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The Central Asian Journal of Global Health to Increase Scientific Productivity
Get PDFThe WHO Collaborating Center at the University of Pittsburgh, USA partnering with Nazarbayev University, developed the Central Asian Journal of Global Health (CAJGH, cajgh.pitt.edu) in order to increase scientific productivity in Kazakhstan and Central Asia. Scientists in this region often have difficulty publishing in upper tier English language scientific journals due to language barriers, high publication fees, and a lack of access to mentoring services. CAJGH seeks to help scientists overcome these challenges by providing peer-reviewed publication free of change with English and research mentoring services available to selected authors.CAJGH began as a way to expand the Supercourse scientific network (www.pitt.edu/~super1) in the Central Asian region in order to rapidly disseminate educational materials. The network began with approximately 60 individuals in five Central Asian countries and has grown to over 1,300 in a few short years. The CAJGH website receives nearly 900 visits per month.The University of Pittsburgh\u27s “open access publishing system” was utilized to create CAJGH in 2012. There are two branches of the CAJGH editorial board: Astana (at the Center for Life Sciences, Nazarbayev University) and Pittsburgh (WHO Collaborating Center). Both are comprised of leading scientists and expert staff who work together throughout the review and publication process. Two complete issues have been published since 2012 and a third is now underway. Even though CAJGH is a new journal, the editorial board uses a rigorous review process; fewer than 50% of all submitted articles are forwarded to peer review or accepted for publication. Furthermore, in 2014, CAJGH will apply to be cross referenced in PubMed and Scopes.CAJGH is one of the first English language journals in the Central Asian region that reaches a large number of scientists. This journal fills a unique niche that will assist scientists in Kazakhstan and Central Asia publish their research findings and share their knowledge with others around the region and the world
Whole genome sequencing of M.tuberculosis in Kazakhstan: preliminary data
Get PDFBackground: Tuberculosis is a major public health problem which infects one third of the world’s population, resulting in more than two million deaths every year. The emergence of whole genome sequencing (WGS) technologies as a primary research tool has allowed for the detection of genetic diversity in Mycobacterium tuberculosis (MTB) with unprecedented resolution. WGS has been used to address a broad range of topics, including the dynamics of evolution, transmission, and treatment. To our knowledge, studies involving WGS of Kazakhstani strains of M. tuberculosis have not yet been performed.Aim: To perform whole genome sequencing of M. tuberculosis strains isolated in Kazakhstan and analyze sequence data (first experience and preliminary data).Results: In the present report, we announce the whole-genome sequences of the two clinical isolates of Mycobacterium tuberculosis, MTB-489 and MTB-476, isolated from the Almaty region. These strains were part of a repository that was created during our project “Creating prerequisites of personalized approach in the diagnosis and treatment of tuberculosis, based on whole genome-sequencing of M. tuberculosis”. Two strains were isolated from sputum samples of patients P1 and P2. Phenotypically, two isolates were drug-susceptible M. tuberculosis. Sequence data was compared with the publicly available data on M. tuberculosis laboratory strain H37Rv and others. The sequencing of the strains was performed on a Roche 454 GS FLX+ next-generation sequencing platform using a standard protocol for a shotgun genome library. The whole genome sequencing was performed for two M.tuberculosis isolates MTB-476 and MTB-489. 96 M bp with an average read length of 520 bp, approximately 21.8X coverage and 104.2 M bp with an average read length of 589 bp and approximately 23.7X coverage were generated for the MTB-476 and MTB-489, respectively. The genome of MTB-476 consists of 257 contigs, 4204 CDS, 46 tRNAs and 3 rRNAs. MTB-489 has 187 contigs, 4183 CDS, 45 tRNAs and 3rRNAs.Conclusion: The results of genome assembling have been submitted into NCBI GenBank and are available for public access under the accession numbers AZBA00000000 and AZAZ00000000. These genome assemblies can be useful for comparative genome analysis and for identification of novel SNPs and gene variants in genomes of M.tuberculosis
Distribution of Beijing Genotype Among Clinical Isolates of M. tuberculosis Circulating in Kazakhstan
