Prevalence and socioeconomic correlates of chronic morbidity among elderly people in Kosovo: a population-based survey.

BACKGROUND: Our aim was to assess the prevalence and demographic and socioeconomic correlates of chronic morbidity in the elderly population of transitional Kosovo. METHODS: A cross-sectional study was conducted in Kosovo in 2011 including a representative sample of 1890 individuals aged ≥ 65 years (949 men, mean age 73 ± 6 years; 941 women, mean age 74 ± 7 years; response rate: 83%). A structured questionnaire inquired about the presence and the number of self-reported chronic diseases among elderly people, and their access to medical care. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of demographic and socioeconomic characteristics with chronic conditions. RESULTS: In this nationwide population-based sample in Kosovo, 42% of elderly people were unable to access medical care, of whom 88% due to unaffordable costs. About 83% of the elderly people reported at least one chronic condition (63% cardiovascular diseases), and 45% had at least two chronic diseases. In multivariable-adjusted models, factors associated with the presence of chronic conditions and/or multimorbidity were female sex, older age, self-perceived poverty and the inability to access medical care. CONCLUSION: This study provides important evidence on the magnitude and distribution of chronic conditions among the elderly population of Kosovo. Our findings suggest that, in this sample of elderly people from Kosovo, the oldest-old (especially women) and the poor endure the vast majority of chronic conditions. These findings point to the urgent need to establish a social health insurance scheme including the marginalized segments of elderly people in this transitional country.

Early neurologic complications and long-term sequelae of childhood bacterial meningitis in a limited-resource country (Kosovo).

PURPOSE: Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo) METHODS: This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997-2002 and 77 children treated during years 2009-2010. RESULTS: Of the 277 vs 77 children treated for bacterial meningitis, 60 (22%) vs 33 (43%) patients developed early neurologic complications, while there were 15 (5.4%) vs 2 (2.6%) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29%), recurrent seizures (11 vs 8%), and hydrocephalus (3 vs 3%). The relative risk (95% confidence interval) for neurologic complications was the highest in infants (3.56 (2.17-5.92) vs 2.69 (1.62-4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09-3.18) vs Streptococcus pneumoniae 2.57(1.26-4.47). Long-term sequelae were observed in 10 vs 12% of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1%, neuropsychological impairment 1 vs 5%, and deafness 1 vs 3%. CONCLUSIONS: In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10% of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.

Prevalence of left chamber cardiac thrombi in patients with dilated left ventricle at sinus rhythm: the role of transesophageal echocardiography.

BACKGROUND: Left atrial appendage (LAA) may be a source of thrombi in patients with dilated cardiomyopathy at sinus rhythm. The objectives of our study were to assess the prevalence of intracardiac left chamber thrombus and/or spontaneous echo contrast and to identify clinical and echocardiographic predictors for left ventricle (LV), left atrium (LA), and/or LAA thrombus formation, particularly as regard to LV, LA, and LAA size, in heart failure patients at sinus rhythm. METHODS: We included 45 patients with dilated cardiomyopathy of ischemic or idiopathic origin with mild to moderate systolic dysfunction, who were at sinus rhythm and without anticoagulation therapy. RESULTS: Mean left ventricular end diastolic diameter was 64.9 ± 6.1 mm, and mean LV ejection fraction was 39.9 ± 7.3%. LV thrombus was found in 13.3% of patients and LAA thrombus in 68. 9%. Left ventricular end diastolic diameter was correlated with LA volume (r = 0.59, p < 0.0001) and LV thrombus (r = 0.38, p = 0.005). LA volume was correlated with LAA maximal area (r = 0.34, p = 0.01), which was an independent predictor for LAA thrombus formation (p = 0.003). CONCLUSIONS: Dilation of left cardiac chambers offers a suitable terrain for thrombus formation. The high probability of LAA thrombosis should be kept in mind when designing the treatment strategy for patients with dilated cardiomyopathy at sinus rhythm.

Secular trends and latitude gradients in the male-female ratio at birth in Yugoslavia and the ex-Yugoslavian States.

