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1893 CNIPH
ISSN 1333-0608 |
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MONTHLY NEWS
Croatian National Institute
of Public Health
CNIPH opened a new
portal
www.zdravlje.hr. on May 5 in collaboration with Croatian Telecom and
CRONET. The opening was attended by the Ministry of Health and Social
Welfare state secretary Prof. Dr Velimir Bozikov and other prominent
public and professional figures. There were several thousand portal
visits in the first two days already.
The 3rd
international symposium on complementary supportive therapies “Art
and Science in Life Potential Development” was organised in Hvar
20-23 May 2004 by Motor Disorder, Chronic Disease and Art Therapy Unit
of the Education and Rehabilitation School, University of Zagreb and by
Croatian Society of Psychosocial Oncology. Professor Marija Strnad gave
a full lecture titled “Epidemiology and Chronic Health Disorders” in
which she particularly underlined the importance of interdepartmental
approach to the primary, secondary and tertiary prevention of health
deterioration. On 26-28 May in Copenhagen, Professor Strnad and Pr
Vlasta Hrabak-Zerjavic, MD, MSc presented the findings of a case study
on the prevention of cardiovascular diseases by gender at a joint
meeting in the WHO/EURO Office. Apart from Croatia other participants in
the study on the same subject were the UK, Netherlands and Ireland. On
the subject of reproductive health and gender Turkey, Kyrghyzstan and
Tajikistan the study was carried out successfully using a common
methodology. Dr Joke Haafkens is the principal investigator of the “Integration
of Gender Perspective in Health Policy” study.
INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE
(Ministry of
Health’s Reference Centre for Epidemiology)
- Head, Prof. Dr Ira Gjenero-Margan
A 4-day training
seminar/workshop for HIV counselling and testing: education for
consultants was organised by the Infectious Disease Epidemiology
Service on 17-20 May in Zagreb. Aims of the workshop were as follows:
familiarise the attendees with the basic principles of counselling and
the conditions necessary for giving counsel, develop in attendees the
skills and techniques required of work at the Centres for Voluntary
Testing and Counselling (CTC)), raise attendee consciousness of
personal and cultural attitudes associated with the HIV/AIDS problem
area and familiarising the attendees with the CTC organisation and its
work rules. Twenty individuals, primarily health institution staffs and
NGO activists who directly or indirectly take part in the activities of
HIV/AIDS Counselling Centres, attended the workshop. Lecturing at the
workshop were staff members of the Fran Mihaljevic Infectious Disease
Clinic and of Croatian National Institute of Public Health. Lena
Nilsson Schonenson, a psychology professor, leading expert in the
counselling field, and Gay Men’s Health Clinic counsellor in Stockholm,
was the workshop leader.
A Round Table
Conference on Tuberculosis attended by 40 epidemiologists and lung
specialists took place at CNIPH on 27 May. The conferees depicted the
situation and tuberculosis-related problems in their respective counties
and institutions. It was noticed that the problems tended to group,
especially in the treatment and monitoring of the patients having no
health insurance category and in their contacts. Discussions also
included patient notification and registration methods as well as the
treatment outcome reporting method. There was also a demonstration of
software for the creation and analysis of a database designed to improve
the registration and follow-up of tuberculars and their contacts.
CHRONIC MASS DISEASE
EPIDEMIOLOGY DEPARTMENT
- Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc
The international Quit
& Win competition that we have joined for the fifth time is over. In
Croatia, 2,613 people registered among whom potential winners
were drawn on 25 May, the World Non-Smokers Day. A
winner’s refraining from smoking for 4 weeks must be confirmed by a
witness and a biochemical test. Drawing of the international prize will
take place in Moscow on 23 June 2004.
CNIPH has organised a
Round Table Conference on the subject “Smoking or Health” at the
Journalist’s Home as an event to mark the World Non-Smokers Day. The
conference was attended by our eminent professionals. This year for
the occasion WHO devised a slogan “Smoking and poverty, a vicious
circle”. Nowadays there is a striking discrepancy in smoking rates
between the lowest and highest social groups in most countries. As in
some countries the poor smoke up to three times as much than the rich,
they are exposed to threefold risk.
The 5th
Congress of Croatian Cardiological Society with international
participation was held 16-19 May at Opatija. Attending it for CNIPH
were Pr V. Hrabak-Zerjavic with a lecture “Public Health Importance of
Cardiovascular Diseases” and a poster “Epidemiological Account of
Cerebrovascular Diseases”, M. Erceg, MSc with a lecture “Health
Promotion and Cardiovascular Disease Prevention within Croatia’s Health
Care Measure Plan and Programme”, as well as by Dr V. Kralj with a
poster “Epidemiology of Ischemic Heart Disease in Croatia”. Also as
part of the congress, Croatian Cardiological Society held its annual
convention. It has confirmed the initiative to establish its
Epidemiology, Prevention and Rehabilitation Chapter with Pr Vlasta
Hrabak-Zerjavic, MD, MSc as the chairperson designate.
