Technical Factors Influencing the Health Information System in Kosova.

Background: Health information systems (HIS) are considered a vital tool to strengthen Low- and Middle-Income Countries' (LMIC) health systems. Unfortunately, little is known about the technical factors of HIS in LMIC. Objective: This study aimed to make an empirical contribution, using the case of Kosova to find out about HIS development, trying to identify dysfunctional areas and opportunities for improvement. Methods: Technical factors of the PRISM framework were analyzed via document analysis, and semi-structured interviews were held with 15 respondents from the Ministry of Health, the National Institute of Public Health of Kosova, and the Hospital Clinical University Services of Kosova. Interviews were transcribed and coded deductively, using the defined theoretical framework to guide the content analysis. Results: The results indicate that MoH considered technical factors while developing HIS in Kosova. Nevertheless, HIS fulfills only some of the essential functions. Barriers to efficient HIS among technical factors are lengthy, time-consuming manual HIS forms, inadequate data from HIS forms for NIPHK analysis, difficulties when changing software and HIS economic operators, and the complexity of HIS functioning. Conclusion: Kosova still faces technical difficulties with an efficient and sustainable HIS system. Complex processes of extensive efforts have yet to produce the desired results, which prevent evidence-based health analysis and informed decision-making in Kosovar healthcare. More research is needed into organizational and behavioral factors influencing HIS efficiency in LMIC.

Meaning-Making of War Experiences: Stories From Kosova.

The research evidence shows that war had many detrimental effects on the mental health, wellbeing, and social functioning of the people of Kosova, which is similar to the findings in many other postconflict societies. However, there are few studies focusing on the process of meaning-making of war experiences and their impacts on resilience and growth. This phenomenological study aimed to explore the lived war experiences of citizens of Kosova from the perspectives of three generations (grandparents, parents and children) through semistructured interviews, which were conducted with 37 participants. Thematic analysis revealed that the journey of the meaning-making of war experiences in Kosova is rather dynamic and reflects the context in which each generational cohort lived and grew. The findings provide a deeper understanding of the strategies used by each generation for meaning-making and how these strategies contributed to resilience and growth. The implications for mental health counselors, social workers, and policymakers are discussed.

The use of dental amalgam and amalgam waste management in Kosova: An environmental policy approach.

Dental amalgam from dental clinics in Kosova is an uncontrolled source of mercury. The environmental legislative framework related to its use does not fully provide measures that reduce amalgam use and the release of its waste into the environment. This paper highlights issues related to environmental policy covering mercury amalgam waste management. Existing national regulations on hazardous waste management in Kosova consider the waste from dental health care as hazardous. Currently, however, no regulations restrict the use of dental amalgam or specifically oblige the generators of amalgam to treat or dispose of waste properly, thus leading to inconsistent legislation. New regulations, revised hazardous waste management standards, and new infrastructure for waste treatment and disposal, in compliance with EU regulations, should be developed to create a holistic approach that prevents the adverse effects of amalgam waste. Integr Environ Assess Manag 2021;17:1037-1044. © 2021 SETAC.

Role of MRI in Diagnosis of Ruptured Intracranial Dermoid Cyst.

INTRODUCTION: Intracranial dermoid cystic tumors account for <1% of all intracranial masses. CASE REPORT: A 52-year-old male, having headaches, nausea and is presented with a history of 2 episodes of new onset seizures. On presentation, the patient had a normal physical exam, including a complete neurological and cranial nerve exam. METHODS: Precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D - HI-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W, Flash/T2W oblique coronal plane, GRE/T2W axial. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping, postcontrast: TSE/T1W sequence in axial, coronal and sagittal planes. RESULTS: Subsequent MRI of the brain revealed an oval and lobulated 47x34x30mm (TRxAPxCC) non-enhancing T1-hyperintense mass in right cavernous sinus, with compression of surrounding mesial temporal lobe and right anterolateral aspect of mesencephalon. Findings are consistent with ruptured dermoid cyst, given the evacuated sebum content at its lower half. Sebum particles in millimetric sizes are seen within right Sylvian fissure, anterior horns of lateral ventricles and to a lesser extent within left Sylvian fissure, right parietal sulci, cerebral aqueduct, and basal cisterns. No restricted diffusion is seen, eliminating the possibility of epidermoid. A shunt catheter is evident traversing between right lateral ventricle and right parietal bone; besides, slit-like right lateral ventricle is noted (likely secondary to over-draining shunt catheter). CONCLUSION: Intracranial dermoid cysts are benign rare slow-growing tumors that upon rupture, however, widespread presence of T1 hyperintense droplets and leptomeningeal enhancement can be noted-making MRI the best imaging modality for diagnosis of this rare entity.

Smoking Behaviors in Kosova: Results of Steps Survey.

