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20PUBLIC HEALTH
Рыскулова Алма-Гуль Рахимовна - к.м.н. заведующая кафедрой Общественного здоровья и социальных наук, ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: r.alma@bk.ru , ORCID https://orcid.org/0000-0003-4768-4799.
Попова Татьяна Владимировна - д.м.н. профессор кафедры Общественного здоровья и социальных наук, ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: mse2008@yandex.kz, ORCID https://orcid.org/0000-0003-30 73-3881.
Имашева Баян Имашкызы - магистр здравоохранения, докторант 3 года обучения по специальности «Общественное здравоохранение», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: imasheva_bayan@nbox.ru, ORCID https:// orcid.org/0000-0003-2261-4428.
Абдуллаева Феруза Саллайдиновна - докторант 2 года обучения по специальности «Общественное здравоохранение», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: Do_little@mail.ru, ORCID https://orcid.org/0000-0002-8405-3630.
Мухалиев Ердан Ерланович - докторант 2 года обучения по специальности «Общественное здравоохранение», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, Email: erdandoctor@gmail.com, ORCID https://orcid.org/0000-0002-0996-1428.
Статья поступила: 08.08.2023.
Статья принята: 04.09.2023.
УДК: 614.446.33 DOI: 10.24412/1609-8692-2023-3-35-44
МРНТИ: 76.01.11.
EPIDEMIOLOGICAL MONITORING OF THE BRUCELLOSIS EPIDEMIC IN THE REPUBLIC OF KAZAKHSTAN OVER A FIVE YEAR PERIOD 2018-2022
*A. Raushan, M. Dosybaev, A. Ryskulova, M. Sarsenbaeva, S. Moldamyrza
LLP Kazakhstan's Medical University «KSPH», Almaty, Kazakhstan
Summary
The epidemiological situation with brucellosis in the Republic of Kazakhstan remains tense. It should be noted that high levels of the disease are noted in brucellosis-positive area, which should alert specialists in this sector. The rate of brucellosis detected for the first time in some region of the country remains stably high. The most frequent routes of brucellosis transmission in the country are the contact-domestic route.
Key words: epidemiology, monitoring, brucellosis, public health, control measures.
Introduction. Brucellosis is a zoonotic infection, a systemic infection that affects virtually all organs and is transmissible from human to human, from animal to animal, and from animal to human.
The causative agent is Brucella spp., a negative aerobic, DNA-containing coc-cobacillus that is an intracellular parasite of humans and animals and causes brucellosis [1].
In addition to the economic damage to livestock, brucellosis is known to pose a serious health risk to humans [2].
According to the World Health Organization (WHO), more than 500,000 cases of newly diagnosed brucellosis are reported each year in more than 170 countries, more than half of them in the Eastern Mediterranean and Middle East. In brucellosis-prone region, the actual incidence can be 10 to 25 times higher than officially reported. In brucellosis-endemic area, where brucellosis is a deep-rooted problem, the infection has global, far-reaching negative consequences for the health and economy of nations [3].
According to D.G. Ponomarenko, D.V. Rusanov, A.A. Khachaturov, O.I. Skudarev, O.V. Logvinenko et al. (2020), over 500,000 new cases of human brucellosis are registered annually in more than 170 countries [4].
This disease among animals is registered in 155 countries of the world, with the highest prevalence of brucellosis in countries of the Mediterranean, Asia Minor, South and SouthEast Asia, Africa, and Central and South America. The incidence of brucellosis in Central Asian countries is 10 times higher. Recorded human cases in Central Asia number 116 per million in Kazakhstan and 362 per million in Kyrgyzstan. Uzbekistan has 18 cases per 1 million people [5].
The incidence of brucellosis has increased in China in recent years. Nationwide surveillance data showed that the overall incidence of human brucellosis increased from 0.92/100,000 in 2004 to 4.2/100,000 in 2014 [6].