ADDICTION PREVENTION SERVICE
-
Acting
head, Pr
Marina Kuzman, MD,
ScD
On May 20, a meeting
of all county public health institute directors, addiction prevention
service heads and centre for addiction prevention heads took place
in Zagreb. Representatives of the Ministry of Health and Social Welfare
and of the Government Office for Addiction Control were also present.
The debate covered the organisational, financial and technical concerns
of the operation of addiction prevention services after the integration
of centres for addiction prevention into institutes of public health.
At the moment 12 centres are integrated with the institutes, an increase
by more than seven since the last meeting. In keeping with the proposed
materials, the network of necessary teams, their work content and
working programmes, as well as the immediate tasks of institutes and
centres were considered in more detail in connection with the financing
of this activity till the end of 2004. A Working Party was formed
charged with making an analysis and possibly filling the gaps in the
Programme for Prevention of Addictions, which has been prepared by the
Addiction Prevention Service, CNIPH, to ready us to apply for a grant
from the health ministry and local self-government bodies and to start
negotiating with the Croatian Institute for Health Insurance about the
financing of the public health activity of addiction prevention for the
next year.
SOCIAL MEDICINE SERVICE
- Head, Urelija Rodin, MD, MSc
CNIPH was a
co-organiser with Croatian Medical Association’s Croatian Society for
Telemedicine of the 2nd Croatian Congress on Telemedicine
with international participation, which took place at the Zagreb
Fair on 19-21 May within the Medicine and Technology fair. For CNIPH,
head of Primary Care Service Pr Ranko Stevanovic, MD, MSc presented a
paper “The Development of Information System and Telemedicine in
Croatia’s Primary Care”. Within the fair, Croatian Society for Medical
Informatics organised on 21 May a highly successful panel discussion on
the development of health information system. Over 100 conferees as well
as representatives of the Ministry of Health, Ministry of Science and
Technology, Central Office of eCroatia, health institutions, and
information equipment and software manufacturers attended.
Introductory accounts of the development of public health information
system and Croatian experiences with the establishment and development
of the information system for primary care were given by Marijan Erceg,
MD, MSc, director of CNIPH, and by Pr Ranko Stevanovic, MD, MSc.
On 18 May 2004, the
Working Party on Executive Subprogram “Development Strategies for
Croatia’s Health 2004-2015: Monitoring of
Health Indicators across Time and Nations”
was held at CNIPH. Under the Strategy and Executive
Subprogram preparation guidelines given by the deputy prime minister
Prof Dr Andrija Hebrang, the health indicator monitoring system has to
be comparable with all EU countries (through Eurostat) and WHO (through
Health for All Database). As regards data, their presentation must be
by health institutions as well at least once for each quarter of the
year. In consequence, the opinion of the Ministry of Health and Social
Welfare is awaited about the proposed “Norwegian project” for the
development of health indicators for Croatia. The above Working Party
has taken the view that this project initiative should be abandoned for
the reason that developing two parallel systems serves no purpose: in
fact, the WHO proposal for Europe, which has already been joined by most
European countries (52) Norway including, merits the priority.
MICROBIOLOGY SERVICE
- Head, Prof.
Dr Gordana Mlinaric-Galinovic
On 18-21 April 2004
the 6th Symposium on Sexually Transmitted Diseases and
Urogenital Infections: Slavko Schoenwald Symposium took place at
Opatija. Attendees from the Bacteriology Department were Dr Z. Persic,
Dr V. Kruzicevic and B. Hunjak, MSc with papers “Bacteriologic
Diagnosis and Bacterial Susceptibility to Antibiotics in Urinary
Infections” (co-authored by Pr R. Stevanovic, MD, MSc and Dr I.
Pristas); “Bacterial and Fungal Infections of Female Lower Genital
System” (co-authored by E. Mlinaric-Missoni, ScD and by V. Vazic-Babic,
ScD); and “Inflammatory Cells in Diseases of Prostate”. S.
