Environmental sensitivity assessment and land degradation in southeastern Serbia: application of modified MEDALUS model.

This paper aims to improve the methodology and results accuracy of MEDALUS model for assessing land degradation sensitivity through the application of different data detail levels and by introducing the application of Ellenberg indices in metrics related to vegetation drought sensitivity assessment. For that purpose, the MEDALUS model was applied at 2 levels of detail. Level I (municipality level) implied the use of available large-scale databases and level II (watershed) contains more detailed information about vegetation used in the calculation of the VQI and MQI factors (Fig. S6). The comparison was made using data based on CORINE Land Cover (2012) and forest inventory data, complemented with object-based classification. Results showed that data based on forest inventory data with the application of Ellenberg's indices and object-based classification have one class more, critical (C1 and C2) and that the percentage distribution of classes is different in both quantitative (area size of class sensitivity) and qualitative (aggregation and dispersion of sensitivity classes). The use of data from Forest Management Plans and the application of Ellenberg's indices affect the quality of the results and find its application in the model, especially if these results are used for monitoring and land area management on fine scales. Remote sensed data images (Sentinel-2B) were introduced into the methodology as a very important environmental monitoring tool and model results validation.

Cyanobacteria, cyanotoxins, and their histopathological effects on fish tissues in Fehérvárcsurgó reservoir, Hungary.

Cyanobacteria are important members of lake plankton, but they have the ability to form blooms and produce cyanotoxins and thus cause a number of adverse effects. Freshwater ecosystems around the world have been investigated for the distribution of cyanobacteria and their toxins and the effects they have on the ecosystems. Similar research was performed on the Fehérvárcsurgó reservoir in Hungary during 2018. Cyanobacteria were present and blooming, and the highest abundance was recorded in July (2,822,000 cells/mL). The species present were Aphanizomenon flos-aquae, Microcystis flos-aquae, Microcystis wesenbergii, Cuspidothrix issatschenkoi, Dolichospermum flos-aquae, and Snowella litoralis. In July and September, the microcystin encoding gene mcyE and the saxitoxin encoding gene sxtG were amplified in the biomass samples. While a low concentration of microcystin-RR was found in one water sample from July, analyses of Abramis brama and Carassius gibelio caught from the reservoir did not show the presence of the investigated microcystins in the fish tissue. However, several histopathological changes, predominantly in gills and kidneys, were observed in the fish, and the damage was more severe during May and especially July, which coincides with the increase in cyanobacterial biomass during the summer months. Cyanobacteria may thus have adverse effects in this ecosystem.

Demographic and socio-economic factors associated with multiple health risk behaviours among adolescents in Serbia: a cross sectional study.

BACKGROUND: The aim of this study was to examine the relationships between demographic and socioeconomic characteristics and engaging in multiple risk behaviours among adolescents in Republic of Serbia. METHODS: This study presents a cross sectional study of 683 adolescents aged 15 to 19 attending high school. The database from the 2006 National Health Survey was used. As a measure of demographic and socio-economic characteristics: age, type of settlement, family structure, having one's own room, school success and the household wealth index were used. Multivariate logistic regression model was performed. RESULTS: Boys were more than twice as likely to engage in multiple risk behaviours than girls. Adolescents who were older (OR = 5.82, 95% CI = 3.21-10.54, boys; OR = 3.76, 95% CI =1.77-7.99, girls) and adolescents who achieved low or moderate (OR = 1.82, 95% CI = 1.02-3.26, boys; OR = 3.36, 95% CI =1.51-7.44, girls) school success had significantly higher risk than younger ones and those with high school success. Also, boys who came from a richer class households (OR = 3.14, 95% CI =1.02-9.66) and girls from incomplete family (OR = 5.07, 95% CI = 2.06-12.50) had higher risk than boys from the poorest households and girls from complete family. CONCLUSIONS: Further preventive interventions in Serbia should be gender and age specific, oriented towards older adolescents, those who have low or moderate school success, boys from richer class households and girls who live in incomplete families.

Work-Related Factors as Predictors of Burnout in Serbian Nurses Working in Hemodialysis.

