Genetic data analysis of HLA-DQA1 in four Colombian populations: Pereira, Armenia, Manizales, and Chocó.
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Colombia↗
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[Cytochemical study of haemogregarines from reptiles of Armenia. II. Changes in hemoglobin and total protein levels in the erythrocytes of rock lizards infected with haemogregarines].
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Animals↗
[Salt fluoridation in 4 Colombian communities. IV. Dietetic survey in Armenia and Montebello].
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Adolescent↗
[Development and chronological eruption of the permanent dentition in school children of both sexes in Armenia (Antioquia, Colombia)].
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Dentistry↗
Health service utilization in the former soviet union: evidence from eight countries.
BACKGROUND: In the past decade, the countries that emerged from the Soviet Union have experienced major changes in the inherited Soviet model of health care, which was centrally planned and provided universal, free access to basic care. The underlying principle of universality remains, but coexists with new funding and delivery systems and growing out-of-pocket payments. OBJECTIVE: To examine patterns and determinants of health care utilization, the extent of payment for health care, and the settings in which care is obtained in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. METHODS: Data were derived from cross-sectional surveys, representative of adults aged 18 and over in each country, conducted in 2001. Multistage random sample of 18,428 individuals, stratified by region and area, was obtained. Instrument contained extensive data on demographic, economic, and social characteristics, administered face-to-face. The analysis explored the health seeking behavior of users and nonusers (those reporting an episode of illness but not consulting). RESULTS: In the preceding year, over half of all respondents visited a medical professional, ranging from 65.7 percent in Belarus to 24.4 percent in Georgia, mostly at local primary care facilities. Of those reporting an illness, 20.7 percent of all did not consult although they felt they should have done so, varying from 9.4 percent in Belarus to 42.4 percent in Armenia and 49 percent in Georgia. The main reason for not seeking care was lack of money to pay for treatment (45.2 percent), self-treatment with home-produced remedies (32.9 percent), and purchase of nonprescribed medicine (21.8 percent). There are marked differences between countries; unaffordability was a particularly common factor in Armenia, Georgia, and Moldova (78 percent, 70 percent, 54 percent), and much lower in Belarus and Russia. In Georgia and Armenia, 65 percent and 56 percent of those who had consulted paid out-of-pocket, in the form of money, gifts, or both; these figures were 8 percent and 19 percent in Belarus and Russia respectively and 31.2 percent overall. The probability of not consulting a health professional when seriously ill was significantly higher among those over age 65, and with lower education. Use of health care was markedly lower among those with fewer household assets or a shortage of money, and those dissatisfied with their material resources, factors that explained some of the effects of age. A lack of social support (formal and informal) decreases further the probability of not consulting, adding to the consequences of poor financial status. The probability of seeking care for common conditions varies widely among countries (persistent fever: 56 percent in Belarus; 16 percent in Armenia) and home remedies, alcohol, and direct purchase of pharmaceuticals are commonly used. Informal coping strategies, such as use of connections (36.7 percent) or offering money to health professionals (28.5 percent) are seen as acceptable. CONCLUSIONS: This article provides the first comparative assessment of inequalities in access to health care in multiple countries of the former Soviet Union, using rigorous methodology. The emerging model across the region is extremely diverse. Some countries (Belarus, Russia) have managed to maintain access for most people, while in others the situation is near collapse (Armenia, Georgia). Access is most problematic in health systems characterized by high levels of payment for care and a breakdown of gate-keeping, although these are seen in countries facing major problems such as economic collapse and, in some, a legacy of civil war. There are substantial inequalities within each country and even where access remains adequate there are concerns about its sustainability.
Commonwealth of Independent States↗
Tuberculosis control in the Caucasus: successes and constraints in DOTS implementation.
