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ТУИ1Н
Е.Н. ИСЛАМОВ, Н.О. ЦОЙ, А.И. БАЕВ, М.Х. ЖYСIПFАЛИЕВА, А.А. ТАУБАЕВА, И.В. ВУЙКО, Г.М. ТОНКОНОГОВА, Ш.Г. АБДРАШИТОВ, О.Ю. ПАЛЕЙ, К.Т. АНАПИЯЕВА
АК.ЫЛЫ КЫЗМЕТ К0РСЕТЕТ1Н ЭИЕЛДЕРДЩ ЭЛЕУМЕТТ1К ТЕГ1, СЕКСУАЛДЫ М1НЕЗ-К¥ЛКЫ
Теривенерологиялык Fылыми-зерттеу институты, Алматы, Казахстан
Зерттеудщ максаты. Коммерциялык секс-ж¥мыскерлершщ (КСЖ) элеуметпк мiнездемесiн жэне ЖЖЖА наукасты^ын, олардын ЖЖЖА туралы бiлiктiлiгi мен алдын алу MYMK^iriHiH eлшемдерiн оку. К,¥ралдар мен эдiстер. Зерттеу БYкiлэлемдiк ЖИТС-пен KYресу kyhi KарсанындаFы USAID «АИВ жэне туберкулез диалогы» жобасы аясында ЖYргiзiлдi. Бакылауда 34 секс ж¥мыскерi болды. Интервьюлендiру жэне клиникалык-лабораториялык зерттеулер ЖYргiзiлдi. Зерттеулердiн кортындысы: 1. КСЖ кeпшiлiгi - сырттан келгендер (94,1%), жаFдайсыз жан¥ядан шыккандар (52,9%); 2. КСЖ кeпшiлiгi - ЖЖЖА кауттштнен хабарсыздар, сактандырылмаFан секске барып жыныс катынасы ЖYKпаларын ЖYKтырып алFандар (38,2%). Т¥жырым. 34 секс ж¥мыскершен анонимдi сауалнама аркылы алынFан мэлiметтер келтiрiлген. КСЖ кeпшiлiгi - сырттан келгендер, жаFдайсыз жан¥ядан шыккандар, ЖЖЖА кауiптiлiгiнен хабарсыздар, сактандырылмаFан секске барып, жыныс катынасы ж¥кпаларын ж¥ктырып алFандар.
Негiзгi свздер: жыныс жолымен ж^татын аурулар, коммерциялык секс ж^мыскерлер'1, интервьюленген, клиникалык-лабораториялык зерттеу.
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I
SUMMARY
Ye.N. ISLAMOV, N.O. TSOY, A.I. BAYEV, M.Kh. DZHUSUPGALIYEVA, A.A. TAUBAEVA, I.V. VUIKO, G.M. TONKONOGOVA, Sh.G. ABDRASHITOV, O.Y. PALEY, K.T. ANAPIYAEVA
SOCIAL ORIGIN, SEXUAL BEHAVIOR IN WOMEN -COMMERCIAL SEX WORKERS
Research Institute for Skin and Venereal Diseases, Almaty, Kazakhstan
The goal of the research was to study the social characteristics of commercial sex workers (CSW) and STI incidence, awareness of STIs and possible preventive measures. Materials and Methods: The research was conducted during the period of World AIDS Day in the framework of USAID ''Dialogue on HIV and TB." We observed 34 sex workers, with whom the interviews, clinical and laboratory examination were carried out. Results: 1. The majority of CSW are the migrants from rural areas (94.1%), from disadvantaged families (52.9%); 2. The majority of CSW do not have a good representation of the dangers of sexually transmitted infections, allow the unprotected sex and become infected with sexually transmitted diseases. Conclusions: The article presents the data obtained in the anonymous survey of 34 sex workers. It is shown that most of CSW visitors from disadvantaged families do not have a proper understanding of the dangers of sexually transmitted infections, allow the unprotected sex and become infected with sexually transmitted diseases.
Key words: sexually transmitted infections, commercial sex workers, interviewing, clinical and laboratory examination.