Nurses who work in hemodialysis (HD) are considered highly susceptible to burnout due to their close relationship with incurable patients and handling sophisticated machinery. A total of 210 nurses from 12 state-owned HD centers in the Republic of Serbia anonymously completed a background information questionnaire providingfactual data on nurses' sociodemographic characteristics and working conditions using the Maslach Burnout Inventory--Health Services Survey. Almost half of the nurses (42.9%) were experiencing burnout High emotional exhaustion, high depersonalization, and low level of personal accomplishment were present in 40.9%, 8.6%, and 31.3% of nurses, respectively. The number of children, involuntary choice of current position, and unwillingness to choose the same type of job again were significant predictors of burnout. Our population of nurses working in HD was more affected by emotional exhaustion than their colleagues in other countries, but maintained high level of empathy and feeling ofpersonal accomplishment.

The influence of maternal smoking and exposure to residential ETS on pregnancy outcomes: a retrospective national study.

In a nationwide study of Serbian births, in 2008, we estimated the influence of maternal prenatal smoking and environmental tobacco smoke (ETS) exposure on birth outcomes. Using stratified two-stage random cluster sampling, 2,721 women were interviewed in-person (response rates 98.1 %), and 2,613 singleton live births were included. Date of birth, gender, birthweight, birth height and head circumference were copied from the official hospital Birth Certificate. Six exposure categories were defined according to mother's smoking history and exposure to ETS. We calculated adjusted mean values and group differences by analysis of covariance, and adjusted odds ratios for the low birthweight (LBW < 2,500 g). Compared to the reference category (non-smoking, non-exposed to ETS) we observed birthweight reductions in infants whose mothers smoked continuously during the pregnancy and were exposed to ETS (-162.6 g) and whose mothers were not exposed to ETS (-173 g) (p = 0.000, and p = 0.003, respectively), as well as reduction in birth length (-1.01 and -1.06 cm; p = 0.003 and p = 0.000, respectively). Reduction in birthweight and birth length related to exposure categories was not linear. Adjusted OR for LBW was almost tripled for mothers who smoked over the entire pregnancy and were non-exposed to ETS (aOR 2.85; 95 % CI 1.46-5.08), and who were exposed to ETS (aOR 2.68; 95 % CI 1.15-6.25). Our results showed strong effects of smoking throughout the pregnancy on reduced birthweight, birth length and head circumference, and increased risk for LBW. We were not able to detect an effect for ETS exposure alone.

Help-seeking behaviour of Serbian women who experienced intimate partner violence.

OBJECTIVE: This study aimed to identify whom women in Serbia approach for help in case of intimate partner violence (IPV), their reasons for seeking help and their satisfaction with the received help. METHODS: A cross-sectional, population-based household survey of a random sample of women aged 15-49 years was conducted in Belgrade (WHO Multi-country Study on Women's Health and Domestic Violence against Women). A standard questionnaire was administered by trained interviewers through face-to-face interviews. RESULTS: The questionnaire was completed by 1456 women and 1196 of them ever had an intimate partner. Almost one in four ever-partnered women reported experiencing either physical and/or sexual violence, at least once in their life. Among these abused women, ≈ 22% had ever sought help from formal institutions. Police and health services were most commonly approached (12% and 10% of abused women, respectively). Satisfaction with services was highest for health services and legal advice and lowest for police and social services. Women sought help especially when violence had a severe impact on them or when they saw that their children suffered. Women who did not seek help stated that they believed that the violence was bearable or had ended. Other reasons for not seeking help were fear of undesirable consequences of seeking help and lack of trust in institutions. CONCLUSIONS: From the abused women's perspective, health care services are the institutions with the highest potential to help women in cases of IPV. Developing a comprehensive health sector response is of critical importance to ensure appropriate care and referral.

Freshwater as a Sustainable Resource and Generator of Secondary Resources in the 21st Century: Stressors, Threats, Risks, Management and Protection Strategies, and Conservation Approaches.

This paper is a synthetic overview of some of the threats, risks, and integrated water management elements in freshwater ecosystems. The paper provides some discussion of human needs and water conservation issues related to freshwater systems: (1) introduction and background; (2) water basics and natural cycles; (3) freshwater roles in human cultures and civilizations; (4) water as a biosphere cornerstone; (5) climate as a hydrospheric 'game changer' from the perspective of freshwater; (6) human-induced stressors' effects on freshwater ecosystem changes (pollution, habitat fragmentation, etc.); (7) freshwater ecosystems' biological resources in the context of unsustainable exploitation/overexploitation; (8) invasive species, parasites, and diseases in freshwater systems; (9) freshwater ecosystems' vegetation; (10) the relationship between human warfare and water. All of these issues and more create an extremely complex matrix of stressors that plays a driving role in changing freshwater ecosystems both qualitatively and quantitatively, as well as their capacity to offer sustainable products and services to human societies. Only internationally integrated policies, strategies, assessment, monitoring, management, protection, and conservation initiatives can diminish and hopefully stop the long-term deterioration of Earth's freshwater resources and their associated secondary resources.