SETTING: The pilot projects for tuberculosis (TB) control, supported by the World Health Organization (WHO) and based on the WHO recommended control strategy, directly-observed treatment, short-course (DOTS) in the Caucasian countries (Armenia, Azerbaijan, Georgia). OBJECTIVE: To evaluate the results 2 years after the implementation of the pilot projects. METHODS: Analysis of data on case detection, sputum conversion and treatment outcome reported quarterly to the WHO from the Ministries of Health in each country. RESULTS: Since the establishment of the project, 1330, 764 and 4866 new cases and relapses, respectively, of TB have been detected in the pilot areas of Armenia, Azerbaijan and Georgia. In Armenia and Azerbaijan, respectively 46% and 57% of all cases were smear positive, whilst in Georgia, the corresponding figure was only 12%. After 3 months' treatment, 93% of new smear-positive patients had become smear-negative. The sputum conversion rate for relapses and other retreatment cases (failure, treatment interrupted) was 85%. In Armenia, 78.1% of new smear-positive patients were treated successfully (cured or completed treatment). The corresponding percentages for Azerbaijan and Georgia were 87.9% and 59.6%. Treatment success rates among retreatment cases was generally low, at respectively 46%, 64%, and 35%, in Armenia, Azerbaijan, and Georgia. CONCLUSION: The results of the implementation of the WHO TB control pilot projects in Armenia, Azerbaijan and Georgia suggest that the DOTS strategy is feasible in emergency situations in general, and in the Caucasus in particular.
Disease Notification↗
[The malaria situation in the WHO European region].
The number of indigenous malaria cases in European region peaked in 1997, when 77,985 cases were officially reported. These were caused almost exclusively by P. vivax, P. falciparum being restricted to a rather limited number of cases in Tajikistan only. Another important problem in the European Region is the importation of malaria associated with a high fatality rate from tropical endemic countries. There were 841 cases of malaria in Armenia, 567 of which were locally transmitted, 30 out of 81 districts recorded malaria cases. 89% of the indigenous cases were registered in Masis district, in the Ararat valley. In 1998, total number of cases increased to 1156. Of the 542 indigenous cases registered, 376 were in Masis district. 9911 cases were officially reported in 1997 in Azerbaijan and 5175 cases in 1998. Approximately half of malaria cases were reported from seven districts: Nakhichivan (10.4%), Imishli (14.6%), Fizuli (8.1%), Sabirabad (6.8%), Saatly (6%), Bejlagan (5.6%) and Bilasuvar (4.8%). Local transmission is also reported from the periurban areas of Baku, where many displaced people are living in temporary shelters. In 1997, a total of 30,054 malaria cases were officially registered in Tajikistan, of which 85.3% occurred in the Khatlon region, 10.5% in Dushanbe region, 3.5% in Gorno-Badakhshan region and 0.7% in Leninabad region. Following implementation of malaria control activities with WHO assistance, the number of malaria cases officially registered in 1998 dropped to 19,361 (187 were cases of falciparum malaria). A dramatic change occurred in malaria situation in Turkmenistan in 1998, when 115 indigenous cases were registered. The majority of malaria cases (104) were registered in the Kushka district, in south-east of Turkmenistan, among military service personnel. In recent years, the Government of Turkey has renewed its efforts to fight malaria, incorporating them into GAP with support from UNDP and WHO. In 1998, 36,451 cases were reported, 87.1% from southeastern Anatolia, 8.7% from Adana area and 4.2% from other areas of Turkey. The epidemics in Armenia, Azerbaijan, Tajikistan and Turkey are having a considerable impact on the malaria situation in neighbouring countries of the European Region. Malaria cases have been imported from Turkey mainly to western Europe; from Azerbaijan to the Russian Federation, Georgia, and the Republic of Moldova; and from Tajikistan to the central Asian republics and to the Russian Federation. WHO made all possible efforts to mobilize and coordinate assistance from international community. WHO/EURO organized missions to those NIS where there is a risk of malaria epidemics. Most of the very limited funds reserved for epidemic prevention and control were immediatelly used to provide a limited stock of antimalarial drugs and to help the national institutions in Kazakhstan and Uzbekistan implement antimalarial activities. In 1997, with the financial support of the Italian Government and the technical assistance of the Instituto Superiore di Sanità in Rome (WHO collaborating centre for research and training in planning tropical disease control) and of the Martsinovsky Institute of Medical Parasitology and Tropical Medicine in Moscow (WHO collaborating centre on vivax malaria), the training of health personnel in the field of malaria diagnosis, treatment and control was initiated in Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. In 1996-1997, Japan provided financial support for a large malaria control project in Tajikistan, and Norway supported activities carried out in 1997 to tackle the malaria outbreak in Armenia. In 1997-1998, Italy supported malaria prevention activities in Kazakhstan, Kyrgyzstan and Uzbekistan, and some of the malaria activities carried out in Tajikistan under the integrated Management of Childhood Illness initiative. Several training courses and seminars were carried out in Turkey in 1998 by the national malaria contro
Disease Outbreaks↗
Armenian Y chromosome haplotypes reveal strong regional structure within a single ethno-national group.
