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.