The trend of the quality of cause-of-death data and its association with socio-economic indicators in Serbia in the period 2005-19.

This study aims to evaluate the temporal trend in the quality of cause-of-death data and garbage code profiles and to determine its association with socio-economic status in Serbia. A longitudinal study was assessed using data from mortality registers from 2005 to 2019. Computer application Analysis of Causes of National Deaths for Action (ANACONDA) calculates the distribution of garbage codes by severity and composite quality indicator: Vital Statistics Performance Index for Quality (VSPI(Q)). A relationship between VSPI(Q) and country development was estimated by analysing two socio-economic indicators: the Socio-demographic Index and the Human Development Index (HDI). Serbia indicates progress in strengthening cause-of-death statistics. The steady upward trend of the VSPI(Q) index has risen from 55.6 (medium quality) to 70.2 (high quality) over the examined years. Significant reduction of 'Insufficiently specified causes with limited impact' (Level 4) and an increase in the trend of 'High-impact garbage codes' (Levels 1 to 3) were evident. Decreased deaths of no policy value (annual percentage change of -1.41%) have manifested since 2014. A strong positive association between VSPI(Q) and socio-economic indicators was assessed, where the HDI has shown a stronger association with VSPI(Q). Improved socio-economic conditions on the national level are followed by enhanced cause-of-death data quality. Upcoming actions to improve quality should be directed at high-impact garbage codes. The study underlines the need to prioritise the education and training of physicians with a crucial role in death certification to overcome many cause-of-death quality issues identified in this assessment.

Assessment of Retinal Microangiopathy in Patients with Balkan Endemic Nephropathy Using Optical Coherence Tomography Angiography-A Pilot Study.

Background and Objectives: It is well known that alterations in microvascular structure and function contribute to the development of ocular, renal, and cardiovascular diseases. Accordingly, the presence of fundus vascular changes in patients suffering from chronic kidney disease (CKD) and Balkan endemic nephropathy (BEN) may provide information of prognostic value regarding the progression of renal disease. This study aimed to examine the associations between clinical characteristics and retinal optical coherence tomography angiography (OCTA) parameters in patients with BEN and compare them with those in CKD. Materials and Methods: This pilot study, conducted from March 2021 to April 2022, included 63 patients who were divided into two groups: the first group consisted of 29 patients suffering from BEN, and the second was a control group of 34 patients with CKD. Demographic, laboratory, clinical, and medication data were noted for all the patients included in this study. Each eye underwent OCT angiography, and the results were interpreted in accordance with the practical guide for the interpretation of OCTA findings. Results: Statistically significantly higher levels of total serum protein and triglycerides were recorded in the BEN group than in the CKD group, while the level of HDL cholesterol was lower. Based on the performed urinalysis, statistically significantly higher values of total protein and creatinine were detected in patients with CKD compared to the BEN group. It was demonstrated that the OCTA vascular plexus density of certain parts of the retina was in significant association with systolic and diastolic blood pressure, creatinine clearance, urinary creatinine, total cholesterol, diabetes mellitus type 2, age, body mass index, total serum and urinary protein, sCRP, and diuretic and antihypertensive treatment. Conclusions: In comparison with CKD, BEN leads to more significant disturbances in retinal vasculature density.

Excess winter mortality of Roma population in Serbia, 1992-2007.

OBJECTIVES: Seasonal fluctuations in mortality are associated with age, outdoor temperature, influenza, health care provision, lifestyle risk factors and economic factors. In the Republic of Serbia almost one half of the Roma population lives in poverty and their housing conditions are very poor. The aim of this paper is to describe and compare excess winter mortality (EWM) in Roma and non-Roma population in Serbia from 1992 to 2007. METHODS: Using the national mortality database, this study compares EWM index and rates in Roma and general populations in Serbia. Mean winter temperature and ethnicity are analysed against the results for relative EWM by multiple linear regression adjusted for age. RESULTS: Frequency analysis showed that Roma population had significantly higher EWM rate per 10,000 (129.2 vs. 76.6) for all causes, all respiratory diseases (26.5 vs. 8.0), and chronic lower respiratory diseases (23.0 vs. 5.2) in comparison to non-Roma population. Influenza and pneumonia related deaths represented a small proportion of EWM in both populations. Cardiovascular EWM rate was slightly higher among non-Roma population. Regression analysis demonstrates that Roma ethnicity was associated with significant increase of respiratory EWM rate (regression coefficient (B) = 1.49; 95% CI: 0.45-2.54). There was no relationship between ethnicity and cardiovascular and all causes EWM rates. CONCLUSIONS: Although both Roma and non-Roma populations in Serbia suffer from very high rates of excess winter mortality, Roma are significantly more vulnerable. EWM rate from chronic lower respiratory diseases is more than four times higher among Roma people and suggests that they represent one of the most important health problems in Roma population in Serbia.

Air quality monitoring in NIS (SERBIA) and health impact assessment.

The aim of this study is to indicate the significance of air quality monitoring and to determine the air quality fields for the assessment of air pollution health effects, with special attention to risk population. Radial basis function network was used for air quality index mapping. Between 1991 and 2005, on the territory of Nis, several epidemiological studies were performed on risk groups (pre-school children, school children, pregnant women and persons older than 65). The total number of subjects was 5837. The exposed group comprised individuals living in the areas with unhealthy AQI, while the control group comprised individuals living in city areas with good or moderate AQI. It was determined that even relatively low levels of air pollution had impact on respiratory system and the occurrence of anaemia, allergy and skin symptoms.