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DYNAMICS OF THE DISEASES PREVALENCE AND MORBIDITY RATE IN THE REPUBLIC OF KAZAKHSTAN
Tochiyeva Zorina, Al-Farabi Kazakh National University, Almaty, Kazakhstan
E-mail: zarina.zt@mail.ru
Abstract. This article presents the results of the analysis of the dynamics of the frequency of diseases and the incidence rate in the Republic of Kazakhstan in the period 2018-2020. Using regression analysis, the main trends of diseases/morbidity in the Republic as a whole (including by regions) and separately in male and female populations were studied. 9
Key words: dynamics, diseases incidence, morbidity, Kazakhstan.
Introduction
In modern conditions, during the current pandemic, the study of the rate characterizing population health is extremely important [1]. The main characteristics reflecting the population health level include: the disease incidence and the morbidity rate and prevalence. Knowledge of the dynamics of disease incidence is the basis for adequate planning in the medical industry (including individual services), and knowledge of medical statistics allow to conduct a comparative analysis of morbidity levels in stratified groups [2].
A significant number of studies on the assessment of the population health of the Kazakhstani people are presented in the modern literature, however, in most cases, the authors have studied individual nosologies or groups of diseases [3, 4].
The purpose of this research was to study the dynamics of all disease cases incidence and mobility rate in the Republic of Kazakhstan (population study).
Materials and methods
The main information source was the official data on the number of disease cases (Form No. 12, "Report on the number of the registered diseases of patients living in the service area of a medical organization and the patient population under regular medical check-up") in the Republic of Kazakhstan. The period of research is 2018-2020.
To calculate the medical and statistical indicators, the data from the Statistics Agency of the Republic of Kazakhstan on the number of the catchment population were used.
The dynamics were evaluated by determining trends (ascending or descending).
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To assess the statistical significance of the trends obtained, the method of linear regression with one regressor was used. The results of the regression analysis were presented in the form of non-standardized coefficients (b) and the level of statistical significance (p).
Results
Table 1 presents data on the number of disease cases of the population of the Republic of Kazakhstan, taking into account nosological entities (gender blind).
In total, in the Republic (gender blind) 19200601 disease cases (including primary - 10449708 cases) were registered in 2018, 19278994 disease cases (including primary - 10148022 cases) in 2019, and 19339562 disease cases (including primary - 10083041 cases) in 2020. The trend of increasing the number of all disease cases detected over the period 2018-2020 is statistically significant (regression statistics b=69480.5, p=0.047), and the trend of a decrease in the number of diseases detected for the first time during this period is not statistically reliable (regression statistics b=-183333.5, p=0.227). It should be noted that in 2020, in reference to 2018, with a general downward trend, the number of primary cases of: 1) infectious and parasitic diseases (by 51219 cases), 2) endocrine diseases, nutritional and metabolic disorders (by 12794 cases), 3) diseases of the circulatory system (by 63659 cases), 4) diseases of the musculoskeletal system and connective tissue (by 4367 cases), 5) diseases classified in the category "R00-R99" (by 3485 cases) and 6) diseases, due to the consequences of injuries, poisoning and other effects of external causes (by 171 cases), as well as, the number of diseases of the category U07.1-U07.2 (80922 cases) has increased (absolute increase).
In the male population in dynamics (in 2018-2020), there is a significant increase in the total quantity of diseases (regression statistics b=106747.5, p=0.003) and a statistically insignificant decrease in the number of primary disease cases (regression statistics b=-5836.5, p=0.899). In 2020 compared to 2018 the number of primary cases of diseases: 1) infectious and parasitic diseases (by 26,545 cases), 2) endocrine diseases, nutritional and metabolic disorders (by 13092 cases), 3) diseases of the circulatory system (by 29,719 cases), 4) diseases of the respiratory system (by 2282 cases), 4) diseases of the musculoskeletal system and connective tissue (by 5625 cases), 5) diseases of the genitourinary system (by 5687 cases), 6) diseases classified in the category "R00-R99" (by 1140 cases), 7) diseases due to the consequences of injuries, poisoning and other effects of external causes (by 155 cases), as well as the number of diseases of the category U07.1-U07.2 (by 38185 cases), has increased (absolute increase).
In the female population in the period 2018-2020, there is a tendency to decrease the total number of diseases and a decrease in the number of primary cases of diseases, however, insignificant: regression statistics b=-37267.0, p=0.094 and b=-177497.0, p=0.114, respectively. The number of primary cases of: 1) infectious and parasitic diseases (by 24674 cases), 2) diseases of the circulatory system (by 33940 cases), 3) diseases of the digestive system (by 2915 cases), 4) diseases classified in the category "R00-R99" (by 2345 cases), as well as the number of diseases in the category U07.1-U07.2 (42737 cases), has increased in dynamics.
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Table 1
The number of disease cases of the population, taking into account nosological entities (on the Republic of Kazakhstan, gender blind).
