prevention

Introduction

Injuries represent a major public health issue, causing approximately 16,000 deaths globally each day (10% of all deaths), which is 32% more than the combined total caused by malaria, tuberculosis, and HIV/AIDS. Over the past 15 years, the WHO and regional initiatives have supported the piloting of trauma registries in low- and middle-income countries as essential tools for monitoring, planning, and prevention.

Objective

This article aims to assess the feasibility and utility of implementing a national trauma registry in the Republic of Moldova, in order to improve injury surveillance and emergency service planning.

Materials and methods

In 2018, the pilot iCREATE trauma registry was tested for the first time in three countries: Moldova, Armenia, and Georgia. The data collection instrument was developed based on WHO recommendations, ICD-10, and IDB-JAMIE standards under the guidance of partners from the University of Iowa and Babeș-Bolyai University, Cluj-Napoca. All trauma cases from the Institute of Emergency Medicine and the Valentin Ignatenco Municipal Clinical Children’s Hospital in Chișinău were included in the registry.

Results

The analyzed sample consists of 7,942 individuals, predominantly male (57.3%). The most represented age groups were 19-29 years (17.8%) and 30-39 years (17.6%), while individuals aged 70 and above accounted for 11% of the total. Most incidents occurred in urban areas (76.9%). Of the total patients, 52.4% were treated and discharged, while 37.5% required hospitalization. Injuries occurred primarily at home (55.4%) and on public roads (24.7%). The leading mechanism of injury was falls (68.2%), followed by other causes (12.2%) and cut/pierce injuries (10.0%). The most frequently affected body regions were the head/skull (12.5%) and knee (11.8%), followed by the hip (6.7%) and wrist (6.4%). Fractures were the most common injury type (34.5%), followed by contusions (23.0%) and open wounds (14.7%). Several gaps in data collection and reporting were identified and should be considered in future efforts to enhance trauma surveillance.

Conclusions

The data highlight the need to develop a national trauma registry as an essential tool for monitoring, prevention, and effective intervention, alongside health promotion campaigns targeting vulnerable groups and the involvement of relevant stakeholders.

Introduction

Acute non-occupational chemical poisoning is a current public health problem in the Republic of Moldova, affecting both children and adults. The global increase in the use of chemical substances and mixtures raises the risk of chemical poisoning, which ranks fourth among the causes of injury in children, after road traffic injuries, burns, and drowning. It also generates a significant economic burden, and its quantification contributes to making informed decisions regarding the efficient allocation of resources.

Material and methods

A descriptive, retrospective, cross-sectional study was conducted based on statistical data from the statistical form f.18-săn and other national reports for the period 2019-2023. Cases of chemical poisoning were analyzed, excluding other types of poisoning. The evaluated indicators included incidence, mortality, distribution by age group and etiology, as well as the direct costs of their treatment.

Results

The analysis of statistical data revealed a total of 9,579 intoxications, with an overall incidence of 69.5 cases per 100,000 inhabitants. The most common causes were medications, which accounted for 41.8% (n = 4,002), followed by alcohol – 18.8% (n = 1,798), toxic gases – 14.5% (1,385 cases), and pesticides – 4.4% (n = 417). During the 2019-2023 period, children had a higher incidence, with 130.58 cases per 100,000 children, while adults recorded 52.21 cases. The peak incidence of chemical poisonings was recorded in 2019, at 64.8 cases per 100,000 population (24%, 95% CI: 23.12–24.83), while the lowest was in 2020, at 56.5 cases per 100,000 population (15.6%, 95% CI: 14.88–16.34). Over the five-year period, treatment costs for chemical poisoning totaled 58 million lei, highlighting the burden on the health system.

Conclusions

Acute non-occupational chemical poisonings continue to be a significant public health problem in the Republic of Moldova, generating not only an impact on the morbidity and mortality of the population but also a considerable economic burden on the health system, highlighted by treatment expenses that amounted to over 57 million lei during the 2019-2023 period. Preventive, educational, and informational measures for the population, including awareness campaigns, are essential for reducing the number of acute poisonings of chemical etiology

Abstract

Introduction

Chronic kidney disease (CKD) is a major and growing global public health problem, contributing to significant morbidity, mortality, and financial strain on healthcare systems. Despite available preventive measures, CKD often remains underdiagnosed and insufficiently addressed by health policies worldwide.

Materials and methods

A literature review was conducted using the MEDLINE electronic database via PubMed, Scopus, and the HINARI (Research4Life) program, focusing on studies published since 2001. Search terms included “primary care”, “chronic kidney disease”, “chronic kidney disease public health”, and “chronic kidney disease costs”. Original articles, meta-analyses, and systematic reviews were included, with English-language articles prioritized. Bibliographic references of selected publications were also examined to identify additional relevant studies.