Get PDFIntroduction. Methods of genotyping of M. tuberculosis play an important role in tuber?ulosis (TB) infection control. These techniques are used to detect or exclude laboratory errors, control recurrent cases, and determine ways of TB transmission. Today, there are more than 10 methods of genotyping; MIRU-VNTR is one of the most widely used methods in the world. In this study we aimed to estimate biological diversity of clinical isolates of M. tuberculosis from different regions of Kazakhstan based on MIRU-VNTR analysis.Materials and methods. MIRU-VNTR was used to genotype 134 clinical isolates of M. tuberculosis isolated from new cases and recurrent cases of TB from different regions of Kazakhstan. Amplification was done using 15 MIRU-VNTR loci. Determination of the number of tandem repeats in the corresponding locus was performed via Quantity One v.4.4.0 (BioRad, USA) software. H37Rv (NC_000962) reference strain was used as a positive control.Results. Phylogenic tree was built using www.miru-vntr.org web-resource based on the results of MIRU-VNTR analysis. Beijing family strains associated with drug resistance to antituberculosis drugs were prevalent among all isolates of M. tuberculosis circulating in Kazakhstan. Strains of the Beijing genotype were prevalent in both new cases (65%) and recurrent cases (89.4%) of tuberculosis. The second meaningful genotype that is spread in the territory of Kazakhstan is LAM, the frequency of distribution is 7.3% in new and 4.5% in recurrent cases. Other families of M. tuberculosis such as Ural, Haarlem, CAS, NEW-1, S were found in less than 4% of cases.Conclusion. Prevalence of Beijing family strains among all isolates of M. tuberculosis from different regions of Kazakhstan was shown. Strains of this family are prevalent among young people. This genotype is responsible for ongoing TB transmission in the present time. This genotype is more virulent; therefore, investigation of the epidemiology of the Beijing genotype plays crucial role in the monitoring of tuberculosis.
Frequency of NAT2 and GSTP1 polymorphisms in the Kazakh population
Get PDFIntroduction: Phase II xenobiotic biotransformation enzymes perform detoxification of hydrophilic and often toxic Phase I products by glutathionetransferase (GST), UDP-glucuronosyltransferase (UDF), N-acetyltransferase (NAT) families and other enzymes. GST protein family metabolizes a large number of electrophilic xenobiotics, including drugs, by conjugating them with glutathione. Arylamine-N-acetyltransferase (NAT) catalyzes the acetylation of the aromatic and heterocyclic amines.Materials and methods: The current study has assessed the frequencies of NAT2 and GSTP1 genes polymorphisms in 326 healthy individuals from different regions of Kazakhstan by using Real-Time PCR and direct sequencing methods.Results: Allele frequencies were derived for NAT2*5 (0.54) and GSTP1 (0.27). GSTP1 alleles were in Hardy – Weinberg equilibrium (p > 0.05), while NAT2*5 (p = 0.00) were not. The population differences between North, Northeast and South Kazakhstan regions were determined. Statistically significant differences in the frequency of genotypes were not found.Conclusion: Allelic polymorphisms of NAT2*5 and GSTP1 genes vary widely in different populations. Kazakh population was significantly different from Asian, Caucasoid, African-American and Hispanic ones by NAT2*5 and GSTP1 genes. Allelic variants of the NAT2*5 were detected with a low frequency in Asian populations. Allelic frequency in other world populations varies from 30 to 50%. The differences between Kazakh (0.54) and the world population were statistically significant (p < 0.05). The frequency of GSTP1 (rs1695) in the African American population is 42%. The frequency of GSTP1 in Asian populations varies from 11% to 23%, in Caucasoid populations it is about 30%. The differences between Kazakh population (0.27) and other populations selected from the literature were statistically significant (p < 0.05).The study of mutations in GSTP1 and NAT2 genes is necessary to assess the risk of the development of various diseases, such as cancer. Information on allelic polymorphisms also might be useful for personalized drug prescription for such drugs as cyclophosphamide, cisplatin, methotrexate, isoniazid, pyrazinamide, and rifampin
Pre-conception preparation at the antiphospholipid syndrome as way to improve reproductive health
Get PDFIntroduction: Reproductive health is characterized by the condition of the woman in association with the course of pregnancy and childbirth. In this case, the absence of disease plays a fundamental role. Unfortunately, conditions that can negatively impact reproductive health and cause deterioration of pregnancy and delivery outcomes are frequent in women of reproductive age. Antiphospholipid syndrome (APS) is one of the leading conditions that can negatively affect reproductive health and lead to various complications in pregnancy including fetal loss.Materials and methods: We assessed the effectiveness of pre-conception preparing, including traditional therapy of APS in conjunction with system enzyme therapy (SET) and plasmapheresis sessions. We conducted a study in two groups: women with APS and pre-conception preparing (n = 49) and the control group were women without pre-conception preparing (n = 46).Results: The effect of pre-conception preparing in women with APS was assessed by the course and outcome of pregnancy. The total number of women with complications of pregnancy were 39.1% lower in the study group compared to the control group. Risk of miscarriage in the basic group observed 68.7 % less frequently compared to the control group. The frequency of pre-eclampsia was 63.5 % less in the study group compared to the control group. We observed significantly lower rates of placental insufficiency in the study group and the difference in this parameter reached 65.2%. The risk of pre-term birth was 59.4 % lower in the study group compared to the control group.Conclusion: We concluded that pre-conception preparing in women with APS increases the possibility of physiological course pregnancy. Pre-conception preparing reduces the incidence of miscarriage, pre-term labor, and the development of pre-eclampsia, and placental insufficiency
