Health hazards in Central Asia on Afghanistan example
Рассмотрены эпидемиологические, демографические и эколого гигиенические аспекты жизнедеятельности населения в современном Афганистане. Проанализированы многочисленные статистические данные о состоянии питания и водоснабжения, уровнях и динамике инфекционной заболеваемости. Делается вывод о необходим...
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| Опубліковано в: : | Актуальні проблеми транспортної медицини |
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| Дата: | 2007 |
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Фізико-хімічний інститут ім. О.В. Богатського НАН України
2007
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| Цитувати: | Health hazards in central Asia on Afghanistan example / K. Korzeniewski // Актуальні проблеми транспортної медицини. — 2007. — № 3 (9). — С. 68-76. — Бібліогр.: 60 назв. — англ. |
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Korzeniewski, K. 2011-06-24T16:31:30Z 2011-06-24T16:31:30Z 2007 Health hazards in central Asia on Afghanistan example / K. Korzeniewski // Актуальні проблеми транспортної медицини. — 2007. — № 3 (9). — С. 68-76. — Бібліогр.: 60 назв. — англ. 1818-9385 https://nasplib.isofts.kiev.ua/handle/123456789/22563 614"056.22(575);(581) Рассмотрены эпидемиологические, демографические и эколого гигиенические аспекты жизнедеятельности населения в современном Афганистане. Проанализированы многочисленные статистические данные о состоянии питания и водоснабжения, уровнях и динамике инфекционной заболеваемости. Делается вывод о необходимости вакцинации всех лиц, выезжающих в страны Центральной Азии, противвирусного гепатита А и В, рекомендовано проведение химиопрофилактики малярии, а также правила поведения, снижающие степень опасности для здоровья и жизни. Розглянуті епідеміологічні, демографічні та еколого гігієнічні аспекти життєдіяльності населення у сучасному Афганістані. Проаналізовані численні статистичні данні щодо стану харчування і водопостачання, рівнях і динаміки інфекційної захворюваності. Робиться висновок щодо необхідності вакцинації всіх осіб, що виїжджають в країни Цен тральної Азії, проти вірусного гепатиту А и В, рекомендовано проведення хіміопрофілактики малярії, а також правила поведінки для зниження ступеню небезпечності для здоров’я и життя. en Фізико-хімічний інститут ім. О.В. Богатського НАН України Актуальні проблеми транспортної медицини Article Лечебно-профилактические проблемы на транспорте Health hazards in Central Asia on Afghanistan example Риски для здоровья В Центральной Азии на примере Афганистана Ризики для здоров’я в Центральній Азії на прикладі Афганістану Article published earlier |
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Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| title |
Health hazards in Central Asia on Afghanistan example |
| spellingShingle |
Health hazards in Central Asia on Afghanistan example Korzeniewski, K. Лечебно-профилактические проблемы на транспорте |
| title_short |
Health hazards in Central Asia on Afghanistan example |
| title_full |
Health hazards in Central Asia on Afghanistan example |
| title_fullStr |
Health hazards in Central Asia on Afghanistan example |
| title_full_unstemmed |
Health hazards in Central Asia on Afghanistan example |
| title_sort |
health hazards in central asia on afghanistan example |
| author |
Korzeniewski, K. |
| author_facet |
Korzeniewski, K. |
| topic |
Лечебно-профилактические проблемы на транспорте |
| topic_facet |
Лечебно-профилактические проблемы на транспорте |
| publishDate |
2007 |
| language |
English |
| container_title |
Актуальні проблеми транспортної медицини |
| publisher |
Фізико-хімічний інститут ім. О.В. Богатського НАН України |
| format |
Article |
| title_alt |
Риски для здоровья В Центральной Азии на примере Афганистана Ризики для здоров’я в Центральній Азії на прикладі Афганістану |
| description |
Рассмотрены эпидемиологические, демографические и эколого гигиенические аспекты жизнедеятельности населения в современном Афганистане. Проанализированы многочисленные статистические данные о состоянии питания и водоснабжения, уровнях и динамике инфекционной заболеваемости. Делается вывод о необходимости вакцинации всех лиц, выезжающих
в страны Центральной Азии, противвирусного гепатита А и В, рекомендовано проведение химиопрофилактики малярии, а также правила поведения, снижающие степень опасности для здоровья и жизни.
