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[Current malaria situation in the Republic of Uzbekistan].

Malaria was once one of the most common diseases in Uzbekistan. There were massive epidemics with high mortality rates, wherein 140,000 to 700,000 cases of malaria were recorded. Following large-scale malaria control measures, the disease was eradicated in Uzbekistan in 1961 and the epidemiological situation is still favorable. The natural and climatic conditions that prevail in the Republic of Uzbekistan mean that the country is very susceptible to malaria. There are large water areas varying in type and origin, which provide a habitat for a number of epidemiologically dangerous species of malaria-transmitting mosquitoes in a single area. These are Anopheles maculipennis, An. pulcherrimus and An. superpictus. The prevailing temperatures promote rapid growth of vector mosquitoes and parasites and the malaria transmission season is over 5 months long. Seven malaria-transmitting mosquito species have been recently recorded in the Republic. DDT resistance has been so far noted in Anopheles maculipennis, An. hyrcanus and An. bifurcatus. An. superpictus is sensitive to all insecticides used in clinical practice (organophosphorus and organochlorine compounds, HOS, carbamates, pyrethroids). The most dangerous areas for transmitting malaria by importation are the flood plains of the country's main rivers, such as Syrdarya, Amudarya, Chirchik, Surkhana, etc., and rice-growing areas (an area of about 150,000 ha was under rice cultivation in 1999). The Republic is still very subjected to large-scale importations of malaria particularly in the towns and areas along the border with Tajikistan. There has been recently an increase in the incidence of infections imported into the Republic: 27 cases in 1995, 51 in 1996, 52 in 1997, 74 in 1998, and 78 in 1999. Eight regions of Uzbekistan border Tajikistan, their population is over 5.6 million people. In addition, close family ties between the populations of the frontier towns and regions further increase the risk for malaria to be imported and passed on. Noteworthy is the Surkhandaryin region that accounted for 60% of the cases recorded in 1999. The number of towns and villages where malaria occurs for the first time increased (49 and 46 cases in 1999 and 1998, respectively). The number of cases imported into rural areas also increased (70 (83%) cases in 1999 versus 48 (65%) cases in 1998); due to the large populations of malaria mosquitoes, there is a real danger that the disease may spread. In 1999, most cases of malaria were imported from Tajikistan (65 cases or 76% of all cases). There was a case from each of the following countries: Afghanistan, Pakistan, and Kazakhstan and 5 cases from Azerbaijan and Kyrgyzstan. The recorded cases included slighly more men than women (54% vs 46%). There were 10 infected children under 14 years, which was 23.5% of all notified cases. Analyzing various populations showed that 67.1% of the patients visited their relatives in malaria-endemic countries (mostly Tajikistan) and 25.8% migrated from Tajikistan. All the detected cases were confirmed by laboratory tests. As in the past, most cases were tertian (P. vivax) malaria (n = 82 or 96.4% of all cases). Tropical (P. falciparum) malaria was confirmed in 3 (3.5%) cases. These cases had been imported from Tajikistan into the Surkhandaryin region. Seventy seven (91%) cases were detected in the epidemical season. Of them 58 (68.2%) cases were detected during a malaria transmission season. Seven cases who contacted the patients with imported malaria and were infected were recorded in 1999. They included 4 and 3 cases in the Surkhandaryin and Kashkadaryin Regions, respectively. In 1999, there was a decline in the number of malaria patients who needed health care and in the diagnosed malaria cases in therapeutical and prophylactic institutions. Throughout the country, 34 (40%) of the 85 detected cases presented within 3 days of malaria outbreak (68.9% in 1998). Malaria was immediate diagnosed in 43.5% of cases (64.9% in 1998). The remaining cases were diagnosed as having acute respiratory viral infections, tropical and parasitic diseases, viral hepatitis, or influenza. Early diagnosis of malaria was made in 60% of cases (77% in 1998). Three cases of imported tertian malaria were recorded in the Tashkent Region in the first quarter of 2000. They were imported from Tajikistan into rural areas and the patients had been infected during the 1999 season. Epidemiological surveillance of malaria in Uzbekistan is regularly carried out by the general network of health facilities and by the departments of parasitology of state epidemiological surveillance centers in collaboration with medical administrative departments, the Ministry of Agriculture and Fisheries, the L.M. Isayev Research Institute of Medical Parasitology, and other agencies. Active links are maintained with WHO under the Roll Back Malaria programme. Great emphasis is laid on medical staff training at all levels. During the 1999 epidemiological survey, 672,536 laboratory tests were performed on blood samples from suspected malaria patients and individuals who had visited malaria-endemic countries, 55% of them suffering from fever. A total area of 17 million m2 of dwelling and nondwelling buildings 20 ha of water areas were treated against mosquitoes and the larvivorous fish Gambusia was put into the water areas occupying 6,500 ha. In all cases of malaria, the focus of infection was epidemiologically surveyed and required epidemic preventive measures were implemented. All malaria patients received a full course of radical therapy and recovered completely. The epidemiological surveillance system for malaria is affected by staff shortages at the parasitology departments of state epidemiological surveillance centers and by shortages of microscopes, reagents, sterilizing equipment, insecticides, etc. There are still difficulties in obtaining supplies of primaquine although a small stock is locally available as due to WHO humanitarian assistance. The Epidemiological Malaria Surveillance Programme for the Republic of Uzbekistan for 2000-2004, intended to strengthen the epidemic control capacity of health care facilities, Ministry of Health, is under adoption. The following activities are scheduled for 2000: to plan malaria control activities, including the zoning of the country by the risk of malaria transmission in accordance with republic-leveled directives, instructions, and methodology and WHO recommendations: adjustments to these plans to be made as necessary; to fill vacant posts in the parasitology departments of state epidemiological surveillance centers; to procure stocks of antimalarial drugs, reagents, insecticides, sterilizing equipment, etc., to be paid for from epidemiological service resources; to include malaria issues into certifying tests for physicians, as appropriate for the posts to be occupied and their level of qualifications; to publish posters, brochures, and leaflets about malaria prevention before the malaria transmission season for health education; to hold seminars and meetings for health workers on the etiology of malaria, its clinical features, diagnosis, treatment, and prevention.

