COVID-19 in the Federation of Bosnia and Herzegovina: Strengthening the public health surveillance using a web-based system to inform public health response, March 2020 - March 2022.

In response to the significant public health threat caused by coronavirus disease (COVID-19), real-time surveillance, containment, and mitigation measures were implemented in the Federation of Bosnia and Herzegovina (FBiH). Our objective was to describe the surveillance methodology, response measures, and epidemiology of COVID-19 cases in FBiH from March 2020 to March 2022. The surveillance system implemented across FBiH enabled health authorities and the population to monitor the development of the epidemiological situation, the daily number of reported cases, as well as basic epidemiological characteristics and geographic distribution of cases. As of 31 March 2022, 249,495 cases of COVID-19, and a total of 8,845 deaths were recorded in FBiH. Upkeeping of real-time surveillance, maintaining non-pharmaceutical interventions, and speeding up the vaccination roll-out were paramount for controlling COVID-19 in FBiH.

Household transmission of SARS-CoV-2: a prospective observational study in Bosnia and Herzegovina, August-December 2020.

BACKGROUND: The secondary attack rate (SAR) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was estimated, and the risk factors for infection among members of households with a coronavirus disease 2019 (COVID-19) index case were identified to inform preventive measures. METHODS: Between 3 August and 19 December 2020, a household transmission study was implemented based on a standardized World Health Organization protocol. Laboratory-confirmed cases of SARS-CoV-2 infection were recruited through the federal COVID-19 database. Trained contact tracers interviewed index cases and household members to collect information on demographic, clinical and behavioural factors. Contacts were followed up for 28 days to identify secondary infections. SAR was estimated and odds ratios (OR) were calculated for risk factors for transmission. RESULTS: In total, 383 households and 793 contacts were included in this study. The overall SAR was 17% [95% confidence interval (CI) 14-21]. Contacts had higher risk for infection if the primary case had both cough and runny nose (OR 4.31, 95% CI 1.60-11.63), if the contact was aged 18-49 years (OR 4.67, 95% CI 1.83-11.93), if the contact kissed the primary case (OR 3.16, 95% CI 1.19-8.43), or if the contact shared a meal with the primary case (OR 3.10, 95% CI 1.17-8.27). CONCLUSIONS: These results add to the global literature by providing evidence from a middle-income setting. Standard preventive measures in households with positive cases remain critical to reduce transmission.