UDC: 616-036.2-616-002.6
Ye.N. ISLAMOV, N.O. TSOY, A.S. USKENBAYEVA, A.A. TAUBAYEVA
EPIDEMIOLOGICAL SITUATION OF SYPHILIS INCIDENCE IN THE REPUBLIC OF KAZAKHSTAN
Research Institute for Skin and Venereal Diseases, Almaty, Kazakhstan
Islamov Ye.N. - candidate of Medical Sciences Tsoy N.O.-PhD.
Uskenbayeva A.S. - candidate of Medical Sciences Taubayeva A.A. - head of Orgmethod department, phone: 8 (727) 397-42-14, E-mail: orgmetod nikvi@mail.ru.
Abstract. This article analyzes the epidemiology of syphilis incidence in the Republic of Kazakhstan, based on the official statistics and reporting for 2013-2014, taking into account the structure of the infection and age and gender characteristics. Results of the analysis show the expediency of the amplification of anti-epidemic measures and ensure better coordination between dermatovenereological and obstetric-gynecological services.
Key words:sexually transmitted infections, syphilis, morbidity, congenital syphilis, pregnant women.
Introduction. During the last decades particular concern cause sexually transmitted infections in public health due to the fact that they are widely used, with a tendency of growth [1-4].
In the Republic of Kazakhstan, since the 90s, in the period of economic transformation, the epidemiological situation of STI continues to be unfavorable. According to Kazakh researchers, acuteness of the problem of sexually transmitted infections in the country is due to the epidemic growth of syphilis and other "new generation" sexually
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transmitted infections (trichomoniasis, chlamydia, urea-micoplasma infections, bacterial vaginosis, anogenital infection) [5-8].
The reasons for the wide spread of STIs has not yet been elucidated and in many respects remain controversial. According to the World Health Organization (WHO), every year about 500 million people suffer from one of four STIs: chlamydia, gonorrhea, syphilis and trichomoniasis [9]. Account being taken mainly only cases with complications and long-term consequences of STIs (infection of the upper genital tract, tubal infertility, chronic pain in the pelvic area, stillbirth, miscarriage, abortion, congenital infection, chronic recurrent genital symptoms, etc.). The number of asymptomatic STIs is unknown and underestimated, and therefore, these cases serve as a reservoir contributing to transmission of these infections to sexual partners and newborns. In addition, the presence of genital infection increases the risk of acquiring and transmirtng of HIV infection [10-12].
Research objective. study and assess the epidemiological situation of syphilis in the territory of the Republic of Kazakhstan in 2014.
Materials and Methods. We have carried out a comprehensive study - a detailed analysis of the incidence of syphilis and its forms across the regions, taking into account age and gender characteristics. Materials for the study were the official statistical data and reporting in the 20132014 period: form #9, obtained during the analysis of negotiability of the population in medical dermatovenereological organizations. Data on the level of syphilis were expressed in absolute values and per 100 thousand population.
Results of research. According to obtained data in 2014 syphilis holds the fifth place in the structure of STI with medium republican parameter of 31.2 per 100 000 population (absolute number of reported cases of syphilis - 5444). Decreasing in the incidence of syphilis is marked in comparison with 2013 year from 35.8 to 31.2 per 100 thousand people, or
Figure 1. The incidence of syphilis across the regions, 2014
In terms of regions of the RoK (Figure 1): in 2014 the highest incidence rates of syphilis in excess of the similar republican indicator were registered in Kyzylorda
Table 1. Structure of syphilis
region (90.1 per 100 thousand population,
Forms 2013 2014
congenital 17 12
I 451 582
II 1880 1561
latent 3686 3257
The high incidence of syphilis falls on
in 2013 - 94.9, decline by 5.1%), in Astana
city (49.5, in 2013 - 7Z1, decline by ^^ the sexually mature, working age patients and Atyrau region (44.6, compared to from 18 to 44 years. While the share of 5°.6 in 2013, a decline of n.<}%); and the men is 53.9% of the total number of cases.
lowest rates were recorded in Mangistau The incidence of syphilis in children
region (18.5), Aktobe region (20.9) and aged 0 to 14 years in the period 2013-2014
South Kazakhstan region (21.3).
remained practically unchanged (down Thus the increase of the incidence 4.8%). Among children aged 15-17 years in of syphilis level is marked in Mangistau 2014, there is a decrease in the incidence
incidence rates.
