Seroprevalence Study of Anti-HBs Antibodies in the General Population of Vojvodina, Serbia.

Background and Objectives: Hepatitis B (HB) is a major global health problem and a potentially life-threatening disease caused by the hepatitis B virus (HBV). Also, it is an important cause of morbidity and mortality worldwide. Thanks to serological surveys, testing hepatitis B surface antibodies (anti-HBs) allows for serological assessments of their prevalence. The presence of anti-HBs, which protects against HBV infection, can be attributed to HB vaccination or natural HBV infection. The aim of our study was to evaluate the prevalence of HB surface antibodies (anti-HBs) as an indicator of collective immunity against HBV in the general population of the Autonomous Province of Vojvodina, Serbia. In addition, to distinguish whether anti-HBs were induced by the vaccine or by infection, the presence of antibodies against the hepatitis B core antigen (anti-HBc) was tested among those who were anti-HBs-positive. Materials and Methods: A total of 3467 residual sera samples, collected according to the specifications of the European Sero-Epidemiology Network 2 (ESEN2) study, from April 2015 to March 2016, were screened for the presence of anti-HBs using a chemiluminescence immunoassay. The difference between categorical variables was tested using the chi-square test. Results: Overall, 1870 (53.9%, 95% CI: 52.3-55.6) participants tested positive for anti-HBs. The median age of the study participants was 17 years (IQR 9-35). The anti-HB seroprevalence decreased with age, ranging from 80.7% (95% CI: 78.9-82.4) in the 1-19-year-old group to 16.4% (95% CI: 12.0-20.9) in the ≥60 years' age group. A total of 71 (3.8%, 95% CI: 2.9-4.7) serum samples were also anti-HBc-positive. Higher prevalence, but not statistically significant, was noticed in women (4.1%, 95% CI: 2.8-5.4) compared with men (3.5, 95% CI: 2.4-4.8) (p = 0.542). Also, there was a significant difference across the age groups, where those ≥60 years old had a prevalence of 65.9% (95% CI: 51.9-79.9) and the age category of 1-19-year-olds had just 0.2% (95% CI: 0.0-0.4) (p < 0.001). Conclusions: This study provides a comprehensive assessment of the anti-HBs seroprevalence of the general population in Vojvodina and provides an opportunity to better shape the national preventive strategy related to HBV.

Seroepidemiology of Human Parvovirus B19 Infection among the Population of Vojvodina, Serbia, over a 16-Year Period (2008-2023).

This study aimed to estimate the serological status and dynamic changes in the prevalence of Parvovirus B19 (PVB19) antibodies within the general population residing in the northern part of the Republic of Serbia (Province of Vojvodina) during a 16-year period. Serum samples were analyzed for Human PVB19-specific IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Throughout the study period, the overall seroprevalence was 49.51%. Approximately 10% of patients exhibited a serologic profile positive for PVB19 IgM antibodies. Notably, seroprevalence varied significantly, ranging from 9.12% in the pediatric cohort (ages 1-4 years) to 65.50% in the adult demographic (40-59 years old). Seroprevalence was higher (51.88%) among women compared to men (42.50%). Immunologically naive pregnant women in the age groups 26-36 and 36-45 years had 45% (OR = 0.55, 95% CI: 0.31-1.00) and 52% (OR = 0.48; 95% CI: 0.24-0.94) lower odds of having negative IgM and IgG compared to those in age group 16-25 years old. Improved knowledge of the epidemiology of PVB19 may assist clinicians in the differential diagnosis of PVB19 clinical manifestations. The PVB19 detection is particularly important for monitoring individuals in risk groups such as women of reproductive age, medical staff, patients with hematological disorders, and those with immunodeficiency.

Transitioning from face-to-face to distance education. Part 1: A cross-sectional study in the former Yugoslavia during COVID-19.

BACKGROUND: The countries of the former Yugoslavia have health and education systems with the same tradition but these have changed over the years. Little is known about how family medicine teaching transitioned from face-to-face to distance education during the COVID-19 pandemic. OBJECTIVES: to investigate student/teacher experience in transitioning from face-to-face to distance education. METHODS: A cross-sectional, online survey was conducted among 21 medical schools of the former Yugoslavia between December 2021 and March 2022. Under/postgraduate teachers and students who taught/studied family medicine during the academic year 2020/2021 were invited to participate. Of 31 questions for students and 35 for teachers, all but nine open questions were analysed using descriptive statistics. RESULTS: Seventeen of 21 medical schools contributed data involving 117 participants representing all countries of the former Yugoslavia. At the beginning of the pandemic, 30%, 26% and 15% of teachers, students and trainees, respectively, received formal preparation in distance education. Of these, 92% of teachers and 58% of students/trainees felt they were not adequately prepared. Synchronous teaching was the main method used, with a third using hybrid methods. All participants were least confident about online assessment. More than 75% of respondents agreed that lectures could be kept online, not patient consultations or practical skills' classes. CONCLUSION: Teachers used various old and new methods to provide learning opportunities despite COVID-19 constraints. Effective technology-based strategies are essential to ensure assessment integrity and enhance the learning environment.

