Introduction. An analysis of 12 cases of acute viral hepatitis of unspecified etiology is presented. In patients, negative
markers of viral hepatitis were obtained twice, the autoimmune nature was excluded by the absence of autoimmune
antibodies. Antibodies (IgG) to HSV (11 patients), EBV (9 patients) and CMV (7 patients) were detected. In patients
with recent infection with HSV (low avidity index), the clinic of acute hepatitis developed in young people against
a background of high immunocompetence, which led to recovery in a short time. Whereas, in the group of patients
with high avidity, the disease developed among the older age group with a longer course.
The aim of study. To study the clinical and laboratory characteristics of viral hepatitis of unspecified etiology.
Material and methods. Clinical and laboratory characteristics of hepatitis of unspecified etiology were studied in 12
patients. All patients underwent a standard general clinical examination, which included an assessment of complaints
and physical examination data, biochemical blood tests, general clinical blood and urine tests, determination of viral
hepatitis markers by ELISA, and ultrasound of the abdominal organs. Antibodies to HSV, CMV, EBV were determined
by ELISA, as well as the avidity of IgG to HSV.
Results and its discussion. According to the RCIB for the period 2014 - 2020 the proportion of hepatitis of unspecified etiology ranged from 2.3% to 7.1%, averaging 4.39 ± 0.58. The observed patients had persistent symptoms of
yellowness of the skin and sclera, weakness, abdominal pain and loss of appetite. The study of biochemical parameters
showed a significant increase in "liver tests" in all examined patients. According to the ultrasound data from the liver,
all patients showed signs corresponding to changes in acute hepatitis. The diagnosis of viral hepatitis was excluded
after repeated negative tests for markers, which served as the basis for further search for an etiological factor and the
patients were examined for viruses of the herpes group (HSV, CMV, EBV), taking into account their hepatotropicity,
as well as for the presence of AMA and ANA to exclude an autoimmune nature. The results of examination for herpes
viruses showed the presence of IgG antibodies to HSV in 11 patients, EBV - in 9 and CMV - in 7 patients. Antibodies
to all three HSV, EBV and CMV viruses were found in 6 patients, to two HSV and EBV viruses - in 3 patients, one
patient had antibodies only in CMV. The hepatotropicity of herpes viruses (CMV, EBV, HSV) was confirmed by the
detection of their antigens in the hepatocytes of the examined patients.
Conclusions: In the etiological structure of viral hepatitis, a certain place can be occupied by viral hepatitis
caused by the herpes simplex virus, cytomegalovirus, Epstein-Barr virus, etc., the clinical picture of viral hepatitis
is similar in form, severity, course and outcomes;in case of laboratory exclusion of viral hepatitis A, B, C, D, E, it
is necessary to continue laboratory studies to confirm the etiology of other viral hepatitis.
Since the end of 2020, work has begun around the world to vaccinate people against COVID-19. But due to
the insufficient supply of vaccines in resource-limited countries, data on COVID-19 in the country were analyzed to determine
effective vaccination strategies. Through age-dependant SIERS deterministic model, the paper compares four
hypothetical age-dependant vaccination strategies and their impact on the epidemic in Kyrgyzstan. So, by March 2022, public health can reduce cases of COVID-19 and the resulting mortality, in the case of increased attention
to high-risk groups (over 50 years old) and moderate vaccination of people with a high incidence (20-49 years
old). It should also be noted the importance of combining vaccination with non-pharmaceutical interventions (wearing
masks and distancing), which will lead to a further decrease in morbidity and mortality from COVID-19 and indirectly
reduce mortality from other causes too. Thus, if this scenario is observed, the mortality rate in the country can be reduced
from 27,000 to 16,000 over the simulation period (March 2020 - March 2022). According to the simulation results, vaccination
is an effective measure of protection against COVID-19, but the effect is increased when combined with vaccination
of non-pharmaceutical interventions. When focusing on the high-risk group, morbidity decreases, then mortality.
And thus, the burden on the health care system is reduced. But to achieve the effect of crowd control of the next peak in
morbidity and mortality, it is necessary to increase coverage with high morbidity (20-49 years).