I
region (18.5, in 2013 - 6.8, an increase of syphilis by 25.4%. of 187.1%), as weN as a slight increase m 2014, 522 pregnant women
observed in Aktobe (3.6%) and North infected with syphilis (rate per 100
Kazakhstan region (1.5%). In aN other thousand women of reproductive age
regions, there is a decrease of syphilis 11.4, which is 9.6% of all cases of syphilis)
registered in the territory of the Republic,
In 2014, 64.7% of newly diagnosed in the same period in 2013 identified 527
cases of syphilis reported in the urban patients (rate per 100 thousand women of
p°pulati°n (intensive indicator - 36.6 per reproductive age 11.5, the proportion of
100 thousand popula«on), against 35.3% all infected - 8.7%), a decline of 0.9%.
- in rural population (intensive indicator -
Increase in the incidence of syphilis
24.6 per 100 thousand popula«on). among pregnant is noted in Mangistau
According to data of Table 1, region (31 cases compared with 2013 year
the number of pa«ents with syphilis I - 4 cases), Pavlodar and Aktobe regions by
increased during the repor«ng period by 40%, 38.9%, Almaty city and Almaty region
29.0%, but the main share in the structure at 25.3%, Karaganda region - 15.2% and
of syphilis con«nues to account for its Atyrau region of 9.7%. Decrease is noted in latent forms - 60.2%.
I
Table 2. Age and sex characteristics of syphilis
Period The absolute number 0-14 years 15-17 years 18-44 years total
m f m f m f m f
2013 6065 17 25 21 42 2667 2573 3149 2916
2014 5444 19 21 12 35 2904 2453 2935 2509
Kyzyl-Orda region of 100%, about 20-25% Spite of considerable efforts made to thesis ... Dis. Doctor of Medical Sciences.
in other regions. determine the simple measures that can - Bishkek, 2010.-46 p.
For the described period in the reduce the extent of infection, behavior 5. Keshileva, Z.B. Analysis of
territory of the Republic there were 12 change remains challenging. Scientific trends and ways to control the incidence
cases of congenital syphilis, in comparison studies have revealed the necessity of syphilis in Kazakhstan // Mater. I Int.
with indicators of 2013 - 17 cases (decline orientation to carefully defined groups of Conference on Primary Prevention STIs. -
by 29.4%). The largest number of cases the population, the extensive consultation Almaty, 1998. - P.49-52.
of congenital syphilis detected in Almaty and involvement in the development, 6. Shakiev, G.J. Sexually transmitted
region - 4 cases, Atyrau region - 3 cases, implementation and evaluation. diseases in the Republic of Kazakhstan:
Kyzylorda region - 2 cases, Akmola, Conclusion. Analysis of the main Author's thesis ... Dis. Candidate of Medical
Karaganda, South Kazakhstan regions - 1 indicators of reproductive health - syphilis - Sciences. - Almaty, 2004, 29 p.
case. shows that, despite the general downward 7. Saparbekov, M.K. Epidemiology,
Particular attention should be paid trend in the index in recent years prevention of HIV infection and STIs. -
to the ways of detection of new cases throughout the Republic, epidemiological Almaty, 2006. - 174 p.
of syphilis in the reporting period. For situation remains quite tense due to the 8. Eshimov, A.E. Epidemiological
example, among all surveyed contacts regular identification of new cases of aspects of the study of the prevalence
(5799) 1133 patients were revealed congenital syphilis and the high numbers of of STIs in the Republic of Kazakhstan,
by dermatovenereologists (19.5%), by registered syphilis in pregnant women. All modern trends in prevention / A.E.