Ljubin-Sternak from the Virology Department presented a paper “Chlamydia
trachomatis in Males with Asymptomatic and Symptomatic
Infections”. The symposium brought into line the opinions and adopted
guidelines on the diagnosis and treatment of urinary infections. One
new development noted at the Congress was the early results of the
prophylactic administration of vaccine in the females having a genital
infection with human papilloma virus (HPV). In view of connectedness
between the HPV infection and cervical carcinoma, a vaccine could be
used to reduce the development of carcinoma indirectly.
CNIPH’s National
Reference Laboratory for Mycobacteria collects and analyses
mycobacteriologic laboratory annual progress reports. As evident from
these reports for 2003 from all over the country, of the 4,760 isolated
strains M. tuberculosis was still the dominant mycobacterium with
4,516 (94.8%) isolates. Compared with the previous years, with 243
(5.1%) isolates “nontuberculous” or atypical mycobacteria exhibited a
mild increase. This was due to the introduction of liquid media for the
cultivation of mycobacteria (MGIT), facilitating and improving the
growth of saprophytic mycobacteria such as M. gordonae, M. terrae
and M. vaccae. Mycobacteriosis was demonstrated in only nine
patients, with M. xenopi being the causative agent in five, M.
kansasii in three, and M. avium complex in one case only.
Three people were found to be affected by respiratory tract colonisation
with M. fortuitum. The number of drug-resistant strains
accompanied the number of patients with drug-resistant tuberculosis. Of
the 4,516 M. tuberculosis strains isolated, 4,270 (94.6%) were
drug-susceptible, as few as 246 (5.4%) being resistant to the first-line
antituberculars. Monoresistance to the first-line antituberculars was
detected in 38% of the strains. Streptomycin (S) with 17.5% of the
strains accounted for most of this, followed by isoniazid (H) with 16.3%
and ethambutol (E) with 0.4% of the strains. Resistance to rifampin (R),
precursor to multiresistance was found in only 9 (3.3%) strains. No
pyrazinamide (Z) resistance was reported in 2003 either. Because the
stable trend of low drug resistance in M. tuberculosis strains
continued, this placed Croatia among countries with a low prevalence
both of mono- and multiresistant tuberculosis.
HEALTH ECOLOGY SERVICE
-
Head, Krunoslav Capak, MD,
MSc
Nutrition Physiology,
Monitoring and Promotion Department has organised two 1-day workshops
on the topic of comprehensive approach to nutritional promotion, which
took place in Zagreb at the Strigova Primary School (12 May) and Otok
Primary School (24 May). Katica Antonic Degac, MSc was the workshop
leader and besides WHO liaison officer Assistant Professor Dr
Antoinette Kaic-Rak participants included the physicians active in
health promotion in Slovenia, as well as teachers, parents and
children. Reemphasised at the workshops was the importance of
interdepartmental approach to nutrition promotion.
Dr Zrinka Petrovic took
part in the 5th Congress of Croatian Cardiological Society
held at Opatija on 16-19 May. Presented there was a poster by
Petrovic Z, Kralj V, Kuzman M, Brkic I, Antonic Degac K, Kaic-Rak A:
The Prevalence of Individual Risk Factors for Cardiovascular Diseases.
Several lectures underlining the importance of proper diet in
cardiovascular disease and hyperlipidaemia prevention were given, as
well as several studies aiming at establishing the occurrence of
myocardial infarction and type of nutrition, respectively consumption of
“riskier” foods.
On May 26-30, Katica
Antonic Degac and Dr Iva Pejnovic Franelic (School Health Service)
attended in Prague the 13th European Congress on Obesity:
ECO 2004. A poster authored by Antonic Degac K, Petrovic Z, Kaic-Rak
A, Mesaros-Kanjski E, and Capak K, titled Obesity Prevalence Trend
and Nutritional Status of Croatia’s Schoolchildren was presented
there. On show at the Congress were the findings of diverse studies on
the aetiology of obesity and those of intervention studies aimed at its
treatment. The Congress also reviewed preventive measures and the
public health importance of obesity generally for the society.
News (monthly) Croatian National
Institute of Public Health
ISSN 1333-0608
Editor-in-chief: Prof. Marija
Strnad, MD, MPH, PhD
Editor and co-ordinator: Mario Troselj, MD
Editorial Board: Bernard Kaic, MD; MSc Verica Kralj, MD; Jasminka
Tunukovic, MD; Andreja Barisin, MD
Translator: Vilim Crlenjak, BA
Graphic design: Mario Hemen, EE
Publisher: Croatian National Institute of Public Health
Rockefellerova 7, 10000 ZAGREB, CROATIA
Tel: 385 1 48 63 222
Fax: 385 1 46 83 002
www.hzjz.hr e-mail:
hzjz@hzjz.hr
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