Endemic Nephropathy in Bosnia and Herzegovina (Study of the Rate of Prevalence and Epidemio-Ecological Characteristics)

Abstract

1. In the studies done so far on the occurrence of the ethology of endemic nephropathy it has been said that this disease occurs in some plain regions by the rivers in S. R. Bosnia and Herzegovina and in those settlements where drinking water is supplied from the shallow wells.

2. Location of such centres of endemic nephropathy is limited to certain geographic areas. this indicates that the endemic nephropathy is a ground-bound disease, very probably dependent on drinking water — which is being a transmitter of so far unknown specific nox or noxes.

3. In order to slow down the spreading of this disease, it is necessary to organize an efficient health protection, to improve hygiene and sanitary situation and specially to increase the level of health education among the population in the endemic areas.

4. The author considers that the number of endemic nephropathy cases decreases owing to introduction of hygienic and sanitary measures and to work and operation of nephritis dispensaries. The number of people sent to haemodialysis is quite normally increasing — which numerous Yugoslav clinicians consider to be the increase in number of endemic nephropathy cases.

5. Even though without knowing the etiological agent while studying endemic nephropathy in North-East Bosnia over a number of years, all author of this work believes that in the formation of this disease the following tries play significant role:

— closeness to rivers or their tributaries (Sava, Bosna, Drina and the others);

— quality and the kind of the water supply objects;

— height above sea level.

In what way, for what reason and when does the water infiltrates in the shallow plain wells and other water supply objects — are the questions which would be solved and answered by the geologists, geochemists and geophysicists cooperating in their work with the medical Services.