Розглянуті епідеміологічні, демографічні та еколого гігієнічні аспекти життєдіяльності населення у сучасному Афганістані. Проаналізовані численні статистичні данні щодо стану харчування і водопостачання, рівнях і динаміки інфекційної захворюваності. Робиться висновок щодо необхідності вакцинації всіх осіб, що виїжджають в країни Цен
тральної Азії, проти вірусного гепатиту А и В, рекомендовано проведення хіміопрофілактики малярії, а також правила поведінки для зниження ступеню небезпечності для здоров’я и життя.
|
| issn |
1818-9385 |
| url |
https://nasplib.isofts.kiev.ua/handle/123456789/22563 |
| citation_txt |
Health hazards in central Asia on Afghanistan example / K. Korzeniewski // Актуальні проблеми транспортної медицини. — 2007. — № 3 (9). — С. 68-76. — Бібліогр.: 60 назв. — англ. |
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| first_indexed |
2025-11-27T05:15:49Z |
| last_indexed |
2025-11-27T05:15:49Z |
| _version_ |
1850801168779837440 |
| fulltext |
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
6868686868
ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
Лечебно�профилактические
проблемы на транспорте
The Medical�preventive Problems
on Transport
Introduction
Traveling to Afghanistan nowadays is
truly health& and life&threatening (1, 2).
Destroyed country infrastructure, low
sanitary and epidemiologic conditions, low
level of medical assistance (lack of
medical personnel, shortage of basic
medicines and hygienic means) – all
contribute to the dissemination of many
infectious and non&infectious diseases (3&
5). More than 70% of the health care
functioning in Afghanistan is dependent
on the help of foreign humanitarian
organizations (6&8). Afghanistan is a
region of an extreme danger of terrorist
and criminal attacks. Bomb attacks,
thefts, kidnappings mostly directed
against Stabilization Forces soldiers and
humanitarian organization workers have
become the order of the day. Remains of
the wartime are visible in the whole
territory of the country with mines and
unexploded shells posing the highest
danger. Just traveling on Afghan roads is
extremely dangerous because of their
catastrophic technical condition and
notorious disobedience of traffic rules by
local riders (1, 9). In July 2005 the
population of Afghanistan was assessed
at 29,929,000 but these data are only
approximate because of regular
migrations of Afghans abroad, mainly to
Pakistan and Iran (during the last three
decades approximately 5 million Afghan
people have emigrated, and 3.1 million of
these have returned), and also within the
country (approximately 2 mill ion of
internal refugees during the civil war,
nowadays the internal displacements are
estimated at 200,000 people) (10,11).
Afghanistan is a country of a highest
population growth rate, estimated at
4.77% per year in 2005. The fertility rate
is 6.75 children per 1 Afghan woman. In
1979, 15,682,000 inhabitants lived in the
country, so during the last 25 years the
population have increased by more than
90% in spite of the high mortality rate
caused by warfare, famine and diseases.
According to the United Nations
calculations, at the present birth rate the
number of Afghans may have reached 97
million by 2050! An average Afghan is very
young. In 2005 as many as 44.7% of the
population were below 14 years of age,
52.9% in the age range 15&64, and only
2.4% were over 65 years old. The mean
age of an average Afghan is 17.56 years.
The population health status parameters
place Afghanistan among the poorest
countries in the world. The total mortality
rate is estimated at 2.07% (20.7 deaths/
1000 inhabitants per year), infant
mortality rate (under 1 year old) – 16.3%
(163 deaths/ 1000 live births), that of
children younger than 5 years – 25.7%
(257 deaths/1000 live births). Life
expectancy at birth of an average Afghan
is estimated at 43 years only, and one per
four Afghan children dies before being 5
years old (10,12&14).
