Introduction: In 2020–2022, Russia, like the rest of the world, faced the COVID-19 pandemic. The necessity to overcome its challenges has led to the expansion of powers of the regions. To improve public policy, it is expedient to evaluate the effectiveness of measures taken by the regions for public health preservation. Such an evaluation is proposed to be carried out using the public health index, which requires the development of appropriate methodological approaches.
Objective: To develop and test a methodological approach to analyzing the effectiveness of public policy measures in terms of preserving public health.
Materials and methods: This work continues a series of studies on establishing the public health index in the Russian Federation, which has already developed an approach to calculating this indicator in view of medical and social resources of the population. The approach is based on the recommendations of the World Health Organization standard "The Urban Health Index". The evaluation of the effectiveness of public policy measures involves the implementation of several stages for calculating the public health index and the classification of Russian regions depending on the degree of its change for 2019-2022. When performing calculations, correlation analysis is used to identify indicators that do not contradict each other. Through the normalization of indicators, as well as the calculation of average geometric values, the calculation of the public health index is carried out. The data for calculating the public health index are taken from the website of Rosstat and the Ministry of Health of Russia.
Results: We established deterioration of public health indicators in most regions. We believe that this finding is primarily related to the COVID-19 pandemic as a large–scale challenge. In 2022, the public health index for the Russian Federation has decreased by 13.15 % compared with 2019. The largest decline has been observed in the Saratov Region (69.14 %). At the same time, an increase in the public health index has been registered in several regions, e.g. by 6 % over the study period in the Tyumen Region.
Conclusion: The analysis of the components of the public health index makes it possible to ascertain the cause of public health worsening in the region and to assess its determinants. Having classified the regions, it is important to identify the determinants of public health that can be influenced through public policy instruments.

Introduction: Along with incidence and mortality rates, the child disability rate is a leading indicator that describes, on the one hand, the state of health of the child population, and, on the other hand, the situation of children in the country, the level of development and effectiveness of governmental and non-governmental systems providing care and assistance to disabled children, as well as services responsible for implementation of disability prevention policies among the child population.
Objective: To analyze child disability in the Primorsky Region in 2017–2020.
Materials and methods: We have examined disability in children of the Primorsky Region based on information of the Federal State Statistics Service (statistical forms No. 7, 7A, 7D, and 7F) and the report of the Ministry of Labor and Social Protection on disability in the child population of the Russian Federation for 2019. The data for 2017–2020 was analyzed in Microsoft Excel using methods of descriptive statistics.
Results: We observed a general trend towards a decrease in primary and recurrent child disability accompanied by a gradual decline in the number of children rejected to qualify for disability for the period under study. The ratio of boys to girls among the disabled was 60 to 40. Children aged 0–4 (39.25 %) prevailed among those qualified for disability for the first time in their life while mental and behavioral disorders (26.78 %) were its most common causes. Most children undergoing the repeated disability determination process were 8 to 14 years of age (35.39 %) with congenital malformations as the main reason.
Conclusion: Our findings show that despite a promising declining trend in primary and recurrent child disability in the Primorsky Region, the total number of disabled children is growing constantly. Overall, the disability rate rose by 19.2 per 10,000 children under the age of 18 (13.4 %) in 2017–2020, which can be explained by children growing up, moving to older age groups, while other children are being acknowledged as disabled.

Introduction: Hygienic education and training of the population are the mechanisms of interaction with the population of the Russian Federation recognized by the scientific community, contributing to the improvement of the culture of health in the society, the level of which has an impact on the sanitary and epidemiological situation and demographic indicators of the country. One of the most important components of hygiene training nowadays is the procedure of occupational hygiene training and certification aimed at constant improvement of the level and quality of knowledge in the field of hygiene and epidemiology among employees of epidemiologically significant facilities.
Objective: To consider prerequisites for the development of the system of hygienic training in the Russian Federation and to substantiate the importance of maintaining occupational hygiene training and certification in view of the experience gained.
Materials and methods: We have searched Scopus, Web of Science, CyberLeninka, RSCI, and eLIBRARY.RU for recent papers with the non-zero Hirsch index (h-index) and/or the Russian Science Citation Index (RSCI) using the following keywords: health education, hygienic education, and hygienic upbringing. We then selected 45 materials published in 1997–2022 (60 % of them – over the past five years) and containing the above keywords in the title.
Results: The article considers historical aspects of the development of such methods of disease prevention as health education accompanying the formation of the sanitary and epidemiological service in the country. It shows that the pivotal points contributing to further legislative regulation of occupational hygiene training and certification in Russia were such historical milestones as wartime and urbanization, which entailed so-called “public health crises”. It also substantiates the relevance of the currently existing system of occupational hygiene training and certification, describing its further development paths determined with account for digitalization of the information space in the Russian Federation, and of implementation of specific tasks aimed at improving the demographic situation in the country.

