Publications by authors named "Stela Bivol"

Between the start of the Russian Federation's invasion of Ukraine on 24 February 2022 and May 2023, more than 8 million individuals have been displaced from Ukraine. Ukraine has the second-largest HIV epidemic in the World Health Organization (WHO) European Region. From a humanitarian and public health perspective it is critical that Ukrainian refugees living with or at risk of HIV have access to testing, treatment and healthcare in their destination country.

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The BPaLM regimen (bedaquiline, pretomanid, linezolid and moxifloxacin) recently recommended by the World Health Organization offers short, safe, and effective treatment for multidrug-resistant/rifampicin-resistant tuberculosis (TB). In a survey with national TB focal points in 18 central and western European countries to explore barriers for the implementation of BPaLM, only three reported full availability of pretomanid, a necessary component of this regimen. Implementation barriers included financing and procurement.

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Following Russia's invasion in 2022, over 4.1 million Ukrainians sought refuge in the EU/EEA. We assessed how this impacted HIV case reporting by EU/EEA countries.

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High rates of drug-resistant tuberculosis (DR-TB) continue to threaten public health, especially in Eastern Europe. Costs for treating DR-TB are substantially higher than treating drug-susceptible TB, and higher yet if DR-TB services are delivered in hospital. The WHO recommends that multidrug-resistant (MDR) TB be treated using mainly ambulatory care, shown to have non-inferior health outcomes, however, there has been a delay to transition away from hospital-focused MDR-TB care in certain Eastern European countries.

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Article Synopsis
  • The study highlights the high incidence of multidrug-resistant tuberculosis (MDR-TB) in Moldova, particularly due to the transmission of resistant strains rather than inadequate treatment.
  • Researchers analyzed data from 2018-2019, finding that 36% of TB cases were MDR-TB, with half of those never having been treated before.
  • The study reveals that spatial and demographic factors play a significant role in transmission, with certain drug-resistant strains clustered geographically, indicating the need for enhanced genomic surveillance to manage the outbreak effectively.
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Background: In the context of WHO's End TB strategy, there is a need to focus future control efforts on those interventions and innovations that would be most effective in accelerating declines in tuberculosis burden. Using a modelling approach to link the tuberculosis care cascade to transmission, we aimed to identify which improvements in the cascade would yield the greatest effect on incidence and mortality.

Methods: We engaged with national tuberculosis programmes in three country settings (India, Kenya, and Moldova) as illustrative examples of settings with a large private sector (India), a high HIV burden (Kenya), and a high burden of multidrug resistance (Moldova).

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Introduction: Several countries have set up youth-friendly-health-services. Relatively little is known about approaches to systematically assess their performance against set standards in terms of quality and coverage and define improvement activities based on the findings. The objective of this paper is to fill this gap and to describe the methods and findings of an external review of youth-friendly-health-services in Moldova and the use of the findings to support further planning.

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Whereas most research investigating drug use transitions narrows its analyses around the individual and their decision-making, we explore how personal narratives of drug transition interplay with broader narratives of social and economic change in a 'transition society' of post-Soviet Europe. Informed by narrative theory, we draw upon analyses of 42 audio-recorded qualitative interviews conducted in the city of Balti, Moldova, in late 2009, with people with current and recent experience of injecting drug use. Accounts of drug transition connect with stories of shifting socio-economic conditions, drug markets, drug law enforcement practices, and social relationships across generations.

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Few studies have explored drug injectors' accounts of their initiation of others into injecting. There also lacks research on the social relations of initiating injecting drug use in transitional society. We draw upon analyses of 42 audio-recorded semi-structured interviews with current and recent injecting drug users, conducted in 2009 in the Republic of Moldova, a transitional society of south-eastern Europe.

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In Russia, charity started developing into a public welfare system after the transition to Christianity. Peter the Great played an important role in establishing the social welfare system. According to his decree from June 8, 1701, "charity houses for beggars, sick people, and elderly" started their existence.

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