Strengthening Primary Healthcare in Kosovo Requires Tailoring Primary, Secondary and Tertiary Prevention Interventions and Consideration of Mental Health

• Published in: Frontiers in public health Vol. 10; p. 794309
• Main Authors: Obas, Katrina Ann, Bytyci-Katanolli, Ariana, Kwiatkowski, Marek, Ramadani, Qamile, Fota, Nicu, Jerliu, Naim, Statovci, Shukrije, Gerold, Jana, Zahorka, Manfred, Probst-Hensch, Nicole
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 05.04.2022
• Subjects: COPD; Cross-Sectional Studies; Depression - diagnosis; Depression - epidemiology; depressive symptoms; diabetes; Diabetes Mellitus - epidemiology; Diabetes Mellitus - prevention & control; Humans; Hypertension; Kosovo - epidemiology; Mental Health; Noncommunicable Diseases; prevention; Primary Health Care; Public Health; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - prevention & control; Tertiary Prevention; Kosovo; depressive symptoms; diabetes; hypertension; prevention; public health; COPD
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2022.794309

Kosovo has the lowest life expectancy in the Balkans. Primary healthcare (PHC) plays an essential role in non-communicable disease (NCD) prevention. We described primary, secondary and tertiary prevention indicators in Kosovo and assessed their association with depressive symptoms. PHC users ( = 977) from the Kosovo NCD cohort baseline study were included. Depressive symptoms were assessed using the Depressive Anxiety Stress Scale-21. Cross-sectional associations between depressive symptoms and prevention indicators were quantified with mixed logistic regression models. Poor nutrition (85%), physical inactivity (70%), obesity (53%), and smoking (21%) were common NCD risk factors. Many cases of hypertension (19%), diabetes (16%) and Chronic Obstructive Pulmonary Disease (COPD) (45%) remained undetected by a PHC professional. Uncontrolled hypertension (28%), diabetes (79%), and COPD (76%) were also common. Depressive symptoms were positively associated with physical inactivity (OR 1.02; 95% CI 1.00-1.05 per 1-point increase in DASS-21) and undetected COPD (OR 1.07; 95% CI 1.00-1.15), but inversely with undetected diabetes (OR 0.95; 95% CI 0.91-1.00). Continued attention and tailored modifications to primary, secondary and tertiary prevention in Kosovo are needed to narrow the Balkan health gap.