Introduction: Correlations are considered as a reliable indicator of adaptive variability in populations.
Objective: To make a comparative assessment of physical development of children and adolescents living in areas with different levels of anthropogenic load.
Material and methods: We analyzed the structure of correlations between morphological and functional indicators of children and adolescents (n = 5,137) and the level of anthropogenic load (from relatively satisfactory to critical) in four territories for the years 2018–2021. We measured body length and weight, chest circumference, right and left hand grip strength, vital capacity of the lungs, heart rate, systolic and diastolic blood pressure, and sexual size dimorphism, and then calculated the body mass index and body surface area. The variability of somatic and functional indices was examined separately in age-standardized groups of 9, 13 and 15-year-old boys and girls. Significant differences in the frequencies of statistical correlations in each group and in different environmental clusters were determined.
Results: We established a statistical decrease in body length by 0.82 % and in right and left handgrip strength by 5.22 % and 9.68 %, respectively, accompanied by an increase in body weight by 5.02 %, chest circumference by 1.26 %, and vital capacity by 5.56 %, all associated with an increase in the level of anthropogenic load in the area. In environmental clusters with intense and critical load, we noted a decrease in systolic and diastolic blood pressure by 4.54 % and 5.89 %, respectively, and an increase in the heart rate by 2.81 %. We found an increase in the total number of age and sex-specific intrasystemic (anthropometric) and intersystemic (anthropometric/hemodynamic) morphofunctional correlations from 186 in clean areas to 228 in heavily polluted ones. Health effects of environmental contamination was the most pronounced in 9-year-old children of both sexes.
Conclusion: An increase in the frequency of significant intrasystemic and intersystemic correlations of morphological and functional indicators in children and adolescents with the increase in environmental load indicates tension of adaptive mechanisms in the body; the effect of interactions between environmental pollution and anthropogenic parameters in age and sex groups is attributed to greater sensitivity in the male cohort.

Introduction: Nowadays, the use of a system of exposure and effect biomarkers is highly relevant in assessing public health disorders associated with chemical exposure. The study of age and sex-specific biomarkers in risk-sensitive populations with certain types of functional disorders and diseases related to airborne chemical exposures helps improve the effectiveness of scientific and methodological support for activities of the bodies and organizations of the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in establishing causes and identifying circumstances for the occurrence and spread of non-communicable diseases related to chemical pollution of the environment.
Objective: To establish and age- and sex-specific biomarkers of exposure and its adverse health effects in children with respiratory diseases and comorbid conditions exposed to a combination of airborne chemicals.
Materials and methods: The object of the research was the system of biomarkers of exposure to six substances and negative effects (eight indicators), substantiated in biomedical studies conducted by the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies in 2021–2022 to establish adverse health effects of a combined exposure to multiple airborne chemicals emitted by metallurgical plants in children aged 4–7 years; the classifying criteria included sex, age, target organs and systems, and adverse effects.
Results: The article gives a detailed description of age- and sex-dependent changes in biomarkers of exposure and adverse health effects in children. It also provides substantiation that the best (most informative) age for studying the levels of markers of exposure and effect in children with respiratory diseases and associated comorbidities is 4–5 years for boys and 6–7 years for girls. General patterns of changes in the levels of biomarkers in response to chronic exposure to airborne chemicals include an increase in the level of chemicals in biological fluids above the reference values, a growth of the spectrum, severity, and prevalence of changes relative to the physiological norm of biochemical parameters, and expansion of the spectrum of adverse health effects.
Conclusions: Our findings can serve as a criteria basis for priority setting in order to objectify and improve the accuracy of hygienic assessments, increase the efficiency of predictive techniques of diagnosis, predict and prevent health risks in the populations sensitive to airborne industrial chemicals.

Introduction: Combating the epidemic of the novel coronavirus disease required decision-making at the state level and joining efforts of medical workers of all specialties. The experience of the Kaliningrad Region deserves special attention since this region is located in Central Europe and the first COVID-19 cases were imported here in March 2020.
Objective: To assess COVID-19 epidemic manifestations and effectiveness of preventive measures at the regional level.
Materials and methods: We performed a retrospective epidemiological analysis of COVID-19 incidence in the Kaliningrad Region from March 2020 to December 2022. All registered cases were confirmed by PCR or immunochromatography assay. The study included 193,259 cases, 1,879 fatal cases, 1,168 samples with the established SARS-CoV-2 genetic variant, and information on 693,627 people vaccinated against COVID-19. The data were analyzed in Microsoft Excel and WinPepi (version 11.65).
Results: In 2020, the COVID-19 incidence rate in the Kaliningrad Region was lower than that in the Russian Federation while in the years 2021 and 2022 the regional rates were, on the opposite, higher than the respective national ones (p < 0.05). All age groups of the population were involved in the outbreak. Periodic rises in the incidence were associated with the replacement of the Delta variant of SARS-CoV-2 with Omicron. We established high efficacy of vaccination against COVID-19: incidence and mortality rates among the unvaccinated were significantly higher than those among vaccinated individuals (p < 0.05).
Conclusion: Organization of uniform infection control measures has enabled timely interdepartmental managerial decision-making to control the epidemic. Russian regions have accumulated unique experience in implementing a set of preventive and anti-epidemic measures to combat the epidemic of the novel infection.