Despite limited preparedness, teachers and students/trainees transitioned to distance education.Students/trainees believed synchronous delivery of lectures and small group work can be conducted online but not practical skills' classes.Online assessments and practical work with patients were considered the most challenging aspects of distance education.

Transitioning from face-to-face to distance education. Part 2: A qualitative study in the former Yugoslavia during COVID-19.

BACKGROUND: Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19. OBJECTIVES: To elucidate obstacles and facilitators of the transition from face-to-face to distance education. METHODS: A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022. RESULTS: In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used. CONCLUSION: The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.

Participants found that distance education offers many possibilities, mainly self-directed, flexible learning.Participants felt that face-to-face education remains invaluable since it facilitates communication and the development of practical skills.A balance between new technologies and personal encounters was believed to be best.

Human papillomavirus-specific antibody status among unvaccinated subjects in the region of Vojvodina, Serbia.

OBJECTIVES: The aim of the study was to evaluate the immune status of young people from the Vojvodina province, Serbia, through the detection of IgG antibodies specific for the L1 protein of HPV types 6, 11, 16, and 18 contained in quadrivalent vaccine. METHODS: The study enrolled 514 healthy persons of both genders, aged between 18 and 30 years. All potential participants were informed about the project's aims by trained interviewers before venous blood collection. Also, participants completed a specially designed anonymous questionnaire to identify socio-demographic characteristics and individual behaviours associated with HPV seroprevalence. VPL HPV L1-specific IgG antibodies were measured using a semi-quantitative HPV IgG ELISA kit (Dia.Pro, Italy). RESULTS: A total of 472 (91.8%) young subjects had no detectable antibodies against high- and low-risk HPV types covered by the quadrivalent vaccine. A slightly higher number of seropositive individuals were detected in the age group of 26-30 years compared to younger than 25. Multivariate analysis showed that the number of lifetime sexual partners was the most powerful predictor of HPV seropositivity (OR = 3.483, 95% CI: 1.294-9.379). CONCLUSIONS: Obtained data point out low levels of naturally induced HPV-specific serum antibodies among the target population in the Vojvodina province. The present work highlights the significance and potential benefits of HPV vaccination. Routine HPV vaccination should be the public health priority in our country and should be included in the national immunization programme as soon as possible.

Vracare: Village wise women, reproductive health, and Yugoslavia's early socialist modernisation project.

This historical article examines post-WWII Yugoslavia and the state's campaigns to modernise and unify the extensive Yugoslav peasantry, and draws comparisons with other countries from the Communist Bloc. It argues that even though Yugoslavia ostensibly set out to create a new 'Yugoslav way' that was dissimilar to Soviet socialism, its tactics and underlying motivations were very similar to those of the Soviet modernisation projects. The article analyses the evolving concept of the vracara (elder women folk healers) as a vehicle for the state's modernising mission. Just as Soviet babki represented a threat to the new 'social order' in Russia, vracare were the targets of the Yugoslav state's anti-folk-medicine propaganda. It also argues that reproductive health provided a moment in the lifecycle when the state attempted to bind women to its services. The first part of the article deals with the bureaucratic push to disempower village wise women using propaganda campaigns and the introduction of medical facilities in remote communities. Even though the medicalization process ultimately failed to fully establish science-based medical services in all areas of the Yugoslav Republic, the negative image of the old crone healer endured well beyond the first post-war decade. The second half of the article examines the gendered stereotype of the old crone and how she became a stand-in for everything backward and undesirable relative to modern medicine.

Bi-objective approach for designing a regional waste management system: A case study of Vojvodina (Serbia).