obstetrician-gynecologists - 452 (7.8%), by of the above undoubtedly requires efforts Eshimov, M.K. Saparbekov // Ukrainian
urology - 64 (1.1%), in hospitals therapeutic in carrying out anti-epidemic measures Journal of Dermatology, Venereology and
profile - 509 (8.8%), and screening of in this direction and full coordination cosmetology. - Kiev, 2008. - №2 - P.91-92.
donors - 94 (5.2%), with periodic and other between dermatovenereological and 9. Sexually Transmitted Infections
preventive examinations - 621 (10.7%), by obstetric and gynecological services of the (STIs). Newsletter#110. http://www.who.
obsLemc and gynecological services oi Lhe other specialists - 697 (12.0%). Republic of Kazakhstan. int/mediacentre/factsheets/fs110/ru/
Discussion. STI have a profound Reference list: 10. CDC. Sexually transmitted
impact on the sexual and reproductive 1. Keshileva, Z.B. Sexually disease surveillance, 2007. U.S.
health throughout the world and enters transmitted infections and skin diseases in Department of Health and Human
in the five main categories of diseases the Republic of Kazakhstan / Z.B. Keshileva, Services, CDC Atlanta, GA , pp: 192.
for which adults seek medical care. V.A. Kozlovsky. - NIKVI. Almaty, 2000.-96 p. 11. Chandeying V., Skov S., Duramad
Syphilis during pregnancy annually is 2. Skripkin, J.K. Sexually P. et al., 2000. The prevalence of urethral
responsible for approximately 305,000 transmitted infections / J.K. Skripkin, G.K. infections amongst asymptomatic young
deaths of the fetus and the newborn, Sharapova, G.D. Tarasova. - M., 2001.- men in Hat Yai, southern Thailand. Int. J.
and the birth of 215,000 children at risk 361p. STD AIDS, 11(6): 402-405. of death due to prematurity, low birth 3. Adaskevich, V.P. Sexually 12. Manavi K., Young H., Clutterbuck
weight, or congenital disease [9]. Despite transmitted infections: Guidelines for D., 2003. Sensitivity of microscopy for
a downward trend in the incidence of doctors. - Nizhny Novgorod, 2004.- 414 p. the rapid diagnosis of gonorrhea in men
syphilis in the Republic, the numbers 4. Orazbekova, B.T. Scientific and women and the role of gonorrhea
are still quite high compared to rates and methodological approaches in the serovars. Int. J. STD AIDS, 14(6): 390-394.
in Europe (3.3 per 100,000 population) surveillance system and STI prevention
and the US (3.1 per 100,000 population). (for example, the Osh region): Author's
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TYMIH РЕЗЮМЕ
Е.Н. ИСЛАМОВ, Н.О. ЦОЙ, А.С. УСКЕНБАЕВА, А.А. ТАУБАЕВА Е.Н. ИСЛАМОВ, Н.О. ЦОЙ, А.С. УСКЕНБАЕВА, А.А. ТАУБАЕВА
КАЗАХСТАН РЕСПУБЛИКАСЫНДА МЕРЕЗБЕН ЭПИДЕМИОЛОГИЧЕСКАЯ СИТУАЦИЯ ЗАБОЛЕВАЕМОСТИ
НАУКАСТАНУДЬЩ ЭПИДЕМИОЛОГИЯЛЫК ЖАГДАЙЫ СИФИЛИСОМ В РЕСПУБЛИКЕ КАЗАХСТАН
Тернвенерологиялык Fылыми-зерттеу институты, Научно-исследовательский кожно-венерологический
Алматы, Казахстан институт, Алматы, Казахстан
Зерттеудщ максаты. Казахстан Республикасы Целью исследования явилось изучение и оценка
аймаFындаFы 2014 жылы мерезбен наукастанудын эпидемиологической ситуации по заболеваемости
эпидемиологиялык жаFдайын оку жэне баFалау. Зерттеудiн сифилисом на территории Республики Казахстан в 2014 году.
