2018 PhD, Faculty of Medicine, Dentistry and Health, School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom
2004 Master Certificate in Public Policy and Management, Graduate School of Public and International Affairs (GSPIA), University of Pittsburgh, USA
2002 Master of Science in Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, University of Tokyo, Japan
1998 Bachelor of Science, Faculty of Pharmacy, University “Ss. Cyril and Methodius”, Skopje, Macedonia
Training future antimicrobial stewards in the ESCMID AMS certificate training programme: From knowledge to action Suzanne M E Kuijpers, Marlies E J L Hulscher, Jan M Prins, Jaap ten Oever, Teske Schoffelen, Neda Milevska-Kostova, Kim C E Sigaloff, Bojana Beovic, Jeroen A Schouten Jac Antimicrobial Resistance, 2025 Objectives ESCMID has established the Antimicrobial Stewardship (AMS) Certificate programme to provide healthcare professionals with AMS expertise. This study evaluated the effectiveness of this 2-year training programme, measuring knowledge, skills and tangible results. Participants and methods This observational cohort study included participants in the first AMS certificate programme, which started in June 2022. The programme included online and live courses covering relevant AMS learning goals. Participants also carried out a local AMS project using a determinant analysis with pre- and post-intervention measurements. Data were collected through surveys, exams, and an evaluation of mandatory reports to assess progress across Kirkpatrick’s four levels of learning: reaction, learning, behaviour and results. Results Forty participants from 22 countries took part in the programme. Individual courses were positively evaluated (reaction, level 1). All participants passed the final exam (learning, level 2). After 2 years, 35/40 (88%) submitted their AMS project reports (behaviour, level 3). In 31/35 (89%) of projects a post-intervention measurement was performed, of which 26/31 (84%) showed a positive effect on either process outcomes (e.g. increase in guideline adherence), quantity outcomes (e.g. reduced broad-spectrum antibiotic use), or patient outcomes (e.g. length of stay) (results, level 4). Conclusions The ESCMID AMS certificate programme effectively transfers knowledge and skills to participants who intend to develop ASPs in different clinical settings. Moreover, the course prompted the development and execution of local AMS projects with measurable impact on appropriate antibiotic use practices.
Antifungal Policy and Practice Across Five Countries: A Qualitative Review David W. Denning, John R. Perfect, Neda Milevska-Kostova, Artes Haderi, Hannah Armstrong, Maarten C. Hardenberg, Emily Chavez, Bruce Altevogt, Patrick Holmes, Jalal A. Aram Journal of Fungi, 2025 The burden of invasive fungal infections (IFIs) is increasing worldwide. National, regional, and local policies on IFI management should respond to the changing landscape. We assessed antifungal policies from five countries of varying size, IFI burden, and geography: the Netherlands, Italy, South Korea, China, and India. These countries were selected as a representative sample reflecting different types of economic and health systems that patients and providers access worldwide. This assessment focused on a comprehensive range of antifungal policy elements, including recognition and prioritization, awareness and education, prevention and monitoring, diagnosis and coordinated care, access to appropriate treatment, and diagnostic and treatment innovation. Although countries in this analysis all have some form of policy for IFI management, we have identified substantial gaps, including low prioritization of IFI diagnostics, omission of fungal pathogens from antimicrobial resistance policies, and a general lack of awareness and healthcare professional (HCP) training on IFI management. The gaps identified are intended to inform HCPs and policy- and decision-makers about aspects to consider in reducing the IFI burden for patients and health systems while demonstrating responsible antifungal stewardship.
North Macedonia: Health System Review Health Systems in Transition, 2024
Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 Kevin S Ikuta, Lucien R Swetschinski, Gisela Robles Aguilar, Fablina Sharara, Tomislav Mestrovic, Authia P Gray, Nicole Davis Weaver, Eve E Wool, Chieh Han, Anna Gershberg Hayoon, Amirali Aali, Semagn Mekonnen Abate, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Sherief Abd-Elsalam, Getachew Abebe, Aidin Abedi, Amir Parsa Abhari, Hassan Abidi, Richard Gyan Aboagye, Abdorrahim Absalan, Hiwa Abubaker Ali, Juan Manuel Acuna, Tigist Demssew Adane, Isaac Yeboah Addo, Oyelola A Adegboye, Mohammad Adnan, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Saira Afzal, Zahra Babaei Aghdam, Bright Opoku Ahinkorah, Aqeel Ahmad, Araz Ramazan Ahmad, Rizwan Ahmad, Sajjad Ahmad, Sohail Ahmad, Sepideh Ahmadi, Ali Ahmed, Haroon Ahmed, Jivan Qasim Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Budi Aji, Mostafa Akbarzadeh-Khiavi, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Fares Alahdab, Ziyad Al-Aly, Mamoon A Aldeyab, Alicia V Aleman, Fadwa Alhalaiqa Naji Alhalaiqa, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Liaqat Ali, Syed Shujait Ali, Yousef Alimohamadi, Vahid Alipour, Atiyeh Alizadeh, Syed Mohamed Aljunid, Kasim Allel, Sami Almustanyir, Edward Kwabena Ameyaw, Arianna Maever L Amit, Nivedita Anandavelane, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Dewi Anggraini, Adnan Ansar, Anayochukwu Edward Anyasodor, Jalal Arabloo, Aleksandr Y Aravkin, Demelash Areda, Timur Aripov, Anton A Artamonov, Judie Arulappan, Raphael Taiwo Aruleba, Muhammad Asaduzzaman, Tahira Ashraf, Seyyed Shamsadin Athari, Daniel Atlaw, Sameh Attia, Marcel Ausloos, Tewachew Awoke, Beatriz Paulina Ayala Quintanilla, Tegegn Mulatu Ayana, Sina Azadnajafabad, Amirhossein Azari Jafari, Darshan B B, Muhammad Badar, Ashish D Badiye, Nayereh Baghcheghi, Sara Bagherieh, Atif Amin Baig, Indrajit Banerjee, Aleksandra Barac, Mainak Bardhan, Francesco Barone-Adesi, Hiba Jawdat Barqawi, Amadou Barrow, Pritish Baskaran, Saurav Basu, Abdul-Monim Mohammad Batiha, Neeraj Bedi, Melaku Ashagrie Belete, Uzma Iqbal Belgaumi, Rose G Bender, Bharti Bhandari, Dinesh Bhandari, Pankaj Bhardwaj, Sonu Bhaskar, Krittika Bhattacharyya, Suraj Bhattarai, Saeid Bitaraf, Danilo Buonsenso, Zahid A Butt, Florentino Luciano Caetano dos Santos, Jiao Cai, Daniela Calina, Paulo Camargos, Luis Alberto Cámera, Rosario Cárdenas, Muge Cevik, Joshua Chadwick, Jaykaran Charan, Akhilanand Chaurasia, Patrick R Ching, Sonali Gajanan Choudhari, Enayet Karim Chowdhury, Fazle Rabbi Chowdhury, Dinh-Toi Chu, Isaac Sunday Chukwu, Omid Dadras, Fentaw Teshome Dagnaw, Xiaochen Dai, Saswati Das, Anna Dastiridou, Sisay Abebe Debela, Fitsum Wolde Demisse, Solomon Demissie, Diriba Dereje, Msganaw Derese, Hardik