Iodine deficiency in the Russian Federation

Epidemiological surveys for iodine deficiency (ID) were made in 30 regions of Russia in 1992 to 1999. A total of 40,999 individuals aged 7 to 17 years were examined. The advent of new assessments of the thyroid and new indicators of iodine deficiency has changed approaches to epidemiological surveys. The WHO standards for estimating the prevalence and severity of ID have been introduced into Russian practice. In Central Russia, the lowest (median 30-58 micrograms/l) iodine concentrations were found in rural dwellers; in more urbanized areas (cities, towns) the median was 50-78 micrograms/l. ID was more pronounced in the regions of East Russia where it was predominantly moderate (median 30-52 micrograms/l). In some areas, ID was severe (median 16-20 micrograms/l). As the severity of ID increases, the incidence of such conditions, as goiter, hypothyroidism, endemic cretinism is on the rise. Mild to moderate goiter endemia prevailed in Central Russia. The manifestations of goiter endemia were more pronounced in rural children (18-30%) than in urban ones (8-14%). East Russia was marked by moderate to severe goiter endemia (8-14%): the incidence of goiter ranged from 17 to 40%. There were only sporadic cases of goiter in some areas of the Sakhalin Region. In the Moscow and Voronezh Regions and the Republic of Kalmykia there were areas showing a high goiter incidence which did not correspond to the level of ID. An epidemiological analysis has indicated that dietary and water iodine intake is decreased in most regions of Russia. The actual dietary iodine intake was 40-80 micrograms/day, i.e. 2-3 times of the recommended allowance (150 micrograms). The Endocrinology Research Center has tested different models of preventive and therapeutical measures for eliminating iodine deficiency-caused diseases by using iodinated foodstuffs (salt, bread, butter) ad iodine medicaments.     

Formation of medical-demographic processes in the Russian Federation

The authors analyze the specific features of the present medical and demographic situation in the Russian Federation, the naturally research regularities determining the evolution and development direction of population processes in the 20th century by using the populational advance to the demographic transition to the present-day reproduction as an example. Socioeconomic factors affecting the demographic structure of society are considered.     

The Policy-Driven HIV Epidemic Among Opioid Users in the Russian Federation

Purpose of Review

To explore the consequences of policies implemented in the Russian Federation in response to syndemic of HIV-1 and opioid use disorder and compare the responses to the concomitant syndemic in rural America.

Recent Findings

The syndemic spread has not been reduced by policies implemented by the Russian government, which continues to underfund harm reduction efforts to reduce HIV transmission, refuses to approve evidence-based opioid agonist treatments for opioid use disorder, and relies on criminal justice and abstinence approaches to control illicit opioids. When effective measures have been undertaken locally, the lessons learned have not been transferred to other parts of the country and local programs have been allowed to wither.

Summary

As in many parts of rural America, Russia has experienced intertwined epidemics of opioid misuse and HIV-1 that continue to expand. The expansion has been facilitated by adoption of policies that run contrary to medical and public health evidence.

     

Health problems of working-age population in the Russian Federation

The paper deals with health problems of working-age population in the Russian Federation. According to foreign and domestic experts reduction of the able-bodied population and its fraction in the general population will be accompanied by ageing of labour force in the nearest two decades. Despite the growth of life expectancy in 2006-2007 demonstrated by disability, mortality and life expectancy indices for the age group of interest, its health status is considered to be critical. Mathematical simulation of mortality rates allowed for the assessment of potential years of life lost (PYLL) from leading causes of death among active working population. The data obtained provide a basis for the elaboration of medical and social programs aimed at increasing life expectancy. The most essential role in current negative tendencies in the health of active working population belongs to the deterioration of work conditions and safety at industrial enterprises coupled to low efficiency of occupational health prevention system accounting for the significantly reduced accessibility of health services. Restoration of occupational health system in Russia is of crucial importance. Experts of the Institute of Occupational Health have elaborated a draft National Action Plan designed to improve health protection of labour force in this country; its implementation would help to solve demographic problems and increase the amount and quality of labour force.     

