№1 (2025)

Introduction. Among cardiovascular diseases in infants, congenital heart defects (CHDs) occupy a leading position regardless of region or the level of medical care. Although a decline in congenital anomalies has been noted in developed countries, CHDs remain one of the leading causes of infant
mortality. Objective: To determine the prevalence of congenital anomalies, including CHDs, and their role in infant mortality in the Kyrgyz Republic. Materials and methods. A retrospective analysis was conducted using statistical data from the National Statistical Committee and the National Center
for Maternal and Child Health (NCMCH) for the period 2020–2024. Results. It was found that, despite a decline in the birth rate in Kyrgyzstan (from 158,112 newborns in 2020 to 145,977 in 2023) and a slight decrease in infant mortality (from 2,270 to 2,040 cases), the detection rate of CHDs
showed an unstable trend amid a general increase in the frequency of congenital anomalies. During the period from 2022 to 2024, 197 cases of CHDs were recorded at the NCMCH, with annual variations of 53, 78, and 66 cases, respectively. Despite an increase in the total number of congenital
anomalies (from 3,565 to 4,564 cases), the detection of CHDs remained inconsistent.
Conclusion. CHDs continue to play a significant role in the structure of infant mortality in Kyrgyzstan. The lack of effective diagnostic tools and limited access to specialized care emphasize the need to implement neonatal screening for CHDs and expand opportunities for early detection.

Introduction. Road traffic injuries are a major public health problem due to high mortality and disability. According to the World Health Organization, 1.3 million people die every year in the world, and more than 90% of deaths occur in low- and middle-income countries. This problem is also relevant
for Kyrgyzstan, due to the ever-increasing level of motorization, urbanization and insufficient road safety standards. The purpose of this study was to assess the gender-age characteristics of
mortality from road traffic injuries in the period from 2019 to 2023. Materials and methods. As a source of information, the data of the reporting form C51 "Distribution of deaths by sex and age groups and causes of death" and indicators of the permanent population of Bishkek by sex and age groups for 2019-2023 of the National Statistical Committee under the President of
the Kyrgyz Republic (NSC) were used. Calculations were carried out according to ICD-10 revision codes V00-V99 "Transport accidents". Age groups for each gender are distributed in increments of 5 years. Statistical data processing, epidemiological analysis and visualization were carried out in Microsoft Excel software. Outcomes. According to the National Statistics Committee, in the period
2019-2023, 566 people died in road accidents in Bishkek, including 179 women and 368 men. Of the total number of deaths from road traffic injuries, the share of people of working age (16-64 years) was, on averag, 8% among women and 76.8% among men over 5 years. Mortality rates increased, with increasing age, in both age groups. Among men, mortality rates have risen more rapidly since adolescence. People over 70 years of age had a greater risk of dying from road injuries than other age groups, especially among men -169.5 per 100,000 population in 2022. An analysis by
year showed a decrease in mortality in 2020, which is due to a decrease in he overall activity of the population during the Covid 19 pandemic, with a subsequent increase in 2021-2023. Findings. The main burden of deaths from road accidents in Bishkek falls on men of working age and the elderly of both sexes. Men are at a higher risk of dying from road traffic accidents, which may be due to behavioral factors and gender stereotypes in driving style. These trends highlight the tneed to develop gender- and age-specific prevention programs to reduce road traffic deaths.

