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Differential Exposure to Borrelia spp. and Spotted Fever Group Rickettsia in Serbia and North Macedonia: A Comparative Study
(MDPI AG, 2025-08-17)
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Mateska, Sofija
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Najdovska, Marija
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Stamenkovska, Angela
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Pavleva, Verica
Several diseases caused by tick-borne pathogens, including Lyme borreliosis (LB) and spotted fever group rickettsioses, are endemic in the Balkan Peninsula, positioned between Central Europe and the Middle East. This cross-sectional study aimed to assess serological exposure to Borrelia spp. and spotted fever group Rickettsiae (SFGR) among individuals with recent tick bites and healthy controls in two Balkan countries-Serbia and North Macedonia. Serum samples from 223 participants were tested for anti-Borrelia and anti-SFGR IgG antibodies. SFGR exposure was significantly higher in tick-exposed individuals from Skopje (North Macedonia) compared to those from Novi Sad (Serbia) (30.9% vs. 8.0%; p = 0.003). In contrast, anti-Borrelia IgG was more frequently detected in Novi Sad, though differences did not reach statistical significance. The findings support a north-to-south gradient in Borrelia exposure and a reverse trend for SFGR, consistent with earlier studies and regional tick infection data. Given the high SFGR exposure and limited clinical reporting in North Macedonia, the results highlight the likelihood that tick-borne rickettsioses remain under-recognized. Additionally, Borrelia exposure in North Macedonia warrants further investigation. These findings emphasize the need for enhanced tick-borne disease surveillance, identification of endemic zones, and improved diagnostic and public health infrastructure in both countries.
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Health Financing and Expenditures in Balkan countries: the case of North Macedonia, Serbia, Bosnia and Herzegovina and Montenegro
(Macedonian Medical Association = Македонско лекарско друштво, 2025-04)
Vasilevska, Hristina
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Filipche, Milcho
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Introduction. The health financing model and health spending should meet the population health needs. The aim of this paper is to analyze and compare the financing of the health systems in the selected Balkan countries: North Macedonia, Serbia, Bosnia and Herzegovina and Montenegro. Material and method. Data from World Health Organization HFA-DB and World Bank has been used as well as from Health in Action Reports for the selected countries. Desk review of official documents and websites of government and health institutions and the literature has been applied. Results. All countries had a socialist system in Yugoslavia and the same health system. The system was reformed later in the transitional period. The Bismarck model of mandatory health insurance is dominant in all countries with recent reforms in Montenegro. Montenegro introduced major health insurance reforms, shifting from a contributions-based system to a fully tax-funded system. In North Macedonia Healthcare spending is relatively low compared to European Union (EU) and Southeastern European countries, current health expenditure as % of GDP is 8.5% in 2021. The health expenditures in 2021 in Bosnia and Herzegovina with 9.6% of GDP, in Serbia 10.01%, and in Montenegro 10.5% are at the level of the average of the European region and EU countries (10.95%). Out-of-pocket (OOP) payments of health spending in 2021 are high, in North Macedonia is accounted for 41.7%, in Montenegro 38.08%, in Serbia 35,86% and in Bosnia and Herzegovina 30.71%. Conclusion. The financing of health systems in the Balkans has improved in the last decade following a series of transition reforms and socio-political challenges. However, inequalities in health systems between countries, as well as with EU countries, persist.
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Tick-borne diseases at the crossroads of the Middle East and Central Europe
(Elsevier BV, 2024-09)
Banović, Pavle
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Bogdan, Ivana
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Simin, Verica
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Mijatović, Dragana
The Balkan Peninsula, acting as a crossroad between central Europe and the Middle East, presents diverse ecosystems supporting various tick species capable of transmitting TBDs. This study focuses on Serbia and North Macedonia, both endemic for TBDs, aiming to investigate human-biting ticks' prevalence, TBD prevalence, and major TBPs in blood samples.
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Differences in body height between the contemporary Western Balkan children and the WHO growth references core sample
(2019-12-31)
Starc, Gregor
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Popovic, Stevo
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Djordjic, Visnja
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Ostojic, Sergej
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Music-Milanovic, Sanja
Body height is the most commonly used anthropometric measure for the assessment and classification of somatic status and growth. The World Health Organization constructed various growth references intended for global use that are directly derived or indirectly affected by body height, but the WHO core sample is based on country-specific, relatively small, and temporally distant reference samples from the Health Examination Survey Cycle II (1963-65) and the Health and Nutrition Examination Survey Cycle I (1971-75). This paper aimed to assess whether the body height of the contemporary 7- to 8-year-olds from the Western Balkans is similar to the body height of their peers from the reference core sample. We utilised the 2017 data from the Western Balkans for comparison, and the analysis showed that contemporary children from this region are more than 4 cm taller from their peers from the core reference sample. The 50th percentile of body height in the Western Balkan sample exceeds the 75th percentile of the core reference sample, which shows that the two populations are quite distinct. The WHO references should, therefore, be used with caution for growth assessment in children from the Western Balkans.

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