{"id":2972,"date":"2023-09-19T18:00:02","date_gmt":"2023-09-19T15:00:02","guid":{"rendered":"https:\/\/yillik.kizilayakademi.org.tr\/?p=2972"},"modified":"2023-09-19T18:31:17","modified_gmt":"2023-09-19T15:31:17","slug":"turkiye-in-2022-from-the-perspective-of-public-health","status":"publish","type":"post","link":"https:\/\/yillik.kizilayakademi.org.tr\/en\/turkiye-in-2022-from-the-perspective-of-public-health\/","title":{"rendered":"T\u00fcrkiye in 2022 from the Perspective of Public Health"},"content":{"rendered":"\n

2022, like in the rest of the world, has been a year that contained many significant events affecting public health in our country as well. The COVID-19 pandemic, which started in 2019, is still ongoing worldwide and in our country. The measures taken during the pandemic, efforts in testing and vaccination, have yielded results, and the impacts of the COVID-19 outbreak has decreased compared to previous years. Another consequence of the measures taken due to the pandemic (such as wearing masks, social distancing, school closures, etc.), is the increase in respiratory tract infections, especially \u2018RSV, Influenza A and B, COVID-19,\u2019 which were not commonly seen in previous years, as these measures have been relaxed this year. <\/p>\n\n\n\n

According to the World Health Organization (WHO) data, more than 83,000 Moneypox cases have been reported in 110 countries in 2022, while the virus has been detected in 12 people in T\u00fcrkiye. In addition, some regional public health incidents have occurred in our country in 2022. In July, cases of gastroenteritis were observed in some individuals affected by drinking water in a village in Bolu, with 14 of them being admitted to intensive care and one person losing their life. Some patients were diagnosed with Hemolytic Uremic Syndrome (HUS) during their examinations. In November 2022, one of two children bitten by a dog were diagnosed with rabies.<\/p>\n\n\n\n

In 2022, within the scope of the \u2018SIHHAT\u2019 project developed by the Ministry of Health, access to healthcare services for vulnerable groups such as immigrants has been increased and services for vulnerable groups such as immigrants has been increased and services have been continued. Towards the end of the year, there have been some new developments in terms of health. It has been decided that the HPV vaccine will be provided free of charge by the Ministry of Health, and screening for SMA disease will be included in the newborn metabolic and endocrine disease screening program (NTP).<\/p>\n\n\n\n

COVID-19<\/strong><\/p>\n\n\n\n

The number of COVID-19 cases has been increasing since it was first reported to the WHO in December 2019. According to the latest data updated by the WHO on December 19, 2022, there have been 649,038,437 cases and 6,645,812 deaths worldwide.<\/a>1<\/a><\/sup> In T\u00fcrkiye, up until that date, there have been a total of 17,042,722 cases and 101,492 deaths.<\/a>2<\/a><\/sup> In 2022, the weekly number of COVID-19 cases reached its peak on February 8 with 103,375 cases and has been decreasing since then.<\/a>3<\/a><\/sup> Due to the decreasing number of COVID-19 cases, the Minister of Health, Dr. Fahrettin Koca, announced in March 2022 that the mask requirement in outdoor and indoor spaces was lifted, and the HES code application was completely discontinued.<\/a>4<\/a><\/sup> On April 4, 2022, it was decided that the Coronavirus Science Committee would not convene except for extraordinary circumstances.<\/a>5<\/a><\/sup> Subsequently according to a circular from the Ministry of Interior, the obligation to wear masks would only continue in healthcare facilities.<\/a>6<\/a><\/sup><\/p>\n\n\n\n

According to the latest data in T\u00fcrkiye, as of December 19, 2022, 93.6% of the population received the first dose of the COVID-19 vaccine, while 85.68% received the second dose. A total of 152,598,271 doses of the vaccine, including the first, second, and third doses, have been administered.<\/a>2<\/a> <\/sup>Additionally, the Phase 3 interim results of the domestic COVID-19 vaccine \u2018TurkoVac,\u2019 were published in an internationally peer-reviewed journal in November 2022, entering the scientific literature.<\/a>7<\/a><\/sup><\/p>\n\n\n\n

