07. Master Thesis of Public Health Program

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    Undergraduate students’ knowledge, attitude and perceptions of infertility, infertility risks and treatment within universities in Astana, Kazakhstan.
    (Nazarbayev University School of Medicine, 2018) Abdukhakimova, Diyora; Alibekova, Raushan; Crape, Byron
    Infertility is a global issue that affects millions (Sami,2006). According to the World Bank, the fertility rate has declining trend in Kazakhstan. Infertility does not have only medical consequences, it also leads to psychosocial and economic issues, thus has public health importance (Rouchou, 2013). Social consequences of infertility consist of stigma, marital instability, social health risks and domestic violence (Rouchou, 2013). This types of social aspects of infertility were detrimental in setting psychological issues in infertile people. The psychological problems included depression, anxiety and identity predicaments (Hasanpoor-Azghdy, 2014). Fertility has immense importance for infertile people. But infertility treatment is costly, thus can bring a financial burden to those who cannot afford it (White, 2005; Boivin, 2007). Knowledge of infertility risks and its treatment options can help to decrease the incidence of infertility by educating youth.
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    Association of problem gambling with psychosocial characteristics among undergraduate students in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2018-04-27) Janabel, Gulzira
    Background. The prevalence of probable pathological gamblers among college students worldwide doubled in 15 years. While gambling addiction causes financial and social losses, there is lack of studies on gambling involvement in Kazakhstan. Aims. The current research aims to find the prevalence of gambling, explore the link with sociodemographic and psychological variables among college and university students is Astana, Kazakhstan. The study also aims to evaluate the association between gambling and school satisfaction, which was not reported before. Methods. The analysis included questionnaires of 399 students from three universities and three colleges in Astana, using random sampling. The survey consisted of demographic questions, and scales on anxiety and depression, alcohol use, school satisfaction, family cohesion and suicide ideation. Results. From 399 questionnaires analyzed, 5.76% were classified as pathological gamblers according to the gambling scale used. The most popular gambling type was betting on sport events with bookmakers. 12.4% reported placing a bet through bookmakers at present time, and of them 91.5% were male, around half (46.8%) were categorized as some-problem gamblers, and one-third (36.1%) as pathological gamblers. Two-third of them (66%) did not reach legal age for gambling. Pathological gamblers in comparison with non-gamblers/non-problem gamblers are more likely to be male, aged older than 21, have alcohol use disorders, have lower family cohesion, more frequent suicide ideation, and their fathers have no after school education. Some-problem gamblers in comparison with non-gamblers/non-problem gamblers are more likely to be male, have lower school satisfaction, show symptoms of depression, and do not combine work and study. Conclusions. The study gives the first overview for gambling problem and associated problems among undergraduate students in Astana. Associates of problem gambling is consistent with the literature. Since every fourth male in the study places a bet with bookmakers, and majority had a gambling problem, there is need for developing interventions to increase awareness and prevent problem gambling and associated psychosocial problems.
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    Prevalence of internet addiction and its association with mood and sleep disorders among young adults in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2018-05) Tolegenova, Akbota
    In recent years, the Internet has become the most essential tool in both studying and entertainment, by giving the fast and easy access to all the information for students. However, uncontrolled excessive use of internet negatively influences a person’s life, leading him to “Internet addiction” (IA) or “Problematic Internet use”. Despite the fact, that more than half of Kazakhstani population (55.8 %), which is approximately 10 million, uses internet on a daily base, there is a lack of studies on internet addiction in Kazakhstan. Therefore, our study aims were: (1) to estimate the prevalence of IA among university and college students; (2) to explore the association of IA with various factors, related to socio-demographics, family relationships, mood and sleep disorders, self-esteem, physical and social activities, and academic performance of the students.
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    Awareness, Knowledge and Attitudes about human papillomavirus infection and vaccination among university students in Astana
    (Nazarbayev University School of Medicine, 2018-05) Shokanbayeva, Torgyn
    Human Papilloma virus is one of the most common infections caused by a virus. Most importantly is the fact that this infection can lead to cervical cancer, which represents a great burden for Kazakhstani women. There is a vaccine to prevent cervical cancer. Kazakhstan has introduced human papilloma virus vaccination program. However, there are no published public health studies about behavioral perception towards HPV and HPV vaccination that could support and encourage such a vaccination program.
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    Awareness, perceptions and understanding of postpartum women and healthcare providers about the postpartum depression: a qualitative study
    (Nazarbayev University School of Medicine, 2018-05) Kanderzhanova, Akbota;
    Postpartum depression is a major public health problem and linked to mothers’ reduced ability of sensitive parenting and increased risk of developmental delays of children. Its prevalence was estimated as 13% in Western countries and 19.8% in lower and middle-income countries. No previous studies have explored the perspectives of postpartum women and healthcare providers regarding postpartum depression in Kazakhstan. The aim of this research is to explore postpartum women’s and healthcare providers’ awareness, understanding and perceptions of postpartum depression, acceptability of the Edinburgh Postnatal Depression Scale (EPDS), and postpartum mental healthcare practices in Kazakhstani context.
