Epidemiology of measles cases and phylogenetic analysis of the virus circulated in the Federation of Bosnia and Herzegovina during 2018: implications for elimination efforts.

Aim To present combined measles cases data and phylogenetic analysis of the virus circulated in 2018 in the Federation of Bosnia and Herzegovina (FB&H, the entity of Bosnia and Herzegovina), in order to analyse endemic transmission patterns of circulating strains and its implications for elimination efforts. Methods The data were derived from epidemiological case investigations and laboratory diagnoses based on serology, molecular detection and genotyping of the measles virus. Results During 2018 16 measles cases were reported in FB&H, of which five were classified as laboratory confirmed cases, one was an epidemiologically linked case and 10 were clinically compatible cases. Among them 12 (75.00%) cases were unvaccinated or had unknown vaccination status. The most affected population was up to 14 years of age (13/16; 81.25%). None of the cases was fully vaccinated. Viruses of other genetic lineages had been introduced in FB&H in the recent period. Two virus lineages of genotype B3 were identified. Phylogenetic analysis indicated the presence of a unique sequence of measles B3 virus in FB&H (Sarajevo). Conclusion Further strengthening of measles surveillance system and renewed efforts to increase vaccination levels are necessary to prevent disease and for elimination setting.

Tumor necrosis factor-alpha serum level in assessment of disease activity in inflammatory bowel diseases.

AIM: To investigate an influence of the concentration of proinflammatory cytokines tumor necrosis factor-alpha (TNF-α) in serum on the activity of inflammatory bowel disease (IBD). METHODS: The IBD patients of both genders (n=60) were divided in two equal groups, ulcerative colitis (UC) and Crohn's disease (CD). Based on the result of activity index each group was subdivided in two subgroups: active and inactive phase of the disease. Age and gender matched apparently healthy individuals (n=30) involved in the control group. Serum TNF-α concentration was determined by enzyme linked immune-adsorbent assay (ELISA). RESULTS: The significant difference (Mann-Whitney Test) in serum TNF-α level was found between healthy controls 28.86 pg/ml (28.74 - 29.19 pg/ml) and CD patients (29.47 pg/ml (29.1 - 29.77 pg/ml) (p less than 0.05) and UC patients 29.34 pg/ml (29.14 - 29.71 pg/ ml) (p less than 0.05) respectively. Serum TNF-α level in patients with CD was higher compared to serum TNF-α level in patients with UC, but the difference was not significant (p more than 0,05). There were no significant difference in serum TNF-α concentrations either in CD or UC patients related to the phase of disease activity: active CD 29.53 pg/ml (29.20 - 29.90 pg/ml) vs inactive CD 29.26 pg/ml (29.15 - 29.53 pg/ml); active UC 29.53 pg/ml (29.32 - 29.85 pg/ ml) vs inactive UC 29.26 pg/ml (29.10 - 29.63 pg/ml). CONCLUSIONS: Since there were no differences in serum TNF-α concentrations related to the disease activity we consider that TNF-α is not an adequate serum biomarker for an assessment of the disease activity in patients with IBD.

Nitric oxide as a potential biomarker in inflammatory bowel disease.

The aim of this study was to investigate changes in serum nitric oxide (NO) concentration in inflammatory bowel diseases (IBD) patients and its use as potential biomarker in differential diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and in disease activity assessment. In 60 patients of both genders - 30 with ulcerative colitis and 30 with Crohn's disease - and 30 controls serum nitric oxide concentration was determined by measuring nitrite concentration, a stable metabolic product of NO with oxygen. Conversion of nitrates (NO3-) to nitrites (NO2-) was done with elementary zinc. The nitrite concentration was determined by classic colorimetrical Griess reaction. Median serum NO concentration was statistically different (p=0,0005) between UC patients (15.25 µmol/L; 13.47 - 19.88 µmol/L), CD patients (14.54 µmol/L; 13.03 -16.32 µmol/L) and healthy controls (13.29 µmol/L; 12.40 - 13.92 µmol/L). When active UC and CD patients were compared with inactive UC and CD patients respectively a significant difference in serum NO level was found (p=0.0005). With a cut-off level of 17.39 µmol/L NO had a sensitivity of 100% and a specificity of 100% in discriminating between active and inactive UC patients. With cut-off value of 14.01 µmol/L serum NO level had a sensitivity of 88% and a specificity of 69% in distinguishing between patients with active CD and inactive CD. Serum NO concentration is a minimally invasive and rapid tool for discriminating between active and inactive IBD patients and could be used as useful biomarker in monitoring of disease activity in IBD patients.

[Diagnosis of chlamydial infections--personal experience]. / Dijagnostika klamidijskih infekcija--nasa iskustva.

OBJECTIVES: In this paper we evaluated the difference of analytic sensitivity, specificity and predictive values using immunoassays based on antigen detection of Chlamydia trachomatis (Ct) in endocervical swab specimens. PATIENTS AND METHODS: 120 fertile female patients were tested for the presence of Ct in the endocervix during two years. The patients represented two risk groups: moderate risk, and low risk group. Three endocervical swab specimens per each patient were collected and each of specimens was analyzed with: DFA-Direct Fluorescence Assay; RIA-Rapid Immunoassay, EIA-Enzyme Immunoassay RESULTS: Total 8 (6.67%) patients were positive on Ct. Out of that 5 (8.33%) were from moderate risk (DFA and EIA), and 3 (5%) from low risk group (DFA and EIA, RIA). 4 (6.67%) out of 5 patients were found positive from moderate risk group by RIA, and 3 (5%) from low risk group (DFA and EIA, RIA). DFA has some results as EIA: sensitivity and specificity are 100%. RIA has sensitivity 87.5% and specificity 100%. Predictive values (PPV, NPV): PPV is the same for the three test assays, and it is 100%. NPV for RIA is 99.1% and for DFA and EIA is 100%. Total prevalence for RIA is 5.83% and for DFA and EIA is 6.66%. CONCLUSION: It was proved that there was some significant difference in validity of applicable immunoassays (DFA and EIA, and RIA), particularly in analytic sensitivity (100% DFA versus 87.5% RIA). With difference to RIA and EIA, DFA does not request confirmation using another method (WHO), which is of great importance for us. Therefore we consider DFA as a method of choice for our conditions.