BACKGROUND: Latitude gradients and secular trends in Europe and North America have been found in the male-female ratio at birth (M/F: male births divided by total births) which approximates 0.515. METHODS: Annual national data for Yugoslavia and the post-Yugoslavia States for male and female live births were obtained from the World Health Organisation and analysed with contingency tables. RESULTS: This study analysed 22,020,729 live births. There was a increasing trend in M/F prior to the breakup of the former Yugoslavia (1950-1990, p = 0.002), followed by a decreasing trend after 1990 (p = 0.02). A latitude gradient was also noted, with more males being born in southern, warmer latitudes (p < 0.0001). There was an overall excess of 42,753 male births based on an anticipated M/F of 0.515. CONCLUSION: M/F is decreasing in this region, similar to the rest of Europe and North America. A latitude gradient is also present with more males being born in warmer (more Southern) latitudes (p < 0.0001), even in this small region and over the short time-frame studied.

Mental health outcomes of widowed and married mothers after war.

We assessed prevalence rates of mental disorders in 206 mothers who had experienced the Kosovo war 10 years previously: 100 lone mothers widowed by the war, 71 non-bereaved married mothers, and 35 married mothers bereaved since the war (loss of family other than husband). A total of 96% of widowed lone mothers reported a major depressive episode, an anxiety disorder or a substance use disorder as compared with 54.9% and 60% in the married groups. Furthermore, 45% of widowed lone mothers reported current suicide risk as compared with 16.9% and 22.9% in the married samples. War-related widowhood combined with lone motherhood constitutes a significant factor for elevated psychopathology.

Left ventricular markers of global dyssynchrony predict limited exercise capacity in heart failure, but not in patients with preserved ejection fraction.

BACKGROUND: The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional capacity assessed by 6 min walk test (6-MWT) in patients with heart failure (HF), irrespective of ejection fraction (EF). METHODS: In 147 HF patients (mean age 61 ± 11 years, 50.3% male), a 6-MWT and an echo-Doppler study were performed in the same day. Global LV dyssynchrony was indirectly assessed by total isovolumic time - t-IVT [in s/min; calculated as: 60 - (total ejection time + total filling time)], and Tei index (t-IVT/ejection time). Patients were divided into two groups based on the 6-MWT distance (Group I: ≤ 300 m and Group II: >300 m), and also in two groups according to EF (Group A: LVEF ≥ 45% and Group B: LVEF < 45%). RESULTS: In the cohort of patients as a whole, the 6-MWT correlated with t-IVT (r = -0.49, p < 0.001) and Tei index (r = -0.43, p < 0.001) but not with any of the other clinical or echocardiographic parameters. Group I had lower hemoglobin level (p = 0.02), lower EF (p = 0.003), larger left atrium (p = 0.02), thicker interventricular septum (p = 0.02), lower A wave (p = 0.01) and lateral wall late diastolic myocardial velocity a' (p = 0.047), longer isovolumic relaxation time (r = 0.003) and longer t-IVT (p = 0.03), compared with Group II. In the patients cohort as a whole, only t-IVT ratio [1.257 (1.071-1.476), p = 0.005], LV EF [0.947 (0.903-0.993), p = 0.02], and E/A ratio [0.553 (0.315-0.972), p = 0.04] independently predicted poor 6-MWT performance (<300 m) in multivariate analysis. None of the echocardiographic measurements predicted exercise tolerance in HFpEF. CONCLUSION: In patients with HF, the limited exercise capacity, assessed by 6-MWT, is related mostly to severity of global LV dyssynchrony, more than EF or raised filling pressures. The lack of exercise predictors in HFpEF reflects its multifactorial pathophysiology.

Use of healthcare services 8 years after the war in Kosovo: role of post-traumatic stress disorder and depression.