Introduction. The development of acute renal failure due to contrast-induced nephropathy is a factor that worsens the overall prognosis and requires timely correction of modifiable risk factors and preventive measures. Purpose of the study. To study the relationship between complete blood cell count parameters and the development of contrast-induced nephropathy in patients with coronary heart disease after endovascular interventions. Materials and research methods. The study included 184 patients who underwent inpatient treatment in the clinical departments of the National сenter for сardiology and therapy named after academician Mirsaid Mirrakhimov
under the Ministry of Health of the Kyrgyz Republic. The age of the patients ranged from 30 to 70 years (mean age was 55,2±8,5 years). Of the surveyed men, there were 132 (71,7%), and women - 52 (28,3%). All patients suffered from various forms of coronary heart disease. Patients underwent a general clinical examination, anthropometric and biochemical studies, including the
determination of a diffuse complete blood count, as well as electrocardiography, echocardiography, ultrasound examination of the kidneys and coronary angiography. All patients were assessed for the risk of developing contrast-induced nephropathy according to the R. Mehran scale (2004). Results. 32 (17.4%) of 184 patients included in the study developed CIN.
The performed logistic regression analysis showed that independent factors associated with the development of CIN in patients with endovascular interventions include: acute myocardial infarction - (RR 3.98; 95% CI 1,05 - 16,6), diabetes mellitus (RR – 5,47; 95% CI 2,9 – 10,1) and an increase in the number of leukocytes (RR – 1,33; 95% CI 1.02 - 1.74). Conclusion. An increase in the number of leukocytes is an independent risk factor for the development of contrast-induced nephropathy in patients with coronary heart disease after endovascular intervention.

Introduction.Hepatitis B among hemocontact infections is a serious public health problem worldwide. Kyrgyzstan is one of the countries with high endemic prevalence of viral hepatitis. Newborns and infants under one year of age are particularly vulnerable, as infection at this age leads to the development of chronic infection in 80-90% of cases. Goal. To assess the epidemiological effectiveness of vaccination against
hepatitis B based on the results of screening studies conducted before and after the vaccination periods, as well as based on the data from state statistical reporting. The research methods are a multi-stage stratified cluster method (stratification by age, region, and degree of urbanization). The personal data was statistically processed using the Excel computer program. Laboratory blood tests were determined using enzyme immunoassay (ELISA) for the presence of the HBsAg marker. Results. The results of several studies conducted in the pre-vaccination period of 1999 and after 2001 are presented. Comparisons of several studies indicating a decrease in morbidity after the introduction of the vaccine are given. Special attention is paid to the study of regulatory documents. The Kyrgyz Republic, on the recommendation of WHO, conducted the first HBV immunization for newborn children in pilot healthcare organizations in 1999. By this order, in April 2009, the country switched to the pentavalent vaccine DPT-HBV-HIB (where HBV vaccine was included in its composition). This approach was implemented in order to reduce the cost of seroprophylaxis. The disease rates range from 2.3 (per 100,000 people) in 2023 to 31.2 (per 100,000 people) in 1994. It should be noted that no cases of the disease were detected among children under 15 in 2022. Conclusions. The relevance of the above research results shows that the hepatitis B vaccine is the most powerful weapon for the elimination of hepatitis B virus in the population of the Kyrgyz Republic.

Introduction. The article presents the results of the study of fulfillment of infection control (IC) requirements of vaccine-preventable infections (VPI) in the HCOs of the Ministry of Health of the Kyrgyz Republic.
The purpose of this study is to assess the implementation of infection control requirements in healthcare organizations of the Kyrgyz Republic for vaccine-preventable infections (VPI) transmitted by airborne droplets, as well as to identify problems and develop recommendations for improving the situation. Materials and Methods. Specially developed checklists for VPI M&E in 8 HCOs were used. Additionally, awareness was assessed using online questionnaires of 802 health workers. Results. Using the data collected, key gaps and weaknesses in the implementation of IC measures were identified, including lack of regulations (%), weak administrative support (%), inadequate staff vaccination (%), and weakisolation infrastructure. (%) based on the monitoring results, specific recommendations were proposed for each HCOs to improve the epidemiological resilience of the health system.
Conclusion. The results of the study revealed significant shortcomings in the implementation of infection control requirements for VPIs in health care organizations of the Kyrgyz Republic. Key systemic gaps were identified,
including a deficit in the regulatory framework, insufficient management support, low vaccination coverage of health care workers and limited resources for isolation. The developed recommendations will strengthen epidemiological sustainability and ensure more effective prevention of airborne VPIs in health care organizations.

