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1893 CNIPH
ISSN 1333-0608 |
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MONTHLY NEWS
Croatian National Institute
of Public Health
By struggling for
everyone’s life and its quality, all health workers play a major role in
stopping a 20-year falling trend in the natural increment of Croatia’s
population. They do this by putting in the foreground the health of the
mother and child as subjects of health care. Gynaecologists,
obstetricians, paediatricians and public health workers have a
particularly important role to play in reducing perinatal mortality.
They participated on 26 November 2004 in a Round Table Conference on
Perinatal Care as Croatia’s Problem that was organised by the
Ministry of Health and Social Welfare of the Republic of Croatia (MHSWRC).
The two lectures
delivered at this gathering by Pr Urelija Rodin, MD, MSc were “Perinatal
mortality” and “Childbirth notification”. Dr Tomislav Benjak dealt with
the topic “Neural-Risk Child Registry”. To note in connection with this
Registry is the fact that within the national strategy on comprehensive
policy on disabled for 2003-06 (Official Journal of the Republic of
Croatia, OJRC 13/03), MHSWRC has defined the mode of operation,
implementation, and data monitoring on at‑risk children until the end of
2005. It has provided for this in collaboration with CNIPH, experts in
this field, and governmental, local and regional self‑government
bodies. CNIPH considers that it should be receiving photocopies of the
forms used by regional centres for at‑risk and impaired children for
their own purposes. Establishing data linkage between data on
neural‑risk children and data on permanently impaired children would be
essential for an evaluation of individual measures taken to prevent
disabilities. The only method affording the prevention of child
disabilities is early diagnosis of neural risks combined with an early
start of rehabilitation.
INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE
(Ministry of
Health’s Reference Centre for Epidemiology)
- Head, Prof. Dr Ira Gjenero-Margan
After a grave illness Prof. Dr Berislav
Borcic, doyen of the national epidemiology and an expert of
world renown, died at the age of 72 on 27 October 2004. He was
CNIPH’s chief epidemiologist, longstanding head of the
Epidemiological Service and, for a period, the CNIPH director.
His activity centred around developing the immunisation schedule,
the application as such of systematic vaccinations to children and
youths, research and control of zoonoses with natural foci,
tularaemia, haemorrhagic fever with renal syndrome, endemic
nephropathy etc. His other concerns involved the organisation and
coordinated operation of the nation’s entire epidemiological
service. Thereby he has indebted us all and contributed to the
betterment of our health. He was active on several WHO expert
bodies, also being a founder of Croatian Medical Association’s
Croatian Epidemiological Society and its meritorious chairman.
Many people are certain to remember Professor Borcic as a
convincing and distinctive lecturer whose words are indelible.
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As this Service has
submitted an Implementing Immunisation Schedule for 2005 to the
minister of health and social welfare, which he accepted, the document
is due for distribution among all its executors in December. New items
on the Schedule are the abandonment of PPD testing and BCG vaccination
of children at the age of two years. On the other hand, it retains PPD
testing in the second form of primary school, but without the
immunisation of BCG reactors. Polio revaccination at the age of four
years is terminated. It is no longer necessary to carry out the
revaccination against measles, mumps, and rubeola in the fourth form of
primary school. The purpose of making these changes to the Schedule is
to facilitate its implementation, while at the same maintaining a high
level of collective population immunity and a highly effective vaccine
protection from the diseases against which young people are immunised.
Our Service staffers
attended the session of the Appointed Committee on AIDS Control at
Croatian government, a session of the Appointed Committee on AIDS
Control at Croatian government during which a National Programme for
HIV/AIDS Control was enacted. Several round table conferences and
seminars with the participation of our Service staffers took place in
November ahead of the World AIDS Day.
CHRONIC MASS DISEASE
EPIDEMIOLOGY DEPARTMENT
- Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc
To mark the World
Diabetes Day, an educational seminar organised by CNIPH
in collaboration with public health institutes in Osijek, Rijeka,
Split and Zagreb was held and a manual “Caring about Health:
Diabetes and Me” with a circulation of 20,000 copies presented.
In the four towns, around 500 family physicians attended the seminars
run by public health specialists, diabetologists, family physicians,
nurses and diabetic society representatives.