Adolescent↗
PubMed2000

The disease burden of hepatitis B in Uzbekistan.

OBJECTIVE: To describe the burden of hepatitis B illness in Uzbekistan by means of model-based estimates. METHODS: A mathematical simulation model was developed to mimic the disease evolution of hepatitis B and calculate the size and age of specific HBV patient groups, defined according to the severity of their illness. RESULTS: The calculations indicate that of 678000 neonates in Uzbekistan, 159185 (235 per 1000) would incur an HBV infection at some time during their lives. About 55095 persons (81 per 1000) would become chronic carriers of hepatitis B and 6307 persons (9.3 per 1000) are expected to die due to hepatitis B before they would die from another cause. In the overall population, we calculated that about 3074 Uzbeki die each year from the consequences of hepatitis B. Only 3.2% of these premature HBV-deaths are due to acute hepatitis B, whereas 96.8% are due to chronic hepatitis B. It was calculated that 2.1% of all deaths (or 1 in 47 deaths), and nearly 25% of deaths (or one in four deaths) between 30 and 40 years of age in Uzbekistan are due to hepatitis B. Vaccination seems easily defensible on the basis of rudimentary but very conservative cost-effectiveness calculations ($84 per carrier prevented; $735 per death prevented and $22 per life-year gained). CONCLUSION: Hepatitis B represents a huge health problem in Uzbekistan, especially in young adults. The potential for prevention by vaccination seems very high, but demands a long-term vision if chronic hepatitis, in particular, is to be reduced. Routine hepatitis B vaccination was found to be a relatively cost-effective intervention in Uzbekistan.

Adolescent↗
PubMed2005

Public participation to improve water resource management in Uzbekistan.