Name of disease categories (ICD code X revision) Registered diseases in the report year
2018 2019 2020
Total For the first time Total For the first time Total For the first time
Total (A00-T98 + U07.1-U07.2) 19200601 10449708 1927899 4 10148022 1933956 2 10083041
Infectious and parasitic diseases (A00-B99) 387785 243968 385948 240764 480305 295187
Neoplasms (C00-D48) 411525 136696 431927 130222 429088 121873
Diseases of blood, hematopoietic organs and certain immune mechanism-related disorders (D50-D89) 647028 325499 630098 311290 610210 266259
Endocrine diseases, nutritional and metabolic disorders (E00-E90) 855448 174813 900954 179564 973699 187607
Mental and behavioral disorders (F00-F09; F20-F99) 219155 10028 233181 9781 223914 8459
Substance-related mental and behavioral disorders (F10-F19) 161079 19263 173672 15955 140237 14202
Diseases of the nervous system (G00-G99) 813873 352176 815797 345893 832134 343631
Diseases of the eye and adnexa (H00-H59) 1098895 449600 1066511 432647 974987 386661
Diseases of the ear and mastoid process (H60-H95) 414538 290468 412873 276498 399987 241525
Diseases of the circulatory system (I00-I99) 2996985 503581 3144167 520547 3338449 567240
Diseases of the respiratory system (J00-J99) 5188805 4445077 5197975 4303263 5213483 4333052
Diseases of the digestive system (K00-K93) 1548314 789349 1539654 780841 1469593 781130
Diseases of the skin and subcutaneous tissue (L00-L99) 683911 531558 686164 514583 668281 487173
Diseases of the musculoskeletal system and connective tissue (M00-M99) 986339 386975 981403 388512 987077 391342
Diseases of the genitourinary system (N00-N99) 1613856 817311 1564264 762561 1430251 664430
Complications of pregnancy, childbirth and the postpartum period (000075, 081-083, 084.1-9, 085-099) 338055 251500 283246 216446 275871 221513
Certain conditions originating in the perinatal period (P00-P96) 67203 67169 66184 66124 63281 63281
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) 180229 80181 176008 78303 176870 72771
Symptoms, signs and abnormalities (R00-R99) 38982 30834 44236 33577 50459 34319
Injuries and poisonings (S00-T88) 528412 528412 524564 524564 505043 505043
Consequences of injuries, poisonings and other effects of external causes (T90-T98) 20184 15250 20168 16087 15421 15421
Coronaviral infection (U07.1-U07.2) 0 0 0 0 80922 80922
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Table 2 presents the data on the diseases incidence (absolute number and per 100 thousand population) of the population by regions of the Republic of Kazakhstan (gender blind and separately for male and female populations).
Table 2
Diseases incidence of the population by all nosological entities (by regions of the Republic of Kazakhstan, gender blind)
Administrative divisions of RK Registered diseases in the report year
2018 2019 2020
total per 100 thousand for the first time per 100 thousand total per 100 thousand for the first time per 100 thousand total per 100 thousand for the first time per 100 thousand
Total RK 19200601 103608,6 10449708 56387,8 19278994 101915,3 10148022 53645,9 19339562 100811,0 10083041 52559,7
Akmola region 788530 101765,8 369344 47666,6 818473 104418,1 360202 45953,4 835437 105903,3 392214 49718,6
Aktobe region 715871 82891,2 363765 42120,6 743168 84444,7 358119 40692,3 732108 81836,7 353164 39477,5
Almaty region 2088804 103583,4 1374683 68170,3 2091486 101529,8 1381663 67071,9 2102054 100079,6 1183506 56347,2
Almaty city 2405394 123869,9 1316265 67783,3 2345547 115999,2 1256075 62119,3 2367874 115259,2 1273892 62008,3
Atyrau region 404729 64382,5 203649 32395,6 406936 63401,1 202727 31585,1 448102 68566,6 241244 36914,1
East Kazakhstan region 1707818 122304,8 928338 66482,6 1642002 117180,1 845637 60348,2 1608890 114835,4 784291 55979,2
Zhambyl region 1152954 103342,0 721808 64697,4 1158076 102423,3 700472 61951,6 1213216 105555,5 721776 62797,9
West Kazakhstan region 552231 82009,3 278995 41432,3 567649 83421,0 281240 41330,7 586779 85424,5 286284 41677,8
Karaganda region 1342206 94570,0 614298 43282,6 1361664 95069,7 587416 41012,7 1356557 94461,9 622663 43358,2
Kostanai region 822849 94789,2 454230 52325,6 835183 95973,4 449664 51672,3 857025 100739,4 452607 53201,9
Kyzylorda region 756794 98917,1 452019 59081,3 770117 98923,7 454434 58373,3 691807 87012,4 428262 53864,9
Mangystau region 547347 80282,8 333470 48912,1 588789 83138,7 315586 44561,6 557334 76019,3 288587 39362,7