This article presents a bi-objective mixed-integer linear model for the waste management system design. Two types of facilities, landfills and transfer stations (TSs), are identified based on two objectives: minimising the total system's costs and the total negative impact of located facilities on end users as waste generators through a defined pollution decay function. Landfills and TSs are categorised as undesirable facilities due to associated environmental risks. In this article undesirability of a located facility is defined as a two-threshold linear decreasing function of the distance between the end users and the located facility. Also, we considered additional restrictions that no two selected landfills or TSs are within a pre-specified distance from each other, limiting the superimposed pollution generated in these facilities. The model performances are tested on a real-scale example for Vojvodina (Serbia). Results showed that the proposed model has potentials and can be beneficial for government organisations, local authorities and other organisations related to waste management issues.

Negative trend in seroprevalence of anti-toxoplasma gondii IgG antibodies among the general population of the province of Vojvodina, Serbia, 2008-2021.

This study aimed to estimate dynamic changes in seroprevalence of Toxoplasma gondii within the general population living in the northern part of the Republic of Serbia (Province of Vojvodina) during a 14-year period. The differences in prevalence of anti-toxoplasma antibodies were analyzed in correlation with age, gender, residential area (rural/urban) and meteorological factors. In this cohort retrospective study, 24,440 subjects between 1 and 88 years old were enrolled. To determine the presence of T. gondii-specific IgM and IgG antibodies in serum samples, commercially available ELISA kits were used (Euroimmun, Luebeck, Germany). During the study period, the overall T. gondii seroprevalence was 23.5%. The seroprevalence continuously decreased over time from 31.7% in 2008 to 20.4% in 2021 (0.81% per year, p < 0.001). Approximately 2% of patients had a serologic profile positive for both anti-Toxoplasma IgG and IgM antibodies. The seroprevalence was higher (28.87%) among men compared to women (24.28%), while urban residents (24.94%) had lower seroprevalence than the rural population (28.17%). A statistically significant negative correlation (r = -0.559) was found between serologic profile of patients positive for both T. gondii IgG and IgM antibodies and the annual mean air temperature. No significant association was observed between seropositivity to T. gondii infection and examined meteorological factors. These data could be useful to national and regional health authorities to create an optimal health policy to reduce rate of T. gondii infections.

Breaking the myth of healthy food production in rural areas: cases studied in Vojvodina Province (Serbia).

The aim of the present study was to analyze the chemical composition of parsley, parsnip, carrot, and celeriac cultivated at different localities (urban, or suburban/village). The concentrations of heavy metals (cadmium, nickel, chromium) and essential elements (potassium, sodium, calcium, phosphorus) in edible plant parts were determined. Human health risks associated with chronic consumption of potentially contaminated vegetables were assessed through the use of hazard quotients. The concentrations of heavy metals and essential elements in the edible parts of the tested plants varied among plant species, cultivation locality and plant organ (leaf/root). Carrots showed the lowest levels of cadmium, nickel, and chromium accumulation, while the highest concentrations were measured for parsley leaves, with respect to average values. Metal pollution index values obtained for cities were lower than those obtained for some villages and a suburban settlement. The hazard quotient revealed the highest values for cadmium. Positive Pearson's correlation between chromium and nickel was found in many cases. Principal component analysis indicated differences in plants ability to accumulate certain nutrients and pollutants, while sample diversification was closely related to growth site properties. We sincerely hope that the present study will inspire similar investigations in other developing countries, as well as in the Western Balkans region, to obtain broader insight into vegetable food safety and local human health risk. Considering that food quality and safety are major concerns, our results should inform the relevant government authorities and provide a foundation for implementation of a system of controls over cultivation processes and vegetable quality in Serbia.

Psychological research and practice in former Yugoslavia and its successors.

This paper presents a brief history of Yugoslav psychology and a review of the current state of psychological research and practice in the former Yugoslav countries. Bibliometric mapping was used to explore the knowledge domain and international visibility of psychological research in Bosnia and Herzegovina, Croatia, North Macedonia, Montenegro, Serbia, and Slovenia. Judging by the number of papers visible in Scopus, psychological research activity in these countries is similar to the other former communist countries. In a relative sense, it is even higher in Slovenia and Croatia. However, psychologists still rely heavily on national journals indexed in Scopus when publishing their papers. Regarding psychological practice, former Yugoslav countries are facing challenges that are more or less typical for all small countries in the global scientific and economic market. Keeping in mind all the obstacles and traumas in the past decades, it should be considered a success that psychology in the former Yugoslav countries is now a fully established profession and a recognized scientific discipline.

Prevalence of obesity and impact of socio-demographic factors on obesity in 15-19 years old adolescents in Vojvodina, Serbia.