BACKGROUND: The aim of the present study was to examine the use of health-care services and medication, as well as health risk behaviours such as smoking, in relation with post-traumatic stress disorder (PTSD) and major depressive episode (MDE) in post-war Kosovo. METHODS: A sample of 864 adults was interviewed in 2007 of which 551 took part in a 2001 survey. They were assessed using the PTSD and MDE sections of the Mini International Neuropsychiatric Interview (MINI) and the Medical Outcomes Study 36-item Short Form Health Survey (SF-36). Use of health-care services, alcohol and tobacco were also recorded. RESULTS: Respondents were predominantly female (56.6%) with a median age of 36 years and a primary educational level (44.6%). While 11.9% of participants met diagnostic criteria for PTSD, MDE prevalence was 30.6%. Both PTSD and MDE were significantly associated with lower scores on the SF-36 physical component summary. After adjustment for sex, age, education, unemployment, municipality and SF-36 perceived physical health, no significant association was observed between PTSD and medical visits in the past 12 months, hospitalizations in the past 12 months and use of medication in the past 7 days. Results were similar for MDE, except for a significantly higher frequency of medication use that included psychotropic and other drug classes. CONCLUSION: Eight years after the war in Kosovo, poor perceived physical health displayed a long-lasting association with PTSD and MDE and was a major determinant of increased use of health-care services without additional contribution of PTSD per se.

Surveillance of tularaemia in Kosovo, 2001 to 2010.

Tularaemia, caused by Francisella tularensis, had not been registered in Kosovo before an outbreak in 1999 and 2000. A national surveillance system has been implemented in Kosovo since 2000 to monitor a number of diseases, including tularaemia. Antibody detection in human sera was used for laboratory diagnosis of tularaemia and F. tularensis lipopolysaccharide antigen was used as a marker of infection. The purpose of this study is to describe the incidence of tularaemia in Kosovo after the 1999-00 outbreak. In 2001 and 2002, a second outbreak occurred, with 327 serologically confirmed cases. From 2001 to 2010, 25-327 cases were registered per year, giving a mean annual incidence of 5.2 per 100,000 population. The most likely sources of infection were contaminated drinking water and food. The dominant clinical manifestations were the glandular (79%) and ulcero-glandular (21%) forms. By 2010, the disease had spread throughout Kosovo. Presumably as a result of war and subsequent environmental disruption, mass population displacement and breakdown of sanitation and hygiene, the two major outbreaks of tularaemia resulted in the establishment of an active endemic area of tularaemia in Kosovo.

Diagnoses of suicidum and tentamen suicidi in the registers of patients of the Kingdom of Yugoslavia's Banovina Public General Hospital in Bjelovar from 1931-1940.

Suicide has been a subject of research of philosophy, ethics, religion and medicine for centuries. Attitudes towards it changed during the history, from condemnation of suicide as an unethical act to the theory of suicide as the utmost expression of a human as an individual. Croatia, with the annual suicide rate above 20 percent belongs to the high-risk countries. Suicide frequency varies from region to region, while the suicide rates for the County Bjelovarsko-bilogorska have been well above Croatia's average for decades. The aim of this retrospective study was to establish some epidemiological features of hospital patients with the diagnoses of "suicidum" and "tentamen suicidi" on the basis of records available in the registers of patients of General Hospital in Bjelovar in the period between 1931 and 1940. In the observed period, thirty-three people were treated in hospital for suicide attempt, seven of them dying. An equal number of men and women attempted suicide (13:13), while in the group of those who died, the ratio was more in favour of women (4:3). Suicide incidence was highest in November, followed by May and June, with the most common method for suicide being acetic acid.

Historical review: Towards the 50th anniversary of the last major smallpox outbreak (Yugoslavia, 1972).

In 1972, Yugoslavia experienced the largest outbreak of smallpox in the history of Europe following the Second World War and its first smallpox outbreak after 1930. The origin of the infection is believed to be a pilgrim who visited countries in the Middle East. In this epidemic in Yugoslavia, from 16th February to 11th April 1972, a total of 175 people fell ill, 35 (20%) of whom died. Measures against the outbreak were based on the strategy that was common in the final phase of the smallpox eradication program. It started with active surveillance and rapid identification of new cases. Measures, such as mass vaccination and quarantine of direct contacts, were promptly taken. In a few weeks, 18 million people had been vaccinated and approximately 15,000 had been quarantined. Yugoslavia was declared free of smallpox on 9th May 1972. The global community today is confronted with serious threats from infectious diseases, which can appear as outbreaks and pandemics.

Mental and physical health of Kosovar Albanians in their place of origin: a post-war 6-year follow-up study.

