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Women who have experienced conflict-related sexual violence report significant long-term effects, including posttraumatic stress disorder (PTSD), depression and relationship difficulties. Research has demonstrated that maternal trauma is associated with children's behavioural difficulties and challenges in family functioning, such as impaired communication and harsh parenting. This pilot study is aimed at evaluating the preliminary effectiveness of family therapy for Kosovar mothers who experienced conflict-related sexual violence in 1998-1999 and later developed PTSD and their children in improving family functioning and reducing behavioural difficulties in postwar times. Sixty-four mothers were randomised to an intervention group or a waitlist control group. Data was collected during a screening phase, at baseline before intervention initiation, after the intervention group completed family therapy and once the waitlist control group received the intervention. Generalised linear mixed models were used to analyse group differences in family functioning and children's behaviours over time. At follow-up, mothers in the intervention group reported improved family functioning. However, mothers in the waitlist control group reported significantly fewer behavioural difficulties than mothers in the intervention group before the control group had started family therapy. There was no significant interaction between group condition and time for child-rated family functioning. Overall, this pilot study suggests that family therapy could be effective in reducing the effects of intergenerational trauma related to PTSD and conflict-related sexual violence. Future research should evaluate the long-term effects of family therapy to assess if immediate effects were maintained.
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Terapia Familiar , Madres , Trastornos por Estrés Postraumático , Humanos , Femenino , Proyectos Piloto , Terapia Familiar/métodos , Adulto , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Madres/psicología , Niño , Delitos Sexuales/psicología , Relaciones Madre-Hijo/psicología , Masculino , Kosovo , Resultado del Tratamiento , Hijo de Padres Discapacitados/psicología , Hijo de Padres Discapacitados/estadística & datos numéricosRESUMEN
BACKGROUND: Conventions adopted by the United Nations and Council of Europe pay special importance to the treatment of prisoners with mental health problems. Their treatment is close-ly related to respect for human dignity, and the prohibition of torture, cruel and degrading treatment or punishment. The Eu-ropean Court of Human Rights, in many cases, has ruled that the detention of a mentally-ill person can raise issues under Ar-ticle 3 of the European Convention on Human Rights and that the lack of adequate medical care can result in treatment in con-travention of this article. The Republic of Kosovo is not a mem-ber of the United Nations and Council of Europe. However, it has incorporated in its Constitution a number of Conven-tions adopted by the United Nations and Council of Europe. Also, Kosovo has adopted a legal framework which prohibits torture, cruel and degrading treatment or punishment in ac-cordance with the international human rights standards. The Constitution also provides that human rights and fundamen-tal freedoms guaranteed by the Constitution shall be interpret-ed in accordance with the case law of the European Court of Human Rights. METHODS: Review of Ombudsperson's, Committee for the Prevention of Torture, Prison Health Department of Kosovo Ministry of Health reports, as well as reports of the NGOs in Kosovo.
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Prisioneros , Tortura , Humanos , Kosovo , Prisioneros/psicología , Tortura/legislación & jurisprudencia , Instalaciones Correccionales , Trastornos Mentales/terapia , Derechos Humanos/legislación & jurisprudencia , Masculino , Enfermos Mentales/legislación & jurisprudenciaRESUMEN
BACKGROUND: COVID-19 vaccines have proven effective against severe outcomes in many settings, yet vaccine effectiveness (VE) estimates remain lacking for Kosovo. We aimed to estimate VE against COVID-19 infections, hospitalisations, and deaths for one and two vaccine doses during the fourth pandemic wave in July-September 2021, the period when vaccination initially became widely available. METHODS: We analysed routine surveillance data to define cases and vaccination status as partially (one dose) or completely (two doses) vaccinated. We used the screening method to calculate the proportion of cases with the outcomes vaccinated (PCV). The proportion of the population vaccinated (PPV) was based on numbers vaccinated and the Kosovo population estimate on 30/09/2021. RESULTS: Between July-September 2021, 51,804 COVID-19 cases were reported in Kosovo with 9.3% of cases partially and 3.4% completely vaccinated. Estimated vaccine effectiveness for one dose was 93.1% (95%CI:92.9-93.2%) for infections, 90.3% (95%CI:88.8-91.7%) for hospitalisations, and 90.3% (95%CI:88.4-92.1%) for deaths. Estimated vaccine effectiveness for two doses was 97.8% (95%CI:97.6-97.9%) for infections, 94.5% (95%CI:93.3-95.6%) for hospitalisations, and 94.2% (95%CI: 93.7-96.5%) for deaths. CONCLUSIONS: This study provides real-world evidence for COVID-19 vaccine effectiveness in Kosovo using routine administrative data sources and the screening method. COVID-19 vaccine effectiveness against infections and severe outcomes in Kosovo was higher with two vaccine doses than one dose, which is in accordance with findings from other study designs and settings. Using the screening method in our study reflects an important initial methodology for estimating vaccine effectiveness with routine surveillance that may be particularly important for low- and middle-income settings with less robust surveillance systems or fewer opportunities to conduct more robust vaccine effectiveness study designs.
