Influenza surveillance in Montenegro - determining the epidemic threshold for influenza by using the moving epidemic method

Grip je visoko kontagiozna akutna zarazna bolest uzrokovana jednim od virusa influence, a javlja se u vidu većih ili manjih epidemija. U Crnoj Gori je, od 2009. godine, počelo izveštavanje Svetskoj zdravstvenoj organizaciji (World Health Organization – WHO) bolesti koja liči na grip (Influenza Like Illness – ILI). Ciljevi: Ciljevi istraživanja odnosili su se na određivanje učestalosti prijavljenih akutnih respiratornih infekcija (Acute Respiratory Infection – ARI) i bolesti koje liče na grip i obuhvata imunizacijom protiv gripa u Crnoj Gori, za period 2010-2017. godine, u odnosu na uzrast i regione države; analizu povezanosti između meteoroloških faktora i obolevanja od bolesti koja liči na grip; određivanje epidemijskih pragova i nivoa intenziteta aktivnosti gripa primenom metoda epidemijskih promena (Moving Epidemic Method – MEM) za sezonu 2016-2017.; analiziranje epidemioloških i kliničkih karakteristika slučajeva teških akutnih respiratornih infekcija (Severe Acute Respiratory Infection – SARI) tokom tri sezone (2014-2015., 2015-2016., 2016-2017.) i upoređivanje demografskih i kliničkih karakteristika, kao i ishoda SARI slučajeva pozitivnih na grip u odnosu na SARI slučajeve koji su bili negativni na grip. Metod: U okviru deskriptivne studije analizirano je kretanje učestalosti prijavljenih akutnih respiratornih infekcija, bolesti koja liči na grip u odnosu na uzrast i regione Crne Gore, kao i obuhvat imunizacijom u posmatranom periodu. Studijom preseka analizirana je povezanost obolevanja od bolesti koja liči na grip i meteoroloških faktora, kao i epidemiološke i kliničke karakteristike SARI slučajeva tokom tri sezone (2014-2015., 2015-2016., 2016-2017.) i izvršeno je poređenje demografskih, kliničkih karakteristika i ishoda SARI slučajeva pozitivnih na grip u odnosu na SARI slučajeve koji su bili negativni na grip...Influenza is a highly contagious acute infectious disease caused by one of the influenza viruses, and occurs in the form of major or minor epidemics. Weekly reporting to the World Health Organization – WHO on Influenza Like Illness (ILI) in Montenegro began in 2009. Aims of research: Determination of the frequency of reported acute respiratory infection (ARI), influenza like illness (ILI), coverage by immunization during 2010-2017. in Montenegro in relation to age groups and regions of the country; to analyze the connection between influenza like illnesses and meteorological parameters; to determine epidemic thresholds and levels of influenza activities intensity using The Moving Epidemic Method (MEM) for season 2016-2017.; to analyze epidemiology and clinical characteristics of severe acute respiratory infection (SARI) cases during three seasons (2014-2015., 2015-2016., 2016-2017.) and to compare demographic and clinical characteristics as well as outcomes of influenza – positive SARI cases to those of influenza-negative SARI cases in Montenegro. Method: Within the framework of descriptive study the frequency has been analysed of reported acute respiratory infections, a influenza like illnesses, with reference to age and regions of Montenegro, as well as immunization coverage in the observed period. The cross-sectional study analysed the connection of getting ill from a influenza like illnesses and meteorological factors,as well as epidemiological and clinical characteristics of SARI cases in the course of three seasons (2014-2015, 2015-2016 and 2016-2017) and the comparison was made of demographic, clinical characteristics and outcomes of the SARI cases positive to influenza in comparison with the SARI cases negative to influenza..

TIMELINESS AND LEVEL OF PRIMARY IMMUNIZATION COVERAGE AGAINST MEASLES AND RUBELLA IN MONTENEGRO

The aim of the paper was to determine the timeliness and level of primary immunization coverage against measles and rubella in Montenegro in the cohort born from January 1 to December 31, 2006.Cross-sectional study was conducted in the period from October to December 2008. All immunization points in Montenegro were visited and immunization records of the entire cohort born in 2006 were reviewed.Timeliness of primary immunization coverage with MMR was 91.4% at the level of Montenegro, but in seven (33,3%) municipalities timeliness of primary immunization coverage was less than 90%, including one municipality even with less than 80%. After the additional activities on the vaccination of previously unvaccinated children, primary immunization coverage with MMR reached the value of 96.1% at the level of Montenegro, and in the majority of municipalities exceeded the value of 95%. However, after additional immunization activities in six out of 21 municipalities (28.6%), primary immunization coverage with MMR was below 95% of which in one municipality below 90%.In the cohort born during 2006, timely primary immunization with MMR was performed in one third of Montenegrin municipalities with the value less than 90%. Supplemental immunization activities related to unvaccinated children significantly increased the primary immunization coverage with MMR in the cohort born in 2006. Yet, in a certain number of municipalities even after additional immunization activities, the primary immunization coverage did not reach the required 95%. In comparison with routine administrative reporting on immunization coverage, the surveys which involve the review of immunization records after additional immunization activities provide more realistic rate of completeness and timeliness of primary immunization coverage

