Screening of Chronic Diseases and Chronic Disease Risk Factors in Two Rural Communities in Kosovo

By Gorgieva, Gordana Subaric; Stasevic, Zvonko et al. | Central European Journal of Public Health, June 2010 | Go to article overview

Screening of Chronic Diseases and Chronic Disease Risk Factors in Two Rural Communities in Kosovo


Gorgieva, Gordana Subaric, Stasevic, Zvonko, Vasic, Suzana, Ristic, Slavica, Lezaic, Visnja, Djukanovic, Ljubica, Central European Journal of Public Health


SUMMARY

Background: A cross-sectional study was carried out in Velika Hoca and Orahovac, two rural communities in Kosovo and Metohia, with the aim of assessing the prevalence of chronic diseases and associated risk factors.

Methods: The study involved 423 (180 male) adult inhabitants aged 51±16 years and included an interview, medical documentation, physical, ultrasound, laboratory examinations and ECG.

Results: Hyperlipidemia was the most frequent (70%) risk factor followed by alcohol consumption (47%), hypertension (42%), smoking (36%) and obesity (32%). Ischemic heart disease was diagnosed in 25 patients, hypertensive cardiomyopathy in 17, other cardiomyopathies in 5 and arrhythmia in 20 patients. Nine persons had chronic obstructive pulmonary disease. Previously diagnosed liver cirrhosis occurred in 5 and chronic hepatitis in 8 subjects, while liver steatosis with elevated serum transaminases (22 persons), elevated transaminases with normal ultrasound (20 persons), tumor or suspected tumor (7 persons) were detected in the survey. Gastrointestinal symptoms were the most prevalent but peptic ulcer and gastritis had been previously diagnosed in 64 and 47 patients. Kidney and urinary tract diseases were known for 52 patients (12 with chronic renal failure and 4 on hemodialysis) and 46 more were detected in the study. Among them in 22 patients with markers of kidney disease and unclear diagnosis 12 had a positive family history, 8 low-grade proteinuria, 14 tubular dysfunctions and 7 eGFR (estimated glomerular filtration rate) below 60 ml/min/1.73 m^sup 2^.

Conclusion: In the Serbian enclave of Velika Hoca and Orahovac the prevalence of cardiovascular diseases was similar to that of gastrointestinal, liver and kidney diseases. This differs from other parts of Serbia where cardiovascular disorders are the leading cause of disease burden.

Key words: chronic disease prevalence, rural community, Kosovo and Metohia

INTRODUCTION

Chronic diseases are the most frequent cause of death all over the world. The global prevalence of all the leading chronic diseases (cardiovascular, cancer, chronic lung diseases, diabetes mellitus) is increasing, with the majority occurring in developing countries (1). Although chronic kidney disease is not among the first ten conditions in terms of disability and mortality, it is becoming a global public health problem due to the great increase of patients on renal replacement therapy (2). Chronic diseases share key risk factors and therefore preventive measures directed to all these risk factors as well as early detection and prevention of chronic diseases are measures that could diminish their increasing prevalence (1, 3).

The whole population of Serbia experienced many social and economic threats during 1990s but since then life under severe conditions has continued in Kosovo and Metohia. Meanwhile, it was unfeasible to devote adequate attention to the disease prevention. Nevertheless, during 2003, we have carried out a screening survey in the Balkan nephropathy focus of Vitina, where in spite of the dramatic demographic changes of the Serb population during the period 1 999-2000 high prevalence of kidney failure was found (4). In addition, physicians from the local primary care units in Velika Hoca and Orahovac have reported an increasing prevalence of patients suffering from chronic kidney diseases (5, 6). In order to confirm these data a cross sectional study was undertaken in Velika Hoca and Orahovac, two rural communities in a Serbian enclave situated in southwestern Kosovo and Metohia. Our team consisting of three doctors (two nephrologists, one cardiologist), two nurses, one laboratory technician and one driver, spent two months (July and August 2006), working in the health dispensary in Velika Hoca. The aim of the study was to assess the prevalence of risk factors for chronic diseases and to evaluate chronic disease burden with special attention to chronic kidney and urinary tract diseases in this population. …

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