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Vacunas contra la COVID-19 , COVID-19 , SARS-CoV-2 , Eficacia de las Vacunas , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/inmunología , Kosovo/epidemiología , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , SARS-CoV-2/inmunología , Femenino , Adulto , Persona de Mediana Edad , Masculino , Vacunación , Hospitalización/estadística & datos numéricos , Anciano , Adolescente , Niño , Adulto Joven , PreescolarRESUMEN
AIMS: This qualitative descriptive study provides insights into the experiences of quality coordinators (QCs) in primary healthcare to inform policy and practice actions and empower QCs to enhance healthcare quality. METHODS: We conducted focus group discussions with purposefully selected QCs to understand their motivations, job experiences, factors influencing healthcare quality, and suggestions for quality improvement. Content analysis and deductive coding were used to scrutinize the responses and answer the research questions. RESULTS: The QCs thought highly about their job performance and were motivated by both extrinsic and intrinsic factors. Clinical audits, collegial reviews, and managerial support positively affected QCs' performance. In contrast, a lack of managerial support, limited working hours, and changes in organizing work caused the opposite. Empowerment and external support positively influenced healthcare quality, whereas lack of resources, managerial support, or training had a negative influence. Suggestions to improve quality include the role of QCs, external supervision, and centralization of the QCs' network. CONCLUSION: Appointing QCs alone does not guarantee quality improvement. It is essential to ensure that QCs have the appropriate skills, tools, management support, and open communication channels. Further research is required to evaluate the effects of sex and age on QCs' performance.
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Grupos Focales , Atención Primaria de Salud , Investigación Cualitativa , Mejoramiento de la Calidad , Humanos , Atención Primaria de Salud/normas , Atención Primaria de Salud/organización & administración , Femenino , Masculino , Adulto , Kosovo , Persona de Mediana Edad , Calidad de la Atención de Salud/normas , Actitud del Personal de SaludRESUMEN
BACKGROUND: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia have committed to becoming European Union (EU) member states. This, among others, implies that candidate/potential candidate states adopt legally authorized EU policies, including health. The study aims to identify the main country-specific health policy areas critical to the EU accession health policy dimension and present the change in associated selected health indicators from 2000 to 2019. METHODS: The study draws on published reports and analyses of official statistics over time and cross-country. Health care policy adherence to the European Commission's recommended country-specific health actions was classified into five health policy areas: financing, payment, organization, regulation and persuasion. Key health policy areas for Western Balkan countries (WBCs) were identified. Health progress or lack thereof in catching up to the EU15 population health, health expenditure and the number of health professionals are measured. RESULTS: The European Commission prioritized financing and regulation for all WBCs in the five policy areas. Nine of the 18 analyzed selected health indicators showed divergence, and the other nine converged towards the EU15 averages. WBCs continue to face diverse public health challenges in improving life expectancy at birth, death rates caused by circulatory system diseases, malignant neoplasms, traffic accidents, psychoactive substance use, tuberculosis incidence, tobacco smoking prevalence and public-sector health expenditure. CONCLUSIONS: By 2019, there is limited evidence of WBCs catching up to the average EU15 health levels and health care policies. Closer attention towards EU health and health care policies would be favourable.