Armenia has been little-studied genetically, even though it is situated in an important area with respect to theories of ancient Middle Eastern population expansion and the spread of Indo-European languages. We screened 734 Armenian males for 11 biallelic and 6 microsatellite Y chromosome markers, segregated them according to paternal grandparental region of birth within or close to Armenia, and compared them with data from other population samples. We found significant regional stratification, on a level greater than that found in some comparisons between different ethno-national identities. A diasporan Armenian sub-sample (collected in London) was not sufficient to describe this stratified haplotype distribution adequately, warning against the use of such samples as surrogates for the non-diasporan population in future studies. The haplotype distribution and pattern of genetic distances suggest a high degree of genetic isolation in the mountainous southern and eastern regions, while in the northern, central and western regions there has been greater admixture with populations from neighbouring Middle Eastern countries. Georgia, to the north of Armenia, also appears genetically more distinct, suggesting that in the past Trans-Caucasia may have acted as a genetic barrier. A Bayesian full-likelihood analysis of the Armenian sample yields a mean estimate for the start of population growth of 4.8 thousand years ago (95% credible interval: 2.0-11.1), consistent with the onset of Neolithic farming. The more isolated southern and eastern regions have high frequencies of a microsatellite defined cluster within haplogroup 1 that is centred on a modal haplotype one step removed from the Atlantic Modal Haplotype, the centre of a cluster found at high frequencies in England, Friesland and Atlantic populations, and which may represent a remnant paternal signal of a Paleolithic migration event.
Armenia↗
[The epidemiology of trichophytosis, microsporosis and favus in the Armenian SSR].
Mycoses of the hairy part of the head have been effectively treated in the two last decades in Armenia. The number of trichophytosis patients has reduced from 32.7 per 100,000 in 1965 to 5.4 per 100,000 in 1987. The share of anthroponotic trichophytosis among all trichophytosis forms has reduced from 24.9 to 6.7 percent. Chronic trichophytosis became quite rare among adult patients. Favus has not been recorded in Armenia since 1976. Epidemic outbreaks of imported anthroponotic microsporosis were recorded in the 60s and 70s. The incidence of zooanthroponotic microsporosis was low and the cases were imported. In recent years cases of human infection from mongrel cats were recorded in Armenia.
Age Factors↗
Massive occurrence of rickettsiae of the spotted fever group in fowl tampan, Argas persicus, in the Armenian S.S.R.
Fowl tampans (Argas persicus) collected in Oktemberyan in the Armenian S.S.R. in 1974 were found to be massively infected with rickettsiae of the spotted fever (SF) group. One isolated rickettsial strain, designated Armenia 9, is antigenically related to, and probably identical with, strain Armenia 11 and strain B of Rickettsia slovaca, isolated from Dermacentor marginatus ticks. Strain Armenia 9 grows readily in chick embryo yolk sacs and in chick embryo cell (CEC) and L-cell cultures. It causes generalized infection in both soft and hard ticks. A fatal disease was produced in Clethrionomys glareolus after subcutaneous inoculation. Similar inoculation of other small wild rodents (Mus musculus, Microtus arvalis, Apodemus flavicollis), hens and laboratory animals (guinea pigs, white mice and hamsters) resulted only in an antibody response.
Animals↗
Genetic differentiation in eastern European and western Asian populations of the liver fluke, Fasciola hepatica, as revealed by mitochondrial nad1 and cox1 genes.
Partial sequences of mitochondrial genes nad1 (316 bp) and cox1 (429 bp) were analyzed to estimate the variability of the liver fluke samples collected in 20 localities in Russia, Belarus, Ukraine, Bulgaria, Armenia, Azerbaijan, Georgia, Turkey, Turkmenistan, and China. The sequences had 4.1% (nad1) and 2.3% (cox1) of variable sites, and 13 and 10 haplotypes were identified among nad1 and cox1 genes, respectively. Spatial analysis of genetic and nucleotide diversity indicated little or no structuring of genetic variation between hosts or regions. The analysis of distribution of both separate and combined (nad1 + cox1) haplotypes revealed the existence of 2 well-defined lineages with 2 main haplotypes and a number of shared divergent haplotypes. Our study showed that the first lineage included the main N1-C1 haplotype, which was found in Australia, China, Georgia, Turkey, Armenia, Azerbaijan, and in all European populations (from Russia, Belarus, Ukraine, Bulgaria). The second lineage was found in all European populations and in populations from Armenia and Azerbaijan. It was suggested that one of the lineages (I) has an Asian origin. The possible source of mtDNA variability and associations between lineage divergence of parasite and its definitive hosts (cattle and sheep) are discussed.
