Browsing by Author "Jovanovic, M. (56765272500)"

SETTING: The Institute for Pulmonary Diseases of Serbia, which specialises in diagnosis and treatment of lung diseases in a region with approximately 550-600 TB admissions per year. OBJECTIVE: To assess the occupational risk of tuberculosis (TB) among health care workers (HCWs) employed at this institution. DESIGN: Retrospective analysis of morbidity of TB among HCWs over a 12-year period (1986-1997). The incidence of TB among HCWs was estimated by the frequency of bacteriologically or histologically confirmed active disease. All HCWs at our institution underwent routine pre-employment screening, consisting of verification of BCG vaccination, PPD tuberculin reactivity, chest X-ray and laboratory evaluation. RESULTS: Of an average 267 employed HCWs, pulmonary TB occurred in nine (six nurses and three laboratory technicians). Cumulative incidence for HCWs was 3451/100000, compared to 454/100000 in the general population, for an incidence rate ratio of 7.6. CONCLUSION: The risk of TB among HCWs employed at the Institute for Pulmonary Diseases of Serbia in Belgrade is 7.6 times higher than that observed in the general population, suggesting occupational acquisition of TB.

OBJECTIVE: To estimate tuberculosis incidence and mortality trends in Central Serbia (excluding Kosovo and Vojvodina provinces) in the period 1956- 1996. DESIGN: The incidence and mortality data of tuberculosis in Central Serbia in the period 1956-1996 were analysed based on the annual reports of the Institute for Lung Diseases and Tuberculosis in Belgrade and the official data of the Republic Health Institute. RESULTS: During the period under observation, tuberculosis incidence decreased from 324.0 to 34.8/100000 population, fitting the exponential model (y = 389.066e -0.0689 ; F = 847.60; P = 0.000). Mortality rates decreased from 76.0 in 1956 to 0.9/100000 in 1982. Over the whole period (1956-1996) the decrease in mortality rates fitted the exponential model (y = 66.83e -0.0922 ; F = 150.95; P = 0.000). The increase in mortality rates in the period 1982-1996 fitted cubic model (y = 7.647 - 2.674x + 0.359x 2 - 0.013x 3 ; F = 12.17; P = 0.001). CONCLUSION: Decreasing trends in tuberculosis incidence are the result of good control programmes. Changes in mortality trends are related to migration from war zones and poor economic conditions which hinder the detection and treatment of tuberculosis.