In the Russian Federation, the epidemic situation for brucellosis has been described as unfavourable over the past 10 years, with a declining trend in the incidence of the disease. Between 2011 and 2020, for the first time, 3508 human cases of brucellosis were registered. The complications of the epidemiological situation with this infection are due to epizootic failure among large and small cattle. According to data from the Ministry of Agriculture of Russia, during the period from 2010 to 2020 in the Russian Federation, 4283 unacceptable points on cattle brucellosis were registered, where 95979 sick animals were found, and 398 bru-
cellosis, where 15880 infected sheep and goats were found. Analysis of the incidence of disease in farm animals indicates the persistence of a long-term upward trend in epizootiological ill health for brucellosis in cattle in Russia [7]. Despite the preventive measures taken, the epizootic and epidemiological situation with brucellosis in humans and animals remains tense. A negative trend is that first-time human cases of brucellosis are detected in farms or settlements that are considered to be free of brucellosis in farm animals [8].
Increased migration of the population in the last two decades and insufficient veterinary and sanitary control over the import of animals from brucellosis-prone countries, including neighboring CIS states (Commonwealth of Independent States), can currently complicate the already tense epizootic and epidemic situation of brucellosis [9].
It should be noted that brucellosis is a major zoonotic infection in the Republic of Kazakhstan [10]. This requires strict control of epidemiological and epizootiological measures in relation to this infection.
At the same time, in brucellosis, as in other anthroponotic infections, the interaction of all three parts of the epidemic process - the source of infection, the routes of transmission of the pathogen, and the susceptible organism - means that humans usually get brucellosis by coming into direct contact with the waste and blood of infected animals and eating non-disinfected animal products (milk, meat, and products made from these) [3].
In humans, brucellosis manifests itself as both an acute and chronic infection. Almost all human infections come from infected animals. Infection through food occurs, as mentioned above, when milk, cheese, and other dairy products from brucellosis-infected animals are not sufficiently cooked. It is also possible to become infected through the consumption of meat and meat products. Direct transmission occurs by contact with infected animals or their excretions, with penetration of the bacteria through cuts or scratches on the skin. Aerogenic transmission of the brucellosis pathogen is possible through inhalation or contact with the conjunctiva of the eyes [11].
It should be noted that brucellosis remains one of the leading zoonotic infections in terms of economic damage [12, 13], which requires the close attention of regulatory authorities.
Unfortunately, current control measures are not yielding the expected results. Brucellosis continues to be reported each year in the country and reoccurs in previously sanitized area. The detection of diseased animals and un-infected points not only does not decrease but also tends to increase. At the same time, it is necessary to clarify the reasons for prolonged unhealthiness and the reasons for the emergence of new cases of the disease in unhealthy farms [14, 15].
In this regard, it's crucial to examine the epidemiological situation of brucellosis on a national scale, identify region with high levels of cases for additional targeted epidemiological and epizootic measures in area not affected by this infection, as well as the most typical routes and transmission factors for more thorough planning of measures to break transmission.
The aim of this study was to analyze the epidemiological situation of brucellosis for the period 2018-2022. Republic of Kazakhstan.
Methods:
1.«Retrospective method: analysis of monitoring data on zootic and epidemiological surveillance of brucellosis in the Republic of Kazakhstan» for the period 2018 - 2022, according to the Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring, Almaty.
2.Statistical method: mathematical processing of the obtained data.
Results. According to epidemiological data from the Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring in Almaty, in Almaty for 2018, a total of 998 people in the Republic of Kazakhstan were detected for the first time with brucellosis, including 130 (13.0 %) children and 66 (6.6 %) adolescents; no cases of occupational brucellosis were registered for the analyzed period; brucellosis among rural residents: 768 (77.0 %) cases; and 934 (93.6 %) cases were registered in safe settlements. The distribution of cases in epidemiologically favourable region of the country at 934 (93.6 %) should alert epidemi-
ologists, which is an indicator of insufficient work on brucellosis prevention.
Analysis of the distribution of the disease by region of the Republic of Kazakhstan (RK) showed the following picture: Turkestan region: 235 (23.5 %) cases of brucellosis, Zhambyl region - 200 (20.0 %) cases, Almaty region - 139 (13.9 %), Kyzylorda region - 87 (8.7 %), Astana - 82 (8.2 %), Atyrau region 65 (6.5 %) 51 (5,11 %) in West Kazakhstan region (WKR), 48 (4,8 %) in megalopolis as Shym-kent, 21 (2,1 %) in Aktobe region, 16 (1,6 %) in Kostanay region, 13 (1,3 %) in Pavlodar and Karaganda region, 10 (1,0 %) in Mangistau region, and 10 (1,0 %) in Almaty city. Almaty region: 8 (0.8 %) cases; Akmola region: 6 (0.6 %) cases; North Kazakhstan region (NKR): 2 (0.2 %) cases each.
