Using pneumococcal and rotavirus surveillance in vaccine decision-making: A series of case studies in Bangladesh, Armenia and the Gambia.

Pneumonia and diarrhea are the leading causes of child morbidity and mortality globally and are vaccine preventable. The WHO-coordinated Global Rotavirus and Invasive Bacterial Vaccine-Preventable Disease Surveillance Networks support surveillance systems across WHO regions to provide burden of disease data for countries to make evidence-based decisions about introducing vaccines and to demonstrate the impact of vaccines on disease burden. These surveillance networks help fill the gaps in data in low and middle-income countries where disease burden and risk are high but support to sustain surveillance activities and generate data is low. Through a series of country case studies, this paper reviews the successful use of surveillance data for disease caused by pneumococcus and rotavirus in informing national vaccine policy in Bangladesh, Armenia and The Gambia. The case studies delve into ways in which countries are leveraging and building capacity in existing surveillance infrastructure to monitor other diseases of concern in the country. Local institutions have been identified to play a critical role in making surveillance data available to policymakers. We recommend that countries review local or regional surveillance data in making vaccine policy decisions. Documenting use of surveillance activities can be used as advocacy tools to convince governments and external funders to invest in surveillance and make it a priority immunization activity

Mercury soil contents and associated ecological and health risks in kindergartens and functional areas of the city of Vanadzor (Armenia)

Mercury is a widespread environmental pollutant becoming a crucial health concern as a result of natural and anthropogenic releases. Understanding Hg distribution pattern between different functional urban areas is needed for urban pollution control and health impact assessment. Therefore, in this paper urban soil Hg spatial distribution, pollution level evaluation, and mercury-induced health risks were studied, for different urban functional areas (355 samples) and kindergartens (18 samples) of Vanadzor. Geospatial mapping and the geostatistical analysis suggest that Hg concentration in the entire area of Vanadzor and its kindergartens has a natural origin, besides a certain anthropogenic impact on some urban sites. According to geoaccumulation index (Igeo), uncontaminated or moderately contaminated levels were detected only in 2 samples from industrial area and 5 samples from residential area, the remaining samples were classified as uncontaminated. In all kindergartens and the 22.15 sq.km of the city (270 samples) are characterized by low level potential ecological risk, whereas 3.85 sq.km (85 samples) correspond to moderate and for 1 sampling site high level of potential ecological risk. A non-carcinogenic health risk assessed for children and adults indicates health hazards neither in Vanadzor entire areas nor in kindergartens. The hazard index (HI) in each urban functional area is less than allowable level (HI <1) for children and adults. Obtained results are indicative and offer the ability for better management of urban soil and urban planning in terms of Hg pollution regulation in different functional areas

The cost-effectiveness of rotavirus vaccination in Armenia.

The cost-effectiveness of introducing infant rotavirus vaccination in Armenia in 2012 using Rotarix(R) was evaluated using a multiple birth cohort model. The model considered the cost and health implications of hospitalisations, primary health care consultations and episodes not leading to medical care in children under five years old. Rotavirus vaccination is expected to cost the Ministry of Health $220,000 in 2012, rising to$830,000 in 2016 following termination of GAVI co-financing, then declining to $260,000 in 2025 due to vaccine price maturity. It may reduce health care costs by$34,000 in the first year, rising to $180,000 by 2019. By 2025, vaccination may be close to cost saving to the Ministry of Health if the vaccine purchase price declines as expected. Once coverage has reached high levels, vaccination may prevent 25,000 cases, 3000 primary care consultations, 1000 hospitalisations and 8 deaths per birth cohort vaccinated. The cost per disability-adjusted life year (DALY) saved is estimated to be about$650 from the perspective of the Ministry of Health, $850 including costs accrued to both the Ministry and to GAVI,$820 from a societal perspective excluding indirect costs and $44 from a societal perspective including indirect costs. Since the gross domestic product per capita of Armenia in 2008 was$3800, rotavirus vaccination is likely to be regarded as "very cost-effective" from a WHO standpoint. Vaccination may still be "very cost-effective" if less favourable assumptions are used regarding vaccine price and disease incidence, as long as DALYs are not age-weighted

