Porous Mullite Ceramic Modification with Nano-WO3.

Mullite and mullite-alumina ceramics materials with dominance of the mullite phase are used in different areas of technology and materials science. Porous mullite ceramics materials can be used simultaneously as refractory heat insulators and also as materials for constructional elements. The purpose of this work was to investigate the WO3 nanoparticle influence on the evolution of the aluminum tungstate and zircon crystalline phases in mullite ceramics due to stabilization effects caused by different microsize ZrO2 and WO3. The use of nano-WO3 prevented the dissociation of zircon in the ceramic samples with magnesia-stabilized zirconia (MSZ), increased porosity by approximately 60 ± 1%, increased the intensity of the aluminum tungstate phase, decreased bulk density by approximately 1.32 ± 0.01 g/cm3, and increased thermal shock resistance by ensuring a loss of less than 5% of the elastic modulus after 10 cycles of thermal shock.

Motives and attitudes of parents toward HPV vaccination: Results from the initial period of HPV vaccine rollout in Serbia.

Human papillomavirus (HPV) infection is one of the most common viral infections in sexually active population worldwide, and is the main cause of cervical cancer, which is the fourth most common cancer among women. Serbia ranks third in incidence and mortality rate of cervical cancer in Europe. We conducted a cross-sectional study considering parents' motivation for the HPV vaccination of their children. Statistical analysis included descriptive statistics and a logistic regression model. We found that the strongest motive was "Recommendation from paediatrician" (20.2%), followed by the attitude that HPV vaccine protects against cancers in different localization (15.4%), the motive "It is better to vaccinate a child than expose them to potential risk of HPV infection" (13.3%) and "Feeling anxiety due to a possible infection and cancer in the child" (13.1%). For those parents that vaccinated their child for some other strongest motive, reasons like "Vaccine is free of charge", "Recommendation from friends and family" and motive "My child received all obligatory vaccines, so I want to receive this one as well", were significantly more frequently selected. In the group where paediatricians' recommendation was not a motive for accepting the HPV vaccine, the largest percentage of parents (89.6%) selected motive "HPV vaccine protects against cancers in different localization" and the motive "It is better to vaccinate a child than expose them to potential risk of HPV infection" (78.1%). Paediatrician's recommendation is very important for parents' decision to vaccinate, however, other motives also influenced and had significance in making the parents' decision to vaccinate their children against HPV. Encouraging trust in public health authorities in Serbia, highlighting the advantages of the HPV vaccine and further encouraging healthcare workers to give stronger recommendations can increase the HPV vaccine uptake. Finally, we provided the basis to create more targeted messages that will empower parents to vaccinate their children.

West Nile virus 'circulation' in Vojvodina, Serbia: Mosquito, bird, horse and human surveillance.

Efforts to detect West Nile virus (WNV) in the Vojvodina province, northern Serbia, commenced with human and mosquito surveillance in 2005, followed by horse (2009) and wild bird (2012) surveillance. The knowledge obtained regarding WNV circulation, combined with the need for timely detection of virus activity and risk assessment resulted in the implementation of a national surveillance programme integrating mosquito, horse and bird surveillance in 2014. From 2013, the system showed highly satisfactory results in terms of area specificity (the capacity to indicate the spatial distribution of the risk for human cases of West Nile neuroinvasive disease - WNND) and sensitivity to detect virus circulation even at the enzootic level. A small number (n = 50) of Culex pipiens (pipiens and molestus biotypes, and their hybrids) females analysed per trap/night, combined with a high number of specimens in the sample, provided variable results in the early detection capacity at different administrative levels (NUTS2 versus NUTS3). The clustering of infected mosquitoes, horses, birds and human cases of WNND in 2014-2015 was highly significant, following the south-west to north-east direction in Vojvodina (NUTS2 administrative level). Human WNND cases grouped closest with infected mosquitoes in 2014, and with wild birds/mosquitoes in 2015. In 2014, sentinel horses showed better spatial correspondence with human WNND cases than sentinel chickens. Strong correlations were observed between the vector index values and the incidence of human WNND cases recorded at the NUTS2 and NUTS3 levels. From 2010, West Nile virus was detected in mosquitoes sampled at 43 different trap stations across Vojvodina. At 14 stations (32.56%), WNV was detected in two different (consecutive or alternate) years, at 2 stations in 3 different years, and in 1 station during 5 different years. Based on these results, integrated surveillance will be progressively improved to allow evidence-based adoption of preventive public health and mosquito control measures.

