Background: Vaccine-preventable diseases such as pertussis, measles, and influenza remain among the most significant medical and socioeconomic issues in Kazakhstan, despite significant vaccination achievements. Thus, here we aimed to analyze the long-term dynamics and provide information on the current epidemiology of pertussis, measles, and influenza in Kazakhstan. Methods: A retrospective analysis of the long-term dynamics of infectious diseases was carried out using the data from the statistical collections for 2010-2020 and the Unified Payment System from 2014 to 2020. Results: During the 2010-2020 years, the long-term dynamics show an unequal distribution of pertussis, measles, and influenza-related morbidity. In comparison with earlier years, registration of infectious disease was the highest in 2019 and 2020. The incidence cases among registered infectious diseases in 2019 were: pertussis-147, measles-13,326, and in 2020: influenza-2,678. High incidence rates have been documented in Pavlodar, North Kazakhstan, Mangystau regions, and the cities of Shymkent and Nur-Sultan. The incidence varies depending on the seasonality: pertussis (summer-autumn), measles (winter-spring), and influenza (mostly in winter). Conclusion: The findings highlight the importance of focusing more on the characteristics of the epidemic process of vaccine-preventable diseases in order to assess the effectiveness of implemented measures and verify new routes in strengthening the epidemiological surveillance system.

BACKGROUND: Measles (rubella) is a highly contagious disease that is caused by a virus in the Paramyxoviridae family. The measles virus is directly responsible for more than 100,000 deaths each year. Epidemiological studies have linked measles to increased morbidity and mortality many years after infection, but the reasons underlying this phenomenon are poorly understood. The virus attacks immune cells, causing acute suppression of the immune system. The World Health Organization recommends a two-dose vaccination policy, with the first dose administered during the 1st year of life, and coverage should be maintained in at least 90–95% of the population to halt transmission. In many countries, the measles vaccine is included in the immunization program and is freely available to all. Today, despite active immunization of the population, measles still occurs in the Republic of Kazakhstan. AIM: The objective of our study was to analyze the epidemiological characteristics of measles in the Republic of Kazakhstan during the rise of the disease. METHODS: Statistical data were obtained from the Committee on Public Health Protection on the incidence of measles in The Republic of Kazakhstan for the period from November 1, 2018 to December 30, 2019. STUDY DESIGN: Epidemiology survey. RESULTS: The article contains epidemiological data on the incidence of measles in the regions of the Republic of Kazakhstan among children, age, and gender characteristics. CONCLUSION: In the period from November 2018 to December 2019, there was a tendency to increase the incidence of measles in the republic. In terms of morbidity, Nur-Sultan was the leader, where the number of cases was 22.9% (n = 3181). The largest number of registered cases, 58.2% (n = 5745), occurred in children aged 1–14 years. Measles remains an unresolved global problem and groups of undervaccinated and unvaccinated populations remain vulnerable during epidemics.