Dineshbhai Desai, Fikadu Nugusu Dessalegn, Samuel Abebe A Dessalegni, Belay Desye, Kartik Dhaduk, Meghnath Dhimal, Sameer Dhingra, Nancy Diao, Daniel Diaz, Shirin Djalalinia, Milad Dodangeh, Deepa Dongarwar, Bezabih Terefe Dora, Fariba Dorostkar, Haneil Larson Dsouza, Eleonora Dubljanin, Susanna J Dunachie, Oyewole Christopher Durojaiye, Hisham Atan Edinur, Habtamu Bekele Ejigu, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Hassan El-Abid, Muhammed Elhadi, Mohamed A Elmonem, Amir Emami, Luchuo Engelbert Bain, Daniel Berhanie Enyew, Ryenchindorj Erkhembayar, Babak Eshrati, Farshid Etaee, Adeniyi Francis Fagbamigbe, Shahab Falahi, Aida Fallahzadeh, Emerito Jose A Faraon, Ali Fatehizadeh, Ginenus Fekadu, João C Fernandes, Allegra Ferrari, Getahun Fetensa, Irina Filip, Florian Fischer, Masoud Foroutan, Peter Andras Gaal, Muktar A Gadanya, Abhay Motiramji Gaidhane, Balasankar Ganesan, Mesfin Gebrehiwot, Reza Ghanbari, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Ali Gholamrezanezhad, Abdolmajid Gholizadeh, Mahaveer Golechha, Pouya Goleij, Davide Golinelli, Amador Goodridge, Damitha Asanga Gunawardane, Yuming Guo, Rajat Das Gupta, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Alemu Guta, Parham Habibzadeh, Atlas Haddadi Avval, Rabih Halwani, Asif Hanif, Md. Abdul Hannan, Harapan Harapan, Shoaib Hassan, Hadi Hassankhani, Khezar Hayat, Behzad Heibati, Golnaz Heidari, Mohammad Heidari, Reza Heidari-Soureshjani, Claudiu Herteliu, Demisu Zenbaba Heyi, Kamal Hezam, Praveen Hoogar, Nobuyuki Horita, Md Mahbub Hossain, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Soodabeh Hoveidamanesh, Junjie Huang, Salman Hussain, Nawfal R Hussein, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Mohammad Tarique Imam, Mustapha Immurana, Leeberk Raja Inbaraj, Arnaud Iradukunda, Nahlah Elkudssiah Ismail, Chidozie C D Iwu, Chinwe Juliana Iwu, Linda Merin J, Mihajlo Jakovljevic, Elham Jamshidi, Tahereh Javaheri, Fatemeh Javanmardi, Javad Javidnia, Sathish Kumar Jayapal, Umesh Jayarajah, Rime Jebai, Ravi Prakash Jha, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Salah Eddine Oussama Kacimi, Vidya Kadashetti, Laleh R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Himal Kandel, Neeti Kapoor, Samad Karkhah, Bekalu Getnet Kassa, Nicholas J Kassebaum, Patrick DMC Katoto, Mohammad Keykhaei, Himanshu Khajuria, Abbas Khan, Imteyaz A Khan, Maseer Khan, Md Nuruzzaman Khan, Moien AB Khan, Moawiah Mohammad Khatatbeh, Mona M Khater, Hamid Reza Khayat Kashani, Jagdish Khubchandani, Hanna Kim, Min Seo Kim, Ruth W Kimokoti, Niranjan Kissoon, Sonali Kochhar, Farzad Kompani, Soewarta Kosen, Parvaiz A Koul, Sindhura Lakshmi Koulmane Laxminarayana, Fiorella Krapp Lopez, Kewal Krishan, Vijay Krishnamoorthy, Vishnutheertha Kulkarni, Naveen Kumar, Om P Kurmi, Ambily Kuttikkattu, Hmwe Hmwe Kyu, Dharmesh Kumar Lal, Judit Lám, Iván Landires, Savita Lasrado, Sang-woong Lee, Jacopo Lenzi, Sonia Lewycka, Shanshan Li, Stephen S Lim, Wei Liu, Rakesh Lodha, Michael J Loftus, Ayush Lohiya, László Lorenzovici, Mojgan Lotfi, Ata Mahmoodpoor, Mansour Adam Mahmoud, Razzagh Mahmoudi, Azeem Majeed, Jamal Majidpoor, Alaa Makki, Galana Ayana Mamo, Yosef Manla, Miquel Martorell, Clara N Matei, Barney McManigal, Entezar Mehrabi Nasab, Ravi Mehrotra, Addisu Melese, Oliver Mendoza-Cano, Ritesh G Menezes, Alexios-Fotios A Mentis, Georgia Micha, Irmina Maria Michalek, Ana Carolina Micheletti Gomide Nogueira de Sá, Neda Milevska Kostova, Shabir Ahmad Mir, Mojgan Mirghafourvand, Seyyedmohammadsadeq Mirmoeeni, Erkin M Mirrakhimov, Mohammad Mirza-Aghazadeh-Attari, Abay Sisay Misganaw, Awoke Misganaw, Sanjeev Misra, Esmaeil Mohammadi, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Syam Mohan, Mohammad Mohseni, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Catrin E Moore, Maryam Moradi, Mostafa Moradi Sarabi, Shane Douglas Morrison, Majid Motaghinejad, Haleh Mousavi Isfahani, Amin Mousavi Khaneghah, Seyed Ali Mousavi-Aghdas, Sumaira Mubarik, Francesk Mulita, Getaneh Baye B Mulu, Sandra B Munro, Saravanan Muthupandian, Tapas Sadasivan Nair, Atta Abbas Naqvi, Himanshi Narang, Zuhair S Natto, Muhammad Naveed, Biswa Prakash Nayak, Shumaila Naz, Ionut Negoi, Seyed Aria Nejadghaderi, Sandhya Neupane Kandel, Che Henry Ngwa, Robina Khan Niazi, Antonio Tolentino Nogueira de Sá, Nafise Noroozi, Hasti Nouraei, Ali Nowroozi, Virginia Nuñez-Samudio, Jerry John Nutor, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Rahman Md Obaidur, Vivek Anand Ojha, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Ahmed Omar Bali, Emad Omer, Nikita Otstavnov, Bilcha Oumer, Mahesh P A, Jagadish Rao Padubidri, Keyvan Pakshir, Tamás Palicz, Adrian Pana, Shahina Pardhan, Jose L Paredes, Utsav Parekh, Eun-Cheol Park, Seoyeon Park, Ashish Pathak, Rajan Paudel, Uttam Paudel, Shrikant Pawar, Hamidreza Pazoki Toroudi, Minjin Peng, Umberto Pensato, Veincent Christian Filipino Pepito, Marcos Pereira, Mario F P Peres, Norberto Perico, Ionela-Roxana Petcu, Zahra Zahid Piracha, Indrashis Podder, Nayanum Pokhrel, Ramesh Poluru, Maarten J Postma, Naeimeh Pourtaheri, Akila Prashant, Ibrahim Qattea, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Saber Raeghi, Sima Rafiei, Pankaja Raghav Raghav, Leila Rahbarnia, Vafa Rahimi-Movaghar, Mosiur Rahman, Muhammad Aziz Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Pradhum Ram, Muhammad Modassar Ali Nawaz Ranjha, Sowmya J Rao, Mohammad-Mahdi Rashidi, Azad Rasul, Zubair Ahmed Ratan, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Elrashdy Moustafa Mohamed Redwan, Misganu Teshoma Regasa, Giuseppe Remuzzi, Melese Abate Reta, Nazila Rezaei, Aziz Rezapour, Abanoub Riad, Rezaul Karim Ripon, Kristina E Rudd, Basema Saddik, Saeid Sadeghian, Umar Saeed, Mohsen Safaei, Azam Safary, Sher Zaman Safi, Maryam Sahebazzamani, Amirhossein Sahebkar, Harihar Sahoo, Saina Salahi, Sarvenaz Salahi, Hedayat Salari, Sana Salehi, Hossein Samadi Kafil, Abdallah M Samy, Nima Sanadgol, Senthilkumar Sankararaman, Francesco Sanmarchi, Brijesh Sathian, Monika Sawhney, Ganesh Kumar Saya, Subramanian Senthilkumaran, Allen Seylani, Pritik A Shah, Masood Ali Shaikh, Elaheh Shaker, Murad Ziyaudinovich Shakhmardanov, Mequannent Melaku Sharew, Athena Sharifi-Razavi, Purva Sharma, Rahim Ali Sheikhi, Ali Sheikhy, Pavanchand H Shetty, Mika Shigematsu, Jae Il Shin, Hesamaddin Shirzad-Aski, K M Shivakumar, Parnian Shobeiri, Seyed Afshin Shorofi, Sunil Shrestha, Migbar Mekonnen Sibhat, Negussie Boti Sidemo, Mustafa Kamal Sikder, Luís Manuel Lopes Rodrigues Silva, Jasvinder A Singh, Paramdeep Singh, Surjit Singh, Md Shahjahan Siraj, Samarjeet Singh Siwal, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Damtew Damtew Solomon, Yimeng Song, Chandrashekhar T Sreeramareddy, Muhammad Suleman, Rizwan Suliankatchi Abdulkader, Saima Sultana, Miklós Szócska, Seyed-Amir Tabatabaeizadeh, Mohammad Tabish, Majid Taheri, Elahe Taki, Ker-Kan Tan, Sarmila Tandukar, Nathan