One Kit Four Tests<\/strong><\/p>\n\n\n\n

Due to the decrease in the number of cases and the increase in vaccinations in 2022, the relaxation of mask and social distancing rules, and the transition to fully face-to-face education in schools as of the 2022-2023 academic year, people have increased contact with each other due to reasons such as a decrease in flexible working hours and remote work.<\/a>4<\/a><\/sup> <\/a>5<\/a><\/sup> <\/a>6<\/a><\/sup>As a result of approximately 3 years of social isolation and the impact of non-pharmacological measures, various respiratory diseases, which had been decreased in frequency, have started to reoccur together. The frequency of lower respiratory tract infections has increased in the entire community, especially in younger children, and there have been increases in hospitalizations.<\/a>8<\/a><\/sup> Based on assessments, it has been determined that COVID-19, Influenza A, Influenza B, and RSV are common infectious agents in the community during the winter period.<\/a>9<\/a><\/sup> In order to detect these four disease-causing agents, the T\u00fcrkiye Health Institute has been assigned the task of developing a single kit, as announced by Health Minister Dr. Fahrettin Koca on November 29, 2022.<\/a>10<\/a><\/sup><\/p>\n\n\n\n

HUS-Monkeypox-Rabies<\/strong><\/p>\n\n\n\n

With the detection of numerous cases of monkeypox in several non-endemic countries in May 2022, a new concern emerged worldwide due to the increasing number of cases reported by the WHO on July 23, 2022, regarding the monkeypox virus. As a result, a global state of emergency was declared.<\/a>11<\/a><\/sup> <\/a>12<\/a><\/sup> The first case in T\u00fcrkiye was announced on June 30, with Health Minister Dr. Fahrettin Koca stating that a 37-year-old patient was in isolation and placed under treatment.<\/a>13<\/a><\/sup> A total of 12 cases of this virus have been detected in T\u00fcrkiye.<\/a>14<\/a><\/sup><\/p>\n\n\n\n

In July 2022, some individuals in a village in Bolu were diagnosed with gastroenteritis due to drinking water contamination. Among them, 112 cases were reported, including children, and 14 of them were admitted to intensive care. Unfortunately, one person lost their life.<\/a>15<\/a><\/sup> During the examination of these patients, some were diagnosed with \u2018Hemolytic Uremic Syndrome (HUS),\u2019 which presented with bloody diarrhea, anemia, and acute kidney failure. Cleanliness and disinfection measures were taken in the sources that provide drinking water to the village, and the pipeline system of the water reservoir was replaced. The water needs of the village residents were provided by the governorship and the Turkish Red Crescent teams.<\/a>15<\/a><\/sup><\/p>\n\n\n\n

In November 2022, one of the two children attacked by street dogs in Bitlis was diagnosed with rabies and placed under intensive care treatment. Following this incident, the District Health Board conducted a screening and directed suspected contacts bitten by stray animals to healthcare institutions, but no other cases of rabies were found.<\/a>16<\/a><\/sup> The 10-year-old patient who was admitted for rabies treatment passed away on November 9, 2022.<\/a>17<\/a><\/sup> Subsequently, certain neighborhoods and villages in Ad\u0131yaman, Kars, and Band\u0131rma were quarantined due to suspicion of rabies, and rabies virus was detected in several animals, leading to a rollout of the vaccination of stray animals in the region.<\/a>18<\/a><\/sup><\/p>\n\n\n\n

SMA Screening-HPV Vaccine<\/strong><\/p>\n\n\n\n

In T\u00fcrkiye, importance has been given to pre-marital health checks and screening programs to protect individuals, families, and the community. As part of the pre-marital screening program in our country, those who apply to family physicians to obtain a mandatory marriage report are subjected to \u2018Anamnesis\u2019 and physical examination, as well as laboratory tests such as blood collection; \u2018Hemoglobinopathy\u2019 screening, blood type determination, and screening for infectious diseases (HIV, HBV, HCV, VDRL, Syphilis) are conducted.<\/a>19<\/a><\/sup> According to 2019 TURKSTAT marriage statistics, while 5.9% of official marriages in 2010 were consanguineous marriages, this rate decreased in subsequent years and was 3.8% in 2020.<\/a>20<\/a><\/sup><\/p>\n\n\n\n

