The National Institute of Public Health of Kosova (NIPHK) is the oldest and highest health, professional and scientific institution of Kosovo, which organizes, develops, supervises and implements public health policies in Kosovo. The NIPHK covers the entire territory of the Republic of Kosovo through its branches - Public Health Institutes (IPH) organized in these Regional Centers: Peja, Prizren, Mitrovica, Gjilan, Gjakova, Ferizaj.
The Balkan Peninsula is a hotspot for sand fly-borne phleboviruses (SbPVs), yet Kosovo had no confirmed viral detection invectors despite serological evidence of human and animal exposure. This study reports the discovery, genetic characterization, and seroprevalence of a novel phlebovirus, Grapi virus (GRPV), in Kosovo. Entomological surveys (2022-2023) collected 3,575 sand flies across seven districts. Morphological and molecular identification revealed Phlebotomus perfiliewi as the dominant species. Pan-phlebovirus RT-PCR screening identified GRPV in seven pools. Complete genome sequencing confirmed its tripartite genome, sharing 97.55-98.70% nucleotide identity with Bregalaka virus, classifying it within the Phlebovirus adanaense species. Phylogenetic analysis revealed segment-specific ancestry, suggesting recombination events between Bregalaka virus, Adana virus, and Medjerda Valley virus. Seroprevalence studies using neutralization assays detected GRPV-specific antibodies in 13.0% of humans and 2.7% of dogs. Human seropositivity peaked in adolescents and declined with age, while dogs showed higher rates in purebred and unhealthy ones. No cross-reactivity with Toscana or Sicilian viruses was observed, indicating distinct immunological responses. GRPV replicated efficiently in Vero cells and more slowly in mosquito cells, suggesting mammalian adaptation. GRPV detection in Kosovo underscores the role of the Balkan region in SbPV emergence. GRPV zoonotic potential is supported by the anthropophilic feeding behaviour of Ph. perfiliewi and by the significant seroprevalence rates in dogs and humans. Limitations include biased human/dog sampling and sparse northern Kosovo coverage. Investigating GRPV pathogenicity and ecology; integrated surveillance and diagnostics are essential for the future.
Introduction: From 12 March 2020, when the first cases of COVID-19 were registered in Kosovo, to 9 March 2023, there were a total of 273,310 reported cases of COVID-19 and 3211 reported deaths in Kosovo (CFR: 1.17%). Health care workers (HCWs) have been at a higher risk of contracting SARS-CoV-2 infection; nevertheless, data on seroprevalence of SARS-CoV-2 antibodies among HCWs in Kosovo are very limited. Methodology: A cross-sectional serology study with 1654 healthcare professionals throughout Kosovo was conducted to determine the presence of antibodies against the spike antigen of SARS-CoV-2. In addition, a structured questionnaire was administered to study participants to obtain basic demographic data, and information on prior infection and COVID-19 vaccination status. Results: Antibodies against the spike antigen of SARS-CoV-2 were detected in almost all (99.8%) HCWs that participated in the study. The average antibody titer was 8030.8 AU/mL in women and 9533.7 AU/mL in men. Sixty-four percent of HCWs in this study reported prior infection with SARS-CoV-2, 6% of whom were hospitalized. Over 98% of study participants had received SARS-CoV-2 vaccination. Conclusions: Almost all HCWs participating in the study had antibodies against the spike antigen of SARS-CoV-2. This is most probably the result of the high COVID-19 vaccination rate in Kosovo as well as infection with SARS-CoV-2.
In Europe, phleboviruses are transmitted by phlebotomine sand flies, which are widely distributed in the Mediterranean basin, including the Balkan peninsula. We report the identification and isolation of Mirusha virus (MRSHV), a novel member of the Phlebovirus corfouense species within the Phenuiviridae family, based on a > 95% genetic identity at the aminoacid level for Large segment between MRSHV and Corfou virus. MRSHV was isolated from a Phlebotomus perfiliewi sand fly specimen collected in Kosovo in 2022. Whole genome sequencing of MRSHV the characteristic trisegmented genome architecture of phleboviruses. Mammalian cells, including green monkey cell lines, were susceptible to MRSHV, with limited replication in dog macrophage cells, whereas no replication was observed in mosquito cell lines, suggesting a vector-specific adaptation. Specific neutralizing antibodies were detected in dogs (2.0%) and in humans (0.8%) from various regions of Kosovo, indicating a broader geographic circulation. Our findings describe a previously uncharacterized phlebovirus and underscore the importance of considering sand fly-borne phlebovirus infections in cases of undiagnosed febrile illness during the vector-active season, as well as expanding arbovirus surveillance to include hematophagous arthropods beyond mosquitoes.