A European Cancer
Registry Network meeting took place in Luxembourg on 26-28
October. Cancer registries, evaluation of clinical care, childhood
cancer, automatic cancer case registration, molecular pathology and
cancer registries were the main subjects of the professional part of the
meeting. A lecture there by Znaor A, Bonassi S, Ceppi M, Norrpa H: “The
role of cancer registries in cytogenetic biomarker research” was
presented by Ariana Znaor, MSc.
A new issue of the
Medicus review is devoted to the problem of depressive disorders. Among
other papers it published one by Pr V. Hrabak-Zerjavic, MD, MSc, Dr M.
Silobrcic Radic et al. titled “Public health importance of depressive
disorders”. At the gathering “Depression today – working guidelines
for reaching a consensus on depressions” this problem was considered
via lectures and a debate aimed at passing guidelines on the
treatment of depressions.
SOCIAL MEDICINE SERVICE
- Head, Urelija Rodin, MD, MSc
In 2003, Croatia
had more than 52,000 deaths and fewer than 40,000 births. Without
appropriate changes to the socioeconomic conditions in the country
this depopulation trend will not stop. Nevertheless, within its terms
of reference and through organisational improvements in perinatal
care, health service is striving to take every technical measure in
order to reduce the number of risk pregnancies and that of deaths in
perinatal period. The subject taken up both by a round table
conference Perinatal care as Croatia’s health problem and by
the Conference on Perinatal Mortality was perinatal mortality
and development strategy for perinatal care with which to attempt
reducing further the present mortality rate. The Conference on
Perinatal Mortality, traditionally an annual event, has now been held
for the twelfth time in the arrangement of the Croatian Society for
Perinatal Medicine.
Within the
implementation of the National Programme for Romanies in health,
CNIPH has conducted an education‑of‑educators programme for educators
from the five counties having the largest number of Romany settlements.
An educational package had been prepared (with the topics dealt with
under the National Programme and with the production of accompanying
leaflets). Representatives of the Romany Association Council, visitor
nurses, public health institute physicians and focal points from county
assemblies who, in accord with local priorities, would monitor the
realisation of health educational actions in Romany settlements.
EUROSTAT’s broader
working group -- on Public Health Statistics – held a meeting in
Luxembourg, 24-25 November 2004. Pr Vlasta Deckovic-Vukres, MD, ScD
attended. In addition to considering progress reports 2004 from all
public health subgroups, the meeting also saw a presentation of their
plan for 2005. A 2005 priority was set before each working subgroup.
For instance, medical consumption in inpatient care is the priority
allocated to the Health Care Statistic Subgroup. As regards the Health
Indicators Subgroup, their priority is introducing HLY (Healthy Life
Years), a new structural indicator. Whereas the Industrial Health and
Safety Subgroup is to draw up certain legislation, the Cause‑of‑Death
Statistic Subgroup shall undertake a pilot project on the introduction
of electronic death notifications. As to the European Health Interview
Survey (EUHIS) Subgroup, its priority is to develop modules of
environmental influences on health. Beyond the mentioned priorities
2005, focus will also be on hospital injuries, traffic accidents, mental
health, medical records and medical workers (nurses).
Croatian Health
Statistical Annual
is based on the data gathered from the health system of the entire
country. The first such publication here was prepared by CNIPH as far
back as 1961. It presented health status figures and an overview of
health service activity in Croatia from 1950 to 1959. The new yearbook
for 2003 offers, of course, more information from each level of health
care about the organisation, work force pattern, health facility
operation and their utilisation, and health status indicators in
international comparisons also. Equally, it shows ecologic and basic
demographic indicators. Its presentations include certain health
statistical data collected through public health registries. A must
reading to those wanting only a basic insight, to professionals making
use of its health statistical data and to anyone using health
statistical data for technical purposes, it is available in the
electronic form as well.