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    Bullying among adolescents in Astana, Kazakhstan: Prevalence and Associated Factors
    (Nazarbayev University School of Medicine, 2018-05) Turegeldiyeva, Madina
    Bullying is one of the main negative phenomenon in children’s mental health development. Studies worldwide showed the association of bullying with different factors, such as gender, race, family and peer relationships, perceptions related to life, health etc. The situation of bullying is not yet explored in Kazakhstan due to absence of proper monitoring tools. The aim of this study was to (1) assess the prevalence of the bullying among school children aged 11-15 years old, and (2) examine patterns of the association between bullying and socio-demographic, mental and physical health characteristics among schoolchildren of Astana city, Kazakhstan.
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    Prevalence and associated factors of job satisfaction among physicians working in public hospitals in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2018-05) Makhanov, Kuat
    Physician job satisfaction is an important factor of quality and sustainability of health care provision, as it determines lengths of care and subsequently health care costs. It is also associated with such aspects of healthcare as quality of the care and physician work efficiency There is a general tendency in declining job satisfaction among health care workers in many countries; although there were no studies found in the literature on job satisfaction among physicians in Kazakhstan. The purpose of the study is to estimate the prevalence and to determine factors of working conditions associated with job satisfaction among physicians working in public hospitals in Astana city of Kazakhstan
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    Spontaneous abortion in Astana: Associated factors, 2015-2017
    (Nazarbayev University School of Medicine, 2018-05) Zhanseitova, Akzhan
    Background Spontaneous abortion is the most common adverse pregnancy outcome. That is a great challenge for any healthcare facility and population health. The present study is aimed to investigate the associated risk factors of spontaneous abortion against normal delivery in population of Astana and provide refence for policy development of prenatal care. Methods A cross-sectional analysis was conducted based on the informational systems of inpatients records (67,759) from 2015 to 2017. This study used records of women with spontaneous abortions and normal delivery pregnancy outcome, older than 18. The prevalence risk ration was calculated using the Poisson family with equal variances.
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    Nutritional and behavioral risk factors for gastritis in Kazakhstani population: preliminary results.
    (Nazarbayev University School of Medicine, 2018-05) RAZBEKOVA, MADINA
    Gastritis is characterized as inflammation in stomach, and it can be acute and chronic. Acute gastritis can go away in several days, while chronic gastritis can persist for years. The latter is implicated with increased risk for gastric cancer. Risk factors for gastritis include H.pylori infection, family history, psychological stress, use of drugs, and lifestyle habits. Since Kazakhstan holds the fifth place among the highest stomach cancer mortality rates worldwide, epidemiology of risk factors for gastric cancer and its potential precursors are needed to study. To address this issue, lifestyle habits and family history were studied for association with chronic non-atrophic gastritis. The survey on nutrition and behavioral habits was given to patients, who underwent gastroendoscopy in two hospitals of Astana, and then further analyzed with bivariate non-parametric and bivariate logistic regression tests. Data from total of 19 gastritis patients and 14 non-gastritis patients were obtained. Though no statistical significance was found during analysis, higher frequency of alcohol drinking, kazy/shuzhyk eating, drinking piped water, having family history of cancer, and hypertension were detected in gastritis patients comparing with controls. Kumys/shubat drinking, eating fresh fruits, and overweight and obesity was less present in gastritis group than in controls. These findings supported existing knowledge on risk factors for gastritis and gave more specific evidence for chronic non-atrophic gastritis. Moreover, more research is needed on larger sample size to elucidate role of food in risk of developing chronic gastritis in people living in Kazakhstan.
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    Analysis of factors associated with profitability of Kazakhstani state hospitals and polyclinics.
    (Nazarbayev University School of Medicine, 2018-05) Shayakhmetov, Yerassyl
    The following study analyzed factors affecting profitability of medical state enterprises. The primary interest of the study was the effect of corporate governance on financial performance of oblast level hospitals and primary care clinics. It was found that the presence of a supervisory board for the hospital or clinic is associated with decreased probability of producing net positive income (37% less chance) in these organizations. Also it was found that characteristics of supervisory boards like number of people in the board and meetings held by supervisory boards are not associated with profitability of state medical enterprises. The profitability of state medical organizations also differed between regions of the country and between organizations located in cities and rural regions.
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    Mental health and suicidality among gay and bisexual men in Kazakhstan. A prevalence study.
    (Nazarbayev University School of Medicine, 2018-05) Seksenbayev, Azamat
    Suicide is the act of killing yourself. According to WHO about 800,000 people die by suicide annually and many more attempt it. The evidence shows that global burden of suicide lay heavily on low- and middle-income countries. In 2015, 78% of all known suicides occurred in these countries, and suicide accounted for 1.4% of all deaths worldwide, and ranked as 17th leading cause of death (WHO, 2013). Men are more likely to die of suicide than women, and this is more prominent in high-income countries with ratio of three men to every woman.
