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[Patterns in the distribution of GPD- alleles in Azerbaijan. I. Incidence and polymorphism of glucose-6-phosphate dehydrogenase deficiency in the Shekii region of the Azerbaijan SSR].

Through examination of G6PD deficiency among 939 pupils of Shekii district of Azerbaijan 52 hemi-, 10 homo- and 58 heterozygous carriers of defect were found. Relatives of probands--inhabitants of 3 settlements in the Shekii district-- were examined on G6PD deficiency too. Average hemizygote frequency is 11.11%, heterozygotes frequency is 12.9%. The cases of disaccordance between phenotype and genotype in female carriers of Gd- are analysed using pedigree data.

Alleles

[Characteristics of the distribution of the markers of hepatitis B vir us infection among the healthy population of the Tadzhik SSR and Azerbaijan SSR].

A total of 708 healthy persons in Tajikistan and 576 healthy persons in Azerbaijan, these groups comprising persons of both sexes and different age groups, were examined by the method of double gel immunodiffusion (the gel precipitation test) and by the passive hemagglutination test for the presence of the markers of hepatitis B virus (HBV) infection (HBsAg and HBeAg) and antibodies to them. This investigation showed that, in accordance with the level of hepatitis B morbidity, HBsAg was significantly more often detected among the population in Tajikistan (7.2%) than in Azerbaijan (2.8%). In both republics HBV carriers occurred most frequently among children aged 1-4 years (4.0% in Azerbaijan and 13.9% in Tajikistan), and among men more frequently than among women. In accordance with different intensity of the spread of HBV infection in the territories under comparison, differences in the age structure of the immune population were noted: in Tajikistan the formation of the immune layer occurred most frequently among younger age groups and in Azerbaijan, among senior adult age groups. The presence of a considerable percentage of persons with HBe-antigenemia (14.3-14.9% as determined by the gel precipitation test) among HBV carriers, observed in Tajikistan and in Azerbaijan, indicates that some of them have undetected chronic hepatitis B.

Adolescent

Epidemic diphtheria in the 1990s: Azerbaijan.

The diphtheria epidemic in the former Soviet Union reached Azerbaijan in 1991, when 66 cases of diphtheria were reported, a number that compared with 4 cases in 1990. From 1990-1996, 2182 cases of diphtheria and 286 diphtheria fatalities (case fatality rate: 13.1%) were reported in Azerbaijan, primarily among persons 5-39 years of age. Almost 45% of cases and 61% of deaths occurred among children 5-14 years of age. The high burden of severe disease among children and young adults suggested a different pattern of preexisting immunity against diphtheria in the Azerbaijani population than was observed in the concurrent diphtheria epidemic in Russia. Because resources were limited in Azerbaijan, mass immunization of the population was carried out in stages, focusing initially on school-aged children. Mass immunization campaigns targeting children were moderately successful in stabilizing the epidemic; mass immunization campaigns targeting both adults and children were eventually needed to fully stop the epidemic.

Adolescent

Drug resistant tuberculosis in prisons in Azerbaijan: case study.

OBJECTIVES: To document the existence of drug resistance in a tuberculosis treatment programme that adheres strictly to the DOTS principles (directly observed treatment, short course) and to determine the extent of drug resistance in a prison setting in one of the republics of the former Soviet Union. DESIGN: Case study. SETTING: Central Penitentiary Hospital in Baku, the referral centre for tuberculosis patients from all prisons in Azerbaijan. SUBJECTS: Prisoners with tuberculosis: 28 selected patients not responding clinically or bacteriologically to the standard treatment (group 1) and 38 consecutive patients at admission to the programme (group 2). MAIN OUTCOME MEASURES: Drug resistance of Mycobacterium tuberculosis strains grown from sputum. RESULTS: All the non-responding patients (group 1) had strains resistant to at least one drug. 25 (89%) of the non-responding patients and nine (24%) of the consecutive patients had M tuberculosis strains resistant to both rifampicin and isoniazid. A further 17 patients in group 2 had strains resistant to one or more first line drugs. CONCLUSIONS: Drug resistant M tuberculosis strains are common in prisons in Azerbaijan. Tuberculosis problems tend to be worse in prisons, but prisoners and former prisoners may have an important role in the transmission of tuberculosis, particularly of drug resistant forms, in the community. National programmes to control tuberculosis will have to take into account and address the problems in prisons to ensure their success.