Knowledge, Attitudes and Practices of Parents and Pediatricians Regarding Antibiotic Use among Children: Differences in Relation to the Level of Education of the Parents in the Republic of Srpska Bosnia and Herzegovina.

Antibiotics are often misused, especially for the treatment of upper respiratory tract infections (URTIs) in children, where their use is unnecessary and leads to antimicrobial resistance. This study sought to explore the knowledge, attitudes and practices (KAP) of parents and pediatricians on the use of antibiotics among children and whether the level of education of parents has an impact on their KAP. The research was carried out among 1459 parents of children under 6 years of age and among 18 pediatricians. Sixty percent of pediatricians (61.1%) were prescribed antibiotics daily in their practice. Most of the surveyed parents (98.4%) state that doctors are their main source of information when deciding on the use of antibiotics in the treatment of their children. Parents with a higher level of education use television less often as a source of information when making this decision compared to parents with a lower level of education (p = 0.039, i.e., p = 0.003). The majority of parents (80.7%) knew that Panklav (amoxicillin/clavulanic acid) is an antibiotic, while 52.5% identified Pancef (cefixime) as an antibiotic. Parents with a higher level of education correctly identified antibiotics significantly more often (p < 0.001). This study shows that in the Republic of Srpska, parents have adequate knowledge about antibiotics, especially those with a higher level of education, who show better KAP when it comes to antibiotic use.

Utility of data from a national health survey: do socioeconomic inequalities in morbidity exist in Serbia?

AIMS: The aim of this study was to analyse the impact of demographic and socioeconomic factors on morbidity in Serbia. Additionally, knowing that there is no a gold standard for measuring morbidity we were concerned whether the results of this study depend on the choice of morbidity indicator. METHODS: Data from the 2006 National Health Survey for Serbia were used. A representative sample of 14,522 persons aged ≥20 years were interviewed. The associations between demographic factors (age, gender, marital status, and type of settlement), socioeconomic indicators (education and wealth index), and health status (morbidity index derived from self-reported data) were examined using linear and logistic regression analyses. RESULTS: Women, elderly people, those who live in urban settings, and those with lower education had higher morbidity regardless of using a morbidity index as a continuous variable (composite index ranging from 0 to 20) or a categorical variable (morbidity status tertiles). Respondents who belong to the most deprived group had higher scores of morbidity index in comparison with the respondents from the most affluent group, but no significant association was found when morbidity status was examined as the outcome. In addition, when those who belong to the middle class group were compared to the most affluent group, they had good more frequently than average morbidity status. CONCLUSIONS: This study suggests that demographic and socioeconomic inequalities in morbidity exist in Serbia. Wise and comprehensive health policies and interventions for reducing these inequalities are urgently needed which primarily focus on the most disadvantaged socioeconomic groups.

Does the Kis-Balaton Water Protection System (KBWPS) Effectively Safeguard Lake Balaton from Toxic Cyanobacterial Blooms?

Lake Balaton is the largest shallow lake in Central Europe. Its water quality is affected by its biggest inflow, the Zala River. During late 20th century, a wetland area named the Kis-Balaton Water Protection System (KBWPS) was constructed in the hopes that it would act as a filter zone and thus ameliorate the water quality of Lake Balaton. The aim of the present study was to test whether the KBWPS effectively safeguards Lake Balaton against toxic cyanobacterial blooms. During April, May, July and September 2018, severe cyanobacterial blooming was observed in the KBWPS with numbers reaching up to 13 million cells/mL at the peak of the bloom (July 2018). MC- and STX-coding genes were detected in the cyanobacterial biomass. Five out of nine tested microcystin congeners were detected at the peak of the bloom with the concentrations of MC-LR reaching 1.29 µg/L; however, accumulation of MCs was not detected in fish tissues. Histopathological analyses displayed severe hepatopancreas, kidney and gill alterations in fish obtained throughout the investigated period. In Lake Balaton, on the other hand, cyanobacterial numbers were much lower; more than 400-fold fewer cells/mL were detected during June 2018 and cyanotoxins were not detected in the water. Hepatic, kidney and gill tissue displayed few alterations and resembled the structure of control fish. We can conclude that the KBWPS acts as a significant buffering zone, thus protecting the water quality of Lake Balaton. However, as MC- and STX-coding genes in the cyanobacterial biomass were detected at both sites, regular monitoring of this valuable ecosystem for the presence of cyanobacteria and cyanotoxins is of paramount importance.