Y Tat, Vivian Y Tat, Belay Negash Tefera, Yibekal Manaye Tefera, Gebremaryam Temesgen, Mohamad-Hani Temsah, Samar Tharwat, Arulmani Thiyagarajan, Imad I Tleyjeh, Christopher E Troeger, Krishna Kishore Umapathi, Era Upadhyay, Sahel Valadan Tahbaz, Pascual R Valdez, Jef Van den Eynde, H. Rogier van Doorn, Siavash Vaziri, Georgios-Ioannis Verras, Harimadhav Viswanathan, Bay Vo, Abdul Waris, Gizachew Tadesse Wassie, Nuwan Darshana Wickramasinghe, Sajad Yaghoubi, Gahin Abdulraheem Tayib Yahya Yahya, Seyed Hossein Yahyazadeh Jabbari, Arzu Yigit, Vahit Yiğit, Dong Keon Yon, Naohiro Yonemoto, Mazyar Zahir, Burhan Abdullah Zaman, Sojib Bin Zaman, Moein Zangiabadian, Iman Zare, Mikhail Sergeevich Zastrozhin, Zhi-Jiang Zhang, Peng Zheng, Chenwen Zhong, Mohammad Zoladl, Alimuddin Zumla, Simon I Hay, Christiane Dolecek, Benn Sartorius, Christopher J L Murray, Mohsen Naghavi Lancet, 2022 BACKGROUND: Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both susceptible and resistant to antimicrobials) is essential to identify the greatest threats to public health. To our knowledge, this is the first study to present global comprehensive estimates of deaths associated with 33 bacterial pathogens across 11 major infectious syndromes. METHODS: We estimated deaths associated with 33 bacterial genera or species across 11 infectious syndromes in 2019 using methods from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, in addition to a subset of the input data described in the Global Burden of Antimicrobial Resistance 2019 study. This study included 343 million individual records or isolates covering 11 361 study-location-years. We used three modelling steps to estimate the number of deaths associated with each pathogen: deaths in which infection had a role, the fraction of deaths due to infection that are attributable to a given infectious syndrome, and the fraction of deaths due to an infectious syndrome that are attributable to a given pathogen. Estimates were produced for all ages and for males and females across 204 countries and territories in 2019. 95% uncertainty intervals (UIs) were calculated for final estimates of deaths and infections associated with the 33 bacterial pathogens following standard GBD methods by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. FINDINGS: From an estimated 13·7 million (95% UI 10·9-17·1) infection-related deaths in 2019, there were 7·7 million deaths (5·7-10·2) associated with the 33 bacterial pathogens (both resistant and susceptible to antimicrobials) across the 11 infectious syndromes estimated in this study. We estimated deaths associated with the 33 bacterial pathogens to comprise 13·6% (10·2-18·1) of all global deaths and 56·2% (52·1-60·1) of all sepsis-related deaths in 2019. Five leading pathogens-Staphylococcus aureus, Escherichia coli, Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa-were responsible for 54·9% (52·9-56·9) of deaths among the investigated bacteria. The deadliest infectious syndromes and pathogens varied by location and age. The age-standardised mortality rate associated with these bacterial pathogens was highest in the sub-Saharan Africa super-region, with 230 deaths (185-285) per 100 000 population, and lowest in the high-income super-region, with 52·2 deaths (37·4-71·5) per 100 000 population. S aureus was the leading bacterial cause of death in 135 countries and was also associated with the most deaths in individuals older than 15 years, globally. Among children younger than 5 years, S pneumoniae was the pathogen associated with the most deaths. In 2019, more than 6 million deaths occurred as a result of three bacterial infectious syndromes, with lower respiratory infections and bloodstream infections each causing more than 2 million deaths and peritoneal and intra-abdominal infections causing more than 1 million deaths. INTERPRETATION: The 33 bacterial pathogens that we investigated in this study are a substantial source of health loss globally, with considerable variation in their distribution across infectious syndromes and locations. Compared with GBD Level 3 underlying causes of death, deaths associated with these bacteria would rank as the second leading cause of death globally in 2019; hence, they should be considered an urgent priority for intervention within the global health community. Strategies to address the burden of bacterial infections include infection prevention, optimised use of antibiotics, improved capacity for microbiological analysis, vaccine development, and improved and more pervasive use of available vaccines. These estimates can be used to help set priorities for vaccine need, demand, and development. FUNDING: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care, using UK aid funding managed by the Fleming Fund.
Universal salt iodization potentially contributes to health equity: Socio-economic status of children does not affect iodine status Neda Milevska-Kostova, Daniela Miladinova, Sonja Kuzmanovska, Venjamin Majstorov, Till Ittermann, Henry Völzke Journal of Pediatric Endocrinology and Metabolism, 2022 Objectives Many studies have shown that socio-economic status (SES) contributes to health inequalities, with nutrition as one of the major risk factors. Iodine intake entirely depends on external sources, and deficiencies are known to be more prevalent in lower social groups, especially in countries with limited access to iodized salt. This study aimed to determine the influence of SES on iodine status and iodine availability from household salt in North Macedonia. Methods Using cluster sampling, 1,200 children were recruited, and 1,191 children participated (response rate: 99.2%). Iodine status was assessed through urinary iodine concentration (UIC), and iodine availability through iodine content in household salt requested from participants. SES was assessed using standardized Family Affluence Score (FAS). Results No statistically significant correlation was found between FAS and iodine in salt. Median regression revealed no significant associations of middle vs. low FAS (β=0.00; 95%-confidence interval (CI)=[−0.61, 0.62]; p=0.999) or high vs. low affluence (β=0.48; 95% CI=[−1.37, 0.41]; p=0.291) with iodine content in household salt. UIC levels were significantly lower in middle FAS children compared to low FAS children (β=−16.4; 95% CI=[−32.3, −0.5]; p=0.043). No statistically significant differences in UIC were found between children with high and low affluence (β=−12.5; 95% CI=[−35.5, 10.5]; p=0.287), possibly due to lowered statistical power for this comparison. Conclusions Universal salt iodization (USI) proves to be a cost-effective measure for appropriate iodine intake in healthy children and adults, irrespective of their social status. It can thus be concluded that USI contributes to reducing health inequalities related to iodine status among population of different social strata.