OBJECTIVES: The aim of this study was to examine the prevalence of overweight/obesity in 15-19 years old adolescents in the Province of Vojvodina, Serbia, and to evaluate the association between obesity and socio-demographic factors. METHODS: A cross-sectional study was conducted in high schools in the territory of Vojvodina, Serbia. The sample consisted of 986 high-school students (47.4% girls and 52.6% boys). Body height, body weight, and waist circumference were measured. Obesity was defined as a body mass index (BMI)-for-age value > x̅ + 2 SD, and overweight as a BMI-for-age value > x̅ + 1 SD and ≤ x̅ + 2 SD. Waist-to-height ratio (WHtR) of ≥ 0.5 was considered high risk. Socio-demographic data was collected using a questionnaire developed for this study. Univariate and multivariate logistic regression analyses were implemented. RESULTS: The prevalence of overweight and obesity in adolescents was 19.6% and 10.1%, respectively. Boys were more likely to be obese than girls (OR = 1.87; 95% CI: 1.37-2.56). Adolescents living in suburban areas had a greater chance of obesity compared to those living in urban areas (OR = 1.84; 95% CI: 1.15-2.94), as well as those who attended trade schools compared to gymnasium students (OR = 1.92; 95% CI: 1.20-3.07). The lower level of the father's education was a significant predictor of obesity. Predictors of high-risk WHtR were gender, high school type, and the father's education level. CONCLUSIONS: Obesity and abdominal obesity are highly prevalent in adolescents in Vojvodina, more in boys. Gender, community type and the level of the father's education were confirmed as significant factors that influenced both obesity and abdominal obesity. This study could help to customize health promotion policies for adolescents in Vojvodina.

Physical activity before and during the COVID-19 pandemic in Vojvodina, Serbia.

Background: The physical activity (PA) of the youth and adult population underwent changes during the last 2 years due to the coronavirus (COVID-19) pandemic, and all for the purpose of maintaining the health of the population. The purpose of this study was to estimate the levels of PA in the youth population and the adult population (young and old) during the COVID-19 pandemic in the territory of Vojvodina, Serbia, and to determine the differences between them, as well as to compare these results with the results before the pandemic. Methods: A total of 1,117 subjects (age 36.27 ± 15.08 years) from the territory of Vojvodina, Serbia, participated in the study. Subjects were recruited and assigned to one of the three groups according to their age: youth group (N = 395; age 18-24 years), young adults group (N = 347; from 25 to 44 years), and old adults group (N = 375; age 45-65 years). All participants in this study completed the International Physical Activity Questionnaire Short-Form between July and November 2021, during the fourth wave of the COVID-19 pandemic in Vojvodina, Serbia. The Kruskal-Wallis test and Dunn multiple comparison post-hoc method were used for statistical analyses. Results: The youth showed the highest result in total weekly energy expenditure (3,893.72 ± 2,010.01 MET-min/week) compared to young adults (2,528.20 ± 1,804.11 MET-min/week) and old adults (2,369.07 ± 2,084.95 MET-min/week) during the COVID-19 pandemic in Vojvodina, Serbia. In addition, adults (young and old) spent more time sitting than youth during the same period. Furthermore, the youth achieved greater results in levels of PA during the COVID-19 pandemic compared to the situation before the COVID-19 pandemic. However, adult populations achieved lower results during the COVID-19 pandemic than before the COVID-19 pandemic. Conclusion: During the COVID-19 pandemic, the youth from Vojovida, Serbia, achieved greater results in PA levels than the adult populations. Based on that, we recommend that it is necessary to take steps toward increasing PA in the adult population, especially old adults.

Clinical Presentations, Predictive Factors, and Outcomes of Clostridioides difficile Infection among COVID-19 Hospitalized Patients­A Single Center Experience from the COVID Hospital of the University Clinical Center of Vojvodina, Serbia