Inequalities that hurt: demographic, socio-economic and health status inequalities in the utilization of health services in Serbia.

BACKGROUND: The aim of this study was to analyse demographic, socio-economic and health status inequalities by gender in the utilization of health services in Serbia. METHODS: Data from 2006 National Health Survey for Serbia were used. A total of 14,522 persons from six geographical regions of Serbia aged >or=20 years were completely interviewed. Logistic regression analyses were used to study the effects of demographic (age, gender, marital status and type of settlement), socio-economic (education and Wealth Index) and health status (self-perceived health) variables on the utilization of health services [visits to general practitioner (GP), private doctor, dentist and hospitalization]. All analyses were carried out separately for males and females. RESULTS: As compared with women (reference category), a lower percentage of men visited a GP [odds ratio (OR) = 0.61; 95% confidence interval (95% CI) = 0.57-0.65], private doctor (OR = 0.62; 95% CI = 0.57-0.67) and dentist (OR = 0.81; 95% CI = 0.76-0.87), but there were no gender differences in hospitalization. Both males and females who belong to disadvantaged classes were less likely to have visited a GP, a private doctor or a dentist in 12 months before the interview, regardless of their health status. No inequalities by social class were observed for the hospitalization among persons with poor self-perceived health status, i.e. those in most need. CONCLUSIONS: This study has shown that demographic, socio-economic and health status inequalities in the utilization of health services exist in Serbia. Wise health policy with equitable utilization of health services, regardless these inequalities should be a priority in shaping Serbian health care system reform.

Predictors of unmet health care needs in Serbia; Analysis based on EU-SILC data.

Unmet health care needs have been designated as an indicator of equality in access to health care, which provides insight into specific barriers faced by respondents when they need medical services. The purpose of this research was to analyze demographic, socioeconomic, regional characteristics and perception of the health status; and identify predictors of unmet health care needs and consequently determine the size of inequalities in the availability, accessibility and acceptability of health care. The cross-sectional study obtained data from the Survey on Income and Living Conditions in the Republic of Serbia in 2014, based on a sample of 20,069 respondents over 16 years. Data was collected by using a household questionnaire and a questionnaire for individuals. Multivariate logistic regressions were applied. Almost every seventh citizen (14.9%) reported unmet health care needs. Predictors of unmet needs, for overall reasons, which increase the likelihood of their emergence included: self-perceived health status as very bad (OR = 6.37), divorced or widower/widow (OR = 1.31), living in the Sumadija region or Western Serbia (OR = 1.54) and belonging to the age group of 27 to 44 (OR = 1.55) or 45 to 64 years (OR = 1.52). The probability for those least reporting unmet health care needs included female patients (OR = 0.81), those with higher education (OR = 0.77), those who belong to the richest quintile (OR = 0.46) and who are unemployed (OR = 0.64). Reasons for unmet needs that indicate the responsibility of the health system amounted to 58.2% and reasons which represent preferences of the respondents amounted to 41.7%. The most frequent reason for unmet needs was financial (36.6%), and the wish to wait and see if the problem got better on its own (18.3%). Health policy should adopt a multidimensional approach and develop incentives for the appropriate use of health services and should eliminate barriers which restrict the accessibility and availability.

Contribution to the improvement of diatom-based assessments of the ecological status of large rivers - The Sava River Case Study.