Antibiotics, Antitubercular

Thalassaemia in Azerbaijan.

beta thalassaemia is present throughout the southern regions of the former USSR. We have defined the clinical picture of the disorder, the spectrum of beta thalassaemia mutations, and the role of customary consanguineous marriage in Azerbaijan, where thalassaemia presents a public health problem of the same order as that in Greece. Contrary to earlier suggestions, we found that the common form of the disorder is typically severe. Typical Turkish, Mediterranean, Azeri, Kurdish, and Asian Indian mutations were found, consistent with the history of the region. The common Mediterranean beta 0 thalassaemia mutation (codon 39) was not found. Three mutations (codon 8-AA, IVS2-1 and IVS1-110) account for over 80% of beta thalassaemia genes. Consanguineous marriage appears to contribute relatively little to the frequency of affected births. These observations provide the basis for a thalassaemia prevention programme in Azerbaijan.

Adolescent

An Internet station for telemedicine in the Azerbaijan Republic.

We have established the first medical Internet and telemedicine station in the Azerbaijan Republic. The station began work on 16 June 1997. In the next three months a list of local and international medical electronic resources was drawn up and contacts made with medical informatics organizations and medical libraries. Five telemedicine consultations were carried out with Moscow clinics in specialties such as cardiology, ophthalmology, endocrinology and surgery. The quickest and most cost-effective way of improving medical care in Azerbaijan is to provide medical information support using modern telecommunications.

Azerbaijan

[Phage-typing of typhoid cultures and results of use of this method in anti-epidemic practice in the Azerbaijan SSR].

This work was aimed at the study of the phage-type pattern of the causative agents of typhoid fever isolated in the Azerbaijan SSR in 1960-1973. As revealed, the following 26 phage-types circulated in Azerbaijan during the period under study: A, B1, B2, B3, C1, C4, C5, D1, D2, D4, D8, E1, E2, E3, E5, F1, F2, I1, M1N, T, 28, 38, 39, 40 and 46. The most widespread were phage-types A (22.86%), E1 (13.96%), F1 (9.74%), F2 (6.70%), and 28 (5.71%) constituting over half of the typed typhoid strains. Sources and ways of transmission of the infection were deciphered with the aid of phage-typing typhoid cultures.

Azerbaijan

[Characteristics of actual nutrition of the long-lived population of Azerbaijan].

The assay of the actual nutrition of old people living in Azerbaijan has evidenced that it corresponds to the climatic and geographical features of the region and has a direct relation to the long-living. The actual nutrition of old subjects in the Azerbaijan SSR is characterized by low fat consumption (vegetable oils among them), by low value of the ratio between polyunsaturated and saturated fatty acids, by high consumption of fruit and vegetables as well as fermented milk products, by an optimal water-salt regimen, high content of vitamins and antioxidants, geroprotectors and a comparatively low energy value of the food rations.

Adult

[The prospects for using Romanomermis culicivorax and R. iyengari (Nematoda: Mermithidae) for mosquito control in Azerbaijan].

The parasitic nematodes Romanomermis culicivorax and R. iyengari, were evaluated as a means of bloodsucking mosquito larvae control in Apsheron Peninsula (the city of Baku) and Lenkoran Lowland (Masally District) in Azerbaijan. Being once brought, mermithids got acclimatized in 12 shallow freshwater nonpolluted pools with aquatic flora and inhibited the emergence of 13-97% of mosquitoes during the summer period. R. culicivorax successfully survived the temporary drying (up to 2 weeks) in 3 and spent a winter in 2 water reservoirs. The possibility of R. iyengari settling via transmission of infected mosquito larvae from a "nursery" pool to a mermithid free water pool was proved. The larvae Cx. modestus, Cx. theileri, Ae. caspius and Ur. unguiculata are first registered as hosts of R. culicivorax and An. sacharovi, Cx. theileri and that of R. iyengari. Both mermithid species may be considered as a means of prolonged inhibition of mosquito emergence in the shallow nonpolluted fresh-water reservoirs in the Azerbaijan SSR.

Acclimatization

[Testing of G----A mutation in position 110 of a minor intron of beta-globin genes in patients with thalassemia in Azerbaijan].

