EVALUATION OF A ROTAVIRUS ACUTE GASTROENTERITIS SEVERITY SCORE IN HOSPITALIZED CHILDREN OVER A TEN YEAR PERIOD IN A CLINIC OF INFECTIOUS DISEASES, SKOPJE, R. MACEDONIA

Abstract Rotavirus infection is the most common viral infection of the gastrointestinal tract in children with the most severe clinical manifestations and rapidly progressive dehydration, especially in infancy and early childhood. Due to its characteristics of high contagiousness and being widespread in both developed countries and developing countries with a still high fatality rate, active prevention of the disease is recognized as the only successful measure for preventing severe forms of the disease. The assessment of the severity of the clinical picture with the corresponding severity scales, Vesikari or Clark, is essential for interpretation of the success of the applied vaccine. The purpose of the study: a ten-year review of the frequency of appearance and laboratory features of Rotavirus Gastroenteritis in Paediatrics at the Infectious Diseases Clinic, Skopje, Macedonia. The goal of the study is to stress the constant presence of infection with severe clinical manifestations and the necessity of the introduction of vaccination Materials and Methods: acute viral gastoenteritis patients were processed, whose clinical presentation indicated mandatory hospitalization. Biochemical laboratory parameters were required for all children, and they were grouped in appropriate severity groups depending on the values of the clinical parameters on the Vesikari and Clark scales. By taking a biochemical laboratory analysis using statistical methods we searched for an answer to whether and to what extent their values are predictive for assessment of the severity of the disease, and how much they influence the values in each of the scales. Results: 1012 children at an average age of 19.51 months, treated from 2003 to 2012, tested with 12 parameters and grouped into scales, showed the existence of a correlation between the scales of 0.8277. Processing our results suggests the use of a modified Vesikari scale for clinical assessment of disease severity, and thus the ability to monitor the effectiveness of vaccination

Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region

Aim To present our 10-year clinical experience with brucellosis patients at the University Clinic for Infectious Diseases and Febrile Conditions in Skopje, Republic of Macedonia. Methods A total of 550 patients with brucellosis treated between 1998 and 2007 were retrospectively assessed for their demographic, epidemiological, and clinical characteristics and outcomes. Results Of the 550 patients, 395 (72%) were male. The median age was 34.5 years (range, 1-82). Direct contact with infected animals was recorded in 333 (61%) patients and positive family history in 310 (56%). The most frequently seen symptoms were arthralgia (438, 80%), fever (419, 76%), and sweating (394, 72%). The most common signs were fever and hepatomegaly, which were verified in 357 (65%) and 273 (50%) patients, respectively. Focal brucellosis was found in 362 patients (66%) and osteoarticular in 299 (54%). Therapeutic failures were registered in 37 (6.7%) patients. Of the 453 (82%) patients who completed a follow- up period of at least 6 months, relapses occurred in 60 (13%). Conclusion Due to non-specific clinical manifestation and laboratory parameters, brucellosis should be considered one of the differential diagnoses of any patient suffering from obscure involvement of various organs in a brucellosis- endemic region. High percentage of relapses and therapeutic failures in spite of the use of currently recommended therapeutic regimens indicates the seriousness of this zoonosis and the need to control it

The changing pattern of fever of unknown origin in the Republic of North Macedonia

Introduction. The study aimed to compare the etiologic spectrum of diseases causing fever of unknown origin (FUO) and methods for definitive diagnosis in a tertiary care hospital in the Republic of North Macedonia during two different time periods