Modelling the contribution of iodised salt in industrially processed foods to iodine intake in Macedonia Neda Milevska-Kostova, Borislav Karanfilski, Jacky Knowles, Karen Codling, John H. Lazarus Plos One, 2022 Evidence from the 1950s showed that Macedonia was iodine deficient. After the introduction of mandatory universal salt iodisation, the country saw a steady increase in iodine intake and decline in goitre prevalence, earning iodine-deficiency free status in 2003. Iodine status assessments in 2007 and 2016 showed adequate iodine intake among school age children (median urinary iodine concentration of 241 μg/L and 236 μg/L respectively). Macedonia participated in piloting the Iodine Global Network Programme Guidance on the use of iodised salt in industrially processed foods to better understand potential iodised salt intake from processed foods. One objective of implementation was to identify the need, opportunities, and required actions to strengthen the processed food component of the national salt iodisation policy. Data from the 2017 Household Consumption and Expenditure Survey (HCES) was used to determine household salt consumption, to identify widely-consumed, salt-containing industrially processed foods, and estimate typical daily intake of these foods. Their estimated contribution to iodine intake was estimated based on their salt content and the percentage of food industry salt that is iodised. Although the study has limitations, including a relatively small selection of foods, the results indicate potential iodine intake from iodised household salt and iodised salt in the selected foods of nearly 300% of the Estimated Average Requirement and over 220% of the Recommended Nutrient Intake for adults. This was approximately 50% of the tolerable safe Upper Level for iodine intake. The study confirmed high daily salt intake (11.2 grams from household salt only). Successful salt reduction would be expected to reduce iodine intake, however, modelling with 10% and 30% reduction implied this is unlikely to put any population group at risk of deficiency. It is recommended that implementation of salt iodisation and salt reduction policies are harmonized, alongside continued regular iodine status monitoring for different population groups.
Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050 Angela E Micah, Ian E Cogswell, Brandon Cunningham, Satoshi Ezoe, Anton C Harle, Emilie R Maddison, Darrah McCracken, Shuhei Nomura, Kyle E Simpson, Hayley N Stutzman, Golsum Tsakalos, Lindsey E Wallace, Yingxi Zhao, Rahul R Zende, Cristiana Abbafati, Michael Abdelmasseh, Aidin Abedi, Kedir Hussein Abegaz, E S Abhilash, Hassan Abolhassani, Michael R M Abrigo, Tara Ballav Adhikari, Saira Afzal, Bright Opoku Ahinkorah, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Budi Aji, Yonas Akalu, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Khurshid Alam, Fahad Mashhour Alanezi, Turki M Alanzi, Yosef Alemayehu, Robert Kaba Alhassan, Cyrus Alinia, Syed Mohamed Aljunid, Sami Almustanyir Almustanyir, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Mostafa Amini-Rarani, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Blake Angell, Mina Anjomshoa, Carl Abelardo T Antonio, Catherine M Antony, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Timur Aripov, Alessandro Arrigo, Tahira Ashraf, Desta Debalkie Atnafu, Marcel Ausloos, Leticia Avila-Burgos, Asma Tahir Awan, Getinet Ayano, Martin Amogre Ayanore, Samad Azari, Gulrez Shah Azhar, Tesleem Kayode Babalola, Mohammad Amin Bahrami, Atif Amin Baig, Maciej Banach, Nastaran Barati, Till Winfried Bärnighausen, Amadou Barrow, Sanjay Basu, Bernhard T Baune, Mohsen Bayati, Habib Benzian, Adam E Berman, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Sadia Bibi, Ali Bijani, Virginia Bodolica, Nicola Luigi Bragazzi, Dejana Braithwaite, Nicholas J K Breitborde, Alexey V Breusov, Nikolay Ivanovich Briko, Reinhard Busse, Lucero Cahuana-Hurtado, Emily Joy Callander, Luis Alberto Cámera, Carlos A Castañeda-Orjuela, Ferrán Catalá-López, Jaykaran Charan, Souranshu Chatterjee, Soosanna Kumary Chattu, Vijay Kumar Chattu, Simiao Chen, Arrigo Francesco Giuseppe Cicero, Omid Dadras, Saad M A Dahlawi, Xiaochen Dai, Koustuv Dalal, Lalit Dandona, Rakhi Dandona, Dragos Virgil Davitoiu, Jan-Walter De Neve, Antonio Reis de Sá-Junior, Edgar Denova-Gutiérrez, Deepak Dhamnetiya, Samath Dhamminda Dharmaratne, Leila Doshmangir, John Dube, Elham Ehsani-Chimeh, Maysaa El Sayed Zaki, Maha El Tantawi, Sharareh Eskandarieh, Farshad Farzadfar, Tomas Y Ferede, Florian Fischer, Nataliya A Foigt, Alberto Freitas, Sara D Friedman, Takeshi Fukumoto, Nancy Fullman, Peter Andras Gaal, Mohamed M Gad, MA Garcia-Gordillo, Tushar Garg, Mansour Ghafourifard, Ahmad Ghashghaee, Asadollah Gholamian, Ali Gholamrezanezhad, Ghozali Ghozali, Syed Amir Gilani, Ionela-Roxana Glăvan, Ekaterina Vladimirovna Glushkova, Salime Goharinezhad, Mahaveer Golechha, Srinivas Goli, Avirup Guha, Veer Bala Gupta, Vivek Kumar Gupta, Annie Haakenstad, Mohammad Rifat Haider, Alemayehu Hailu, Samer Hamidi, Asif Hanif, Harapan Harapan, Risky Kusuma Hartono, Ahmed I Hasaballah, Shoaib Hassan, Mohamed H Hassanein, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Delia Hendrie, Ileana Heredia-Pi, Claudiu Herteliu, Kamal Hezam, Ramesh Holla, Sheikh Jamal Hossain, Mehdi Hosseinzadeh, Sorin Hostiuc, Tanvir M Huda, Bing-Fang Hwang, Ivo Iavicoli, Bulat Idrisov, Olayinka Stephen Ilesanmi, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Nahlah Elkudssiah Ismail, Gaetano Isola, Mohammad Ali Jahani, Nader Jahanmehr, Mihajlo Jakovljevic, Manthan Dilipkumar Janodia, Tahereh Javaheri, Sathish Kumar Jayapal, Ranil Jayawardena, Seyed Behzad Jazayeri, Ravi Prakash Jha, Jost B Jonas, Tamas Joo, Farahnaz Joukar, Mikk Jürisson, Billingsley Kaambwa, Rohollah Kalhor, Tanuj Kanchan, Himal Kandel, Behzad Karami Matin, Salah Eddin Karimi, Getinet Kassahun, Gbenga A Kayode, Ali Kazemi Karyani, Leila Keikavoosi-Arani, Yousef Saleh Khader, Himanshu Khajuria, Rovshan Khalilov, Mohammad Khammarnia, Junaid Khan, Jagdish Khubchandani, Neda Kianipour, Gyu Ri Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Stefan Kohler, Soewarta Kosen, Rajasekaran Koteeswaran, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, G Anil Kumar, Dian Kusuma, Demetris Lamnisos, Van Charles Lansingh, Anders O Larsson, Savita Lasrado, Long Khanh Dao Le, Shaun Wen Huey Lee, Yeong Yeh Lee, Stephen S Lim, Stany W Lobo, Rafael Lozano, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Mokhtar Mahdavi Mahdavi, Azeem