Spinal Muscular Atrophy (SMA) is a genetic disease characterized by muscle atrophy and weakness. Considering that there were 1.2 million live births in T\u00fcrkiye annually, it is estimated that the annual number of new cases for SMA is between 130-180, and a total of 3,000 SMA patients are being monitored. As of December 2021, the premarital \u2018SMA Carrier Screening Program\u2019 has been implemented in all provinces.<\/a>21<\/a><\/sup> Following this development, as of May 9, 2022, the screening for SMA disease has been added to the newborn metabolic and endocrine disease screening program. While Phenylketonuria (PKU), Cystic Fibrosis (CF), Congenital Hypothyroidism, and Biotinidase Deficiency are screened with the heel blood sample taken from newborns, Congential Adrenal Hyperplasia (CAH) was added to the screening panel in 2017, and SMA was added in 2022. Currently, a total of 6 diseases are screened, and studies are being conducted regarding diseases that can be added to the panel.<\/a>22<\/a><\/sup><\/p>\n\n\n\n

Human Papillomavirus (HPV) is a virus that is primarily transmitted through sexual contact and is known to cause cervical cancer in women, as well as vulgar, vaginal, anal, penile, and oral cavity centers.<\/a>23<\/a><\/sup> WHO called for global action in 2018 aimed at eliminating cervical cancer and stated that if action is not taken, the mortality rate from cervical cancer will increase by 50% by 2040.<\/a>24<\/a><\/sup> Therefore, since 2014, the Ministry of Health Cancer Department has been implementing the \u2018National Cervical Cancer Screening Program.\u2019 As part of this program, cervical samples are taken every five years from women aged between 30 and 65 for HPV testing or Pap smear. National community-based cervical cancer screenings are carried out by Cancer Early Diagnosis, Screening, and Training Centers (KETEM) within Family Health Centers (ASM) and Community Health Centers (TSM). Currently, vaccines have been developed against the types of HPV that are most likely to cause cancer.<\/a>23<\/a><\/sup> There are three types of HPV vaccines available: \u2018Cervavix 2,\u2019 \u2018Gardasil 4,\u2019 and \u2018Gardasil 9.\u2019 The bivalent and quadrivalent vaccines are approved for females and males aged 9-26, while the nonvalent vaccine is approved for females and males aged 9-45. Many countries, including developed countries worldwide, are attempting to include HPV vaccines in their national immunization programs.<\/a>24<\/a><\/sup> As of November 2022, Minister of Health Dr. Fahrettin Koca announced that the HPV vaccination would be initiated in specific groups and gradually expand, and subsequently, it was announced that the vaccination would be included in the national vaccination schedule and provided free of charge.<\/a>26<\/a><\/sup>\u00a0<\/p>\n\n\n\n

Project on Migrant Health and Wellbeing<\/strong><\/p>\n\n\n\n

As a result of the internal turmoil that broke out in Syria in 2011, a large number of people had to migrate to T\u00fcrkiye. Currently, according to official data, there are 3,561,183 Syrians living under temporary protection in our country.<\/a>27<\/a><\/sup> T\u00fcrkiye ranks first among refugee-receiving countries, according to the IOM 2022 Report.<\/a>28<\/a><\/sup> The nationalities of irregular migrants apprehended most frequently are Afghanistan, Syria, and Pakistan.\u00a0<\/p>\n\n\n\n

Health services for Syrians under temporary protection in T\u00fcrkiye are provided in accordance with the \u2018Principles Directive on Health Services to be Provided to Persons Under Temporary Protection,\u2019 dated November 4, 2015, no. 9,648. Syrians registered and issued temporary identification numbers in T\u00fcrkiye can benefit from emergency health, preventive and basic healthcare services, as well as curative health services free of charge. For those who do not have a temporary identification number, services related to combating infectious diseases, immunization, and emergency health care are provided in line with the \u2018Temporary Protection Regulation.\u2019<\/a>29<\/a><\/sup><\/p>\n\n\n\n

Since 2016, healthcare services for Syrian refugees have been provided under the Ministry of Health. These services are carried out within the scope of the \u2018SIHHAT Project\u2019 financed by the European Union. The aim of the SIHHAT Project is defined as supporting and improving the primary and secondary healthcare services provided by the Ministry of Health for Syrian refugees in T\u00fcrkiye.<\/a>30<\/a><\/sup> The health services provided consist of Migrant Health Centers, Enhanced Migrant Health Centers, Health Services, and Community Mental Health Centers.<\/p>\n\n\n\n

In line with this aim, so far:<\/p>\n\n\n\n