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PubMed2006

The cost-effectiveness of expanding harm reduction activities for injecting drug users in Odessa, Ukraine.

OBJECTIVES: The objectives of this study were to estimate the cost-effectiveness of a harm reduction intervention among injecting drug users (IDUs) in Odessa, Ukraine; and to explore how the cost-effectiveness changes if the intervention were scaled up to 60% as recommended by WHO/UNAIDS. STUDY DESIGN: Economic providers' costs were estimated. A dynamic mathematical model, fitted to epidemiologic data, projected the intervention's impact. The cost per HIV infection averted for different intervention coverages was estimated. RESULTS: From September 1999 to August 2000, at the current coverage of between 20% to 38% and an injection drug user (IDU) HIV prevalence of 54%, projections suggest 792 HIV infections were averted, a 22% decrease in IDU HIV incidence, but a 1% increase in IDU HIV prevalence. Cost per HIV infection averted was $97. Scaling up the intervention to reach 60% of IDUs remains cost-effective and reduces HIV prevalence by 4% over 5 years. CONCLUSION: At the current coverage, the harm reduction intervention in Odessa is cost-effective but is unlikely to reduce IDU HIV prevalence in the short-term. To reduce HIV prevalence, more resources are needed to increase coverage.

Adult↗
PubMed2025

VANTAGE: van-based real-time HIV sequencing for transmission mapping and drug resistance profiling in war-affected Ukraine.

We deployed the VANTAGE (VAN for Transmissible Agent Genomic Epidemiology) mobile system in Lviv, Ukraine, demonstrating end-to-end sequencing of dried blood spot samples within a clinic van usually serving de-occupied and frontline regions. HIV-1 pol sequences were obtained from 50% of samples, all subtype A6. Median time to 100× coverage was 38 min. Phylogenetic analysis revealed a local transmission cluster including a displaced person and the non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutation E138A, supporting real-time HIV genomic surveillance in humanitarian crises.

Humans↗
PubMed1994

Colonization of professional divers by toxigenic Vibrio cholerae O1 and V. cholerae non-O1 at dive sites in the United States, Ukraine and Russia.

Vibrio cholerae, recognized as the causative agent of epidemic cholera, was isolated from healthy professional divers and from water samples collected at dive sites in the United States, Ukraine and Russia. Swabs of nose, ear and throat of divers and their tank regulators, i.e. the divers and their diving gear, were taken before and after routine dives. Blood samples were collected before and 30-60 days after each dive to measure IgG and IgA titers against the whole cell antigen of V. cholerae O1. Nine strains of V. cholerae O1 and nine strains of V. cholerae non-O1 were isolated during this study. These isolates were identified by conventional biochemical tests and indirect fluorescent antibody staining methods, using fluorescein isothiocyanate-labeled monoclonal antibody, COLTA, prepared against the 'A' antigenic factor of the lipopolysaccharide of V. cholerae O1, and serotyped by slide agglutination. Seven of the nine strains of V. cholerae O1 isolated and successfully cultured during the studies, were toxigenic by enzyme-linked immunosorbent assay and polymerase chain reaction. Analyses of IgG and IgA antibodies of the divers showed that most of the divers had prior exposure to V. cholerae O1. V. cholerae serotype non-O1 strains isolated during the study were found to be non-toxigenic.

Antibodies, Bacterial↗
PubMed2006

Refractive and visual outcome of paediatric cataract surgery in the Ukraine.

PURPOSE: To describe the refractive and visual outcomes after surgery for congenital or developmental cataract in the Ukraine. METHODS: Cataract surgery was performed in 65 children aged 3-15 years. The cataracts were bilateral in 44 children and unilateral in 21. Examinations, including visual acuity (VA) and objective refraction using retinoscopy, were performed preoperatively and at 1 day, 6 months and 2 years postoperatively. Neither occlusion therapy nor spectacles were prescribed. RESULTS: Almost all children (96%) gained in VA. In all, 40% of the bilateral cases achieved a corrected Snellen VA > or = 0.5 and 44% of the unilateral cases obtained a corrected VA > or = 0.2. The difference between VA (logMAR) preoperatively and 2 years postoperatively was statistically significant (p < 0.05). The bilateral cases showed a postoperative reduction in mean astigmatism from 3.9 D (1 day postoperatively) to 0.6 D (2 years postoperatively) (p < 0.001), while the unilateral cases showed a reduction from 4.2 D (1 day postoperatively) to 0.4 D (2 years postoperatively) (p < 0.001). CONCLUSION: Good postoperative VA was achieved in the group with bilateral cataract. Surprisingly, even in the group with unilateral cataract, an increase in VA was obtained, despite the lack of postoperative correction with glasses or occlusion therapy.

