Prevalence and determinants of stunting in a conflict-ridden border region in Armenia - a cross-sectional study

Background Despite global efforts, stunting remains a public health problem in several developing countries. The prevalence of stunting among 0- to 5-year-old children in Armenia has increased from 17% in 2000 to 19% in 2010. A baseline study was conducted among preschool children in Berd, a region near the northeastern border of Armenia that has experienced intermittent military tension for over 20 years. Methods We conducted a cross-sectional study including 594 children aged 6-month- 6 years old and their caregivers in our analysis, to assess the prevalence and determinants of stunting. We calculated the anthropometric measurements and hemoglobin levels of children; analyzed children’s stool and conducted a survey with children’s caregivers. We employed the hierarchical logistic regression model to explore the predictors of stunting among 25–72 months old children and multivariable logistic regression models to investigate the predictors of stunting among 6–24 months old children. Individual and residence level variables were included in the models including anemia, minimum dietary diversity, mothers’ height, the overall duration of breastfeeding, birthweight, child’s history of diarrhea and mean socio-economic score. Results The prevalence of stunting was significantly higher among the 6–24 months old children (13.3%) compared to the children aged 25–72 months old (7.8%). We did not find any differences in the prevalence of stunting by place of residence in either age group. The 6–24 months old children who consumed at least four food groups during the previous day (minimum dietary diversity) had 72% lower odds of being stunted (p < 0.05). Each kilogram increase in birthweight was associated with 76% lower odds of being stunted (OR = 0.24, p < 0.01). Mother’s height significantly decreased the odds of stunting among the children 25–72- months old (OR = 0.86, p < 0.001). BMI was also a significant predictor of stunting among both age-groups. Conclusions The study results highlight the significance of mother’s height, birthweight, and adequate complementary feeding to reduce stunting. Further studies are needed to determine the possible association of anemia and stunting with the ongoing conflict in the region, as well as socioeconomic conditions and food insecurity in the region

Short-term nutrition and growth indicators in 6-month- to 6-year-old children are improved following implementation of a multidisciplinary community-based programme in a chronic conflict setting

Objective: We investigated short- and long-term indicators of malnutrition and diet before and after the community-based ‘Breaking the Cycle of Poverty’ multidisciplinary intervention. Design: A historically and geographically controlled study using data collected in 2013 and 2016. We compared the prevalence of short-term indicators (anaemia, breast-feeding duration and minimum dietary diversity) and long-term indicators (stunting and wasting) in exposed communities at two time points. We then compared these factors in geographic areas exposed or not exposed to intervention. We conducted logistic regression analyses on the 2016 sample to measure associations between living in intervention communities and child growth indicators. Setting: Berd region, a chronic conflict zone near the north-eastern border of Armenia and Azerbaijan. Participants: Children aged 6 months to 6 years. Results: Analyses included data from 2013 comprising 382 children, and data from 2016 comprising 348 children living in communities where the programme was implemented, and 635 children from unexposed communities. Anaemia prevalence in exposed communities was significantly lower in 2016 v. 2013 (10·9 v. 19·1 %, P < 0·01). Minimum dietary diversity (79·0 v. 68·1 %, P < 0·001) and breast-feeding duration (13·0 v. 11·5 months, P < 0·002) were significantly improved in exposed communities. Prevalences of stunting (11·5 v. 10·2 %, P = 0·57) and wasting (4·8 v. 2·0 %, P = 0·07) were not significantly different. Odds of anaemia were significantly lower (OR = 0·24, 95 % CI 0·16, 0·36) in intervention communities. Conclusions: Exposure to a community-based multidisciplinary intervention reduced the rate of anaemia and improved dietary indicators

Assessment of Lockdown Effectiveness during COVID-19 Pandemic Using Air Pollution Data in Armenia in March–June 2019 and 2020: A Cross-Sectional Study

