Aim To present combined measles cases data and phylogenetic analysis of the virus circulated in 2018 in the Federation of Bosnia and Herzegovina (FB&H, the entity of Bosnia and Herzegovina), in order to analyse endemic transmission patterns of circulating strains and its implications for elimination efforts. Methods The data were derived from epidemiological case investigations and laboratory diagnoses based on serology, molecular detection and genotyping of the measles virus. Results During 2018 16 measles cases were reported in FB&H, of which five were classified as laboratory confirmed cases, one was an epidemiologically linked case and 10 were clinically compatible cases. Among them 12 (75.00%) cases were unvaccinated or had unknown vaccination status. The most affected population was up to 14 years of age (13/16; 81.25%). None of the cases was fully vaccinated. Viruses of other genetic lineages had been introduced in FB&H in the recent period. Two virus lineages of genotype B3 were identified. Phylogenetic analysis indicated the presence of a unique sequence of measles B3 virus in FB&H (Sarajevo). Conclusion Further strengthening of measles surveillance system and renewed efforts to increase vaccination levels are necessary to prevent disease and for elimination setting.

Infekcija virusom hepatitisa D (HDV) javlja se samo u HBsAg pozitivnih osoba. Oko 350 milijuna ljudi u svijetu zara`eno je virusom hepatitisa B (HBV), a oko 5 % njih ima i HDV infekciju. Prikazana su prva dva prijavljena slu~aja hepatitisa D u Bosni i Hercegovini. Bolesnici su lije~eni u Slu`bi za zarazne bolesti Kantonalne bolnice Zenica, tijekom 2013. i 2014. godine. Serolo{ki testovi na HDV ra|eni su u Klinici za mikrobiologiju Klini~kog centra Sarajevo. Kod prvog, 67-godi{njeg mu{karca radilo se o akutnoj HBV-HDV koinfekciji, s te`im, produ`enim klini~kim tijekom i povoljnim ishodom bolesti: negativnim HBsAg, HDVAg i anti-HDV. Kod drugog, 34-godi{njeg mu{karca radilo se o superinfekciji hepatitis D virusom, na terenu kroni~nog hepatitisa B. Potrebno je podi}i svijest zdravstvenih djelatnika o opasnosti od udru`ene HBV i HDV infekcije i osigurati bolju dostupnost HDV dijagnostici.

Between January 2014 and the beginning of February 2015, the Federal Institute of Public Health in the Federation of Bosnia and Herzegovina has reported 3,804 measles cases. Notable transmission has been observed in three Central Bosnia Canton municipalities: Bugojno, Fojnica and Travnik. Most cases were unvaccinated 2,680 (70%) or of unknown vaccination status 755 (20%). Health authorities have been checking vaccination records and performing necessary prevention measures. The epidemic is still ongoing.

AIM To investigate an influence of the concentration of proinflammatory cytokines tumor necrosis factor-alpha (TNF-α) in serum on the activity of inflammatory bowel disease (IBD). METHODS The IBD patients of both genders (n=60) were divided in two equal groups, ulcerative colitis (UC) and Crohn's disease (CD). Based on the result of activity index each group was subdivided in two subgroups: active and inactive phase of the disease. Age and gender matched apparently healthy individuals (n=30) involved in the control group. Serum TNF-α concentration was determined by enzyme linked immune-adsorbent assay (ELISA). RESULTS The significant difference (Mann-Whitney Test) in serum TNF-α level was found between healthy controls 28.86 pg/ml (28.74 - 29.19 pg/ml) and CD patients (29.47 pg/ml (29.1 - 29.77 pg/ml) (p less than 0.05) and UC patients 29.34 pg/ml (29.14 - 29.71 pg/ ml) (p less than 0.05) respectively. Serum TNF-α level in patients with CD was higher compared to serum TNF-α level in patients with UC, but the difference was not significant (p more than 0,05). There were no significant difference in serum TNF-α concentrations either in CD or UC patients related to the phase of disease activity: active CD 29.53 pg/ml (29.20 - 29.90 pg/ml) vs inactive CD 29.26 pg/ml (29.15 - 29.53 pg/ml); active UC 29.53 pg/ml (29.32 - 29.85 pg/ ml) vs inactive UC 29.26 pg/ml (29.10 - 29.63 pg/ml). CONCLUSIONS Since there were no differences in serum TNF-α concentrations related to the disease activity we consider that TNF-α is not an adequate serum biomarker for an assessment of the disease activity in patients with IBD.