A point mutation G-A in the 110 position of the beta-globin gene small intron has been revealed by cloning and sequencing from the material of a homozygote beta-thalassemia patient in Azerbaijan. In the present study two allele-specific oligonucleotide probes for testing the mutation have been synthesized. Assessment frequency of the mutation among the beta-thalassemia patients in Azerbaijan has been performed with the use of the amplified beta-globin gene fragments obtained by using the thermostable DNA-polymerase from T. thermophilus with the subsequent dot-hybridization in gel of the amplified material with the oligonucleotide probes. The possibility to test the mutation by hybridization of the oligonucleotide probes with the donors and beta-thalassemia patients restricted genomic DNA has been analyzed. Only one of 50 thalassemia alleles of beta-globin genes under study has been shown to possess the mutation mentioned.

Azerbaijan

[Strongyloidiasis prevalence in the subtropics of the Azerbaijan SSR].

The Berman technique was used in the authors' modification for strongyloidiasis survey of 18212 persons in various areas of Azerbaijan. It was stated that with the height increasing up to 500 m over the sea surface the infestation with strongyloidiasis increased and varied between 5.7 and 9.3 +/- 0.1%. At the height of 500-1500 meters the value decreased up to 3.5 +/- 0.1% and at the height of 2000-2400 meters was the lowest one (2.2 +/- 0.1%). The investigation revealed that the disease foci could appear not only in the plains or foothills but in mountainous and high-mountain areas of the Azerbaijan subtropics.

Age Factors

Molecular characterization of beta-thalassemia in Azerbaijan.

We have analyzed the beta-thalassemia mutations in 99 chromosomes of 49 adults with beta-thalassemia major and of one with Hb S-beta-thalassemia, who are regular patients at a large hematology clinic in Bakü, Azerbaijan. A total of 20 different mutants were identified; three [frameshift at codon 8 (-AA); IVS-II-I (G-->A); IVS-I-110 (G-->A)] were present in about two-thirds of all chromosomes. Most alleles are the same as found in Mediterranean populations; a few have an Asian origin or come from Kurdistan, Lebanon, Saudi Arabia, or a black population. One mutant [frameshift at codons 82/83 (-G)] might be specific for the Azerbaijanian population. Nearly all patients were transfused, which made quantitation of Hb F impossible; high G gamma values were present in the Hb F of those patients whose beta-thalassemia chromosome carried the C-->T mutation at position -158 in the promoter of the G gamma-globin gene.

Adult

Primary health care revitalization in Azerbaijan.

Of Azerbaijan's 7,564,800 inhabitants, 52.2% live in urban and 47.8% in rural areas. With the transition to market-oriented economy, health problems have worsened. Expenditures for health care fell from 2.9% of GDP in 1990 to 1.2% in 1997. In case of illness, 37% of population prefer self-treatment, and 68% of treatment refusals are due to the inability of patients to pay for the treatment. Maternal mortality rate increased from 10.5 deaths per 100,000 live births in 1991 to 52 deaths per 100,000 live births in 1996. However, diphteria has been reduced to sporadic cases, whereas polio has not been reported since 1996. A pilot reform of primary health care was initiated in one of the districts, and soon expanded to four more districts. The aims were the improvement of health management, rationalization/optimization through development of traditional services, organization of preventative activities, rational use of drugs, institution of sustainable financial mechanisms through affordable fees for services, drug sales within health facilities with corresponding management and the accounting systems for the revenues, development of the exemption system, and community participation in district health. Increased patient attendance to health facilities, improved access to the vulnerable population health services, empowered health system management, better quality of care, and reduced overall individual expenditures were observed.

Azerbaijan

[Analysis of some viral infections, transmitted by parenteral and sexual routes, in the Republic of Azerbaijan].

Representatives of various population groups in Azerbaijan were tested for infection with human T-lymphotropic (HTLV-I and HTLV-II) and hepatotropic viruses (HCV and HBV). A total of 835 sera were studied by screening and specific tests for virus-specific antibodies and/or antigens. Thirty-five DNA specimens from peripheral blood lymphocytes were analyzed in the PCR for HTLV-I-specific sequences. No HTLV-I or HIV were detected, but two cases with integration of the HTLV-I LTR gene into cellular DNA genome were detected. A high rate of infection with hepatitis B and C was revealed. The level of anti-HCV was 8.7%, HBsAg 4.1%, and antiHBs 23.4%. Six cases with double HBV-HCV infection were detected. High values of ALT among HBV/HCV-seronegative subjects prompts their testing for other types of hepatitis viruses.

Adolescent