General practitioners and family doctors in the Russian Federation.

This paper looks at the emergence in Russia of a strategy for delivering primary health care which differs radically from the specialist-based system of the former Soviet Union. Drawing on Russian language sources, the paper outlines previous training arrangements, the limited role of 'sector' doctors and the reasons for official endorsement of general practice during the years of perestroika. It reports that the Health Ministry asked all the country's regions to make a gradual transition to general practice in 1992, and that legislation made the choice of family doctor a universal right in 1993. The conclusion refers to factors which are likely to determine whether that right will become a reality.     

Tick-borne encephalitis in the Russian Federation: state-of-the-art and prevention policy

The last quarter of the 20th century in the Russian Federation was marked by an unprecedented increase in the incidence of tick-borne encephalitis (TBE) with its peaks in 1996 and 1999 when as high as 10,000 cases of the disease were notified. Its highest incidence was recorded in the Regions of the Urals and Siberia. As many as 70-80% of the persons who felt ill were urban dwellers who had been infected mainly in the anthropurgic foci occurring in abundance in the environs of cities and towns. It was found that the area of TBE had been expanded and virus-infected ticks had actively penetrated into the urban parks and small public gardens. There were as many as 70 TBE-endemic regions. As of now, it has been ascertained that TBE foci are generally combined with other infections transmitted by Ixodes ticks and caused by viruses, bacteria, rickettsia and protozoa. This result is the occurrence of mixed infections, which requires new approaches to their diagnosis, treatment, and prevention. The prevention of TBE is conventionally based on vaccination of high-risk groups comprising mainly "forest" occupations. Under the present conditions, the strategy of TBE control should be radically revised towards mass vaccination of the population living in the highly endemic areas, which will drastically reduced morbidity in the country.     

Postmortem service in the Russian Federation (state-of-the-art and trends)

According to the order of the Ministry of Health and Social Development, Professor O. D. Mishnev is appointed principal pathologist of the Ministry. The principle pathologists of federal districts are Professor I. A. Kazantseva (Central Federal District); Prof. N. M. Anichkov, Corresponding Member of the Russian Academy of Medical Sciences (North-Western Federal District); Prof. I. S. Derizhanova (Southern Federal District), Prof. T. A. Fedorina (Volga Federal District), Prof. V. L. Kovalenko, Corresponding Member of the Russian Academy of Medical Sciences (Urals Federal District); Prof. L. M. Nepomnyashchikh (Siberian Federal District), and Prof. Yu. V. Kaminsky (Far-Eastern Federal District). The above specialists and the principal pathologists of the Health Departments of Moscow and St. Petersburg Prof. O. V. Zairatyants and Prof. M. G. Rybakova make up a working group whose objective is to develop standards of postmortem studies, to coordinate, and to analyze the activities of postmortem services of the country. The role of principal pathologists of the bodies (ministries, departments, committees) of health care of federal districts, republics, territories, and regions is essential. It is necessary to set up a federal organizational-and-methodical center for postmortem studies under the Ministry of Health and Social Development. The chief results of the activities of postmortem services of Russia and federal districts over 6 years (2000-2005) are presented. The shortcomings and trends of postmortem services of the country are outlined.     

Atmospheric air pollution and population mortality in Russian Federation regions

Regularly published national reports on population health in Russian Federation, based on the results of statistic analyses and the data from hygienic and epidemiological studies, demonstrate associations between exposure to hazardous environmental factors and population morbidity. Research into correlations between exposure to such factors and population health status using extensive databases, makes it possible to obtain statistically significant results and put forward hypotheses for epidemiological studies. The aim of this research was to study the levels and dynamics of population mortality, and atmospheric air condition, as well as correlations between them in regional centers of Russian Federation. The study covers the period from 1985 through 1998.