During the COVID-19 pandemic, a ban on inspections of small businesses, including pharmacies, was imposed in Kazakhstan, which relaxed law enforcement efforts regarding the prohibition of over-the-counter antibiotic (AB) sales. This study aimed to investigate how this affected the knowledge, attitudes, and practices (KAP) related to AB and antimicrobial resistance (AMR), as well as to assess actual AB consumption at the community level. The study comprised two cross-sectional sub-studies: the first involved a KAP survey conducted in 2022 and 2024, utilizing the Special Eurobarometer questionnaire on AMR. The second sub-study analyzed AB consumption in 2021 and 2023, measured in defined daily doses per 1000 inhabitants. Results revealed an increase in the percentage of individuals reporting receipt of information about ABs and AMR in the past year (37.3% in 2022 vs. 52.9% in 2024, p < 0.001) and an increase in the percentage of individuals reporting AB use in the past year (49.0% in 2022 vs. 54.0% in 2024, p = 0.056). The most consumed ABs were from the Watch group, with azithromycin and ceftriaxone ranking highest. These findings support the hypothesis that the relaxation of law enforcement contributed to an increase in AB consumption and emphasize the need for public health policies to address this issue.

Background: In February 2021 Kazakhstan began offering COVID-19 vaccines to adults. Breakthrough SARS-CoV-2 infections raised concerns about real-world vaccine effectiveness. We aimed to evaluate effectiveness of four vaccines against SARS-CoV-2 infection.Methods: We conducted a retrospective cohort analysis among adults in Almaty using aggregated vaccination data and individual-level breakthrough COVID-19 cases (≥14 days from 2nd dose) using national surveillance data. We ran time-adjusted Cox-proportional-hazards model with sensitivity analysis accounting for varying entry into vaccinated cohort to assess vaccine effectiveness for each vaccine (measured as 1-adjusted hazard ratios) using the unvaccinated population as reference (N = 565,390). We separately calculated daily cumulative hazards for COVID-19 breakthrough among vaccinated persons by age and vaccination month.Results: From February 22 to September 1, 2021, in Almaty, 747,558 (57%) adults were fully vaccinated (received 2 doses), and 108,324 COVID-19 cases (11,472 breakthrough) were registered. Vaccine effectiveness against infection was 79% [sensitivity estimates (SE): 74%–82%] for QazVac, 77% (SE: 71%–81%) for Sputnik V, 71% (SE: 69%–72%) for Hayat-Vax, and 70% (SE: 65%–72%) for CoronaVac. Among vaccinated persons, the 90-day follow-up cumulative hazard for breakthrough infection was 2.2%. Cumulative hazard was 2.9% among people aged ≥60 years versus 1.9% among persons aged 18–39 years (p < 0.001), and 1.2% for people vaccinated in February–May versus 3.3% in June–August (p < 0.001).Conclusion: Our analysis demonstrates high effectiveness of COVID-19 vaccines against infection in Almaty similar to other observational studies. Higher cumulative hazard of breakthrough among people ≥60 years of age and during variant surges warrants targeted booster vaccination campaigns.

Background/Objectives: Few studies have examined the prevalence of healthcare-associated infections (HAIs) and antimicrobial use (AMU) in acute care hospitals in Kazakhstan. This study aimed to address this gap by conducting a point-prevalence survey (PPS) of HAIs and AMU, as well as evaluating hospital antibiotic consumption via internationally recognized methodologies. Methods: PPS was conducted in four acute care hospitals in Kazakhstan on 11 May 2022, following the methodology of the European Center for Disease Prevention and Control, and included 701 patients. Antibiotic consumption in the same hospitals was assessed via the Global Antimicrobial Resistance and Use Surveillance System methodology. Results: HAIs were observed in 3.8% of patients (27/701), with intensive care unit wards accounting for 48.1% of these cases (13/27). Pseudomonas aeruginosa was the most frequently identified pathogen (5 out of 14 documented cases, 35.7%). Resistance to carbapenems was the most common resistance, followed by resistance to glycopeptides and third-generation cephalosporins. The rate of AMU was 38.2%, with an average of 1.37 antibiotics administered per patient. Surgical prophylaxis lasting more than one day was the most common indication for antimicrobial prescription (44.8%). Ceftriaxone and cefazolin are the most commonly used antibiotics. Conclusions: The results of this study are important for understanding the current situation in Kazakhstan and for informing national antimicrobial stewardship and infection control strategies.

