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GOAL Reporting on infectious diseases is one of the most important measures for controlling the infectious diseases. In Bosnia and Herzegovina is in the implementation an archaic system of reporting, older than 20 years, which is incorporated into the partially reformed health system. The aim of this study is to determine and analyze the quality of keeping records of communicable diseases and quality of data obtained. It also sought to identify weaknesses in the system that contributes to poor reporting and poor data quality. METHODS The study was retrospective-prospective, descriptive and analytical. Data were collected during June 2010 from all health facilities of Zenica-Doboj Canton. The data are collected from regular reports from medical institutions, received reports on contagious diseases, examination of 12.5% of the medical records of patients who were examined in June 2010, and the survey on 19% 9% physicians and 9% nurses. RESULTS The survey showed that about 40% of infectious diseases do are not reported by individual application forms. Most often not reported are fungal infections (99.7% unreported) and intestinal infectious diseases. From found diseases in a sample of medical records reviewed, only 1.4% of them were reported. Health professionals in 51% agree that reporting is not satisfactory, and in 49% of the cases agree that the great merit of this situation have the management of health institutions and local epidemiologists who do not organize professional meetings regarding the reporting on infectious diseases. A large number of health professionals (40%) do not fill properly report on the illness, so we have a 58% incorrectly filled forms that arrived in the Institute of Public Health. CONCLUSIONS The health workers from Zenica-Doboj Canton did not sufficiently developed awareness about the need to report infectious diseases. In order to overcome this situation, management of health care institutions must have a responsible attitude towards the medical documentation and records, and binding continued medical education of health professionals to raise awareness about the importance of proper medical documentation management.

Caring for the health of people is a potent factor in the development of social values. However, a bad set of health policy framework, without firm control mechanisms, creating the possibility of making politically motivated protectionist decisions that will give the poor outcomes of health services. Following the health needs of patients in the period since 2005 to 2010 in the area of Zenica-Doboj Canton and behavior of specialist consultants, after making an poorly judged, politically motivated decisions, we found increased demands of patients within primary health care (PHC) and specialist health care (SHC), an increase in the number of hospital patients, increasing demands for diagnostic tests, and dissatisfied patients for an inefficient health service. In order to prevent the possibility of making such decisions, or unethical behavior of health professionals, it is necessary to establish clear regulatory mechanisms and responsibilities in society and the health system, such as strategic plans, bylaws and standards, with guidelines for good practice.

The aim of this article is to investigate and identify all the relevant ways of epidemiology significance for transmitting infectious diseases in the existing unsatisfactory hygienic and sanitary conditions in rural areas of the municipality of Zenica, which are positively correlated with occurrence and spread of infectious intestinal diseases. The study was conducted in seven rural localities of Zenica municipality where the dominant livestock are sheep and cows, and the population is mostly dealing with individual production of cheese and milk. This research aimed to examine and identify the conditions favoring life as the primary issues that affect the increase in the risk of and maintenance of intestinal infectious diseases such as: the level of environmental sanitation in investigated villages, sanitary and hygiene habits of families living in the villages studied, ratio of population to personal hygiene, health safety of water supply, hygienic disposal of fecal waste and waste generated in the breeding of animals. The study included the monitoring and statistical analysis of the epidemiological situation in the values of average prevalence rates of the intestinal infectious diseases in the 1000 inhabitants of each village studied. The study identified five major negative epidemiological indicators that have a major impact on the appearance and maintenance of intestinal infectious diseases. The leading indicator is a negative relationship and personal hygiene attitude in the broader sense, the pending state of water supply, sanitary toilets and unresolved rubbish dump with a negative attitude and stance toward general hygiene. Identified are all the relevant ways of epidemiology importance that are positively correlated with occurrence and spread of infectious intestinal disease. Investigations of the epidemiological situation regarding the occurrence of intestinal infectious disease in the study population showed that intestinal infectious diseases in the investigated area is constantly maintained and that the average prevalence rate is shown suffering intestinal infectious diseases in the 1000 inhabitants significantly higher than the prevalence of these diseases in the urban area where they can be identified in a significant number of negative epidemiological indicators.