Analysis of Variance↗
Integration of United States emergency medicine concepts into emergency services in the New Independent States.
At this writing, a collaborative partnership has been in place for 30 months between the Boston University Medical Center, the University of Massachusetts Medical Center, the Armenian Ministry of Health, and the Emergency Hospital of Yerevan, Armenia, to improve emergency and trauma care in that city. Fifty-five individuals have traveled to and from the Emergency Hospital, the partner hospital. The collaboration has led to the creation of the Emergency Medical Services Institute (EMSI) at Emergency Hospital, an 800-bed facility that serves as a trauma center and as base for the Yerevan ambulance system. A curriculum (text and slides) has been developed and translated into Armenian and Russian. To date, the Armenian EMSI has trained nearly 300 emergency medical personnel: physicians, nurses, drivers, and first responders. The Armenian EMSI faculty have received training in directing instruction of emergency care providers. Plans are in place to begin training in Armenian cities outside of Yerevan and in neighboring republics. An emergency medicine residency program received ministry approval and was begun with six resident physicians in January 1995. To date, 45 nurses have graduated from a 400-hour training program. This partnership program chose an education initiative as the vehicle for interaction between the United States and the formerly Soviet-directed Armenian health care system. Officials of the partner hospital requested assistance in upgrading the skills of its abundant emergency care workforce, citing cardiovascular disease, trauma, and accidents as leading causes of death and disability in Armenia.(ABSTRACT TRUNCATED AT 250 WORDS)
Armenia↗
The Armenian earthquake of 1988: a milestone in the evolution of nephrology.
A dreadful earthquake struck a densely populated region of Armenia on December 7, 1988. All principal determinants of structural damage and crush injury converged to magnify the dreadful outcomes of this otherwise modest earthquake, which registered 6.9 on the Richter scale. Two circumstantial events focused unprecedented world attention on this natural disaster. First, the news media, assembled to cover the historic visit of Mikhail Gorbachev to the United States, were suddenly deprived of the news they had gathered to cover when Gorbachev interrupted his visit to examine the disaster personally. As a result, the world news media channeled their collective force on covering the tragic events in Armenia. Second, an official Soviet request for dialysis assistance was delivered at the opening session of the annual meeting of the American Society of Nephrology in San Antonio on Sunday, December 11, 1988. As a result, the entire nephrology community was suddenly engulfed in the mounting worldwide enthusiasm to provide humanitarian aid. The subsequent efforts of the National Kidney Foundation and the International Society of Nephrology prompted the discipline to examine, evaluate, and establish a role for nephrologists in preparedness and response to natural disasters.
Acute Kidney Injury↗
Posttraumatic stress reactions after single and double trauma.
This study evaluated the severity and symptom profile of posttraumatic stress reactions of 202 adults exposed in 1988 to political violence in Azerbaijan and/or the earthquake in Armenia. High rates of severe posttraumatic stress reactions were found among the most highly exposed individuals, irrespective of the type of trauma. There was no difference in symptom profile for subjects exposed to earthquake versus violence. These similarities in severity and symptom profile may be attributable to common features of the exposures, which included experiencing life-threat and witnessing injury, multilation and death. Recent prior exposure to violence contributed to the severity of reaction to the earthquake. The high rates of chronic and severe posttraumatic stress reactions in Armenia constitute a major public mental health problem.
Adult↗
International development of emergency medical systems: educational techniques for the future.
