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[PMID]: 28675360 [Au] Autor: Hotineanu V; Hotineanu A; Burgoci S; Ivancov G; Taran N; Peltec A; Cazacu D; Sîrghi V [Ti] Título: Four Years of Hepatic Transplantation in the Republic of Moldova. [So] Source: Chirurgia (Bucur);112(3):244-251, 2017 May-Jun. [Is] ISSN: 1221-9118 [Cp] País de publicação: Romania [La] Idioma: eng [Ab] Resumo: Ever since the first liver transplant in the Republic of Moldova in 2013 we have performed 30 liver transplantations, the first having been performed in collaboration with the surgical team from Romania, led by Professor Irinel Popescu. The serious deficit of available cadaveric organs has forced us to begin with right hemi-liver transplantation from a living donor. In one third of liver transplantations we used right hemi-liver graft from a living donor, and in 2/3 of cases whole liver graft was harvested from brain-dead donors. The indication for surgical intervention in most cases was hepatic cirrhosis of viral aetiology in terminal stages, three cases of hepatocellular carcinoma, and one case for each of primary biliary cirrhosis, drug-induced toxic hepatitis, and liver retransplantation caused by hepatic arterial thrombosis. 10 cadaveric grafts were harvested from elderly donors ( 65 years). In the early postoperative period, four recipients died (2 live donor graft recipients and 2 graft recipients from donors with brain death). Causes of death were: intracerebral haemorrhage in the early postoperative period - 1, acute graft rejection - 1, hepatic artery thrombosis - 1, primary graft dysfunction - 1. There were no deaths during the late postoperative period. Of the complications that occurred during the early postoperative period we can highlight acute graft rejection -2, hepatic arterial thrombosis - 1, intraabdominal postoperative haemorrhage - 1, hepatic artery thrombosis -1, biliary peritonitis - 1, primary graft dysfunction -1, seizures -1. Complications during the postoperative period: biliary peritonitis after choledochal drainage removal - 1, "small-for-size" - 2. The accumulated experience and the use of modern technologies has allowed us to reduce the postoperative mortality rate, as well as the rate of occurring complications, in order to transfer this surgical intervention from the category of exclusivity operations to the category of daily interventions. [Mh] Termos MeSH primário: Hepatopatias/cirurgia Transplante de Fígado Doadores Vivos Listas de Espera [Mh] Termos MeSH secundário: Adulto Cadáver Carcinoma Hepatocelular/cirurgia Feminino Seres Humanos Cirrose Hepática/cirurgia Hepatopatias/mortalidade Neoplasias Hepáticas/cirurgia Transplante de Fígado/métodos Masculino Meia-Idade Moldávia Estudos Retrospectivos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171113 [Lr] Data última revisão: 171113 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170705 [St] Status: MEDLINE

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[PMID]: 28334036 [Au] Autor: Droznin M; Johnson A; Johnson AM [Ad] Endereço: Department of Health Professions, Rollins College, Winter Park, Florida, United States of America. [Ti] Título: Multidrug resistant tuberculosis in prisons located in former Soviet countries: A systematic review. [So] Source: PLoS One;12(3):e0174373, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: A systematic literature review was performed to investigate the occurrence of multidrug-resistant tuberculosis (MDR TB) in prisons located in countries formerly part of the Soviet Union. METHODS: A systematic search of published studies reporting MDR TB occurrence in prisons located in former Soviet countries was conducted by probing PubMed and Cumulative Index Nursing and Allied Health Literature for articles that met predetermined inclusion criteria. RESULTS: Seventeen studies were identified for systematic review. Studies were conducted in six different countries. Overall, prevalence of MDR TB among prisoners varied greatly between studies. Our findings suggest a high prevalence of MDR TB in prisons of Post-Soviet states with percentages as high as 16 times more than the worldwide prevalence estimated by the WHO in 