Epidemiološko istraživanje lajšmanijaze u Crnoj Gori 1992-2013. godine

Introduction The diseases caused by Leishmania are spread worldwide and represent a significant public health problem. Objective The aim of this study was to present the results of epidemiological surveillance of leishmaniasis in humans in Montenegro in the period from 1992 to 2013. Methods The study was planned and realized as a descriptive epidemiological study. The sample included patients of leishmaniasis in Montenegro in the period from 1992 to 2013. The health and demographic data were collected from medical records. The disease was microbiologically proven in the patients. For statistical analysis the χ2-test was used, which examined the significance of the incidence rate. Results During this period, 66 cases of leishmaniasis were identified (40 men and 26 women) aged 0 to 62 (mean 15.61±16.76 years). A visceral form of the disease was diagnosed in 65 (98%) patients, and one patient was diagnosed with cutaneous leishmaniasis. The average incidence rate for the abovementioned period is 0.48 per 100,000 inhabitants. The highest average incidence rate was identified in patients up to seven years of age (3.50 per 100,000 inhabitants). The highest average incidence rates of leishmaniasis were identified in the coastal region of Montenegro, while seasonal distribution indicates that the disease occurs throughout the year with predominance in late spring and summer. Conclusion The research has shown that Montenegro is among the countries with low incidence of leishmaniasis. Nevertheless, because of leishmaniasis re-emergence in the entire Mediterranean Basin, a comprehensive research of ecological and epidemiological characteristics of leishmaniasis, including better monitoring and notification system, is required.Uvod Oboljenja izazvana lajšmanijama su rasprostranjena širom sveta i značajan su zdravstveni problem. Cilj rada Cilj rada je bio da se predstave rezultati epidemiološkog istraživanja lajšmanijaze kod ljudi na području Crne Gore u periodu 1992-2013. godine. Metode rada Istraživanje je planirano i realizovano kao deskriptivna epidemiološka studija. Uzorak istraživanja su činili oboleli od lajšmanijaze u Crnoj Gori od 1992. do 2013. godine. Zdravstveni i demografski podaci prikupljeni su iz medicinske dokumentacije. Kod svih obolelih bolest je mikrobiološki dokazana. Za statističku analizu rezultata korišćen je χ2-test, kojim je ispitana značajnost stopa incidencije. Rezultati U navedenom periodu od lajšmanijaze je obolelo 66 osoba (40 muškaraca i 26 žena) starih do 62 godine (prosečno 15,61±16,76 godina). Kod 65 (98%) bolesnika dijagnostikovan je visceralni oblik oboljenja, a kod jednog bolesnika kožni tip lajšmanijaze. Prosečna stopa incidencije bila je 0,48 obolelih na 100.000 stanovnika. Najviša prosečna stopa incidencije bila je u uzrastu do sedam godina (3,50 na 100.000 stanovnika). Prosečne stope incidencije lajšmanijaze s najvišom vrednosti bile su u priobalju Crne Gore, dok sezonska distribucija ukazuje na to da se bolest javlja tokom cele godine s predominacijom s kraja proleća i na leto. Zaključak Naše istraživanje je pokazalo da je Crna Gora među državama s niskom stopom incidencije obolevanja od lajšmanijaze. Ipak, zbog ponovnog pojavljivanja ove bolesti u Mediteranskom basenu i značaja za narodno zdravlje, potrebno je sveobuhvatno istraživanje ekoloških i epidemioloških odlika lajšmanijaze, uključujući bolji monitoring i sistem registracije

HIV– Related Knowledge, Attitudes and Practice among Health Care Workers in Montenegro

The objective of the present study was to assess HIV-related knowledge, attitudes and practice of health care workers (HCWs) in Montenegro. A cross-sectional study was conducted in the University Clinical Centre of Montenegro in Podgorica. A self-administered anonymous questionnaire was used for data collecting. Out of 526 HCWs, 422 were included in the survey and response rate was 80%. An insuffi cient level of knowledge on HIV transmission and the risk after exposure was observed generally, although the knowledge was better in physicians compared to other HCWs categories. A rather high proportion of HCWs showed inappropriate attitude regarding the need of HIV testing of all hospitalized patients (64.7%) and obligation of HIV+ patient to report his/her HIV status (88.9%) in order to practice universal precaution. Additionally, 6.2% HCWs would refuse to treat an HIV+ patient. More than a half (55.7%) of study participants were educated in HIV/AIDS and 15.9 % of them were HIV tested. Majority of HCWs (67.5%) always applied universal precautions during their daily work with patients. In spite of applying protective devices, number of accidents was great. A continuous education is necessary to increase the level of knowledge of HCWs about the risk of infection at the workplace. This would potentially infl uence the modifi cation of their attitudes regarding HIV patients and improve prevention at the workplace. Continuous research regarding the professional risk would provide better health and safety among medical staff

Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022

© 2023 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.Background: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40–20) and inter-seasonal periods (weeks 21–39) during the pandemic between October 2020 and September 2022. Methods: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons. Results: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic. Conclusion: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.Peer reviewe

HIV– Related Knowledge, Attitudes and Practice among Health Care Workers in Montenegro

The objective of the present study was to assess HIV-related knowledge, attitudes and practice of health care workers (HCWs) in Montenegro. A cross-sectional study was conducted in the University Clinical Centre of Montenegro in Podgorica. A self-administered anonymous questionnaire was used for data collecting. Out of 526 HCWs, 422 were included in the survey and response rate was 80%. An insuffi cient level of knowledge on HIV transmission and the risk after exposure was observed generally, although the knowledge was better in physicians compared to other HCWs categories. A rather high proportion of HCWs showed inappropriate attitude regarding the need of HIV testing of all hospitalized patients (64.7%) and obligation of HIV+ patient to report his/her HIV status (88.9%) in order to practice universal precaution. Additionally, 6.2% HCWs would refuse to treat an HIV+ patient. More than a half (55.7%) of study participants were educated in HIV/AIDS and 15.9 % of them were HIV tested. Majority of HCWs (67.5%) always applied universal precautions during their daily work with patients. In spite of applying protective devices, number of accidents was great. A continuous education is necessary to increase the level of knowledge of HCWs about the risk of infection at the workplace. This would potentially infl uence the modifi cation of their attitudes regarding HIV patients and improve prevention at the workplace. Continuous research regarding the professional risk would provide better health and safety among medical staff

Climate Variables Related to the Incidence of Human Leishmaniosis in Montenegro in Southeastern Europe during Seven Decades (1945–2014)

Leishmaniosis (or leishmaniasis) is a neglected parasitosis most commonly transmitted by the sandfly bite. Changes in temperature, precipitation, and humidity can greatly affect the vectors and reservoir hosts. This study aimed to determine the association between temperature, air humidity, and weather conditions with the incidence of leishmaniasis in Montenegro during a seven-decade period (1945–2014) and to statistically compare and correlate the obtained data. In the studied period, there were 165 registered cases of leishmaniosis, 96.4%, in the coastal and central region of Montenegro, with an average incidence rate of 0.45/100.000. The visceral form of leishmaniosis predominated (99% of the cases), with only one case of cutaneous disease. Climate factors (average temperature, air humidity, and precipitation) had an impact on the occurrence of leishmaniosis in Montenegro. Air temperature elevated by 1 °C in all regions of Montenegro was significantly correlated with an increased incidence of leishmaniosis, by 0.150 (0.013 to 0.287; p < 0.05). In order to improve prevention and control of this disease, it is also necessary to investigate other factors with a possible impact on the number of cases of this neglected parasitosis

Epidemiological surveillance of Leishmaniasis in Montenegro, 1992-2013

Introduction. The diseases caused by Leishmania are spread worldwide and represent a significant public health problem. Objective. The aim of this study was to present the results of epidemiological surveillance of leishmaniasis in humans in Montenegro in the period from 1992 to 2013. Methods. The study was planned and realized as a descriptive epidemiological study. The sample included patients of leishmaniasis in Montenegro in the period from 1992 to 2013. The health and demographic data were collected from medical records. The disease was microbiologically proven in the patients. For statistical analysis the χ2-test was used, which examined the significance of the incidence rate. Results. During this period, 66 cases of leishmaniasis were identified (40 men and 26 women) aged 0 to 62 (mean 15.61±16.76 years). A visceral form of the disease was diagnosed in 65 (98%) patients, and one patient was diagnosed with cutaneous leishmaniasis. The average incidence rate for the abovementioned period is 0.48 per 100,000 inhabitants. The highest average incidence rate was identified in patients up to seven years of age (3.50 per 100,000 inhabitants). The highest average incidence rates of leishmaniasis were identified in the coastal region of Montenegro, while seasonal distribution indicates that the disease occurs throughout the year with predominance in late spring and summer. Conclusion. The research has shown that Montenegro is among the countries with low incidence of leishmaniasis. Nevertheless, because of leishmaniasis re-emergence in the entire Mediterranean Basin, a comprehensive research of ecological and epidemiological characteristics of leishmaniasis, including better monitoring and notification system, is required