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Política de Salud , Humanos , Peninsula Balcánica/epidemiología , Bosnia y Herzegovina/epidemiología , Unión Europea , Serbia/epidemiología , Montenegro/epidemiología , República de Macedonia del Norte/epidemiología , Albania/epidemiología , Kosovo/epidemiologíaRESUMEN
The study was carried out to define the distribution of mercury in surface soils in the Mitrovica region, Republic of Kosovo and to assess the level and extent of contamination. A total of 156 soil samples were collected from a depth of 5 cm at each grid point of 1.4 × 1.4 km in an area of 301.5 km2. The mercury content was found to be between 0.02 mg/kg and 11.16 mg/kg. The average Hg content (0.49 mg/kg) exceeded the mean content in European (0.037 mg/kg) and world (0.06 mg/kg) soils by 13.2 and 8.2 times, respectively. From the calculated enrichment factors (EF) and the geo-accumulation index (I-geo), as well as from the distribution map of Hg content, it is evident that the soils of the study area are highly contaminated with mercury, with extremely high enrichment of Hg in the soils of Zone I, which was classified as the most contaminated zone with Hg and other potentially toxic elements in the study area as well as in the towns of Zveçan and Mitrovica. The higher Hg content is of anthropogenic origin, mainly due to lead and zinc mining and metallurgical activities in the study area. The mercury levels were also found to exceed the New Dutch List target value (0.3 mg/kg) in 90 km2 of the study area.
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Mercurio , Contaminantes del Suelo , Mercurio/análisis , Suelo , Kosovo , Zinc , Contaminantes del Suelo/análisis , Monitoreo del Ambiente , ChinaRESUMEN
SUMMARY: Height and body weight measurements are among the most important anthropometric variables when assessing a population's growth, development and body composition. This study aimed to evaluate the height and body weight variability of male entities aged 17-18 years within 35 years. This goal was realized by comparing the height and body weight of the population of the same gender and age in three different time studies. The descriptive statistical parameters and T-test for independent groups show systematic and significant differences in measured variables between three measurements in different timelines. Both in body height and body weight, from measurement to measurement, significant systematic and statistically significant differences (p<0.01) have been identified (1985: BH= 172.8cm, BW= 61.7kg; 2004: BH=176.8 cm, BW=66.9 kg; 2019: BH=178.5 cm, BW=72 kg). The results of this study prove that the change in the socio-economic status of a population over a period time of 35 years can significantly affect the growth and development of children/adolescents.
Las medidas de altura y peso corporal se encuentran entre las variables antropométricas más importantes a la hora de evaluar el crecimiento, el desarrollo y la composición corporal de una población. Este estudio tuvo como objetivo evaluar la variabilidad de la altura y el peso corporal de entidades masculinas de 17 a 18 años dentro de 35 años. Este objetivo se logró comparando la altura y el peso corporal de la población del mismo sexo y edad en tres estudios temporales diferentes. Los parámetros estadísticos descriptivos y la prueba T para grupos independientes muestran diferencias sistemáticas y significativas en las variables medidas entre tres mediciones en diferentes líneas de tiempo. Tanto en la altura como en el peso corporal, de medición en medición, se han identificado diferencias significativas sistemáticas y estadísticamente significativas (p<0,01) (1985: BH= 172,8 cm, BW= 61,7 kg; 2004: BH=176,8 cm, BW=66,9 kg; 2019: BH=178,5 cm, BW=72 kg). Los resultados de este estudio demuestran que el cambio en el estatus socioeconómico de una población durante un período de 35 años puede afectar significativamente el crecimiento y desarrollo de niños/ adolescentes.
