ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1665990
This article is part of the Research TopicInnovative Strategies for Urban Public Health Resilience in Crisis SituationsView all 28 articles
Outpatient pediatric care during the COVID-19 pandemic, Almaty, Kazakhstan 2021-2022
Provisionally accepted
Nailya Kozhekenova1,2,3*
Milena Santric Milicevic4,5*
Zhansaya Nurgaliyeva1,3
Ainash Oshibayeva3
Danilo Jeremic6
Milan Dinic7Saltanat Kyrykbayeva3
Zhanar Zhagiparova3
Arshat Smasheva8Anastassiya Miller9
Shyryn Tolekova10
Natalya Glushkova1,11,3- 1Al-Farabi Kazakh National University, Almaty, Kazakhstan
- 2Alatau City Hospital, Almaty, Kazakhstan
- 3Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan, Kazakhstan
- 4Univerzitet u Beogradu Institut za socialnu medicinu, Belgrade, Serbia
- 5Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity, Belgrade, Serbia
- 6Institut za ortopedsko-hirurske bolesti Banjica, Belgrade, Serbia
- 7Serbian Medical Chamber, Belgrade, Serbia
- 8Karaganda Buketov University, Karaganda, Kazakhstan
- 9Nazarbayev University School of Sciences and Humanities, Astana, Kazakhstan
- 10Telemedicine Center, Central City Clinical Hospital, Almaty, Kazakhstan
- 11Health Research Institute Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Background/Objectives: During the COVID-19 pandemic, primary health care systems worldwide adapted to manage cases in outpatient settings, including those involving children. The aim of this study was to investigate the epidemiological characteristics of 27,205 outpatient COVID-19 cases among children (0-17 years) in Almaty, Kazakhstan, from 1 January 2021 to 31 December 2022, compared with major epidemiological events and public health measures. Methods: A cross-sectional analysis was conducted to assess the likelihood of hospitalization regarding demographic characteristics, concomitant diseases, the severity of COVID-19 course, as well as the dynamic of cases. Results: The majority of children (99.3%) were asymptomatic or mild. Children in the younger age group (0-4) had a higher risk of severe course and hospitalization compared with adolescents aged 15-17 years. Sex and chronic diseases (diabetes mellitus, obesity and chronic obstructive pulmonary disease) did not demonstrate statistical significance. The longest spike in outpatient COVID-19 cases in children coincided with the circulation of Delta and Eta strains, the highest with Omicron. Conclusions: Among outpatient COVID-19 cases in children, the likelihood of severe forms and hospitalization is higher if the child is under five years of age.
Keywords: COVID-191, coronavirus infection2, Children3, outpatient4, non-pharmaceutical interventions5, epidemiology6
Received: 14 Jul 2025; Accepted: 19 Sep 2025.
Copyright: © 2025 Kozhekenova, Santric Milicevic, Nurgaliyeva, Oshibayeva, Jeremic, Dinic, Kyrykbayeva, Zhagiparova, Smasheva, Miller, Tolekova and Glushkova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Nailya Kozhekenova, nailyakozhekenova@gmail.com
Milena Santric Milicevic, milena.santric-milicevic@med.bg.ac.rs
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.