Background: Central Asia is known to face various ecological challenges that constitutes major risk factors for Parkinson’s disease (PD). This study examines the burden of PD in Central Asia, a region where data on neurological disorders is notably sparse. Methods: Building on the latest Global Burden of Disease Study (GBD 2021), this study investigates the Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs) associated with PD in Central Asia and its countries from 1990 to 2021. The authors calculated average annual percent change (AAPC) to analyze trends, and compared individual country estimates to global figures. Additionally, incorporating data from the World Bank, both Bayesian hierarchical and non-hierarchical frequentist regression models were employed to assess their impact on DALYs. Results: The DALYs varied across the study period, primarily driven by YLLs. While YLLs showed a uniform trend, YLDs were mostly incremental. Kazakhstan had the highest estimates across all metrics and was the only country aligned with global patterns. Age- and sex-specific estimates revealed substantial variations, with notably high figures found in male subjects from Tajikistan. The YLLs, YLDs, and DALYs for Kazakhstan, Uzbekistan, and Turkmenistan saw a significant increase in AAPCs. In contrast, Kyrgyzstan and Tajikistan saw declines, likely attributable to civic conflict and inter-country differences in population structure. Further comparison of DALY trends revealed significant deviations for all countries from the global pattern. Conclusion: This study showed an overall increase in PD burden from 1990 to 2021. These findings underscore the need for targeted strategies to reduce PD burden, with a particular focus on Kazakhstan. Integrating historical information is crucial for discussing the plausible mechanisms in studies sourced from the GBD.

Epilepsy is one of the major neurological disorders affecting millions of people worldwide, with significant variations in incidence and prevalence across different regions. This study focuses on the epidemiological trends of idiopathic epilepsy in Central Asia, a region characterized by a long process of healthcare system transformation and socioeconomic conditions after the collapse of the Soviet Union. Understanding these trends is crucial for developing effective public health strategies tailored to the unique needs of the population. GBD 2021 data were analyzed for 9 Central Asian countries (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, Mongolia), identifying trends in incidence, prevalence, mortality, and disability-adjusted life years associated with idiopathic epilepsy from 1990-2021. The average annual percentage change (AAPC) was determined to compare regional and global trends. The data were disaggregated by country, year, age, and sex to identify demographic patterns. In 2021, the highest prevalence of idiopathic epilepsy was in Uzbekistan (473 per 100,000; 95 % UI: 140.1-761.1), while Armenia had the lowest (291.3; 95 % UI: 94.8-486.1). Incidence decreased across most countries, with Tajikistan showing a significant decline (AAPC:0.89 %; 95 % CI:0.98 to -0.8). Mortality was highest in Tajikistan (4.6; 95 % UI: 3.4-6.1) and lowest in Armenia (0.9; 95 % UI: 0.7-1.1). DALYs were highest in Tajikistan (422.7; 95 % UI: 284.1-591.7) and lowest in Armenia (118.8; 95 % UI: 57.4-204.9). Most trends were declining, except for Turkmenistan, which showed increases in prevalence and DALYs. The sex-specific estimates are consistently greater in the male population across all the metrics. Central Asia has demonstrated promising downward trends in the burden of epilepsy; however, challenges persist in some countries. This study underscores the urgent need for local data generation, robust registries, and tailored policies to improve care for people with epilepsy in the region.

Stroke is a major public health concern requiring valid estimates for planning and evaluating health interventions. The GBD (Global Burden of Disease) studies have become a major source of information; however, data sources have historically been a limitation. We sought to compare stroke mortality estimates in Kazakhstan with those reported by the GBD study. Mortality data were extracted from the Unified Electronic Healthcare System of Kazakhstan (UNEHS). We used the autoregressive integrated moving average (ARIMA), Bayesian structural time-series (BSTS), and Extreme Gradient Boosting (XGBoost) to model data from the UNEHS and forecast its trends until 2030. The accuracy metrics were mean absolute error, root mean square error, and mean absolute percentage error. We calculated the standardized difference in mortality estimates between the databases for the observed and forecasted estimates. The BSTS, ARIMA, and XGBoost models revealed slight variations in accuracy metrics, which depended on forecasting horizons and mostly favored XGBoost. During 2014-2030, the absolute difference in death counts was 207,108 between the GBD and UNEHS. The GBD estimates were twice as many across both the observed and predicted periods, with a moderate standardized difference (0.73) when considering their average. This study showed a systematic difference between GBD and national data. We found that UNEHS estimates were not comparable despite our efforts to replicate the GBD methods. Further studies are needed to explore the discrepancies between the national or regional data and GBD. Current limitations related to primary data and reproducibility require caution when interpreting GBD findings.

Background: This study examined the treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) in Kazakhstan, where its burden is notably high. Methods: The authors conducted a retrospective longitudinal study using the National Tuberculosis Registry, this study analyzed treatment outcomes in MDR-TB patients from 2018 to 2021, and included adult patients (≥ 18 years) who completed a specific treatment. Outcomes were categorized into successful and unsuccessful treatments. Bivariate and multivariate Poisson regression models with modified errors were employed to obtain crude and adjusted risk ratios (aRR). Results: The study cohort comprised 12,698 cases, of which 10, 306 (81.16%) completed treatment with a successful outcome, while 2,392 (18.84%) had unsuccessful outcomes. Male sex (aRR 1.35, 95% CI 1.24–1.45), urban residency (aRR 1.16, 95% 1.07–1.24), having both extrapulmonary and pulmonary tuberculosis (aRR 1.49, 95% 1.04–2.15), XDR-TB (aRR 1.31, 95% 1.08–1.59), excessive alcohol consumption (aRR 1.43, 95% 1.28–1.59), HIV-positive status (aRR 2.24, 95% 2.01–2.47), and drug abuse (aRR 1.37, 95% 1.10–1.71) significantly elevated the risk of the unsuccessful treatment. Conclusion: Our findings underscore the need for focused strategies to reduce the MDR-TB burden, particularly among adults, male sex, relapsed cases, and XDR-TB. Despite the encouraging findings observed, further studies are necessary to update our estimates.

Background/Objectives: This study explored the epidemiology of Status Epilepticus (SE) in Kazakhstan. Methods: Utilizing data from the National Health System from 2014 to 2023, we investigated the age-standardized incidence rate (ASIR) of SE. The authors employed restricted mean survival time (RMST) models to evaluate how sex, older age, epilepsy, history of cerebrovascular diseases (CVD), central nervous system (CNS) infections, brain tumors, and cancer affected survival during 30 days through the fifth year following hospital admission for SE. Results: This study included 14,010 patients. The ASIR per 100,000 increased threefold, from 4.15 (95% CI: 3.85; 4.46) in 2014 to 12.12 (95% CI: 11.64; 17.59) in 2023, with a sharp increase during the COVID-19 pandemic. The 30-day and 5-year mortality were 2.10% and 8.85%, respectively. The RMST identified that all-cause mortality was driven by elderly age, brain tumors, and cancer, where the difference in survival increased from one day at baseline to over a year by the fifth year. The effects of CVD, CNS infections, and sex on survival were substantially lower. However, epilepsy was associated with a better prognosis. Conclusions: We observed an incremental increase in the SE incidence over a decade. Our findings warrant actions to resolve issues related to rescue medicines to improve SE outcomes in both country and region. It may be a priority for elderly patients and those with systemic tumors. Further research is needed to understand the role of epilepsy in SE epidemiology, with emphasis on design-related biases.