The results of brucellosis monitoring for 2019 showed that a total of 842 cases of brucellosis were detected for the first time in the Republic of Kazakhstan, including 106 (2.1 %) cases of brucellosis in children - 46 (6.7), in teenagers, and no cases of occupational brucellosis. 671 (79.7 %) cases of brucellosis among rural residents and 780 (92.6 %) cases in safe settlements were registered.
The distribution of brucellosis cases by region in Kazakhstan in 2019 was as follows: Zhambyl region: 184 (21.8 %), Turkestan region: 163 (19.3 %), Almaty region: 138 (16.4 %), Kyzylorda region: 73 (8.6 %), East Kazakhstan Region: 66 (7.8 %), 48 (5.7 %) in West Kazakhstan Region: 28 (3.3 %) cases of brucellosis were reported in Kazakhstan's megalopolis like Shymkent, 27 (3.2 %) in Almaty, 24 (2.8 %) in Atyrau region, and 8% in Pavlodar and Karaganda region - 18 (2.1 %).
Further, as the analysis of the epidemio-logical situation for 2020 has shown, in total, there were 504 cases of brucellosis in RK in children (83,6 %), teenagers (25,3 %), and professional brucellosis cases were not registered. For the analyzed period, brucellosis in the rural population was 406 (80,6 %) cases, and patients in prosperous settlements were 459 (91,1 %) cases.
In 2020, the following region had the highest incidence of brucellosis: Zhambyl region had 127 (25,1 %) cases, Almaty region
had 86 (17 %), Turkestan region had 91 (18 %), Kyzylorda region had 30 (5,9 %), East Kazakhstan Region had 50 (9,9 %), West Kazakhstan Region had 38 (7,5 %), Pavlodar region had 16 (3,1 %), Shymkent city had 17 (3,3 %), Aktobe region had 20 (3,9 %).
The epidemiological situation on brucellosis for 2021 was as follows: in particular, in Kazakhstan, 448 cases of brucellosis were revealed for the first time; 61 (1,1 %) cases of brucellosis were registered among children; 29 (3,5 %) cases of brucellosis were among teenagers; 0 cases of professional diseases; 349 (77,9 %) among the rural population; and 415 (92,6 %) among patients in healthy localities.
The epidemiological situation of brucellosis in region of Kazakhstan in 2021 was as follows: In Zhambyl - 98 (21,8 %), Almaty - 81 (18 %), Turkestan - 76 (16,9 %), Kyzylorda -41 (9,1 %), East Kazakhstan region - 38 (8,4 %), West Kazakhstan region - 37 (8,2 %), Pavlodar region - 32 (7,1 %), Shymkent city - 11 (2,4 %), Aktobe region - 10 (2,2 %), Akmo-la, Kostanay region and Almaty city - 5 (1, In Karaganda and Mangistau region, there were 3 (0.6 %) cases of brucellosis; in Atyrau region,
there were 2 (0.4 %) cases; in Astana city, 1 (0.2 %) case of brucellosis was registered; and in North Kazakhstan, no cases of brucellosis were found during the analyzed period.
And at last, for 2022, the brucellosis ep-idemiological situation on RK was as follows: in particular, on RK, 681 cases of brucellosis were revealed for the first time: in children, 83 (1,5 %) cases; among teenagers, 50 (6,1 %) cases; cases of professional diseases, 0; in the rural population, 3546 (77,9 %); and patients in favourable settlements, 635 (93,2 %).
The epidemiological situation of brucellosis in region of Kazakhstan for 2022 was as follows: Turkestan region: 105 (15,4 %), Zhambyl region: 103 (15,1 %), Zhetysu region: 81 (11,9 %), Almaty region: 63 (9,2 %), West Kazakhstan Region: 48 (7 %), slightly less in Kyzylorda region: 46 (6.8 %), Abay region: 41 (6 %), Pavlodar region: 37 (5.4 %), Karaganda region: 24 (3.5 %).
