy (LM) and sent to ZRH for electron microscopy (EM) and immunohistochemistry. Biopsies from ZRH were evaluated by LM, EM, and immunofluorescence. The significant difference concerns the high frequency of amyloidosis in EVN (25.4 % in the first and 19.4 % in the second decade vs. 0 % in ZRH) and of IgA nephropathy in ZRH (30.2 % in the first and 26.1 % in the second decade vs. 8.1 in EVN). Certain forms of glomerulonephritis (membranoproliferative type I and membranous) and primary focal segmental glomerulosclerosis tended to be more frequent in EVN than in ZRH. Amyloid nephropathy due to familial Mediterranean fever is still highly frequent in Armenia with a slight decrease in the second decade. In Switzerland, the most common finding was IgA nephropathy.
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Affiliation(s)
- Guido F Laube
- University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland,
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Abstract
This study aims to add to the scant research on the association between labour migration and sexually transmitted infections (STIs). It builds upon earlier findings suggesting that left-behind migrants' wives tend to have higher risks of contracting STIs than women married to non-migrants. Using data from a 2007 survey in rural Armenia, a post-Soviet patriarchal setting with high levels of seasonal male migration and high rates of STIs, we examine how migration influences spousal communication about STIs, and how this communication, in turn, affects women's use of medical care for STI-like symptoms. The results of random-intercept logistic regression models show that migrants' wives were significantly more likely to talk about STI-related risks with their husbands than were non-migrants' wives. However, among women reporting STI-like symptoms in 12 months before the survey, migrants' wives were less likely to have talked to their husbands about these symptoms. We also find that women married to migrants were less likely to seek professional care for their STI-like symptoms than those married to non-migrants, but this association was moderated by women's communication about these symptoms with their spouses.
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Affiliation(s)
- Arusyak Sevoyan
- a Australian Population and Migration Research Centre, School of Social Sciences, University of Adelaide , Adelaide , Australia
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Demirchyan A, Petrosyan D, Armenian HK. Rate and predictors of postpartum depression in a 22-year follow-up of a cohort of earthquake survivors in Armenia. Arch Womens Ment Health 2014; 17:229-37. [PMID: 24435250 DOI: 10.1007/s00737-013-0404-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 12/26/2013] [Indexed: 11/26/2022]
Abstract
Disasters have serious long-term impact on mental health for those exposed. The aim of this study was to identify predictors of postpartum depression among survivors of the 1988 devastating earthquake in Armenia. A nested case-control design was applied to investigate postpartum depression in a large-scale cohort of survivors followed between 1990 and 2012. From an original group of 725 adults who were assessed for psychopathology in 1990, 146 women reported having a delivery after the earthquake and were included in this study. Women with postpartum depression were identified using Edinburgh Postnatal Depression Scale. A logistic regression model was fitted to identify the predictors of postpartum depression. Of the 146 women, 19 (13.0%) had postpartum depression. Five independent predictors of postpartum depression were identified: number of woman's stressful life events (odds ratio (OR)=2.06), her prior history of postpartum depression (OR=16.98), delivering sick/dead neonate (OR=13.65), poor living standards during the post-earthquake decade (OR=5.77), and perceiving oneself reliable in 1990 (OR=0.24). Anxiety in 1990 was marginally significantly related to the outcome (OR=3.75). The rate of postpartum depression in this 22-year cohort was similar to that among the Armenian general population. Earthquake exposure was not related to postpartum depression, indicating that the impact of disaster-related trauma diminishes over time. The identified predictors provided evidence to develop interventions targeting groups of women most prone to postpartum depression under such circumstances.
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Affiliation(s)
- Anahit Demirchyan
- School of Public Health, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan, 0019, Armenia,
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Hovhannisyan L, Demirchyan A, Petrosyan V. Estimated prevalence and predictors of undernutrition among children aged 5-17 months in Yerevan, Armenia. Public Health Nutr 2014; 17:1046-53. [PMID: 23673150 PMCID: PMC10282360 DOI: 10.1017/s1368980013001171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/19/2013] [Accepted: 03/20/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Child undernutrition is a serious public health problem in many low- and middle-income countries. Data on child undernutrition prevalence and its risk factors in Armenia are limited. The present study aimed to estimate the prevalence and explore the predictors of undernutrition among children aged 5-17 months in Yerevan. DESIGN The study was cross-sectional and employed a review of the ambulatory charts of children selected through a multistage cluster sampling. This phase was followed by a case-control study. The cases were undernourished children identified during the record review and randomly matched with normally growing controls of the same age and gender from the same pool of records. Mothers of cases and controls participated in a telephone interview. The study used conditional logistic regression analysis. SETTING Yerevan, Armenia. SUBJECTS Children aged 5-17 months residing in Yerevan, Armenia. RESULTS Review of 570 ambulatory charts suggested the prevalence of stunting, underweight and wasting among 5-17-month-old children in Yerevan to be 17·9 %, 7·3 % and 3·1 %, respectively. The case-control study of eighty-nine matched pairs identified four significant predictors of child undernutrition: family's socio-economic status score (P = 0·030), child's length at birth (P = 0·027), duration of predominant breast-feeding (P = 0·046) and food diversity score (P = 0·039). CONCLUSIONS The factors determining growth patterns of children in Yerevan are mostly behavioral and environmental, hence modifiable. Reducing poverty and inequalities in food availability, promoting breast-feeding and adequate complementary feeding, and ensuring optimal care before, during and after pregnancy are likely to help reduce child undernutrition in Yerevan, Armenia and societies with similar public health concerns.