PURPOSE: Long-term outcome of traumatic experiences among war-exposed civilians living in their home country has been seldom documented. The present study examined change in posttraumatic stress disorder (PTSD) frequency and perceived physical and mental health in a cohort of Kosovar Albanians over 6 years (2001-2007). METHODS: Of 996 Albanian Kosovar civilians included in the 2001 survey, 551 subjects (55.3%) were recalled and interviewed in 2007. Diagnoses of PTSD and major depressive episode were assessed using the Mini International Neuropsychiatric Interview. Subjective physical and mental health were investigated using the Medical Outcomes Study 36-Item Short-Form (SF-36). A list of traumatic events adapted from the Harvard Trauma Questionnaire and other stressful life events was also considered. RESULTS: Posttraumatic stress disorder was significantly less frequent in 2007 than in 2001 (14.5% vs. 23.2%, p < 0.001). For 18.0, 5.3 and 9.3% of participants, PTSD remitted, persisted and developed over the 6-year follow-up period, respectively. Ill health without having access to medical care and major changes in responsibilities at work were associated with both persistence and new occurrence of PTSD. While the SF-36 mental component summary score significantly improved (mean change +4.5, p < 0.001), the physical component summary score did not change between 2001 and 2007, after adjustment for age (mean change -0.8, p = 0.14). CONCLUSIONS: Results point at the importance of economic and health system reconstruction programs with respect to public health in post-conflict countries.

Toxoplasmosis in Kosovo pregnant women.

This study presents the initial results of a collaborative project aimed at the evaluation of Toxoplasma seroprevalence in a population of Kosovar pregnant women. The serum samples of 334 pregnant women were tested to detect IgG, IgM, IgG avidity for toxoplasmosis. Data regarding age, occupation, area of origin and education were also obtained for the pregnant women examined; 97/334 (29.4%) resulted positive for IgG antibodies, four of whom (4.1%) were also positive for IgM, (1.2% of the total population examined). All four IgM-positive pregnant women also demonstrated low avidity tests. The rate of IgG seroprevalence found in our study was lower than that observed in various European countries, especially those of western Europe. Conversely, the percentage of recent infections was higher than expected. The higher rate of infections could be the result of a recent toxoplasmosis epidemic in Kosovo, most likely due to the altered hygienic conditions caused by the forced transfer of the ethnic-Albanian population from an area of low (Serbia) to high (Kosovo) toxoplasmosis prevalence.

Problem of substance misuse and lack of national strategy in Kosovo.

UNLABELLED: The aim of this project was to explore the problem of substance misuse among adolescent town dwellers in Kosovo, as a result of lack of a national strategy related to this problem. DESIGN: 261 students from 4 secondary schools took part in cross sectional survey performed in October 2005. The survey was carried out in Gjilan town in south-east of Kosovo. MAIN RESULTS: From all questioned students, 36% smoked cigarettes every day, 12.6% consumed alcohol occasionally and 1.4% consumed all kind of drugs regularly. Girls consumed more cigarettes, whereas boys consumed more alcohol and other drugs. The prevalence of substance misuse was higher among students in their last year of high school attendance. Students in Gjilan continue to smoke, consume alcohol and drugs despite their knowledge about the adverse health consequences of substance misuse, but in the same time, most of them consider information and counselling the best way of substance misuse prevention. CONCLUSIONS: The prevalence and trends of substance misuse among students in our survey indicates that it is time to start acting. It is assumed that results of survey may be a very useful source of information for policy-makers, government and ministry of health in developing and implementing national strategy that would address the most important issues in connection with addiction among adolescents.

Prevalence of apical periodontitis and endodontic treatment in a Kosovar adult population.

