Stamenova, Aleksandra

Preferred name

Official Name

Stamenova, Aleksandra

Main Affiliation

aleksandra.stamenova@medf.ukim.edu.mk

Now showing 1 - 10 of 38

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Rising prevalence of diabetes: evidence from the national registry in North Macedonia
(Oxford University Press (OUP), 2019-11-01)
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Stevanovski, G
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Disease reporting and data collection are key tools for the health care systems in order to identify opportunities to address burden of diseases. The country’s diabetes patients register was the first registry to be integrated with the e-health system in North Macedonia in 2017. We aimed to estimate type 2 diabetes mellitus prevalence and effectiveness of diabetes control as one of the proposed national priorities in tackling the non-communicable diseases. </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Cross-sectional descriptive study was conducted on patients entered in the National Diabetes Register in 2017/2018. Patients’ socio-demographic and anthropometric characteristics in association with diabetes’ complications and outcomes were determined by Pearson correlation coefficient (P < 0.0001, 95% CI).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>This study identified a total of 35541 patients with a diagnosis of diabetes, out of which 32888 with type 2. This corresponds to a prevalence rate of 1583.9 per 100,000 population. The prevalence increased with age (65+) and was higher among females than males (56.8% vs. 43.2%). Over 80% of type 2 patients were overweight out of which 34.5% obese (BMI>30kg/m2). Diabetic retinopathy is reported as first diagnosed complication in diabetic patients, followed by neuropathies and vascular complications. Patient’s low level of education and higher BMI were associated with increased number of early and late-onset complications.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Evidence accumulating suggests high burden of complications in type 2 diabetic patients, indicating that the patients understanding of diabetes care, treatment adherence and healthy lifestyle are important topics to be address by health professionals in order to avoid complications and premature deaths in people with diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>Key messages</jats:title> <jats:p>Integrated reporting of non-communicable diseases and risk factors is needed to complete current information gaps, from completeness of data to quality and comparability. The action plan for chronic diseases should specifically address diabetes control, as most of the patients with diabetes have high prevalence of comorbidities, complications and unfortunate outcomes.</jats:p> </jats:sec>
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Smoking Prevalence and Attitudes Toward Smoking Among Medical Doctors in the Republic of Macedonia
(European Network for Smoking and Tobacco Prevention, 2018-06-13)
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CHARACTERIZING FOOD, DAIRY, AND BEVERAGE AVAILABILITY IN PRIMARY SCHOOL PREMISES IN NORTH MACEDONIA - COSI STUDY
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07)
Mihajlova, Katerina
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Wallace, Lorraine
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Introduction: Childhood obesity remains a global public health challenge. Aim: Using WHO COSI-6th round data, the aim of this study was to depict availability of select foods, dairy and beverages in a nationally representative sample of primary schools across North Macedonia. Material and methods: Data were drawn from the WHO COSI-6th round conducted in North Macedonia in 2022. A designated official (n=111) at the respective primary school reported availability of the following: (1) food (fruits, vegetables, ice cream, sweet snacks, and savory snacks), (2) dairy (milk, yogurt, and/or ayran), (3) beverages without added sugar (water, tea, and fruit juices), and (4) beverages with added sugar (non-carbonated fruit juices, carbonated drinks, hot drinks [e.g., cocoa], and flavored milk). Additionally, the designated school official reported whether their primary school had a canteen and/or shop/cafeteria where foods or beverages could be purchased. Results: Across primary schools in North Macedonia, availability of healthy options (i.e., fruits and vegetables) was lower as compared to energy-dense selections (i.e., sweet and savory snacks). Overall, 18.3% of schools offered dairy products (including milk, yogurt, and ayran). Water was the most commonly available (69.0%) beverage. No significant differences emerged in availability of food, dairy, beverages without added sugar or beverages with added sugar across primary school enrollment (small versus large). Less than one-fifth of primary schools had a canteen (17.4%) and/or shop/cafeteria (14.4%) where foods or beverages could be purchased. Conclusion: In conclusion, access to food, dairy, and beverages for primary school children in North Macedonia was limited.
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Strengthening Clinician-Researchers' Communication and Knowledge Translation Skills: An Innovative Game Model From the Breathe Well Group
(Sage Publishing, 2024-09-12)
Williams, Siân
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Fernandes, Genevie
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Adab, Peymané
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Adams, Rachel