2014. CONCLUSION: All studies suggested a high prevalence of MDR TB in prison populations in Post-Soviet states. [Mh] Termos MeSH primário: Prisões Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia [Mh] Termos MeSH secundário: Azerbaijão/epidemiologia Bases de Dados Factuais República da Geórgia/epidemiologia Seres Humanos Cazaquistão/epidemiologia Quirguistão/epidemiologia Moldávia/epidemiologia Prevalência Federação Russa/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170825 [Lr] Data última revisão: 170825 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170324 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0174373

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[PMID]: 28270115 [Au] Autor: Cocos R; Schipor S; Hervella M; Cianga P; Popescu R; Banescu C; Constantinescu M; Martinescu A; Raicu F [Ad] Endereço: "Carol Davila" University of Medicine and Pharmacy, Chair of Medical Genetics, 19-21, Prof. dr. Dimitrie Gerota St., 020032, Bucharest, Romania. [Ti] Título: Genetic affinities among the historical provinces of Romania and Central Europe as revealed by an mtDNA analysis. [So] Source: BMC Genet;18(1):20, 2017 Mar 07. [Is] ISSN: 1471-2156 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: As a major crossroads between Asia and Europe, Romania has experienced continuous migration and invasion episodes. The precise routes may have been shaped by the topology of the territory and had diverse impacts on the genetic structure of mitochondrial DNA (mtDNA) in historical Romanian provinces. We studied 714 Romanians from all historical provinces, Wallachia, Dobrudja, Moldavia, and Transylvania, by analyzing the mtDNA control region and coding markers to encompass the complete landscape of mtDNA haplogroups. RESULTS: We observed a homogenous distribution of the majority of haplogroups among the Romanian provinces and a clear association with the European populations. A principal component analysis and multidimensional scaling analysis supported the genetic similarity of the Wallachia, Moldavia, and Dobrudja groups with the Balkans, while the Transylvania population was closely related to Central European groups. These findings could be explained by the topology of the Romanian territory, where the Carpathian Arch played an important role in migration patterns. Signals of Asian maternal lineages were observed in all Romanian historical provinces, indicating gene flow along the migration routes through East Asia and Europe. CONCLUSIONS: Our current findings based on the mtDNA analysis of populations in historical provinces of Romania suggest similarity between populations in Transylvania and Central Europe, supported both by the observed clines in haplogroup frequencies for several European and Asian maternal lineages and MDS analyses. [Mh] Termos MeSH primário: DNA Mitocondrial/genética Genética Populacional/métodos Análise de Sequência de DNA/métodos [Mh] Termos MeSH secundário: Variação Genética Migração Humana Seres Humanos Moldávia Filogenia Filogeografia Análise de Componente Principal Romênia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (DNA, Mitochondrial) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170922 [Lr] Data última revisão: 170922 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170309 [St] Status: MEDLINE [do] DOI: 10.1186/s12863-017-0487-5

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[PMID]: 28213870 [Au] Autor: Pluta A; Rola-Luszczak M; Kubis P; Balov S; Moskalik R; Choudhury B; Kuzmak J [Ad] Endereço: OIE Reference Laboratory for EBL, Department of Biochemistry, National Veterinary Research Institute, Pulawy, Poland. aneta.pluta@piwet.pulawy.pl. [Ti] Título: Molecular characterization of bovine leukemia virus from Moldovan dairy cattle. [So] Source: Arch Virol;162(6):1563-1576, 2017 Jun. [Is] ISSN: 1432-8798 [Cp] País de publicação: Austria [La] Idioma: eng [Ab] Resumo: Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis (EBL), a disease that has worldwide distribution. Whilst it has been eradicated in most of Western Europe and Scandinavia, it remains a problem in other regions, particularly Eastern Europe and South America. For this study, in 2013, 24 