The slamic authors of the medical and other works have become very known for West, but under well changed names, as for example Razes for Ar-Razi, Avicenna for Ibn Sina, Alhazen for Ibn Haitham, Avenzoar for Ibn Zuhr, Avveroes for Ibn Rusd etc. Up to those changes in the names has not come at any case come accidentally. This was the result of the religious striving to the cultural worls of the West, and not to speak about the plebs, only the giants are represented wich was imppossible to avoid. It is indusputable the great contribution of the Islamic authors to the development of the biomedical sciences. They not only succeeded to preserve the achievements of the pre Islamic authors, than they by the own researches gave the great contribution to the development of these sciences and their disciplines, and they have overgiven to us as a dowry.

CONFLICT OF INTEREST: NONE DECLARED New discoveries in technology indeed enabled significant improvement of health care in the last three decades. Only during the last few years a significant breakthrough is achieved in the field of antiviral drugs, biotechnology, digital diagnostic technology, molecular diagnosis, tissues and organs transplantation as well as surgical and information technologies, which all contributed to the improvement of health care. Rapid growth of medical technology has led to the increase in costs of health care, increased access to these technologies and improvement of health care that is permanently encouraging the further development of technology. Technology encompasses the skills, knowledge and ability to understand, use and create useful things. It is the practical application of knowledge. Evaluation of health technology is the systematic evaluation of characteristics, results or impact of health technologies. The primary purpose of evaluation is to provide information to responsible parties for the technology in the health care system, which will be used in decision-making and introduction of these technologies. Information technology in medicine and health care represents all medical and health technology in the process of work, monitoring and evaluation done using computer technology. Progress of medical science in recent years especially needs to thank to the development of information technologies. The health care system of Bosnia and Herzegovina is currently operating in the two sub-systems of primary health care. One is inherited from the past system, in which the primary health care is provided by general practitioners, specialists in general practice, as well as gynecologists, pediatricians and pulmologists, and the second subsystem occurs when in PHC is introduced the system of family medicine doctors and family medicine specialists. Family medicine, based on the concept of orientation towards the methods which are more effective, rational and cost-effective health care, use of defined procedures and evidence-based medicine, and more adequate education can empower and stimulate general practice doctors, especially family medicine specialists, who have passed various forms of training and courses in this area, to more rational and efficient use of diagnostic technology in their daily practice, without unnecessary duplication of tests. With this they make savings to the healthcare system, improve the financial position of overall health system, especially in the PHC segment, increase satisfaction of doctors providing that health care, but also the users of health services.

New discoveries in technology indeed enabled significant improvement of health care in the last three decades. Only during the last few years a significant breakthrough is achieved in the field of antiviral drugs, biotechnology, digital diagnostic technology, molecular diagnosis, tissues and organs transplantation as well as surgical and information technologies, which all contributed to the improvement of health care. Rapid growth of medical technology has led to the increase in costs of health care, increased access to these technologies and improvement of health care that is permanently encouraging the further development of technology. Technology encompasses the skills, knowledge and ability to understand, use and create useful things. It is the practical application of knowledge. Evaluation of health technology is the systematic evaluation of characteristics, results or impact of health technologies. The primary purpose of evaluation is to provide information to responsible parties for the technology in the health care system, which will be used in decision-making and introduction of these technologies. Information technology in medicine and health care represents all medical and health technology in the process of work, monitoring and evaluation done using computer technology. Progress of medical science in recent years especially needs to thank to the development of information technologies. The health care system of Bosnia and Herzegovina is currently operating in the two sub-systems of primary health care. One is inherited from the past system, in which the primary health care is provided by general practitioners, specialists in general practice, as well as gynecologists, pediatricians and pulmologists, and the second subsystem occurs when in PHC is introduced the system of family medicine doctors and family medicine specialists. Family medicine, based on the concept of orientation towards the methods which are more effective, rational and cost-effective health care, use of defined procedures and evidence-based medicine, and more adequate education can empower and stimulate general practice doctors, especially family medicine specialists, who have passed various forms of training and courses in this area, to more rational and efficient use of diagnostic technology in their daily practice, without unnecessary duplication of tests. With this they make savings to the healthcare system, improve the financial position of overall health system, especially in the PHC segment, increase satisfaction of doctors providing that health care, but also the users of health services