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de Sousa, Jaime Correia
Communication is a core component of a clinician's role; however, when clinicians conduct research, communicating the emerging findings and recommendations to different types of stakeholders can be unfamiliar territory. Communicating research to advocate for change can be even more challenging. Clinician researchers seeking to be agents for change need to conceive and craft specific, evidence-based messages and communicate these effectively to different stakeholders to negotiate action. As part of a global health research program, we developed and tested a novel game-based model to strengthen the communication skills of clinician researchers, from 4 countries, for improving services for chronic obstructive pulmonary disease. This model focused on communication with 3 key stakeholder groups for knowledge translation: Patients/carers, healthcare providers and policy makers/healthcare managers. Delivered through a series of facilitated, online meetings, this model consisted of 2 parts: developing and rehearsing advocacy messages with coaching support, and then testing them with a panel of 3 representative stakeholders, and an audience of fellow researchers. All the country teams reported increased confidence in crafting advocacy messages for specific stakeholders and have applied lessons learned from the model. Delivering this model within a global health research program requires mentoring, time, commitment, resources and translation support to address language barriers. It offers an exemplar to build the communication skills of clinician and non-clinician researchers so that they can go beyond dissemination toward translation of evidence into policy and practice.
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The legal and institutional response to gender-based violence in Macedonia
(Institute of Public Health of Republic of Macedonia, 2018-12)
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Spasovska, Elena
Background: The role of the women and gender equality are important issues in Macedonia, both the Constitution and the national laws guarantee equality between men and women. Additionally, Macedonia has ratified both the Convention on the elimination of all form of discrimination against women (CEDAW) and the Istanbul Convention. However, widespread violence against women and girls persists. Objective This study examines the legal and institutional state response to gender-based violence, the potential and shortcomings of legislative and policy action. Methods An extensive desk research was conducted of policy documents, national strategies, reports and specific legislation, enriched with public policy framework analysis and system approach. Results Legal protection in Republic of Macedonia, in case of gender-based violence is realized through a positive legal framework, addressing domestic violence, rape, sexual violence as well as sexual harassment at the workplace and trafficking in women. Over the past decade, one national strategy was implemented for protection against domestic violence, and one action plan for the fight against human trafficking and illegal migration. Institutional response and support services include: six women’s shelters for survivors of domestic violence, one for victims of trafficking, complemented with free legal aid, three counseling centers and three women’s help lines. Discussion Despite this progress in the adoption of national violence laws, major challenges persist related to the application of legislation, procedural challenges in providing evidence and access to legal, healthcare and other services for survivors. Furthermore, laws are not enforced due to the culture of patriarchy and social norms. In addition, there is not specific provision that criminalizes rape or sexual assault within marriage, nor a shelter for survivors of sexual violence. Conclusion This study concludes that a comprehensive approach and overarching strategy is needed, to include: violence prevention, strengthening legal and policy frameworks and co-operation between all involved actors.
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Lifestyle risk factors and control of chronic non-communicable diseases
(Institute of Public Health of Republic of Macedonia, 2018-06-15)
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Chingoska, Daniela
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Pecev, Petar
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Non-communicable diseases, also known as modern-life diseases, are the leading cause of morbidity and mortality in the world and in the Republic of Macedonia. The complexity of their occurrence, often associated with multifactorial etiology and lifestyle risk factors, has a significant impact on preventive interventions, requiring broad intersectoral cooperation. The aim of the paper is to present thecurrent situation and burden of malignant neoplasms, cardiovascular diseases and diabetes in the Republic of Macedonia, associated with unhealthy lifestyle. Comparison between the mortality data for cardiovascular and malignant neoplasms and the prevalence of diabetes with data for Croatia, Slovenia and France was made. Data on morbidity and mortality for malignant neoplasms, cardiovascular diseases and diabetes was obtained from the reports on the health status of the population in the Republic of Macedonia, from the Register of chronic non-communicable diseases, as well as from