cattle from three farms in three regions of Moldova were screened by ELISA and nested PCR. Of these cattle, 14 which were PCR positive, and these were molecularly characterized based on the nucleotide sequence of the env gene and the deduced amino acid sequence of the encoded gp51 protein. Our results demonstrated a low level of genetic variability (0-2.9%) among BLV field strains from Moldova, in contrast to that observed for other retroviruses, including human immunodeficiency virus (HIV) (20-38%) Mason IL (Trudy vologod moloch Inst 146-164, 1970) and equine infectious anemia virus (EIAV) (~40%) Willems L et al (AIDS Res Hum Retroviruses 16(16):1787-1795, 2000), where the envelope gene exhibits high levels of variation Polat M et al (Retrovirology 13(1):4, 2016). Sequence comparisons and phylogenetic analysis revealed that BLV genotype 7 (G7) is predominant in Moldova and that the BLV population in Moldovan cattle is a mixture of at least three new sub-genotypes: G7D, G7E and G4C. Neutrality tests revealed that negative selection was the major force operating upon the 51-kDa BLV envelope surface glycoprotein subunit gp51, although one positively selected site within conformational epitope G was detected in the N-terminal part of gp51. Furthermore, two functional domains, linear epitope B and the zinc-binding domain, were found to have an elevated ratio of nonsynonymous to synonymous codon differences. Together, these data suggest that the evolutionary constraints on epitopes G and B and the zinc-binding domains of gp51 differ from those on the other domains, with a tendency towards formation of homogenous genetic groups, which is a common concept of global BLV diversification during virus transmission that may be associated with genetic drift. [Mh] Termos MeSH primário: Doenças dos Bovinos/virologia Indústria de Laticínios Leucose Enzoótica Bovina/virologia Variação Genética Vírus da Leucemia Bovina/genética [Mh] Termos MeSH secundário: Animais Bovinos Doenças dos Bovinos/epidemiologia Leucose Enzoótica Bovina/epidemiologia Genes env/genética Genótipo Seres Humanos Vírus da Leucemia Bovina/classificação Vírus da Leucemia Bovina/isolamento & purificação Moldávia/epidemiologia Filogenia Reação em Cadeia da Polimerase Alinhamento de Sequência Proteínas do Envelope Viral/genética [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Viral Envelope Proteins) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170720 [Lr] Data última revisão: 170720 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170219 [St] Status: MEDLINE [do] DOI: 10.1007/s00705-017-3241-4

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[PMID]: 27889805 [Au] Autor: Zinicovscaia I; Hramco C; Duliu OG; Vergel K; Culicov OA; Frontasyeva MV; Duca G [Ad] Endereço: Joint Institute for Nuclear Research, Joliot-Curie 6, Dubna, Russian Federation, 141980. zinikovskaia@mail.ru. [Ti] Título: Air Pollution Study in the Republic of Moldova Using Moss Biomonitoring Technique. [So] Source: Bull Environ Contam Toxicol;98(2):262-269, 2017 Feb. [Is] ISSN: 1432-0800 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Moss biomonitoring using the species Hypnum cupressiforme (Hedw.) and Pleurocarpous sp was applied to study air pollution in the Republic of Moldova. A total of 41 elements (Na, Mg, Al, Cl, K, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Br, Rb, Sr, Zr, Cd, Sb, Cs, Ba, La, Ce, Nd, Sm, Eu, Gd, Tb, Tm, Yb, Hf, Ta, W, Pb, Th, and U) were determined by instrumental epithermal neutron activation analysis and atomic absorption spectrometry. Principal component analysis was used to identify and characterize different pollution sources. Geographical distribution maps were prepared to point out the regions most affected by air pollution and relate this to potential sources of contamination. Median values of the elements studied were compared with data from the European moss biomonitoring program. The cities of Chisinau and Balti were determined to experience particular environmental stress. [Mh] Termos MeSH primário: Poluição do Ar/análise Bryopsida/química Monitoramento Ambiental Metais/análise [Mh] Termos MeSH secundário: Moldávia Análise de Ativação de Nêutrons Análise de Componente Principal Espectrofotometria Atômica [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Metals) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161128 [St] Status: MEDLINE [do] DOI: 10.1007/s00128-016-1989-y