The Sava River Basin is a major drainage basin of southeastern Europe, significantly influenced by anthropogenic activities. Our study was focused on diatom communities as an indicator of the ecological status of running waters. We investigated over 937km of the Sava River at 19 sampling sites. Benthic diatom communities and 17 diatom indices were analyzed along with a large set of environmental parameters. CCA revealed that the most important elements along the spatial gradient were As and Si. Our results show that the species Navicula recens (Lange-Bert.) Lange-Bertalot and Eolimna minima (Grunow) Lange-Bertalot are very abundant at downstream localities where the highest concentrations of As were measured. The number of motile diatoms increased along the nutrient gradient, i.e. with Si availability. Correlations between diatom indices and selected environmental factors showed that temperature, As, Si and Fe are in significant negative correlation with most diatom indices. Analysis revealed the influence of As and metals in water on diatoms, although their concentrations did not exceed environmental standards. While our findings do not confirm that diatom indices reveal the intensity of pressures solely caused by nutrient and/or organic pollutants, they suggest that in moderately polluted large rivers benthic diatoms are good bioindicators of multiple pressures, and that diatom indices could serve as indicators of the level of overall degradation of an ecosystem.

Impact of the toxicity of Cylindrospermopsis raciborskii (Woloszynska) Seenayya & Subba Raju on laboratory rats in vivo.

In vivo laboratory studies of toxicity were performed on Wistar rats using a methanol extract produced by the natural population of Cylindrospermopsis raciborskii (abundance of 2.13 × 105 trichomes mL-1) collected at Aleksandrovac Lake (Serbia). HPLC analysis showed that the extract contains 6.65 µg cylindrospermopsin (CYN) mg-1. The rats were killed 24 or 72 h after a single intraperitoneal injection of C. raciborskii extract in concentrations of 1500, 3000, 6000 and 12,000 µg kg-1 body weight (bw) and an equivalent amount of CYN as present in the highest dose of the extract (79.80 µg CYN kg-1 bw). The genotoxic effect on the livers treated with C. raciborskii was evaluated using comet assay and potential induction of oxidative stress as the toxicity mechanism associated with the presence of CYN in extract. The results from the analyses of DNA damage in the comet tail length, tail moment and percentage of DNA in the tail in the liver indicated that administration of extract and CYN present statistically significant difference when compared with the negative control group. Although an increase in the frequency of selected parameters induced by the CYN was observed in the liver, this damage was less than the damage resulting from the administration of the highest dose of extract. The changes in the biochemical parameters of the hepatic damage showed that the application of single doses of the extract and CYN did not cause serious liver damage in rats. The extract and CYN significantly increased oxidative stress in rats' liver after a single exposure.

The utility of two marine community indices to assess the environmental degradation of lotic systems using fish communities.

Multimetric approaches are commonly used to evaluate the ecological status of aquatic ecosystems. However, it has been recommended that the sensitivity of existing methods be improved through the investigation of the potential of new metrics to detect environmental disturbances. In this study we tested the effectiveness of two community indices (Taxonomic distinctness index (TDI) and Abundance biomass comparison (ABC) method), primarily proposed for marine ecosystems, to identify sites with different levels of environmental degradation in lotic systems using fish community data. Fish samples were collected over the period 2003-2011 at 131 sampling stations. To generate water and habitat quality classes, a self-organizing map (SOM) based on environmental data was applied. Gradients over the SOM map were investigated for the values of the TDI and ABC indices. The results of this study reveal that the values of both the TDI and ABC indices are highly correlated with water and habitat quality gradients. However, despite the observed correlation, the utility of TDI as a potential metric in bioassessment programs is rather limited, due to its lack of discriminatory power. In contrast, the ABC method could be proposed as a novel metric, but can only be applied in type-specific multimetric approaches.

The Alburnus benthopelagic fish species of the Western Balkan Peninsula: An assessment of their sustainable use.

In this study, we aimed to assess the population status of bleak (Alburnus spp.) over the Western Balkan Peninsula in terms of its sustainable use. A second objective was to determine key factors important for fishery management planning. Two different basins, continental (the Danube Basin and the Sava River sub-basin) and marine (the Adriatic and the Aegean Sea Basins) were examined. A sustainability assessment and factor analysis were conducted using the adjusted ESHIPPOfishing model, extended with additional socio-economic sub-elements, and the categorical principal components analysis (CATPCA), respectively. The results of the assessment revealed the bleak populations in the Danube Basin and the Sava River sub-basin to be highly sustainable. The population characteristics with abiotic and biotic factors were responsible for this status, while the influence of socio-economic factors was insignificant. The sustainability status of the bleak populations of the Mediterranean basin varied, with the populations from Ohrid and Skadar Lakes showing a high and those from Prespa and Dojran Lakes a medium status. Socio-economic factors with traditional fishing were the most important for the Mediterranean bleak populations.

Multimodal assessment of the primary healthcare system of Serbia: a model for evaluating post-conflict health systems.