the annual health reports for the population in R. Macedonia 2014 and 2015 and HFA database of the World Health Organization. The results are statistically analyzed, tabulated and graphically presented using an analytical-descriptive method. The data shows that in R. Macedonia the mortality rate from cardiovascular diseases is 545 per 100,000 inhabitants in 2014, and 180.4 per 100,000 inhabitants of malignant neoplasms. The prevalence of type 2 diabetes for 2013 expressed at the rate of 100.000 inhabitants is 2386.3. In R. Macedonia the data shows a continuous decline in hospital morbidity, both of cardiovascular diseases and malignant neoplasms, while ambulatory - polyclinic morbidity is on a steady increase. France shows the lowest rate of CVD mortality and malignant neoplasms. By analyzing the risk factors of chronic non-communicable diseases, we have noticed that a high percentage of the population in R. Macedonia has unhealthy lifestyle, especially the young population.
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FAMILY SOCIOECONOMIC DIFFERENCES AMONG CHILDREN LIVING WITH OVERWEIGHT AND OBESITY IN NORTH MACEDONIA
(Institute of Public Health of the Republic of North Macedonia, 2024-12)
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Wallace, Silver Lorraine
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Mihajlova, Katerina
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Dimitrievska, Ljubica
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Globally, the prevalence of overweight and obesity is increasing among children and adolescents. Halting the rise in obesity is a significant challenge because of the complex interplay of factors and influences. We aimed to explore the role of family socioeconomic status (SES) indicators in relation to overweight and obesity prevalence rates among primary school children in North Macedonia. Materials and methods: Data were collected on a nationally representative sample of children and their parent(s)/caregiver(s) participating in the 6th round of World Health Organization (WHO)-European Childhood Obesity Surveillance Initiative (COSI) in North Macedonia. Every child had their height and weight objectively measured and their family sociodemographic and SES data were obtained through a self-reported record form by their parent(s)/caregiver(s). According to COSI reporting, responses on three SES indicators (parental educational attainment, parental employment status and family-perceived wealth) were categorized in levels for data analysis. Overweight and obesity rates were estimated based on 2007 WHO growth references. Pearson’s χ2-tests, corrected with the Rao-Scott method, were used to test differences in overweight and obesity across various subgroups. Results: The sample consisted of primarily native-born children (97.3%) and parents (mothers - 96.2%; fathers - 97.6%), living in urban areas (66.9%), in two-parent families (84.9%) and spoke Macedonian at home (59.8%). The majority of children lived in families with low to medium SES level. Prevalence of overweight was 30.5% [95% CI: 28.5-32.7], whilst of obesity 14.1% [95% CI: 12.3-16.0]. There were no significant differences observed across family SES indicators in overweight or obesity rates. Conclusion: Our findings contribute towards reporting on family SES among children living with overweight and obesity to better understand and address potential obesity risk factors. Future research should focus on exploring family SES within the long-term context of children’s health-related behaviours.
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Challenges in the organization of the emergency care units in Skopje
(2019)
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Pangovski, Ivan
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Mehmedoviкј, Zlate
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Hasani, Shpresa
Background: Emergency ambulance care is regulated at national level, where services are provided manly at the public health centers with free access to all, as integrated care consists of ambulance services, home visits and night shifts services. Aim: This study provides an evaluation of emergency medicine preparedness, national response plan to manage health threads and outlines the current demands on the health care system. Methods: Retrospective analysis on patient's medical records was conducted to review emergency care, including ambulance services provided on the territory of the capital city, Skopje. Operational, human resources capacity, availability and time response were the assessed outcome measures, compared with community needs and national operational minimum standards for care, equipment and qualifications. Results: In our study we have analyzed 181785 medical records of provided integrated ambulance services per 700,000 inhabitants in 2018, recorded by the Health Center. The average rate of emergency calls per day was 88, out of which 22 were level 1 emergency, with response time of 36 minutes. The delay in time response is the result of lack of operational and human resources. According to the population there should be minimum of 100 teams, but the public emergency units have only 28 teams with total of 57 medical doctors and 11 emergency vehicles, out of which, two type A for patient transport and nine emergency ambulances type B. Conclusion: Enhancing the capacity of emergency and ambulance care is an important demand on the health care system in order to meet community and local needs. Introducing a paramedic workforce in the ambulance services and collaboration with social and mental health teams to improve access and quality of services are proposed interventions.