Results

CKD affects approximately 700-850 million people globally, with rising prevalence and mortality rates, especially in low- and middle-income countries. The disease disproportionately burdens vulnerable populations and health systems due to high direct and indirect costs, particularly for advanced-stage care. While cost-effective prevention and early detection strategies are available, their implementation is uneven, and policy responses have historically lagged. Successful national initiatives demonstrate that early intervention and integrated care can reduce the incidence and economic impact of end-stage kidney disease.

Conclusions

CKD is a preventable, yet increasingly prevalent disease that requires urgent public health action. Prioritizing early detection, integrated care models, and policy reforms can significantly curb its global burden. Coordinated efforts at international, national, and local levels are essential to translate existing knowledge into effective practice and reduce the societal and financial costs of CKD.

Introduction

Osteoporosis remains a major public health issue, particularly affecting the elderly, and is characterized by decreased bone mass and deterioration of bone structure, increasing the risk of severe fractures. The development of specific and precise tools that allow for the identification and estimation of the influence of modifiable factors on the development of osteoporosis is an important step in early intervention for at-risk individuals.

Material and methods

The initial version of the questionnaire was created to identify modifiable factors contributing to the development of osteoporosis, including the type and frequency of drinking water consumption, water quality, knowledge about its mineral composition, dietary preferences, alcohol and tobacco use, physical activities, and stressful situations. The questionnaire initially contained 65 questions, organized into three sections. Five experts reviewed the content validity, evaluating the clarity, cultural and linguistic relevance, structure, and coherence of the questions. The feedback led to adjustments, reducing the questionnaire to 52 questions. A pre-test was conducted with 30 adults from the Republic of Moldova, confirming the validity and internal consistency of the questionnaire, with a Cronbach’s Alpha coefficient of 0.768.

Results

To ensure content validity, experts evaluated the questionnaire, and based on their comments and suggestions, semantic and syntactic reformulations and modifications were made. As a result, 13 questions were eliminated, reducing the second version of the questionnaire to 52 questions. During the pre-testing stage, the order and content of the questions were deemed appropriate by the respondents. The average time required to complete the questionnaire was 14.19 minutes (SD ± 1.567), with a minimum of 11.90 minutes and a maximum of 17.33 minutes. The sample used in the pre-testing stage included 30 respondents, the majority of whom (93.3%) were women. The respondents’ ages ranged from 25 to 72 years, with a mean age of 50.37 ± 2.6 years. The distribution of respondents was balanced between urban (53.3%) and rural (46.7%) areas. Regarding education level, 56.6% had higher education, 26.7% had secondary vocational education, and 16.7% had no higher education.

Conclusions

The study demonstrated that the new questionnaire is a valid and reliable instrument for assessing the impact of modifiable risk factors on morbidity due to osteoporosis. Ongoing research is necessary to refine and further validate the questionnaire within the broader population.

Introduction

The incidence and prevalence of gout have increased worldwide in recent decades. Scientists at the Rochester Epidemiology Project (MN, USA) have seen a two-fold increase in the incidence of primary gout (patients without diuretic exposure) over a 20-year period, which ended in 1996. The increase of incidence may be related due to the difficulty and often unsatisfactory treatment options. The aim of the study was to systematize the recommendations on dietary treatment, and medication for patients with gout.

Materials and methods

An analytical, qualitative, and secondary study was performed in the form of a synthesis article. 115 sources were identified and analyzed; from this list, 44 sources were selected according to the impact score during the publication period and according to the level of recommendations.

Results

44 articles were included. Most studies were small, retrospective analyses performed in single centers, with concerns for bias. Eleven studies (including five randomized controlled trials) reported improved patient outcomes following pharmacological interventions with known efficacy in gout, including allopurinol, prednisolone, NSAIDs and anakinra. Eight studies reported improved outcomes associated with non-pharmacological interventions: inpatient rheumatology consultation and a hospital gout management protocol. No studies to date have prospectively evaluated strategies designed to prevent re-admissions of patients hospitalized for gout flares.

Conclusions

Urate crystals is completely soluble when we can lower the serum level of uric acid to normal values, but this often requires long-term treatment. The early onset of rehabilitation of affected joints helps to reduce the articular inflammatory process, the pain syndrome and it delays the progression of the underlying pathology while improving the quality of life in patients with gout. Further research is needed to enable healthcare providers to individualize and optimize gout treatment strategies, ensuring that patients with gout receive effective, safe, and high-quality care.