Introduction. Road traffic injuries (RTIs) represent a major public health
concern and a leading cause of premature mortality globally. In low- and
middle-income countries, including Kyrgyzstan, the burden of RTI-related
deaths disproportionately affects young and economically active populations.
This study aims to quantify the demographic and economic losses associated
with RTI-related premature mortality in Bishkek over a five-year period
using Years of Life Lost (YLL) and the Human Capital Approach (HCA).
Methods. We conducted a retrospective analysis of mortality data from road
traffic injuries in Bishkek for the years 2019–2023. Age- and sex-specific
YLL were calculated based on standard life expectancy tables. Economic
losses were estimated by multiplying the total YLL by annual GDP per
capita and age-specific workforce adjustment factors (WAF), without discounting. Descriptive statistics, including means and standard deviations
(SD), were used to assess interannual variability.
Results. A total of 16,200 YLL were attributed to RTI-related deaths over
the study period, with men accounting for 65% of the total burden. The highest YLL rates were observed among males aged 20–29 and females aged
25–34. Interannual variability was significant in several age groups, with
standard deviations exceeding 100 in working-age males, suggesting susceptibility to external, potentially unpredictable factors. The estimated total
economic loss due to RTI mortality over five years amounted to approximately 14.7 million USD, with an upward trend peaking at 5.02 million USD in 2023.
Conclusion. RTI-related mortality in Bishkek leads to considerable loss of
human potential, particularly among the economically productive population. Quantifying this burden through YLL and economic valuation provides
a strong foundation for advocating targeted road safety interventions. Policymakers should prioritize young men as a high-risk group and incorporate
demographic and economic data into traffic injury prevention strategies.

Introduction. A new article 153 “Respect for the Human Person” was introduced into the Law No. 14 “On the Protection of Citizens’ Health in the
Kyrgyz Republic” dated January 12, 2024, which establishes the principle
of respect for the individual as the basis for the professional activities of
medical professionals. However, not only the presence of the article in the
law is important, but also the understanding of its ethical and legal grounds
for effective practical application is of great importance.
The purpose of the study is to explore the legal and ethical grounds of Article
153 of the Law “On the Protection of Citizens’ Health in the Kyrgyz Republic” dated January 12, 2024 No. 14 “Respect for the Human Person” to
improve its practical application in the field of medicine.
Materials and methods. Secondary data from open sources in the field of
law and bioethics in Kyrgyz, Russian and English were studied using the
method of qualitative documentary analysis.
Results. Research has shown that the ethical understanding of "respect",
which includes recognition of the dignity, rights and internal values of an
individual, has undergone changes in bioethics and is represented by the
principle of respect for the individual autonomy, as the right to make independent decisions regarding medical interventions. The legal norms of the
studied article ideally correspond to the bioethical understanding of the concept of respect, since all the requirements of the law are aimed at observing
the principle of respect for individual autonomy. As a result, the Kyrgyz Republic, by introducing this article into the Law, defines the duties of medical
professionals to respect the individual autonomy of a person as the right to
self-determination regarding medical interventions.
Conclusion. The study showed that the legal and ethical grounds of Article
153 of the Law “On the Protection of Citizens' Health in the Kyrgyz Republic” dated January 12, 2024 No. 14 “Respect for the Human Person”
fully complies with the requirements of international bioethical standards
of respect for individual autonomy at medical interventions. At the same
time, it is important to understand that respect, as a moral category should
be realized not only through legal and bioethical norms, but also through
mechanisms embedded in the cultural traditions of the Kyrgyz people.