Majeed, Alaa Makki, Afshin Maleki, Reza Malekzadeh, Ana Laura Manda, Fariborz Mansour-Ghanaei, Mohammad Ali Mansournia, Carlos Alberto Marrugo Arnedo, Adolfo Martinez-Valle, Seyedeh Zahra Masoumi, Richard James Maude, Martin McKee, Carlo Eduardo Medina-Solís, Ritesh G Menezes, Atte Meretoja, Tuomo J Meretoja, Mohamed Kamal Mesregah, Tomislav Mestrovic, Neda Milevska Kostova, Ted R Miller, GK Mini, Andreea Mirica, Erkin M Mirrakhimov, Bahram Mohajer, Teroj Abdulrahman Mohamed, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Modhurima Moitra, Ali H Mokdad, Mariam Molokhia, Mohammad Ali Moni, Yousef Moradi, Jakub Morze, Seyyed Meysam Mousavi, Christine Mpundu-Kaambwa, Moses K Muriithi, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Mukhammad David Naimzada, Vinay Nangia, Atta Abbas Naqvi, Aparna Ichalangod Narayana, Bruno Ramos Nascimento, Muhammad Naveed, Biswa Prakash Nayak, Javad Nazari, Rawlance Ndejjo, Ionut Negoi, Sandhya Neupane Kandel, Trang Huyen Nguyen, Justice Nonvignon, Jean Jacques Noubiap, Vincent Ebuka Nwatah, Bogdan Oancea, Foluke Adetola Ogunyemi Ojelabi, Andrew T Olagunju, Babayemi Oluwaseun Olakunde, Stefano Olgiati, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Adrian Otoiu, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Jagadish Rao Padubidri, Raffaele Palladino, Songhomitra Panda-Jonas, Eun-Cheol Park, Fatemeh Pashazadeh Kan, Shrikant Pawar, Hamidreza Pazoki Toroudi, David M Pereira, Arokiasamy Perianayagam, Konrad Pesudovs, Cristiano Piccinelli, Maarten J Postma, Sergio I Prada, Mohammad Rabiee, Navid Rabiee, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Mosiur Rahman, Amir Masoud Rahmani, Usha Ram, Chhabi Lal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Priya Rathi, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Robert C Reiner Jr, Andre M N Renzaho, Bhageerathy Reshmi, Mavra A Riaz, Rezaul Karim Ripon, Anas M Saad, Mohammad Ali Sahraian, Maitreyi Sahu, Joseph S Salama, Sana Salehi, Abdallah M Samy, Juan Sanabria, Francesco Sanmarchi, João Vasco Santos, Milena M Santric-Milicevic, Brijesh Sathian, Miloje Savic, Deepak Saxena, Mehdi Sayyah, Falk Schwendicke, Subramanian Senthilkumaran, Sadaf G Sepanlou, Allen Seylani, Saeed Shahabi, Masood Ali Shaikh, Aziz Sheikh, Adithi Shetty, Pavanchand H Shetty, Kenji Shibuya, Mark G Shrime, Kanwar Hamza Shuja, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Shahin Soltani, Moslem Soofi, Emma Elizabeth Spurlock, Simona Cătălina Stefan, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Biruk Wogayehu Taddele, Yonas Getaye Tefera, Aravind Thavamani, Ruoyan Tobe-Gai, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Lorainne Tudor Car, Anayat Ullah, Saif Ullah, Nasir Umar, Eduardo A Undurraga, Pascual R Valdez, Tommi Juhani Vasankari, Jorge Hugo Villafañe, Francesco S Violante, Vasily Vlassov, Bay Vo, Sebastian Vollmer, Theo Vos, Giang Thu Vu, Linh Gia Vu, Richard G Wamai, Andrea Werdecker, Mesfin Agachew Woldekidan, Befikadu Legesse Wubishet, Gelin Xu, Sanni Yaya, Vahid Yazdi-Feyzabadi, Vahit Yiğit, Paul Yip, Birhanu Wubale Yirdaw, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Ismaeel Yunusa, Telma Zahirian Moghadam, Hamed Zandian, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Arash Ziapour, Yves Miel H Zuniga, Simon I Hay, Christopher J L Murray, Joseph L Dieleman Lancet, 2021 BACKGROUND: The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. METHODS: We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. FINDINGS: In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7-8·8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5-0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0-25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. INTERPRETATION: Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. FUNDING: Bill & Melinda Gates Foundation.
Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia Maja Avramovska, Neda Milevska Kostova, Borislav Karanfilski, Sandra Hunziker, Olivija Vaskova, Goran Dimitrov, Elena Dzikova, Ana Daneva Markova, Marija Hadzi Lega, Gligor Tofoski, Aleksandar Sikole Revista Brasileira De Ginecologia E Obstetricia, 2021 Objective Thyroid diseases are the second most common endocrine disorders in the reproductive period of women. They can be associated with intrauterine growth restriction (IUGR), preterm delivery, low Apgar score, low birthweight (LBW) or fetal death. The aim of the present study is to explore thyroid dysfunction and its relationship with some poor perinatal outcomes (Apgar Score, low birthweight, and preterm delivery). Methods Dried blood spot samples from 358 healthy pregnant women were analyzed for thyroid stimulating hormone (TSH), total thyroxine (TT4), and thyroglobulin (Tg). Neonatal data were collected upon delivery. Four groups were formed based on thyroid function tests (TFTs). Results Of the 358 tested women, 218 (60.72%) were euthyroid. Isolated hypothyroxinemia was present in 132 women (36.76%), subclinical hyperthyroidism in 7 women (1.94%), and overt hypothyroidism in 1 (0.28%). The perinatal outcomes IUGR (p = 0.028) and Apgar score 1 minute (p = 0.015) were significantly different between thyroid function test [TFT]-distinct groups. In the multiple regression analysis, TT4 showed a statistically significant inverse predictive impact on LBW (p < 0.0001), but a positive impact of Tg on LBW (p = 0.0351). Conclusion Thyroid hormones alone do not have a direct impact on neonatal outcomes, but the percentage of their participation in the total process cannot be neglected. Based on the regression analysis, we can conclude that TT4 and Tg can be used as predictors of neonatal outcome, expressed through birthweight and Apgar score. The present study aims to contribute to determine whether a test for thyroid status should become routine screening during pregnancy.
North Macedonia Health Politics in Europe A Handbook, 2021
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Standardized Map of Iodine Status in Europe Till Ittermann, Diana Albrecht, Petra Arohonka, Radovan Bilek, Joao J. de Castro, Lisbeth Dahl, Helena Filipsson Nystrom, Simona Gaberscek, Eduardo Garcia-Fuentes, Monica L. Gheorghiu, Alicja Hubalewska-Dydejczyk, Sandra Hunziker, Tomislav Jukic, Borislav Karanfilski, Seppo Koskinen, Zvonko Kusic, Venjamin Majstorov, Konstantinos C. Makris, Kostas B. Markou, Christa Meisinger, Neda Milevska Kostova, Karen R. Mullen, Endre V. Nagy, Valdis Pirags, Gemma Rojo-Martinez, Mira Samardzic, Ljiljana Saranac, Ieva Strele, Michael Thamm, Işık Top, Malgorzata Trofimiuk-Müldner, Belgin Ünal, Liisa Valsta, Lluis Vila, Paolo Vitti, Benjamin Winter, Jayne V. Woodside, Katja Zaletel, Vaclav Zamrazil, Michael Zimmermann, Iris Erlund, Henry Völzke Thyroid, 2020