A New Paradigm of Primary Health Care in Kazakhstan: Personalized, Community-based, Standardized, and Technology-driven
Get PDFThis paper discusses the need for change from Kazakhstan’s current disease-centric healthcare paradigm to a new primary health and wellness-centric health care paradigm, technology-driven and based on personal relationships within a social context. While many different papers have been published about the importance of prevention and primary health care, few have focused on healthcare transition in Kazakhstan or other countries in Central Asia. The WHO’s historic 1978 Alma-Ata Declaration signed in Kazakhstan promoted the centrality of primary care to the provision of effective, efficient, and equitable health services. Modern technologies such as the Internet, social media, and portable medical devices democratize medicine, providing great opportunities to rethink the Alma-Ata Declaration and reinvent primary health care on an entirely new platform that is knowledge-based and technology-assisted. The new paradigm suggested for the future development of health in Central Asian region emphasizes personal relationships and encourages sustainable solutions created by communities. This paper also introduces HealthCity, a new project in Kazakhstan aiming at introducing private, community-based and standardized primary healthcare that is driven by SmartHealth innovative technology
Erythrocytes as Carriers for Drugs and Contrast Agents
Get PDFErythrocytes, also known as Red Blood Cells (RBC), are typically used in transfusion medicine to replace lost blood in patients who underwent different kinds of medical treatments as well as those involved in accidents resulting in blood loss. In addition to these common uses, RBC are being used for a variety of new applications either as therapeutics or as diagnostics. Most of these novel approaches are made possible due to the peculiar properties of these cells. We have invented a technology that allows cells to be opened and resealed without affecting their main physiological characteristics with a minimal amount of patient blood. Uses of processed RBCs in biomedical engineering include work with drugs, biomedical compounds and/or nanomaterials. These constructs are a new armamentarium available to the physicians for the release of drugs in circulation, for targeting drugs to selected sites in the body, or for in vivo diagnostic procedures based on magnetic and/or optical methods. Autologous human RBC loaded with dexamethasone (EryDex), a common corticosteroid, have been used in the treatment of Cystic Fibrosis, Crohn’s Disease, and other severe inflammatory conditions. Benefits and safety of this technology have been documented in over 2,500 treatments. EryDel SpA is a company focused on developing and commercializing innovative therapies and diagnostics based on the use of autologous RBCs as agent carriers. More recently, EryDel SpA completed a Phase II Proof of Concept study in patients with Ataxia Telangiectasia (AT), a rare progressive neurological autosomal recessive disorder that leads to mortality in most patients at an early age, with significant benefit seen on primary and secondary end-points. EryDex treatment has received Orphan Drug Designation by EMA for the treatment of Cystic Fibrosis and both by EMA and FDA for the treatment of AT.The encapsulation of superparamagnetic nanoparticles within RBC has lead to the generation of new biomimetic constructs that now permits the use of these nanomaterials in vivo avoiding their rapid sequestration and their accumulation in unwanted districts (PCT WO 2008/003524 A3). Similarly, the encapsulation of infrared fluorescent agents into RBC gives opportunity to the measurement of vasomotion in the human retinal vasculature suggesting a possible correlation with retinal edema.In summary, the newly developed RBC-based drug delivery system is an innovative technology platform that could be used in a wide range of applications opening to unlimited new therapeutic approaches. Furthermore, the same system has been adapted to deliver contrasting agents within the body enabling the improvement of current fluorangiographic procedures and the imaging by Magnetic Resonance (MRI) and Magnetic Particle (MPI). EryDel S.p.A. has recently completed trials to bring EryDex treatment to the market and to implement the clinical applications of the RBC technology
Biopharmaceutical characteristics of autologous red blood cells ghosts containing cytokines and antibiotics