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Characterizing food, diary and beverage availability in primary schools premises in North Macedonia COSI-Study
(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2024-07)
Mihajlova, Katerina
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Wallace, Silver Lorraine
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Introduction: Childhood obesity remains a global public health challenge. As part of the World Health Organization's (WHO) Childhood Obesity Surveillance Initiative (COSI), North Macedonia participates in each data collection round to monitor primary school nutritional environments across the country. School nutrition environment characteristic exploration is necessary for managing and tracking childhood obesity and associated risk factors over time. Aim: Using WHO COSI-6thround data, the aim of this study was to depict availability of select foods, dairy and beverages in a nationally representative sample of primary schools across North Macedonia. Material and methods: Data were drawn from the WHOCOSI-6thround conducted in North Macedonia in 2022. A designated official (n=111) at the respective primary school reported availability of the following: (1) food (fruits, vegetables, ice cream, sweet snacks, and savory snacks), (2) dairy (milk, yogurt, and/or ayran), (3) beverages without added sugar (water, tea, and fruit juices), and (4) beverages with added sugar (non-carbonated fruit juices, carbonated drinks, hot drinks [e.g., cocoa], and flavored milk).Additionally, the designated school official reported whether their primary school had a canteen and/or shop/cafeteria where foods or beverages could be purchased. Results: Across primary schools in North Macedonia, availability of healthy options(i.e., fruits and vegetables)was lower as compared to energy-dense selections (i.e., sweet and savory snacks). Overall, 18.3% of schools offered dairy products (including milk, yogurt, and ayran).Water was the most commonly available (69.0%) beverage. No significant differences emerged in availability of food, dairy, beverages without added sugar or beverages with added sugar across primary school enrollment (small versus large). Less than one-fifth of primary schools had a canteen (17.4%) and/or shop/cafeteria (14.4%) where foods or beverages could be purchased. Conclusion: In conclusion, access to food, dairy, and beverages for primary school children in North Macedonia was limited.
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Health System Preparedness And Response For COVID-19 Pandemic In North Macedonia
(Македонско лекарско друштво = Macedonian medical association, 2020-11)
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Chingoska, Daniela
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Pangovski, Ivan
Objectives: Health systems are the first defense line against epidemics and pandemics. However, in the past two decades, several epidemics including the SARS-CoV-2 virus pandemic have shown unprecedented challenges for the health system’s response and the need to strengthen national capacities and preparedness plan in terms of sustainability and financing. The main objective of this study was to explore the preparedness of the health system and to evaluate the national health -care response to COVID-19. Material and Methods: World Health Organization’s (WHO) toolkit was used for assessing health-system capacity for crisis management and emergency preparedness. Assessment of essential attributes and key components for health system function: a) leadership and governance; b) health workforce; c) medical products vaccines and technology; d) health information; e) health financing; f) service delivery. Data was retrieved from legislation and policy documents, reports, and publications published at the official websites of the Ministry of Health, Institute of Public Health, and Government of the Republic of North Macedonia. Results: The national risk management was led by the Government and the Ministry of Health based on the national plan for preparedness and response of the healthcare system in emergencies, crises and disasters as well as an adapted version of the WHO’s strategic preparedness and response plan, according to which the country was classified as level 3 preparedness. Shortage in laboratory testing capacity, personal protective equipment and healthcare capacity as ICU ventilators and health workforce capacity were the main challenges for the national health system. Informing the public community was an important component of the national response which included risk communication, key prevention and preparedness measures to ensure individuals adopt protective behaviors and daily infographic statistics. Conclusion: COVID-19 is a public health emergency that tested the resilience of the national healthcare system as well as other sectors of government and the whole society. We identified a great need to increase capacity to identify suspected cases of COVID-19 in the general population, to introduce participatory community interventions, and to ensure sustainable financing in the health sector for crises and epidemics. An absolute priority in the pandemic is hospital preparedness and health workforce training and coordination.

Stamenova, Aleksandra

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