SOCIOECONOMICS CONDITIONALITY OF SEROPREVALENCE OF HEPATITIS A IN THREE SOUTH-WEST CANTONS OF THE FEDERATION OF BOSNIA AND HERZEGOVINA

The prospective study, which was made from Jan 1st 2009. till Dec 31st 2010. in the Clinic for Infectious Diseases within Clinical Hospital Mostar has been implemented in the areas of three southwestern cantons of the Federation of Bosnia and Herzegovina. We wanted to define the seroprevalence of the researched area using seroepidemiological testing of different groups of the population, based on the distribution by sex, age, education, residence and watersupply. The aim of this research was to prove the hypothesis that the decrease of seroprevalency of Hepatitis A has been directly related to the improvement of socio-economic conditions of life that at the end brought the decrease of the total prevalence in patients in younger age groups. The total of 420 examinees from the reasserted sample were analysed and they were classify into age groups. The first group was for the children up to 10 years. Then the group 11-20 follows and etc up to the last group, that complies examinees older than 60. In this way we have got seven groups of 60 examinees, from which the half of them was urban, and the other half was rural inhabitants. In every group analysed the half of examinees were females and the other half were males. The results we acquired with this research did not show any statistically relevant differences of seroprevalence of Hepatitits A between the urban and rural areas, between the sexes, nor between the populations which used different wattersupply objects. A statistically relevant difference was found between populations of different levels of education, but the most important difference was found between seroprevalency in different age groups. Seroprevalence in younger age groups was substantially low and increased in groups rising with age. Comparing this data to results from other similair researches from developed and undeveloped countries we concluded that the researched area, by the level of seroprevalency of Hepatitis A belongs to the category of developed countries

The Occurrence of Hemorrhagic Fever with Renal Syndrome in Southern Parts of Bosnia and Herzegovina

Bosnia and Herzegovina (B&H) has been known as an endemic region for hemorrhagic fever with renal syndrome (HFRS) for over 50 years. Multiple epidemics of this disease have been registered so far, especially in endemic parts of Central and Northeastern Bosnia, as well as the Sarajevo region. Seroepidemiological investigations demonstrate naturalization of Hantaviruses and their wide spread in B&H. However, there are no studies from the southern areas of B&H, and endemic foci of this disease are unknown. The aim of this study was to determine the distribution and serologic prevalence of Hantavirus infections by testing for specific IgG antibodies against hantaviruses in the population of Herzegovina. This study included two groups of participants. The target group consisted of 300 participants from exposed professional and population groups, and control group included 100 educators with lower exposure to HFRS. Identification of specific IgG antibodies against hantaviruses in 16 participants confirmed an initial assumption about the presence of Hantavirus infections in the region of interest. Seroprevalence of 5% was registered in the »exposed« and 1% in the »unexposed« group. Simultaneous circulation of Puumala (PUU) and Dobrava (DOB) viruses was discovered. The frequency of positive antibody results was higher in the population above 50 years of age, and three times more prevalent in men then at women. The highest proportion of exposed participants (80%) was registered in the municipalities which geographically belong to high or mountainous Herzegovina

Snakebites in Mostar Region, Bosnia and Herzegovina

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern

PANDEMIJSKA INFLUENCA A (H1N1) 2009.: BLAGA BOLEST U HOSPITALIZIRANE DJECE U NAJVEĆOJ KLINICI ZA INFEKTIVNE BOLESTI U HRVATSKOJ

