Vector-borne and zoonotic infections and their relationships with regional and socioeconomic statuses: An ID-IRI survey in 24 countries of Europe, Africa and Asia.

BACKGROUND: In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. METHOD: VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. RESULTS: 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. CONCLUSIONS: Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.

Epidemiological characteristics of brucellosis in Federation of Bosnia and Herzegovina.

AIM: To analyze the frequency and distribution of human brucellosis in the Federation of Bosnia and Herzegovina in the period 2001-2008, and measures and activities undertaken for prevention and control of the disease. METHOD: In this descriptive, retrospective study, we used official reports on infectious diseases from public health institutes at the federal and cantonal level, as well as epidemiological surveys. For comparison with animal brucellosis cases, we used the distribution data from veterinary surveillance. RESULTS: Since 2001, the number of infected people has rapidly increased and brucellosis has become a very important public health problem. In the period 2001-2008, there were 1639 human brucellosis cases and the number of cases increased every year. The morbidity rate over the study period ranged from 3.8 to 33.4 per 100,000 inhabitants. According to epidemiological surveys, in villages human brucellosis was transmitted mostly by contact with infected animals and their products, and in cities by consumption of dairy products made from contaminated, unpasteurized milk. When test-and-slaughter control approach was used, the prevalence of seropositive livestock was 4.6% and approximately 70,000 animals were slaughtered after testing between 2001 and 2008. From 1 June 2009, this approach was replaced with mass vaccination of sheep and goats. CONCLUSION: The large number of human brucellosis cases and seropositive livestock poses a very serious problem for Bosnia and Herzegovina. The solution may be the introduction of mass vaccination.

Interdisciplinary aspects of possible negative effects of dogs on humans in Bosnia and Herzegovina.

The coexistence of humans and dogs, in addition to all positive effects, can result in negative effects on human health. A particular risk is posed by a population of stray dogs, that is, dogs without owners and veterinary supervision. A contact with dogs in addition to bites, carries the risk of viral, bacterial and parasitic zoonoses, and can also cause psychological trauma. Children, the elderly and pregnant women are the categories most susceptible to the negative effects of dogs. The aim of the paper was to make an interdisciplinary analysis of the negative effects of dogs on humans. Dog bites cause wounds and dysfunction of damaged tissue, and often lead to various infections. The risks of rabies and tetanus are particularly significant if proper and timely treatment is not performed. Ongoing training for dog owners can significantly reduce the number of bites inflicted by owned dogs, but stray dogs remain a serious social problem and pose potential health risks of some zoonosis. Timely and adequate management of bite wounds and the use of rabies-post-exposure prophylaxis as well as psycho-therapy, where indicated, significantly reduce possible adverse health effects for patients who have been bitten by dogs.

Intravenous drugs abuse as the main risk factor of increasing hepatitis C infection prevalence in prisoners in Zenica, Bosnia and Herzegovina.

Aim To determine the prevalence of hepatitis C virus infection (HCV) among prisoners in Zenica prison, and to investigate the relation between HCV and risky behaviors: intravenous drugs use (IDU), tattooing, promiscuity. Methods This cross-sectional study conducted at the High Security Penitentiary in Zenica involved 200 convicted persons who gave their consents for the research. Their blood was tested by AraGen Hepatitis C Test. Risky behaviors (IDU, tattooing, promiscuity) were tested by an anonymous self-administered questionnaire. Results The prevalence of HCV was 13% (26/200). There was a statistically significant correlation of HCV infection and drug abuse before imprisonment (p=0.00), injection drug abuse before imprisonment (p=0.00), tattooing in prison (p=0.03) and having sex with homosexual partners (p=0.00). Conclusion The prevalence of HCV in prisoners at Zenica prison was significantly higher than in the general Bosnia and Herzegovina population. Intravenous drugs use had highest risk for HCV infection among prisoners.

The impact of war on vaccine preventable diseases.

INTRODUCTION: During the war in Bosnia and Herzegovina, which lasted from 1992-1995, the functioning of all sectors was disturbed, including the health sector. The priority of the heath sector was treatment and less attention was paid to prevention, and this applies also to the Program of implementation of obligatory immunization, as one of the most important prevention measures. This program was conducted with difficulty and sometimes was completely interrupted because of the lack of necessary vaccines and the inability of adequate maintenance of the cold chain. It was difficult and sometimes completely impossible to bring children to vaccination. Because of these problems, a great number of children stayed unvaccinated so they suffered from vaccine-preventable diseases several years after the war. MATERIALS AND METHODS: This is a retrospective epidemiological study. We analyzed data from January 1994 to July 2014 in Canton Sarajevo, and data about measles outbreak in 2014. RESULTS: In the period from January 1994 to July 2014, 3897 vaccine-preventable diseases were registered in Canton Sarajevo. Among them measles, rubella and mumps were the most frequent. In March 2014, measles outbreak was registered. Almost all cases are unvaccinated (99%) and 43% of all cases are connected with failure of vaccination during the war. CONCLUSION: During the war, routine immunization program was disrupted in Bosnia and Herzegovina (also in Canton Sarajevo). The consequences are presented as vaccine preventable diseases cases.