Ibrahim Aličkovič, S. Tandir, Senka Imamovic, Nisvet Trako

SUMMARY Hemorrhagic fever with renal syndrome (HFRS), also known as mice fever, is an acute viral zoonosis and it appears in the natural focus after the human contact with Hantaan virus infected mice. The objective (purpose) of this project is: to determinate the rate of Morbidity (Mb), Mortality and Lethality (Lt); to investigate the collective immunity in endemic focus. In this project we applied the epidemiological method of studying with retrospective-perspective, the serological method for determination and detecting antibodies from the persons of epidemical focus and statistical methods. The disease diagnosis is based on the epidemiological, clinical and serological records. The collected samples have been sent to referral laboratory in Medical Faculty-Institute of Microbiology Ljubljana for laboratory confirmation. From the results we came to conclusion that in the territory of Republic of Kosovo, the HFRS is still a serious health, economic and biological problem. The lethality rate from HFRS in 1986 was 15.4%, 1986-89 10.8%, from 1995-2006 8.70%. The lowest rates of morbidity, mortality and lethality of HFRS compared with the previous periods of time, prove collective immunity growth in Dukagjini valley. For collective immunity research and to conduct the persistence of antibodies for viral corresponding (relative) antigen, after the disease, the samples were collected in the time period of May-June 2008, with 203 persons that were tested with serological method IIF (Indirect immune fluorescence) from which 187 cases (92.1%) resulted sero-negative and 16 cases (7.9%) resulted sero-positive with HFRS. This proves the collective immunity increase for HFRS. Out of the total number of sero-positive persons with HFRS (16 cases) the highest number resulted in persons of first contact with 12 cases (75%) sero-positive with HFRS, while the lowest number in persons with hemodialysis with only 1 case (6.3%); (high level of antibody for HTN and DOB, with level 1:1024).The collected samples in the period May – June 2008, have been tested with serological method IIF in health workers and 20 healthy persons (control group). Antibodies for viral antigen were not found in any of the cases (HTN, PUU and DOB).From 13 recovered patients previously diagnosed with HFRS (1986-1989-1995), levels of antibodies were screened in 2008 with IIF. Out of 13 persons, positive antibodies were found in 10 cases, while 3 cases were negative for antibodies (HTN, PUU, and DOB).After 13, 19 and 22 years HTN, PUU and DOB antibodies persisted in level (1:16-1:512). Based on the gathered results, we came to conclusion that it is necessary to compile the National Strategy of Surveillance for the Kosovo Health System for a 5 year period, for avoiding this high risk disease. Keywords: HFRS, collective immunity, HTN PUU DOB antibodies, IIF, Republic of Kosovo After the war in Bosnia and Herzegovina, sudden increase in the number of people suffering from brucellosis was registered

CONFLICT OF INTEREST: NONE DECLARED Introduction The International classification of diseases (ICD) is the most important classification in medicine. It is used by all medical professionals. Concept The basic concept of ICD is founded on the standardization of the nomenclature for the names of diseases and their basic systematization in the hierarchically structured category. Advantages and disadvantages The health care provider institutions such as hospitals are subjects that should facilitate implementation of medical applications that follows the patient medical condition and facts connected with him. The definitive diagnosis that can be coded using ICD can be achieved after several visits of patient and rarely during the first visit. Conclusion The ICD classification is one of the oldest and most important classifications in medicine. In the scope of ICD are all fields of medicine. It is used in statistical purpose and as a coding system in medical databases.

Area of Zenica Doboj Canton (ZDC), as well as other areas in Bosnia and Herzegovina, due to geographic, climate and agricultural features, also because of the fact, that animal farms and human habitats are closely related, as well as due to the poor hygiene conditions in places with dominant sheep farming, have fruitful conditions for endemic persistence and spreading of brucellosis, as a typical zoonosis. Lack of systematic research about farms that keeping the animals, and Program of control and suppression of brucellosis, as well as other veterinary measures in order to control the health of domestic animals, in order to protect the health of the human population, have the consequence in continuous presence of brucellosis among animals and humans in this area. As the confirmation of this is also the data about the frequency of this disease in the period 2000-2007, is analyzed in this paper. Follow up and control of brucellosis within human population in ZDC during the period observed showed continuous presence of brucellosis with changing morbidity rate and with the tendency for increasing in this period. During observed time period also noticed was the epidemic occurrence of this disease in two municipalities with the largest number and concentration of herds and sheep farms in ZDC (Zenica and Zepce). In total during the epidemic and non epidemic period we registered 294 patients. The number of occasional cases is contained within the total number of cases reported during epidemics.

