Relationships between socioeconomic backgrounds, caries associated microflora and caries experience in 12-year-olds in Bosnia and Herzegovina in 2004.

AIM: To present the prevalence of dental caries in Bosnia and Herzegovina (BH), to estimate the levels of salivary mutans streptococci and lactobacilli and compare them with caries prevalence in 12-years-old children from different socioeconomic backgrounds. STUDY DESIGN AND METHODS: A survey was carried out in 8 cantons of the Federation of BH (FBH) and in Republic Srpska (RS) in 2004. The final sample included 560 12-year-olds. The clinical examinations focused on dental status, expressed as DMFT index, and they were carried out by one examiner, following WHO standard methodologies. Additionally, the study involved 109 12-years old children from Sarajevo, divided in three groups, based on their socioeconomic background. For measuring lactobacillus and mutans streptococci (MS) count in saliva Dentocult LB and Dentocult SM-Strip Mutans were used. Levels of MS and lactobacilli were expressed as a score between 0 and 3, indicating very low to very high levels of SM and lactobacilli. RESULTS: The average DMFT of the 12-year-olds was 4.16+/-2.92. On average, 91% of the 12-year-olds were affected with dental caries. The SiC Index was 7.41+/-3.31. Investigating the relationship between caries associated microflora and caries experience in children of different socioeconomic status showed the following: significant difference in caries prevalence was found in children with different living conditions, where children with high socioeconomic status had better oral health compared to the other two groups. For mutans streptococci, 25.7% of the children had mutans class 0, 24.8% class 1, 34.9% class 2 and 14.6% class 3. The mean DMFT for mutans class 0 was 3.50, for class 1 was 4.30, for class 2 was 5.62 and for class 3 was 6.0. For lactobacilli, 38.5% of the children had lactobacilli class 0, 25.7% class 1, 23.9% class 2 and 11.9% class 3. The mean DMFT for lactobacilli class 0 was 4.3, for class 1 was 4.9, for class 2 was 4.8 and for class 3 was 6.0. No significant differences in the level of mutans streptococci and lactobacilli were found between the groups. CONCLUSION: There is moderate caries prevalence among BH 12-year-olds (DMFT 4.16+/-2.92). Caries experience varies between children with different living condition but no relation between levels of salivary mutans streptococci and lactobacilli and socioeconomic status of children could be found.

Serotesting of human Q fever distribution in Bosnia and Herzegovina.

Q fever is a zoonotic disease with worldwide distribution. It occurs in different geographic regions and climate zones. From 1990 till the end of 1997, only three infected individuals were registered in Bosnia and Herzegovina, during the year 1991, with the incidence of 0.05% 000. From 1996 onward, there was a sudden aggravation of epizoological and epidemiological situation in particular regions of Bosnia and Herzegovina. We performed serotesting during the 4-year period from 2000 to 2003. We tested serum samples from 708 individuals from different regions of Bosnia and Herzegovina. Q fever was serologically diagnosed in 249 individuals. The overall seroprevalence was 35.2%. The acute disease form was confirmed in 79.9% of the whole seropositive sample. Most of the Q seropositive individuals were from Kakanj (17.3%), Mostar (15.3%), Sarajevo (12.5%), Bihac (9.6%), Zenica (9.2%), Gornji Vakuf (8.9%), Tesanj (4.4%), Visoko (2.8%), and Travnik (2.4%). The number and distribution of seropositive individuals suggests that Q fever is endemic in Bosnia and Herzegovina.

Public health problem of zoonoses with emphasis on Q fever.

Zoonoses are animal and human diseases. Q fever is primarily a zoonosis-an animal disease that can be transmitted to humans under certain conditions. Recent epidemiological studies suggest that Q fever should be considered as a public health problem in many countries where it is present, but unrecognizable due to inadequate disease controls. Through specific serological diagnosis of clinically suspected human Q fever cases, we are trying to determine a level of general Coxiella burnetii (C. burnetii) exposition among populations in different regions of Bosnia and Herzegovina. This would be a contribution in controlling the present and the future disease outbreaks, as well as its prevention, which is one of the prime objectives of public health. During the period from January to June 2004, in the Laboratory of the Department for Microbiology in the Medical Faculty of the University of Sarajevo, of 58 tested sera from 48 clinically suspected individuals, we confirmed the presence of specific anti-C. burnetii antibodies in 30 sera (51.7%), from 25 seropositive individuals (52.0%), by means of indirect immunofluorescent antibody (IFA) testing. Urgent steps must be taken in public education to help decrease the risk of C. burnetii infection among at-risk populations in regions of Bosnia and Herzegovina.