Актуальность. Корь – высококонтагиозное (95-96%) вирусное, потенциально элиминируемое заболевание, поскольку резервуар является исключительно человеческим. На сегодняшний день разработаны и повсеместно используются безопасные эффективные вакцины, а также чувствительные и специфические диагностические тесты. Нужно отметить, что во многих странах вакцина против кори включена в программу иммунизации населения и находится в свободном доступе. Цель исследования: Изучить показатели заболеваемости корью у детей в возрасте от 0 до 14 лет в Республике Казахстан, а также их вакцинальный статус. Материалы и методы: Проведен ретроспективный эпидемиологический анализ заболеваемости корью и вакцинального статуса детей, в возрасте от 0 до 14 лет, за период с 1 ноября 2018г. по 30 декабря 2019 г., по данным Комитета охраны общественного здравоохранения Республики Казахстани данным Комитета санитарно-эпидемиологического контроля Мининстерства здравоохранения Республики Казахстан. Статистический анализ проводился в программах R statistics (V.4) при соблюдении условий: количественные данные с ненормальным распределением: непараметрические критерий Крускала-Уоллиса для независимых групп. Результаты и выводы: Анализ заболеваемости корью среди населения показал тенденцию роста заболеваемости корью, которая составила 13 873 случаев, из них 73% (n=10189) - дети до 14 лет. Подавляющее большинство вспышек данного заболевания связано с ограниченным охватом населения в программах вакцинации. В данном исследований выявлен низкий охват вакцинацией детей до 1 года 50,2% (n=4098), от 1 года до 14 лет 49,8% (n=4072), который связан с разными причинами (не достижение возраста, медицинский отвод, отказ родителей от вакцинации). На сегодняшний день доказано, что самым надежным средством предотвращения кори является вакцинация населения. Мировой опыт ликвидации кори среди населения рекомендует всеобщую иммунизацию детей и вакцинацию всех восприимчивых людей противокоревой вакциной. Measles is a highly contagious (95-96%) viral, potentially eliminated disease, since the reservoir is exclusively human. To date, safe, effective vaccines have been developed and are widely used, as well as sensitive and specific diagnostic tests. It should be noted that in many countries, the measles vaccine is included in the immunization program of the population and is freely available. The purpose of the study: To study the incidence of measles in children aged 0 to 14 years in the Republic of Kazakhstan, as well as their vaccination status. Materials and methods: The retrospective epidemiological analysis of the incidence of measles and the vaccination status of children aged 0 to 14 years was carried out for the period from November 1, 2018 to December 30, 2019, according to the data of the Public Health Protection Committee of the Republic of Kazakhstan and the data of the Sanitary and Epidemiological Control Committee of the Ministry of Health of the Republic of Kazakhstan. The statistical analysis was carried out in the programs R statistics (V. 4) under the following conditions: quantitative data with an abnormal distribution: nonparametric Kruskal-Wallis criterion for independent groups. Results and conclusions: The analysis of the incidence of measles among the population showed an increase in the incidence of measles, which amounted to 13,873 cases, of which 73% (n=10189) were children under 14 years of age. The vast majority of outbreaks of this disease are associated with limited coverage of the population in vaccination programs. This study revealed a low vaccination coverage of children under 1 year of 50.2% (n=4098), from 1 year to 14 years of 49.8% (n=4072), which is associated with various reasons (not reaching age, medical withdrawal, refusal of parents from vaccination). To date, it has been proven that the most reliable means of preventing measles is vaccination of the population. The world experience in eliminating measles among the population recommends universal immunization of children and vaccination of all susceptible people with measles vaccine. Актуальность. Қызылша - өте жұқпалы (95-96%) вирустық, ықтималды элиминацияланатын ауру, өйткені резервуар тек адам болып табылады. Бүгінгі таңда қауіпсіз тиімді...

Measles is an acute infectious disease characterized by a combination of catarrhal symptoms and specific exanthema. This is a highly contagious, potentially fatal infection with an airborne transmission mechanism. A distinctive feature of the pathogen of which is the ability to cause prolonged post-infectious immunosuppression. Fever in combination with one of the following manifestations: cough, runny nose, conjunctivitis are the first clinical manifestations of the disease. The Belsky-Filatov-Koplik spots are specific rashes on the mucous membrane of the cheeks, allowing to establish a diagnosis even before the appearance of exanthema. The rash usually appears 3-4 days after the onset of an increase in body temperature and is characterized by a gradual rash, initially occurs on the face and behind the ears, which is associated with the peak of the clinical picture. Measles is characterized by a polysystemic lesion, with a predominant involvement in the pathological process of the central and respiratory systems of the body, while pneumonia is one of the most frequent complications that lead to a fatal outcome. In the treatment of measles, supportive therapy, correction of dehydration and nutrient deficiency, as well as treatment of secondary bacterial infections and providing the body with vitamin A are of great importance. It is important to note that measles has lifelong immunity after an infection or vaccination, while vaccination against measles plays a crucial role in its elimination. Previously, it was believed that measles is on the verge of eradication, but its outbreaks in Europe at the present stage have led to the return and spread of this infection. Measles remains the leading cause of global child mortality in the world, as children from developing countries are most susceptible to this disease. About 45 million new cases of measles are registered annually in the world, among which almost a million people die.

Introduction: Genetic characterization of measles viruses (MVs) is an important component of laboratory surveillance of measles. In this study, a phylogenetic analysis was performed of the nucleoprotein gene sequences isolated in the Republic of Kazakhstan in 2018 year. Objective: To study the epidemiological characteristics of measles and identify the circulating strain in the Republic of Kazakhstan during the period of increasing incidence for 36 global efforts to eliminate measles among the population. Material and Methods: On the basis of the reference laboratory “Center for Sanitary and Epidemiological Expertise and Monitoring” of the RSE at the PEM “NCPH” genotyping of measles virus isolated from biological material (urine) from laboratory-confirmed cases was performed. Results: According to the results of the study, it was revealed that the genotypes of the measles virus circulating in the Republic of Kazakhstan belong to two genotypes, the majority of samples (n=16) belonged to the D8genotype and2 samplesto the B3 genotype/MVi/Harare.ZWE/38.09./.