Introduction. Although the majority of registered HIV cases in the Kyrgyz Republic are among men, women face distinct social and structural vulnerabilities. Domestic violence, economic dependence, limited decision-making power, and difficulty in negotiating safe sexual practices with partners significantly increase the risk of HIV infection among women. In manycases, women learn about their HIV status only when registering for antenatal care, highlighting the need to strengthen preventive efforts and raise awareness during family planning and pregnancy. Stigma and discrimination increase women’s fear of society and family and prevent them from seeking help and treatment if they become infected with HIV. Many women with HIV are afraid to openly admit their HIV status and refuse treatment. In these cases, the likelihood of women becoming infected sexually increases. Most women are not sufficiently informed about the prevention of HIV
transmission to the infant. Modern methods of HIV treatment allow working and studying, having a family and healthy children, living a full life. Objective. To assess the level of awareness about HIV infection among pregnant women, young families, and their family members in the Kyrgyz Republic, and to evaluate the impact of ongoing information and educational interventions on improving public awareness regarding the prevention of mother-to-child transmission of HIV. Material and methods of the study. A cross-sectional research method was used in this study. The questionnaire layout was created in the Google application Forms, interviewers entered data directly into the electronic data base via smartphones. To ensure the reliability of the data collected, the location of the questionnaires was tracked by the GPS navigation of the interviewers’ mobile device. Results and discussion. In order to increase knowledge on HIV infection issues and to form a responsible attitude towards HIV prevention in infants, a two-stage study was conducted in the country. The majority of respondents in both stages of the study were pregnant women and young spouses (28% and 29%); the study included women regardless of the duration of pregnancy, husbands of pregnant women (17%), and mothers-in-law of pregnant women (13%). At both stages of the study, women made up 70% of respondents, and men – 30%. Rural residents, especially women, often lack opportunities to get an education and earn money, which limits their chances of improving their material well-being, which can affect their health. Less than half of the respondents (42%) are unemployed, which is due to the fact that most respondents are women who are currently caring for children or have recently married and have not yet settled in a new place. In addition, women, especially rural residents, most often experience problems with employment. Respondents were asked questions about transmission routes, prevention of vertical transmission, the need for testing pregnant women and their partners for HIV, and treatment against HIV. As a result, respondents’ knowledge of HIV infection improved. Conclusions. In order to achieve better results in informing the general population about prevention of mother-to-child transmission of HIV issues
(PMTCT), it is necessary to continue to improve PMTCT training modules and continue informing the population, focusing on newly formed young families.

Introduction. Tuberculosis is one of the most significant infectious diseases causing serious health problems in the world, including the Kyrgyz Republic. Accurate diagnosis, effective treatment and careful monitoring using laboratory information systems (LIS) are necessary to successfully combatuberculosis. The purpose of the work is to evaluate the effectiveness of the implementation of a laboratory information system in the laboratories of the anti-tuberculosis service of the Kyrgyz Republic. Materials and methods. In 2019, a laboratory data management information system (LDMIS) was introduced in the laboratories of the anti-tuberculosis service in the Kyrgyz Republic with the support of USAID for collecting, analyzing, monitoring, and storing tuberculosis data. Results and discussion. A laboratory information system for data management has been implemented in 9 regional laboratories and 72 district laboratories. In 2023 (95%), compared to 2021 (50%), the sending of samples for culture before the start of treatment has improved. The implementation of LIS has improved tuberculosis monitoring. Conclusion. The implementation of LIS in laboratories made it possible to automate and use specialized software, which contributed to the improvement of the process of processing, analysis and storage of data, increasing the quality of tuberculosis test results and laboratory productivity.

