Rifampicin-resistant/multidrug-resistant (RR/MDR) and extensively drug-resistant (XDR) strains of M. tuberculosis (TB) are serious public health problem in Kazakhstan. In 2012 and 2013, stringent regulatory authorities approved the first new TB drugs in fifty years, bedaquiline and delamanid, offering hope for more effective and less toxic MDR-TB treatment. The endTB Observational Study is a multi-country study that enrolled patients receiving a bedaquiline- or delamanid-containing regimen for RR/MDR-TB between 01 April 2015 and 30 September 2018. In Kazakhstan, 675 patients participated in the study; all had at least 6-months or longer of follow-up after the start of treatment. The present analysis focuses on endTB Observational Study patients living in Kazakhstan who had a positive baseline sputum culture (220 patients) and initiated a bedaquiline- or delamanid-containing regimen between February 1, 2016 and March 31, 2018. Of them, 195 (89%) of patients experienced culture conversion within six months. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Background. The undoubted importance of this work lies in the fact that for the first time in the Republic of Kazakhstan, an analysis is being made of the relationship between age and treatment outcome in patients with a comorbid diagnosis of tuberculosis and diabetes mellitus.Purpose of the study. Identification of the correlation between the age of patients with tuberculosis with diabetes mellitus and the outcome of treatment.Materials and methods. Cross-sectional retrospective study of 2,125 patients with TB and diabetes mellitus out of a total of 43,807 of all patients diagnosed with TB (2017-2019). The study analyzed the data of patients with comorbidity from all regions of Kazakhstan (data from 14 regions and 3 cities of republican significance) (2017-2019).Results. A high prevalence of tuberculosis morbidity with a concomitant diagnosis of diabetes mellitus in the age group from 45 to 64 years was revealed. This group consisted of 1193 patients out of 2115 (56.4% of the total number of patients with tuberculosis and diabetes mellitus). The average age of all studied patients with DM was 54.7±13.4 years. There is a positive correlation between age and treatment outcome in TB patients. Mortality was higher in the age group over 45 years old – OR95%CI = 0.213 [0.019–2.362], p – 0.0000015 (p < 0.05).

Relevance The World Health Organization estimates that in 2020, around 13.5 million children around the world did not receive routine immunizations, as expected, due to a shift in focus to fight a deadly pandemic. Aim Determine how the COVID-19 pandemic has affected the routine immunization of children using the example of vaccination against pneumococcal infection. Materials and methods of research The ongoing retrospective study in the city polyclinic No. 3 of the city of Almaty of the Republic of Kazakhstan covered the period from 2019 to 2021. Statistical analysis was performed to determine significance (p < 0.05) using Z-score. Results Annual coverage of the first vaccination in children aged 2 months in 2019 was 98%, and in 2020 it decreased to 86.1% (Z = 4.112431; P = 0.000039). In 2021, the indicator increased again, and reached the level of 96.8%. For the second dose of pneumococcal vaccine, coverage decreased from 98% (2019) to 80% (2020) (Z = 5.056653; P = 0.000001). In the next 2021, coverage was 96.7%. The null hypothesis is also rejected for the third dose of pneumococcal vaccine in children aged 12-15 months. If in 2019 the implementation of the annual plan was 98.5%, then in 2020 it decreased significantly, and showed only 85.4% (Z = 5.562573; P = 0.000001). Coverage recovery was successful in 2021, meeting the target by 96.6%. According to the data, coverage was lowest in 2020 and also for the second dose of pneumococcal vaccine. Conclusions The current study demonstrates the decline in vaccination coverage among Kazakh children during the 2020 COVID-19 pandemic.