Adolescent↗
PubMedDate not supplied

TGFBI gene mutation analysis in families with hereditary corneal dystrophies from Ukraine.

In our study, 5 previously reported mutations of the TGFBI gene - R124C, R124H, R124L (exon 4), R555W, R555Q (exon 12) - were analyzed using polymerase chain reaction followed by restriction digestion in 48 individuals from 19 unrelated families with different forms of corneal dystrophy from different regions of Ukraine. The R555W mutation was detected in 6 patients from 4 families with granular corneal dystrophy. The R124C mutation was detected in 1 unaffected 10-year-old individual and in 24 patients from 8 families with lattice corneal dystrophy. As far as the R124C mutation detected in 1 patient with clinically diagnosed Reis-Bucklers corneal dystrophy is concerned, we concluded that this patient was misdiagnosed. The obtained results show that TGFBI gene mutation analysis is important as well for the early differential diagnosis of corneal dystrophies and genetic consulting in high-risk families.

Child↗
PubMed2006

Lice infestation and lice control remedies in the Ukraine.

A permanent decrease was seen in the prevalence of lice infestation among population of the Ukraine from 1990-2004. The prevalence of lice infestation among children under 14 years of age was 6-27 times more than that in adults. The highest figures were among children 7-14 years old. During all of the observation period there were changing tendencies relative to the groups. The greatest number of cases of infection with lice were noted in the months when the control inspections of children in education institutions were performed.

Adolescent↗
PubMed2005

Increasing trends in HIV and TB rates in Odessa and the Ukraine.

Notification rates for HIV and tuberculosis (TB) have increased in the Ukraine and particularly in Odessa. In 1962, the incidence of TB in Odessa region was 178 cases per 100,000 cases, declining to 73.0, 42.0 and 41.6 cases per 100,000 in 1972, 1982 and 1992, respectively. In 2002, TB incidence and prevalence were 80.4 and 330.1/100,000 population, respectively. TB mortality in the port almost doubled from 10.2/100,000 to 21.6/100,000 between 1990 and 2001. In 2002, the HIV incidence and prevalence and AIDS incidence and prevalence were 46.4 and 241.0 cases/100,000 population and 14.5/100,000 and 26.9/100,000, respectively. There are increasing numbers of TB cases co-infected with HIV (200 in 2002), suggesting that the HIV and TB epidemics are converging. Significant effort is needed for the effective control of these two outbreaks to prevent high levels of morbidity and mortality from these diseases.

Adolescent↗
PubMed1997

Lessons learned from the study of immigrants to Israel from areas of Russia, Belarus, and Ukraine contaminated by the Chernobyl accident.

During the past 6 years, immigration to Israel of 700,000 persons from the former Soviet Union (FSU) included about 140,000 from radiocontaminated regions of Belarus, Ukraine, and Russia near Chernobyl. In Beer Sheva, a major center for immigrant absorption in Israel, a primary objective was to evaluate their health status and to refer them for care. 137Cs levels in 1228 men, women, and children were measured with a portable whole-body counter. Whole-body counts showed clear correlation with the degree of 137Cs ground contamination in previous regions of residence. The population could thus be sub-divided according to degree of exposure, based on previous regions of residence. The thyroid status of 300 local immigrant children was evaluated because of the increased risk of childhood thyroid cancer in the regions from which they came. This group was subdivided into comparative groups of children who came from less and more contaminated areas according to the International Atomic Energy Agency soil 137Cs contamination maps. Enlarged thyroids were found in about 40% of both groups. One 12-year-old girl from Gomel had a malignant papillary carcinoma. Thyroid-stimulating hormone levels, though within normal limits, were significantly greater (p < 0.02) for girls from high exposure regions. Liquidators showed significant increases in serum clastogenic factor and in the number of circulating glycophorin A-mutated red cells. In studies of over 700 people from both radiocontaminated and unaffected regions of the FSU, evidence for posttraumatic stress disorder was found more frequently in persons coming from the more contaminated areas.

