North-West Public Health Research Center

BackgroundEliminating maternal and perinatal morbidity and mortality are global health priorities. Cameroon has some of the highest levels of maternal and neonatal mortality in the world. Evidence-based maternal healthcare is vital to ensuring women’s and infants’ health; however, offering such services in low-income countries is often challenging. Mobile health interventions have the potential to overcome longstanding public health barriers to fill gaps in maternal and infant care. This is among the first qualitative studies in Cameroon that examines individual and interpersonal barriers to maternity care to inform mHealth intervention adaptation.MethodsWe conducted qualitative in-depth interviews (n=38) and three focus groups (n=18) with key stakeholders including previously pregnant women who experienced an adverse event, currently pregnant women, maternity care providers, healthcare administrators, and Ministry of Health representatives. Thematic analysis was performed using NVivo12 software. Themes were categorized on the individual and interpersonal levels. The current study is part of a larger, long-term implementation project to adapt MIST to the local contexts of Cameroon using mobile phones.ResultsA total of 56 respondents, 14 men and 42 women, participated in this qualitative research. Participants reported individual-level barriers for women’s timely and appropriate maternity care related to antenatal care initiation, antenatal care utilization, health literacy, and blind trust in providers. Participants suggested that women waited to initiate antenatal care, underutilized antenatal care, lacked perinatal health literacy, and trusted their providers, regardless of health outcomes and complications. At the interpersonal level, husbands, religious leaders, and family were identified by participants as influencing women’s perinatal healthcare decisions-making, both positively and negatively.ConclusionOur data reveal individual and interpersonal forces that affect maternal and perinatal care in Cameroon. Future public health efforts can focus on improving health literacy during pregnancy and reproductive years among women as well as in their close social networks.

Introduction. The federal project “Clean Air” currently covers forty one settlement, including the cities of Petrovsk-Zabaikalsky and Ussuriysk, included in 2023. Comprehensive plans to reduce emissions for these cities are in the approval stage, and therefore studies to assess the levels of air pollution and the contribution of industrial emissions to it remain relevant. The purpose of the study was to substantiate the priority air pollutants for quotas in the cities participating in the federal project “Clean Air” Petrovsk-Zabaikalsky and Ussuriysk based on calculated and natural data. Materials and methods. The results of atmospheric air monitoring for 2023–2024 were used. Databases of pollutant emission sources generated for each city were used to carry out consolidated calculations. A hygienic assessment, determination of the frequency of exceeding hygienic standards, and an assessment of the risk to public health were carried out. Based on the data from consolidated volumes, lists of priority pollutants were formed and consolidated dispersion calculations were carried out. Based on the calculated and in-kind data, an assessment of the risk to public health was carried out. The risk values ​​obtained on the basis of the calculated and in-kind data were compared. Visualization of the distribution of concentrations and risk levels was carried out using the ESRI ArcGIS 9.3 geographic information system. Results. The conducted study made it possible to form lists of pollutants that are priority for quotas within the framework of the federal project “Clean Air” for the cities of the Far Eastern Federal District Petrovsk-Zabaikalsky and Ussuriysk, justified from the position of the predicted advers impact on public health based on the results of risk assessment and monitoring conducted by Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing. Limitations. The work took into account the results of monitoring conducted by the bodies and institutions of Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing without taking into account the monitoring data of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing. Conclusion. The formed list of priority pollutants for quotas is included in the monitoring programs of the studied cities and will be updated annually in the future as the federal project “Clean Air” is implemented and emissions of priority pollutants are reduced.