Infectious diseases
УДК 614"056.22(575);(581)
HEALTH HAZARDS IN CENTRAL ASIA ON AFGHANISTAN EXAMPLE
Krzysztof Korzeniewski
Department of Maritime and Tropical Medicine, Military Institute of Medicine,
Gdynia, Poland
Впервые поступила в редакцию 11.09.2007 г. Рекомен"
дована к печати на заседании ученого совета НИИ ме"
дицины транспорта (протокол № 5 от 05.10.2007 г.).
ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
6969696969
Afghanistan is considered to be a
country where the risk of infectious
diseases occurrence is very high. This
situation results mainly from
contamination of water and soil, limited
access to uncontaminated drinking water,
catastrophic status of plumbing, water
and sewage treatment plants, limited
access to health&care institutions, lack of
basic medicines and medical equipment
(3,15). Another health risk factors are
numerous asymptomatic carriers of
infectious diseases among local
population, mass migrations of people
(inside and outside the country),
overcrowding in refugee camps, large
territory of endemic areas, and high
number of vectors of infectious diseases
(16,17).
Vector�borne diseases
Malaria. Approximately 80% of the
disease cases are caused by Plasmodium
vivax but in the recent years an increased
number of cases have been caused by P.
falciparum (18,19). The disease occurs
seasonally (April through November) and
endemically in the most part of the
country, usually below 2000 meters above
sea level, along river valleys, in rice
farmland, near water reservoirs (20&22).
A research study conducted by the World
Health Organization experts has revealed
that nowadays malaria occurs in
Afghanistan also at higher altitudes.
A high malaria incidence rate was
confirmed in the local population of the
Bamian province (2250&2400 meters
above sea level). Most of the cases had
been caused by P. falciparum (23). Today
in Afghanistan, malaria contributes to 10&
20% of all pyretic diseases (24,25). The
studies carried out in 2002 revealed that
10% of the Afghan population living in
areas below 1500 meters above sea level
were infected with Plasmodium parasites
(25). In 2003 Afghan medical services
registered more than 591 thousand
suspected and confirmed cases of malaria
in the whole country (26). However, the
anecdotal number of all malaria cases in
Afghanistan is estimated at as many as 3
million per year (21). In the Jalalabad
region, with its irrigated areas of rice
cultivation, the morbidity rate is estimated
at 240 cases/1000 people per year (21).
Malaria cases are observed in villages and
in towns, including the capital city of
Kabul. In the early 1980s, the number of
malaria cases caused by P. falciparum did
not exceed 1&2%. Nowadays it reaches
20%, which mainly results from an
increased resistance of Plasmodium
parasites to the treatment used so far
(Chloroquine), and an increased
insensitivity of infection vectors
(Anopheles mosquito) to pesticides
employed (21,27,28).
Leishmaniasis. Two clinical forms of
the disease occur in Afghanistan:
cutaneous and visceral (kala"azar).
Cutaneous leishmaniasis (CL) in the
Afghan territory is caused by L. major
(wild rodents are the source of infection,
e.g. gerbils) and L. tropica (human source
of infection) (3,17). Most CL cases in
Afghanistan are caused by L. tropica (29).
The disease is encountered endemically
countrywide, in the west (Herat), south
(Kandahar), north (Mazar&e Szarif), and
east (Kabul) (20,22). Kabul, the capital
city of Afghanistan, is nowadays the
biggest focus of cutaneous leishmaniasis
in the world. In 1996 the number of cases
was estimated at 270 thousand (3,20). In
2001, 2.7% of Kabul inhabitants (out of
total nearly 3 million) had active skin
lesions resulting from CL, and 21.9%
displayed post inflammatory scars (20).