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Humanos , Masculino , Adolescente , Estatura , Peso Corporal , Antropometría , Factores Socioeconómicos , Factores de Tiempo , Estudios Transversales , Kosovo , Estatus SocialRESUMEN
Crimean-Congo haemorrhagic fever orthonairovirus (CCHFV) is a tick-borne, risk group 4 pathogen that often causes a severe haemorrhagic disease in humans (CCHF) with high case fatality rates. The virus is believed to be maintained in a tick-vertebrate-tick ecological cycle involving numerous wild and domestic animal species; however the biology of CCHFV infection in these animals remains poorly understood. Here, we experimentally infect domestic sheep with CCHFV Kosovo Hoti, a clinical isolate representing high pathogenicity to humans and increasingly utilized in current research. In the absence of prominent clinical signs, the infection leads to an acute viremia and coinciding viral shedding, fever and markers for potential impairment in liver and kidney functions. A number of host responses distinguish the subclinical infection in sheep versus fatal infection in humans. These include an early reduction of neutrophil recruitment and its chemoattractant, IL-8, in the blood stream of infected sheep, whereas neutrophil infiltration and elevated IL-8 are features of fatal CCHFV infections reported in immunodeficient mice and humans. Several inflammatory cytokines that correlate with poor disease outcomes in humans and have potential to cause vascular dysfunction, a primary hallmark of severe CCHF, are down-regulated or restricted from increasing in sheep. Of particular interest, the detection of CCHFV RNA (including full-length genome) in a variety of sheep tissues long after the acute phase of infection indicates a widespread viral dissemination in the host and suggests a potentially long-term persisting impact of CCHFV infection. These findings reveal previously unrecognized aspects of CCHFV biology in animals.
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Virus de la Fiebre Hemorrágica de Crimea-Congo , Fiebre Hemorrágica de Crimea , Garrapatas , Humanos , Animales , Ratones , Ovinos , Fiebre Hemorrágica de Crimea/diagnóstico , Oveja Doméstica/genética , ARN Viral/genética , Kosovo , Interleucina-8RESUMEN
BACKGROUND: During the COVID-19 pandemic, effective contact tracing was recognized as a crucial public health response to mitigate the spread of SARS-CoV-2 and reduce COVID-19-related morbidity and mortality, particularly before widespread vaccination. The World Health Organization (WHO) recommended implementing active surveillance strategies to trace and quarantine contacts of confirmed or suspected COVID-19 cases. METHODS: A detailed review and analysis of the COVID-19 contact tracing responses was conducted in five European countries and territories, between March 2021 and August 2022. The countries and territories were selected to ensure geographical representation across the WHO European Region and applied a mixed-methods approach of in-depth interviews with various stakeholders across different administrative levels to identify good practices in COVID-19 contact tracing. The interviews covered 12 themes, including methods and procedures for COVID-19 contact tracing, information technology, quality assurance and key performance indicators. RESULTS: The findings demonstrate that the policy approach, digitalization capabilities and implementation approach varied in the countries and territories and were dynamic throughout the pandemic. The analysis revealed that some practices were applicable across all countries and territories, while others were context-specific, catering to each country's and territory's unique needs. The study highlighted a need for all countries to institutionalize contact tracing as an essential function of existing health systems, to digitalize contact tracing practices and processes, and to build and retain contact tracing capacities for better pandemic preparedness. CONCLUSION: The lessons related to COVID-19 contact tracing should be utilized to strengthen future outbreak response operations as part of epidemic and pandemic preparedness.
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COVID-19 , Humanos , Austria , Trazado de Contacto/métodos , COVID-19/epidemiología , COVID-19/prevención & control , Georgia (República) , Kosovo , Kirguistán , Pandemias/prevención & control , SARS-CoV-2 , UcraniaRESUMEN
BACKGROUND Multiple sclerosis (MS) is treated with disease-modifying therapies (DMTs) that can increase susceptibility to viral infections. This retrospective study aimed to evaluate the presentation, management, and outcomes of patients with MS on DMTs admitted with symptoms of COVID-19 to a single center in Prishtina, Kosovo between March 2020 and April 2022. MATERIAL AND METHODS In this observational, single-center study, we included 282 patients with MS (mean age 37.8±11, 64.9% females), of whom 272 (96.4%) had confirmed COVID-19 infection, either through the presence of antibodies in the serum or a positive PCR test. RESULTS Most patients with COVID-19 infection were either asymptomatic or mildly symptomatic, while 11 patients were hospitalized due to moderate to severe symptoms. Among those with severe infection, 2 patients have died. Patients with moderate and severe COVID-19 had more advanced MS disease (P=0.001) and higher disability scales (P<0.001). In a logistic regression analysis, advanced MS remained significantly associated with worse symptoms, even after adjusting for other risk factors, with a relative risk (RR) of 2.8 (95% CI=1.1-6.6, P=0.018). MS patients on anti-CD20 DMTs more frequently experienced moderate and severe symptoms (RR=2.1, 95% CI=1.1-4.0, P=0.012). Anti-SARS-CoV-2 IgG was also lower in patients treated with anti-CD20. Notably, patients receiving vitamin D supplementation experienced a lower frequency of moderate to severe symptoms (P=0.007). CONCLUSIONS Patients with advanced MS exhibiting higher disability scales and those on anti-CD20 therapy faced an increased risk of experiencing more pronounced symptoms after COVID-19 infection. Patients on vitamin D supplementation had better clinical outcomes.