At present Uzbekistan uses about 42 km3 of transboundary river flow and 27 km3 of this is from the Amu Darya. Annual average flow entering the upper reaches of Amu Darya within Uzbekistan is over 60 x 10(9) m3, which is already contaminated, but significant adverse water quality changes occur downstream where the river is the main source of drinking water. After independence Uzbekistan made a commitment to transfer management of farms and the rural economy from the public sector to private hands. Living conditions have deteriorated severely throughout Uzbekistan, but rural areas have been hit hardest. Several studies and projects in Uzbekistan have adopted the integrated water management-based environmental approach. A structured public participation and consultation process was followed during these projects including a social and the environmental assessment. This paper presents the two case studies to illustrate the effects of uniting the potential of all interested participants to improve water management and environmental safety. Consultation between the two main groups of stakeholders is essential for the future of the water sector. There is substantial support for WUAs among all stakeholders, at all levels, including among those stakeholders who currently manage the existing system.

Agriculture↗
PubMed2005

Outbreak of a West African recombinant of HIV-1 in Tashkent, Uzbekistan.

OBJECTIVES: This research describes the genetic diversity of HIV-1 in Uzbekistan. METHODS: During 2002 and 2003, blood from HIV-positive patients in Uzbekistan was collected, and part of the proviral pol gene and nearly full-length genomes were sequenced and analyzed. RESULTS: Among 142 Uzbek strains, most clustered genetically with the subtype A strain common in the former Soviet Union. Most of these subtype A-infected drug-naive subjects (65.6%) had an accessory drug resistance mutation, A62V, in the reverse transcriptase gene. Thirteen of the strains (9.2%) clustered with CRF02_AG, an HIV strain common in West Africa. People infected with CRF02_AG were all residents of Tashkent and sampled in 2002. The CRF02_AG strains were monophyletic and probably descended from a single ancestor. Two strains were recombinant between CRF02_AG and subtype A, with each having a different subtype structure. The CRF02_AG and the subtype A elements of the recombinants were monophyletic with Uzbek CRF02_AG and subtype A. New full-length genomes of 12 Uzbek strains suggested that neither the subtype A and nor the CRF02_AG strains in this epidemic were mosaics with other subtypes or circulating recombinant forms. CONCLUSION: A genetic analysis of Uzbek HIV strains demonstrated the predominance of subtype A in the epidemic. An outbreak of a West African strain of HIV-1, CRF02_AG, occurred in Tashkent, Uzbekistan in 2002, however. The cocirculation of the 2 strains has resulted in new recombinants that are apparently unique to Uzbekistan.

Africa↗
PubMed2003

Hepatitis C virus molecular epidemiology in Uzbekistan.

The aim of this study was to identify hepatitis C virus (HCV) genotypes and to estimate their prevalence in various risk groups and the regional distribution in Uzbekistan. Preliminary serological screening of 1,269 subjects revealed 6.5% anti-HCV-positive in a general population, 27.1% in patient groups, and 51.7% among intravenous drug users. HCV genotypes of 104 anti-HCV-positive subjects were determined using a PCR-genotyping system in core region, and the results were supported by nucleotide sequencing of the NS5B region. Genotype 1b identified in total 64.2%, was the most prevalent. The genotype 3a identified in 25.0% was the second one distributed. HCV genotypes 2a, 1a, 2b, and 3b were identified in 3.8%, 2.9%, 2.9%, and 1.0% of cases, respectively. The intravenous drug users were distinguished from other groups by having the highest prevalence of genotype 3a, i.e., 50.0%, higher than the 33.3% for genotype 1b in this group. Geographically, genotype 1b was common; genotype 3a was also found frequently in all three regions. Uncommon HCV genotypes (1a, 2a, 2b, and 3b) were found in comparatively greater variability in the western region. Molecular evolutionary analysis based on the NS5B region did not reveal specific clustering or indigenous strains among Uzbekistan HCV isolates. In summary, two main mechanisms of HCV infection distribution were observed in Uzbekistan: HCV 1b genotype infection is widespread through blood products, and HCV 3a genotype infection is spreading through the growing number of intravenous drug users.