According to the findings of the monitoring of the epidemiological situation in the RK for the years 2018 - 2022, brucellosis cases increased in 2022 after tending to decline from 2018 to 2021 (Figure 1).
Figure 1. Evolution of first-time brucellosis over a five-year period in Kazakhstan.
The monitoring of first-time brucellosis has shown a 1.5-fold increase in the incidence of brucellosis over five years compared to 2021.
The alarming fact is that the population from the favorable settlements had brucellosis more often during the five years analyzed (Figure 2).
Figure 2. Rate offirst-time detection of brucellosis in the safe region of Kazakhstan for the period 2018 - 2022.
During the analyzed period, as can be seen in Figure 2, the incidence of brucellosis in the population from favorable region was very high, and the rate increased from 91.6 % to 93.2 %.
Under natural conditions, infection of humans with brucellosis is known to occur through consumption of infected products, direct contact with diseased animals, or inhalation of contaminated aerosols [16].
Humans usually get infected with brucellosis pathogens through direct contact with the waste, blood, or raw materials of brucellosis-infected animals; consumption of brucellosis-contaminated uninfected animal products (milk, dairy, and meat products); and inhalation of air and dust mixtures containing brucellosis-contaminated pieces of fur, manure, soil, etc.
The two leading routes of brucellosis transmission are contact and alimentary. Humans become infected as a result of close contact with sick animals (when caring for livestock, providing veterinary care, slaughtering
and dressing such animals, and eating meat and dairy products contaminated with brucellosis without sufficient heat treatment) [7].
In order to identify the most frequent pathways by which the brucellosis pathogen enters the body of the population of our country, we analyzed the routes of transmission of this disease for the period 2018 - 2021.
Particularly in 2018, the routes of brucellosis transmission in Kazakhstan were as follows: contact: domestic route of transmission in 740 (74.1 %) cases; alimentary route of transmission in 140 (14.0 %) cases; mixed route of transmission in 43 (4.3 %) cases; and in 75 (7.5 %) cases, the route of transmission was not established. The route of transmission analysis for 2019 was as follows: contact-domestic route in 588 (69.8 %) cases; the alimentary route of brucellosis was transmitted in 146 (17.4 %) mixed routes in 50 (5.9 %) cases; and in 58 (6.95 %) cases, route cases, the transmission was not detected.
In the year 2020 analyzed, the transmission routes of this disease were as follows:
Contact-domestic route of transmission in 361 (71.6 %) cases, alimentary route in 79 (15.7 %) cases, mixed route of transmission brucellosis was transmitted in 26 (5.2 %) cases, and in 38 (7.55 %) cases no route of transmission was identified.
Further, we studied the routes of transmission of brucellosis in 2021, which were as follows: contact-domestic route of transmis-
sion: 311 (69.4 %) cases; alimentary route: 81 (18.1 %) cases; mixed route of transmission: 6 (1.3 %); and in 50 (11.25 %) cases, no route of transmission was established.
In 2022, the transmission routes of brucellosis were as follows: contact-household transmission in 448 (65.8 %) cases; dietary transmission in 136 (20 %) cases; mixed transmission in 18 (2.6 %) cases; and in 79 (11.6 %) cases, the route of transmission was not established (Figure 3).
Figure 3. Routes of brucellosis transmission in Kazakhstan for the period 2019-2022.
The analysis of five years of monitoring (Figure 3) of brucellosis transmission routes in Kazakhstan revealed that contact-domestic, alimentary, and mixed routes were the main ones. At the same time, it should be noted that most often brucellosis pathogen enters human body by contact-domestic way, which was the most in 2018 (74,1 %), in dynamics had a tendency to decrease and was 65,80 % of cases in 2022, i.e., for the analysed period, most often contact-domestic way of transmission decreased by 1,1 times. The majority of brucellosis infections are contracted through the contact route, which is supported by our data. An important role in brucellosis foci is played by the gastrointestinal route of infection, which is associated with the consumption of unpasteurized milk, sour cream, and cheese, as well as meat
from sick animals that has not been adequately cooked [18].
