Keyword: Epidemiology

ABSTRACT: Coronary artery disease remains a major cause of death and disability worldwide. Chronic Coronary disease one of its most common clinical forms, reflects the combined effects of age, obesity, hypertension, diabetes, and other chronic conditions. This study analyzed national administrative data from Kazakhstan between 2014 and 2021 to explore trends in Chronic Coronary disease incidence, comorbidities, and mortality among patients coded under ICD-10 codes I20–I20.9 within the Unified National Electronic Healthcare System (UNEHS). A total of 624,852 patients with Chronic Coronary disease were identified through the national electronic health system. Demographic, clinical, and outcome indicators were examined to assess trends and disparities across sex, ethnicity, and place of residence. During the study period, the recorded incidence of Chronic Coronary disease decreased from 584 to 211 cases per 100,000 population, whereas the mortality rate rose from 19 to 100 per 100,000. The 2014 incidence figure should be interpreted with caution as it likely reflects a prevalent pool effect at the inception of systematic UNEHS data capture. Mortality was highest among men, older adults, ethnic Russians, and rural residents. Patients undergoing coronary artery bypass grafting showed better survival than those treated with percutaneous coronary intervention, though this comparison should be interpreted cautiously given potential confounding by indication. Hypertension, diabetes, and multiple comorbidities substantially increased the risk of death and adverse cardiovascular events. These results underline widening health inequalities and the urgent need for improved prevention, equitable access to care, and integrated management of chronic cardiovascular disease in Kazakhstan.

ABSTRACT: Antimicrobial resistance (AMR) poses an escalating threat to global public health, undermining the effectiveness of infectious disease prevention and treatment and placing sustained pressure on health systems worldwide. Advances in genomic technologies, including whole-genome sequencing and metagenomic analyses, have substantially enhanced the resolution and scope of AMR surveillance. However, despite growing investments in genomic surveillance, the routine translation of genomic data into public health policy and action remains limited. This review examines the persistent data-to-decision (D2D) gap that constrains the public health impact of genomic AMR surveillance. Using a narrative review approach, the literature on genomic AMR surveillance, public health surveillance systems, and decision-making frameworks was synthesized to assess how genomic data are generated, interpreted, and operationalized within public health systems. The review integrates evidence from international and national surveillance initiatives, policy analyses, and implementation studies, with particular attention to organizational, analytical, and governance factors influencing data use. Findings indicate that while genomic surveillance offers high potential for early detection of resistance, transmission tracking, and proactive intervention, its public health utility is frequently limited by insufficient integration with decision-making structures, lack of standardized reporting and interpretation frameworks, and unclear action thresholds. The review highlights emerging best practices, including standardized translational reporting, decision-support tools, predefined genomic action triggers, and multidisciplinary collaboration, as critical mechanisms for closing the D2D gap. Persistent inequities in access to genomic surveillance capacity, particularly in low- and middle-income countries, further underscore the need for governance models that prioritize sustainability, local ownership, and equitable capacity building. Overall, this review argues that realizing the full public health value of genomic AMR surveillance requires moving beyond technological advancement toward intentional systems-level integration that aligns genomic intelligence with timely, evidence-informed public health decision-making.

ABSTRACT: The burden of non-communicable diseases (NCDs), particularly cancer, is steadily increasing in Kazakhstan alongside socioeconomic development, highlighting the urgent need for effective national management and control strategies. The Electronic Registry of Oncological Patients (EROP) is a key initiative designed to support this goal by enabling comprehensive surveillance of cancer patients across the country. This review examines the patient journey that informs EROP’s data collection process and explores its potential as a foundation for local cancer epidemiology research. Analysis of the registry reveals extensive coverage of dispensary, outpatient, and inpatient visits, capturing detailed socio-demographic information, diagnoses, treatments, and mortality outcomes. EROP provides valuable insights into cancer morbidity, mortality, and quality of life across spatial and temporal dimensions in Kazakhstan. The review also addresses current limitations and underexplored aspects of the registry, emphasizing the importance of careful interpretation to ensure robust, evidence-based research.