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Publikacije (53)

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A. Pilav, A. Nissinen, A. Haukkala, D. Nikšić, T. Laatikainen

BACKGROUND Federation of Bosnia and Herzegovina (FBiH) has high cardiovascular disease mortality as other countries in Eastern Europe and situation has even deteriorated in the post war period. Reliable information on risk factor levels and patterns needed in prevention planning and disease management has been lacking. METHODS A cross sectional population survey was conducted in the FBiH in autumn 2002. A random sample of population, aged 25-64 years, was taken using a three stage stratified sampling methodology. Altogether, 2750 persons participated in the survey (1121 men and 1629 women). The survey was done according to internationally established standards and protocols. RESULTS The mean systolic blood pressure was 132 mmHg among men and 135 mmHg among women. The mean diastolic blood pressure was 84 mmHg in both genders. Almost 40% of the participants were recognized as hypertensive (blood pressure level over 140/90 mmHg). The prevalence of hypertension among men was 36% and among women 45%. The mean Body Mass Index (BMI) was 26.5 kg/m(2) among males and 27.0 kg/m(2) among females. About 75% of both men and women were overweight (BMI > 25 kg/m(2)) and 16% of men and 20% of women were obese (BMI > 30 kg/m(2)). About 50% of men and 30% of women reported to be daily smokers. CONCLUSIONS As a whole the non-communicable disease risk factor levels in the FBiH seems to be relatively high. The data can be utilized in health promotion planning and as a baseline for future monitoring activities with possibility of international comparison of results.

I. Jokić, A. Lolić, F. Memić, D. Nikšić, A. Pilav

The Multiple Indicator Cluster Survey 3 (MICS3) was implemented in Bosnia and Herzegovina (BiH) during 2006 as a national survey with the primary objective to fill in the data gaps and to create the baseline to assess the status of children and women in the country. MICS3 in BiH has ensured that the countrys institutions now have information on 15 out of 48 MDG indicators as well as the data responding to the objectives set out in the World Fit for Children (WFfC) the resulting document of the 2002 UN Special Session for Children. In compliance with the complex administrative structure of the country as well as with its actual accountability for the well being and development of children and women the MICS3 in Bosnia and Herzegovina was implemented by three national partners at state and entity levels: the Directorate for Economic Planning of BiH; the Ministry of Health and Social Welfare of the RS; and the Federal Ministry of Health Federal Institute for Public Health in FBiH. (excerpt)

D. Nikšić, Amira Kurspahić-Mujicić, A. Pilav, H. Niksic

Considering that a register for cancer was established in Federation of Bosnia and Herzegovina only recently, basic reliable source for the analysis of cancer mortality trends are the data on death cases caused by such diseases. Lack of census as well as standardized mortality rate data makes the study even more difficult to make. The aim of the study is the analysis of the malign diseases trend in the post-war period according to the available data. The study is the descriptive work on the analysis of the system using linear regression methods for expected trend for the total population and age group from 0 to 64 years. Registered rate of cancer mortality in Federation of Bosnia and Herzegovina in 2004 was 142 per 100000 inhabitants, and indicates input stream in the analyzed period. Total increase in mortality of males and females is 2.5% per year. It is expected that in 2020 around 5000 inhabitants of Federation of Bosnia and Herzegovina will die of some malign disease. Trend of mortality of malign diseases in males is higher than in females and more probable in older population. There is a tendency of mortality decrease in the group of 0-64 years of age. Mortality list of the most frequent locations of cancer has undergone changes. Liver cancer, colon cancer, sigma and rectum cancer as well as lung and breast cancer lead the list. Objective ageing of the population, technological drawbacks, insufficient primary and secondary prevention worsened by socio-economic life conditions will affect the increase in number of people with malign diseases in Bosnia and Herzegovina.