Get PDFIntroduction: Transport systems based on autologous red blood cells for targeted drug delivery can be considered as a promising approach in the treatment of surgical infections. Experimental studies have revealed the feasibility of targeted drug delivery by encapsulation of cytokines and antibiotics into autologous erythrocyte ghosts.Purpose: To study biopharmaceutical characteristics of autologous erythrocyte ghosts containing cytokines and antibiotics (pharmacocytes). Material and methods: The erythrocyte pharmacocytes were prepared by the hypotonic hemolysis method, or the use of human red blood cells. The association and dissociation indicators of rifampicin and cytokine substances with the erythrocyte ghosts were conducted using standard methods.Results: We have defined the following extracellular concentrations to be optimal for deposition of drug substances into pharmacocytes: for rifampicin – 10 000 ?/ml, erythropoietin - 1000 IU / ml, TNF-a - 5000 IU / ml, IL-1-? - 5000 U / ml, IFN-? - 10 000ME / ml, IL-2 - 50 000 IU / ml, angiogenin - 0.04 mg / ml. Two types of correlations of cytokines and pharmacocytes were identified. In this study, we found that 40-60 % of the erythropoietin, IFN- ? and angiogenin were bound to red blood cells ghosts, more than 10% of which were bound irreversibly. For TNF-a, IL-1-? and IL-2, the red blood cells ghosts were capable of binding and depositing within 10-20 % of the input extracellular concentration, and these bindings were almost completely reversible. The rifampicin was bound by red blood cells ghosts with 5 % efficiency and also completely reversibly.Conclusion: The study has shown the effectiveness of inclusion of the studied components, such as erythropoietin, IFN-? and angiogenin into the red blood cells ghosts, with significant efficiency (40-60 %). It presents the potential of using this system in targeted delivery of cytokines and antibiotics for treatment of surgical infections, thus facilitating the reduction in toxicity and adverse systemic effects of drugs and improving the treatment results
Individuality and temporal stability of the human gut microbiome
Get PDFIntroduction: The breakthrough of next generation sequencing-technologies has enabled large-scale studies of natural microbial communities and the 16S rRNA genes have been widely used as a phylogenetic marker to study community structure. However, major limitations of this approach are that neither strain-level resolution nor genomic context of microorganisms can be provided. This information, however, is crucial to answer fundamental questions about the temporal stability and distinctiveness of natural microbial communities.Material and methods: We developed a methodological framework for metagenomic single nucleotide polymorphism (SNP) variation analysis and applied it to publicly available data from 252 human fecal samples from 207 European and North American individuals. We further analyzed samples from 43 healthy subjects that were sampled at least twice over time intervals of up to one year and measured population similarities of dominant gut species.Results: We detected 10.3 million SNPs in 101 species, which nearly amounts to the number identified in more than 1,000 humans.Conclusion: The most striking result was that host-specific strains appear to be retained over long time periods. This indicates that individual-specific strains are not easily exchanged with the environment and furthermore, that an individuals appear to have a unique metagenomic genotype. This, in turn, is linked to implications for human gut physiology, such as the stability of antibiotic resistance potential
Screening of Gestational Diabetes and Hypertension Among Antenatal Women in Rural West India
Get PDFBackground: Hypertension and gestational diabetes are among the leading causes of maternal and perinatal mortality, especially in rural areas of developing countries with meager health facilities. With early diagnosis and timely treatment, these adverse events can be decreased. The primary aim of this study was to implement a screening program for gestational diabetes and hypertension, and to assess risk factors associated with these conditions among antenatal women in the rural area of the Gujarat province in India.Methods: A cross–sectional study was conducted at one of the rural areas of Gujarat province in India. Following a random cluster sampling procedure, the village of Davas was selected. A multistage random sampling method was utilized, resulting in a sample of 346 antenatal women. Screening guidelines from the American Diabetes Association were followed for gestational diabetes screening.Results: The majority of antenatal mothers (55.50%) were between 21-25 years of age. 242 antenatal women were multigravida, and among them, 85.96% had institutional delivery at their last pregnancy. Of the total 346 women, 17.60% were prehypertensive. The prevalence of systolic hypertension was 1.40%, diastolic hypertension was 0.90%, and gestational diabetes was 1.73%.Conclusion: Socioeconomically upper class, a family history of hypertension, and BMI ? 25 were strong risk factors for hypertension during pregnancy and gestational diabetes. Health education should be made readily available to antenatal mothers by paramedical workers regarding symptoms of hypertension and gestational diabetes mellitus for early self identification