Provider-initiated vs. client-initiated HIV testing in Autonomous Province of Vojvodina, Serbia, 2000-2008.

BACKGROUND: This paper describes the changes in Human Immundodeficiency virus (HIV) testing rates in Autonomous Province (AP) Vojvodina, Serbia since 2000 and compares provider-initiated with client-initiated HIV testing. METHODOLOGY: Between 2000 and 2008, 66,327 HIV screening tests were reported from AP Vojvodina. During this time HIV testing rates increased from 1.2 per 1,000 inhabitants in 2000, to 7.7 per 1,000 inhabitants in 2008. RESULTS: The results showed an increase in testing as a consequence of increased mandatory testing of surgical patients as well as an upsurge in the use of Voluntary Counselling and Testing (VCT).  Pregnant women that were tested represented less than 5% of the overall sample population. CONCLUSION: Public health efforts in AP Vojvodina to increase HIV testing rates lead to a continuous increase in testing rates, but with different limitations. HIV testing in low prevalence middle income countries could be highly affected by procurement difficulties, low motivation of medical professionals to initiate testing, and opportunities for testing limited to large towns and cities.

Knowledge and attitudes of health care workers from the Primary Health Centre in Indija, Serbia on professional exposures to blood-borne infections.

Exposure to blood-borne infections (HIV, hepatitis B, hepatitis C) poses a serious risk to health care workers (HCWs). The aim of this cross-sectional study was to determine the level of knowledge and attitudes on occupational exposure in primary health care. In 2009, a total of 100 health care workers from the Primary Health Care Centre in Indija, Autonomous Province of Vojvodina, Serbia were included in the study. The results suggested that the health care workers who participated in the survey possess basic knowledge about blood-borne virus transmission routes. Most incorrect answers were related to the transmission of blood-borne viruses by tears, saliva, urine and stool. This study also demonstrated that health workers tend to unrealistically estimate the risk of HIV infections. As for the level of education about the prevention and control of blood-borne infections, 49 % of the participants had never had any education on this topic, while 22 % had been educated during the last five years. Around 75 % consider education on blood-borne infection and protective measures at work unnecessary.

[Epidemiological characteristics of hepatitis A in Vojvodina from 1988 to 2009].

INTRODUCTION: Hepatitis A represents a significant epidemiological problem in many regions of the world. This research was aimed at analyzing trends and distribution of hepatitis A in the Autonomous Province of Vojvodina in Serbia. MATERIAL AND METHODS: The authors used data on individual cases and outbreak reports in the period from 1988 to 2009 obtained from the Registry of Communicable Diseases kept at the Center for Disease Control and Prevention, Institute of Public Health of Vojvodina. RESULTS: The total of 10.471 cases was recorded with average incidence of 23.4/100.000 and with a decreasing trend. This disease occurs as an endemoepidemic with a cyclic increase in the incidence in time intervals of 3, 4 and 6 years. The disease has seasonal character and is most frequently observed in autumn and winter with the highest percentage of cases in October-November after the beginning of school year and forming of school collectives. The age-specific incidence is highest in school age children due to agglomeration of susceptible population. During the observed period, the total of 160 outbreaks was recorded with over 5,000 reported cases. The highest number of outbreaks was recorded in school collectives and then in peri-urban settlements with poor hygiene. Two outbreaks occurred at institutions for people with special needs. Outbreaks were progressive in course and contact was the dominant mode of transmission. CONCLUSION: Although hepatitis A incidence trend is decreasing, this disease still has endemoepidemic character of occurrence. Such an epidemiological situation is most probably caused by slow and limited impact of hygienic measures. A significant contribution to further incidence reduction could be achieved by active immunization.

[Importation and spread of pandemic influenza virus A(H1N1) in autonomous province of Vojvodina in preepidemic period].

