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PubMedDate not supplied

[Epidemiological and immunological monitoring of tetanus in Georgia (Republic)].

During the period of 1961-1990 the regular immunological and epidemiological monitoring of tetanus was carried out. At the prevaccination period (1937-1960) 140 cases of tetanus were registered, 77 patients died (morbidity rate being 0.97-0.11 per 100,000 of the population with mortality rate equal to 55.6%). At the period of mass vaccinal prophylaxis (1960-1990) 56 cases were registered and 27 patients died (the corresponding values: 0.09-0.11 with 48.2% mortality). In 1981-1990 altogether 53,213 vaccinees were examined. 4,864 vaccinees (8.9%) proved to be seronegative and 43,615 vaccinees (81.9%) were found to have protective antibody titers. 4,220 pregnant women were examined; 476 women (11.2%) proved to be seronegative and 3,576 women (84.3%) were found to have protective antibody titers. Timely specific prophylaxis proved to be the only way for decreasing tetanus morbidity.

Adolescent↗
PubMed2005

Anatomical descriptions, comparative studies and evolutionary significance of the hominin skulls from Dmanisi, Republic of Georgia.

Evidence for ancient hominin occupation in Eurasia comes from Dmanisi in the Georgian Caucasus. Stratigraphic and sedimentological arguments, geochemical observations, paleomagnetic sampling and radiometric dates all point to the conclusion that bones and artifacts were deposited at this site during a brief interval following the close of the Olduvai Subchron (1.77 million years ago). In this report we present further descriptive and comparative studies of the D2280 braincase, the D2282 partial cranium, now linked with the D211 mandible, and the skull D2700/D2735. The crania have capacities ranging from 600 cm3 to 775 cm3. Supraorbital tori and other vault superstructures are only moderately developed. The braincase is expanded laterally in the mastoid region, but the occiput is rounded. The pattern of sagittal keeling is distinctive. D2700 displays a prominent midfacial profile and has a very short nasoalveolar clivus. Also, the M3 crowns are reduced in size. Although there is variation probably related to growth status and sex dimorphism, it is appropriate to group the Dmanisi hominins together. With the possible exception of the large D2600 mandible, the individuals are sampled from one paleodeme. This population resembles Homo habilis in brain volume and some aspects of craniofacial morphology, but many of these features can be interpreted as symplesiomorphies. Other discrete characters and measurements suggest that the Dmanisi skulls are best placed with H. erectus. There are numerous similarities to individuals from the Turkana Basin in Kenya, but a few features link Dmanisi to Sangiran in Java. Some traits expressed in the Dmanisi assemblage appear to be unique. Reconstructing the evolutionary relationships of these ancient populations of Africa and Eurasia is difficult, as the record is quite patchy, and determination of character polarities is not straightforward. Nevertheless, the evidence from anatomical analysis and measurements supports the hypothesis that Dmanisi is close to the stem from which H. erectus evolved.

Animals↗
PubMed2003

The aftermath of health sector reform in the Republic of Georgia: effects on people's health.

After the collapse of the Former Soviet Union a health reform process was undertaken in Georgia beginning in 1994. This process was intended to encompass all aspects of the health-care sector and to transform the Soviet-style health system into one that was directed towards quality of care, improved access, efficiency, and a strengthened focus on Primary Health Care (PHC). Health sector reform fundamentally changed the ways health care is financed in Georgia. There has been a transition to program-based financing, and payroll-tax-based social insurance schemes have been introduced. Despite these measures, the performance of the health system is still disappointing. All health programs are severely under-funded, and when the majority of the population is unemployed or self-employed, collection of taxes seems impossible. Overall, Georgian consumers are uninformed about the basic principles of health reforms and their entitlements and therefore do not support them. The analysis introduced in this paper of the current situation in Georgia establishes that the rush to insurance-based medicine was more a rush from the previous system than a well-thought-out policy direction. After 70 years of a Soviet rule, the country had no institutional capacity to provide insurance-based health care. To achieve universal coverage, or at least ensure that the majority of the population has access to basic health services, government intervention is essential. In addition, educating the public on reforms would allow the reform initiators to fundamentally change the nature of the reform process from a "top-down" centralized process to one that is demand-driven and collaborative.

Cause of Death↗
PubMed2000

Evaluation of a single dose of diphtheria toxoid among adults in the Republic of Georgia, 1995: immunogenicity and adverse reactions.

To determine the immunogenicity and safety of a single dose of diphtheria toxoid among adults, blood samples for detecting serum antitoxin levels were obtained from 18- to 59-year-old subjects (n=248) before and 30 days after immunization with Td (tetanus-diphtheria toxoids; manufactured by Serum Institute of India). By day 30, the seroprevalence of antitoxin levels >/=0.1 IU/mL increased from 22.6% to 81.5%; median antitoxin levels increased from 0.01 to 4.0 IU/mL. These parameters were lowest among subjects who were 40-59 years old, especially among those 40-49 years old. Adverse reactions (local redness, swelling, induration, fever>39 degrees C) were reported by 5.3% of participants. Our findings suggest that, in general, one dose of the Indian-produced Td vaccine is efficacious and safe in inducing an adequate immune response against diphtheria in adults; however, in Georgia, persons 40-59 years old, especially those 40-49 years old, will require additional doses of toxoid to achieve protective levels of antitoxin.

