A large outbreak of tularemia occurred in Kosovo in the early postwar period, 1999-2000. Epidemiologic and environmental investigations were conducted to identify sources of infection, modes of transmission, and household risk factors. Case and control status was verified by enzyme-linked immunosorbent assay, Western blot, and microagglutination assay. A total of 327 serologically confirmed cases of tularemia pharyngitis and cervical lymphadenitis were identified in 21 of 29 Kosovo municipalities. Matched analysis of 46 case households and 76 control households suggested that infection was transmitted through contaminated food or water and that the source of infection was rodents. Environmental circumstances in war-torn Kosovo led to epizootic rodent tularemia and its spread to resettled rural populations living under circumstances of substandard housing, hygiene, and sanitation.
Background:Antimicrobial resistance is becoming a major public health challenge
worldwide, caused primarily by the misuse of antibiotics. Antibiotic use is
closely related to the knowledge, attitudes and behaviour of a
population.Objective:The objective of this study was to assess the level of knowledge, attitudes
and practices about antibiotic use among the general public in Kosovo.Methods:A cross-sectional face-to-face survey was carried out with a sample of 811
randomly selected Kosovo residents. The methodology used for this survey was
based on the European Commission Eurobarometer survey on antimicrobial
resistance.Results:More than half of respondents (58.7%) have used antibiotics during the
past year. A quarter of respondents consumed antibiotics without a medical
prescription. The most common reasons for usage were flu (23.8%),
followed by sore throat (20.2%), cold (13%) and common cold
(7.6%). 42.5% of respondents think that antibiotics are
effective against viral infections. Almost half of respondents
(46.7%) received information about the unnecessary use of antibiotics
and 32.5% of them report having changed their views and behaviours
after receiving this information. Health care workers were identified as the
most trustworthy source of information on antibiotic use (67.2%).Conclusion:These results provide quantitative baseline data on Kosovar knowledge,
attitudes and practice regarding the use of antibiotic. These findings have
potential to empower educational campaigns to promote the prudent use of
antibiotics in both community and health care settings.
* This designation is without prejudice to positions on status, and is in line with UNSCR 1244/99 and the ICJ Opinion on the Kosovo declaration of independence.
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