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A. Obradovic

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Introduction: Legionella bacteria are ubiquitous microorganisms mostly found in artificial water environments, especially those which produce aerosol, such as swimming pools, saunas, and spas. Development of Legionella depends on several factors, including water temperature and chlorine. The aim of this study was to evaluate the occurrence of Legionella spp. to the temperature and free residual chlorine in tap water, water from fountains, swimming pools, cooling and heating systems. Methods: We collected 238 samples of water taken from different places and analyzed the presence of Legionella spp. by BAS EN ISO 11731-2:2009 - Water quality – Detection and enumeration of Legionella - Part 2: A direct membrane filtration method for waters with low bacterial counts, as samples were the waters with low expectancy of bacterial contamination compared to the temperature and free residual chlorine. The X2 test was used to show statistical significance. Results: Legionella spp. was detected in 18.62% of tap water and in 8.82% samples of water taken from fountains, swimming pools, and cooling and heating systems. The highest number of positive samples were detected in waters with the temperature higher than 20°C and lower than 50°C. The highest number of positive samples were reported by the concentration of free residual chlorine lower than 0.2 mg/l. The X2 test showed a statistically significant difference between positive and negative results for the presence of Legionella spp. among three groups of water samples. Conclusion: The research has shown a connection between environmental factors and the presence of Legionella spp. in the water systems of public and tourist facilities.

Influenza is one of the most common respiratory diseases in the world, annually causing over one million of deaths. It is triggered by one of the types of influenza viruses (A, B or C). Most usually, it assumes the form of epidemic disease, sometimes it is a pandemic, and is very rare as a sporadic disease. In temperate zones, the influenza occurs seasonally - during the cold months of a year. In tropics, however, it occurs throughout the year, though the highest number of patients is registered during the rainy seasons. Influenza is a mild disease for young and healthy persons; however, if affecting those with a weakened immune system, it can lead to complications and even to death. The only effective preventive measure is vaccination, which precludes the disease. So far, no consensus is reached on whether the vaccination should be compulsory or recommended and who should be vaccinated. In most European countries, vaccination is recommended for certain categories of the population, while the United States recommend it to the entire population above six months of age.

S. Bektaš, A. Obradovic, M. Aljičević, F. Numanović, Dunja Hodžić, L. Sporišević

Background: The increase in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections lacking risk factors for exposure to the health care system has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). These strains have been distinguished from health care-associated MRSA (HA-MRSA) strains by epidemiological, molecular and genetic means as well as by antibiotic susceptibility profile, tissue tropism and virulence traits. Objective: To assess prevalence and antibiotic susceptibility profile of CA-MRSA in Canton Sarajevo, Bosnia and Herzegovina. Results: Out of 1.905 positive Staphylococcus aureus isolates from various samples of outpatients collected during six months, 279 (14,64%) were MRSA isolates. Out of 279 MRSA samples, 133 (47,67%) were found in nasal swabs, from which 48 (36,09%) were in the age group <1 year and 39 (29,32 %) are in the age 1-5 year. Rate of the positive skin swabs was highest among the subject of age group <1 year (46 or 54,12 %) and 1-5 year (18 or 21,18 %). Predominantly antibiotic types among MRSA strains are resistant to penicillin and cefoxitin (36,90 %) and to penicillin, cefoxitin and erythromycin (61,35 %). Conclusion: Continued monitoring of epidemiology and emerging drug resistance data is critical for the effective management of these infections.

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

Z. Obradović, A. Obradovic, Ifeta Ćesir Škoro

Introduction: The work of nurses is human. They help people in protection against diseases. Nurses are the largest group of health workers and all problems that appear in the health system are first recognized among them. Burnout syndrome appears among nurses very frequently. We present the leading factors for burnout among nurses in RMC „Dr Safet Mujic“ in Mostar, Bosnia and Herzegovina.Methods: It is a cross sectional descriptive study. We used an anonymous questionnaire with 20 questions. Our sample was random with 30% of all nurses which were working in this Medical Center in January-February 2012.Results: In our study 77.9% nurses work in the hospital. 52% have over 16 years of work experience. 34.6% of examinees are satisfi ed with interpersonal relationships, 31.7 % are satisfi ed with relationships with the superior. Motivation for work have 51% of examinees, a big number comes unwilling on work.For 83.7% overtime work is the reason for dissatisfaction 71.2% examinees think that they can't make progress on work. A high percentage of examinees doesn't think about problems related to work outside working hours, a good sleep have 38.5% and 56.7% wakes up tired. Many of examinees are not satisfiedwith workplace, and 58.7% would like to change it.Conclusion: Nurses employed in RMC „Dr Safet Mujic“ Mostar are exposed to many factors during work which can cause the burnout syndrome. It is necessary to expand the study on a larger group of nurses and to implement the measures for reducing risks of burnout syndrome.

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

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