BACKGROUND: Despite numerous studies on the prevalence of apical periodontitis (AP) and endodontic treatment in diverse geographical populations, there are currently no data on the prevalence of these conditions in populations of adults native to Kosovo. Therefore, little is known about how widespread these conditions are, and whether there is any correlation between root canal treatment and AP. The purpose of our research was to address this anomaly by investigating AP and endodontic treatment in an adult Kosovar population based on radiographic examination. METHODS: The sample used for this study consisted of randomly selected individuals referred to the University Dentistry Clinical Center of Kosovo in the years 2006-2007. Orthopantomographs of 193 patients were evaluated. The periapical status of all teeth (with the exception of third molars) was examined according to Ørstavik's Periapical Index. The quality of the root canal filling was rated as 'adequate' or 'inadequate' based on whether all canals were filled, the depth of fill relative to the radiographic apex and the quality of compaction (absence/presence of voids). Data were analyzed statistically using the Chi-square test and calculation of odds ratios. RESULTS: Out of 4131 examined teeth, the prevalence of apical periodontitis (AP) and endodontic treatment was 12.3% and 2.3%, respectively. Of 95 endodontically-treated teeth, 46.3% were associated with AP. The prevalence of AP increased with age. The prevalence in subjects aged over 60 years old (20.2%) was higher than in other age groups. A statistically significant difference was found for the frequency of endodontically-treated teeth associated with AP in the 40-49 year age group (P < 0.001). Of some concern was the discovery that only 30.5% of the endodontically-treated teeth examined met the criteria of an acceptable root canal filling. Inadequately root-filled teeth were associated with an increased AP risk. CONCLUSIONS: The prevalence of AP and the frequency of endodontically-treated teeth with AP in this Kosovar population are higher than those found in other countries. Inadequate root canal fillings were associated with an increased prevalence of AP.

Epidemiological characteristics of malignant ovarian tumors in Vojvodina.

PURPOSE: Ovarian cancer ranks 6th in relation to new cases of malignant diseases among females and 2nd concerning gynecological cancers. The purpose of this study was to determine the epidemiological situation of ovarian cancer in Vojvodina, Serbia. METHODS: In our study, we used a descriptive epidemiological method for the analysis of incidence and mortality of ovarian cancer in Vojvodina, based on the data of the Cancer Registry of Vojvodina. RESULTS: In the period 1987-2006, the average incidence rate of ovarian cancer was 15.28%/100,000 with an average annual increase of 1.15%; the average mortality rate for the same period was 9.24/100,000 with an average annual increase of 0.95%. The values of crude incidence rate (15.28/100,000) and standardized incidence rate (range 7.47 - 12.55/100,000) in Vojvodina correspond to the values in eastern and southern Europe. CONCLUSION: In the observed period of 20 years, the incidence and mortality rate indicate a tendency for increase, which can be characterized as an unfavorable epidemiological situation. New markers are being studied in order to find a solution for ovarian cancer screening.

Early childhood caries in preschool children of Kosovo - a serious public health problem.

BACKGROUND: Even though it has been widely studied, early childhood caries (ECC) remains a serious public health problem, especially in countries where there is no national program of oral health assessment and no genuine primary oral health care, such as in Kosovo. The purpose of this study was to assess the prevalence of ECC and analyze caries risk factors. METHODS: The subjects were 1,008 preschool children, selected by stratified random cluster sampling, in the municipality of Prishtina, capital of Kosovo. Data were collected through clinical examination and interviews. Dmft data were recorded according to WHO criteria. Bacterial examination (CRT bacteria test) and plaque test of Greene-Vermillion were used. RESULTS: The mean dmft of preschool children was found to be 5.8. The prevalence of ECC was 17.36%, with a mean dmft of 11 ± 3.6. Streptococcus mutans prevalence in ECC children was 98%. A significant correlation between dmft and S mutans counts (≥105 CFU/mL saliva) was demonstrated. A correlation was also found between daily sweets consumption and dmft in children with ECC (P < 0.001). Comparing the dmft of ECC children and duration of bottle feeding showed a statistical correlation (P < 0.001). The mean plaque test was 1.52. None of the examined children had ever used fluoride. CONCLUSION: The prevalence of ECC was high among preschool children in the municipality of Kosovo. We recommend increasing parents' knowledge of proper feeding habits and oral health practices, and increasing preschool children's accessibility to dental services.

Educational health inequalities in former Yugoslavia: evidence from the South-East European Social Survey Project.