The number of CL cases in Kabul in 2003
was estimated at 67,500 (5), however,
given a massive influx of external refugees
from Pakistan and Iran, and internal
displacements from other regions of the
country, who can contribute to an increase
of the infection rate, the disease morbidity
and incidence rates are bound to become
higher (29).
Visceral leishmaniasis (VL) in
Afghanistan is caused by L. donovani. The
source of infection is of animal origin
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
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ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
(dogs, foxes, jackals). This form of the
disease occurs much less frequently than
CL. The endemic areas are located in the
western part of the country (20). The
transmission of cutaneous and visceral
leishmaniasis occurs in Afghanistan
seasonally, from April to October (30).
Crimean"Congo Hemorrhagic Fever.
In 2000, 27 cases of the disease
(including 16 deaths) were registered in
the Herat province (20,31). Another 47
cases in the region of the Afghan&
Pakistani border were recorded in 2001
(3,17). In March 2002 unknown
hemorrhagic fever (Crimean&Congo is
suspected) killed 28 people in eastern
Afghanistan (3,17). In the Afghan territory
the transmission of the disease occurs
from May to October (30).
Food� and water�borne diseases
Diarrheas. The diarrheal diseases
morbidity risk in Afghanistan is high
regardless of the season of the year.
Seemingly, diarrheas can pose no health
problem to the local population, as the
number of asymptomatic carriers is rather
large. On the other hand, diarrheal
diseases are quite common because food
and water are contaminated not only with
human and animal excrements but also
with pesticides and toxic industrial
chemicals (15,18). Diarrheas are
responsible for more than 50% of deaths
among children under 5 years of age
(6,32). In 2004, in Kabul only, more than
6000 cases of diarrheal diseases were
registered weekly, half of them affected
children younger than 5 (32). Only 7.7%
of Afghans have access to tap drinking
water (2003). Most Afghans use water
from wells or directly from rivers and
canals. Only 32.5% of all used sources
contain safe, controlled, and
decontaminated water (6). In the whole
territory of the country there are only 2.8%
of toilets meeting basic hygienic
standards. In the majority (more than
60%) of cases cesspools function as
lavatories (12). The main contagious and
parasitic etiologic factors of diarrheal
diseases are enterotoxic Escherichia coli,
Campylobacter, Salmonella, Shigella,
adeno& and rotaviruses, and also protozoa
(Entamoeba histolytica, Giardia
intestinalis). The amebiasis morbidity rate
among Afghans is estimated at 3% of the
population. The giardiasis morbidity in
children reaches 11% (33).
Intestinal helminth worm infections.
It is estimated that 90% of the Afghan
population are infected by at least one
helminth worm (33). Because of
ascariasis only, the morbidity including an
asymptomatic carrier state is estimated at
60% of the country population. Among
other helminthic infections, the most
popular ones are ancylostomiasis,
strongyloidiasis, trichuriasis and taeniasis
(33).
Viral hepatitis type A & E. The
diseases occur endemically in all
Afghanistan (22). There is a high risk of
infection regardless of the season of the
year. The morbidity is strictly connected
with low hygienic standards and the
contamination of food and water with
pathogenic microorganisms (30).
Cholera. It is not one of the main
gastrointestinal tract infectious diseases
in Afghanistan, but it is an extremely
dangerous disease because of its severity
and epidemicity (34). The last epidemic
took place in Kabul in May and June 2005,
when 3245 people developed an acute
diarrheal disease. A bacteriological
screening examination of stool revealed
cholera in most cases (35). In the recent
years, cholera has been diagnosed in 14
provinces of the country (27).
Respiratory tract diseases
Lower respiratory tract diseases are
one of the main causes of the Afghan
population morbidity and the mortality of
children under 5 (36). The main etiologic
factors responsible for lower respiratory
tract diseases are Streptococcus
pneumoniae, Mycoplasma pneumoniae
and Influenza virus (3,17).