According to several authors, cow's milk and dairy products cause infection in people who are not professionally involved in animal husbandry [19].
In this regard, it should be noted that the alimentary route also has a place in the epidemiological linkage of this disease and tends to increase over the period 2018 - 2022, by 1.4 times.
According to domestic scientists Orak-bay L. Zh., Cherepanova L. Yu., and Deniso-va T.G. (2015), the formation of foci of infection in brucellosis-free territories is due to the cross-border movement of farm animals in the absence of proper veterinary and customs control, while there is also an increase in the number of brucellosis patients with an unspecified
source of infection [20]. In addition, it should be noted that, according to monitoring, cases with an unspecified route of transmission were identified, which increased significantly by 1.5 times in 2022 compared to 2018.
Discussion. The results of epidemiological monitoring of brucellosis in the Republic of Kazakhstan for the period 2018 - 2022 showed a decrease in 2018 - 2021, with a further increase in the incidence of the disease by 2022. The most important routes of brucellosis transmission in the Republic of Kazakhstan are contact-residential, alimentary, and mixed modes of transmission. It should be noted that most often the brucellosis pathogen enters the human body through the contact-domestic route. The alarming fact is that the population of the wealthy settlements fell ill with brucellosis more often during the five years analysed. High
rates of brucellosis cases among the region of Kazakhstan were observed in the southern region of the country, such as the Zhambyl and Turkestan region.
Conclusion. Monitoring of the epidemiological situation of brucellosis in the Republic of Kazakhstan in 2018-2022 revealed the following important points:
1. An increase in the incidence of brucellosis by 1.5 times since 2021.
2. High rates of brucellosis were noted in the Zhambyl and Turkestan region of RK.
3. The incidence of brucellosis in favourable region of Kazakhstan was very high and this epidemiologic indicator increased from 91.6 % to 93.2 % for the analysed period.
4. According to our findings, the brucellosis pathogen is more commonly ingested through contact and household contact.
ЦАЗАЦСТАН РЕСПУБЛИКАСЫНДАГЫ БРУЦЕЛЛЕЗДЩ БЕС ЖЫЛДЬЩ 2018-2022 АРАЛЫГЫНДАГЫ ЭПИДЕМИОЛОГИЯЛЫЩ МОНИТОРИНГ НЭТИЖЕЛЕР1
*А. Раушан, М. Досыбаев, А. Рыскулова, М. Сарсенбаева, С. Молдамырза
«^ДСЖМ» ^азакстанды; медициналы; университет ЖШС, Алматы, ^азакстан
Тушндеме
^азакстан Республикасында бруцеллез ауруы бойынша эпидемиологиялы; ахуал ауыр жагдайда калып отыр. Аурудыц жогары децгей бруцеллез бойынша каушаз аудандарда екендшн ерекше атап ету керек, бул жагдай осы сала мамандарыныц назарында болуы тшс. Ел тещрепнде бруцеллездщ ец жиi таралган жолдарына карым-катынас турмысты; жол жатады.
ТYШндi свздер: эпидемиология, мониторинг, бруцеллез, денсаулыц сацтау, куресу шаралары.
РЕЗУЛЬТАТЫ ЭПИДЕМИОЛОГИЧЕСКОГО МОНИТОРИНГА ЗА БРУЦЕЛЛЕЗОМ В РЕСПУБЛИКЕ КАЗАХСТАН ЗА ПЯТИЛЕТНИЙ ПЕРИОД
2018-2022 ГГ.
*А. Раушан, М. Досыбаев, А. Рыскулова, М. Сарсенбаева, С. Молдамырза
ТОО Казахстанский Медицинский Университет «ВШОЗ», Алматы, Казахстан
Аннотация
Эпидемиологическая ситуация по бруцеллезу в Республике Казахстан остается напряженной. Следует отметить, высокий уровень заболевания отмечаются в благополучных районах по бруцеллезу, что должно насторожить специалистов в этой отрасли. По данным, впервые выявленного бруцеллеза в некоторых регионах страны остается стабильно высокими. Наиболее частыми путями передачи бруцеллеза по стране является контактно-бытовой путь.
Ключевые слова: эпидемиология, мониторинг, бруцеллез, общественное здравоохранение, меры борьбы.