Pandemic influenza A virus (H1N1) 2009 causes a disease that is epidemiologically and clinically not significantly different from seasonal influenza, but there are differences. The aim of the study was to display and compare epidemiological and clinical characteristics of pandemic influenza in children. At Dr. Fran Mihaljević University Hospital for Infectious Diseases in Zagreb, in the first two seasons, the incidence of pandemic influenza virus A (H1N1) in particular was exhaustively analyzed only in patients with laboratory-confirmed pandemic influenza A virus (H1N1) 2009. In hospitalized children with documented influenza pandemic, moderate form of the disease predominated, which ultimately meant shorter hospital stay and fewer complications. Otitis media was the rarest complication in children in both seasons. In conclusion, children younger than 5 years, especially boys, were vulnerable groups for pandemic influenza, presenting as a mild disease with low mortality and few complications. Most of the affected children with influenza did not have important risk factors such as asthma and obesity, highlighted by other authors as significant risk factors.Pandemijski virus influence A (H1N1) 2009. uzrokuje bolest koja se epidemiološki i klinički ne razlikuje značajno od sezonske gripe, ali ipak postoje razlike. Cilj studije bio je prikazati i usporediti epidemiološke i kliničke karakteristike u djece s dokazanim pandemijskim virusom influence A (H1N1) 2009. U Klinici za infektivne bolesti Dr. Fran Mihaljević u Zagrebu u prve dvije sezone incidencija pandemijskog virusa influence A (H1N1) posebno je bila iscrpno analizirana samo u bolesnika s dokazanim pandemijskim virusom influence A (H1N1). U hospitalizirane djece s dokazanim pandemijskim virusom influence A prevladavao je umjereni oblik bolesti, što je u konačnici značilo kraći boravak u bolnici i manje komplikacija. Upala srednjeg uha je bila najrjeđa komplikacija kod djece. Zaključno, djeca mlađa od 5 godina, osobito dječaci, češće su obolijevali od pandemijskog virusa influence A (H1N1), koja se prezentirala kao blaža bolest s niskom smrtnošću i rjeđim komplikacijama. Većina oboljele djece od pandemijske influence nisu imala čimbenike rizika kao što su astma i pretilost, što drugi autori u svojim istraživanjima ističu kao važne čimbenike rizika za virus influence

The occurrence of hemorrhagic fever with renal syndrome in southern parts of Bosnia and Herzegovina [Pojavnost hemoragijske vrućice s bubrežnim sindromom u južnim područjima Bosne i Hercegovine]

Bosnia and Herzegovina (B&H) has been known as an endemic region for hemorrhagic fever with renal syndrome (HFRS) for over 50 years. Multiple epidemics of this disease have been registered so far, especially in endemic parts of Central and Northeastern Bosnia, as well as the Sarajevo region. Seroepidemiological investigations demonstrate naturalization of Hantaviruses and their wide spread in B&H. However, there are no studies from the southern areas of B&H, and endemic foci of this disease are unknown. The aim of this study was to determine the distribution and serologic prevalence of Hantavirus infections by testing for specific IgG antibodies against hantaviruses in the population of Herzegovina. This study included two groups of participants. The target group consisted of 300 participants from exposed professional and population groups, and control group included 100 educators with lower exposure to HFRS. Identification of specific IgG antibodies against hantaviruses in 16 participants confirmed an initial assumption about the presence of Hantavirus infections in the region of interest. Seroprevalence of 5% was registered in the »exposed« and 1% in the »unexposed« group. Simultaneous circulation of Puumala (PUU) and Dobrava (DOB) viruses was discovered. The frequency of positive antibody results was higher in the population above 50 years of age, and three times more prevalent in men then at women. The highest proportion of exposed participants (80%) was registered in the municipalities which geographically belong to high or mountainous Herzegovina

Snakebites in Mostar region, Bosnia and Herzegovina [Ugrizi zmija na mostarskom području, Bosna i Hercegovina]

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern

Pojavnost hemoragijske vrućice s bubrežnim sindromom u južnim područjima Bosne i Hercegovine