Ibrahim Aličkovič, S. Tandir, Z. Puvacić, S. Zvizdić, S. Hamzić

After the war in Bosnia and Herzegovina there is a sudden increase in number of infected with the Q-fever, which becomes huge public health and economic problem. Although this disease occurred in very different geographic areas of Bosnia and Herzegovina the Zenica-Doboj Canton was among the most affected. Infections of Q-fever at the Zenica-Doboj Canton represent very complex epidemiology problem, because it is in highest incidence rates not only for Bosnia and Herzegovina, but also for Europe. The total number of population affected by Q-fever in Zenica-Doboj Canton since the beginning of 1998 until the end of 2005 was 193, with the average morbidity rate of 48.30 %000. In Zenica-Doboj canton affected by Q-fever was the inhabitants of both genders, all ages and on wide territory, which in majority of cases did not have the contact with domestic animals. Incubation period varies from 14 to 27 days. Actual incidence rate due to asymptomatic occurrence of this disease is for sure higher. Researches of spreading manner for the Q-fever among humans showed that this disease can be spread in epidemic and sporadic manner in Zenica-Doboj Canton, and that there are many risk factors which influence its occurrence.

AIM AND PURPOSE Estimation of hematological laboratory effectiveness usage in family medicine, by an assessment of appropriate testing indications and efficiency of testing interpretation. METHODS For each patient who was sent to hematological testing, physicians fulfilled the questionnaire. Data gathered was used for computation of diagnostic technology operational characteristics: sensitivity, specificity, predictive values, clinical effectiveness, diagnostic odds ratio and error odds ratio. The data were served for interpretation assessment of testing results. For assessment of indications for hematological testing accuracy setting we used: the number needles (unwanted) testing according to operating diagnosis, number of confirmed operating diagnosis, and number of cases in which testing influence to therapy selection or health improving. RESULTS The results have shown sensitivity value of 0.88, specificity value of 0.97, positive predictive value of 0.98, and negative predictive value of 0.85. Effectiveness of diagnostic technology was 0.92, diagnostic odds ratio was 238 and error odds ratio was 0.2. Unwanted haematological testing has noted in 37.3% cases, but pre-test diagnosis had confirmed in 51.8% cases. The testing contribution to improving health status of patients was noted in 57.8% of cases. CONCLUSION The results have shown high level of accuracy, effectiveness and diagnostic odds ratio. However, poor assessment of testing indications has shown poor contribution to improving of patient health status.

Rotaviruses belong to the family Reoviridae, genus Rotavirus with several types that are important for human and animal medicine. Rotavirus genome is consisted of 11 segments of double-stranded RNA, which code the synthesis of structural (VP) and non-structural proteins (NSP). The virus genome is enclosed in the three-layer capsid. Protein of the middle layer (VP6) is responsible for group specificity, and two proteins of the external capsid layer (VP7 and VP4) are responsible for belonging of rotaviruses group A to different sero/genotypes, in further text G and P. These two important antigen proteins stimulate an organism to produce specific neutralizing antibodies. Today, there are overall 15 G and 23 P serotypes of rotaviruses known and discovered so far. It infects humans, with 10 G and 11 P serotypes of rotaviruses discovered, with the most frequent presence of group A of serotypes G1 to G4, and serotypes P4 and P8, respectively. The most frequently found serotype among them is G1. According to recent reports, rotaviruses are still one of the most important causes of acute gastroenteritis in the population of young children, with endemic distribution in all geographic regions. Annually, around 50,000 of rotavirus-infected individuals are hospitalized in USA and around 80,000 in Europe. Compared to other pathogens, rotaviruses are present in causing of acute diarrheas in children in 30-40 % of cases. In children younger than 5, around 136 millions of gastroenteritis cases with rotavirus etiology are registered annually. Out of this number, 111 millions are treated at homes, 25 millions ask for medical consultations, 2 millions are hospitalized, and around 440,000 die.