ADDICTION PREVENTION SERVICE
-
Acting head, Pr
Marina Kuzman, MD,
ScD
Aspects of a
topical issue discussed at a technical gathering organised by the Zagreb
County Centre for Control of Addictive Drug Abuse and by the Counselling
Centre on Addiction Prevention covered sociology and some facets of
delinquency and drug addict treatment. Two lectures given by medical
staff members of this Service have completed this picture in regard of
its content and quality. Pr Marina Kuzman spoke on family factors
and addictive behaviour in youths, with Dr Dragica Katalinic
presenting and comparing data on the
Zagreb County drug addicts with nation‑wide data.
MICROBIOLOGY SERVICE
- Head, Prof.
Dr Gordana Mlinaric-Galinovic
In Tallinn,
Estonia, WHO organised on 28-29 September 2004 a SUB-regional WHO
Polio Laboratory Network Meeting for Countries of Central and
Eastern Europe
(CCEE/Baltics). Very important since
2002 when the infantile paralysis virus was proclaimed eradicated in
Europe
a reliable and rapid poliovirus diagnosis has been one of the key
segments of polio surveillance. Attending on behalf of CNIPH, Dr S.
Ljubin Sternak presented Croatian National Polio Laboratory’s progress
report. The Meeting concluded by passing WHO guidelines on the
forthcoming activities for national polio laboratories.
Biological
Medical Defence Conference 2004
took place in Munich, Germany on 20-21 October 2004. Professor G.
Mlinaric-Galinovic and Dr Z. Persic attended on behalf of our Service,
Dr A. Simunovic attending for the Epidemiology Service. Two posters
presented were “Q-fever in Croatia” authored by Professor G. Mlinaric
Galinovic et al., and “Croatian Experience with the Prevention of
Terrorist Use of Anthrax Spores in 2001” by Dr Persic et al. In
addition to presenting the posters, they also established contacts with
distinguished European and American professionals in the antiterrorist
defence area. During their trip, our representatives also visited a
level‑III biosafety laboratory, which our Microbiological Diagnostic
Service also perceives as necessary for microbiological diagnosis in its
area of protection from bioterrorism.
At the invitation
of the Czech Mycobacterium Reference Laboratory from Prague, Dr Vera
Katalinic-Jankovic participated as guest lecturer in the Conference
on Microbiology and Epidemiology of Tuberculosis and Nonspecific
Pulmonary Infections. It took place at the township of Jihlava on
25-27 October 2004. Within the section “Tuberculosis and mycobacterial
diagnostics – current situation” she presented a lecture titled “The
role of laboratory diagnostics in TB Control in
Croatia”.
The focus was on the therapy for mycobacterioses and on new trends in
assaying the molecular markers of tuberculosis, as well as on detecting
latent infections. The Conference had assembled professionals from
different branches of medicine and veterinary medicine that are active
in the national tuberculosis control and prevention programmes of the
Czech and Slovak republics.
HEALTH ECOLOGY SERVICE
-
Head, Krunoslav Capak, MD,
MSc
On 4 November 2004 at
Croatian Medical Association in Zagreb an interdisciplinary symposium
“General and Inner Working Environments: Medical and Preventive
Aspects” took place under the auspices of the Croatian Academy of
Medical Sciences. It was organised by Croatian Medical Ecology
Society and by Croatian Medical Association in collaboration with the
Institute for Medical Research and Occupational Health (IMROH), and
with the Croatian Medical Association’s Occupational Health Society,
Croatian Society for Allergology and Clinical Immunology. Scientific
knowledge on healthy housing and environmental health with a manifest
domination of chronic non-infectious diseases, especially diseases of
the respiratory system (some of which occur in the youngest age groups
already) were presented to the gathering. A rule adopted, following
WHO, was that it is necessary to focus on promoting the prevention,
i.e. control of the risk factors leading to chronic diseases. With
this, environmental health workers continue the technical and
scientific tradition of participating actively in the encouragement of
prevention campaigns together with other health workers profiles and
with other renowned professionals who through their research
contribute to improving the environment and human health. During the
debate, positions were harmonised on the influence of noxious
substances in the immediate living and working environment, which are
milestones to the subsequent activity of professional societies.
Krunoslav Capak, MD, MSc, Vlasta Deckovic-Vukres MD, ScD, and Andreja
Barisin, MD, who are also members of the Croatian Medical Ecology
Society, attended on behalf of CNIPH.
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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