Introduction. The Murmansk Region is a highly industrialized region of the Russian Arctic. Therefore, the quality of its surface waters is significantly influenced by both climatic and geographical factors, as well as by mining activities. In light of this, it is an urgent priority to conduct a comprehensive hygienic assessment of the status of water supply sources in the urban areas within the region. Materials and methods. The yearbooks of the Main Geophysical Observatory named after A.I. Voeikov “The state of atmospheric pollution in Russian cities” for 2021–2022; state reports “On the state of sanitary and epidemiological welfare of the population in the Murmansk region” for 2021–2023, the results of laboratory studies of the surface water sources quality for 2018–2023; sanitary and epidemiological conclusions on the possibility of using water bodies for drinking and domestic water supply. A study was conducted on 13 surface water bodies in the Murmansk Region, which serve as sources of drinking water for 14 settlements in the region. Results. The most frequent excess of hygiene standards was observed in the following indicators: sanitary-chemical – Fe, Ni, Hg, Mn, NH4, benz(a)pyrene, phenol; generalized including chemical oxygen demand (COD), biological oxygen demand (BOD), permanganate oxidizability, pH; sanitary as microbiological – GCB, TCB, E. coli, coliphages. A list of indices has been determined for inclusion in the programs of industrial surface water sources quality control in the Murmansk region. The water treatment was determined to be provided only in 5 of the 13 water sources in the region with widespread disinfection. Chlorination is used at 11 of the 13 water sources, and ultraviolet irradiation is used at the other 2 ones. Limitations. In this research the list of indicators was limited by the research programs of social and hygienic monitoring and UGMS. Sampling points in the UGMS don`t correspond to water intake points in all settlements. Also, the results of laboratory tests of water before entering distribution networks aren`t considered in this work. In addition, the risk assessment was carried out taking into account the uncertainties associated with the fact that the population uses water after water treatment. The risk assessment in this situation was aimed at identifying priority indicators that need to be included in production control programs. Conclusions. The supervisory authorities are recommended to pay attention to the widespread excess of hygienic standards for sanitary-microbiological indicators in the Murmansk region`s drinking water to prevent outbreaks of infectious diseases with aquatic transmission.

Introduction. Currently, the hygienic characteristics of the working conditions of employees of enterprises with harmful working conditions are based mainly on the standard method of workplace air sampling without taking into account individual physiological parameters, different degrees of physical exertion of employees at individual levels of the technological process during the work shift. The study aims to make a comparative assessment of the air pollution indicators of the working area of workers of the nickel electrolysis workshop using standard and individual sampling methods. Materials and methods. The scientists have conducted research at mining and metallurgical enterprises of the Murmansk region located in the European part of the Arctic zone of the Russian Federation. These enterprises are part of the mining complex of the region and are engaged in the extraction and processing of copper-nickel sulfide ores in order to obtain finished products — electrolytic nickel. The authors conducted air sampling in industrial premises using standard methods using individual samplers during a work shift.The nickel content in the aerosol was determined using a polarographic method based on the reduction of nickel dimethylglyoximate complexes on a mercury droplet electrode in the presence of chloride‑ammonia buffer and sodium sulfite. The method of inductively coupled plasma atomic emission spectrometry was used to analyze the metal content. Results. A comparative analysis of the results showed that the use of individual sampling devices makes it possible to objectively assess the level of exposure to toxic water-soluble nickel compounds. Experts have established that the method of individual sampling in terms of the frequency of exceeding the maximum permissible concentration in the air of the working area by 30.5%, compared with the standard procedure, gives a more accurate picture of the degree of risk of harm to the health of workers with harmful chemical factors. The use of individual sampling techniques can increase the objectivity of the results of control and supervisory measures in the field of occupational health and expert decisions in establishing a link between diseases and the profession of workers in harmful chemical industries. Limitations. Conducting studies on the hygienic assessment of chemical air pollution in the working area in the production facilities of the nickel electrolysis workshop was difficult due to the difficulties of passing the admission procedure to the territory of the metallurgical enterprise. Conclusion. Hygienic characteristics of chemical air pollution in the work area using the method of individual sampling significantly increases the objectivity of quantifying the risk to the health of chemical industry workers and reduces the time required for laboratory tests. Ethics. The study does not require the provision of an opinion from the biomedical Ethics Committee or other documents.

