Public Health Services in Herzegovina Region during 1992–1995 War

The aim of this study was to describe the situation and the development of Croatian Defense Council medical corps during the 1992–1995 war in Bosnia and Herzegovina. The paper provides an overview and describes the main events that lead to development of the medical care in the wartime conditions, with special emphasis on the public health system in Herzegovina region. This included the creation of three distinctive public health system settings: initial, integral and post-war period, all marked by certain specificities in organization and delivery of the public health and overall health care to both military and civilians. The knowledge and skills gathered during this period can be useful in situations that involve the need for fast public health actions, such as various natural disasters and disease outbreaks, and could be used for establishing highly mobile response public health teams. Furthermore, the experiences gathered during these periods may be useful during the planning phases of the health care reforms, all aiming to deliver the best possible health care to the entire population

Alimentary Infections during War Conditions: Mostar and Tomislavgrad, Bosnia and Herzegovina, 1992–1995

The aim of this study was to assess the outcome of sanitary and epidemiologic measures undertaken in relation to alimentary infections in the military corps of the Croatian Defense Council (Hrvatsko vije}e obrane) and civilian population in Mostar and Tomislavgrad regions during the 1992–1995 War in Bosnia and Herzegovina. A total of 25 (4.8%) of soldiers and 7 (7.1%) of non-military personnel were not being granted medical clearance to be employed in the food provision services. We recorded a total of 68 alimentary infections cases in military personnel (with an incidence of 536,2 per 100,000 persons), and 436 in civilian population (573,9 per 100,000 person), without significant difference between them (p=0.647).We did not record any alimentary infection outbreak in the military personnel, while two smaller epidemics of the abdominal typhus were recorded among civilian populations, but without lethal outcomes. The results of this study suggest that even the most basic adherence to the principle of standard sanitary and epidemiologic preventive measures may substantially reduce the probability of alimentary infections outbreaks, even in the highly disruptive, warfare environment

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

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

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

Utjecaj religioznosti na prosocijalnost medicinskih sestara Sveučilišne kliničke bolnice Mostar Effect of religious freedom of nurses in University Clinical Hospital Mosta

Prosocijalan odnosno pravedan odnos prema drugim ljudima podržavaju sve religije svijeta. Prosocijalno ponašanje vid je moralnog nastupa koji uključuje društveno poželjna ponašanja poput pomaganja, suradnje i dijeljenja s drugima. Religioznost pozitivno korelira s mjerama prosocijalnosti kao što su empatija, altruizam i socijalna poželjnost. Cilj istraživanja bio je ispitati utječe li religioznost na prosocijalnost medicinskih sestara Sveučilišne kliničke bolnice (SKB) Mostar. Konkretno, cilj je bio usporediti razinu prosocijalnosti u medicinskih sestara Klinike za unutarnje bolesti s centrom za dijalizu i sestara Klinike za dječje bolesti SKB Mostar. Hipoteza je da su medicinske sestre koje rade s djecom požrtvovanije i empatičnije od internističkih. Istraživanje je pokazalo da je opća religioznost značajno pozitivno povezana s emocionalnom empatijom te altruizmom ispitanika. Odnosno, što su ispitanici religiozniji, to pokazuju i veću emocionalnu empatiju i altruizam. Međutim, za pojedinačne mjere intrinsične i ekstrinsične religioznosti nije se pokazalo da su bitno povezane s mjerama prosocijalnosti. Za emocionalnu se empatiju pokazalo da je bitno povezana s mjerama altruizma (pozitivno) i socijalne poželjnosti (negativno). Odnosno, što je osoba emocionalno empatičnija, to je i altruističnija te manje sklona socijalno poželjnim ponašanjima i odgovorima. Prikupljanje podataka provedeno je među medicinskim sestrama Klinike za unutarnje bolesti s centrom za dijalizu (n=35) i Klinike za dječje bolesti SKB Mostar (n=34). Upitnik religiozne orijentacije korišten u ovom istraživanju nastao je po uzoru na dva korištena upitnika, Intrinsic/Extrinsic Scale (IES; Feagin, 1964) odnosno u prijevodu Ljestvica intrinsične i ekstrinsične religiozne orijentacije (SIERO) i ‘Age Universal’ I-E Scale (AU; Gorsuch i Venable, 1983). Upitnik prosocijalnosti sadrži upitnike emocionalne empatije, altruizma i socijalne poželjnosti (Raboteg-Šari, 1993)