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[PMID]: 27912786 [Au] Autor: ȘuleÈ™co T; von Thien H; ToderaÈ™ L; ToderaÈ™ I; Lühken R; Tannich E [Ad] Endereço: Institute of Zoology, Academy of Sciences of Moldova, Chisinau, Moldova. [Ti] Título: Circulation of Dirofilaria repens and Dirofilaria immitis in Moldova. [So] Source: Parasit Vectors;9(1):627, 2016 Dec 03. [Is] ISSN: 1756-3305 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Over the last two decades, a significant spread of dirofilariasis has been observed in eastern and central Europe. However, data on the circulation of Dirofilaria spp. in Moldova were absent although direct neighbor states reported high incidence rates of human dirofilariasis. METHODS: Daily mean temperature data were used to calculate Dirofilaria spp. development units, which were used to estimate the potential for complete extrinsic development in the mosquitoes (= sum of potential Dirofilaria spp. transmission days). In addition, 4,481 adult female mosquitoes were collected from 25 trapping sites. From 2010 to 2015, sampling was conducted with Centers for Disease Control miniature light traps, indoor resting mosquito collections as well as human landing catches in urban, rural and natural areas. Mosquitoes were analyzed for the presence of D. repens and D. immitis DNA using a duplex real-time PCR assay targeting nucleotide differences within the cytochrome c oxidase subunit 1 (D. repens) and 16S rRNA gene fragment (D. immitis). RESULTS: The average of the yearly sum of potential Dirofilaria spp. transmission days between 2010 and 2015 ranged from 90 to 140 days with an increasing gradient from the North to the South of Moldova. Positive mosquito pools for D. repens were found countrywide at 13 of the 25 trapping sites and in 17 of the 22 screened mosquito taxa (26.51% of all 347 tested pools), while D. immitis was detected only at 4 of the trapping sites (Center and South) in 4 different mosquito species (8.65% of all 347 tested pools). Highest infection rates (EIR) per 100 specimens for both Dirofilaria species were found in An. maculipennis (s.l.) (D. repens: EIR = 4.91; D. immitis: EIR = 2.01), whereas the most frequent mosquito taxon Cx. pipiens (s.l.)/torrentium had significantly lower infections rates (D. repens: EIR = 0.88; D. immitis: EIR = 0.47). CONCLUSIONS: The temperature conditions in Moldova are suitable for transmission of Dirofilaria spp. within the entire country, which is supported by a wide distribution of Dirofilaria spp.-positive mosquitoes with high infection rates. The low number of reported human cases most likely does not reflect the current epidemiological situation of dirofilariasis in Moldova. [Mh] Termos MeSH primário: Culicidae/parasitologia Dirofilaria immitis/isolamento & purificação Dirofilaria repens/isolamento & purificação Dirofilariose/epidemiologia Dirofilariose/parasitologia [Mh] Termos MeSH secundário: Animais DNA de Helmintos/química DNA de Helmintos/genética DNA Ribossômico/química DNA Ribossômico/genética Dirofilaria immitis/classificação Dirofilaria immitis/genética Dirofilaria repens/classificação Dirofilaria repens/genética Seres Humanos Moldávia/epidemiologia Reação em Cadeia da Polimerase Multiplex Filogenia Prevalência RNA Ribossômico 16S/genética Reação em Cadeia da Polimerase em Tempo Real Análise de Sequência de DNA Temperatura Ambiente [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (DNA, Helminth); 0 (DNA, Ribosomal); 0 (RNA, Ribosomal, 16S) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170929 [Lr] Data última revisão: 170929 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161204 [St] Status: MEDLINE