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Karami, B. K. Matin, A. Karch, Mohd A. Karim, S. Karki, A. Kasaeian, Gebremicheal Gebreslassie Kasahun, H. Kasaye, Tesfaye Dessale Kassa, Hagazi Gebremedhin Kassaye, Nicholas J. Kassebaum, A. K. Karyani, A. Kengne, Daniel Bekele Ketema, Y. Khader, M. A. Khafaie, Mojtaba Khaksarian, Nauman Khalid, I. Khalil, R. Khalilov, A. Khan, E. A. Khan, M. N. Khan, M. S. Khan, M. Khan, Khaled Khatab, Amir M Khater, M. M. Khater, Mahalqua Nazli Khatib, Maryam Khayamzadeh, Maryam Khazaei-Pool, M. Khazaei, S. Khazaei, Mohammad Taghi Khodayari, M. Khosravi, R. Khundkar, A. Kiadaliri, N. Kianipour, Daniel N. Kiirithio, Y. Kim, R. Kimokoti, A. Kisa, S. Kisa, Tufa Kolola, Hamidreza Komaki, Shivakumar K. M. Kondlahalli, A. Koolivand, P. Koul, A. Koyanagi, M. Kraemer, K. Krishan, Kris J. Krohn, Nuworza Kugbey, M. Kumar, P. Kumar, V. Kumar, O. Kurmi, O. Kuti, C. L. Vecchia, Ben Lacey, D. Lad, A. Lal, D. Lal, Faris Lami, Prabhat Lamichhane, J. Lang, V. Lansingh, Savita Lasrado, G. Lebedev, Paul H. Lee, S. Lee, M. Leili, Ian Letourneau, S. Lewycka, S. Li, Lee-Ling Lim, Shai Linn, S. Liu, Simin Liu, R. Lodha, J. Longbottom, J. C. F. Lopez, S. Lorkowski, Erlyn K Macarayan, M. Madadin, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P. Maghavani, P. Mahasha, N. Mahotra, V. Maled, A. Maleki, S. Maleki, D. Malta, A. Manafi, Farzad Manafi, Navid Manafi, Narendar Dawanu Manohar, F. Mansour-Ghanaei, B. Mansouri, M. Mansournia, C. C. Mapoma, Dadi Marami, L. Marczak, C. M. Arnedo, Francisco Rogerlândio Martins-Melo, Anthony Masaka, B. Massenburg, P. Maulik, B. Mayala, M. Mazidi, M. Mehndiratta, Freshteh Mehri, K. Mehta, Wahengbam Bigyananda Meitei, F. Mekonnen, Teferi Mekonnen, Gebrekiros Gebremichael Meles, H. Meles, Addisu Melese, Walter Mendoza, R. Menezes, Meresa Berwo Mengesha, G. A. Mensah, T. Meretoja, T. Miazgowski, Neda Milevska Kostova, T. Miller, E. Mills, G. Mini, Seyed Mostafa Mir, Mohammad Miri, H. Mirjalali, E. M. Mirrakhimov, H. Mirzaei, M. Mirzaei, Roya Mirzaei, M. Mirzaei-Alavijeh, Prasanna Mithra, B. Moazen, E. Mohamadi, A. Mohamadi-bolbanabad, K. Mohammad, Y. Mohammad, Dara K. Mohammad, Aso Darwesh, Naser Mohammad gholi Mezerji, A. Mohammadian-Hafshejani, Mousa Mohammadnia-Afrouzi, Milad Mohammadoo-Khorasani, Reza Mohammadpourhodki, Salahuddin Mohammed, S. Mohammed, Jemal Abdu Mohammed, A. S. Mohammed, Farnam Mohebi, Amin Mokari, A. Mokdad, J. C. Montañez, Pablo A. Montero-Zamora, Y. Moodley, Maryam Moossavi, Ghobad Moradi, M. Moradi, Y. Moradi, M. Moradi-Joo, M. Moradi-Lakeh, F. Moradpour, Rahmatollah Moradzadeh, Paula Moraga, S. Morrison, Abbas Mosapour, J. Mosser, Simin Mouodi, A. M. Khaneghah, D. Mozaffarian, U. Mueller, C. Murray, G. Murthy, Kamarul Imran Musa, G. Mustafa, S. Muthupandian, B. Nabavizadeh, M. Naderi, G. Nadkarni, A. J. Nagarajan, M. Naghavi, A. Naheed, G. Naik, F. Najafi, J. R. Nansseu, K. Narayan, B. Nascimento, Vinod C. Nayak, J. Nazari, D. Ndwandwe, Ionut Negoi, R. Negoi, J. Ngunjiri, C. Nguyen, H. Nguyen, D. Nigatu, Yesdhambel T. Nigatu, Rajan Nikbakhsh, D. Ningrum, C. A. Nnaji, V. M. Nong, J. J. Noubiap, C. Nowak, B. Oancea, R. Ofori-Asenso, Onome Bright Oghenetega, I. Oh, O. Oladimeji, M. Oladnabi, A. T. Olagunju, T. O. Olagunju, B. O. Olusanya, J. O. Olusanya, M. Oluwasanu, Muktar Omer Omer, O. Onwujekwe, Kwaku Oppong Asante, E. Oren, O. E. Orisakwe, A. Ortiz, O. Osarenotor, Aaron Osgood-Zimmerman, M. Owolabi, M. P. A., Jagadish Rao Padubidri, K. Pakshir, Adrian Pana, Songhomitra Panda-Jonas, Hadi Parsian, T. Pashaei, D. K. Pasupula, S. Patel, A. Pathak, M. Pathak, S. Pati, Ajay Patle, G. Patton, Kebreab Paulos, H. P. Toroudi, V. C. F. Pepito, N. Perico, William A. Petri, Brandon V. Pickering, D. Pigott, M. Pirestani, Bakhtiar Piroozi, M. Pirsaheb, K. Pokhrel, M. Postma, Hadi Pourjafar, Farshad Pourmalek, Reza Pourmirza Kalhori, A. Pourshams, H. Poustchi, Sergio I. Prada, L. Preoțescu, Dimas Ria Angga Pribadi, Zahiruddin Quazi Syed, M. Rabiee, Navid Rabiee, Amir Radfar, A. Rafiei, F. Rahim, V. Rahimi-Movaghar, M. Rahman, S. Rahman, R. Rai, Ali Rajabpour-Sanati, Fatemeh Rajati, Kiana Ramezanzadeh, S. M. Rana, C. L. Ranabhat, S. J. Rao, D. Rasella, V. Rashedi, Prateek Rastogi, Priya Rathi, S. Rawaf, D. Rawaf, L. Rawal, S. Ray, G. Remuzzi, Vishnu Renjith, A. Renzaho, S. Resnikoff, N. Rezaei, S. Rezaeian, Mohammad Sadegh Rezai, A. Rezapour, S. M. Riahi, A. Ribeiro, Jennifer Rickard, A. Rodríguez, L. Roever, Elias Merdassa Roro, G. Roshandel, A. Rostami, Enrico Rubagotti, A. Saad, Seyedmohammad Saadatagah, Y. Sabde, S. Sabour, E. Sadeghi, M. Sadeghi, Saeed Safari, Yahya Safari, Hamid R. Safarpour, R. Sagar, A. Sahebkar, M. A. Sahraian, S. Sajadi, M. Salahshoor, N. Salam, Farkhonde Salehi, Saleh Salehi Zahabi, Hosni Salem, M. Salem, Yahya Salimi, H. Salimzadeh, H. S. Kafil, E. Sambala, A. M. Samy, I. S. Santos, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, A. Sarker, Benn Sartorius, A. Sarveazad, B. Sathian, Maheswar Satpathy, Sonia Saxena, Mehdi Sayyah, Alyssa N. Sbarra, Megan F. Schipp, M. Schmidt, A. Schutte, D. Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, S. Seyedmousavi, F. Shaahmadi, O. Shafaat, S. Shahabi, M. A. Shaikh, A. Shalash, Mehran Shams-Beyranvand, A. Shamshirian, M. Shamsizadeh, Mohammed Shannawaz, K. Sharafi, Mehdi Sharif, Rajesh Sharma, H. S. Shehata, A. Sheikhtaheri, K. Shibuya, W. S. Shiferaw, M. Shigematsu, J. Shin, R. Shiri, Reza Shirkoohi, Ivy Shiue, Kerem Shuval, Soraya Siabani, T. Siddiqi, I. D. Sigfusdottir, D. A. S. Silva, B. Simonetti, A. Singh, P. Singh, Virendra Singh, J. A. Singh, P. Singh, D. Sinha, Yitagesu Sintayehu, M. M. Sisay, A. Soheili, Bija Soleymani, Farzaneh Soltani, S. Soltani, J. Soriano, Muluken Bekele Sorrie, S. Soshnikov, Ireneous N. Soyiri, Adel Spotin, Chandrashekhar T. Sreeramareddy, R. Srivastava, A. Starodubova, A. Sudaryanto, M. Sufiyan, H. A. R. Suleria, G. Sulo, B. Sunguya, Bryan L. Sykes, R. Tabarés-Seisdedos, T. Tabuchi, B. T. Tadesse, Amir Taherkhani, K. S. Tamirat, S. Tassew, Nuno Taveira, B. Teklehaimanot, Gebretsadkan Hintsa Tekulu, Mohamad-Hani Temsah, A. Terkawi, Zemenu Tadesse Tessema, N. Thomas, M. V. Titova, Kenean Getaneh Tlaye, H. R. Tohidinik, M. Tonelli, M. Tovani-Palone, Eugenio Traini, K. Tran, M. Tripathi, R. Uddin, I. Ullah, B. Unnikrishnan, Era Upadhyay, Ushotanefe Useh, M. Usman, O. Uthman, M. Vacante, M. Vaezghasemi, Pascual R. Valdez, John Vanderheide, E. Varavikova, S. Varughese, T. Vasankari, Yasser Vasseghian, Y. Veisani, S. Venkatesh, N. Venketasubramanian, M. Verma, S. Vidale, F. Violante, Vasily Vlassov, S. Vollmer, Rade Vukovic, Y. Waheed, H. Wang, Yafeng Wang, Yuan-Pang Wang, G. T. Weldesamuel, Andrea Werdecker, Taweewat Wiangkham, K. Wiens, Tissa Wijeratne, Haileab Fekadu Wolde, D. Z. Wondafrash, Tewodros Eshete Wonde, A. Wondmieneh, A. Wu, G. Xu, A. Yadegar, A. Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Yuichiro Yano, S. Yaya, Vahid Yazdi-Feyzabadi, Alex Yeshaneh, Yigizie Yeshaw, Yordanos Gizachew Yeshitila, Mekdes Tigistu Yilma, P. Yip, N. Yonemoto, Seok-Jun Yoon, Y. Youm, M. Younis, Zabihollah Yousefi, H. S. Yousof, Chuanhua Yu, Hasan Yusefzadeh, T. Z. Moghadam, L. Zaki, Sojib Bin Zaman, M. Zamani, Maryam Zamanian, Hamed Zandian, Hadi Zarafshan, Nejimu Biza Zepro, T. Zerfu, Taye Abuhay Zewale, Y. Zhang, Zhi-Jiang Zhang, Xiu-Ju Zhao, S. Zodpey, K. Zomorodian, F. Zotor, A. Afshin, S. Hay Nature Medicine, 2020
Changes in disease burden in Poland between 1990-2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017 Maria Gańczak, Tomasz Miazgowski, Marta Kożybska, Artur Kotwas, Marcin Korzeń, Bartosz Rudnicki, Tomasz Nogal, Catalina Liliana Andrei, Marcel Ausloos, Maciej Banach, Alexandra Brazinova, Maria-Magdalena Constantin, Eleonora Dubljanin, Claudiu Herteliu, Mihaela Hostiuc, Sorin Hostiuc, Mihajlo Jakovljevic, Jacek Jerzy Jozwiak, Katarzyna Kissimova-Skarbek, Zbigniew J. Król, Tomislav Mestrovic, Bartosz Miazgowski, Neda Milevska Kostova, Mohsen Naghavi, Ionut Negoi, Ruxandra Irina Negoi, Adrian Pana, Salvatore Rubino, Mario Sekerija, Radoslaw Sierpinski, Lucjan Szponar, Roman Topor-Madry, Isidora S. Vujcic, Justyna Widecka, Katarzyna Widecka, Bogdan Wojtyniak, Vesna Zadnik, Jacek A. Kopec Plos One, 2020
Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050 Angela Y. Chang, Krycia Cowling, Angela E. Micah, Abigail Chapin, Catherine S. Chen, Gloria Ikilezi, Nafis Sadat, Golsum Tsakalos, Junjie Wu, Theodore Younker, Yingxi Zhao, Bianca S. Zlavog, Cristiana Abbafati, Anwar E Ahmed, Khurshid Alam, Vahid Alipour, Syed Mohamed Aljunid, Mohammed J. Almalki, Nelson Alvis-Guzman, Walid Ammar, Catalina Liliana Andrei, Mina Anjomshoa, Carl Abelardo T. Antonio, Jalal Arabloo, Olatunde Aremu, Marcel Ausloos, Leticia Avila-Burgos, Ashish Awasthi, Martin Amogre Ayanore, Samad Azari, Natasha Azzopardi-Muscat, Mojtaba Bagherzadeh, Till Winfried Bärnighausen, Bernhard T Baune, Mohsen Bayati, Yared Belete Belay, Yihalem Abebe Belay, Habte Belete, Dessalegn Ajema Berbada, Adam E. Berman, Mircea Beuran, Ali Bijani, Reinhard Busse, Lucero Cahuana-Hurtado, Luis Alberto Cámera, Ferrán Catalá-López, Bal Govind Chauhan, Maria-Magdalena Constantin, Christopher Stephen Crowe, Alexandra Cucu, Koustuv Dalal, Jan-Walter De Neve, Selina Deiparine, Feleke Mekonnen Demeke, Huyen Phuc Do, Manisha Dubey, Maha El Tantawi, Sharareh Eskandarieh, Reza Esmaeili, Mahdi Fakhar, Ali Akbar Fazaeli, Florian Fischer, Nataliya A. Foigt, Takeshi Fukumoto, Nancy Fullman, Adriana Galan, Amiran Gamkrelidze, Kebede Embaye Gezae, Alireza Ghajar, Ahmad Ghashghaee, Ketevan Goginashvili, Annie Haakenstad, Hassan Haghparast Bidgoli, Samer Hamidi, Hilda L. Harb, Edris Hasanpoor, Hamid Yimam Hassen, Simon I. Hay, Delia Hendrie, Andualem Henok, Ileana Heredia-Pi, Claudiu Herteliu, Chi Linh Hoang, Michael K. Hole, Enayatollah Homaie Rad, Naznin Hossain, Mehdi Hosseinzadeh, Sorin Hostiuc, Olayinka Stephen Ilesanmi, Seyed Sina Naghibi Irvani, Mihajlo Jakovljevic, Amir Jalali, Spencer L. James, Jost B. Jonas, Mikk Jürisson, Rajendra Kadel, Behzad Karami Matin, Amir Kasaeian, Habtamu Kebebe Kasaye, Mesfin Wudu Kassaw, Ali Kazemi Karyani, Roghayeh Khabiri, Junaid Khan, Md Nuruzzaman Khan, Young-Ho Khang, Adnan Kisa, Katarzyna Kissimova-Skarbek, Stefan Kohler, Ai Koyanagi, Kristopher J. Krohn, Ricky Leung, Lee-Ling Lim, Stefan Lorkowski, Azeem Majeed, Reza Malekzadeh, Morteza Mansourian, Lorenzo Giovanni Mantovani, Benjamin Ballard Massenburg, Martin McKee, Varshil Mehta, Atte Meretoja, Tuomo J Meretoja, Neda Milevska Kostova, Ted R Miller, Erkin M Mirrakhimov, Bahram Mohajer, Aso Mohammad Darwesh, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Shane Douglas Morrison, Seyyed Meysam Mousavi, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Vinay Nangia, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Son Hoang Nguyen, Shirin Nosratnejad, Olanrewaju Oladimeji, Stefano Olgiati, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Stanislav S Otstavnov, Adrian Pana, David M. Pereira, Bakhtiar Piroozi, Sergio I Prada, Mostafa Qorbani, Mohammad Rabiee, Navid Rabiee, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Usha Ram, Chhabi Lal Ranabhat, Anna Ranta, David Laith Rawaf, Salman Rawaf, Satar Rezaei, Elias Merdassa Roro, Ali Rostami, Salvatore Rubino, Mohamadreza Salahshoor, Abdallah M. Samy, Juan Sanabria, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Miloje Savic, Falk Schwendicke, Sadaf G. Sepanlou, Masood Sepehrimanesh, Aziz Sheikh, Mark G Shrime, Solomon Sisay, Shahin Soltani, Moslem Soofi, Moslem Soofi, Vinay Srinivasan, Rafael Tabarés-Seisdedos, Anna Torre, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Eduardo A. Undurraga, Pascual R Valdez, Job F M van Boven, Veronica Vargas, Yousef Veisani, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Sebastian Vollmer, Giang Thu Vu, Charles D A Wolfe, Naohiro Yonemoto, Mustafa Z. Younis, Mahmoud Yousefifard, Sojib Bin Zaman, Alireza Zangeneh, Elias Asfaw Zegeye, Arash Ziapour, Adrienne Chew, Christopher J L Murray, Joseph L Dieleman Lancet, 2019
The crossroads of development assistance and national development agendas in the countries of South Eastern Europe Routledge Handbook on the Politics of Global Health, 2018
The former Yugoslav Republic of Macedonia: Health System Review Health Systems in Transition, 2017
Antibiotic allergy delabeling requires more than guidelines: the role of patient perspective N Milevska-Kostova, T Schoffelen, T Langeveld, J Schouten, ... Clinical Microbiology and Infection , 2026 2026
Training future antimicrobial stewards in the ESCMID AMS certificate training programme: from knowledge to action SME Kuijpers, MEJL Hulscher, JM Prins, J Ten Oever, T Schoffelen, ... JAC-Antimicrobial Resistance 7 (5), dlaf157 , 2025 2025 Citations: 2
Antifungal policy and practice across five countries: a qualitative review DW Denning, JR Perfect, N Milevska-Kostova, A Haderi, H Armstrong, ... Journal of Fungi 11 (2), 162 , 2025 2025 Citations: 6