Relevance: Bacterial meningitis (BM) remains a significant cause of neurological complications and high mortality among children. Aim: to study the clinical features of BM in children to optimize the diagnosis and etiopathogenetic therapy. Methods: The object of the study is children diagnosed with meningitis, treated at the Multidisciplinary City Children's Hospital No. 3 in Astana, for the period from 2015 to 2023. Study design: prospective, control - case. Methods included clinical examination, complete blood count, cerebrospinal fluid test, CT and brain MRI. Descriptive statistics and Pearson's method were used for statistical processing. Results: Introduction of the PCV13 vaccine led to a fourfold decrease in the incidence of pneumococcal meningitis, while cases of meningococcal meningitis declined 1.6 times from 2014 to 2023. The main clinical manifestations in children with BM included high fever (80–90% of patients, with febrile temperatures ranging from 38.7°C to 39.9°C), neurological deficits, and complications: seizures and cognitive impairment developed in 50% of children. Hypertensive syndrome was observed in 81.8% of children with pneumococcal meningitis (PM), and in 55.6% of meningococcal meningitis (MM) cases among children under one year old. Pneumococcal CNS involvement was characterized by focal symptoms in 45.5% of young children, while such changes were statistically significantly lower in MM cases—threefold less (16.7%, p≤0.001). Spearman’s correlation analysis in the PM group showed a strong direct positive relationship between the following variables: delayed medical consultation and hospital stay duration (r=0.7; p≤0.001), delayed diagnosis and hospital stay duration (r=0.7; p≤0.001). Conclusion: PCV13 vaccination has significantly reduced the incidence of pneumococcal meningitis, which presents most severely, with early neurological complications in 41.5% of cases, cerebral edema in 90.9% of infants, and hypertensive syndrome in 81.8%. Early diagnosis and timely treatment contribute to the prevention of both early and late neurological complications. Актуальность: Бактериальные менингиты (БМ) остаются значимой причиной неврологических осложнений и высокой смертности среди детей. Цель исследования: изучение клинических особенностей БМ у детей для оптимизации диагностики и этиопатогенетической терапии. Методы: Объект исследования - дети с диагнозом "менингит", пролеченные в Многопрофильной городской детской больнице №3 в г.Астана, за период с 2015 по 2023 гг. Дизайн исследования: проспективный, контроль – случай. Методы включали клинический осмотр, общий анализ крови, анализ спинномозговой жидкости, КТ и МРТ головного мозга. Для статистической обработки использовались описательная статистика и метод Пирсона. Результаты: Введение вакцины ПКВ13 привело к четырехкратному снижению заболеваемости пневмококковым менингитом, в то время как случаи менингококкового менингита уменьшились в 1,6 раз с 2014 по 2023 годы. Основные клинические проявления у детей с БМ включали высокую температуру (80-90% пациентов, с фебрильной температурой от 38,7°С до 39,9°С), неврологические дефициты и осложнения: судороги и когнитивные нарушения–развивались у 50% детей. Гипертензионный синдром наблюдали в 81,8 % случаях в группе детей с ПМ, в 55,6% случаях при ММ у детей до 1 года. Пневмококковое поражение ЦНС характеризовалось развитием очаговой симптоматики в 45,5% случаев у детей раннего возраста, при ММ данные изменения зарегистрированы статистически достоверно меньше в 3 раза (16,7% р≤0,001). Корреляционный анализ по методу Спирмена в группе детей с ПМ продемонстрировала сильную прямую положительную связь между показателями: поздней обращаемости и количеством койко-дней (r=0,7;р≤0,001), поздней диагностикой и количеством койко-дней (r=0,7;р≤0,001). Заключение: Вакцинация ПКВ13 привела к значительному снижению заболеваемости пневмококковым менингитом, который протекает наиболее тяжелее с ранними неврологическими осложнениями в 41,5% случаев, отеком головного мозга у детей первого года жизни в 90,9%, гипертензионным синдромом в 81,8%. Ранняя диагностика и своевременное лечение способствуют предотвращению ранних и поздних неврологических осложнений. Өзектілігі: Бактериялық...