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

THE IMPACT OF SOCIO-ECONOMIC PROCESSES ON THE HEALTH OF THE ADULT POPULATION

Background: A cross-sectional study in the Primary Care Medical Centre Mostar and Regional Medical Center "Safet Mujić" was conducted. Family physicians randomly surveyed, examined, and analyzed laboratory tests from 300 subjects divided into three age groups from 20-39, 40-54 and 55-65 years, totally 100 subjects. Data for age, sex, smoking status, alcohol consumption, body mass index, blood pressure, blood glucose, triglycerides and cholesterol, and the presence of chronic non-communicable diseases, including diagnosis of depression and the presence of stress were entered in medical records. Results: Levels of cholesterol were significantly higher in rural population as well as among students, and high triglyceride levels most frequently were presented in the student population. A group of farmers had a significantly higher prevalence of hypertension, DM and CVD compared to other investigated groups. The largest number of smokers and people who drink alcohol was present in group with the highest incomes, while obesity was significantly expressed in people with lower incomes. The group of examinees with the highest incomes had the greatest exposure to stress. Conclusions: Socioeconomic processes have an impact on risk behavior of the adult population, and the presence of a number of chronic diseases that are accompanied with increased laboratory blood glucose, cholesterol and triglycerides levels

Učinak socio-kulturoloških čimbenika na mentalno zdravlje i česte kronične bolesti u pacijenata opće medicine u Istočnom i Zapadnom Mostaru, Bosna i Hercegovina: preliminarni rezultati

Since war activities, the previously mixed population of Mostar, Bosnia and Herzegovina, live in segregated parts of the town based on ethnicity. The aim of this study was to examine differences in health risks and health status between populations of the two parts of the town. Health status of 300 randomly selected primary care patients was evaluated by practicing family physicians in two main primary care centers in West and East Mostar. Each group consisted of 150 patients. Data were collected between December 2013 and May 2014. Patients were evaluated for smoking habit, alcohol consumption, body mass index, blood pressure and laboratory measurement of fasting glycemia. Family physicians provided diagnosis of chronic noninfectious diseases (hypertension, diabetes mellitus, cardiovascular disease, malignant disease, depression, and alcoholism). The two groups differed according to age, income, employment status, and rate of alcoholism and hypertension. Alcoholism (OR= 4.105; 95% CI 2.012-8.374) and hypertension (OR=1.972; 95% CI 1.253-3.976) were associated with inhabitants of West Mostar, adjusted for age, employment and income status on logistic regression. In conclusion, ethnic differences between inhabitants of the two parts of the town might influence health outcomes. These are preliminary data and additional studies with larger samples and more specific questions considering nutrition and cultural issues are needed to detect the potential differences between the groups.Ranije miješana populacija Mostara u Bosni i Hercegovini od rata živi u dijelovima grada podijeljenim na osnovi etničke pripadnosti. Cilj istraživanja bio je ispitati razlike u zdravstvenim rizicima i zdravstvenom statusu između populacija dvaju dijelova grada. Obiteljski liječnici dvaju domova zdravlja istočnog i zapadnog Mostara ispitali su zdravstveni status 300 slučajno izabranih ambulantnih pacijenata. Svaka skupina sastojala se od 150 pacijenata. Podaci su prikupljani između prosinca 2013. i svibnja 2014. godine. Prikupljeni su podaci o pušenju, konzumaciji alkohola, indeksu tjelesne težine, krvnom tlaku i laboratorijski mjerenoj glukozi natašte. Dijagnoze kroničnih nezaraznih bolesti (hipertenzija, dijabetes melitus, kardiovaskularne bolesti, maligne bolesti, depresija i alkoholizam) utvrdili su liječnici obiteljske medicine. Dvije skupine razlikovale su se prema dobi, prihodima, zaposlenju, zastupljenosti alkoholizma i hipertenzije. Alkoholizam (OR=4,105; 95% CI 2,012-8,374) i hipertenzija (OR=1,972; 95% CI 1,253-3,976) povezani su sa stanovanjem u zapadnom Mostaru prilagođeno za dob, zaposlenje i zaradu u logističkoj regresiji. Zaključno, etničke razlike između stanovnika dvaju dijelova grada mogu utjecati na zdravstvene ishode. Ovo su preliminarni podaci i potrebna su dodatna istraživanja s većim uzorcima i specifičnim pitanjima vezano uz prehranu i kulturološka pitanja za otkrivanje mogućih razlika među ovim skupinama

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