Background: This study aimed to investigate the clinical form, risk factors, and outcomes of patients with COVID-19 and Clostridioides difficile co-infections. Methods: This retrospective study (2 September 2021-1 April 2022) included all patients with Clostridioides difficile infection (CDI) and COVID-19 infection who were admitted to the Covid Hospital of the University Clinical Center of Vojvodina. Results: A total of 5124 COVID-19 patients were admitted to the Covid Hospital, and 326 of them (6.36%) developed hospital-onset CDI. Of those, 326 of the CDI patients (88.65%) were older than 65 years. The median time of CDI onset was 12.88 days. Previous hospitalizations showed 69.93% of CDI patients compared to 38.81% in the non-CDI group (p = 0.029). The concomitant antibiotics exposure was higher among the CDI group versus the non-CDI group (88.65% vs. 68.42%, p = 0.037). Albumin levels were ≤ 25 g/L among 39.57% of the CDI patients and 21.71% in the non-CDI patients (p = 0.021). The clinical manifestations of CDI ranged from mild diarrhea (26.9%) to severe diarrhea (63.49%) and a complicated form of colitis (9.81%). Regarding outcomes, 79.14% of the CDI patients recovered and 20.86% had fatal outcomes in-hospital. Although a minority of the patients were in the non-CDI group, the difference in mortality rate between the CDI and non-CDI group was not statistically significant (20.86% vs. 15.13%, p = 0.097). Conclusions: Elderly patients on concomitant antibiotic treatments with hypoalbuminemia and with previous healthcare exposures were the most affected by COVID-19 and CD co-infections.

Repetitive suicide attempts by poisoning in Vojvodina, Serbia - Psychotropic drugs as main causes.

OBJECTIVE: Repetitive acute self-poisoning takes great part of all admissions at the Emergency Department including self-harm as one of the main reasons. The aim of this study is to analyze the characteristics of the patients treated for repetitive self-poisoning with suicidal intent (RSP-SI) in Vojvodina (Serbia), in order to propose preventative strategy and better management of the issue. PATIENTS AND METHODS: The retrospective study included data regarding patients treated for RSP-SI during a 5-year period in Vojvodina, Serbia. RESULTS: Repetitive self-poisoning was determined in 485 patients, of whom 35.05% reported suicidal intention. Mean number of RSP-SI per patient was 3.61±3.08. The mean period between two RSP-SI in group of females and males was 9.69±13.60 and 6.95±11.02 months, respectively. Almost two thirds (65.29%) of them were unemployed. Most of the patients had mental and behavioral disorders due to psychoactive substance use (ICD F10-19; 51.18%) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (ICD F40-48; 33.53%). The sole etiological agent was identified in 39.15% attempts. In 58.08% of the attempts more than one substance was detected (2.50±0.73 per attempt). The co-ingestion of alcohol and benzodiazepines was the most common combination (19.41%). Psychiatry intervention was needed in 70.31% of the patients. Five of all patients with RSP-SI (2.94%) committed suicide. CONCLUSIONS: The recognition and the treatment of mental disorders as well as the control of psychiatric medications prescribing could represent one of the most important preventive strategies for repetitive suicidal behavior.

Incidence of Type 1 Diabetes Mellitus and Characteristics of Diabetic Ketoacidosis in Children and Adolescents during the First Two Years of the COVID-19 Pandemic in Vojvodina.

Background and Objectives: The COVID-19 pandemic has led to significant changes globally, which has also affected patients with type 1 diabetes mellitus (T1DM). This study aimed to determine the incidence of T1DM and the characteristics of diabetic ketoacidosis (DKA) during the pandemic comparing it to pre-pandemic period. Materials and Methods: Data from patients <19 years with newly diagnosed T1DM between 1st January 2017 and 31st December 2021 from four regional centers in Vojvodina were retrospectively collected and analyzed. Results: In 2021, the highest incidence of T1DM in the last five years was recorded, 17.3/100,000. During the pandemic period (2020−2021), there were 99 new-onset T1DM, of which 42.4% presented in DKA, which is significantly higher than in the pre-pandemic period (34.1%). During the pandemic, symptom duration of T1DM lasted significantly longer than before the COVID-19 period. At the age of 10−14 years, the highest incidence of T1DM and COVID-19, the highest frequency rate of DKA, and severe DKA were observed. Conclusions: The pandemic is associated with a high incidence rate of T1DM, longer duration of symptoms of T1DM, a high frequency of DKA, and a severe DKA at diagnosis. Patients aged 10−14 years are a risk group for the occurrence of T1DM with severe clinical presentation. Additional studies are needed with a longer study period and in a wider geographical area, with data on exposure to COVID-19 infection, the permanence of new-onset T1DM, and the psychosocial impact of the pandemic.

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.

Performance evaluation of general public hospitals in territories of the Former Yugoslavia: An ecological study using the Pabon Lasso model.