Adolescent↗
PubMed2006

Epidemiology of obesity and hypertension and related risk factors in Uzbekistan.

OBJECTIVE: This study examined the prevalence of obesity and hypertension and associated behavioral risk factors in adult men and women in Uzbekistan. The study also examined the association between obesity and hypertension. METHOD: The analysis used data from the 2002 Uzbekistan Health Examination Survey, which included a nationally representative sample of 2333 men aged 15-59 years and 5463 women aged 15-49 years. The survey measured height, weight and blood pressure and included questions on physical activity, dietary habits, tobacco smoking, alcohol use and other characteristics. The analysis was conducted using binary and multinomial logistic regression methods, separately for men and women. RESULTS: Eating animal source protein and tobacco smoking in the past were positively associated with obesity, but there were no consistent associations with other dietary indicators, physical activity level or alcohol use. Obese men and women were about three times as likely to suffer from hypertension as those with a normal BMI (odds ratio (OR)=3.01; 95% confidence interval (CI): 1.67-5.44; P<0.001 for men and OR=2.82; 95% CI: 2.05-3.86; P<0.001 for women), independent of physical activity level, dietary habits, tobacco smoking and other factors. For men, the risk of hypertension was strongly positively associated with BMI only at BMI levels above 25 kg/m(2), but for women a positive relationship was observed at all BMI levels. CONCLUSION: The study found a strong positive association between obesity and hypertension in adult men and women in Uzbekistan. The shape of the relationship between BMI and hypertension is different for women than for men, requiring further research to explore this relationship.

Adolescent↗
PubMed2000

Diphtheria epidemic in the Republic of Uzbekistan, 1993-1996.

The Republic of Uzbekistan, like the other Newly Independent States in the 1990s, experienced epidemic diphtheria during the 1990s. The outbreak in Uzbekistan began in 1993 in southern regions that bordered areas of Tajikistan that were experiencing a very intense diphtheria epidemic. However, the Uzbek epidemic rapidly spread and threatened to involve the entire country. From 1993-1996, 1169 cases of diphtheria were reported, compared with 58 in 1990-1992. Unvaccinated or only partially vaccinated cases were more likely to have clinically severe forms of diphtheria than those who were fully vaccinated. Strong epidemiologic links with the Tajik diphtheria epidemic and the predominance of mitis biotype strains of Corynebacterium diphtheriae in Uzbekistan make it likely that the Uzbek outbreak arose independently of the predominantly biotype gravis epidemic that began in Russia. The epidemic appeared to be due to low population immunity and the large-scale reintroduction of toxigenic strains of C. diphtheriae. Several mass vaccination campaigns and general enhancement of routine immunization procedures led to control of the epidemic in 1996.

Adolescent↗
PubMed2003

Human immunodeficiency virus in Uzbekistan: epidemiological and genetic analyses.

This study investigates the molecular epidemiology of HIV in Uzbekistan--a former Soviet Union (FSU) country located in central Asia. A total of 18,910,370 subjects were involved in an HIV serological examination through a population survey conducted in 1987-2002. Rapid changes in epidemiological dynamics and transmission modes have been observed since 1999: incidence rose from 25 newly HIV-infected subjects per year to more than 100 new cases per month within the first half of 2002, and the rate of intravenous drug use (IVDU)-associated HIV infection increased to 75% per year during the same period. Thirty HIV-1 strains, isolated from specimens obtained in 1999-2000, were directly sequenced in the env region. Phylogenetic analysis revealed a relationship to genotype A in 56.7%, and to 03_CRFAB in 13.3%; both variants have been previously reported in the FSU. The majority (85.7%) of these strains were isolated from IVDUs. The demographic history of the most prevalent HIV strain in Uzbekistan was inferred from reconstructed molecular phylogenies; exponential growth of the viral population size was thus observed to occur after the mid-1990s. In summary, detectable HIV seroprevalence remains low in the general population of Uzbekistan. However, the current study demonstrates a substantially increasing number of new infections, in association with IVDU, and an exponentially growing effective population size of the IVDU-associated HIV strain.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Reproductive and sexual health among young adults in Uzbekistan.