Viral hepatitis A is an endemic disease with periodic epidemics, or sporadic cases within endemic areas. It is present in a majority of world countries, more often in undeveloped ones. In our country it occurs occasionally, so it still cannot be considered as solved problem. This is because Bosnia and Herzegovina until 1990 was in the group of countries with the largest hepatitis A morbidity in Europe, and municipality Zenica within B&H with the largest morbidity in the period from 1987 until 1996. By studying the occurrence of the viral hepatitis A according to age groups, we can notice that the largest number of patients is at the age between 7 and 18 years (school children and youth) with 68.86% of baseline, than follows patients up to 6 years of age with 15.34%. In analysis of occurrence season, it is noticed that disease have a season features with the peak occurrence during November and December. Regarding the area of living, it is noticed that the disease occurs significantly less frequently among urban than rural and suburban population (78%). Among total number of patients within the period of epidemic we have registered 82.0% of patients, and only 18.0% was occasional cases. In majority of cases virus spreads by contact, which is the consequence of poor hygiene and sanitation that was, or still are present in the rural areas, because of inadequate infrastructure and lack of sufficient quantity of clean drinking water, or to say low level of health knowledge among rural population.

S. Tandir, E. Drljević, L. Čalkić

INTRODUCTION Leptospirosys belong to zoonoses that affects both humans and animals, and they are caused by the bacterias of leptospira sort. This is a relatively widely spread illness in the majority of countries around the world as well as in our country, whit often epidemic occurrence. The goal of the paper is to point out the importance of leptospira as a potential cause for individual or epidemic sickening of miners at the "Stara Jama" mine in Zenica. MATERIAL AND METHODOLOGY This research is conducted on a sample of 31 respondents--miners at the "Stara Jama" mine in Zenica during the epidemic of leptospirosys from 1st august until 6th September 2005. Selection of suspected patients is done based on a clinical signs of illness. All hospitalized had high fever, headache and hepatorenal syndrome. All complete and relevant tests are done for the 30 respondents, and from 26 of them one or two serum samples are taken, while from 4 patient's three samples are taken. Serological examination is conducted by the standard method of microscopic agglutination - liza-test with 14 serotypes of leptospira, RESULTS From the baseline of 30 respondents in 16 cases existed serological confirmation of leptospirosys etiology of illness. Among them also is determined a presence of specific antibodies in I, II and/or III serum sample for the certain serotypes of leptospira. Among other 14 hospitalized, from the sample of 30 respondents we did not find increase in titre for the specific antibodies within samples. Illness developed mainly among those in the age group between 24 and 56 years, and the highest frequency was between 20 and 50 years of age among male respondents. Antibody titre within the taken samples was in a solution 1:100 up to 1:16000, and the highest tested titres were for the L. Ballum, L. Tarassovi, L. Poi and L. Icterohaemorrhagiae. DISCUSSION AND CONCLUSION Vectors for the leptospirosys in our environments are mainly rodents (mice's and rats, wild mice's, and voles) that lives in the vicinity of the settlements and which represents natural reservoir of illness. Epidemiological researches, especially in the environments such as mines, as one of the natural reservoirs, can be a significant indicator of frequency and development and this disease, which is one of the reasons why we choose to explore characterictics of the leptospirosys epidemic in the Mine "Stara Jama" in Zenica, and based on results and experience take adequate preventive actions in order to prevent some future occurrence of similar epidemic.

S. Uzunović-Kamberović, S. Durmišević, S. Tandir

In the Zenica-Doboj Canton, 1106 hepatitis A virus (HAV) infections were reported during 2000 (an incidence rate of 252/100 000 population), with 996 (90.1%) cases occurring in nine community-wide outbreaks. Analysis of water supplies showed that 398 (19.1%) samples contained coliforms, including 202 (50.8%) that were contaminated with thermotolerant Escherichia coli. Sewage sanitation systems were absent or substandard in 53 910 (81.8%) rural households. The group most affected during outbreaks comprised children aged 7-14 years (incidence rate of 598/100 000). The development of health promotion and prevention initiatives in schools, combined with rigorous hygiene measures, will be necessary to achieve control of the spread of HAV.

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