Polymethylmethacrylate (PMMA) bone cement is a commonly used material in total hip arthroplasty (THA) intervention procedures due to its ability to provide mechanical stability. However, as any other external material implanted in the organism, it imposes certain risks for potentially provoking inflammatory and acute allergic reaction. This study aimed to investigate the organism's systemic inflammatory response in patients undergoing cemented versus uncemented THA. This prospective study included 58 patients aged 72.9 ± 8.8 years (37 females) undergoing primary THA. Participants received either cemented or uncemented femoral stems based on preoperatively established clinical criteria. Serum levels of histamine, CRP, ESR, IL-6, and TNF-α were assessed at two time points: preoperatively and 24 h postoperatively. Postoperative levels of all inflammatory biomarkers increased significantly compared to the baseline assessments (p < 0.001). Patients receiving PMMA bone cemented implantations showed significantly higher levels of histamine and TNF-α (p < 0.001), IL-6, CRP (p = 0.001) and ESR (p = 0.002) compared to the uncemented group. The increase was more pronounced in biological females for IL-6, ESR and CRP. Cemented THA using PMMA bone cement implantation is associated with a stronger systemic inflammatory response compared to uncemented procedures, particularly among female patients. These findings underscore the importance of considering biomaterial-induced inflammation in both surgical planning and postoperative monitoring. Further large-scale, longitudinal studies should follow to evaluate the clinical significance of these immunological changes.Trial is registered at the ClinicalTrials.gov (29/04/2019; ID: NCT03930537) while being part of a series of investigations on the implantation of hip prosthesis encompassing the PhD of Dr. Skender Ukaj.
BACKGROUND:Few studies have evaluated COVID-19 vaccine effectiveness (VE) in middle-income countries, particularly in eastern Europe. We aimed to estimate COVID-19 VE against SARS-CoV-2-confirmed hospitalizations and severe outcomes in Kosovo. METHODS:We conducted a test-negative case-control study using data from Kosovo's severe acute respiratory infection (SARI) sentinel surveillance system from January 2022 to June 2024. We enrolled adult patients aged ≥ 18 years hospitalized with SARI. From all patients, we collected clinical data, vaccination history, and a nasopharyngeal specimen, which was tested for SARS-CoV-2 using RT-PCR. SARS-CoV-2-positive patients were cases; those testing negative were controls. We estimated VE overall and against severe outcomes (requiring oxygen, intensive care admission, or in-hospital death) using logistic regression, adjusting for age, sex, and comorbidities, calculating VE as (1-adjusted odds ratio) × 100. RESULTS:We included 564 SARI patients; 218 (39%) tested positive for SARS-CoV-2. Overall, 24% of SARI patients had received at least one COVID-19 vaccine dose in the previous 12 months. VE against SARS-CoV-2-confirmed SARI hospitalization among all adults was 72% (95% CI: 30%-89%) at 14-179-day postvaccination, and 26% (95% CI: -33%-59%) at 180-364 days. In adults ≥ 60 years, VE was 52% (95% CI:-31%-82%) at 14-179-day postvaccination, and -36% (95% CI: -190%-36%) at 180-364 days. VE against severe outcomes was 67% (95% CI: -14%-91%) at 14-179 days, and 17% (95% CI:-111%-67%) at 180-364 days. CONCLUSIONS:Our findings suggest that COVID-19 vaccination in Kosovo offered substantial protection against hospitalization and severe outcomes within 6 months, though confidence intervals were wide for some subgroups. Effectiveness waned after 6 months, highlighting the need for periodic booster doses.