INTRODUCTION: Tobacco use continues to be the leading global cause of preventable death. Most of these deaths occur in low and middle-income countries, and this trend is expected to widen further over the next several decades. The overall objective of the study is to describe and analyse the smoking behaviours of adults in Kosova. METHODS: According to the STEPs methodology, 6,400 respondents, aged 15 - 64 years, are selected randomly within each sex and 10-year age-group. Out of 6,400 participants, 6,117 were selected, which is approximately 95.6%. RESULTS: The prevalence of smoking was higher among males (37.4%) compared with females (19.7%). In all age groups, the prevalence of smoking was higher among males compared with females. Regarding the age group of 15 - 24 years, the prevalence of smoking was 16.0%, but in the age group of 25 - 34 years, it nearly doubled to the rate of 31.9%. We have a smaller increase in the age group of 35 - 44 years, and after the age of 45, it falls gradually. CONCLUSIONS: The prevalence of smoking in Kosova is high compared with other countries in Eastern Europe. In future decades, Kosova will face a high probability of an increased burden of smoking-related diseases.

Knowledge, Attitudes and Practices of Mothers in Kosova About Complementary Feeding for Infant and Children 6-24 Months.

AIM: This cross sectional study assessed knowledge, attitudes and practices regarding complementary feeding among mothers with children between 6-24 months at the national level. METHODS: The sample of 492 mothers with children between 6-24 months, with a confidence level of 95%, the acceptable margin of 5%, the expected prevalence of 50% knowledge and effect of 1.3, were interviewed from all regions, in all Kosovo. Data were analyzed using SPSS version 17.0 and presented using descriptive and inferential statistics such as Chi-square with significance level set at 5%. RESULTS: Overall, 88.4% of respondents had good knowledge of complementary feeding, while only 38.4% of mothers had good practices regarding time for starting complementary feeding. We found association between maternal knowledge and level of education for complementary feeding. CONCLUSION: There is a need to further explore the factors responsible to improving practices for complementary feeding.

PATIENTS' SATISFACTION WITH HEALTH SERVICES AT THE NATIONAL INSTITUTE OF PUBLIC HEALTH OF KOSOVA.

AIM: Purpose of the research is to assess patient satisfaction with the quality of health services provided in National Institute of Public Health of Kosova. METHODS: Study was observational and cross-sectional. Interviews were conducted with 625 clients of IPH. Inclusion criteria for enrollment in the study were patients above 18 years old, with verbally informed consent. RESULTS: In our study, access to IPH, efficacy, patient-provider interpersonal communication, and explanations regarding procedures, readiness to answer to patients need and physical settings and appearance are valued satisfactorily whereas cleanliness was rated with minimal grades. Evaluated 12 quality components, were scored with average mark 3.6. CONCLUSIONS: SWOT analysis, and fishbone diagram should be used on regular bases and a new position for a manager for administrative issues, is opened, complaints box and list of rights and responsibilities of patients were dislocated in a more visible place, and internal staff turnover, is introduced.

Effects of pollutants from power plants in Kosova on genetic loads of Drosophila melanogaster.

It has been reported by the Ministry of Environment in Kosova that particle emissions from one of the units of the coal-fired power plants (Kosova A) in Kastriot/Obiliq were exceeding the European standard by some 74 times. Besides the particle emission, there is also release of sulphur dioxide, mono-nitrogen oxide (NOx), carbon monoxide, carbon dioxide, organic compounds and heavy metals. In addition, there is also release of heavy metals and organic compounds from a nearby solid waste dumpsite. Together, they are considered to be responsible for the increased health problems of the population living in the vicinity.To study the genetic effects of these emissions we focused on the genetic load, that is, recessive mutations that affect the fitness of their carriers, of exposed wild living Drosophila melanogaster The effects of ash from the dumpsite on the other hand were investigated upon feeding the ash with the nutrient medium. Our results revealed that the D. melanogaster population from the Kastriot/Obiliq area carries a high genetic load of 54.7%. Drosophila fed with the nutrient medium containing ash in a concentration of 1% carried a genetic load of 37.1%, whilst increasing concentrations (2% and 3% of ash) led to higher genetic loads of 68.7% and 67.4%, respectively.

Mental health problems in Kosovar adolescents: results from a national mental health survey.

