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.

Purpose: Assessment of public knowledge of chronic kidney disease (CKD) is an essential step in development of CKD prevention and screening programs. Our aim was to estimate the level of public CKD knowledge and its predictors in the former Soviet Union countries using a validated questionnaire. Materials and methods: This cross-sectional survey was conducted in 10 countries using an adapted validated online questionnaire. Descriptive statistics were used to describe participants’ characteristics and assess public CKD knowledge level. A multiple linear regression analysis was performed to identify predictors of CKD knowledge. Results: 2,715 participants satisfied the inclusion criteria. Respondents having higher level of education, living in countries belonging to the lower middle-income countries, having a personal history of diabetes and hypertension, and having a family history of kidney disease showed significantly better CKD knowledge. Conclusions: The level of CKD knowledge among the population of post-Soviet states was found to be low, although some personal characteristics were associated with better CKD knowledge.

Purpose Health-related quality of life (HRQoL) is a key outcome in chronic kidney disease (CKD), yet data from low- and lower-middle income countries (LLMICs) are underrepresented. The study systematically reviewed and meta-analyzed HRQoL among CKD patients in LLMICs by disease stage and treatment modality. Methods Registered in PROSPERO (CRD420251016382), the review searched PubMed, Ovid MEDLINE, Scopus, and Web of Science (January 1, 2000 – March 28, 2025) for studies including adults with CKD stages 1–5, on dialysis, or post-transplant, using validated HRQoL instruments. Two reviewers independently screened studies, extracted data, and assessed quality using Joanna Briggs Institute tools. Pooled mean scores were estimated using random-effects meta-analysis, with meta-regression and Egger’s test exploring heterogeneity and small-study effects. Results A total of 123 studies (n = 24,007) from 22 countries were included. Pooled SF-36 scores were 42.8 (95% CI 39.4–46.3) for Physical Component Summary (PCS) and 47.7 (43.8–51.6) for Mental Component Summary (MCS) in early CKD, versus 36.9 (34.0–39.9) and 42.5 (38.9–46.1), respectively, in late CKD. Transplant recipients showed higher HRQoL than dialysis patients across WHOQOL-BREF domains. The EQ-5D index declined from 0.706 (0.589–0.823) in CKD 1–3 to 0.486 (0.357–0.614) in dialysis. Conclusion CKD patients in LLMICs experience substantial deterioration in quality of life, particularly at advanced stages. Compared to high-income settings, HRQoL scores in LLMICs remain markedly lower, revealing major global inequities. This first region-specific synthesis provides benchmarks for HRQoL across CKD stages and underscores the need for earlier intervention and broader access to transplantation.

Background and Objectives: Evidence on epilepsy surgery from Central Asia is limited, reflecting the real-world challenges of developing this service in low- and middle-income settings. We evaluated one-year seizure outcomes after resective surgery for drug-resistant focal epilepsy at a single center in Kazakhstan, and we assessed whether the use of advanced presurgical imaging was associated with seizure freedom. Materials and Methods: A retrospective cohort study was conducted, including consecutive adults who underwent curative-intent resective epilepsy surgery from 2017 to 2023. Outcomes at 12 months or more post-surgery were classified using the Engel criteria. Logistic regression was used to examine associations between the advanced presurgical diagnostic tool and achieving an Engel class I outcome. Crude and adjusted risk ratios (RRs) for not achieving Engel I were estimated using modified Poisson regression with robust SEs. Results: Among 112 patients (median age 31 years; median epilepsy duration 19 years), 76% underwent temporal lobe procedures and 71% had lobectomies. At one year, 74 patients were seizure-free (Engel II: 15.2%, III: 11.6%, IV: 7.1%). Year-to-year Engel I rates varied without a significant linear trend from 2018 to 2023. In bivariable analyses, MRI-defined atrophy (RR, 3.14) and mixed lesions (RR, 2.62) were associated with a higher risk of not achieving Engel I, whereas longer epilepsy duration was linked to a lower risk (RR, 0.97 per year). In adjusted models, predictors of not achieving Engel I included generalized tonic–clonic seizures (aRR, 1.96), atrophy (aRR, 2.98), mixed lesions (aRR, 2.45), and undergoing any advanced diagnostic test (aRR, 3.38). Longer epilepsy durations remained protective (aRR 0.95 per year). In modality-specific logistic models, fMRI use was associated with higher odds of Engel I (aOR 3.39), and MR spectroscopy was associated with lower odds (aOR 0.33). Conclusions: In this Central Asian single-center cohort, about two-thirds of adults achieved complete seizure freedom one year after resective surgery—comparable to international benchmarks. Advanced imaging modalities showed divergent associations with outcomes, likely reflecting confounding by indication. These findings support the feasibility of effective epilepsy surgery in a low-resource context and the value of targeted use of advanced imaging.