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COVID-19 , Esclerosis Múltiple , Femenino , Humanos , Masculino , Anticuerpos Antivirales , Ceguera , COVID-19/complicaciones , Kosovo/epidemiología , Esclerosis Múltiple/complicaciones , Estudios Retrospectivos , Factores de Riesgo , Vitamina D , Adulto , Persona de Mediana EdadRESUMEN
BACKGROUND: In recent years, the global response to the HIV/AIDS pandemic has encountered significant challenges, impeding the collective aim of eliminating AIDS as a public health threat by 2030. A major concern undermining this goal is the delayed presentation (late presentation - LP) of individuals diagnosed with HIV/AIDS. METHODOLOGY: This study includes 85 HIV positive individuals with available CD4 count and viral load (VL) data at the time of HIV diagnosis, out of 169 registered people living with HIV in Kosovo. Employing descriptive and frequency statistics, Chi-square tests, non-parametric Mann-Whitney tests, and logistic regression analyses using SPSS Version 29, we generated statistical results with 95% confidence intervals. RESULTS: The prevalence of LP in HIV positive individuals included in the study was 50.59%, with 30.59% classified as very late presenters (VLP). Determinants associated with LP included male gender, young adulthood, MSM mode of transmission, and a high viral load (log10 4.1-5.0 copies/mL). Comparative analysis with studies on this subject indicated similar patterns of LP in adults, males, and viral load, but different transmission mode patterns. CONCLUSION: This research illuminates the specific determinants of LP in Kosovo, offering valuable insights for tailoring interventions to enhance timely diagnosis and access to care for people living with HIV/AIDS.
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Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Minorías Sexuales y de Género , Adulto , Humanos , Masculino , Adulto Joven , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Factores de Riesgo , Homosexualidad Masculina , Kosovo/epidemiología , Diagnóstico TardíoRESUMEN
BACKGROUND: Prevalent physical inactivity and poor nutrition contribute to high non-communicable disease (NCD) morbidity and mortality in Kosovo. To improve health services for patients with NCD the Accessible Quality Healthcare project developed behaviour change interventions following the principles of the WHO Package of Essential NCD (PEN) protocol. They were implemented into the public primary healthcare (PHC) system of five early-stage implementation municipalities (ESIM, 2018) and seven late-stage implementation municipalities (2020). OBJECTIVE: To assess the effect of the behaviour change interventions; motivational stages of behaviour change for physical activity and nutrition; and body mass index (BMI). DESIGN: Prospective cohort study. DATA COLLECTION AND ANALYSIS: We included 891 public PHC users aged 40 years and above, who were enrolled in the KOSCO (Kosovo Non-Communicable Disease Cohort) cohort in 2019 and followed-up biannually until February 2021. The PHC users who consulted for themselves any health service were approached and recruited for cohort participation. Each participant contributed up to four self-reports of nutrition and physical activity, and up to three reports of motivation to change for a better lifestyle. These outcomes were modelled prospectively with robust mixed-effects Poisson regressions. The association between behaviour change interventions and BMI was quantified using linear regression. RESULTS: There was a high rate of smokers 20.5% and obesity 53.1%, and high rates of self-reported diagnoses of diabetes: 57.1%; hypertension 62.6%. We found no effect of residing in an ESIM, but adherence to both guidelines was higher in ESIM at the latest follow-up time point. ESIM residence was also associated with a twofold increase in the probability of reporting a high motivation for a better lifestyle and with a statistically non-significant decrease in BMI of -0.14 kg/m2 (95% CI: -0.46 to 0.19) at the latest follow-up. CONCLUSION: The longitudinal results extend evidence on the effect of WHO PEN protocol in promoting physical activity and nutritional behaviour in the Kosovo context.