INTRODUCTION: Conflicts, social unrest, and disasters can significantly affect the ability of a healthcare system to provide for the needs of its citizens. The collapse of the primary healthcare system in Serbia is a model of the effects that civil unrest can have on the health of a population. However, with improving social and political conditions, focus now can be turned towards the greatly needed development and reorganization of the primary healthcare system in Serbia. Due to the complexity of health-system reform in the post-conflict/post-disaster setting, attempts to restructure health services are fraught with pitfalls that often are unanticipated because of inadequate preliminary assessments. A multimodal assessment involving quantitative and qualitative methodologies may provide a more robust mechanism to identify key programmatic priorities and critical barriers for appropriate and sustainable health-system interventions. The purpose of this study is to describe a multimodal assessment using primary healthcare in post-conflict Serbia as a model. METHODS: Integrated quantitative and qualitative methodologies--system characterization and observation, focus group discussions, free-response questionnaires, and Q-methodology--were used to identify needs, problems, and potential barriers to primary healthcare development in Serbia. Participants included primary healthcare providers and administrators from 13 institutions throughout Belgrade. RESULTS: Demographic data indicate a well-established infrastructure of primary health centers and stations. However, focus group discussions and free-response questionnaires reveal significant impediments to delivery of care: (1) Inadequate equipment, supplies, and medications; (2) Poor financial investment; (3) Discouraging worker salaries; (4) Few opportunities for professional development; and (5) Little emphasis on or respect for primary healthcare. Q-methodology of provider perceptions and opinions supports these concerns, shows remarkable consensus among participants, and provides further insights toward system development by grouping respondents into distinctive types. CONCLUSIONS: This study identified the critical needs and barriers to development of primary healthcare in Serbia. This combined methodology may serve as a model for future health system assessments in the post-conflict and post-disaster settings.

[Assessment of required resources for implementation of national breast cancer screening program in Serbia].

INTRODUCTION: High values of standardized mortality and morbidity rates of standardized cancer mortality in Serbia, especially colorectal, cervical and breast cancer led to creation of national programs for their early detection and engagement of the international support for their implementation. OBJECTIVE: Assessment of required resources (time, personnel, financial) to implement the National program for screening of breast cancer in the Republic of Serbia. METHODS: Three possible scenarios have been prepared (optimistic, realistic and pessimistic) based on the expected coverage by screening of women aged 45 to 69 years, and time, personnel and financial feasibility estimates were made for a two-year screening cycle. RESULTS: Time aspect of feasibility even under conditions of "relaxation" of the assumption on the number of working days during the year did not question feasibility of any of the scenarios. Personnel feasibility is only possible in the pessimistic scenario, while the financial feasibility only makes sense in optimistic scenario as the least unfavorable solution due to economies of scale. CONCLUSION: Establishment of the initial base of skilled radiologists and radiology technicians and the system for their continuous medical education as well as allocation of specific MoH budget line for screening program expenditures, along with donated mammographs and good organization and coordination, may provide unobstructed implementation of the National program for early detection of breast cancer in the Republic of Serbia.

Risk Factors Associated with Overweight among Adolescents in Serbia.

INTRODUCTION: The pandemic of obesity in adolescents is one of the challenges of public health. AIM: The aim of this study was to examine the association of overweight with demographic, socioeconomic and lifestyle factors among Serbian adolescents. METHOD: A cross-sectional study of 2139 adolescents aged 10 to 19 years was carried out. Data used in this study were from the 2006 Health Survey. In accordance with the international sex- and age-specific Body Mass Index cut-off points, all participants were classified as being normal weight or overweight, including obese. The association between the risk factors and overweight were examined using a multivariate logistic regression model. RESULTS: The study showed that 28.9% of boys and 17.0% of girls were overweight, while 14.5% of boys and 8.1% of girls were obese. Boys were more likely to be overweight/obese, compared with girls. Being younger (p< 0.01 for 14 to 15 years) and (p< 0.01, for 16 to 19 years), engaging in physical activities that last less than 7 hours a week, in such a manner that they breathe quickly and become sweaty, (p< 0.01) and skipping breakfast (p< 0.05) were risk factors significantly associated with overweight among adolescents. No significant association was found with wealth index. CONCLUSION: These findings should be an integral part of further preventive interventions, especially oriented towards younger adolescents, who are physically inactive, have a habit of skipping breakfast and are boys.