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    Patient satisfaction with physician-patient communication in outpatient care: A pilot study
    (Nazarbayev University School of Medicine, 2018-05) Tursynkhan, Aigerim
    Measurement of patient satisfaction plays an important role in the health care practice to improve overall health care delivery of health care organizations, to do effective strategic decision making and monitoring of health care performance. There is a shortage of studies conducted about patient satisfaction with health system of former Soviet Union countries, as the range of patient satisfaction studies is limited mainly to countries of the USA and Europe (Footman et.al. 2013). Consequently, there is no standard scale which can be used for studies about patient satisfaction with physician-patient communication. Aim. 1) to identify the level of patient satisfaction with physician – patient communication in outpatient care; 2) to explore factors associated with patients’ satisfaction with physician-patient communication.
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    Costs associated with obesity in Kazakhstan
    (Nazarbayev University School of Medicine, 2018-05) Kosherova, Zhanar
    The aim of this study is to estimate direct medical costs attributable to obesity in Kazakhstan from the governmental perspective for 2008, 2020 and 2030. Cost-of-illness prevalence-based approach was used to estimate the medical direct costs including hospital care, drugs, physician and nursing care covered by the government. There are three types of data required for this study including the actual and predicted estimates of prevalence of the obesity in Kazakhstan for 2008, 2020 and 2030, relative risks for IHD, stroke and T2D and costs on specific disease treatment. All the required information was taken from the secondary data. Thus, the main formula includes multiplying Population Attributable Fraction by the costs for diseases’ treatment.
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    Compliance of antibiotic prophylaxis therapy with clinical protocols.
    (Nazarbayev University School of Medicine, 2018-05) Bizhigitova, Raushan
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    Practice, knowledge and attitudes of physicians towards shared decision- making in their healthcare practice in the National scientific center of oncology and transplantology CF “UMC” in Astana, Kazakhstan: Pilot study
    (Nazarbayev University School of Medicine, 2018-05) Mukhamedyarova, Meruyet
    Despite the importance of shared decision-making in clinical practice, it is not widely implemented in health care systems in the world, including Kazakhstan. In order to develop an effective implementation strategy for shared decision-making to be practiced in hospitals in Kazakhstan, it is necessary to identify and understand physician’s knowledge, practices, attitudes and barriers towards shared decision-making.
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    Antibiotic/antimicrobial resistance patterns of bacterial pathogens isolates from national research center for mother and child health in Astana, Kazakhstan
    (Nazarbayev University School of Medicine, 2018-05) Iskhakova, Dinara
    The rapid emergence of drug resistant bacteria is occurring worldwide, endangering the efficacy of antibiotics, which have transformed medicine and saved millions of lives (1-6). Many decades after the first patients were treated with antibiotics, bacterial infections have again become a threat (7). The antibiotic resistance crisis has been attributed to the overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical industry due to reduced economic incentives and challenging regulatory requirements.
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    Determinants of nonadherence to hypertension treatment among patients in Astana city: A pilot study
    (Nazarbayev University School of Medicine, 2018-05) Salkhayeva, Botagoz
    The purpose of this study was to assess the level of nonadherence to hypertension treatment and to identify the associated factors among patients with hypertension. This was a cross-sectional study. 48 participants were recruited at the urban polyclinic #8 in Astana city for this pilot study. The study participants were patients enrolled to the therapeutics appointment with diagnosis of hypertension. Overall, 48 patients consented to participate and filled out the self-administered questionnaires. The survey consisted of five sections, including questions on socio-demographic characteristics, health lifestyles, dietary habits, antihypertensive drug adherence, and perceptions of severity and susceptibility to hypertension, perception of barriers and benefits of hypertension treatment. Descriptive, bivariate and multivariate logistic regression analyses were conducted in Stata 12.
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    Prognostic capacity of preoperative levels of selected blood inflammatory markers for glioma patient’s survival
    (Nazarbayev University School of Medicine, 2018-05) Yelaman, Konysbek
    Glioma is considered to be a rare type of cancer of the central nervous system (CNS) with the average age-adjusted incidence rate of 3.4 per 100, 000 population. Moreover, gliomas are the most common type of malignant brain tumors among adult population. They account for about 80% of all diagnosed brain tumors originating from brain parenchyma. Despite achievements in medical treatment and technologies glioblastoma patients still have poor prognosis with 3-5% of surviving patients after 12-15 months following standard therapy. In addition, recent studies highlight importance of blood, and molecular markers in predicting presence of gliomas.
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    Identifying and measuring associations between dietary factors and the risk of developing gastric cancer in Astana, Kazakhstan: preliminary findings from an ongoing study
    (Nazarbayev University School of Medicine, 2018-05) Sadykova, Gulnaz
    Gastric cancer is one of the most common type of cancer in Kazakhstan as well as worldwide with high mortality and morbidity rate. The aim of the study is to identify and measure associations between nutritional risk factors and the risk of having gastric cancer in Astana, Kazakhstan.