References:
1.Дудоладова Т.С. Диагностика бруцеллеза методом ПЦР с детекцией в РЕАЛ-ТИМЕ // Современные научные подходы к решению проблемы бруцеллеза. Сборник материалов конференции. Омск. - 2020 г. - с.51-54. {Dudoladova T.S. Diagnostika brucelleza metodom PCR s detekciej v REAL-TIME // Sovremennye nauchnye podhody k resheniju problemy brucelleza. Sbornik materialov konferencii. Omsk. - 2020g. - s.51-54}.
2.Куликова Е.В., Гордиенко Л.Н., Новиков А.Н. Сравнительная оценка биологических свойств Бруцелла Рангифери, находящихся в типичной (С-) и измененной Л - форме // Современные научные подходы к решению проблемы бруцеллеза. Сборник материалов конференции. Омск. 2020 г. с. 54 - 61. {Kulikova E.V., Gordienko L.N., Novikov A.N. Srav-nitel'naja ocenka biologicheskih svojstv Brucella Rangiferi, nahodjashhihsja v tipichnoj (S-) i izmenennoj L -forme // Sovremennye nauchnye podhody k resheniju problemy brucelleza. Sbornik materialov konferencii. Omsk. 2020g. s.54-61}.
3.Бруцеллёз. Современное состояние проблемы. Под редакцией академика РАН Г.Г. Онищенко, член-корр. РАН А.Н. Куличенко. -2019. - с.336. {Brucelljoz. Sovremennoe sosto-janie problemy. Pod redakciej akademika RAN G.G. Onishhenko, chlen-korr. RANA.N. Kulichen-ko. -2019.-s.336}.
4.Пономаренко Д.Г., Русанова Д.В., Хачатурова А.А., Скударева О.И., Логвиненко О.В. и др. Анализ эпидемической и эпизоотической ситуации по бруцеллёзу в мире в 2019 г. и прогноз на 2020г. В Российской Федерации // Проблемы особо опасных инфекций.-2020.- №2. - С. 48-56. https://doi.org/10.21055/0370-1069-2020-2-48-56). {Ponomarenko D.G., Rusanova D.V., Hachaturova A.A., Skudareva O.I., Logvinenko O.V. i dr. Analiz jepidemicheskoj i jepizooticheskoj situacii po brucelljozu v mire v 2019g. i prognoz na 2020g. VRossijskoj Feder-acii //Problemy osobo opasnyh infekcij.- 2020.- №2. - S. 48-56. https://doi.org/10.21055/0370-1069-2020-2-48-56)}.
5.Ярмухамедова Н.А., Джураева К.С., Самибаева У.Х., Бахриева З.Д., Шодиева Д.А. Клинико-эпидемиологические аспекты нейробруцеллеза по данным областной инфекционной клинической больницы города Самарканда // Вестник науки и оборазования. №18(96). Часть 2. 2020. С.72-76. {Jarmuhamedova N.A., Dzhuraeva K.S., Samibaeva U.H., Bahrieva Z.D., Shodieva D.A. Kliniko-jepidemiologicheskie aspekty nejrobrucelleza po dannym oblastnoj infekcionnoj klinicheskoj bol'nicy goroda Samarkanda // Vestnik nauki i oborazovanija. №18(96). Chast'2. 2020. S.72-76}.
6.Wenhui Jiwang Chen, Qian Li, Lisheng Jiang, Yanxin Huang, Yinhua Lan, Yongguo Li. Epidemiological characteristics, clinical manifestations and laboratory findings in 850 patients with brucellosis in Heilongjiang Province, China https://bmcinfectdis.biomedcentral.com/arti-cles/10.1186/s12879-019-4081-5.
7.Коршенко В.А., Щипелева И.А., Кретенчук О.Ф., Марковская Е.И. Прошлое, настоящее, перспективы и проблемы совершенствования специфической профилактики бруцеллёза. Медицинский вестник Юга России. 2021; 12 (3): 12-21. https://doi. org/10.21886/2219-8075-2021-12-3-12-21). {Korshenko V.A., Shhipeleva I.A., Kretenchuk O.F., Markovskaja E.I. Proshloe, nastojashhee, perspektivy i problemy sovershenstvovanija specifich-eskoj profilaktiki brucelljoza. Medicinskij vestnik Juga Rossii. 2021;12(3):12-21. https://doi. org/10.21886/2219-8075-2021-12-3-12-21)}.
