A worldwide occurrence, climate change has profound effects on many facets of human existence, including health. The frequently disregarded relationship between climate change and female reproductive health is the major topic of this review. The reproductive health of women has particular challenges due to climate change, which is also linked to extreme weather events and environmental degradation. Maternal and child health outcomes are jeopardized, access to reproductive healthcare services is restricted, and healthcare infrastructure is disrupted as a result of rising temperatures, changing precipitation patterns, and an increase in the frequency of natural disasters. Furthermore, alterations in environmental factors have the potential to worsen the existing disparities in reproductive health, with a disproportionate impact on marginalized communities. A comprehensive strategy that incorporates gender-sensitive legislation, community resiliencebuilding, and climate change mitigation techniques is needed to address the psychosocial effects of climate change on women. Understanding the intersectionality of vulnerabilities and addressing the particular difficulties experienced by women in various situations are crucial. A comprehensive strategy that takes into account sustainable farming methods, healthcare access, economic empowerment, and nutritional education is needed to address the complex interactions between food security and female fertility behavior. Communities' general growth and well-being can benefit from policies and initiatives that work to enhance both food security and reproductive health. One should keep in mind that this field is complex and constantly changing, and our understanding of these relationships is always expanding. The current review delves into the various ways that climate change affects the health of women through direct and indirect pathways. These include changes in fertility rates, elevated risks of unfavourable pregnancy outcomes, and increased rates of maternal illness and mortality. 

Introduction: Increased life expectancy and related population ageing, growing rates of cancer and chronic diseases have led to a greater demand for palliative care and its adequate organization.

Objective: To analyze organization of palliative care for the population of the Republic of Crimea.

Materials and methods: The materials of the study included laws and regulations of the Russian Federation and the Republic of Crimea, analytical reports of the Chief Specialist of the Ministry of Health of the Republic of Crimea, and statistics collected by the Federal State and Crimean Statistics Services (Rosstat and Сrymstat) for 2020–2022. The data were analyzed using standard methods of variation statistics in Statistica 10 for Windows. Dynamic indicators, including absolute growth, growth and increment rates, were calculated and evaluated.

Results: A palliative care service has been established and is functioning in the Republic of Crimea; its activities are regulated by regional legal and regulatory acts. The work of relevant offices and six visiting nursing teams has been launched at 11 health facilities of the Crimea. Disease-specific inpatient palliative care is provided by 17 facilities. The staffing of regional outpatient and inpatient palliative care facilities is 80 % and 78.8 %, respectively.

Conclusions: The regulatory framework has been established in the Republic of Crimea and harmonized with the federal one. The regional model for palliative care organization has been created, is functioning and constantly improved. To increase its availability, regional palliative care facilities should overcome the staffing shortage in the first place.

Introduction: Today, demographic issues are in the focus of attention in a whole number of countries. Birth rate is one of the most important indicators largely dependent on the level of reproductive health of the population. Patterns of health and sexual behavior, including the use of contraception, are among the significant direct factors of reproductive health.

Objective: To analyze health and sexual (contraceptive) behavior as determinants of reproductive health in Russians.

Materials and methods: This is the secondary analysis of responses of the formalized surveys conducted by the Analytical Center “National Agency for Financial Research” in 2024 involving 3,000 respondents, by the All-Russian Public Opinion Research Center in 2023 involving 1,845 respondents, and by the “Mikhailov and Partners. Analytics” Agency in 2021 covering 2,005 people, all devoted to issues of reproductive and sexual health and behavior. SPSS Statistics and Microsoft Excel were used for data analysis.

Results: The Russians consider sexually transmitted diseases to be the main risk factor for reproductive health, so they pay more attention to practicing safe sex than to being able to conceive and bear a child (8.64 versus 6.43 out of 10). Barrier (condoms) and calendar methods of birth control are popular with 65 % and 26 % of the respondents, respectively, while 21 % of the respondents do not use contraceptives. Less than 35 % examine their reproductive health annually. Only 38 % of the respondents are ready to use assisted reproductive technologies to overcome infertility.

Conclusions: Reproductive health of Russian people is at risk because of low efficiency of contraceptive behavior noted for predominance of the rhythm method of birth control and refusal of contraceptives due to misinformation about their side effects and low health activity in the field of reproduction and sex, including a lack of interest in assisted reproductive technologies.

Introduction: Studying in higher school is associated with increased intensity of impact of various adverse factors, the combination of which can cause depletion of physiological reserves of the body. Monitoring the health status of students allows timely detection and correction of emerging deviations.