Introduction. Biosafety in tuberculosis (TB) diagnostic laboratories is a critical aspect of protecting staff, patients, and the environment from the biological risks associated with working with Mycobacterium tuberculosis. In the Kyrgyz Republic, where tuberculosis remains a significant public health problem, the introduction of a systematic assessment and monitoring of biosafety risks is becoming particularly relevant. The basis of biological risk management is their identification, analysis of the probability and severity of consequences, as well as the development of control strategies. Objective of the Study. The development and implementation of a biosafety
risk assessment system for TB diagnostic laboratories in the Kyrgyz Republic began. The tasks included the development of standard operating procedures (SOP), monitoring their application, analyzing the results and making recommendations to reduce the risks of intra-laboratory infection.
Materials and Methods. An electronic matrix developed in excel format based on WHO recommendations (LBM4) was used to assess the risks. The matrix classified risks by levels of probability (low, medium, high) and severity of consequences (minor, moderate, severe). The main stages included: collecting information on the stages of the laboratory cycle; risk assessment with the assignment of a level; development of control measures; implementation and analysis of the effectiveness of measures. Results and Discussion. At the analytical stage, 7 key risks were identified, including equipment breakdowns (autoclaves, biological safety cabinets)
and personnel errors. At the preanalytical stage, 6 risks related to the transportation and storage of samples were identified. At the post-analytical stage, 5 risks were identified, including data loss and documentation errors. 14 control measures have been implemented for the preanalytical, 15 for the
analytical and 7 for the postanalytical stages. The effectiveness of the measures has been confirmed by a decrease in the number of incidents, but there remains a need for additional funding to upgrade the infrastructure. Conclusion. Regular equipment maintenance and staff training reduce the likelihood of critical incidents. It is necessary to adapt international standards (ISO 35001, WHO recommendations) to the regional conditions of the Kyrgyz Republic. Political support and allocation of resources are essential for the modernization of the biosafety system. The developed SOP
and risk assessment matrix can serve as a model for other Central Asian countries.

Introduction. Diabetes mellitus (DM) is a global medical and social problem and a top priority for national healthcare systems in the Kyrgyz Republic. The purpose of the work is to evaluate the results of the introduction of glycated hemoglobin (Hb1Ac) in clinical diagnostic laboratories (CDL) of the
Talas region of the Kyrgyz Republic. Materials and methods. In the KDL, blood samples are analyzed for glycated hemoglobin (GH) Hb1Ac using photometric and immunofluorescence methods of research. The following devices are used to analyze blood samples: biochemical analyzer Mindray BS-240 and fluorescent analyzer Finecare FIA Meter Plus. The subjects of the study were the following quality elements: personnel, equipment, documents/logs of registration of analyzes, process control. To analyze data in clinical diagnostic laboratories, the Laboratory Information System (LIS) – Ilab is used. The analysis of the data of the journals on the GG was carried out for the period 2022-2023. Results and discussion. Studies on diabetes mellitus were conducted in six healthcare organizations of the Talas region of the Kyrgyz Republic, clinical
diagnostic laboratories (KDL), at 4 General Practice Centers (GPC) Manassky, Aitmatov, Bakai-Ata and Talassky, as well as 2 Family Medicine Centers (FMC) in the city of Talas. (Talas Regional United Hospital - TOOB and Talas Regional Family Medicine Center - TRCSM). In total, there were 2,730 patients with diabetes mellitus in 2022, 2,864 people in 2023. Conclusion. The quality of work in the laboratories of the Talas region depends on the availability of human resources: for example, out of four general medical practice centers in the Manas district, there is no doctor, while the situation with the staffing of doctors is better identified in the Talas regional united hospital (5 laboratory doctors). For the laboratory information
system to operate effectively, it is necessary to have constant access to the Internet, and for maintaining documentation and monitoring the results of sample analysis, it is necessary to introduce a barcoding system. To improve the quality of testing for diabetes mellitus, it is necessary to train employees of clinical diagnostic laboratories in validation and verification methods, in accordance with the international standard ISO 15189