BACKGROUND: An important gap in our knowledge of social inequalities in health is the former Yugoslavia, a region of culturally and historically diverse countries, with recent conflict. The aim of the present paper is to investigate relative and absolute inequalities in self-assessed health in former Yugoslavia (Bosnia-Herzegovina, Croatia, Kosovo, Macedonia, Montenegro, Slovenia and Serbia) by sex and education. METHODS: The data source is the South-East European Social Survey Project fielded in December 2003 to Winter 2004, covering the former Yugoslavia with a total sample of 18 481 respondents. Data from Slovenia were obtained from the 2004-wave of the European Social Survey. The health outcome variables were self-reported general health (SRH) and limiting longstanding illness (LLI). RESULTS: Both absolute and relative educational health inequalities were present throughout the former Yugoslavia to a larger or lesser extent, although odds ratios (ORs) for LLI and SRH were not significant for Montenegrin women [LLI OR = 1.12, 95% confidence interval (CI): 0.92-1.37; SRH OR = 1.16, 95% CI: 0.96-1.40] and with respect to the reporting of LLI among Slovenian men (OR = 1.16, 95% CI: 0.96-1.44). Overall, Montenegro held the best position. CONCLUSIONS: The prevalence of poor health and the degree of relative inequality in self-assessed health in the former Yugoslavian countries were similar in order to one another, and to other East European countries during the same period. Influences on subjective health require further elucidation. Further research should study a wider range of health outcomes using larger survey samples and a wider range of cultural and other predictor variables.

Lead poisoning among internally displaced Roma, Ashkali and Egyptian children in the United Nations-Administered Province of Kosovo.

BACKGROUND: This study assessed the association between lead poisoning prevention activities and blood lead levels (BLLs) among children living in lead-contaminated camps for internally displaced persons in the United Nations-Administered Province of Kosovo. METHODS: We conducted a population-based study to examine the relationship among geometric mean BLLs in children (i) born before any lead poisoning prevention activities were instituted, (ii) born when specific interim interventions were instituted and (iii) born after relocation and medical therapy were available. The study population consisted of 145 of the 186 children born in the camps between December 1999 and July 2007. RESULTS: Lower mean BLLs were found in children born following implementation of the interventions as compared with the children born before the interventions. However, this decrease in mean BLLs was attenuated in children born into families suspected of informal lead smelting. CONCLUSION: Despite lower BLLs following interventions, children living in these camps have BLLs that remain unacceptably high. Further efforts are urgently needed to control or eliminate lead exposure in this population. Continued blood lead monitoring of the population is also warranted.

Ongoing outbreak of aseptic meningitis associated with echovirus type 30 in the City of Novi Sad, Autonomous Province of Vojvodina, Serbia, June - July 2010.

Since June 2010, incidence of aseptic meningitis has increased in Novi Sad, Autonomous Province of Vojvodina, Serbia. From 2 June to 25 July 2010, 80 cases of aseptic meningitis were notified, with an incidence rate ranging from 10 to 366 per 100,000 population in different local communities. The majority of cases (n=64) were aged between two and 15 years. Echovirus 30 was cultured from two of four cerebrospinal fluid specimens. The outbreak, for which no common source has yet been identified, is ongoing.

High prevalence of kidney disease in two rural communities in Kosovo and Metohia.

A systematic survey was carried out in an enclave in Kosovo and Metohia, with the aim of assessing the prevalence of kidney diseases. The survey involved 423 (180 males) adult inhabitants from two small settlements, Velika Hoca and Orahovac, and included an interview, medical documentation, physical, ultrasound, and laboratory examinations. Persons with any detected disorder indicating kidney disease were invited for additional examination of kidney function. Using urine dipstick test, proteinuria was detected in 19.1% and hemoglobinuria in 4.5% of the examined subjects. Glomerular filtration rate (Modification of Diet in Renal Disease (MDRD) formula) below 60 mL/min/1.73 m(2) was found in 5.2% of subjects. Kidney ultrasound examination detected reduced length of right and left kidneys in 38 and 24 persons, respectively. Cysts were also a frequent finding, but polycystic kidney, hydronephrosis, and kidney stones were found in about 2% each. The analysis of data obtained by the present examination and available medical documentation revealed kidney and urinary tract diseases in 98 persons: 52 patients with already known disease and 46 patients detected in the survey. Out of them in 22 patients diagnosis of kidney disease could not be established during the survey but laboratory analyses indicated that they might suffer from tubulointerstitial disease: 14 had tubular dysfunctions, 8 of them low-grade proteinuria, and 12 had a positive family history for kidney disease. In the enclave of Velika Hoca and Orahovac the prevalence of kidney disease was 7.0% indicating that these communities might be placed among those with a high prevalence of kidney disease in Serbia.