From March to May 2020, 1306 oilfield workers in Kazakhstan tested positive for SARS-CoV-2. We conducted a case-control study to assess factors associated with SARS-CoV-2 transmission. The cases were PCR-positive for SARS-CoV-2 during June–September 2020. Controls lived at the same camp and were randomly selected from the workers who were PCR-negative for SARS-CoV-2. Data was collected telephonically by interviewing the oil workers. The study had 296 cases and 536 controls with 627 (75%) men, and 527 (63%) were below 40 years of age. Individual factors were the main drivers of transmission, with little contribution by environmental factors. Of the twenty individual factors, rare hand sanitizer use, travel before shift work, and social interactions outside of work increased SARS-CoV-2 transmission. Of the twenty-two environmental factors, only working in air-conditioned spaces was associated with SARS-CoV-2 transmission. Communication messages may enhance workers’ individual responsibility and responsibility for the safety of others to reduce SARS-CoV-2 transmission.

Background and Aims: Seroprevalence studies are needed to determine the cumulative prevalence of SARS‐CoV‐2 infection and to develop pandemic mitigation strategies. Despite the constant monitoring and surveillance, the true level of infection in the population of Kazakhstan remains unknown. The aim of this study was to determine the sero‐prevalence of SARS‐CoV‐2 in the main cities of Kazakhstan.Methods: The research was conducted as a cluster‐randomized cross‐sectional national household study in three cities of Kazakhstan. The study covered the period: from October 24, 2020, to January 11, 2021. A total of 5739 people took part in the study. All participants agreed to be tested for antibodies to IgM/IgG. Demographic characteristics were analyzed. The presence of symptoms of respiratory diseases and the results of polymerase chain reaction (PCR) testing were determined. The antibodies to the SARS‐CoV‐2 virus were detected using the method of enzyme‐linked immunosorbent assay (ELISA).Results: There was significant geographic variability with a higher prevalence of IgG/IgM antibodies to SARS‐CoV‐2 in Almaty 57.0%, in Oskemen 60.7% than in Kostanay 39.4%. There were no significant differences in prevalence between men and women (p ≥ 0.05). In Almaty, only 19% of participants with antibodies reported the presence of respiratory symptoms during a pandemic. At the same time, the percentage of patients with antibodies who had respiratory symptoms was 36% in Oskemen and 27% in Kostanay.Conclusion: The findings indicate that despite reasonable level of seroprevalence, the country has not yet reached the baseline minimum of herd immunity scores. The prevalence estimates for asymptomatic or subclinical forms of the disease ranged from 64% to 81%. Thus, given that almost half of the population of Kazakhstan remains vulnerable, the importance of preventive strategies such as social distancing, the use of medical masks, and vaccination to protect the population from the transmission of SARS‐CoV‐2 is highly critical.

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has had major social and economic consequences worldwide. Whole genome sequencing (WGS) is essential for genomic monitoring, enabling tracking of viral evolution, detection of emerging variants, and identification of introductions and transmission chains to inform timely public health responses. Here, we compile and harmonize SARS-CoV-2 genomic data generated by multiple laboratories across Kazakhstan together with publicly available sequences to provide a national overview of genomic dynamics across successive epidemic waves from 2020 to 2022. We analyzed 4462 genomes deposited in GISAID (including 340 generated in this study), of which 3299 passed Nextclade quality filters, and summarized lineage turnover across major phases (pre-VOC, Alpha, Delta, Omicron BA.1/BA.2, Omicron BA.4/BA.5, and a later recombinant-dominant period). Sequencing intensity varied markedly over time (0.60‰ of confirmed cases during Delta vs. 11.57‰ during the Omicron BA.5 wave), suggesting that lineage diversity and persistence may be underestimated. Pre-VOC circulation included ≥12 Pango lineages with evidence of multiple introductions and sustained local transmission, including a Kazakhstan-restricted B.4.1 lineage that emerged in Nur-Sultan/Astana and disappeared after April 2020. The Tengizchevroil oilfield outbreak comprised B.1.1 viruses with phylogenetic support for ≥three independent introductions. Alpha and Omicron waves were characterized by repeated introductions and heterogeneous origins, whereas Delta was dominated by AY.122 with an additional distinct AY.122 cluster; a notable BF.7 local transmission event was observed during BA.5. We also highlight locally enriched non-lineage-defining mutations. Overall, recurrent importations and variable local amplification shaped SARS-CoV-2 dynamics in Kazakhstan, while interpretation is constrained by strongly time-skewed sequencing.