Since 1991, contraceptive use has risen significantly in Uzbekistan while reliance on abortion has declined; yet reproductive health improvements have not translated into better conditions for sexual health. The prevalence of sexually transmitted diseases increased significantly in the 1990s, and UNAIDS currently identifies the Central Asian region as a high HIV-growth zone. Structural, institutional, and attitudinal factors have contributed to the disconnection between reproductive and sexual health in Uzbekistan, even though family planning programs have been well established during the HIV pandemic. Integrating state statistics, Demographic and Health Survey data, and focus-group-discussion results, we highlight the ways in which a heavily centralized program focusing on reproductive health did little to better sexual health, especially among young adults. The example of Uzbekistan reveals pathways by which reproductive health efforts may continue to be compartmentalized, decreasing their potential contributions to sexual health, especially among young adults.

Adolescent↗
PubMed2006

Challenges to integrating sexual health issues into reproductive health programs in Uzbekistan.

This study examines the direction and result of efforts of nongovernmental organizations (NGOs) in the area of reproductive and sexual health in Uzbekistan. It focuses specifically on the institutional, structural, epidemiological, and cultural forces responsible for the exclusion of sexual health issues from reproductive health campaigns in the most populous Central Asian country. In Uzbekistan, as in other countries of the region, significant international support was given to NGOs providing reproductive health services in the mid-to-late-1990s, well into the early period of the HIV/AIDS pandemic and after the 1994 mandate of the International Conference on Population and Development for the inclusion of sexual health as a key reproductive health component. Examining the exclusion of sexual health issues from reproductive health campaigns in Uzbekistan highlights problems relating to time lags in program and evaluative development and the difficulties NGOs experienced in balancing donor-state agendas with recipient-state priorities. Findings question standard assumptions regarding the advantageous structural aspects of NGOs, in terms of flexibility, responsive agenda generation, and state independence.

Abortion, Induced↗
PubMed2006

Laboratory transmission of Japanese encephalitis and West Nile viruses by molestus form of Culex pipiens (Diptera: Culicidae) collected in Uzbekistan in 2004.

We evaluated the molestus form of Culex pipiens pipiens (L.) (hereafter referred to as "molestus") captured near Tashkent, Uzbekistan, for their ability to transmit Japanese encephalitis (family Flaviviridae, genus Flavivirus, JEV) and West Nile (family Flaviviridae, genus Flavivirus, WNV) viruses under laboratory conditions. These molestus were highly competent laboratory vectors of WNV, with infection and dissemination rates of 96 and 81%, respectively. Approximately 75% of female molestus that fed after development of a disseminated infection transmitted virus by bite. Therefore, approximately 60% of those molestus taking a second bloodmeal between 16 and 25 d after an infectious bloodmeal would be expected to transmit WNV by bite. In contrast, these molestus were less efficient vectors of JEV, with infection and dissemination rates of 51 and 25%, respectively. In addition, only 33% of individuals with a disseminated infection transmitted JEV by bite, indicating a significant salivary gland barrier. Therefore, only approximately 8% of orally exposed individuals would be expected to transmit JEV by bite if they took a second bloodmeal 16-25 d later. These data indicate that the molestus form of Cx. p. pipiens should be considered a potentially important vector of WNV in Uzbekistan and may become involved in the transmission of JEV, should this virus be introduced into Uzbekistan.

Animals↗
PubMed1998

Glucose intolerance and associated factors in the Fergana Valley, Uzbekistan.