Development of

Optimization of in vitro culture conditions of grapevine phylloxera-resistant rootstock cultivar ‘Ruggeri-140’(Vitisberlandieri x Vitisrupestris) was carried out. Among the different sterilization treatments, maximum aseptic cultures were obtained for both explants apical tips and nodal segments when treated with Ca(ClO)2 at concentration of 1.5 % for 10 minutes plus 70 % ethanol for 30 s (T7). The maximum shoot proliferation was observed both in apical and nodal meristems cultured on MS medium supplemented with 1.0 mg/l BAP. MS/2 medium containing 1.0 mg/l indole-3-butric acid (IBA) gave the highest rooting percentage (100%) with the highest mean number and length of roots. The ex vitro survival of rooted micro shoots was 75.0%

Radiolarian ages for the sedimentary cover of sevan ophiolite (Armenia, lesser Caucasus)

International audienc

Prevalence of hepatitis B virus infection among general population of Armenia in 2021 and factors associated with it: a cross-sectional study

Objectives This study sought to determine the prevalence and associated factors of hepatitis B virus (HBV) infection ever in life and chronic HBV infection in Armenia.Design A population-based cross-sectional seroprevalence study combined with a phone survey of tested individuals.Setting All administrative units of Armenia including 10 provinces and capital city Yerevan.Participants The study frame was the general adult population of Armenia aged ≥18 years.Primary and secondary outcome measures The participants were tested for anti-HBV core antibodies (anti-HBc) and HBV surface antigen (HBsAg) using third-generation enzyme immunoassays. In case of HBsAg positivity, HBV DNA and hepatitis D virus (HDV) RNA PCR tests were performed. Risk factors of HBV infection ever in life (anti-HBc positivity) and chronic HBV infection (HBsAg positivity) were identified through fitting logistic regression models.Results The seroprevalence study included 3838 individuals 18 years and older. Of them, 90.7% (3476 individuals) responded to the phone survey. The prevalence of anti-HBc positivity was 14.1% (95% CI 13.1% to 15.2%) and HBsAg positivity 0.8% (95% CI 0.5% to 1.1%). The viral load was over 10 000 IU/mL for 7.9% of HBsAg-positive individuals. None of the participants was positive for HDV. Risk factors for HBsAg positivity included less than secondary education (aOR=6.44; 95% CI 2.2 to 19.1), current smoking (aOR=2.56; 95% CI 1.2 to 5.6), and chronic liver disease (aOR=8.44; 95% CI 3.0 to 23.7). In addition to these, risk factors for anti-HBc positivity included age (aOR=1.04; 95% CI 1.04 to 1.05), imprisonment ever in life (aOR=2.53; 95% CI 1.41 to 4.56), and poor knowledge on infectious diseases (aOR=1.32; 95% CI 1.05 to 1.67), while living in Yerevan (vs provinces) was protective (aOR=0.74; 95% CI 0.59 to 0.93).Conclusion This study provided robust estimates of HBV markers among general population of Armenia. Its findings delineated the need to revise HBV testing and treatment strategies considering higher risk population groups, and improve population knowledge on HBV prevention

New data on the tectonic evolution of the Khoy region, NW Iran

The Khoy region (NW Iran) is important in the clarification of the structural framework of the alpine belt between the Taurides, the Lesser Caucasus and the NW Iran belt. The area is wellknown for these ophiolitic units. We present here new stratigraphic and structural data that can be used to reconstruct the tectonic evolution of this region and then try to establish connections between these belts. According to new dates from nannoplankton assemblages, the obducted ophiolite of the Khoy complex was thrust over a sheared Campanian olistostrome and lenses of amphibolite are included within the contact. The obduction event is also marked by erosion of the ophiolitic unit and the deposition of conglomerates, shales, sandstones and siltstones. Poorly extended Paleocene detrital deposits cover the Campanian–Maastrichtian rocks. The Eocene formations characterize a basin filled with volcanogenic and sedimentary layers. The Middle and Upper Eocene series unconformably overlie the ophiolites and their cover of Campanian–Maastrichtian and Paleocene deposits. This corresponds to a syn orogenic basin formed after the collision between Eurasia and the Taurides Anatolides–South Armenian microplate. The Oligocene–Miocene Qom Formation with basal conglomerates unconformably covers all the earlier formations, including the Palaeozoic formations, indicating intense shortening before its deposition. Compressional deformation continued and is manifested by numerous folds, mainly west-dipping thrusts and reverse faults cutting the Qom Formation, and by recent NW–SE dextral strike-slip faults. This illustrates the continuous shortening and uplift (with intense erosion) resulting from the advanced stage of the collision between Arabia and Eurasia. The structural location of the tectonic units suggests that the Khoy Gondwana-related basement was part of the South Armenian Block and that the Khoy allochthonous ophiolites were obducted on it from the Amasia–Stepanavan –Sevan–Hakari suture zone