Introduction. The problem of comorbid pathology, which is becoming increasingly more important for internal medicine, is still little known in occupational medicine. The purpose of the study is to obtain new data on the development, prevalence, and structure of occupational comorbidity in the copper-nickel ore metallurgical processing. Materials and methods. We studied the data from the register of extracts from occupational disease and poisoning records (Order of the Ministry of Health and Social Development of Russia No. 417 dated 27.04.2012 Health of Russia dated May 28, 2001 No. 176) in the Murmansk region and Krasnoyarsk Territory for 2007-2021. Results. In 2007–2021, 24.6% of nickel industry workers with newly diagnosed occupational diseases developed comorbid pathology. Its prevalence rose from 0% in 2007–2008 to 83.3% in 2021, and the number of diseases increased by 3.17 times over this period. Two diseases were diagnosed in 66 (14.9%), three in 22 (5.0%), four in fifteen (3.4%), five in eleven (2.5%), and six in three (0.7%) of employees. The development of occupational comorbidity is associated with a rise in exposure to the combined effect of harmful production factors (primarily chemicals and the severity of labor), the imperfection of technological processes, and the working conditions of some specialists (primarily cleaners of finished products and crane operators). Respiratory and musculoskeletal diseases were the most prevalent in the structure of comorbid pathology: 31.5% and 23.0%, respectively. Research limitations. The study is limited to the study of the causes of development, prevalence and structure of comorbid occupational pathology in workers engaged in metallurgical processing of copper-nickel ore at enterprises in the Murmansk region and Krasnoyarsk territory. Conclusion. In the nickel industry workers, exposed to combination of production hazards of various natures, the development of occupational comorbidity is caused by the continued work activity of individuals with initial signs of health disorders. For its prevention, it is necessary to timely determine the compliance of the workers´ health status with the current production hazards exposure

This study presents the first comprehensive examination of 137Cs behavior in northern taiga ecosystems of the Kola Peninsula, a previously understudied region regarding radionuclide mobility. The background radioactive contamination of these ecosystems stems from global fallout and differs from more extensively studied contaminated areas. Twelve monitoring sites at varying distances from the Kola nuclear power plant were established to assess 137Cs accumulation in dominant plant species across three forest tiers. Gamma-spectrometric measurements revealed high mobility of 137Cs with specific activity ranging within 4.7-34.5 Bq/kg in trees, 8.4-164.8 Bq/kg in shrubs, and 15.0-94.5 Bq/kg in mosses. Notably, Ericaceae family plants demonstrated the highest accumulation capacity. 137Cs concentrations were significantly higher at the background site (30 km from the power plant) than in the sanitary protection zone, indicating no detectable influence from the nuclear facility. Strong correlations (up to |rs| = 0.93) between bioaccumulation indicators and soil properties were found-particularly with potassium content, exchangeable cation concentration, and organic matter content-suggesting that soil characteristics primarily determine 137Cs mobility. These findings highlight the potential risk of 137Cs movement through food chains in northern taiga ecosystems, with bioaccumulation coefficients exceeding those of central Russian landscapes and being comparable to those of Scandinavian taiga ecosystems.

In accordance with the International Classification of Diseases 10th Revision (ICD-10), malignant tumors (MT) of the nasal cavity and paranasal sinuses include diagnosis codes with sub-codes C30 and C31. In world and state statistics, summary data on morbidity is summarized under two diagnosis codes, C30 and C31. Our PCR database of the North-West Federal District of the Russian Federation contains more than 1.5 million cases, which allows us to consider the peculiarities of the prevalence of cancer in rare groups of malignant neoplasms. The population of the Northwestern Federal District of the Russian Federation is 13.9 million people, which is more than the population of Belarus, Latvia and Estonia combined.Objective. To study the prevalence and survival patterns of patients with malignant neoplasms of the nasal cavity, middle ear and paranasal sinuses using the database of the newly created NMR of the Northwestern Federal District of the Russian Federation, taking into account the detailed localization structure by subheadings: C30.0.1 and C31 with subheadings C31.0.1–3.8.9.Materials and methods. The study material is the data of the International Agency for Research on Cancer (IARC), reference books of the P.A. Herzen Moscow Oncology Research Institute and the N.N. Petrov National Medical Research Center of Oncology. Data processing was carried out using licensed programs MS Excel 2013–2016 and STATISTICA 6.1. A modified EUROCARE program was used to calculate survival. The calculations are based on the NMR of St. Petersburg and the Northwestern Federal District of the Russian Federation.Results and discussion. The conducted study with the analysis of prevalence, assessment of the quality of registration and survival of cancer patients with malignant neoplasms of the nasal cavity, middle ear and paranasal sinuses, confirmed the rarity of this pathology in the world and Russia. In general, a decrease in standardized morbidity rates, including age-related ones, was established. Improvement in the quality of registration of primary patients and provision of medical care was noted. An increase in the one-year survival of patients with malignant neoplasms of the nasal cavity, middle ear over three observation periods by 20.5% and paranasal sinuses by 15.4% was revealed. Five-year survival has remained virtually unchanged.