8.Уразаева А.Б., Бекенов Ж.Е., Уразаева С.Т. Эпидемический потенциал бруцеллеза в Актюбинской области. Медицине (Алматы), №11 (197), - 2018 г. с.71-77. {Urazaeva A.B., Bekenov Zh.E., Urazaeva S.T. Jepidemicheskijpotencial brucelleza v Aktjubinskoj oblasti. Medicine (Almaty), №11 (197), - 2018 g. s.71-77}.
9. Желудков М.М. Автореферат д.м.н. на тему: Бруцеллез в России: современная
эпидемиология лабораторная диагностика. Москва - 2009. - С.55. {Zheludkov M.M. Avtoreferat d.m.n. na temu: Brucellez v Rossii: sovremennaja jepidemiologija laboratornaja diagnostika. Moskva -2009. - S.55.}.
10.Epidemiology of Brucellosis and Genetic Diversity of Brucella abortus in Kazakhstan Article in PLoS ONE December 2016 https://doi.org/10.1371/journal.pone.0167496.
11.Айкимбаев А.М. Особо опасные и эмерджентные инфекции. - Алматы, 2017. -376 с. {Ajkimbaev A.M. Osobo opasnye i jemerdzhentnye infekcii. - Almaty, 2017. - 376 s.}.
12.Санникова И.В., Махиня О.В., Малеев В.В., Дейнека Д.А., Голубь О.Г., Ковальчук И.В., Лямкин Г.И. Бруцеллез в Ставропольском крае: результаты 15-летнего наблюдения эпидемиологических и клинических особенностей. Терапевтический архив. 2015; 87 (11): 11 - 17. {Sannikova I.V., Mahinja O.V., Maleev V.V., Dejneka D.A., Golub' O.G., Koval'chuk I.V., Ljamkin G.I. Brucellez v Stavropol'skom krae: rezul'taty 15-letnego nabljudenijajepide-miologicheskih i klinicheskih osobennostej. Terapevticheskij arhiv. 2015; 87 (11): 11 -17}.
13.Sannikova I.V., Makhinya O.V., Maleev V.V., Deineka D.A., Golub O.G., Koval'chuk I.V., Lyamkin G.I. Brucellosis in the Stavropol Territory: Results of 15-year follow-up of epidemiological and clinical features. Terapevticheskii Arkhiv. 2015; 87 (11): 11-17. (In Russian). https://doi.org/10.17116/terarkh2015871111-17.
14.Ашетов И.К., Ешмухаметов А.Е., Ашетова И.Н. Мониторинг и анализ эпизоотической ситуации по бруцеллезу КРС в РК за 2007-2012 годы. - Алматы. - 2016. С. 79 - 86. {Ashetov I.K., Eshmuhametov A.E., Ashetova I.N. Monitoring i analiz jepizootich-eskoj situacii po brucellezu KRS v RK za 2007-2012 gody. - Almaty. - 2016. S. 79-86}.
15.Иванов Н.П., Тургенбаев К.А. Инфекционные болезни животных. Общая эпизоотология. — Алматы: Нур-Принт, 2013. — Т. 1. С. 87. {Ivanov N.P., Turgenbaev K.A. Infekcionnye bolezni zhivotnyh. Obshhaja jepizootologija. — Almaty: Nur-Print, 2013. — T. 1. S. 87}. '
16.В.Ю. Охапкина, Н.В. Пяткова, Д.Л. Павлов, А.А. Суслопаров. Эпидемическая опасность бруцеллеза в современных условиях. Эпидемиология и Вакцинопрофилактика.
- № 3 (88) 2016, с. 11-22. {V.Ju. Ohapkina, N.V. Pjatkova, D.L. Pavlov, A.A. Susloparov. Jep-idemicheskaja opasnost' brucelleza v sovremennyh uslovijah. Jepidemiologija i Vakcinopro-filaktikaY. - № 3 (88) 2016, s. 11-22}.