Objective: To establish the health status of medical university students in the process of learning.

Materials and methods: In 2022–2023, we conducted a questionnaire-based survey of 1,587 students aged 17 to 25 years to analyze their physical development indicators, incidence and prevalence rates. A 36-item short form survey instrument (SF-36) was used to determine their self-rated health.

Results: Most students had deviations in physical development largely related to underweight in the girls (21.0 %) and overweight in the boys (18.8 %). Obesity was detected in 4.8 % of the male respondents. 3.9 % of the girls and 1.8 % of the boys reported having acute respiratory infections five or more times a year while 24.2 % of the boys and 11.4 % of the girls had chronic diseases. 55.9 % of the boys and 40.5 % of the girls rated their health as excellent and very good.

Conclusions: Health deterioration and deviations in physical development observed in the students by the time of graduation necessitate additional studies of factors that can have a negative impact on their health. 

Introduction: Motor transport exhausts contain more than 250 chemicals, including benzene and phenol. Inhalation exposure to the latter can induce immune disorders in children.

Objective: To analyze immune disorders in children exposed to airborne benzene and phenol in the area with heavy traffic.

Materials and methods: The objects of the study included ambient air of the observation and reference areas and two respective groups of 286 and 97 preschoolers. Blood levels of benzene and phenol were assayed by gas chromatography and high-performance liquid chromatography, respectively. The established differences between the groups were tested for statistical significance using Student’s t-test and Z-test. The Pearson’s goodness-of-fit test (χ²) was used to determine normality of the quantitative data.

Results: In 2019–2022, average annual concentrations of benzene and phenol (n = 368) in the high traffic area demonstrated up to a 3.5- and 3.26-fold excess of the maximum allowable concentration (MAC), while in the reference area, they were 0.91 and 0.58 of the annual MAC (n = 268), respectively. Due to long-term inhalation exposure to benzene and phenol, blood levels of the latter in the observation group were 2.3 and 2 times higher than in the controls, respectively. The findings were verified by statistical cause-and-effect relationships between ambient concentrations of benzene and phenol and their blood levels in children.

Conclusion: We established an imbalance of cell differentiation phenotypes, elevated production of immunoglobulins G specific to benzene and phenol, and stress of the key adaptation compartments.

Introduction: A decrease in the incidence of tuberculosis (TB) in the regions of the Russian Federation is accompanied by spatial heterogeneity in the distribution of detected TB cases in their municipal districts, which requires optimization of planning annual periodic health examinations aimed at early detection of TB in the population.

Objective: To establish spatial distribution of detected tuberculosis cases in the municipal districts of the Kaluga Region.

Materials and methods: We used data from Rosstat report forms Nos. 8 and 30 for 2019–2023, QGIS 3.36.1, and Statistica software to map the spatial distribution of detected TB cases. The correlation coefficient (r) and the Fisher’s exact test were used for the analysis. The differences were regarded as statistically significant at p < 0.05.

Results: We identified the Northern and the Southern Clusters comprising 459 detected TB cases in the Kaluga Region, the former including 75 % of the patients. The density of TB cases in the Northern Cluster per square kilometer was 4 times higher than in the Southern Cluster. Tuberculosis case detection rates in the Northern Cluster were 71.7 %, 78.8 %, and 79 % in the years 2021, 2022, and 2023, respectively, which indicated a higher risk of TB spread among the population living in this territory.

Conclusion: The cluster analysis of spatial distribution of newly detected TB cases across municipal districts of the constituent entities of the Russian Federation allows timely measures to be taken to optimize scheduling of annual tuberculosis screening among the population.

Introduction: Cervical cancer ranks fourth among the most common cancers in women worldwide. HIV-infected women account for 5 % of all cases of cervical cancer. Poor awareness of the role of human papillomavirus in the development of malignant neoplasms has a negative impact on the effectiveness of preventive measures.

Objective: To compare the level of awareness of papillomavirus infection in women stratified by HIV status in some countries of Eastern Europe and Central Asia.

Materials and methods: The survey using the control question technique was conducted in 2022–2024 among 600 HIVpositive and 600 HIV-negative women aged 39.6 ± 12.3 years living in the Russian Federation, the Republic of Azerbaijan, the Republic of Belarus, the Kyrgyz Republic, and the Republic of Tajikistan. The systematized data was processed automatically using an online platform. A comparative analysis of the data obtained with results of the previous study (2016–2018) was carried out. Statistical data processing was carried out using the STATTECH online service.