Blood Pressure↗
PubMed1999

Organochlorines in breast milk from two cities in Ukraine.

Reports of environmental problems in the former Soviet Union, including excess use of pesticides, have led to concerns about high levels of contamination in humans, but little information is available to assess whether these concerns are warranted. Samples of breast milk from 197 women from two cities in Ukraine were analyzed for p,p'-DDT, p,p'-DDE, endrin, dieldrin, heptachlor epoxide, trans-nonachlor, oxychlordane, hexachlorobenzene, ss-hexachlorocyclohexane (HCH), and 18 polychlorinated biphenyl congeners, and results were compared to previous reports from Europe. The median ss-HCH concentration was 731 ng/g milk fat, which is higher than other reports from Europe but lower than reports from other parts of the world. The median DDE concentration was 2,457 ng/g milk fat, which is higher than most but not all other reports from Europe. Concentrations of other chemicals were comparable to or lower than other reports from Europe. Concentrations from the city of Kyiv were generally lower than those from Dniprodzerzhinsk, but the magnitudes of these differences were modest.

Adult↗
PubMed2006

Thyroid cancer risk in areas of Ukraine and Belarus affected by the Chernobyl accident.

The purpose of the present study was to analyze the thyroid cancer incidence risk after the Chernobyl accident and its degree of dependence on time and age. Data were analyzed for 1034 settlements in Ukraine and Belarus, in which more than 10 measurements of the (131)I content in human thyroids had been performed in May/June 1986. Thyroid doses due to the Chernobyl accident were assessed for the birth years 1968-1985 and related to thyroid cancers that were surgically removed during the period 1990-2001. The central estimate for the linear coefficient of the EAR dose response was 2.66 (95% CI: 2.19; 3.13) cases per 10(4) PY-Gy; for the quadratic coefficient, it was -0.145 (95% CI: -0.171; -0.119) cases per 10(4) PY-Gy(2). The EAR was found to be higher for females than for males by a factor of 1.4. It decreased with age at exposure and increased with age attained. The central estimate for the linear coefficient of the ERR dose response was 18.9 (95% CI: 11.1; 26.7) Gy(-1); for the quadratic coefficient, it was -1.03 (95% CI: -1.46; -0.60) Gy(-2). The ERR was found to be smaller for females than for males by a factor of 3.8 and decreased strongly with age at exposure. Both EAR and ERR were higher in the Belarusian settlements than in the Ukrainian settlements. In contrast to ERR, EAR increases with time after exposure. At the end of the observation period, excess risk estimates were found to be close to those observed in a major pooled analysis of seven studies of childhood thyroid cancer after external exposures.

Adolescent↗
PubMed1996

Induced abortions and childbirths: trends in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine during 1970 to 1994.

BACKGROUND: To analyse trends in childbirth, induced abortions and maternal morbidity from 1970 to 1994 in Estonia, Latvia, Lithuania, Russia, Belarussia and the Ukraine. METHODS: Official health statistics from the six countries were compiled and analysed. RESULTS: High abortion rates (up to 142 per 1000 women of fertile ages and years) were seen in all countries analysed, but since 1980 a continuing decrease is noted for Estonia, Latvia and Kalimingrad with a lowest rate of 50 abortions/1000 women/year in Latvia in 1994. Teenage abortions and childbirths are increasing. Maternal mortality, including complications of abortions, is still a reality in all the countries studied. CONCLUSION: The high abortion frequencies in all countries studied here indicate that national abortion prevention programs are needed. Such programs should focus on education, both of medical professionals, teenagers, fertile women and males. Concomitantly, the availability of cheap and modern contraceptives must increase, especially to defined risk groups.

Abortion, Induced↗
PubMedDate not supplied

Rehabilitation in a rural community in Ukraine--a pilot project.

The World Health Organization has promoted the concept of community-based rehabilitation as a means of fulfilling the needs of disabled persons in their home environment, and at the same time decreasing the costs of tertiary rehabilitative care. This paper reports on the 10-year experience of a village rehabilitation hospital in rural Ukraine. The hospital was converted to a rehabilitation facility by provision of rehabilitation space, training of local medical and allied health personnel in the principles of rehabilitation, provision of modalities, exercise, hydrotherapy, apiotherapy, and obtaining the necessary physical medical equipment. The cost of this conversion was quite modest and was more than compensated for by the efficient utilization of the facility in the region together with the significant saving in tertiary care costs, including travelling time for patients.