An ongoing collaborative partnership between the University of Massachusetts Medical Center, Boston University Medical Center, the Armenian Ministry of Health, and the Emergency Hospital of Yerevan, Armenia has been established since 1993. The primary goal of this partnership is to reform and improve the delivery of emergency medical care through a process of education and training that is reproducible, practical, and self-sustaining for the advancement of health care into the future. A six-step educational process was developed, using Armenia as the initial model site for this format. Through the development of a regional training center and two emergency medicine training curricula, the partnership has trained over 1800 health care workers and first responders. Preliminary results from pre- and post-course examinations show a significant overall improvement in scores. An ongoing trauma database collection also shows significant improvement in the number of advanced life support measures being implemented since the inception of this educational training programme. This educational strategy has subsequently been replicated in nine similar partnerships in other countries of the New Independent States, formed after the dissolution of the former Soviet Union in 1990. We believe this six-step educational format is effective for the development and improvement of emergency medical systems in developing countries worldwide.
Armenia↗
[Distribution of HLA antigens in the armenian population of Nagornyi Karabakh].
Characteristics of the distribution of 31 HLA antigens of classes I (A, B, and Cw) and II (DR) in Nagornyi Karabakh Armenians are reported for the first time. It has been found that the antigens most common in this population are A2, A3, A9, B5, B7, B12, Cw4, DR4, DR2, and DR3; the least common antigens are B15, B16, and B40. The results are compared with the data for Armenians living in Armenia and those for major ethnic groups. The frequencies of HLA antigens in Nagornyi Karabakh Armenians match those in Armenians living in Armenia. In the HLA-antigen distribution, Armenians are generally close to Caucasoids.
Armenia↗
[Dermatoglyphics in the study of genetic processes in human populations (the example of the population of Arminia)].
Demographic data on the sizes of local populations of Armenia and the rates of people migration were employed for prediction of genetic differentiation level using S. Wright's f-statistics. This expected value of fe was applied for approximation of the observed level of dermatoglyphic f0d and familial f0n differentiation. Both empirical estimations of f were found to be closely to each other (f0d = 0,0616, f0n = 0,0600) and fall within the limits 0,0712 greater than or equal to fst greater than or equal to 0,0580 predicted from "island" model of Armenian population structure. The present state and direction of the genetic process in Armenia is discussed in the paper with the main conclusion that the dermatoglyphics and family surnames could be used in studies of the genetic process in human population.
Armenia↗
Tuberculosis trends in eastern Europe and the former USSR.
The aim of this paper is to assess trends in tuberculosis morbidity and mortality in the countries of Eastern Europe and the former USSR. Data on morbidity and mortality were obtained from reports of the Ministries of Health, a 1992 WHO questionnaire, national tuberculosis associations, and other sources. The quality of surveillance of tuberculosis cases differs widely between countries. Ranging from 19 to 80 per 100,000 population in 1990-1992, tuberculosis notification rates of most Eastern European and former USSR countries are higher than those of Western European countries. The lowest tuberculosis notification rate is reported in the Czech Republic, while the highest are reported in Romania and Kazakhstan. While in Albania, Croatia and Slovenia notification rates have continued to decline, in the remaining countries of Eastern Europe the declining trend has recently stopped. Nevertheless, countries such as the Czech Republic, Hungary, Poland and the Slovak Republic have experienced a distinct rate decrease when the 3-year average rate around 1985 is compared to that around 1990, despite the very recent levelling-off or increase. In Romania, the previous decline in notification rate ended in 1985 and in the period 1986-1992 an average 5.4% annual increase was observed. In this country, two-thirds of all cases still occur among young adults. Among the Baltic countries of the former USSR, the declining trend continues in Estonia, whereas in Latvia and Lithuania notification rates decreased less markedly from 1985 to 1990 than in the first half of the 1980s. Among the other European countries of the former USSR, Russia and Ukraine had a slow decline in the first half of the 1980s and a more pronounced one from 1985 to 1990. During the latter period of time, in Belarus and Moldova the decrease has been steeper. In the Caucasian countries of the former USSR, where underreporting and low case-finding are recognized, case rates have stabilized in Armenia, while in Azerbaijan and Georgia there was a decrease from 1985 to 1990. Among the Asian countries of the former USSR, Kazakhastan and Tajikistan reported a lower decline in case rates from 1985 to 1990 than from 1980 to 1985. Kyrgyzstan, Turkmenistan, and Uzbekistan reported increases in notification rates from 1985 to 1990: in Turkmenistan an average 5.5% annual increase in rate was observed between 1987 and 1991. Tuberculosis mortality is steadily increasing in Romania, Armenia, Kyrgyzstan, Latvia, Lithuania, Moldova, and Turkmenistan, while no decline is seen in most of the other countries of Eastern Europe and the former USSR.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