Changes in nutrition among residents and refugees in Sarajevo during the war.

OBJECTIVE: To assess how food shortage has been reflected in changes in nutritional status and dietary intake of resident and refugee populations in wartime Sarajevo. DESIGN: Longitudinal observations were carried out on residents (who stayed in their homes) and refugees (living in collective centres). Three out of four municipal areas of Sarajevo were covered in the sample and households and collective centres in close proximity to the homes of fieldworkers were selected. The same households were visited in October 1992-March 1993 and November 1993-January 1994. SETTING: The study took place in besieged Sarajevo. SUBJECTS: In the first round 362 households (170 resident and 192 refugee) were visited and in the second round 324 households (146 resident and 178 refugee) were visited. INTERVENTIONS: Nutritional information was gathered through anthropometric measurements, medical examination and questionnaires which included a seven day dietary recall. RESULTS: Nutritional status was assessed by calculating body mass index (BMI) (weight/height2) in adults and weight for age percentiles in children (2-18 years of age). Undernutrition in adults was defined as BMI < 18.5 and in children as weight for age < 25th percentile. Results from the first round of data collection showed a higher level of undernutrition among refugees (15.0%) compared to residents (5.3%). The second round revealed higher levels of undernutrition among residents (8.1%) than refugees (7.0%). Daily energy intake in the first round met only half recommended dietary allowances for the former Yugoslavia which is 2700 kcals per day. Refugees were found to consume slightly higher quantities of energy (1500 kcals) compared to residents (1272 kcals). In the second round, energy intake had increased both among refugees (1832 kcals) and residents (1630 kcals). CONCLUSIONS: The population of Sarajevo have been forced to eat a monotonous diet during the war which is deficient both in quantity and quality. Nevertheless the nutritional status of the resident and refugee populations has been maintained. Dietary intake was found to be low but this may have been partly due to under-reporting. The accuracy of data obtained through dietary intake surveys in emergency conditions may be questionable.

Nutrition in pre-war Sarajevo.

OBJECTIVE: To assess nutritional status, dietary intake and lifestyle habits of non-manual workers in Sarajevo. DESIGN: Healthy employees in non-manual occupations from four large companies were invited to participate in a nutrition and health survey during 1990 and 1991. SETTING: All the subjects were working in the city centre of Sarajevo. SUBJECTS: 1860 subjects (1120 men and 740 women) aged from 20-65 years of age participated. INTERVENTIONS: Nutritional status was evaluated through anthropometric measurements (weights and heights) and body mass index (BMI) was calculated. Data on health status, diet and lifestyle were gathered through individual questionnaires. RESULTS: Overall, 4.3% of the sample was found to be underweight (BMI < 18.5). Nearly 12% of women and 5.5% of men were obese (BMI > 30.5). The majority of the obese men were in responsible positions (for example, directors, heads of departments). The majority of obese women were in the 35-45 years old age group in the post-maternity period. Intakes of energy, protein, fat and carbohydrate exceeded former Yugoslavian recommended dietary allowances. About one third of participants (34.3% men and 27.3% women) smoked heavily and 18.1% of men drank alcohol. A total of 16.2% of men and 11.6% of women suffered from hypertension. CONCLUSIONS: The food intake of the population of Sarajevo before the war was generally high. There was high consumption of meat, fatty foods and alcoholic drinks (particularly among men) and low levels of physical activity. This resulted in high levels of obesity and chronic degenerative diseases such as hypertension. Thus, high living standards and physical inactivity had a damaging effect on the health of non-manual workers in pre-war Sarajevo.

[Postoperative contamination of wounds April-September 1992]. / Ispitivanje postoperativnih kontaminacija rana u periodu april-septembar 1992. godine.

In this paper we have analyzed random sample of 108 nosocomial infections at a surgical services of Clinical Center of University and a State Hospital in Sarajevo during april-september of 1992. The overall rate of nosocomial infections of postoperative wound was 69.45%. Gram negative bacterias were more frequently isolated then gram positive bacteria. Pseudomonas aeruginosa was detected at 20.37% of all wound infections, E coli and Klebsiella Sp. with 12.96%, and Staphylococcus pyogenes with 12.03%. Without a continuous germ control of the hospital flora no calculated antibiotic is possible. Pseudomonas has emerged as an important nosocomial pathogen and this suggest that the epidemiology of nosocomial infections differs from epidemics infections.