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[PMID]: 27909581 [Au] Autor: Hone T; Habicht J; Domente S; Atun R [Ad] Endereço: Department of Primary Care and Public Health, Imperial College, London, UK. [Ti] Título: Expansion of health insurance in Moldova and associated improvements in access and reductions in direct payments. [So] Source: J Glob Health;6(2):020702, 2016 Dec. [Is] ISSN: 2047-2986 [Cp] País de publicação: Scotland [La] Idioma: eng [Ab] Resumo: BACKGROUND: Moldova is the poorest country in Europe. Economic constraints mean that Moldova faces challenges in protecting individuals from excessive costs, improving population health and securing health system sustainability. The Moldovan government has introduced a state benefit package and expanded health insurance coverage to reduce the burden of health care costs for citizens. This study examines the effects of expanded health insurance by examining factors associated with health insurance coverage, likelihood of incurring out-of-pocket (OOP) payments for medicines or services, and the likelihood of forgoing health care when unwell. METHODS: Using publically available databases and the annual Moldova Household Budgetary Survey, we examine trends in health system financing, health care utilization, health insurance coverage, and costs incurred by individuals for the years 2006-2012. We perform logistic regression to assess the likelihood of having health insurance, incurring a cost for health care, and forgoing health care when ill, controlling for socio-economic and demographic covariates. FINDINGS: Private expenditure accounted for 55.5% of total health expenditures in 2012. 83.2% of private health expenditures is OOP payments-especially for medicines. Healthcare utilization is in line with EU averages of 6.93 outpatient visits per person. Being uninsured is associated with groups of those aged 25-49 years, the self-employed, unpaid family workers, and the unemployed, although we find lower likelihood of being uninsured for some of these groups over time. Over time, the likelihood of OOP for medicines increased (odds ratio OR = 1.422 in 2012 compared to 2006), but fell for health care services (OR = 0.873 in 2012 compared to 2006). No insurance and being older and male, was associated with increased likelihood of forgoing health care when sick, but we found the likelihood of forgoing health care to be increasing over time (OR = 1.295 in 2012 compared to 2009). CONCLUSIONS: Moldova has achieved improvements in health insurance coverage with reductions in OOP for services, which are modest but are eroded by increasing likelihood of OOP for medicines. Insurance coverage was an important determinant for health care costs incurred by patients and patients forgoing health care. Improvements notwithstanding, there is an unfinished agenda of attaining universal health coverage in Moldova to protect individuals from health care costs. [Mh] Termos MeSH primário: Financiamento Governamental Financiamento Pessoal Gastos em Saúde Acesso aos Serviços de Saúde/economia Cobertura do Seguro Seguro Saúde Aceitação pelo Paciente de Cuidados de Saúde [Mh] Termos MeSH secundário: Adolescente Adulto Fatores Etários Idoso Idoso de 80 Anos ou mais Criança Pré-Escolar Feminino Seres Humanos Lactente Recém-Nascido Masculino Pessoas sem Cobertura de Seguro de Saúde Meia-Idade Moldávia Fatores Sexuais Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170424 [Lr] Data última revisão: 170424 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161203 [St] Status: MEDLINE

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[PMID]: 27886027 [Au] Autor: Guriev V; Spinu C; Sajen O; Isac M; Spinu I; Cebotari S; Donos A [Ad] Endereço: National Center for Public Health of the Republic of Moldova, Viral Diseases Control Center, Chisinau, Republic of Moldova. guriev_vladimir@yahoo.com. [Ti] Título: Epidemiology of hepatitis C in the Republic of Moldova: achievements and remaining challenges in prevention and control. [So] Source: J Infect Dev Ctries;10(11):1162-1167, 2016 Nov 24. [Is] ISSN: 1972-2680 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: Viral hepatitis, especially those with parenteral and sexual transmission, still remain a major problem of public health, both globally and for the Republic of Moldova, due to wide spreading, endemicity, increased morbidity and mortality and high rate of invalidity following the chronization of infection, but usually