Characteristics of travellers from bosnia and herzegovina to Africa.

CONFLICT OF INTEREST: none declared. INTRODUCTION: Travellers from Bosnia and Herzegovina (B&H) travel to different world countries. The awareness of people is changing every day and nowadays travellers seek advices related to their travel and destination more often than before. In the previous years, travellers came to Travel Clinics almost only to get the vaccines which were obligatory for entry into a country. In B&H travel clinics are a part of public health institutes. The largest Travel Clinic which provides service for the highest number of travellers is in the Public Health Institute of Sarajevo Canton, in the city of Sarajevo, which is the capital of B&H. In the last years we have seen an increasing interest for travel to Africa because the highest number of travellers travel to African countries. OBJECTIVE: To show the characteristics of persons travelling to Africa, the reasons of their travel, the destination countries and the types of vaccines applied. MATERIALS AND METHODS: We used protocol books of the Travel Clinic in Public Health Institute of Sarajevo Canton and the data from individual forms of travellers. RESULTS: Persons travelling to Africa make 55% of all travellers that are advised and vaccinated in the Travel Clinic in Public Health Institute of Sarajevo Canton. There are significantly more men than women among people travelling to Africa. The highest number of travellers is in the category of working population which means age group of 20-50 years. The most visited countries are Kenya, Ethiopia, Somalia and Ghana. Travellers received the following vaccines: yellow fever, VHA, VHB, meningitis, tetanus. All travellers were given the advice on how to dress, feed and protect against malaria.

[Echinococcosis in Bosnia and Herzegovina]. / Ehinokokoza u Bosni i Hercegovini.

Echinococcosis is zoonosis transmitted by dogs in livestock-raising areas and accidentally affects man. Disease is endemic in certain parts of the world, including our country particularly region of Herzegovina. The most frequent site of hydatid cysts in the liver (78 %), followed by the lungs (17 %), and less frequently, the spleen, kidneys, heart, bones, central nervous system, and elsewhere. The diagnosis is based on clinical features, imaging examinations and serology. In the treatment of hydatidosis, three options are available: surgery, medical treatment by benzimidazole carbamates and percutaneous drainage. Drug therapy has scolicidal activity bat are clinically effective in less than 30 % of patients with hepatic hydatidosis. Surgery is no longer the treatment of first choice for hydatidosis located in abdomen. Percutaneous drainage associated with albendazole therapy is safe and efficient treatment for hydatid cysts in abdomen and retroperitoneal space. Surgery should be reserved for patient with hydatid cysts where PAIR with albendazole therapy can not be performed. Moreover, a multidisciplinary approach is advisable to assure a better clinical management to patients with cystic echinococcosis and eradication of hydatidosis. The socio-economic impact of cystic echinococcosis is reviewed with special reference to the following topics: consequences in man and livestock, costs and benefits of control programmes and economic procedures for evaluating control programmes. The durability of control programs is the corner stone for obtaining a significant decrease of hydatid infection. Many consequences in man and livestock are difficult to evaluate from an economic point of view, because some basic data are difficult to obtain in our country. Health education represents essential elements in the control and eradication campaigns of echinococcosis/hydatidosis.

[Status of drug addiction in Mostar]. / Aktuelno stanje narkomanije u Mostaru.

Drug addiction is becoming a more serious problem in many countries in transition and so in B and H. The age limit is decreasing to younger age groups, and the number of i.v. drug users is increasing every day. The aim of our research was to examine the habits, attitudes and practise related to drug taking of young people in the area of the city of Mostar. Following methods were used in our research: polls, focus groups, interviews, observation and mapping. Results showed that one third of all examinees used or use some kind of drug. Marihuana is mostly used, although other drugs are also used, like in the rest of the world. Drugs are available to everybody and on many places in town. The main reasons for taking drugs are dissatisfaction with the actual social and political and also economical situation, lack of contents for the youth and lack of meeting places for them. Drug consuming is a try of running away from reality. Most addictives consider that they dont need any kind of help. Just a small number of addictives would be ready for medical treatment, but if it were noninstitutional. Drug addiction is one of the more important problems for the city of Mostar. We must take its solving more organising then by now. The including and co-working of more sectors is necessary, but the role of the family is the most important.