INTRODUCTION
The prevalence of atopic eczema has increased for the past decades,
although the variability of this trend is high and depends in part on
the region of the world and on the socioeconomic
status1. According to the last report from the Global
Asthma Network (GAN) recently published2, the increase
in adolescents of 13-14 years has been 0.98% per decade for the las 27
years. In the first GAN survey, carried out between 2015 and 2020, the
prevalence in the group of low and middle-low, and on the upper-middle
income countries, symptoms of current eczema and lifetime eczema were
significantly lower than that of high income
countries3. At the time when the survey was performed,
Kosovo was in the group of upper-middle income
countries4. Additionally, Kosovo, although not having
direct access to the sea, can be considered a Mediterranean country.
This warm and humid area, as compared to others in the world, has shown
relatively low prevalence of atopic eczema5 with some
studies pointing at climate, and in particular the number of sunny
hours, as being part of the explanation1,6.
The prevalence of eczema in Kosovo is basically unknown although there
has been some epidemiological data in the Balkan area previously. The
International Study of Asthma and Allergies in Childhood (ISAAC) phase
III (the methodology of which has been used by GAN) reported data from
Albania in the age groups of 6-7 and 13-14 years, which was one of the
world lowest for current symptoms of eczema5. Both in
this ISAAC report and in the more detailed one by Zivković et al.7 the lowest prevalence of current eczema symptoms in
Serbia and Montenegro was found to be in Novi Sad, (north of Serbia).
However, neither of the two reports, nor previous ones in the
Balkans8,9, included the study of risk or protective
factors for eczema at the individual or centre level. To the best of our
knowledge, only one study in Croatia has reported epidemiological
factors associated to eczema in the Balkan area in
adolescents10. Another one focused on the association
of traffic pollution with allergic diseases11.
Thus, the study of the epidemiology, including potential risk or
protective factors, of eczema in adolescents in the main cities of a
country such as Kosovo could add important information on the subject:
it would show the current size of the problem in an area which has
previously presented low prevalence of the condition; may add
information about the epidemiological factors in a low prevalence region
in order to facilitate comparison with areas of higher prevalence; could
allow for comparisons between centres in the same low-prevalence area;
and might show paths for prevention.