engleski

Prevalence of endemic (Balkan) nephropathy and urothelial cancers in Croatia

The estimation of the specific dynamics of endemic nephropathy (EN) in the endemic area of Brodska Posavina is facilitated by medical surveillance of the population over several decades, frequent large-scale field screening, almost unvaried diagnostic criteria and uniform files in this region.In the last 25 years, approximatly 70% of inhabitans from 13 Croatian endmeic villages (10, 865 individuals) were examined several times using the WHO criteria. In the period 1980-1991, the mean prevalence for the entire region was 1, 3%, and ranged from 0, 4-2, 3% for each village. Between 1991 and 2002 average mortality in the endemic region was 10, 3/1000 and the specific mortalithy for pathientswith EN was 0, 65/1000. The average age at death of patients with EN was 69, 2 years, which is similar to the rest of the population in the county (67, 8). The specific mortality of all patients with cancer of the pyelon and ureter was 14 times higher in the endemic region than in Brodsko-posavska county and 55 times higher than in Croatia overal. In the spring of 2005, 1081 inhabitans of three endemic villages (Kaniža, Bebrina, Banovci)and control nonendemic village of Klakar were examined using the same criteria, and persons were divided as folows: having the disease of EN ; suspected of having EN ; at risk of EN ; and the others inhabitans. Among the 1081 persons, we found 25 with EN (12 men and 13 women). This group consisted of autohtonous Croats as well as Ukrainian immigrants. The prevalece of EN was 0, 6% in Kaniža, 2, 1% in Bebrina, and 2, 3% in Banovci, while the prevalence of suspected EN was twice or three times higher. One fifth of the inhabitans were at risk of having EN. The disease has not vanished in any of the endemic villages. This epidemiologic survey found that the prevalence of EN in three endemic villages a serious health problem in Brodsko-posavska county.In addition to medical and scientific examinations, we will need help in elucidating the ethiology of EN as well as in improving the treatment of this poor rural population.

ndemic Nephropathy; Urothelial cancers; epidemiology; Croatian focus

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