Prevalence of glucose intolerance and other noncommunicable diseases has been examined in subjects aged 35 years and over in semirural and urban communities in the Fergana Valley in the eastern part of Uzbekistan, Central Asia. Diabetes and impaired glucose tolerance (IGT) were diagnosed according to the recommendations of the latest WHO Study Group on diabetes. Crude prevalence of diabetes was 9% and 5%, respectively, in semirural men and women, 13% and 9% in urban men and women. Crude prevalence of impaired glucose tolerance (IGT) was 6% and 9%, respectively, in semirural men and women, 9% and 8% in urban men and women. After adjustment for non-response, prevalence of diabetes was 5% and 4%, respectively, in semirural men and women and 8% in both urban men and women. Adjusted prevalence of IGT was 4% and 8%, respectively, in semirural men and women, 5% and 6% in urban men and women. The majority of subjects with a prior diagnosis of diabetes were being treated with oral hypoglycaemic agents. Almost one-half of subjects in both communities had body mass index of 25 kg m(-2) or greater. Central obesity (waist-hip ratio 0.95 or greater for men, 0.85 or greater for women) was observed in over one-quarter of subjects in both communities. Clinical hypertension was not frequent by international standards (9% in semirural subjects and 13% in urban subjects) but a number of subjects who were clinically normotensive claimed to be taking antihypertensive medication. It is concluded that glucose intolerance and central obesity are common in this region of Uzbekistan, about which there was previously little information.

Adult↗
PubMed2002

Hepatitis B virus genotypes in Uzbekistan and validity of two different systems for genotyping.

Hepatitis B virus (HBV) has been classified into seven genotypes, designated A-G. The HBV genotype has a characteristic geographical distribution. The Republic of Uzbekistan is located in the heart of Asia and has been considered to be a region with high endemicity of hepatitis viruses. However, the present distribution of hepatitis virus infection in this region is unknown. The aim of this study was to investigate the distribution of HBV genotypes and to elucidate the validity of two genotyping systems in Uzbekistan. Fifty-four patients with hepatitis B surface antigen were investigated. HBV genotypes were determined by two methods: one based on restriction fragment length polymorphism (RFLP) targeting to S region, and another on enzyme-linked immunosorbent assay (ELISA), using monoclonal antibodies to pre-S2 region. Seven (13%) and 47 (87%) of the 54 subjects were classified into genotypes A and D, respectively. Dual infection of two viral populations of the same genotype was observed in one subject. No significant difference of ALT level (203.3 +/- 244.7 vs. 190.6 +/- 39.5) and HBeAg (42.9% vs. 42.6%) were found between genotypes A and D. In this study, the validity of the genotyping systems in this region was confirmed.

Base Sequence↗
PubMed2005

Efforts of Uzbekistan to prevent nuclear terrorism and smuggling of radioactive and nuclear materials.

Uzbekistan is located on the cross-roads from the north--Russia, Western Europe--to the south--Afghanistan, Iran, Iraq and others. The appearance of terrorist organizations urged some Asian countries to make the nuclear weapons, the making the task of stopping the transportation of nuclear materials and technologies from the north (from countries possessing nuclear weapon) to the south (to countries desiring to have weapons and its components) a reality. To resolve this problem, on the main transportation routes, "Yantar" stationary radiation monitors of Russian production were installed, and development and production of monitors of our own make was started. This paper covers these works as well as those on preventing possible terrorist attacks on nuclear objects of Uzbekistan.

Elements, Radioactive↗
PubMed2004

Novel antioxidants isolated from plants of the genera Ferula, Inula, Prangos and Rheum collected in Uzbekistan.

We examined the effects of 48 compounds isolated from Ferula pallida, F. penninervis, Inula macrophylla, Prangos pabularia, P. tschimganica and Rheum maximowiczii collected in Uzbekistan on ADP/Fe2+-induced lipid peroxidation of egg yolk phosphatidylcholine liposomes. Of those compounds, 23 inhibited ADP/Fe2+-induced lipid peroxidation and nine showed especially strong inhibition of lipid peroxidation. Most compounds that inhibited peroxidation scavenged the 1,1'-diphenyl-2-picrylhydrazyl (DPPH) radical, indicating that the inhibition was due to radical scavenging. However, some compounds did not scavenge DPPH but inhibited lipid peroxidation significantly, suggesting that their inhibitory effect was not due to radical scavenging but to some other mechanism, such as prevention of Fe2+ function. Thus, we found various new antioxidants, some of which had a unique mechanism of action, in Ferula, Inula, Prangos and Rheum plants collected in Uzbekistan as seeds used in medicine.