Adolescent↗
PubMed1996

Analysis of clinical and environment Yersinia isolates in the Republic of Georgia.

The Center for Infectious Diseases Control, Georgian Ministry of Health, isolated 2,493 Yersinia enterocolitica and Y. enterocolitica-like strains, 22 Y. pestis strains, and 21 Y. pseudotuberculosis strains from 130,574 clinical and environmental samples. Analysis of 100 Y. enterocolitica and Y. enterocolitica-like strains showed none to be within traditional pathogenic biogroups or serogroups, and none carried genetic markers for virulence. However, some strains were enterotoxigenic in infant mice, while others were associated with prolonged carriage in adult mice.

Adult↗
PubMed1999

Diphtheria in the Republic of Georgia: use of molecular typing techniques for characterization of Corynebacterium diphtheriae strains.

Sixty-six Corynebacterium diphtheriae strains (62 of the gravis biotype and 4 of the mitis biotype) isolated during the Georgian diphtheria epidemic of 1993 to 1998 and 13 non-Georgian C. diphtheriae strains (10 Russian and 3 reference isolates) were characterized by (i) biotyping, (ii) toxigenicity testing with the Elek assay and PCR, (iii) the randomly amplified polymorphic DNA (RAPD) technique, and (iv) pulsed-field gel electrophoresis (PFGE). Fifteen selected strains were ribotyped. Six RAPD types and 15 PFGE patterns were identified among all strains examined, and 12 ribotypes were found among the 15 strains that were ribotyped. The Georgian epidemic apparently was caused by one major clonal group of C. diphtheriae (PFGE type A, ribotype R1), which was identical to the predominant epidemic strain(s) isolated during the concurrent diphtheria epidemic in Russia. A dendrogram based on the PFGE patterns revealed profound differences between the minor (nonpredominant) epidemic strains found in Georgia and Russia. The methodologies for RAPD typing, ribotyping, and PFGE typing of C. diphtheriae strains were improved to enable rapid and convenient molecular typing of the strains. The RAPD technique was adequate for biotype differentiation; however, PFGE and ribotyping were better (and equal to each other) at discriminating between epidemiologically related and unrelated isolates.

Bacterial Typing Techniques↗
PubMedDate not supplied

[Actual nutrition and health of several groups of rural and urban population of the Republic of Georgia].

The results of the study have shown that the nutrition of rural population is characterized by excessive consumption of bread and baked products, by high content of phosphorus, magnesium and iron, low content of animal proteins, vegetable oils, calcium, vitamins A, ascorbic acid and riboflavin. The incidence of cardiovascular, respiratory and alimentary diseases in this group of population was rather high. The nutrition of students is characterized by excessive consumption of polysaccharides, vegetable oils, thiamine, niacin, ascorbic acid (in winter-spring period), and calcium. Diseases associated with nutrition disorders (obesity, hepatitis, cholecystitis, colitis) are most often recorded in this group of population.

Diet↗
PubMed1996

Epidemiology and clinical management of endometrial carcinoma in the Republic of Georgia in the last 30 years.

Endometrial carcinoma incidence in Georgia from 1965 to 1992 was 5.3 women per 100,000 and in the structure of gynecological malignant tumors this pathology occupied third place (19.1%). Morbidity incidence varied from 2 to 8 depending on ethnic regions overall a 2.5 times rise in morbidity was observed. Within the period of 1968-1994 1731 patients with uterine carcinoma were subjected to surgical intervention (stage I-81.2%; stage II-9.4%; stage III-9.0%; stage IV-0.3%). Surgical intervention is the optimal method to determine the stage of the disease and planning of adjuvant treatment. Metastases in regional lymph nodes were found in 13.0% (T1-7.7%; T2-20.07%; T3-35.3%). Adenocarcinoma was histologically confirmed in 97.4% (G1-21.3%; G2-57.8%; G3-18.8%). Management of the disease was predominantly started with surgical intervention. In pathogenetic version I (71.4%) total extirpation of the uterine was carried out, while in cases of the pathogenetic version II (28.6%) patients were subjected to the modified extended extirpation. Postoperative management was prescribed based on the peculiarities of the organism and tumor. Highly sensitive classification of endometrial carcinoma of stage I (including 5 subgroups) as well as a synoptic table of optimal management were worked out. As a result, 5 year survival increased by 15%, and 29% of the women operated were spared from additional treatment. On the whole, five-year-survival was observed in 71.0% of women (stage I-77.7%; Early Form-95.5%; stage II-51.5%; stage III-34.2%).