Tuberculosis. It is an endemic
ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
7171717171
disease observed in all Central Asia, and
poses a serious epidemiologic problem
also in Afghanistan (22). In 1997 the
morbidity rate in Afghanistan was
estimated at 753 cases/100 thousand
inhabitants (among them 35% were
infected but asymptomatic) (33). In 2003
this rate decreased to the level of 321
cases/100 thousand people, which still
located Afghanistan as one of the first
places in the world. Such a high morbidity
rate results from two factors. The first one
is a small percentage of vaccinated infants
(according to WHO, 49% were BCG
vaccinated in 2002, and 59% – in 2003).
The second factor is coexistent diseases
impairing immunity. It is estimated that in
Afghanistan 5% of tuberculosis patients
are HIV&positive (27,35). Since 1996, the
World Health Organization have started
promoting a new tuberculosis treatment
and control strategy (DOTS – directly
observed treatment short"course).
Although the new strategy has been
introduced in 85% in the world,
Afghanistan has succeeded to implement
it in 15%, and Pakistan in 6% only, which
results in the tuberculosis morbidity just
in these two countries contributing to the
majority of cases in the Middle East and
Central Asia (37).
Sexually transmitted diseases
In Afghanistan such sexually
transmitted diseases as gonorrhea,
chlamydiasis and trichomoniasis are quite
widespread (15,38). Cases of syphilis and
chancroid are also diagnosed. One has to
remember that hepatitis B virus is also
transmitted by sexual contacts, and cases
of hepatitis B infection are often
diagnosed in the Afghan population (the
prevalence from 10% of population in
Kabul to 15&20% in Ghazni in 2002) (39).
Surveys conducted in 5 Afghan provinces
showed a considerable percentage of
illnesses caused by the genitourinary tract
inflammations. Among them the venereal
etiology was most frequent (38).
According to the World Health
Organization the number of HIV/AIDS
cases in the Central Asia region, including
Afghanistan, has increased recently (15).
The incidence increase is noticed among
drug addicts who repeatedly use needles
and syringes which are not sterile. The
Afghan Ministry of Health so far has
confirmed 31 cases of HIV/AIDS and 1
case of death caused by AIDS, but
unofficially they say about 600&700 cases
of HIV infections and AIDS in the country
(4).
Enzootic diseases
The highest risk results from rabies,
which occurs endemically in Afghanistan
(22). Affected dogs are the main source
of infection, but so can be wolves, foxes
and jackals. It is estimated that in
Afghanistan a few hundred people die
every year because they have been bitten
by rabid dogs (33). In 2001 the World
Health Organization estimated that in
Kabul only there were noticed as many as
4 cases of rabies daily among bitten
people. Nowadays the highest risk of
contact with rabid animals is observed in
rural areas (3,17).
Another enzootic disease diagnosed
in Afghanistan is brucellosis, mainly
because of consumption of unpasteurized
diary products processed from sick
animals (3,17). In the early 1990s anthrax
was of high epidemiologic importance (49
cases in 1991) (27,33). The disease was
caused mainly by contact with sick
animals, consumption of contaminated
meat, aspiration of air containing
pathogenic microorganisms. Mass
preventive vaccinations of farm animals
(the main sources of infection in
Afghanistan are sheep and goats)
reduced the risk. In spite of this, singular
cases of the disease among people can
be still diagnosed (3,17).
Injuries
Traffic accidents are the most
frequent cause of death affecting travelers
to Afghanistan. Afghans, just l ike
representatives of other Muslim countries,
do not obey nor care to know traffic
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
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ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
regulations. Another problem is the
terrible condition of all roads destroyed
during wars, and the very poor technical
state of most Afghan motor vehicles. All
this makes traveling by local means of
transport (there are no railroads in
Afghanistan) an unforgettable experience
on one hand, on the other a serious health
threat (1,22).