Antioxidants↗
PubMed1997

High prevalence of GB virus C/hepatitis G virus infection among the Jewish population in Uzbekistan.

Although a new virus, GB virus C/hepatitis G virus (GBV-C/HGV), has been isolated from patients with hepatitis by two different research groups, its prevalence in the world and pathogenesis are still unknown. In this study, 92 samples from the Jewish population of Uzbekistan were investigated for the prevalence of GBV-C/HGV. GBV-C/HGV RNA was detected by reverse transcription polymerase chain reaction (RT-PCR) using specific primers derived from the 5'-untranslated region (5'-UTR). Sequences were analyzed by a molecular evolutionary method. Of 92 samples, GBV-C/HGV RNA was detected in ten (10.9%), HCV RNA was present in two (2.2%), and HBsAg in eight (8.7%). HTLV-I and HIV infection was not detected. Single GBV-C/HGV infection was detected in eight (80%), and co-infection with HBV or HCV was detected in only two of the GBV-C/HGV infections. Alanine aminotransferase (ALT) levels were elevated in three (3.3%), but none with single GBV-C/HGV infection had an elevated ALT level. Nine people (90%) with GBV-C/HGV infection were distributed under the mean age of the population (P < 0.05). Molecular evolutionary analysis showed all GBV-C/HGV strains in this study were related to the HGV derived from the US. These results indicate that (1) GBV-C/HGV infection is highly prevalent among the Jewish population in Uzbekistan; (2) single GBV-C/HGV infections without persistent hepatitis are common; and (3) GBV-C/HGV infection is present among the younger generation.

Adolescent↗
PubMed1999

Childhood blindness in Uzbekistan.

PURPOSE: To elucidate the aetiology of childhood blindness in the Republic of Uzbekistan and to assess the needs for future provision of ophthalmic services for children. METHODS: Six hundred and seventy-one children in seven schools for the blind and visually impaired throughout Uzbekistan were examined using the WHO/PBL (World Health Organization Prevention Of Blindness) childhood blindness proforma. The locations were chosen to give a representation of the major areas of population within the country. RESULTS: Of the 671 children examined, 506 (75.4%) were blind or severely visually impaired (corrected visual acuity of less than 6/60 (20/200) in the better eye). Cataract-related blindness (35%), retinal dystrophies (24%) and microphthalmos (23%) formed the three largest diagnostic categories. CONCLUSIONS: The commonest avoidable cause of blindness was found to be cataract; the cause of poor vision may be due to unoperated cataract, aphakia, amblyopia or post-operative capsular fibrosis. The high proportion of retinal dystrophies may be related to the common practice of consanguineous marriage. The frequent finding of microphthalmos is discussed and compared with findings from other surveys. Glaucoma accounted for approximately 5% of the avoidable blindness.

Adolescent↗
PubMed2007

Prevalence and correlates of risky sexual behaviors among injection drug users in Tashkent, Uzbekistan.

The objective of this paper is to describe prevalence and correlates of sexual risk behaviors among injection drug users (IDUs) in Tashkent, Uzbekistan. Participants in this cross-sectional study completed a questionnaire detailing sociodemographic, medical and drug and sexual risk behaviors and HIV antibody testing. Of 701 IDUs surveyed, only 20.5% reported consistent condom use, which was more likely for women. Prior sexually-transmitted infection (STI) diagnosis was reported by 36.2% of participants and was associated with early (</=18 years) drug initiation, group drug use, being older, higher educational level, marriage, needle sharing, multiple sex partners in the preceding month and daily injection use. Having multiple partners in the preceding month was common (29.71%) and related to employment, consistent condom use with regular partners and STI self-treatment in multivariate logistic regression. Participants with a history of sharing needles were less likely to have had multiple partners in the previous month. Risky sexual behaviors are common and interrelated with risky injection habits among IDUs in Tashkent, Uzbekistan, representing a continued threat of infection with HIV and other blood-borne agents.

Adolescent↗