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, et al. 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, et al. 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
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, et al. 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.
Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia Maja Avramovska, Neda Milevska Kostova, Borislav Karanfilski, Sandra Hunziker, Olivija Vaskova, et al. 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
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