Results: 49.8 % (95 % CI: 45.9–53.8) of HIV-positive and 33.5 % of HIV-negative (95 % CI: 29.8–37.4) women were unaware of papillomavirus infection and its effects. The statistical significance of the results was confirmed using a control question (p < 0.001). The main sources of information reported were healthcare professionals (44.5 % to 83.5 %), Internet, acquaintances (12 % to 45.5 %), and mass media (0 % to 6 %). The percentage of HIV-positive women unaware of HPV showed a 3.3-fold decrease (from 11.6 % to 3.5 %) compared to the years 2016–2018.

Conclusions: Our findings indicate a lower awareness of papillomavirus infection among HIV-positive than among HIV-negative women, regardless of the region of residence. We noted a positive trend towards greater trust in medical personnel and increased awareness through obtaining information on the Internet. The need to strengthen awareness raising and education using all available resources among the population was confirmed.

Introduction: Influenza is a highly contagious disease which can cause severe complications and even death, particularly in high-risk populations. Continuous monitoring and careful testing of seasonal influenza viruses, especially for severe cases, is necessary to develop and optimize prevention and treatment.

Objective: To establish genetic and antigenic characteristics of influenza viruses detected in lethal cases in the Russian Federation in the 2023–2024 respiratory virus season.

Materials and methods: From September 29, 2023 to June 1, 2024, 859 specimens from influenza cases (nasopharyngeal swabs) and 101 autopsy specimens of trachea, bronchi, and lungs from lethal cases of the disease from 57 regions of the Russian Federation were analyzed by PCR. For those with a sufficient amount of genetic material, whole-genome sequencing was performed using the Illumina MiSeq platform.

Results: The 2023–2024 influenza season in the Russian Federation was characterized by the dominance of A/H3N2 viruses of subclade 2a.3a.1. Influenza A/H1N1pdm09 and influenza type B viruses were detected to a lesser extent in that period. Additional diversification of A/H3N2 viruses was observed during the season with accumulation of amino acid substitutions in the hemagglutinin antigenic sites. Most lethal cases were among those at high risk and unvaccinated. No mutations associated with increased pathogenicity and virulence were identified in A/H3N2 viruses from lethal cases. No molecular markers of drug resistance to neuraminidase inhibitors and baloxavir marboxil were identified in all viruses tested in the 2023–2024 season.

Conclusion: Influenza A/H3N2 viruses from the lethal cases of the diseases tested at the State Research Center for Virology and Biotechnology “Vector” in the 2023–2024 respiratory virus season were similar to those detected in recovered patients. The isolated viruses were genetically and antigenically similar to the vaccine strain and had no markers of increased pathogenicity or drug resistance.

Introduction: Ticks are among the most common vectors of pathogens that cause infectious diseases in humans. According to official government statistics, tick-borne infections are the most common zoonotic diseases in Russia, particularly in the Northwestern Federal District.

Objective: To detect the prevalence of Borrelia burgdorferi sensu lato, Rickettsia spp. SFG, Ehrlichia chaffensis/ E. muris, Coxiella burnetii, tick-borne encephalitis virus, and Anaplasma phagocytophilum in ixodid ticks collected in the Arkhangelsk, Leningrad, and Pskov regions, the Republic of Karelia, and the city of St. Petersburg.

Materials and methods: We tested 3,585 adult ixodid ticks of two species: Ixodes ricinus (48 %) and Ixodes persulcatus (52 %). Questing ticks were collected from vegetation by flagging and then tested individually by real-time PCR for genetic markers of tick-borne pathogens using commercial test systems and following the manufacturer’s instructions.

Results: 35.8 % of the collected ticks contained the genetic material of at least one pathogen. The prevalence of B. burgdorferi s.l. was 24.7 %; Rickettsia spp. SFG – 10.1 %; E. chaffensis/ E. muris – 6.9 %; C. burnetii – 5.1 %; tick-borne encephalitis virus – 2.1 %, and A. phagocytophilum – 1.1 %. Multiple pathogens were detected in 8.4 % of the ticks in 15 different combinations, the most common being B. burgdorferi s.l. + E. chaffensis/E. muris (3.5 %) and B. burgdorferi s.l. + Rickettsia spp. SFG (2.7 %).

Conclusions: Our findings show the existence of active natural foci of tick-borne infections in the Northwestern Federal District and justify the expediency of continuous monitoring of the prevalence of tick-borne pathogens in ixodid ticks.