Objective: This study examines the prevalence and predictors of mental health issues, specifically anxiety, depression, and stress, among Ukrainians during the military conflict with Russia.Method: A cross-sectional correlational study was conducted six months after the beginning of the conflict. Sociodemographic factors, traumatic experiences, anxiety, depression, and stress were assessed. The study included 706 participants, both men and women, from different age groups and living in various regions of Ukraine. The data were collected from August till October 2022.Results: The study found that a large portion of the Ukrainian population shows increased levels of anxiety, depression, and stress due to the war. Women were found to be more vulnerable to mental health issues than men, and younger people were found to be more resilient. Worsened financial and employment statuses predicted increased anxiety. Ukrainians who fled the conflict to other countries exhibited higher levels of anxiety, depression, and stress. Direct exposure to trauma predicted increased anxiety and depression, while war-related exposure to “other stressful events” predicted increased acute stress levels.Conclusion: The findings of this study highlight the importance of addressing the mental health needs of Ukrainians affected by the ongoing conflict. Interventions and support should be tailored to address the specific needs of different groups, particularly women, younger individuals, and those with worsened financial and employment statuses.

Aim. To determine trace element status and aetiologic factors for development of trace elements deficiencies in children with iron-deficiency anaemia (IDA) aged 0 to 3 years.Contingent and Methods. 30 patients of the University Hospital, Pleven, Bulgaria—I group; 48 patients of the Sumy Regional Child’s Clinical Hospital, Sumy, Ukraine—II group; 25 healthy controls were investigated. Serum concentrations of iron, zinc, copper, chromium, cobalt, and nickel were determined spectrophotometrically and by atomic absorption spectrophotometry.Results. Because the obtained serum levels of zinc, copper, and chromium were near the lower reference limits, I group was divided into IA and IB. In IA group, serum concentrations were lower than the reference values for 47%, 57%, and 73% of patients, respectively. In IB group, these were within the reference values. In II group, results for zinc, cobalt, and nickel were significantly lower (P<0.05), and results for copper were significantly higher in comparison to controls.Conclusion. Low serum concentrations of zinc, copper, cobalt, and nickel were mainly due to inadequate dietary intake, malabsorption, and micronutrient interactions in both studied groups. Increased serum copper in II group was probably due to metabolic changes resulting from adaptations in IDA. Data can be used for developing a diagnostic algorithm for IDA.

Aim: Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians.Methods: A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review.Results: In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication.Conclusion: Ukrainian children often have poor health and host countries need to be aware of their needs.

Introduction: The war in Ukraine places a great burden on its population as well as the people who have been displaced from it. The aim of this study is to assess the prevalence of symptoms of depression, anxiety and Post-traumatic stress disorder (PTSD) in Ukraine and Ukrainian refugees in Switzerland and contextualise them with a non-war affected population. Methods: Participants were recruited into prospective cohorts using random population sampling from 25 March to 9 August 2024. Raw prevalence estimates were adjusted using Bayesian modelling to account for instrument inaccuracy. Estimates were calculated according to age, sex and regional strata. Results: 6036 Ukrainians from 10 regions, 657 refugees in Zürich and 766 Zürich residents were recruited. Prevalence of symptoms was generally high but varied across population strata in Ukraine. Median prevalence estimates for depression ranged 19.6%–54.8%; for anxiety disorder, the range was 3.7%–33.4%, and for PTSD, it was 15.0%–41.2%. We observed consistent patterns: (1) The burden was higher in south-east and central Ukraine than in the north-west; (2) refugee mental health closely resembles that of south-eastern and central Ukraine; (3) prevalences among women were higher than for men across conditions. To contextualise differences in mental health burden, we highlight the example of the group of old women aged 25–44 years. We found a prevalence of depression of 11.1% (95%CI: 4.6% to 19.6%), anxiety 3% (0.5% to 9.5%) and PTSD 4.8% (1.3% to 10.6%) in Zurich residents and a prevalence of depression of 46.9% (39.4% to 59.8%), anxiety 25.2% (19.8% to 31.3%) and PTSD 33.9% (28.7% to 39.4%) in women from Central Ukraine. Conclusions: This first large-scale population-based study highlights a significant mental health burden among adult Ukrainians across the age range, in Ukraine and in Zurich compared with a non-war affected general population. These findings inform the planning and evaluation of urgently needed public mental health and mental healthcare services while also aiming to destigmatise mental health disorders by highlighting the substantial impact on the civilian population. Trail registration number: ISRCTN17240415.

The child healthcare system in Ukraine is coordinated and managed at a central level by the Ministry of Health and at a local level by the regional health authorities. The Ministry of Health has executive the power for the implementation of state health policies and controls and manages state-owned health facilities. The system of public funding for the pediatric healthcare system is divided into two sources: central and local. Primary healthcare is organized by the National Health Service of Ukraine. Secondary level healthcare is mostly organized by the Ministry of Health, which gives money for hospitals and medical centers. Since 2014, due to reform and decentralization in Ukraine, local, regional, and city administrations received money from the Ukrainian government for the formation of decentralized budgets.

Gabapentin has shown efficacy in the treatment of chronic neuropathic or mixed pain in adults. Although pediatric pain specialists have extensive experience with gabapentin for the treatment of neuropathic pain, its use is off-label. Its efficacy and safety in this context have never been shown. The aim of this trial is to compare gabapentin with placebo as add-on to morphine for the treatment of severe chronic mixed or neuropathic pain in children. This trial is part of the European Union Seventh Framework Programme project Gabapentin in Paediatric Pain (GAPP) to develop a pediatric use marketing authorization for a new gabapentin suspension. The GAPP-2 study is a randomized, double-blind, placebo-controlled, multicenter superiority phase II study in children with severe chronic neuropathic or mixed pain. Its primary objective is to evaluate the efficacy of a gabapentin liquid formulation as adjunctive therapy to morphine. Sixty-six eligible children 3 months to 18 years of age with severe pain (pain scores ≥ 7), stratified in three age groups, will be randomized to receive gabapentin (to an accumulating dose of 45 to 63 mg/kg/day, dependent on age) or placebo, both in addition to morphine, for 12 weeks. Randomization will be preceded by a short washout period, and treatment will be initiated by a titration period of 3 weeks. After the treatment period, medication will be tapered during 4 weeks. The primary endpoint is the average pain scores in the two treatment groups (average of two measures each day for 3 days before the end-of-study visit [V10] assessed by age-appropriate pain scales (Face, Legs, Activity, Cry, Consolability scale; Faces Pain Scale–Revised; Numeric Rating Scale). Secondary outcomes include percentage responders to treatment (subjects with 30% reduction in pain scale), number of episodes of breakthrough pain, number of rescue interventions, number of pain-free days, participant dropouts, quality of life (Pediatric Quality of Life Inventory), and acceptability of treatment. Outcomes will be measured at the end-of-study visit after 12 weeks of treatment at the optimal gabapentin dose. Groups will be compared on an intention-to-treat basis. We hope to provide evidence that the combination of morphine and gabapentin will provide better analgesia than morphine alone and will be safe. We also aim to obtain confirmation of the recommended pediatric dose. EudractCT, 2014-004897-40 . Registered on 7 September 2017. ClinicalTrials.gov, NCT03275012 . Registered on 7 September 2017.