In this single-centre, retrospective, pragmatic, longitudinal case-series clinical study triple-frequency LDM (TF-LDM) technology with frequencies of 1/3/10 MHz and 3/10/19 MHz was applied for treatment of cellulite to reveal the effect of these waves on the cellulite skin and assess the sustainability of treatment outcomes during the long-term follow-up controls. Twenty Caucasian females with mild-to-severe gynoid lipodystrophy aged 27-53 years who received cellulite monotherapy with TF-LDM were included in this study. All participants were evaluated at three time points: baseline (T1), on the day of the last treatment (T2), and during the last follow-up (T3). Cellulite severity was assessed by six independent clinicians using the five-grade Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS). Patient satisfaction was evaluated using a 10-grade GAIS scale, ranging from 0 to 10 (0 - dissatisfied; 10 - fully satisfied). To objectify the treatment outcomes, 17 subjects were investigated using B-mode ultrasonography and real-time compression elastography at baseline and during follow-up. The average values of CR-PCSS (T1), CR-PCSS (T2) and CR-PCSS (T3) over all participants were 2.22±0.82, 1.18±0.77, and 0.84±0.77, respectively, which corresponded to the skin improvement between T1 and T2 of 0.93±0.27 (p < 0.0001) as well as between T1 and T3 of 1.38±0.47 (p < 0.0001). Assessment of elasticity of the dermis and adipose tissue on the basis of the 5-grade coloration scale revealed significant reinforcement of both tissues as well as of the superficial fascia at follow-up as compared to their baseline values. The obtained treatment outcomes were long-lasting and could be clearly observed even in individuals with a long-term follow-ups. Assessment of the satisfaction of participants with the treatment results revealed a high satisfaction of 8.95 ± 1.49. The method demonstrated no side effects, was pain-free, well-tolerated, and highly accepted by patients.

Regulatory control of the quality of bottled drinking water is an important area of protecting health and enhancing quality of life in population, including children. The aim of the study is to conduct a comparative analysis of regulatory measures for the quality of bottled drinking water based on chemical indices, with a view to considering international standards to improve the Russian legal framework in this field. The analysis incorporates foreign regulatory and legal instruments in the area of control and monitoring of the quality of packaged drinking water, such as the Codex Alimentarius and directives of the European Parliament, Council of the European Union, Code of Special Regulations of Food and Drug Administration, ТР ЕАЭС 044/2017 Technical Regulations.Current international and domestic regulations, ensuring bottled water quality, have been analyzed. In spite of the fact that regulatory documents comprise fifty three common indices, over half of the international standard values differ significantly as compared to ТР ЕАЭС 044/2017 Regulations. There are noted advantages of domestic regulations, considering the specific requirements for bottled drinking water for children and the physiological benefits of water. In this study, only the regulation of chemical indices in packaged drinking water has been considered based on 4 regulatory documents. Additionally, the work has not taken into account in detail those indices that are not included in domestic regulations. Conclusion. A comparative analysis of international and national regulations has shown the Russian Federation to have more stringent requirements for the regulatory values of bottled water quality. Taking into account current trends it is necessary to improve and expand constantly the system of regulatory quality control of bottled drinking water by including those indices concentrations of which are regulated by international legislation.