Acute myocardial infarction and brain infarction morbidity as a quality indicator of the chronic non-communicable diseases overcoming in Turkmenistan

Improving the provision of medical care to patients with chronic non-communicable diseases should be based on objective indicators of the effectiveness of preventive measures and medical examinations. Such an indicator can be the incidence of acute myocardial infarction and cerebral infarction. Objective: to characterize the trends in the dynamics of the incidence of myocardial infarction and acute disorders of cerebral circulation in Turkmenistan. Materials and methods. A retrospective descriptive epidemiological study was performed. The dynamics, spatial and temporal characteristics of the incidence of myocardial infarction (ICD-10 code I21–I23), cerebral infarction (ICD-10 code I63) in the period 2016– 2020 in Turkmenistan as a whole and by administrative-territorial units were studied. Results. During the study period, Turkmenistan has seen a decrease in the overall incidence of acute myocardial infarction from 10.9 per 100 thousand in 2016 to 7.8 per 100 thousand in 2020. Currently, the highest level of total incidence of myocardial infarction is registered in Ashgabat and the Balkan Velayat (9.0 per 100 thousand people), the smallest is in the Mary Velayat (6.9 per 100 thousand people). There is also a decrease in the overall incidence of acute disorders of cerebral circulation. In the whole country from 2016 to 2020, the indicator decreased from 5.6 to 4.7 per 100 thousand population. At the level of individual administrative-territorial units, significant fluctuations in indicators were observed during the study period, and in the city of Ashgabat, an increase in the overall incidence of brain infarction. Conclusion. The decrease in the overall incidence of acute cerebral circulatory disorders and acute myocardial infarction indicates the high quality of the work of the national health system in the aspect of prevention of chronic NCDs. In some administrative-territorial units of Turkmenistan, the peculiarities of the dynamics of morbidity were revealed, requiring special organizational approaches.

1. Abdulloev S.M., Gulbekova Z.A., Odinaeva N.S., Makhmudov K.R. The most important aspects of epidemiology and risk factors of chronic noninfectious diseases. Health care of Tajikistan. 2020; 2: 75–87 (In Russian).

2. Drozdova L.Yu., Ivanova E.S., Egorov V.A., et al. Quality assessment of the secondary prevention of chronic noncommunicable diseases during the public dispancery observation in regions of the Russian Federation. Profilakticheskaya Meditsina. 2020; 23(6): 21–25 (In Russian). https://doi.org/10.17116/profmed20202306221

3. Kobiakova O.S., Deev I.A., Kulikov E.S., et al. Chronic noncommunicable diseases: combined effects of risk factors. Profilakticheskaya Meditsina. 2019; 22(2): 45–50 (In Russian). https://doi.org/10.17116/profmed20192202145

4. Lukyanets A., Ryazantsev S., Moiseeva E., Manshin R. The economic and social consequences of environmental migration in the Central Asian countries. Central Asia and the Caucasus. 2020; 21(2): 160–176 (In Russian).

5. Starovoitova E.A., Shibalkov I.P. Health centers – a tool for improving the prevention of chronic non-communicable diseases in the russian federation. Manager zdravoohranenia. 2021; 5: 41–50 (In Russian). https://doi.org/10.21045/1811-0185-2021-5-41-50

6. Rijken M., Bekkema N., Boeckxstaens P., et al. Chronic Disease Management Programmes: an adequate response to patients’ needs? Health Expect. 2014; 17(5): 608– 621. https://doi.org/10.1111/j.1369-7625.2012.00786.x

7. Min J., Zhao Y., Slivka L., Wang Y. Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev. 2017; 19(1): 49–61. https://doi.org/10.1111/obr.12605

8. Yildiz B., Schuring M., Knoef M.G., Burdorf A. Chronic diseases and multimorbidity among unemployed and employed persons in the Netherlands: a register-based crosssectional study. BMJ Open. 2020; 10(7): e035037. http://dx.doi.org/10.1136/bmjopen-2019-035037

9. Williams P. Reduction in incident stroke risk with vigorous physical activity: evidence from 7.7-year follow-up of the national runners health study. Stroke. 2009; 5(40): 1921–1923. https://doi.org/10.1161/STROKEAHA.108.535427

10. Palmer K., Monaco A., Kivipelto M., et al. The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing. Aging Clin Exp Res. 2020; 32(7): 1189–1194. https://doi. org/10.1007/s40520-020-01601-4

11. Wang L.M., Chen Z.H., Zhang M., et al. Study of the prevalence and disease burden of chronic disease in the elderly in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2019; 40(3): 277–283.