Background. Viral hepatitis is a major burden for the healthcare system worldwide. Up to date, a comprehensive analysis of the prevalence of viral hepatitis in Kazakhstan and Central Asia has not been carried out yet. Our epidemiological study aimed at investigating the frequency and spread of viral hepatitis B, C, and D depending on age and sex in Kazakhstan (5-year period). Materials and Methods. We utilized the data from the primary registration of the incidence of hepatitis B, C, and D in 18 regions of Kazakhstan (period: from 2015 to 2020). Age indicators, gender, and territorial characteristics of registered cases were determined and analysed. The data were obtained from the state information system “Electronic Register of Dispensary Patients”, based on the International Classification of Diseases-10 for coding diseases. Results. During the period studied, 268 975 cases of hepatitis B, C, and D were detected in Kazakhstan. Hepatitis B was registered in n = 109 734 cases. In women, the incidence rate was 40.6% of all cases (n = 44545), and in men it was 59.4% (n = 65189) of all cases ( p ≤ 0.01 ). Hepatitis D was detected in 8 656 cases, of which 58.3% (n = 5049) were in men and 41.7% (n = 3607) in women ( p ≤ 0.01 ). Hepatitis C was registered in n = 159 585 cases. The rate was higher in the male population (54.6%; n = 82 203) compared to women 45.4% (n = 68382) ( p ≤ 0.01 ). In 2020 (in comparison with 2015), there was a significant increase in the incidence of hepatitis D by 68.3%, hepatitis B by 49.8%, and hepatitis C by 46.4%. The largest prevalence of hepatitis D was recorded in 2016 which is 22.3% higher compared to 2020. A significant increase in hepatitis C was recorded in 2019 compared to 2015, where indicators were 49.2% higher. Conclusion. An analysis of the prevalence of hepatitis B, C, and D showed an increase in new cases in Kazakhstan. These findings indicate the need to develop effective preventive measures and screening strategies among people in a high-risk group. The results of the study can be used for the development of a national program to combat the spread of viral hepatitis.

Background & aims Kazakhstan has implemented comprehensive programs to reduce the incidence of Hepatitis B and Hepatitis C. This study aims to assess seroprevalence and risk factors for HBsAg and anti-HCV positivity in three large regions of Kazakhstan. Methods A cross-sectional study was conducted in three regions geographically remote from each other. Participants were randomly selected using a two-stage stratified cluster sampling and were surveyed by a questionnaire based on the WHO STEP survey instrument. Blood samples were collected for HBsAg and anti-HCV testing. Results A total of 4,620 participants were enrolled. The seroprevalence was 5.5% (95%CI: 3.6%-8.4%) for HBsAg and 5.1% (95%CI: 3.5%-7.5%) for anti-HCV antibodies. Both were more prevalent in the western and northern regions than in the southern. A history of blood transfusion was significantly associated with anti-HCV presence, with odds ratios (ORs) of 2.10 (95%CI: 1.37–3.21) and was borderline associated with HBsAg 1.39 (95%CI: 0.92–2.10), respectively. Having a family member with viral hepatitis was also borderline associated (2.09 (95%CI: 0.97–4.50)) with anti-HCV positivity. Conclusions This study found a high-intermediate level of endemicity for HBsAg and a high level of endemicity for anti-HCV antibodies in three large regions of Kazakhstan. We found that history of surgery was not associated with HbsAg neither with anti-HCV seropositivity rates. Blood transfusion was associated with anti-HCV seropositivity, however, to investigate effectiveness of the introduced comprehensive preventive measures in health care settings, there is a need to conduct further epidemiological studies.

Aim: Little is known about the epidemiology of fatty liver disease (FLD) among high-risk primary care subjects in Kazakhstan. We investigated the prevalence of FLD (alcoholic liver disease [ALD] and non-alcoholic fatty liver disease [NAFLD]) and abnormal liver function tests (LFTs) in high risk adults in Kazakhstan during their routine visit to the general practitioner. Methods: This multicenter, cross-sectional epidemiological study was carried out at 75 clinical sites in the Republic of Kazakhstan. The full analysis set population consisted of 5109 subjects. Results: Among type 2 diabetes mellitus (T2DM) subjects, established metabolic syndrome (MetS) and/or obese subjects, the prevalence of FLD was 30.8%. LFT abnormalities were found in 53.2% subjects with FLD and 40.0% without FLD. FLD subjects had significantly higher levels of alanine transaminase (ALT; p < 0.001), aspartate transaminase (AST; p < 0.001), serum total bilirubin (STB; p < 0.001), and gamma-glutamyl transpeptidase (GGT; p = 0.021) compared to those without FLD. LFTs increases were significantly higher in subjects with FLD compared to those without FLD and were also significantly higher in ALD subjects compared to those with NAFLD. Conclusion: This study provides insights into the prevalence of FLD and abnormal LFTs in subjects with T2DM and/or established MetS and/or who are obese in primary care settings in Kazakhstan. These findings can help healthcare providers in Kazakhstan and elsewhere to better recognize and manage patients at risk of liver disease, which will improve clinical outcomes.

Our national center of gastroenterology provides highly specialized care, including chronic pancreatitis. Another area of our activities is educational programs, including postgraduate and fellows' courses. Thereby, we have noted significant gaps in the knowledge of the specialists that involved in the chronic pancreatitis management. The most critical downsides are related to insufficient attention to etiology and risk factors, using outdated classifications, the lack of knowledge in arsenal of diagnostic techniques, polypharmacy or application of low level of evidence treatment methods. Finally, we have made amendments in the National Clinical Protocol in Chronic Pancreatitis [1], updated the State Educational Standard for residents of the gastroenterological profile [2]. The aim of the study was the analysis of the basic knowledge among different specialists in the management of chronic pancreatitis (CP) around the country. This qualitative study consists of two parts, including focus group interviews followed by interviews with the specialists across the country, which was conducted during the period 2015-2018. In this paper, we present results of diagnostic approaches at the different levels of medical care. The general practitioners have noted the absence of modern methods of laboratory and visual diagnostics in their routine practice, therefore explaining the plenty of the complicated forms. Another issue is the low specialist's adherence to clinical guidelines, poor knowledge of the risk factors and overestimation of the clinical presentation value except malnutrition symptoms. On the other hand, surgeons and other specialists are not ready to implement modern diagnostic tools and methods in their practice.