Significance of Q fever serologic diagnosis in clinically suspect patients.

Q fever is caused by C. burnetii, an intracellular obligate bacterium. For clinical confirmation of Q fever, diagnosis of interstitial pneumonia is of significance. The acute disease varies in severity from minor to fatal, with the possibility of serious complications. Chronic endocarditis is a well-known outcome. Symptoms of Q fever can vary; fixing diagnosis is done by serology with the phase I and the phase II antibody. We tested 44 sera of 31 clinically suspect patients. From these, 22 patients were taken to the infection clinic, 8 to the pulmonary clinic, and one to the general hospital. From the 31 patients, 21 patients had one serum, 7 patients, 2 sera, and 3 patients, 3 sera. Blood samples were collected by vein puncture, and serum samples were kept at -20 degrees C until testing. All sera were processed by indirect immunofluorescent assay (IFA) Q fever IgM and IgG. Of 44 processed sera, 21 were seropositive. Specific IgM antibody was found in sera of 6 patients (19.4%), and specific IgG antibody in sera of 16 patients (51.2%). In sera of 15 clinically suspect patients (48.3%), no specific anticoxiella antibody was found. From these results we can confirm the importance of serology in laboratory diagnosis and clinical affirmation of suspect Q fever. Indirect immunofluorescent assay (IFA) is reliable and appropriate for daily, routine diagnosis of human Q fever.

[Cytomegalovirus disease in immunocompromised patients]. / Citomegalovirusne bolesti kod imunokompromitiranih pacijenata.

Human Cytomegalovirus are a ubiquitous herpesvirus establishing virus-infections which are usually asymptomatic in immunocompetent individuals. In patients with Acquired Immunodeficiency Syndrome (AIDS) and immunocompromised hosts, the virus causes primary, latent or chronic persistent infection. Primary CMV infection is very severe in immunocompromised patients as well as among healthy population. Among patients with AIDS Cytomegalovirus (CMV) is usually isolated from patients specimen in association with other pathogens (Pneumocystis carinii, Candida albicans). The prevalence of serious CMV (chorioretinitis, gastrointestinal disease, interstitial pneumonia and central nervous system disease), in AIDS population are respectable.

[Serologic verification of epidemic hemorrhagic fever during the lifting of the blockade in Sarajevo]. / Seroloska potvrda epidemije hemoragicne groznice u toku deblokade Sarajeva.

OBJECTIVES: After four years of Sarajevo siege, the deblocade started on July 1995. Many soldiers involved in the deblocade developed a clinical symptoms of hemorrhagic fever indicating a possible epidemic. METHODS: Suspected patients were treated in the war hospital Igman-Fojnica. Blood samples of all the patients were processed on IgM and IgG antibodies with ELISA test, using "the double sandwich" technique. RESULTS: IgM and IgG were performed on Puumala (PVV), Hantaan (HTN) and Dobrava antigens. 38 out of 45 treated serums had high antibody titres. Sera of 28 patients had high titres of specific IgM antibodies on Hantaan antigen (12,800). A ten patients had a same titre level for specific antibodies of Puumala antigen. A 20 patients had specific IgG antibodies on Dobrava antigen with the titre 400. Our results confirmed the epidemic for which were responsible two serotypes of HFRS-PVV and HTN. They also proved the existence of a new serotypes appearing for the first time in Sarajevo region. This epidemic confirms that BiH especially Sarajevo region are among the biggest epidemic areas of HFRS in Europa.

[Evolution of laboratory technics in the detection of herpes simplex virus infections]. / Evolucija laboratorijskih tehnika za dokazivanje herpes simplex virusnih infekcija.

In this report we proved that all of three methods for laboratory diagnosis of HSV infections which we used, have approximately the same degree of sensibility. Even though there is no statistically significant differences among sensibility of chosen methods, we think that IF test by monoclonal antibodies is the most suitable method for the routine work, in consideration of the high sensibility, typical specificity and fast results.