The Russian Federation has been working consistently to assist partner countries in building scientific capacity and expanding co-operation in the study of infectious diseases. At the beginning of the COVID-19 pandemic, with the support of the Government of the Russian Federation, Rospotrebnadzor developed a multi-stage programme of seromonitoring of population immunity to SARS-CoV-2, which was implemented in the Russian Federation, the Kyrgyz Republic, the Republic of Belarus, the Republic of Armenia and the Republic of Tajikistan. Different age and professional groups of the countries were included in the studies. IgG antibody levels to two major SARS CoV2 antigens: nucleocapsid (Nc) and receptor-binding domain S-protein (RBD) were assessed in volunteers because of their maximal presence during the infection or postvaccination processes. In general, in those countries where the study began in 2020-2021, there was a steady trend towards increasing levels of population immunity (the proportion of seropositive individuals) during the pandemic. In those countries that joined the study later in the pandemic in 2022, a significant proportion of the population had already experienced COVID-19 in manifest or asymptomatic form, so there were no statistically significant age, occupational orgeographic differences in seroprevalence due to both the intensive "pro-epidemic" and the vaccination campaign that began in mid-2021. In the first half of 2021, vaccination against coronavirus (both primary and booster), which was actively carried out in all countries, became the main reasons for the increase in the level of population immunity. At the same time, there was a shift in the structure of seropositivity towards an increase in the proportion of individuals who had antibodies only to RBD. At the late dates of the pandemic in 2022-2023, almost 90% of seropositive volunteers had humoral immunity represented by antibodies to both antigens (Nc+RBD). It is evident that population immunity is "hybrid" in the latepandemic, under conditions of high incidence of a highly transmissible strain and high vaccination coverage.
The results of the innovative pilot project for kit development for hepatitis E serum-diagnostic assays of the Interstate Program for Innovative Cooperation of the CIS member states for the period up to 2020 are presented. The project was carried out by I.I. Mechnikov Federal State Medical Research Institute for Vaccines and Sera in association with the National Institute of Public Health of the Ministry of Health of the Kyrgyz Republic and Belarusian medical and veterinary research institutions. As a result of research recombinant antigens of the prevalent in the CIS countries HEV genotypes 1 and 3 were developed, and a set of diagnostic assays was made, namely: test for quantification of IgG antibodies to HEV, test for determination the avidity of IgG antibodies to HEV, test for measuring the total antibodies to HEV, test for detection IgM antibodies to HEV, test for detection HEV antigen, confirmation test for detection antibodies to HEV by linear immune assay, immune-chromatographic rapid test for detection the antibodies to HEV and a high-precision test for detection HEV RNA in sera and plasma by PCR. The results of serum epidemiological and molecular epidemiological studies performed in the regions of Russia, Kyrgyzstan and Belarus indicated a consistent increase proportion of hepatitis E in the structure of acute hepatitis cases in these countries with the avoidance of a large number of the cases from diagnosis and registration.
Introduction. The state of infection control makes it possible to assess the readiness of healthcare organizations to work in conditions of pandemics. In this regard, the Republican Scientific and Practical Center for Infection Control of the NGO Preventive Medicine (NIPH) in 2020 initiated the development of a new guideline for monitoring and evaluating infection control in healthcare organizations (Order of the Ministry of Health No. 1062) and monitored infection control in healthcare organizations of the Ministry of Health that provided COVID-19 treatment services. The development of the guidelines and monitoring were carried out with the technical support of UNAIDS within the framework of the project "Raising awareness and knowledge among medical professionals for effective infectious patient safety in medical institutions in Kyrgyzstan".
The purpose of the study is to assess the readiness of healthcare organizations to work in a pandemic.
Materials and methods: The assessment of infection prevention and infection control was carried out in accordance with the checklist approved by Order of the Ministry of Health No. 1062 dated December 15, 2020. The study was conducted by employees of the Republican Scientific and Practical Center for Infection Control, which has now been renamed the Scientific and Practical Center for Infection Control and Management of Medical Waste at the Research Institute of the Ministry of Health of the Kyrgyz Republic.
Conclusion. The total percentage of compliance with the infection control criteria for all 35 healthcare organizations in the second Monitoring and Assessment was (81.2%), which corresponds to the assessment is a high level of implementation of infection control from 76 to 100%. And above the results at the first Monitoring and evaluation is 78%. The results of the study were provided to the heads of healthcare organizations, infection control specialists, hospital epidemiologists and other partners and stakeholders. The study itself and its results will be useful for organizations planning to carry out monitoring, evaluation and audit of infection control in healthcare organizations of the Ministry of Health of the Kyrgyz Republic.