Bosnia and Herzegovina (B&H) has been known as an endemic region for hemorrhagic fever with renal syndrome (HFRS) for over 50 years. Multiple epidemics of this disease have been registered so far, especially in endemic parts of Central and Northeastern Bosnia, as well as the Sarajevo region. Seroepidemiological investigations demonstrate naturalization of Hantaviruses and their wide spread in B&H. However, there are no studies from the southern areas of B&H, and endemic foci of this disease are unknown. The aim of this study was to determine the distribution and serologic prevalence of Hantavirus infections by testing for specific IgG antibodies against hantaviruses in the population of Herzegovina. This study included two groups of participants. The target group consisted of 300 participants from exposed professional and population groups, and control group included 100 educators with lower exposure to HFRS. Identification of specific IgG antibodies against hantaviruses in 16 participants confirmed an initial assumption about the presence of Hantavirus infections in the region of interest. Seroprevalence of 5% was registered in the »exposed« and 1% in the »unexposed« group. Simultaneous circulation of Puumala (PUU) and Dobrava (DOB) viruses was discovered. The frequency of positive antibody results was higher in the population above 50 years of age, and three times more prevalent in men then at women. The highest proportion of exposed participants (80%) was registered in the municipalities which geographically belong to high or mountainous Herzegovina.Bosna i Hercegovina (BiH) je više od 50 godina poznata kao endemska regija hemoragijske vrućice s bubrežnim sindromom (HVBS). Do sada je registrirano više epidemija ove bolesti, poglavito u endemskim dijelovima središnje i sjeveroistočne Bosne, te u sarajevskoj regiji. Seroepidemiološka istraživanja potvrđuju udomaćenost hantavirusa i njihovu distribuciju u BiH. Međutim, do sada nisu provedena nikakva seroepidemiološka istraživanja u južnim područjima BiH, niti su poznata prirodna žarišta ove bolesti. Cilj ovog istraživanja bio je seroepidemiološkim istraživanjem i nalazom specifičnih IgG protutijela na hantaviruse utvrditi rasprostranjenost i seroprevalenciju hantavirusnih infekcija u Hercegovini. U istraživanje su uključene dvije skupine ispitanika. Ciljana skupina obuhvaća 300 ispitanika iz izloženih profesionalnih i populacijskih skupina, a kontrolna skupina 100 prosvjetnih djelatnika, koji imaju manju izloženost HVBS-u. Nalazom specifičnih IgG protutijela na hantaviruse kod 16 ispitanika potvrđena je polazišna pretpostavka o pojavnosti hantavirusnih infekcija i u istraživanom području. Kod ispitanika u izloženoj skupini bilježi se seroprevalencija od 5%, a u neizloženoj skupini 1%. Otkrivena je istodobna cirkulacija Puumala i Dobrava virusa. Češća prokuženost registrira se u starijih od 50 godina, a triput je veća kod muškaraca nego u žena. Najviše prokuženih ispitanika (80%) registrira se u općinama koje zemljopisno pripadaju visokoj ili planinskoj Hercegovini

Ugrizi zmija na mostarskom području, Bosna i Hercegovina

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern.Cilj ovog istraživanja bio je prikazati pojavnost zmijskih ugriza među pacijentima koji su bili hospitalizirani u Kliničkoj bolnici Mostar, u razdoblju 1983.–2006. godine. Ukupno je tijekom tog razdoblja zabilježen 341 pacijent, s nešto većim brojem muškaraca (52,8%). Većini pacijenata to je bio prvi ugriz (99,1%). Također, kod većine pacijenata ugriz se dogodio na golu kožu, najviše tijekom ljetnih mjeseci. Ugrizi su bili najčešći kod poljoprivrednika (48,1%). Do 2003. godine pacijetni su liječeni Russelovom shemom liječenja, a od 2003. godine korišten je novi oblik liječenja koji je bio obilježen manjom količinom korištenja zmijskog protuotrova i smanjenjem broja alergijskih reakcija. Serumska bolest zabilježena je samo kod dva pacijenta, a smrtni ishod samo kod jednog (0,3%). Sveukupni rezultati govore u prilog malom mortalitetu i da je pacijentima često primjenjeno liječenje bez stvarne indikacije. Veliki broj turista i vojnog osoblja u ovom području je razlog zbog kojeg pojavnost zmijskih ugriza nije samo lokalni nego i mnogo širi problem