A. Pilav, D. Nikšić, V. Gerc

Actual transitional moment in Bosnia and Herzegovina has the significant health implication. Several population surveys conducted in the past 10 years period showed the rather high prevalence of main cardiovascular risk factors, including hypertension. It was proof that cardiovascular risk factors are preventable. Hence, development and establishment of a model of integrated management of hypertension in actual moment in BIH is necessities due to relatively high level of prevalence of hypertension and limited financial resources in health sector. This paper shows a possible model a model of integrated management of hypertension at population level with active participation of actors from three managerial levels--strategic, tactical and operational.

B. Nakaš, A. Pilav

In this moment in the health sector of Bosnia and Herzegovina, the need for reform is especially highlighted in sector of the management and organization of the health protection, on all levels, from the administrative level up to clinical institutions for professionals, from who the professional managerial skills are requested. Only on this way, the creation of the health system based on the EU standards will be possible, using the modern managerial techniques. Because of that, in reform strategies of both entities, it has been necessary to develop the wider concept of development and strengthening of the health management, on all levels of managerial process--strategic planning, decision making, control of the use of health services, programme planning, monitoring and evaluation. The first pre-condition is revision of the education programme on all levels, from the secondary education, pregraduate, postgraduate education, and continued training.

N. Vanis, M. Gribajčević, N. Borovac, R. Mesihović, S. Gornjaković, N. Zubcević, A. Pilav

BACKGROUND The pathogenic role of Helicobacter pylori (H. pylori) infection in the setting of NSAID use is still controversial. Aim of the study is to prove increased incidence of gastric mucosa damage in H. pylori positive NSAID users compared to H. pylori negative patients. METHODS Patients with dyspeptic symptoms (n = 160, average age 62.13 +/- 6.24, ranged from 51 to 77 years) were divided in two groups: 80 patients (45 male, 35 female) with positive history of using NSAID and same group with negative history for NSAID. All patients underwent endoscopy, examined to H. pylori presence by rapid unease test. Patients with ulcer or erosions (> 5) were evaluated and grade of gastric mucosa damage were done according to Forrest classification of gastrointestinal bleeding. RESULTS In first group 69/80 of examined patients were H. pylori positive, in second group 56/80 were H. pylori positive (X2 = 5.266; p = 0.022). In gastric mucosa bleeding, caused with NSAIDs, H. pylori was not diagnosed more often compared to other group (p > 0.05). CONCLUSION Patients with NSAID induced gastric injury were significantly greater incidence of H. pylori infection compared to patients without history of NSAIDs abuse. H. pylori was not significantly present in complication of ulcer disease (bleeding) caused by NSAID.

Health information undoubtedly has great social, political and economic importance. To have relevant information, it means to have basis for timely reporting, basis for action, and prerequisites for success. The purpose is to produce and use adequately appropriate information about health status, health risks and health outcomes in order to establish priorities. Health information should be useful and easy accessible to all potential users in every moment, from health care providers to the general public. Health indicators, as aggregated health statistical data, present measure instruments in this process, and because of that definition, development and implementation of basic set of health indicators at all levels (public health and clinic) must be the priority activity in the current moment of health sector reform in Bosnia and Herzegovina. Basic set of relevant and measurable indicators should be founded on different aspects of health and health care (health promotion, diseases prevention, clinical treatment, rehabilitation), monitoring and evaluation as a part of everyday's routine in health sector.

A. Pilav, S. Dracić-Purivatra

Health-statistic information system in Bosnia and Herzegovina is presented, its content, problems and reform objectives in accordance with new European trends. Adequate and prompt health information plays a key role in the policy of planning and decision-making at all health levels. Therefore, data collecting must be conducted in accordance with the country's needs aimed to the health promotion and health of the population improvement. Scope and structure of health information system varies from country to country depending on health status of population, health policy and, of course, economic capacity. Public Health Institute of Federation BH is authorized by the Law to conduct statistical research in the health sector, and, therefore, the Proposal of statistical research in health sector is made, according to these regulations. This Proposal offered 17 statistical researches for 1998. Unfortunately, only 7 researches have been carried out. The shortcomings of the existing health-statistic information system have been found out on the local, cantonal, entity and state level.

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