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Affiliation(s)
- Lilit Hovhannisyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
| | - Anahit Demirchyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
| | - Varduhi Petrosyan
- College of Health Sciences, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia
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Galstian AG. [The prevalence of main risk factors of development of cardio-vascular diseases in persons of young age]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2013:11-13. [PMID: 24175379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The article deals with results of study of main risk factors of development of cardio-vascular diseases in students of Stepanokert in 2007-2010. The main characteristics of prevalence of analyzed factors and their dynamics during established study period are presented are presented. The structure of prevalence of main risk factors predisposing to development of cardio-vascular diseases is determined. The predominance of risk factors of hypodynamia and higher psycho-emotional stress is established.
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Harhay MO, Harhay JS, Nair MM. Education, household wealth and blood pressure in Albania, Armenia, Azerbaijan and Ukraine: findings from the Demographic Health Surveys, 2005-2009. Eur J Intern Med 2013; 24:117-26. [PMID: 23246126 PMCID: PMC3638237 DOI: 10.1016/j.ejim.2012.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 09/13/2012] [Accepted: 11/05/2012] [Indexed: 01/19/2023]
Abstract
BACKGROUND While socioeconomic gradients in cardiovascular disease have been well established in high-income countries, this relationship is not well understood in middle-income countries. METHODS Data from Demographic Health Surveys collected in Albania (2008-09), Armenia (2005), Azerbaijan (2006) and Ukraine (2007) were used to estimate age-adjusted differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), hypertension (HTN), elevated blood pressure, and optimal blood pressure across a standardized wealth index, level of educational attainment, and urban versus rural residence. RESULTS The wealthiest Albanian females had lower average SBP, DBP, PP (all p<0.01) and HTN status (odds ratio [OR]=0.3, CI: 0.2-0.5, p<0.001) compared to the poorest; similar education gradients were also found. Such disparities also existed for Albanian men. Among Armenian women, urban (OR=1.4, 1.1-1.8, p<0.01), more educated (OR=0.7, CI: 0.6-0.9, p<0.01), and wealthier (OR=1.8, 1.4-2.4, p<0.001) women were more likely to have optimal blood pressure. Urban Armenian men were also more likely to have optimal blood pressure (OR=1.8, 1.2-2.9, p<0.01). Wealthier and urban Azerbaijani had lower risk of elevated blood pressure and Azerbaijani women displayed strong wealth gradients with higher quintiles of wealth associated with lower continuous blood pressure measures. There were no socioeconomic gradients for Ukrainian males or females. CONCLUSIONS There is compelling evidence that wealth and education gradients affect the probability of HTN for women in Albania, Armenia, and Azerbaijan, and for men in Albania.
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Lang DL, Salazar LF, DiClemente RJ, Markosyan K. Gender based violence as a risk factor for HIV-associated risk behaviors among female sex workers in Armenia. AIDS Behav 2013; 17:551-8. [PMID: 22760740 DOI: 10.1007/s10461-012-0245-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This cross-sectional study identified the prevalence of gender based violence (GBV) and examined its association with sexual risk behavior among female sex workers (FSWs). Among 120 participants between ages 20 and 52, a total of 56.7 % reported lifetime GBV. Multivariate analyses revealed that GBV was significantly associated with inconsistent condom use, unprotected sex, condom misuse, fear of client reaction to requests of condom use, self-reported history of STIs, and earlier age of initiation of sex work. GBV must be considered an urgent public health priority among FSWs in Armenia. Interventions addressing FSWs, in addition to targeting skill-based, sexual risk reduction must also introduce a discourse among FSWs, sexual partners, clients and community members about the role of GBV in HIV-associated risk behaviors and infection. Structural level initiatives must address economic opportunities for women, health-sector policies and responses to FSWs' health needs, law enforcement training and societal norms toward women.
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Affiliation(s)
- Delia L Lang
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Armenia 2010: results from the demographic and health survey. Stud Fam Plann 2012; 43:315-20. [PMID: 23239250 DOI: 10.1111/j.1728-4465.2012.00329.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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50
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Tadevosian NS, Muradian SA, Tadevosian AE, Khachatrian BG, Dzhandzhapanian AN, Parsadanian GG, Pogosian SB, Gevorkian NB, Guloian AA. [Monitoring of environmental pollution in Armenia and certain issues on reproductive health and cytogenetic status of organism]. Gig Sanit 2012:48-51. [PMID: 23243720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Investigations aimed at the study on the state of environment from the point of pollution by organochlorine pesticides and their metabolites (HCH, DDT, DDE and DDD), as well as on possible unfavorable impact due to carriage of mentioned persistent organic pollutants (POPs) towards reproductive health and cytogenetic status of organism were done. In parallel, monitoring of possible mutagenic components of the environment was also conducted. As to obtained data, residues of organochlorine pesticides are continually determined with high frequency both in environmental media, agricultural foodstuffs and biomedia of rural population of observed region (Aragatsotn marz, Armenia). No changes in mutagenic background were registered. The represented results of the study make fragment of complex social-hygienic, monitoring investigations on environmental quality that would further serve as a platform for working out the recommendations on reduction of environmental pollution and improvement of health protection issues in Armenia.
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