Health Systems in Action (HSiA) Insights–North Macedonia B Rechel, S Atanasova, N Milevska-Kostova European Observatory on Health Systems and Policies, WHO Regional Office for … , 2025 2025
North Macedonia: Health System Review. N Milevska Kostova, S Atanasova, V Dimkovski, G Stevanovski, ... Health systems in transition 26 (6), 1-164 , 2024 2024 Citations: 6
Development of the ABXGUIDE: a pathogen-directed consensus guideline for antimicrobial use in resource-constrained settings H Kadri, NM Kostova, T Schoffelen, S Kanj, H Wertheim Journal of Global Antimicrobial Resistance 39, 53 , 2024 2024
The European researchers’ network working on second victim (ERNST) policy statement on the second victim phenomenon for increasing patient safety J Mira, I Carillo, S Tella, K Vanhaecht, M Panella, D Seys, MI Ungureanu, ... Public health reviews 45, 1607175 , 2024 2024 Citations: 31
Systematic in vitro optimization of antimicrobial peptides against Escherichia coli A Shukri, AC Carroll, R Collins, F Charih, A Wong, KK Biggar JAC-Antimicrobial Resistance 6 (4), dlae096 , 2024 2024 Citations: 1
Global patient safety report 2024 World Health Organization World Health Organization , 2024 2024 Citations: 140
SPICE: bevordering van duurzame zorg voor patiënten met een infectie N Milevska-Kostova, E Bowles, M Sijtsma, J Schouten, H Wertheim Ned Tijdschr Med Microbiol 32 (4), 163 , 2024 2024 Citations: 1
Kawaldip Sehmi: global champion of patients’ rights T Richards, N Milevska, E Doble bmj 383 , 2023 2023
Report of the 69th session of the WHO Regional Committee for the Eastern Mediterranean WHO Regional Office, Cairo, Egypt, 10-13 October 2022 World Health Organization World Health Organization. Regional Office for the Eastern Mediterranean , 2023 2023
Acknowledgment to the Reviewers of Tropical Medicine and Infectious Disease in 2022 TME Office Tropical Medicine and Infectious Disease 8 (2), 70 , 2023 2023
Acknowledgment to the Reviewers of Antibiotics in 2022 AE Office Antibiotics 12 (2), 185 , 2023 2023
Acknowledgment to the Reviewers of Antibiotics in 2022 Antibiotics Editorial Office Antibiotics 12 (2), 185 , 2023 2023
Household spending in pharmacies: how much and on what? Applied research in North Macedonia to improve tracking of health expenditure World Health Organization World Health Organization. Regional Office for Europe , 2023 2023
Acknowledgment to the Reviewers of Tropical Medicine and Infectious Disease in 2022 AN Anoopkumar, A Goli, A Martín-Park, A Harvey-Vera, AJ Karim, ... 2023
Acknowledgment to the Reviewers of Antibiotics in 2022 AA Korzhenkov, A Frum, ANM Mamun-Or-Rashi, AR Kolli, ... 2023
Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 KS Ikuta, LR Swetschinski, GR Aguilar, F Sharara, T Mestrovic, AP Gray, ... The Lancet 400 (10369), 2221-2248 , 2022 2022 Citations: 2414
Universal salt iodization potentially contributes to health equity: socio-economic status of children does not affect iodine status N Milevska-Kostova, D Miladinova, S Kuzmanovska, V Majstorov, ... Journal of Pediatric Endocrinology and Metabolism 35 (9), 1154-1160 , 2022 2022 Citations: 5
MOST CITED SCHOLAR PUBLICATIONS
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 T Vos, SS Lim, C Abbafati, KM Abbas, M Abbasi, M Abbasifard, ... The lancet 396 (10258), 1204-1222 , 2020 2020 Citations: 16248
Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 KS Ikuta, LR Swetschinski, GR Aguilar, F Sharara, T Mestrovic, AP Gray, ... The Lancet 400 (10369), 2221-2248 , 2022 2022 Citations: 2414
World report on hearing World Health Organization World Health Organization , 2021 2021 Citations: 1817
WHO regional offices World Health Organization 2017 Citations: 529
Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries … AY Chang, K Cowling, AE Micah, A Chapin, CS Chen, G Ikilezi, N Sadat, ... The Lancet 393 (10187), 2233-2260 , 2019 2019 Citations: 462
Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3 AE Micah, Y Su, SD Bachmeier, A Chapin, IE Cogswell, SW Crosby, ... The Lancet 396 (10252), 693-724 , 2020 2020 Citations: 175
World health statistics 2022: monitoring health for the SDGs, sustainable development goals GWH Organizatio Geneva: World Health Organization , 2022 2022 Citations: 173
Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 … AE Micah, IE Cogswell, B Cunningham, S Ezoe, AC Harle, ER Maddison, ... The lancet 398 (10308), 1317-1343 , 2021 2021 Citations: 149
Global patient safety report 2024 World Health Organization World Health Organization , 2024 2024 Citations: 140
Mapping local patterns of childhood overweight and wasting in low-and middle-income countries between 2000 and 2017 Nature medicine 26 (5), 750-759 , 2020 2020 Citations: 128
WHO policy on disability World Health Organization World Health Organization , 2021 2021 Citations: 127
Standardized map of iodine status in Europe T Ittermann, D Albrecht, P Arohonka, R Bilek, JJ De Castro, L Dahl, ... Thyroid 30 (9), 1346-1354 , 2020 2020 Citations: 122
Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by … M Dyakova World Health Organization , 2017 2017 Citations: 108
Key policies for addressing the social determinants of health and health inequities M Saunders, P McHale, C Hamelmann World Health Organization , 2017 2017 Citations: 99
Changes in disease burden in Poland between 1990–2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017 M Gańczak, T Miazgowski, M Kożybska, A Kotwas, M Korzeń, B Rudnicki, ... PloS one 15 (3), e0226766 , 2020 2020 Citations: 74
Multisectoral and intersectoral action for improved health and well-being for all: mapping of the WHO European Region. Governance for a sustainable future: improving health and … World Health Organization World Health Organization. Regional Office for Europe , 2018 2018 Citations: 62
Ensuring effective prevention of iodine deficiency disorders H Völzke, P Caron, L Dahl, JJ De Castro, I Erlund, S Gaberšček, ... Thyroid 26 (2), 189-196 , 2016 2016 Citations: 52
The former Yugoslav Republic of Macedonia: Health System Review. NK Milevska, S Chichevalieva, NA Ponce, J Winkelmann Health systems in transition 19 (3), 1-160 , 2017 2017 Citations: 48
Health politics in Europe: A handbook EM Immergut, KM Anderson, C Devitt, T Popic Oxford University Press , 2021 2021 Citations: 46
How digital transformation can help achieve value-based healthcare: Balkans as a case in point RA Rosalia, K Wahba, N Milevska-Kostova The Lancet Regional Health–Europe 4 , 2021 2021 Citations: 43