Various methods used by different countries’ governments to control the spread of coronavirus disease 2019 (COVID-19), the cause of pandemic in 2020, affected air quality. The aim of this study was to evaluate the effects of lockdown in Armenia on the content of the main air pollutants—dust, SO2 and NO2. This was a cross-sectional study. We analyzed data on the concentrations of SO2, NO2 and dust from March to June, 2019 and the same period in 2020 as well as data on positive COVID-19 cases from Yerevan, Vanadzor and Hrazdan. In 2020, dust was found to be lower in Yerevan and in Hrazdan and higher in Vanadzor than in the same period in 2019. The same pattern was present for SO2 concentrations: in Yerevan and Hrazdan there was a decrease, and there was an increase in Vanadzor. The concentrations of NO2 increased in Yerevan and Hrazdan, with a slight decrease in Vanadzor. New cases of COVID-19 had a negative correlation with dust and a positive correlation with SO2. The strict quarantine measures were effective in containing the spread of COVID-19

Assessment of Lockdown Effectiveness during COVID-19 Pandemic Using Air Pollution Data in Armenia in March&ndash;June 2019 and 2020: A Cross-Sectional Study

Various methods used by different countries&rsquo; governments to control the spread of coronavirus disease 2019 (COVID-19), the cause of pandemic in 2020, affected air quality. The aim of this study was to evaluate the effects of lockdown in Armenia on the content of the main air pollutants&mdash;dust, SO2 and NO2. This was a cross-sectional study. We analyzed data on the concentrations of SO2, NO2 and dust from March to June, 2019 and the same period in 2020 as well as data on positive COVID-19 cases from Yerevan, Vanadzor and Hrazdan. In 2020, dust was found to be lower in Yerevan and in Hrazdan and higher in Vanadzor than in the same period in 2019. The same pattern was present for SO2 concentrations: in Yerevan and Hrazdan there was a decrease, and there was an increase in Vanadzor. The concentrations of NO2 increased in Yerevan and Hrazdan, with a slight decrease in Vanadzor. New cases of COVID-19 had a negative correlation with dust and a positive correlation with SO2. The strict quarantine measures were effective in containing the spread of COVID-19

Digital Health Information Systems in the Member States of the Commonwealth of Independent States: Status and Prospects

This paper examines the status of the development of national digital health information systems (HIS) in Commonwealth of Independent States (CIS) member states. Data for research were collected using a questionnaire adapted from the questionnaire of the WHO’s Third Global Survey on eHealth. The results showed that the digital transformation of HIS was occurring in all seven CIS member states (participating in the study), which were financed by different resources. Laws and regulations on electronic medical records (EMR) use were present in almost all participating CIS member states. Various international standards and classifications were used to support development and the interoperability of digital health information system (d-HIS), including International Classification of Diseases (ICD), Digital Imaging and Communications in Medicine (DICOM), ISO 18308, Logical Observation Identifiers, Names, and Codes (LOINC), Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), and ISO TC 215. Several CIS member states had adopted a national information security strategy for the safe processing of both personal data and medical confidential information. The digital transformation of healthcare and the Empowerment through Digital Health initiative are taking place in all CIS member states, which are at different stages of introducing electronic medical and health records

Morphological Changes in the Oral Mucous Membrane in Viral Hepatitis C Patients: A Cross-Sectional Study

Background: The objective was to reveal the most typical changes in oral mucosa in HCV patients and compare them with those in HCV negative patients. Methods: The study involved 96 HCV patients and 100 patients without HCV who applied to a dental clinic. The content of cytokines IL-2, IL-4, IL-10 and &#612;-INF in the oral fluid was determined by ELISA. Buccal mucosa and gums biopsies passed histological examination. An immunohistochemical study of mucous membrane biopsies was performed using monoclonal mouse antibodies to CD3+ and CD20+. Results: The HCV patients group included 96 (63.5% males), and the non-HCV group included 100 subjects (62.0% males) with lesions of the oral mucous membrane. The lesions of lips and oral mucosa were more frequent in HCV than in the non-HCV group&mdash;e.g., erosion (13.5% vs. 1%), cracks in the mouth corners (42.7% vs. 0%), changes in the oral mucosa surface (89.6% vs. 3.0%), hemorrhages (78.1% vs. 0%), etc. The pro-inflammatory IL-2 level was higher and anti-inflammatory IL-4 level was lower in HCV patients compared with those in the non-HCV group. Conclusions: Morphological changes developed in the microvasculature both worsen the tissue trophism and accelerate the healing with differentiation into coarse-fibrous connective tissue. Immunohistochemical findings indicated a decrease in local humoral immune response