17.Н.И. Брико, Г.Г. Онищенко, В.И. Покровский. Руководство по эпидемиологии инфекционных болезней: в 2 т. Т. 1 // Москва: Медицинское информационное агентство, 2019. С. 880. {N.I. Briko, G.G. Onishhenko, V.I. Pokrovskij. Rukovodstvopo jepidemiologii in-fekcionnyh boleznej: v 2 t. T. 1 //Moskva: Medicinskoe informacionnoe agentstvo, 2019. S .880}.
18.Corbel M. J. Food and Agriculture Organization of the United Nations, World Health Organization & World Organisation for Animal Health. // Brucellosis in humans and animals. World Health Organization. (2006) - 89. https://apps.who.int/iris/handle/10665/43597.
19.С.И. Ерениев, В.Г. Демченко, О.В. Плотникова, А.Д. Сафонов, Н.В. Рудаков, Л.Н. Гордиенко, О.Г. Пономарева, А.Е. Тархов. Санитарно-гигиенические и клинико-иммунологические аспекты профессионального бруцеллеза в современных условиях. Коллективная монография. Под общей редакцией профессора В.Г. Демченко, профессора А.Д. Сафонова, профессора Н.В. Рудакова и профессора С.И. Ерениева. ТЕССА Санкт-Петербург - 2014. - С.220. {S.I. Ereniev, V.G. Demchenko, O.V. Plotnikova, A.D. Safonov, N.V. Rudakov, L.N. Gordienko, O.G. Ponomareva, A.E. Tarhov. Sanitarno-gigienicheskie i kliniko-immunologicheskie aspekty professional'nogo brucelleza v sovremennyh uslovijah. Kollektivnaja monografija. Pod obshhej redakciej professora V.G. Demchenko, professora A.D. Safonova, professora N.V. Rudakova iprofessora S.I. Erenieva. TESSA Sankt-Peterburg
- 2014. - S.220}.
«MEDICINE, SCIENCE AND EDUCATION», № 3, 2023
20. Оракбай Л.Ж., Черепанова Л.Ю., Денисова Т.Г. Современные аспекты эпидемического процесса бруцеллёза. Современные проблемы науки и образования. 2015 - С. 90. https://science-education.ru/ru/article/view?id=22737. {Orakbai L.Zh., Cherepanova L.Ju., Denisova T.G. Sovremennye aspekty jepidemicheskogoprocessa brucelljoza. Sovremennyeproble-my nauki i obrazovanija. 2015 - S. 90. https://science-education.ru/ru/article/view?id=22 737}.
Конфликт интересов. Все авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье.
Вклад авторов. Все авторы внесли равноправный вклад в разработку концепции, выполнение и обработку результатов, и написание статьи. Заявляем, что данный материал ранее не публиковался и не находится на рассмотрении в других издательствах.
Финансирование. Отсутствует.
Сведения об авторах
Корреспондирующий автор. Раушан Айбек Царацулулы - магистрант по специальности «Медико-профилактическое дело», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: raushan.aibek@mail.ru, ORCID https:// orcid.org/0000-0001-7104-4412.
Досыбаев Мурат Кырыкбаевич - к.м.н., доцент кафедры «Эпидемиологии, доказательной медицины и биостатистики», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: m.dossybayev@ksph.kz, ORCID https://orcid.org/0000-0002-8909-5944.
Рыскулова Алма-Гуль Рахимовна - к.м.н., доцент, заведующая кафедрой Общественного здоровья и социальных наук, ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: r.alma@bk.ru, ORCID https://orcid.org/0000-0003-4768-4799.
Сарсенбаева Майра Заманбековна - к.м.н., старший преподаватель кафедры, «Общественного здоровья и социальных наук», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: maira.sarsenbaeva@mail.ru, ORCID https://orcid.org/0000-0002-0921-2224.
Молдамырза Санжар Сейтцалиулы - магистрант по специальности «Общественное здравоохранение», ТОО Казахстанский медицинский университет «ВШОЗ», Казахстан, Алматы, E-mail: sanjar.moldamyrza.1980@mail.ru, ORCID https://orcid.org/0009-0006-6744-6228.
Статья поступила: 10.05.2023.
Статья принята: 21.08.2023.