Endometrial Neoplasms↗
PubMed2002

The burden of out-of-pocket payments for health care in Tbilisi, Republic of Georgia.

CONTEXT: In the 1990s, the Republic of Georgia instituted health care reforms to convert the centralized, state-operated health care system inherited from the Soviet Union to a decentralized, market-driven system of health care delivery. Under the new system, 87% of health care expenditures are financed through out-of-pocket payments at the point of service. OBJECTIVE: To describe the effects of health care reforms on access to care and health care financing among ill residents of Tbilisi, Georgia. DESIGN, SETTING, AND PARTICIPANTS: A probability-proportionate-to-size cluster survey conducted in 1999 of 248 households containing 306 household members who had been ill in the past 6 months in Tbilisi, Georgia. MAIN OUTCOME MEASURES: Reported health care utilization, out-of-pocket expenditures, and financing practices. RESULTS: Of sick household members, 51% used official health care services at hospitals and clinics; 49% did not use official services and sought advice from relatives or friends, used traditional medicines, or did nothing. Those with serious illness were more likely to seek care through official services (82%) than those with nonserious illness (27%). Ninety-three percent of respondents said costs were the major deterrent to obtaining health care. Ten percent of ill household members reported that they were unable to obtain health care because of high costs; 16% reported being unable to afford all the medications necessary to treat their illness. Sixty-one percent of ill household members used savings to pay for health care expenditures and 19% of those able to obtain care had to use strategies such as borrowing money or selling personal items to pay for health care. Total out-of-pocket health care expenditures (53%) were paid for by borrowing money or selling personal items. A significant portion of households with ill members (87%) reported an interest in purchasing health care insurance. CONCLUSIONS: Economic disruption and health care reforms have led to access problems and out-of-pocket financing strategies that include reliance on personal savings, selling personal items, and borrowing money. Future reforms should consider an appropriate system for health care insurance risk pooling for the population of Tbilisi, Georgia.

Cluster Analysis↗
PubMed2006

Mandibular size and shape variation in the hominins at Dmanisi, Republic of Georgia.

The hominin fossils of Dmanisi, Republic of Georgia, present an ideal means of assessing levels of skeletal size and shape variation in a fossil hypodigm belonging to the genus Homo because they have been recovered from a spatially and temporally restricted context. We compare variation in mandible size and shape at Dmanisi to that of extant hominoids and extinct hominins. We use height and breadth measurements of the mandibular corpus at the first molar and the symphysis to assess size, and analyze shape based on size-adjusted (using a geometric mean) versions of these four variables. We compare size and shape variation at Dmanisi relative to all possible pairs of individuals within each comparative taxon using an exact resampling procedure of the ratio of D2600 to D211 and the average Euclidean distance (AED) between D2600 and D211, respectively. Comparisons to extant hominoids were conducted at both the specific and subspecific taxonomic levels and to extinct hominins by adopting both a more, and less speciose, hominin taxonomy. Results indicate that the pattern of variation for the Dmanisi hominins does not resemble that of any living species: they exhibit significantly more size variation when compared to modern humans, and they have significantly more corpus shape variation and size variation in corpus heights and overall mandible size than any extant ape species. When compared to fossil hominins they are also more dimorphic in size (although this result is influenced by the taxonomic hypothesis applied to the hominin fossil record). These results highlight the need to re-examine expectations of levels of sexual dimorphism in members of the genus Homo and to account for marked size and shape variation between D2600 and D211 under the prevailing view of a single hominin species at Dmanisi.

Animals↗
PubMed2000

Diphtheria epidemic in the Republic of Georgia, 1993-1997.

Epidemic diphtheria reemerged in the republic of Georgia in 1993. From 1993 to 1997, 1405 cases were reported (28 in 1993, 312 in 1994, 429 in 1995, 348 in 1996, and 288 in 1997), with a cumulative incidence of 25.8/100,000 and a case fatality ratio of 9.5%. During 1993-1997, 53% of the diphtheria cases occurred among persons >/=15 years of age. Unvaccinated patients were more likely to have toxic forms (relative risk=2.24; 95% confidence interval=1.69-2.96) or to die of diphtheria (relative risk=2.24; 95% confidence interval=1. 36-3.68) than those who had received at least one dose of diphtheria toxoid. Improvement in routine childhood vaccination coverage and implementation of mass adult vaccination campaigns have been critical to bringing the epidemic under control. By mid-1998, the overall diphtheria situation in Georgia appeared to have been controlled. Only 53 cases were reported from January to June 1998, representing a 64% decrease from the 148 cases during the corresponding period in 1997.

Adolescent↗
PubMed1991

Neuroscience in the Republic of Georgia.

The current uncertain status of the republics of the USSR poses special problems for the future development of their scientific communities. The system of Institutes within an Academy, on which most Eastern European research was modelled, was developed in the USSR. Because of the Republic of Georgia's relatively small population, its research might be especially at risk if collaborative integration with other Republics and the West is not achieved.

Academies and Institutes↗