Nursultan city 1381249 125790,2 755311 68786,1 1444462 124173,6 766893 65926,2 1487886 123349,1 822051 68149,9
Pavlodar region 1019864 129675,3 549155 69824,9 1006633 126734,8 526566 66294,5 977847 122631,3 516171 64732,7
North Kazakhstan region 635852 109505,6 300009 51667,2 631676 108877,7 293975 50670,5 653324 113252,7 316727 54904,1
Turkestan region 1720768 90596,4 795026 41857,2 1654179 85464,4 728049 37615,2 1698706 86023,1 778145 39405,6
Shymkent city 1157341 113229,5 639343 62550,7 1212954 115071,9 639304 60650,2 1164616 107370,3 621457 57294,5
The medical and statistical indicator of prevalence and morbidity in the Republic (gender blind) in 2018 amounted to 103608,6%0 and 56387,8%00, in 2019 -101915,3%00 and 53645,9%00, and in 2020 - 100811,0%00 and 52559,7%00. The revealed decreasing trend of indicators is insignificant (regression statistics b=-1398,8, p=0,077 and b=-1914,1, p=0,156, respectively). In all regions of the country, the prevalence rate in dynamics has not changed significantly (at the level of p>0,05). The incidence rate significantly decreased only in Aktobe region (regression statistics b=-1321,6, p=0,030) and Mangystau region (regression statistics b=-4774,7, p=0,033). The absolute increase in prevalence and morbidity in the period 2018-2020 is observed in such regions as: Akmola, Atyrau, West Kazakhstan, Kostanay and North Kazakhstan; in other regions, there was a decrease in these indicators, except for Zhambyl region, where there was an increase in the prevalence rate and a decrease in
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the incidence rate and Karaganda region, where there was a decrease in the prevalence rate and an increase in the incidence rate.
In the male population, the prevalence and incidence rate is without statistically significant dynamics (at the level of p>0.05). The increase in these indicators was observed in Atyrau region, West Kazakhstan region, Kostanay region, North Kazakhstan region and the city of Nursultan. In Akmola region, Almaty region and Zhambyl region, there was an increase in the prevalence rate and a decrease in the incidence rate, and in Karaganda region - a decrease in the prevalence rate and an increase in the incidence rate.
In the female Kazakhstani population, there was a significant decreasing trend of the prevalence rate (regression statistics b=-2238,1, p=0,044) and an insignificant decrease in morbidity (at the level of p>0,05). The increase in the studied indicators is observed in the Akmola region, Atyrau region, Kostanay region and North Kazakhstan region. In such regions as: Aktobe, Zhambyl, West Kazakhstan and Karaganda, there was an increase in the prevalence rate and a decrease in the incidence rate.
Conclusion
In general, in Kazakhstan in the period 2018-2020, there is an increasing trend of the number of all disease cases and an insignificant decrease in the number of diseases detected for the first time. The prevalence and incidence rate in dynamics has changed slightly. At the same time, the trends of morbidity (general and primary) in stratified groups (by gender and by regions of the Republic) are not the same.
References:
1. Perkhov Vladimir Ivanovich, Korkhmazov Valeriy Tamazovich, Khodakova Olga Vladimirovna. the impact of the Covid-19 pandemic on the population morbidity // Current problems of health care and medical statistics. - 2022. - No. 4 [Электронный ресурс]. - Режим доступа: https://cyberleninka.ru/article/n/vliyanie-pandemii-covid-19-na-pokazateli-zabolevaemosti-naseleniya (reference date: 05.01.2023).
2. L.A. Brushlinskaya. The importance of morbidity statistics in assessing the health of the population // Hygiene and sanitation. - 1968. - No. 5 [Электронный ресурс]. - Режим доступа: https://cyberleninka.ru/article/n/znachenie-statistiki-zabolevaemosti-v-otsenke-zdorovya-naseleniya (reference date: 05.01.2023).
3. Mira Turbekova, Vitaliy Kamkhen, Maulen Malgazhdarov. Characteristics of deaths from coronavirus infection in Kazakhstan // AMJ. - 2022. - No. 2 [Электронный ресурс]. - Режим доступа: https://cyberleninka.ru/article/n/ harakteristika-smertelnyh-ishodov-ot-koronavirusnoy-infektsii-v-kazahstane (reference date: 05.01.2023).
4. Kamkhen V.B., Reznik V.L. Gender differences in the number of cases of malignant neoplasms in Kazakhstan // Journal. Medicine (Medicine Almaty). - 2015. - № 6 (156). - PP. 21-24 [Электронный ресурс]. - Режим доступа: http:// www.medzdrav.kz/images/magazine/medecine/2015/2015-6/M_06-15_21-24.pdf (reference date: 05.01.2023).