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Enfermedades no Transmisibles , Humanos , Índice de Masa Corporal , Kosovo , Estudios Prospectivos , Dieta , Ejercicio Físico , Atención Primaria de SaludRESUMEN
Evidence-based assessment (EBA) in mental health is a critical aspect of improving patient outcomes and addressing the gaps in mental health care. EBA involves the use of psychometric instruments to gather data that can inform clinical decision-making, inform policymakers, and serve as a basis for research and quality management. Despite its potential, EBA is often hindered by barriers such as workload and cost, leading to its underutilization. Regarding low- and middle-income countries (LMIC), the implementation of EBA is recognized as a key strategy to address and close the prevalent mental health treatment gap.To simplify the application of EBA including in LMIC, an international team of researchers and practitioners from Tanzania, Kosovo, Chile, and Switzerland developed the Mental Health Information Reporting Assistant (MHIRA). MHIRA is an open-source electronic health record that streamlines EBA by digitising psychometric instruments and organising patient data in a user-friendly manner. It provides immediate and convenient reports to inform clinical decision-making.The current article provides a comprehensive overview of the features and technical details of MHIRA, as well as insights from four implementation scenarios. The experience gained during the implementations as well as the user-feedback suggests that MHIRA has the potential to be successfully implemented in a variety of clinical contexts and simplify the use of EBA. However, further research is necessary to establish its potential to sustainably transform healthcare services and impact patient outcomes.In conclusion, MHIRA represents an important step in promoting the widespread adoption of EBA in mental health. It offers a promising solution to the barriers that have limited the use of EBA in the past and holds the potential to improve patient outcomes and support the ongoing efforts to address gaps in mental health care.
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Atención a la Salud , Salud Mental , Humanos , Tanzanía , Kosovo , SuizaRESUMEN
The Ferronikel smelter in Drenas is one of the main industrial areas in the Kosovo and pollution by heavy metals causes serious threat for all living organisms on this area. The objective of this study was to determine the concentration of some heavy metals (Fe, Cu, Mn, Cr, Cd, Ni and Pb) in agricultural soils and in maize plants, and their potential toxic effects on this plant through some sensitive biochemical and molecular markers. Maize seedlings growth in nine soil samples from different locations of this area. The highest concentrations of heavy metals in soils and maize leaves were conducted close to the Ferronikel smelter, and in some locations, the nickel and chromium concertation in soils exceeded 800 mg kg-1. A significant effects of heavy metals induced toxicity resulted in the, build-up aminolevulinic acid and reduced activity of δ-aminolevulinic acid dehydratase, and chlorophyll content in the maize leaves. In general, maize seedlings growth in polluted locations showed an increase in nuclear DNA content and in G2M phase. We concluded that locations close to the smelter are affected by soil heavy metals pollution and these biochemical and molecular analysis would be a powerful ecotoxicological tool in biomonitoring of heavy metal pollution.
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Metales Pesados , Contaminantes del Suelo , Suelo/química , Zea mays , Kosovo , Monitoreo del Ambiente/métodos , Contaminantes del Suelo/análisis , Metales Pesados/toxicidad , Metales Pesados/análisis , Biomarcadores , Daño del ADN , Medición de Riesgo , ChinaRESUMEN
A total of 300 tree-associated samples were collected from green areas in three towns in Kosovo, and cultured to isolate Cryptococcus species. One soil sample from Prizren tested positive, yielding three isolates identified as C. neoformans var. neoformans (C. deneoformans), molecular type VNIV, two MATα, and one MATa. Mating experiments revealed that they were fertile when crossed together, and multilocus sequence typing analysis showed unique sequence types not found in the global database. The study reports the presence of C. neoformans strains in the environment in Kosovo and highlights the importance of monitoring pathogen distribution and the potential impacts of climate change.
We collected tree samples from three main towns in Kosovo to isolate the human fungal pathogen Cryptococcus. The results showed that C. neoformans var. neoformans isolates, able to produce basidiospores, were present in the environment, confirming that population at risk can be potentially infected.