материалы мен эдiсi болып, тернвенерологиялык баFыттаFы Материалами и методами для изучения использованы данные
медициналык ¥ЙымдарFа каралуы бойынша талдаулардан официальной статистики и отчетности в период 2013-2014 гг.,
алынFан 2013-2014 жж. кезеншщ ресми статистикасы мен форма №9, полученные при анализе обращаемости населения
есеп мэлiметтерi, №9 Yлгi колданылды. Зерттеулердщ в медицинские организации дерматовенерологического
корытындысы. Жалпы ЖЖЖА к¥рылымында мерез 5-орында профиля. Результаты исследования: в общей структуре ИППП
(100 000 а.ш. - 31,2); Аурудын денгейiне карай 100 мын сифилис занимает 5 место (31,2 на 100 тыс. населения). По
адамFа шакканда, 1-орынды Кызылорда облысы - 90,1; уровню заболеваемости 1 место занимает Кызылординская
2-орынды Астана каласы - 49,5; 3-орынды Атырау облысы - область - 90,1 на 100 тыс. населения, 2 - г. Астана - 49,5 и 3 -
44,6 к¥райды. Жанадан айкындалFан мерездщ шшде 64,7% Атырауская область - 44,6. 64,7% вновь выявленных случаев
- кала T¥рFындары. Мерездщ к¥рылымында негiзгi бeлiгi - сифилиса зарегистрированы у городских жителей. Основная
яFни, 60,2% онын жасырын TYрiне келедК 2014 жылы мерездi доля в структуре сифилиса приходится на его скрытые формы
Ж¥KTырFан 522 ЖYKтi эйел тiркелген немесе барлык мерезбен - 60,2%. В 2014 году зарегистрировано 522 беременных
ауырFандардын 9,6%-ын к¥райды. Т¥жырым. Казакстан женщин, зараженных сифилисом, что составляет 9,6% от всех
Республикасы аймаFындаFы мерездщ талдауы эпидемияFа заболевших сифилисом. Выводы: анализ заболеваемости
карсы iс-шараларды, терi-венерологиялык жэне акушерлт- сифилисом на территории Республики показал необходимость
гинекологиялык кызметтердiн Yйлестiгiн зорайту керектiгiн усиления противоэпидемиологических мероприятий и
керсетп. координации дерматовенерологической и акушерско-
Негiзгi свздер: жыныс жолымен ж^татын аурулар, гинекологической службами.
мерез, туа б'1ткен мерез, ЖYктi эйелдер. Ключевые слова: инфекции, передающиеся половым
путем, сифилис, заболеваемость, врожденный сифилис, беременные женщины.
УДК:616-073.756.8
Н.М. КАДЫРБЕКОВ
ПРИМЕНЕНИЕ МУЛЬТИСПИРАЛЬНОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ ПРИ ЭРЕКТИЛЬНОЙ ДИСФУНКЦИИ
Научный центр урологии имени Б.У. Джарбусынова, Алматы, Казахстан
Кадырбеков Н.М. - к.м.н., заведующий отделением лучевой диагностики, раб.тел.: 8(727)3378501, e-mail: bioloQ-aiQul@mail.ru
Аннотация. Цель исследования - оценка эффективности кавернозографии в диагностике эректильной дисфункции.
Исследование было проведено на 50 мужчинах с ЭД. Трехмерная компьютерная кавернозография применялась для подтверждения диагноза веноокклюзивной ЭД, кроме того, определяли состояния кавернозных тел и визуализацию венозных сосудов, по которым, преимущественно, происходит сброс крови из кавернозных тел.
Кавернозография позволяет выявить у пациентов, страдающих эректильной дисфункцией структурные изменения в пещеристой ткани и тяжесть венозной
Актуальность. За последнее время в практику были внедрены многие методы хирургического лечения эректильной дисфункции (ЭД), но правильный выбор метода лечения и его эффективность зависят от точной диагностики. Анатомия кавернозных тел может быть изучена при помощи кавернозографии, которая выполняется путем наполнения кавернозных тел рентгеноконтрастным веществом [1,2,3].