neglected by population and public health authorities. This paper describes the epidemiology and preventive and control measures of hepatitis C in Moldova. Epidemiological analysis of the surveillance data on hepatitis C incidence in the Republic of Moldova was conducted. The data were obtained from the national reporting system of infectious diseases and serosurvey studies. Epidemiological particularities of acute and chronic hepatitis C in general Moldovan population and specific risk groups were evaluated. National hepatitis policies for prevention and control were analyzed. Only consolidation of all the actions stipulated in the national and international normative documents on the prevention and control of hepatitis, will help to reduce the morbidity of viral hepatitis C and probably to eliminate the new cases of disease in some regions. [Mh] Termos MeSH primário: Controle de Doenças Transmissíveis/métodos Controle de Doenças Transmissíveis/organização & administração Hepatite C/epidemiologia Hepatite C/prevenção & controle [Mh] Termos MeSH secundário: Monitoramento Epidemiológico Política de Saúde Seres Humanos Incidência Moldávia/epidemiologia Fatores de Risco [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170203 [Lr] Data última revisão: 170203 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161126 [St] Status: MEDLINE [do] DOI: 10.3855/jidc.7884

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[PMID]: 27781013 [Au] Autor: Isabel Fernandes Guerreiro A; Kuttumuratova A; Monolbaev K; Boderscova L; Pirova Z; Weber MW [Ad] Endereço: Independent Consultant on children's rights, Albufeira, Portugal, WHO Regional Office for Europe, Copenhagen, Denmark. [Ti] Título: Assessing and Improving Children's Rights in Hospitals: Case Studies from Kyrgyzstan, Tajikistan, and Moldova. [So] Source: Health Hum Rights;18(1):235-248, 2016 Jun. [Is] ISSN: 2150-4113 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: There is a recognized need to raise evidence on how to adopt human rights-based approaches (HRBAs) to health and to assess their impact. In 2013 and 2014, the World Health Organization (WHO) Regional Office for Europe used a set of tools to assess and improve the situation of children's rights in 11 hospitals in Kyrgyzstan, 10 hospitals in Tajikistan, and 21 hospitals in Moldova, by applying a HRBA to health, taking as a reference the Convention on the Rights of the Child (CRC). The assessment results show a similar situation across countries in some areas, and more or less significant variation in others. Common gaps include the need to improve adolescent-friendly health services, the rights to privacy and play; and infrastructure and equipment. In Kyrgyzstan and Tajikistan, a second round of assessment, was carried out, which showed an effective change in several areas, whilst other areas showed persistent gaps. Moldova did not carry out a second round of assessment. Involving children and parents in the assessment was crucial to obtain more reliable data; the project showed how to use the CRC as a framework to improve quality of care for children (QoC); and the tools were proven useful for self-assessment. [Mh] Termos MeSH primário: Serviços de Saúde da Criança/normas Assistência à Saúde/normas Hospitais Direitos Humanos [Mh] Termos MeSH secundário: Adolescente Serviços de Saúde do Adolescente/normas Criança Seres Humanos Quirguistão Moldávia Inquéritos e Questionários Tadjiquistão [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170613 [Lr] Data última revisão: 170613 [Sb] Subgrupo de revista: E; IM [Da] Data de entrada para processamento: 161027 [St] Status: MEDLINE