Length of Stay↗
PubMedDate not supplied

[The epidemic situation in relation to HIV infection in Ukraine (1987-1997)].

The analysis of the dynamics of the epidemic process for 10 years made it possible to find out the presence of two separate epidemic waves of HIV infection. The first wave (1987-1994) was manifested as the slow type of the development of the epidemic, characterized mainly by sexual transmission. During this period 398 persons with HIV infection were detected, 24 persons were found to have AIDS; of these, 13 persons died. The second epidemic wave began in 1995 and was due to the spread of HIV among users of drugs introduced by injection. By the end of 1995 the number of HIV carriers was 34 times greater than that of 1994, reaching 1490 persons. In 1996-1997 this figure increased 8 times (annually). The number of AIDS patients rose to 420 persons. The most unfavorable regions with respect to HIV infection and AIDS morbidity were determined. The western regions of the Ukraine were noted to be in a more favorable situation in this respect with infection indices being lower more than 30 times. Up to 80% of all infected persons were found to be addicts introducing drugs intravenously. Growing morbidity in sexually transmitted disease, particularly in syphilis, contributed to the deterioration of the epidemiological situation. The conclusion was made on the necessity of introducing new prophylactic programs and expanding current ones. The signs of stabilization in Odessa and Nikolayev were observed; in these cities pilot programs aimed at the strategy of the "decrease of harm" have been introduced (in collaboration with UNAIDS) since 1996.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[HIV infection in the penitentiaries of Ukraine].

In connection with a sharp increase of the number of HIV-infected persons in the Ukraine the natural growth of the number of such persons in penitentiary institutions was registered, starting from 1995 (455 persons in 1995, 2,937 persons in 1996, 2,779 persons in 1997 and 173 persons during 5 months of 1998). 83% of HIV infection persons were drug addicts introducing drugs intravenously. In 1997 the strategy of decreasing the risk of infection in penitentiary institutions was worked out in collaboration with UNAIDS experts: repressive and isolation measures were replaced with measures aimed at the "decrease of harm". Special attention is given to circumstances aggravating the epidemic situation in HIV infection, and particularly at the sharp growth of morbidity in tuberculosis and syphilis (10.6 and 10.3 times respectively in 1997 in comparison with 1993). In addition, in 1997 the number of person having drug addiction was noted to increase 2.3 times in comparison with 1993. The necessity of taking constant information and educational measures aimed at decreasing the risk of the spread of HIV infection is emphasized.

Female↗
PubMedDate not supplied

[The testing policy for HIV infection in Ukraine].

The policy of the Ministry of Health of the Ukraine since 1987 concerning the control of the spread of HIV infection was analyzed. The main measure for the prophylaxis and epidemiological control of the infection was mass testing for HIV, carried out in accordance with the law adopted in 1991. In 1997 changes and amendments were supplemented to this Law, which legally abolished obligatory testing for HIV. The data on the effective and less effective testing policy are presented. In particular, these data revealed that the irrational testing policy resulted on the fact that only 5% of the whole population of drug addicts were covered by surveillance. Future prospects were shown to include the introduction of the system of "patrol" epidemiological surveillance, the strengthening of the analytical component of epidemiological surveillance, the approval of the new strategic plan of the prophylaxis for AIDS for 1998-2000, as well as the renewal of the normative and methodological basis.

AIDS Serodiagnosis↗
PubMed1997

Health telematics in Ukraine: problems and prospects.

The state of medical telecommunication networks in Ukraine is described. The concepts of creating and architecture of the National Direct Access Computer Network 'UkrMedNet' are given.

Computer Communication Networks↗
PubMedDate not supplied

[Gene frequencies and heterozygosity of the population of Donetsk Province, Ukraine by the alleles of the ABO and Rhesus systems].

Frequency and heterozygosity indices of AB0 and Rh gene systems in the population of Donetsk Province were calculated. Uneven distribution of the genes was found and heterozygosity indices of the population were 0.554-0.573 for AB0 and 0.410-0.499 for Rh. Heterozygosity in this population was higher than average heterozygosity in total population of Ukraine as a result of intensive migrations and prevalence of heterolocal marriages over homolocal ones.

ABO Blood-Group System↗