PURPOSE: Our purpose was to determine the effects of gender and age on Kosovar YSR scores and the prevalence of self-reported behavioral/emotional problems in Kosovar adolescents based on scores above a cutpoint. METHODS: Participants were 1351 adolescents recruited from secondary schools in seven regions of Kosova who completed the Youth Self-Report. RESULTS: The oldest adolescents had the highest scores on many YSR scales. Although Kosova's mean problems scores were not elevated relative to international norms, the percentage of adolescents scoring in the deviant range (borderline + clinical) was much higher than expected for almost all YSR problem scales, including Total Problems (31.2%), Internalizing (40.8%), and Externalizing (23.4%). The 23% prevalence of elevated scores on Stress Problems was triple the expected 7% prevalence based on a 93rd percentile cutpoint. CONCLUSION: Results revealed much higher prevalence of psychopathology than would be expected based on international norms, with 25-40% of Kosovar adolescents scoring in the deviant range on YSR scales, Thus, our research indicates a need for expanding psychiatry services to meet the pressing mental health needs of Kosovar adolescents as well as the importance of considering mental health problems in their social context.

Acute arthritis in crimean-congo hemorrhagic Fever.

Crimean-Congo hemorrhagic fever is a severe viral disease caused by a Nairovirus. An atypical manifestation in the form of acute arthritis was found in a confirmed Crimean-Congo hemorrhagic fever virus Kosova-Hoti strain positive patient. Acute arthritis in Crimean-Congo hemorrhagic fever (CCHF) may be as a result of immune mechanisms or the bleeding disorder underlying CCHF.

Characteristics of rotavirus diarrhea in hospitalized children in kosovo.

BACKGROUND: Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. METHODS: This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the specially designed form. RESULTS: 116 children with rotavirus diarrhea are included in the study. The majority boys (74.4%) and children aged 0 - 12 months (82.75%). Mean age of children in the study was 16.38 months. Almost every third child in the study was hypotrophic (29.2%). More than half of the infants (55.2%) were on mixed food, somewhat more than every third was breast feeding (36.45%), and every twelfth (8.33%) was on artificial milk (animal or formula). Apart from diarrhea, present in all patients, vomiting (97.41%) and fever (43.96%) were characteristics of the clinical presentation of the diarrhea. Two thirds of the children had mild grade dehydration (70.7%). All patients recovered with no sequels. CONCLUSION: Rotavirus continues to be responsible for a significant portion of acute diarrhea in Kosovo. Clinical features, epidemiological data and the agglutination test are safe enough to establish the diagnosis. Treated correctly rotavirus diarrhea has a favorable outcome.

Epidemiological characteristics of tularemia in kosova in the period 2006-2011.

INTRODUCTION: Tularemia is an important zoonosis in Kosovo. The first cases of tularemia in Kosovo were reported in 1999 among civil population in the west part of Kosovo. Tularemia has become an important problem in Kosova after 1999. AIM: The aim of this study was to analyze the frequency and distribution of Tularemia in Kosovo in the period from 2006 to 2011, propose measures and activities for prevention and control of the disease. MATERIAL AND METHOD: In this descriptive, retrospective study, we used official reports on infectious diseases from National Institute of Public Health of Kosova (NIPHK), as well as epidemiological surveys. The data collected were analyzed and the corresponding statistical parameters were tested with SPSS for the level of significance for P<0.01 and P<0.05. RESULTS AND DISCUSSION: The morbidity rate over the study period ranged from 0.38 (2011) to 11.26 (2010) per 100000 inhabitants. We found statistical significance between years for the level of P<0.00001. (X(2)-test=387.5; DF=5; P<0.0001). The majority of tularemia cases occurred in female (59%) with statistical significance for P<0.001 (X(2)-test=16.07; DF=1; P<0.001) The peak of cases in age group 20-40 years, with 242 cases or 48%, with statistical significance for the level of P<0.0001 (X(2)-test=253.14; DF=3; P<0.001) The main route of human infection is consumption of no safety water from wells (50%). The majority of tularemia cases occurred in female in Kosovo with 59% of observed cases while in a study in Central Anatolia region 54.7% were female. CONCLUSION: Kosova is an endemic zone of this disease since 1954 where the first cases were registered. Tularemia is a zoonosis, so in order to avoid human infections it is very important to implement measures well as perform public health education activities.

Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova teaching hospital

Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacterbaumannii in the Central Intensive Care Unit (CICU) of a University hospital in Kosova using pulse field gel electrophoresis (PFGE). During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised. Twenty patients had ventilator-associated pneumonia, one patient had meningitis, and two had coinfection with bloodstream infection and surgical site infection. The most common diagnoses upon admission to the ICU were politrauma and cerebral hemorrhage. Bacterial isolates were most frequently recovered from endotracheal aspirate (86.7 percent). First isolation occurred, on average, on day 8 following admission (range 1-26 days). Genotype analysis of A. baumannii isolates identified nine distinct PFGE patterns, with predominance of PFGE clone E represented by isolates from 9 patients. Eight strains were resistant to carbapenems. The genetic relatedness of Acinetobacter baumannii was high, indicating cross-transmission within the ICU setting. These results emphasize the need for measures to prevent nosocomial transmission of A. baumannii in ICU.