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[PMID]: 27102194 [Au] Autor: Ene-Iordache B; Perico N; Bikbov B; Carminati S; Remuzzi A; Perna A; Islam N; Bravo RF; Aleckovic-Halilovic M; Zou H; Zhang L; Gouda Z; Tchokhonelidze I; Abraham G; Mahdavi-Mazdeh M; Gallieni M; Codreanu I; Togtokh A; Sharma SK; Koirala P; Uprety S; Ulasi I; Remuzzi G [Ad] Endereço: IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Clinical Research Center for Rare Diseases "Aldo e Cele Daccò", Ranica, Italy. Electronic address: bogdan.ene-iordache@marionegri.it. [Ti] Título: Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. [So] Source: Lancet Glob Health;4(5):e307-19, 2016 May. [Is] ISSN: 2214-109X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Chronic kidney disease is an important cause of global mortality and morbidity. Data for epidemiological features of chronic kidney disease and its risk factors are limited for low-income and middle-income countries. The International Society of Nephrology's Kidney Disease Data Center (ISN-KDDC) aimed to assess the prevalence and awareness of chronic kidney disease and its risk factors, and to investigate the risk of cardiovascular disease, in countries of low and middle income. METHODS: We did a cross-sectional study in 12 countries from six world regions: Bangladesh, Bolivia, Bosnia and Herzegovina, China, Egypt, Georgia, India, Iran, Moldova, Mongolia, Nepal, and Nigeria. We analysed data from screening programmes in these countries, matching eight general and four high-risk population cohorts collected in the ISN-KDDC database. High-risk cohorts were individuals at risk of or with a diagnosis of either chronic kidney disease, hypertension, diabetes, or cardiovascular disease. Participants completed a self-report questionnaire, had their blood pressure measured, and blood and urine samples taken. We defined chronic kidney disease according to modified KDIGO (Kidney Disease: Improving Global Outcomes) criteria; risk of cardiovascular disease development was estimated with the Framingham risk score. FINDINGS: 75,058 individuals were included in the study. The prevalence of chronic kidney disease was 14·3% (95% CI 14·0-14·5) in general populations and 36·1% (34·7-37·6) in high-risk populations. Overall awareness of chronic kidney disease was low, with 409 (6%) of 6631 individuals in general populations and 150 (10%) of 1524 participants from high-risk populations aware they had chronic kidney disease. Moreover, in the general population, 5600 (44%) of 12,751 individuals with hypertension did not know they had the disorder, and 973 (31%) of 3130 people with diabetes were unaware they had that disease. The number of participants at high risk of cardiovascular disease, according to the Framingham risk score, was underestimated compared with KDIGO guidelines. For example, all individuals with chronic kidney disease should be considered at high risk of cardiovascular disease, but the Framingham risk score detects only 23% in the general population, and only 38% in high-risk cohorts. INTERPRETATION: Prevalence of chronic kidney disease was high in general and high-risk populations from countries of low and middle income. Moreover, awareness of chronic kidney disease and other non-communicable diseases was low, and a substantial number of individuals who knew they were ill did not receive treatment. Prospective programmes with repeat testing are needed to confirm the diagnosis of chronic kidney disease and its risk factors. Furthermore, in general, health-care workforces in countries of low and middle income need strengthening. FUNDING: International Society of Nephrology. [Mh] Termos MeSH primário: Conscientização Doenças Cardiovasculares/epidemiologia Diabetes Mellitus/epidemiologia Conhecimentos, Atitudes e Prática em Saúde Hipertensão/epidemiologia Insuficiência Renal Crônica/epidemiologia [Mh] Termos MeSH secundário: Adulto Idoso Bangladesh/epidemiologia Bolívia/epidemiologia Bósnia e Herzegóvina/epidemiologia China/epidemiologia Estudos de Coortes Estudos Transversais Diabetes Mellitus/diagnóstico Egito/epidemiologia Feminino República da Geórgia/epidemiologia Seres Humanos Hipertensão/diagnóstico Índia/epidemiologia Irã (Geográfico)/epidemiologia Masculino Programas de Rastreamento/estatística & dados numéricos Meia-Idade Moldávia/epidemiologia Mongólia/epidemiologia Nepal/epidemiologia Nigéria/epidemiologia Prevalência Insuficiência Renal Crônica/diagnóstico Fatores de Risco Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1701 [Cu] Atualização por classe: 170111 [Lr] Data última revisão: 170111 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160423 [St] Status: MEDLINE

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