Introduction. Antibacterial drugs play an important role in the treatment of infectious diseases, and cephalosporin-type antibacterial drugs are one of the most widely used groups of antibiotics. In the context of an increase in the prevalence of infectious diseases, as well as an increase in the inefficient
use of antibiotics, including cephalosporins, the Kyrgyz Republic is showing an upward trend. This article provides a structural analysis of the cepha losporin-type antibacterial drugs market, examines its nomenclature and group features. The purpose of the study. Conducting a structural analysis of registered antibacterial drugs of the cephalosporin series. Materials and methods. The methods of content analysis, comparison, and ranking were used to conduct the research. Data from the State Register of Medicines of the Kyrgyz Republic for 2024, containing information on registered antibacterial drugs, including trade names, dosage forms, dosages, manufacturers, and countries of origin, were used as the main material for analysis. Results. By copying data from official information sources - the State Register of Medicines of the Kyrgyz Republic - a list of antibiotics has been
formed, which includes 55 trade names (TN), 36 international nonproprietary names (INN) and 22 drugs in various dosage forms. According to the State Register of Medicinal Products of the Kyrgyz Republic, 625 antibiotics have been registered for 2024 (including trade names of medicines, forms of release, dosages, manufacturing companies, and countries of production). Of those registered, 20.6% are penicillins, 27.7% are cephalosporins, 14.5% are quinolones, 5.3% are aminoglycosides, 12.8% are macrolides, 2.8% are tetracyclines, and 16.3% are other groups of antibacterial drugs. In the structure of the range of registered antibacterial drugs of the cephalosporin series, the generational distribution in relative terms can be represented as follows (taking into account INN): 1st generation - 11% (cefazolin); 2nd generation – 15% (cefuroxime); 3rd generation -62% (ceftriaxone, cefotaxime, ceftazidime, cefoperazone); 4th generation – 12% (cefipime). Conclusion. The conducted content analysis of the range of antibiotics registered in the Kyrgyz Republic according to the Register of Permitted Drugs
for 2024 allows us to conclude about a structured and rich picture of the pharmaceutical market of antibacterial drugs. The excessive variety and quantity of antibiotics on the country's market raises concerns about their irrational use in medical practice. All this leads to an increase in the resistance of microorganisms to antibiotics.

Introduction. Blood sterility testing is a key stage in the diagnosis of severe infectious diseases such as sepsis and bacteremia. The effectiveness of diagnosis directly depends on the quality of the culture media used. In the context of increasing antibiotic resistance and the spread of nosocomial infections, timely and reliable identification of pathogens becomes increasingly important. Objective. To assess the effectiveness of commercial culture media (TDR
Resin Aerobic, TDR Resin Anaerobic, PPA medium with MPB) for blood sterility testing, analyzing their sensitivity, specificity, and speed of pathogen detection. Materials and Methods. A total of 732 blood samples were analyzed, with
480 collected and tested in 2023 and 252 in 2024. The study was conducted at the Clinical Diagnostic Laboratory of the Republican Clinical Infectious Diseases Hospital. Classical microbiological methods were used, including
blood culture on nutrient media, incubation, microorganism identification, and determination of detection time. Both aerobic and anaerobic culture conditions were examined. Results. The use of commercial culture media significantly reduced the time to pathogen detection compared to traditional methods, while improving diagnostic accuracy. The TDR Resin media were the most effective for detecting both aerobic and anaerobic microorganisms. All three media
demonstrated high sensitivity and specificity, as well as resistance to environmental factors. Conclusion. The use of commercial culture media in clinical practice is advisable, as it improves the quality of laboratory diagnostics, contributes to early detection of bacteremia, timely initiation of therapy, and reduction of complication risks in patients with septic conditions.

The Guidelines present the basic mechanism for ethical regulation of biomedical research at the university level. They describe the role and authorities of the local ethics committee of the university, as well as the procedures for ethical review of biomedical research. The purpose of the Guidelines is to help researchers successfully pass the ethical review and obtain approval from the local ethics committee of the university to do research studies. The Guidelines is intended for researchers who plan to do biomedical research involving humans as research subjects or experiments on laboratory animals, as well as the implementation of the results of scientific and technical developments in medical practice. The Guidelines, first published in print in 2015, are currently being republished as an article in a scientific journal in order to expand access to the material and ensure its relevance for the professional community.