Introduction Sexually transmitted infections (STIs) have become a leading global public healthcare problem. The aim of the study was to determine and evaluate certain aspects of sexual behaviours among medical students in Sarajevo. Methods The two parts of the survey were cross-sectional analysed among 188 and 220 students by means of valid self - reported questionnaires in 2011/2012 and 2012/2013 at University of Sarajevo, BaH. Results In the first part of the survey a total of 188 students were observed, out of which in the group 18–21 of age – 35.3% males and 64.7% females and in the group of 22–25 of age – 50.9% males and 49.1% females, respectively. Sexual experiance have had 67.5% of students, out of which at the age of ≤ 16–86.9% males and 13.1% females, while at the age of ≥ 17–46.1% males and 53.69% females. In the last 12 months 56.9% males used condom each time during sexual intercourse as well as 41.5% females. In the second part of the survey a total of 220 students were observed, out of which in the group 18–21 of age-31.4% males and 68.6% females; in the group of 22–25 of age-40.5% males and 59.5% females; in the third group ≥ 26 of age-46.0% males and 54.0% females. Sexual experiance have had 53.6% of students, out of which at the age of ≤ 16–94.7% males and 0.53% females, while at the age of ≥ 17–47.5% males and 52.5% females, respectively. In the last 12 months 33.8% males used condom each time during sexual intercourse as well as 30.2% females. There was not a significant difference in condom use in relation to students knowledge about STIs (p0.05). Conclusions Health education of youth improves their knowledge of sexual behaviour, provides support and develops skills needed for avoiding risk-taking behaviour, as well as preventing major STIs.

The aim of this study was to investigate changes in serum nitric oxide (NO) concentration in inflammatory bowel diseases (IBD) patients and its use as potential biomarker in differential diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and in disease activity assessment. In 60 patients of both genders - 30 with ulcerative colitis and 30 with Crohn's disease - and 30 controls serum nitric oxide concentration was determined by measuring nitrite concentration, a stable metabolic product of NO with oxygen. Conversion of nitrates (NO3-) to nitrites (NO2-) was done with elementary zinc. The nitrite concentration was determined by classic colorimetrical Griess reaction. Median serum NO concentration was statistically different (p=0,0005) between UC patients (15.25 µmol/L; 13.47 - 19.88 µmol/L), CD patients (14.54 µmol/L; 13.03 -16.32 µmol/L) and healthy controls (13.29 µmol/L; 12.40 - 13.92 µmol/L). When active UC and CD patients were compared with inactive UC and CD patients respectively a significant difference in serum NO level was found (p=0.0005). With a cut-off level of 17.39 µmol/L NO had a sensitivity of 100% and a specificity of 100% in discriminating between active and inactive UC patients. With cut-off value of 14.01 µmol/L serum NO level had a sensitivity of 88% and a specificity of 69% in distinguishing between patients with active CD and inactive CD. Serum NO concentration is a minimally invasive and rapid tool for discriminating between active and inactive IBD patients and could be used as useful biomarker in monitoring of disease activity in IBD patients.

SUMMARY A rubella outbreak involving 1900 cases was recorded in the Federation of Bosnia and Herzegovina between mid-December 2009 and the end of May 2010. Sera from 389 suspected rubella cases were examined for the presence of rubella-specific IgM and IgG antibodies. A total of 32 throat swabs from suspected rubella cases were tested by RT–PCR and were used to attempt virus isolation. Most patients (945/1900, 49·73%) had never received rubella vaccination or had an unknown vaccination status (563/1900, 29·63%). About 45% (178/389) of suspected rubella patients were IgM positive. From 13 of the throat swabs a virus isolate and E1 gene sequences attributed to genotype 2B were obtained. The rubella outbreak was due to failure to vaccinate during the war period (1992–1995) and emphasizes the need for additional vaccination opportunities.

SUMMARY The extent of hantavirus seroprevalence in the healthy population from Bosnia and Herzegovina has not yet been investigated; therefore, the aim of this study was to assess the hantavirus seroprevalence in the population from different regions of Bosnia and Herzegovina and in different risk groups. The serosurvey included 1331 subjects from endemic and non-endemic regions in Bosnia and Herzegovina. All sera samples were examined using IgG ELISA, and Western blot (Bunyavirus IgG) tests. Hantavirus seroprevalence was 7·4% in the endemic region and 2·4% in the non-endemic region (P<0·05). Former soldiers from the endemic region had significantly the highest seroprevalence (16·1%) compared to the general population from the endemic region (6·2%), the occupational risk group from the non-endemic region (5·6%) and the general population from the non-endemic region (0·8%) (P<0·01). No difference in hantavirus seroprevalence between gender or age groups was observed. Hantavirus seroprevalence in different populations in Bosnia and Herzegovina was found to be highest compared to other central European countries.