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Cryptococcus neoformans , Animales , Cryptococcus neoformans/genética , Kosovo , Ambiente , Cambio Climático , Bases de Datos FactualesRESUMEN
Blastocystis species (sp.) is one of the less well-understood water- and foodborne protozoa of medical and veterinary importance linked to different gastrointestinal disorders. Soldiers participating in military missions are particularly vulnerable to infection with this protozoa. The present study used molecular methods to detect, identify, and subtype (ST) Blastocystis sp. in Polish soldiers stationed in the Republic of Kosovo. Fecal samples were collected from 192 soldiers on arrival and after four months of stay. After DNA extraction, the barcoding region of the small subunit ribosomal RNA (SSU-rRNA) gene was amplified and sequenced. The DNA of Blastocystis sp. was detected in six (3.13%) and thirty (15.16%) samples in the first and second batch, respectively. Sequencing analysis revealed infections with ST 2, 3, 4, and 7. There was no statistical association between Blastocystis sp. infection and the parasite's ST or the age or rank of soldiers. The results indicate that the visit to a new environment and prolonged stay in the area of military operation in Kosovo resulted in a significant increase in both Blastocystis sp. infections and ST diversity among surveyed soldiers. This shows the need to undertake appropriate countermeasures to reduce Blastocystis infections in the military environment abroad.
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Blastocystis , Blastocystis/genética , Kosovo , Polonia , Heces , AguaRESUMEN
Here, we determined the concentrations of Pb, Ni, Zn and Fe in the soil and in vegetative organs of stinging nettle (Urtica dioica) collected from the banks of the Drenica River in the vicinity of the Ferronikeli smelter. The results were compared with samples collected from the banks 20 km (Shalë village) upriver. In addition, the bioaccumulation factor (BCF) and translocation factor (TF) were determined. Meanwhile, to evaluate the level of pollution in the study area was used the contamination factor (CF), potential ecological risk factor (Eri) and the potential ecological risk index (RI). The order of heavy metals according to their concentration in the soil samples at both sampling sites was as follows: Fe > Ni > Zn > Pb. Concentrations in excess of the limits allowed for soils in the samples collected in the vicinity of the smelter were recorded for Pb (173.13 mg kg-1), Zn (1217.48 mg kg-1), and Ni (1443.93 mg kg-1), while at the control site, Zn (270.82 mg kg-1) and Ni (375.47 mg kg-1) were found in excess concentrations. But lead (Pb) level was under allowed limit. The data showed that the stinging nettle is not a hyperaccumulator because BCF < 1 at both sites for all metals under study. Furthermore, analysis of the translocation factor (TFsteam/root) showed that at low of heavy metal concentrations, their mobility was higher (TF > 1). The lowest mobility (TF < 1) was observed at site I (Poklek), where the concentration of heavy metals was higher, except for Fe. The opposite was shown for mobility of metals from stems to leaves (TFleave/steam). The evaluation of CF showed that the area near the Ferronikeli smelter had low degree of Pb, moderate degree of Zn and considerable degree of Ni contamination. The values of RI indicate low potential ecological risk index.
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Metales Pesados , Contaminantes del Suelo , Urtica dioica , Plomo/análisis , Bioacumulación , Kosovo , Vapor , Metales Pesados/análisis , Monitoreo del Ambiente , Zinc/análisis , Suelo , Medición de Riesgo , Contaminantes del Suelo/análisis , ChinaRESUMEN
BACKGROUND: Very limited information is available on the prevalence and risk factors of asthma in adolescents in Kosovo, and no study has previously addressed the role of Human Development Index (HDI) on asthma in the region. The present study addresses these two issues. METHODS: Following the Global Asthma Network (GAN) methodology, a cross-sectional survey, through standardised self-completed questionnaires, was conducted in the following six centres of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina and Prizren. Current asthma symptoms (CAS) and severe current asthma symptoms (sCAS) were defined according to the GAN standards. Environmental questionnaire inquired about gender, exercise, screening time, siblings, truck traffic, use of paracetamol, pet ownership, and smoking habits. Height and weight were also measured. Multivariate logistic regression analyses were performed in each centre along with meta-analyses to summarise the overall effects of each factor in the centres as a whole. Meta-regression of the prevalence rates was calculated using HDI as a moderator. RESULTS: Participation rate was high (80.0-99.9%). Prevalence of CAS ranged from 4.6% to 11.3%, and sCAS from 1.7% to 4.5%. Factors associated with CAS were exercise, computer time, paracetamol use and dog ownership. sCAS was associated with paracetamol use and physical exercise. HDI explained 46% and 80% of prevalence variability of CAS and sCAS between centres, respectively. CONCLUSIONS: Prevalence of CAS and sCAS in Kosovo varies highly between centres. This variability is explained partly by HDI. Individual risk factors are common, with some determined in other studies conducted in other regions.