INTRODUCTION: Influenza is the most frequently reported communicable disease, having epidemic and pandemic potential. The first influenza pandemic in this century started in Mexico and spread quickly throughout the world. This paper analyses importation of pandemic influenza cases and local transmission among population in the Autonomous Province of Vojvodina. MATERIAL AND METHODS: According to the WHO guidelines and national recommendations, the influenza surveillance activities were conducted in Vojvodina in order to detect, isolate and treat affected international travelers and their close contacts. Patients whose pandemic influenza infection was laboratory confirmed were classified as confirmed cases, while those with symptoms who were epidemiologically linked with confirmed cases were classified as probable cases. RESULTS: During the period from the 24th of June to 17th of August 2009, 123 pandemic influenza cases were recorded in Vojvodina. Infection was imported through international travelers and our citizens coming from countries affected by influenza outbreaks. Majority of cases had mild clinical picture. Most frequently reported symptoms were high fever (above 38 degrees C) (85.6%), and cough (61.6%). Difficulty in breathing was recorded in 20 (16.0%) cases, while pneumonia developed in 4 (3.2%) cases but none of the cases required mechanical ventilation. CONCLUSION: The imported cases of pandemic influenza in the pre-epidemic period led to limited local transmission in general population and caused a small outbreak among visitors of International music festival called EXIT.

[Effects of the immunization program in Vojvodina].

INTRODUCTION: With the widespread use of active immunization, significant results have been achieved in the control and prevention of numerous communicable diseases. The Expanded Programme on Immunization of the World Health Organization is intended to strengthen national programs for the reduction in the incidence and mortality rates and global elimination or eradication of communicable diseases. The aim of this paper is to analyze results of the immunization program in Vojvodina. MATERIAL DND METHODS: The results of the immunization program were analyzed on the basis of the incidence rates, since the introduction of the mandatory reporting system, till 2006. The analysis included immunization coverage against diphtheria, tetanus, pertussis, poliomyelitis and measles as well as reported cases of missed opportunities in the period from 1997 to 2006. RESULTS: Poliomyelitis has not been reported in Vojvodina since 1963, diphtheria since 1978 and measles in the period from 2001 to 2006. Sporadic cases of pertussis have been reported in unimmunized children of the youngest age, and tetanus in unimmunized elderly population. Vaccination coverage against poliomyelitis, diphtheria, tetanus and pertussis was above 96%. Vaccination coverage against measles was lower (95% vaccination, 87% revaccination). The highest proportion of missed opportunities was caused by not responding to immunization calls (46.6%). CONCLUSION: These results can be maintained by up-to-date (UTD) immunization and high vaccination coverage without territorial and population differences. Data on the total number of children without up-to-date vaccination cannot be obtained on the basis of administrative coverage follow-up. It is necessary to establish follow-up mechanisms for UTD immunization, which would reveal the number of children at risk from vaccine preventable diseases and characteristics of unimmunized population.

[Epidemiological characteristics of tetanus in Vojvodina].

INTRODUCTION: Vojvodina is an endemic area for tetanus. MATERIAL AND METHODS: Epidemiological characteristics of tetanus were analyzed based on registered cases of disease and death in the period 1960-2004, and epidemiological investigation of 50 registered cases during the last 10 years of this period. Epidemiological characteristics were analyzed chronologically, demographically and topographically. RESULTS AND DISCUSSION: During the period of observation, the incidence rate of tetanus declined steadily. Due to immunization and extremely high coverage, tetanus has been practically eliminated in the age group of younger than 29 years. Neonatal tetanus and tetanus in the age group 30-59 years has been reduced to individual cases. Today, tetanus is a problem of the elderly population. Tetanus deaths occur statistically more often among persons older than 66 years. The average case fatality rate during the period of observation was 33.1%. The vaccination history in the majority of investigated cases was unknown (52%) or they have never been vaccinated (28%) because they were mainly elderly people born before introduction of mandatory immunization. Tetanus most often occurs after minor wounds, because of which patients do not seek medical attention. In the majority of cases tetanus occurred after limb injuries. CONCLUSION: Tetanus in Vojvodina is a problem among unimmunized elderly people. It mostly occurs after minor injuries or after contamination of chronic skin lesions. Mandatory vaccination of older age groups should contribute to further reduction in the incidence rate of tetanus.