No abstract

Despite a small and unrepresentative sample, the results of this study indicate serious problems and significant risks associated with sexual behavior of children and young people who live and work in streets. This pilot study suggests that it is necessary to conduct new research on sexual behavior of street children and youth on a representative sample and with appropriate methodology. The results of a new study should be used to plan and carry out appropriate preventive measures regarding sexual behavior of street children.

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According to UNICEF, street child is any child under the age of 18 for whom the street has become home and/or source of income and which is not adequately protected or supervised by adult, responsible person. It has been estimated that there are between 100 and 150 million street children worldwide. Life and work on the street have long term and far-reaching consequences for development and health of these children. By living and working in the street, these children face the highest level of risk. Street children more often suffer from the acute illness, injuries, infection, especially gastrointestinal, acute respiratory infections and sexually transmitted diseases, inadequate nutrition, mental disorders, and drug abuse. They are more often victims of abuse, sexual exploitation, trafficking; they have higher rate of adolescent pregnancy than their peers from poor families. Street children and youth have higher rates of hospitalization and longer hospital stay due to seriousness of illness and delayed health care. Street children/youth are reluctant to seek health care, and when they try, they face many barriers. Street children are invisible to the state and their number in Serbia is unknown. Recently, some non-governmental organizations from Belgrade, Novi Sad and Nis have recognized this problem and tried to offer some help to street children, by opening drop-in centers, but this is not enough. To solve this problem, an engagement of the state and the whole community is necessary, and primary responsibility lies in health, social and educational sector. The best interests of the child must serve as a basic guideline in all activities aimed at improving health, quality of life and rights of children involved in the life and work in the street.

The study was done to show that in certain areas of paediatric pharmacotherapy unexpected discrepancies may arise between accepted therapeutic principles and the actual behaviour of a prescribing doctor. The first example was of a great reduction in penicillin use in a university teaching hospital after certain therapeutic accidents: in one year, there were 2 fatal cases of rhabdomyolysis due to use of procaine benzyl-penicillin. Other antimicrobial drugs inferior to penicillin, such as lincomycin and sulphonamides, replaced penicillins. The second example showed the inverse relationship between the use of antitussives and other drugs in symptomatic treatment of respiratory diseases in outpatients and inpatients; the pressure of unduly optimistic expectations of therapy imposes a high prescribing rate of these drugs in the outpatient population, in contrast to hospitalized patients, whose doctors, being spared such pressure, prescribe antitussives far less often. The third example demonstrates the possibility of inadequate education in the use of antimicrobial drugs. Although doctors from regional hospitals receive their training at an university hospital, they tend to prescribe chloramphenicol ten times more per bed-day than their colleagues in an university hospital. In terms of the cost/effectiveness ratio, a high prescribing rate of cephalosporins is not economically favourable in a university teaching hospital. It is also shown that studies of drug utilization in children are feasible if age--appropriate adaptation of the statistical value expressed as the defined daily dose is performed. The adaptation was evaluated by comparing pharmacy-based drug consumption data expressed in "paediatric defined daily doses", with actual days of treatment with particular drugs, i.e. data from patient records for 244 beds in the University Teaching Hospital.

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Considering the fact that adolescent engagement in risky behaviours significantly affects adolescent morbidity and mortality, it is essential to implement comprehensive preventative programmes, which should include all adolescents before they start to engage in risky behaviours. In this process, the most important role belongs to the family. However, the entire community, schools, and health workers, should also play an active part.

SUMMARYSera of 1000 persons in Voyvodina were tested with radioimmunoassay for antibodies against hepatitis A virus (HAV).The morbidity and age incidence of positive findings have been analysed and compared with relevant findings in other countries. Below the age of 19 years the morbidity rates are higher (0.138 to 0 595 per mill) and the prevalences of seropositives are lower (17.1-64-0%) than the respective frequencies above that age (0.011 to 0-052 per mill and 85-7-98-7 % respectively). Below the first year of life seropositivity is more frequent than in 1-to 14-year old children. After the first year until the age of 30-39 years the frequency of seropositives increases with increasing age up to a maximum of about 90 %.