Background/Objectives: Epilepsy is a major neurological disorder associated with significant comorbidity and treatment challenges. In low- and middle-income countries, access to newer antiseizure medications (ASMs) remains limited, and prescription patterns often rely on older agents. This study aimed to characterize national prescribing patterns of ASMs among patients with epilepsy in Kazakhstan from 2021 to 2023. Methods: We conducted a retrospective observational study using de-identified electronic health record data from the Unified National Electronic Health System of Kazakhstan. All patients with an ICD-10 diagnosis of epilepsy (G40) and at least one ASM prescription during 2021–2023 were included. Prescription frequencies, therapy type, and chronic polytherapy levels were analyzed. Associations between therapy type, age, and comorbidity status were determined. Results: A total of 54,274 patients were identified (median age 42 years; interquartile range (IQR) 31–57). Monotherapy predominated: 61.7% remained on monotherapy, 18.5% remained on polytherapy, and 19.8% had mixed exposure. Carbamazepine and valproic acid were most frequently prescribed (64.3% and 45.6% of patients, respectively). Among those with chronic medication data (n = 15,752), nervous-system drugs were common (70.1%), led by psycholeptics (49.7%); frequently dispensed agents included chlorpromazine (n = 5991), clozapine (n = 1875), and risperidone (n = 1642). Cardiovascular agents were recorded in 37.2% (acetylsalicylic acid n = 4056; atorvastatin n = 2235), and diabetes drugs in 12.1% (metformin n = 1430). Conclusions: Epilepsy treatment in Kazakhstan remains dominated by older broad-spectrum ASMs, while the use of lamotrigine and levetiracetam is steadily increasing. The frequent co-prescription of psychotropic and cardiometabolic drugs underscores the need for coordinated, multidisciplinary care and continued monitoring of prescribing patterns to enhance treatment safety and effectiveness.

Objectives: Adoption of recommended self-management behaviors has been associated with a lower risk of disease progression, cardiovascular morbidity, and mortality in patients with chronic kidney disease (CKD). This systematic review aims to identify factors associated with the adherence of non-dialysis-dependent CKD (NDD-CKD) patients to recommended self-management practices. Methods: Following PRISMA guidelines, we searched PubMed, Embase, Scopus, Medline, and CINAHL Plus databases from 1st January 2010 to 30th June 2024. The extracted data included associations of variables with self-management scores. The findings were descriptively presented in a grouped tabular form. The study was registered with the PROSPERO, CRD42024547304. Results: From 1,914 studies identified, 16 cross-sectional studies with 3,658 participants were selected for inclusion. Objective CKD knowledge, health literacy, self-efficacy and social support consistently showed positive associations with self-management across multiple studies. Conclusion: This systematic review revealed multiple factors associated with self-management in NDD-CKD patients, with disease-related knowledge, health literacy, and self-efficacy showing the most consistent positive associations across studies. Healthcare providers and policymakers should develop and implement health literacy and awareness programs as a strategy for improving patient outcomes. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=547304 , identifier CRD42024547304.