Introduction: According to the World Health Organization, Toxocara canis, a nematode in the order Ascarididia, is an epidemic and epizootic risk factor for humans and animals around the world and in the Russian Federation. Human toxocariasis is one of the commonest parasitic zoonoses with up to 900 million incident cases registered annually in different age and social groups of the population and a global public health problem of our time.
Objective: To study the nematode Toxocara canis (Werner, 1782) as a health risk factor for the population of southern regions the Russian Federation.
Materials and methods: We estimated the incidence of larval toxocariasis in the population of 10 districts and two cities of Karachay-Cherkessia based on the results of enzyme immunoassay of blood samples of 6,000 people in 2019–2022. The Tiascar diagnostic test kit (2017) was applied showing toxocariasis for the antibody titer ≥ 1:800 and infestation with Toxocara larvae for those of 1:200 and 1:400. The stool ova and parasite test was used to study 600 dog stool samples from the study areas. In addition, 1,200 soil samples were tested for the presence of Toxocara canis eggs.
Results: We established that the incidence rate of larval toxocariasis in the population of 10 districts and two cities of Karachay-Cherkessia varied from 2.00 to 5.40 %. Toxocara canis larvae were not found in human feces, since humans are a biological dead end for this species of worms. Toxocara canis infestation rates in feces of dogs ranged from 2.7 ± 0.4 to 6.9 ± 0.8 eggs/g, potentially accounting for a high level of soil contamination with eggs. The current epidemic situation of human toxocariasis in the Karachay-Cherkess Republic is relatively favorable owing to planned preventive measures. Yet, this constituent entity is at risk of the disease in the future since the number of children, adults and migrants with larval toxocariasis shows a dynamic growth throughout the year.
Conclusion: Incidence rates of larval toxocariasis in the child population and migrants demonstrate a 2.74–2.78-fold increase during the year. Toxocara canis eggs contaminate 46 to 94 % of soils in different areas of the republic posing high risks of larval toxocariasis for the local population. In terms of canine toxocariasis, the Karachay-Cherkess Republic can be attributed to disadvantaged territories of the North Caucasian Federal District.

Introduction: Studying the functioning of natural foci of leptospirosis, analyzing the structure of pathogens and the species composition of animal carriers are important parts of assessing the current epizootic situation in natural foci, necessary for planning and organizing anti-epidemic measures, including specific prevention of this bacterial disease.
Objective: To establish Leptospira interrogans serogroups in natural foci in the Baikal Region.
Materials and methods: In 2011–2021, we conducted zoological surveys of the territories of the Irkutsk Region within the borders of 10 administrative districts. In total, 1,255 small mammals of 36 species were caught in their natural habitats in accordance with the guidelines of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). The animals belonged to five orders, including rodents (Rodentia) – 74.2 %, insectivores (Eulipotyphla) – 24.7 %, hares (Lagomorpha) – 0.6 %, predators (Carnivora) – 0.4 %, and bats (Chiroptera) – 0.2 %. Samples collected from the animals were tested using bacteriology, microscopy, and serology methods.
Results: Of all the samples collected, 2.3 % gave a positive test result for Leptospira interrogans. Its main carriers in the Baikal Region were representatives of the order of insectivores: tundra borer (Sorex tundrensis Merriam, 1900) and rodents: housekeeper vole (Alexandromys oeconomus Pallas, 1776), water vole (Arvicola amphibius Linnaeus, 1758), long-tailed ground squirrel (Urocitellus undulatus Pallas, 1779), muskrat (Ondatra zibethicus Linnaeus, 1766), and narrowcrusted vole (Lasiopodomys gregalis Pallas, 1779). The serogroups detected included Icterohaemorrhagiae, Grippotyphosa, Javanica, Australis, Pomona, Sejroe, Autumnalis, with the antibody titers ranging from 1:20 to 1:640.
Conclusions: Natural foci of leptospirosis are widespread in the Baikal Region. Compared with the results of studies conducted in the 20th century, the relative number of seropositive animals has increased slightly while the landscape of Leptospira serotypes has undergone changes.