BACKGROUND: Measuring hospital performance is an area of great importance due to limited resources. Additionally, hospital activities are vital during emergencies providing care under pressure of external factors. AIM: This study aimed at analysing performances of general public hospitals from territories of the Former Yugoslavia. METHOD: This ecological study includes 99 hospitals from 6 territories based on annual reports of institutions in charge of territorial health data. The Pabon Lasso method was used, considering hospitals in the third quadrant of the plot as top-performing in the territory. A particular focus was on performance changes during the pandemic caused by SARS-COV-2 coronavirus. RESULTS AND CONCLUSION: There is considerable heterogeneity in the length of stay, bed occupancy and turnover rate between territories. The proportion of top-performing hospitals varied between 20% and 43%, providing between 16% and 69% of inpatients episodes within the territory. However, countries did not differ in how their hospitals were distributed across the four quadrants of the Pabon Lasso plot. Comparison of Croatian and Kosovar data from 2019 to 2020 suggested a significant decrease in turnover and occupancy rates, but most hospitals retained their plot quartiles from the previous year. This supports the finding that there were no significant changes in hospital performance based on the Pabon Lasso method. The analysis showed significant room for performance improvement and highlighted the ability of the Croatian and Kosovar hospitals and their health systems to maintain efficiency during emergencies.

ANALYSIS OF SUICIDES IN THE PROVINCE OF VOJVODINA, REPUBLIC OF SERBIA, DURING THE 2001-2015 PERIOD.

Suicide is an act of intentionally causing one's own death. Every year, approximately 800,000 people commit suicide. The average suicide rate in Serbia is around 19 per 100,000 people, which puts Serbia in the upper half on the list of European countries. The aim of this study was to define the number of suicides committed in the 2001-2015 period in the Province of Vojvodina, the male to female ratio of suicides, the most commonly used method of execution, the proportion of complex suicide, and distribution of suicides according to age groups, seasons, and days of week. This study was conducted as a descriptive retrospective study in the Center for Forensic Medicine, Toxicology and Molecular Genetics, Clinical Center of Vojvodina, by examining autopsy medical records. All suicide cases were divided according to age, gender, method of execution, season of the year, and day of the week. For statistical analysis, χ2 test included in Statistical Package for the Social Sciences (SPSS) version 23.0 was used, where the value of p<0.05 was considered statistically significant. During the 2001-2015 period, in the Province of Vojvodina, suicide was committed by 2241 people, 1812 men and 429 women. The highest number of suicides was recorded in the 45-54 age group in men and in the ≥75 age group in women. The most commonly used method was hanging in both genders. The proportion of complex suicides was 0.4%. There was no statistically significant difference in the number of suicides committed in different seasons. The highest number of suicides was committed on Friday. This research suggests that there is a need for intensive work on the prevention of suicides, especially among males aged 45-54 and females older than 75, especially in certain months and days when the suicide rate is higher.

Susceptibility to Bacteriocins of Multiresistant, mecA Gene Possessing Staphylococcus pseudintermedius Strains from Lesions on Dogs in Vojvodina (Serbia).

Aims: Staphylococci are considered commensal organisms; however, they can also cause diseases in animals. The species Staphylococcus pseudintermedius was originally isolated from the nares and anal mucosa of healthy dogs; nowadays, the incidence of methicillin-resistant S. pseudintermedius strains in dogs has increased, and this species has also become the most common cause of canine skin lesions. S. pseudintermedius were tested for their susceptibility to bacteriocins to show the potential of bacteriocins to eliminate/reduce S. pseudintermedius as a causative agent. Material and Methods: In this study, S. pseudintermedius were isolated from skin lesions on dogs of various breeds and ages in the Vojvodina region (Serbia) in the framework of our international co-operation. Results: S. pseudintermedius strains were identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and the species allocation was confirmed by genotypization and corroborated using phenotyping tests. The strains were multiresistant, involving methicillin-resistance. In addition, the mecA gene was detected in S. pseudintermedius strains, confirming the presence of a genetic feature for methicillin resistance. S. pseudintermedius strains produced large amounts of the enzymes alkaline phosphatase and acid phosphatase; they were low-grade biofilm forming (0.1 ≤ A570 < 1.0), except S. pseudintermedius SPs1. All strains were susceptible to gallidermin (inhibition activity up to 204,800 arbitrary unit [AU]/mL); however, they were mostly resistant to enterocins. However, biofilm-forming S. pseudintermedius SPs1 was susceptible to enterocins (200 AU/mL). Conclusion: Establishing the susceptibility of multiresistant and mecA gene-possessing S. pseudintermedius strains to gallidermin is an innovative, original result; it provides a new opportunity for preventing/eliminating infection caused by those agents.

Water, sanitation, and hygiene services in health care facilities in the Autonomous Province of Vojvodina, Serbia.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.