But the biggest hazard to the health
and life of Afghans and that of foreigners
visiting the country is trauma inflicted by
mines and unexploded ordnance. In
Afghanistan, one of the most mined
countries in the world, there are still
planted approximately 7 mill ion
antipersonnel (95%) and antitank (5%)
mines (40&42). Except for mines there is
a huge number of unexploded ordnance,
remainders of bombs, grenades, shells,
which were not exploded. It is estimated
that mines and unexploded ordnance still
cover more than 700 million square
meters of the Afghan territory (43).
Probably only two provinces are free of
these lethal traps. The most mined
provinces of Afghanistan are Herat and
Kandahar, however any amount of mines
and unexploded shells are practically met
everywhere, especially near the borders
with Pakistan and Iran. Also in the capital
city of Kabul, there are a lot of places not
cleared of mines (44). It is estimated that
most mines and unexploded ordnance are
still in pastures (61%), arable fields (26%),
near roads (7%), places of residence (4%)
and irrigation systems (1%) (44). In the
Afghan land there are approximately 50
various types of mines made in the USSR,
China, Yugoslavia, Czechoslovakia and
many other countries (44). Out of all the
countries in the world, Afghanistan has
the highest casualty toll from explosions
of mines and other shells (45,46). Every
month in 1993, the number of Afghans
injured and killed by explosions reached
(47). In 1997&2002, UNMACA (United
Nations Mine Action Center for
Afghanistan) basing on reports from
Afghan hospitals registered 6114 cases of
blast injuries among civil ians (48).
Nowadays, the number of victims is
estimated at over 100 injured or killed
every month. However, these are only
estimated data because a lot of trauma
cases are registered nowhere. In 1999 the
percentage of handicapped Afghans was
estimated at 3&4% of the country
population. Most of them had a limited
access to the health service (49).
Nowadays the situation looks even worse.
There are new casualties of the civil war
from the time of the Taliban regime (50).
Adults are mainly injured by antipersonnel
mines’ explosions during travel, moving
on terrains which has not been cleared of
mines (51). Children are mainly affected
by blast injuries which occur during play
and pasturage of farm animals (50). Most
mines in Afghanistan were planted in the
time of the Russian occupation in the
1980s (52). Many areas were covered by
mines and unexploded shells during fights
between the mujahideen and the Taliban
in the 1990s (46). Mines are often planted
near objects of economical importance
(factories, roads, water sources).
Unexploded shells often lie on the ground
surface and are easily discernible. They
are very interesting mainly for children,
which usually ends fatally (44). Explosions
of mines and unexploded ordnance cause
deaths or injuries, such as limb
amputations and multiorgan trauma (53&
56). A study carried out in Afghanistan
revealed that the mortality rate due to
explosions of mines and unexploded
ordnance remains at 50&55% (40).
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Резюме
РИСКИ ДЛЯ ЗДОРОВЬЯ В
ЦЕНТРАЛЬНОЙ АЗИИ НА ПРИМЕРЕ
АФГАНИСТАНА
Кореневский К.
Рассмотрены эпидемиологичес&
кие, демографические и эколого&гиги&
енические аспекты жизнедеятельности
населения в современном Афганиста&
не. Проанализированы многочислен&
ные статистические данные о состоя&
нии питания и водоснабжения, уровнях
и динамике инфекционной заболевае&
мости. Делается вывод о необходимо&
сти вакцинации всех лиц, выезжающих
в страны Центральной Азии, противви&
русного гепатита А и В, рекомендова&
но проведение химиопрофилактики
малярии, а также правила поведения,
снижающие степень опасности для здо&
ровья и жизни.
Резюме
РИЗИКИ ДЛЯ ЗДОРОВ’Я В
ЦЕНТРАЛЬНІЙ АЗІЇ НА ПРИКЛАДІ
АФГАНІСТАНУ
Кореневський К.
Розглянуті епідеміологічні, демог&
рафічні та еколого&гігієнічні аспекти
життєдіяльності населення у сучасному
Афганістані. Проаналізовані численні
статистичні данні щодо стану харчуван&
ня і водопостачання, рівнях і динаміки
інфекційної захворюваності. Робиться
висновок щодо необхідності вакцинації
всіх осіб, що виїжджають в країни Цен&
тральної Азії, проти вірусного гепатиту
А и В, рекомендовано проведення
хіміопрофілактики малярії, а також пра&
вила поведінки для зниження ступеню
небезпечності для здоров’я и життя.