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Acetaminofén , Asma , Humanos , Adolescente , Animales , Perros , Acetaminofén/efectos adversos , Estudios Transversales , Kosovo/epidemiología , Asma/epidemiología , Asma/inducido químicamente , Factores de Riesgo , Encuestas y Cuestionarios , PrevalenciaRESUMEN
Mucopolysaccharidosis type IIIB (MPS IIIB), also known as Sanfilippo syndrome type B, is a metabolic disease caused by mutations in both alleles of the NAGLU gene encoding for the enzyme α-N-acetylglucosaminidase. A malfunction of this enzyme causes inability to degrade heparan sulfate, which leads to accumulation of glycosaminoglycans in the cells. MPS IIIB is associated with different symptoms such as neurodegeneration, extreme hyperactivity, sleeping problems, aggressive behavior, reduced fear, and cognitive deterioration. The condition is by now not curable. Here we describe a patient with MPS IIIB diagnosed at the age of 5 presenting with communication problems, motor dysfunctions, and speech and sleeping problems.Standard biochemical tests for neurodegenerative disorders and DNA analyses including NAGLU mutation screening were performed. We also did some psychological tests assessing the patient's communication skills and behavior. The patient was heterozygote for two mutations in the gene NAGLU (Y140C and Ser169fs). Thus, he suffered from MPS IIIB due to two mutations in the disease-causing gene.The patient presented with clear signs and symptoms of MPS IIIB with at least one of the two mutations affecting the α-N-acetylglucosaminidase protein function severely. Here we report the combination of a well-known and previously unreported mutation in the NAGLU gene; this could be dependent on geographical origin of the patient, which needs to be clarified by molecular studies of more MPS IIIB patients from Southeast Europe.
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Mucopolisacaridosis III , Masculino , Humanos , Kosovo , Mucopolisacaridosis III/diagnóstico , Mucopolisacaridosis III/genética , Ansiedad , MiedoRESUMEN
OBJECTIVES: Our study described how the WHO intra-action review (IAR) methodology was operationalised and customised in three Western Balkan countries and territories and the Republic of Moldova and analysed the common key findings to inform analyses of the lessons learnt from the pandemic response. DESIGN: We extracted data from the respective IAR reports and performed a qualitative thematic content analysis to identify common (between countries and territories) and cross-cutting (across the response pillars) themes on best practices, challenges and priority actions. The analysis involved three stages, namely: extraction of data, initial identification of emerging themes and review and definition of the themes. SETTING: IARs were conducted in the Republic of Moldova, Montenegro, Kosovo and the Republic of North Macedonia between December 2020 and November 2021. The IARs were conducted at different time points relative to the respective pandemic trajectories (14-day incidence rate ranging from 23 to 495â¯per 100â¯000). RESULTS: Case management was reviewed in all the IARs, while the infection prevention and control, surveillance and country-level coordination pillars were reviewed in three countries. The thematic content analysis identified four common and cross-cutting best practices, seven challenges and six priority recommendations. Recommendations included investing in sustainable human resources and technical capacities developed during the pandemic, providing continuous capacity-building and training (with regular simulation exercises), updating legislation, improving communication between healthcare providers at all levels of healthcare and enhancing digitalisation of health information systems. CONCLUSIONS: The IARs provided an opportunity for continuous collective reflection and learning with multisectoral engagement. They also offered an opportunity to review public health emergency preparedness and response functions in general, thereby contributing to generic health systems strengthening and resilience beyond COVID-19. However, success in strengthening the response and preparedness requires leadership and resource allocation, prioritisation and commitment by the countries and territories themselves.