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ № 3 (9), 2007 г.
7676767676
ACTUAL PROBLEMS OF TRANSPORT MEDICINE # 3 (9), 2007
Summary
HEALTH HAZARDS IN CENTRAL ASIA ON
AFGHANISTAN EXAMPLE
Krzysztof Korzeniewski
The situation of Afghanistan after
nearly three decades of war is dramatically
bad. A prevailing part of the Afghan
population live in extreme poverty. Food
supply is scarce, access to uncontaminated
drinking water is limited, and there are
hardly any sanitary facilities enabling basic
hygienic standards. Malnutrition is
common. To make the situation even more
catastrophic there are frequent disasters,
mainly droughts and floods. Most of the
country is all the time controlled by drug
barons who, having at their disposal their
private armies, decide about the existence
of local communities.
Those about to leave for Afghanistan
are recommended to get vaccinated against
viral hepatitis A and B, poliomyelitis, typhoid
fever, tetanus and rabies. Antimalarial
chemoprophylaxis is also recommended
(Doxycycline, Mefloquine or Atovaquone/
УДК: 313.13
РЕЗУЛЬТАТИ СЕРОЛОГІЧНОГО МОНІТОРИНГУ ІМУНІТЕТУ ДО
ПОЛІОВІРУСІВ У ДІТЕЙ НА ЛЬВІВСЬКІЙ ЗАЛІЗНИЦІ
Думський В.П., Щербакова Л.В., Осьмак Н.В.
Санітарно"епідеміологічна станція на Львівській залізниці
Впервые поступила в редакцию 12.07.2007 г. Рекомен"
дована к печати на заседании ученого совета НИИ ме"
дицины транспорта (протокол № 5 от 05.10.2007 г.).
В травні 1988 року Всесвітня асам&
блея охорони здоров’я поставила завдан&
ня добитися глобальної ліквідації поліом&
ієліту до 2000 року. Цю ініціативу підтри&
мали всі країни – члени ВООЗ, в тому
числі і Україна. Для вирішення поставле&
ного завдання необхідно було, насампе&
ред, створення і тривалого підтримання
на високому рівні протиполіовірусного
імунітету.
З 1989 року і по даний час на
Львівській залізниці проводиться робота
по вивченню напруженості імунітету у
дітей до вірусів поліомієліту. Метою було
вивчення стану імунітету у дітей, що от&
римали повний вакцинальний комплекс і
не менше однієї ревакцинації.
Матеріали і методи
Враховуючи те, що територія
Львівської залізниці проходить по семи
областях Західної України дані досліджен&
ня охопили не тільки дітей ст. Львів, а
також ближні і віддалені дільниці обслу&
говування. В процесі моніторингу дослі&
джувались проби від дітей організованих
дитячих колективів і неорганізованих
proguanil) and so is the usage of repellents
against insects (numerous vectors of
arthropod&borne diseases) (57,58). Yellow
fever does not exist in the territory of
Afghanistan, however people coming from
the zones of the endemic occurrence of this
disease (Equatorial Africa and most
countries in South America) have to
possess a current international certificate of
vaccination against this disease (58). An HIV
carrier state test (which is mandatory in
some Muslim countries) is not required (1).
Travelers to Afghanistan should have health
insurance covering hospital treatment and
medical transport (1). Unknown terrain,
where the local people do not go, must
never be entered. Motor vehicles must
never leave hard&paved roads, not even to
pull over (15,59). If you happen to see an
unknown object, you must never pick it up
because it can be a booby&trap (during the
war Russians used perfidious tricks, such
as planting mines mimicking toys, which
caused a lot of casualties among Afghan
children) (45,60).
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