Improving the health status and medical care of the elderly without a knowledge of basic demographic and health indicators is unfeasible.  In collaboration with the Gerontology Centre of the Zagreb Institute of Public Health, a group of authors from CNIPH has issued out a publication “Health status and medical care of the elderly population in Croatia” (in Croatian).  Besides demographic indicators, it encompasses the leading causes of death, health care utilisation and morbidity indicators in primary health care, inpatient care and morbidity indicators from hospital statistics, data on disabled, functional capacity indicators, and vaccination data on the elderly.  Particular emphasis was placed on cardiovascular diseases, malignant diseases, mental disorders and suicides as important public health problems.  Not only health workers, but also other workers dealing with the problems of elderly people in any way may find the bulletin useful.

INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE
(Ministry of Health’s Reference Centre for Epidemiology)
- Head, Prof. Dr Ira Gjenero-Margan

The annual meeting of Croatian Medical Association’s Epidemiological Society took place in June.  It had been organised by our Service and by the Splitsko-Dalmatian County’s Public Health Institute.  Organised by this Service as part of the “Promoting the Combating of HIV/AIDS in Croatia” project, a workshop for consultants at the centres for voluntary and anonymous HIV testing was held.  To serve the Ministry of Health and Social Welfare, a Service staffer took part in a health‑inspection surveillance of one general hospital.  Brochures on the side effects of vaccination in Croatia in 2004 have been printed and distributed among the vaccinators.  The brochure can also be found on CNIPH’s web page.

CHRONIC MASS DISEASE EPIDEMIOLOGY DEPARTMENT
- Head, Pr Vlasta Hrabak-Zerjavic, MD, MSc

On 10-11 June at Jelsa, Pr Vlasta Hrabak‑Zerjavic, MD, MSc presented at the 58th technical session of the Croatian Epidemiological Society a paper “Public Health Importance of Mental Disorders”, authored by herself and Silobrcic Radic M. 

Being also a member of the WHO/EURO Working Party for the preparation of the European Strategy against Noncommunicable/Mass Diseases, Pr Zerjavic participated in Stockholm on 12-14 June 2005 in a session at which the basic terms and the methodological approach were defined as a framework for the elaboration of the Strategy.

SOCIAL MEDICINE SERVICE

- Head, Pr Urelija Rodin, MD, MSc

According to the mortality figures of the National Bureau of Statistics, 2004 saw the death of 49,756 (1,121/100,000) people with permanent residence or domicile in Croatia.  Of these, 25,307 (50.9%) were male (1,185/100,000) and 24,449 (49.1%) female (1,062/100,000).  

Consonant to the cooperation agreement with the National Bureau of Statistics, coding of causes of death and the quality of mortality figures is CNIP’s responsibility.  It furthers this quality through a network of county public health institutes consisting of county health statistical commissioners.  The quality of mortality statistical figures manifests in a continuous decline of the share of unknown and not otherwise specified causes of death, which, in 2004, accounted for 1.5%.

Attending as an author and lecturer the 1-3 June 2005 Conference of International Council on Medical Care Compunetics at The Hague was Pr Ranko Stevanovic, MD, ScD.  The first work was titled “Croatian Telehealth Strategy: Objectives, Technology, Customers, Benefits”, the second “Development of Health Information System in Transitional Countries (Croatian Experience)”. 

The paper “Development of Health Information System in Transitional Countries (Croatian Experience)” (authored by Pr Ranko Stevanovic, MD, ScD, Dr Ivan Pristas, Dr Ana Ivicevic Uhernik and Dr Arsen Stanic) also appeared in the book Medical and Care Compunetics 2/Bos, Lodewijk; Lexminarayan, Swarni: March, Andy.  Amsterdam:   IOS Press 2005 (82-87).

ADDICTION PREVENTION SERVICE

Acting Head, Pr Marina Kuzman, MD, ScD

MICROBIOLOGY SERVICE
- Head, Prof. Dr Gordana Mlinaric-Galinovic

Public health mycobacteriological (TB) laboratory plays a key role in the diagnosis, treatment and epidemiological monitoring of tuberculosis.  On this track, the WHO has founded a Laboratory Strengthening Task Force (LSTS) for TB Control for the European Region.  One also of the seven appointed professionals is Dr Vera Katalinic‑Jankovic, head of CNIPH’s Tuberculosis Diagnostics Department.  This group had its first meeting at The Hague on 27-28 May 2005.  Its immediate tasks are to prepare strategic documents on the diagnostics of tuberculosis, strengthen the laboratory network in individual countries of the European region, identify and assess the needs for the implementation of national programmes of individual states, and to monitor and evaluate TB laboratory operation indicators.  Discussed at the group’s session was the enactment and publication of the document “Recommended Standards for Modern TB Laboratory Services in EURO” in an internationally indexed review.  Materials also were prepared for the meeting of national reference laboratory managers from 17 countries of Central and Eastern Europe, which was to have taken place in mid‑June in Riga, Latvia.  In the end, the LSTF group joined in the activity of the 11th Wolfheze Workshops for Tuberculosis Control in Europe held 28 May-1 June 2005 at Scheveningen, Netherlands.  The focus was on millennium goals for the control and monitoring of tuberculosis. 

A methodological course named “First Training Course in Multilocus Variable Number Tandem Repeat‑Genotyping of Mycobacterium Tuberculosis” was held on 22‑28 May 2005 at the Pasteur Institute in Lille, France.  With 11 course takers from around the world, graduate engineer Mihaela Obrovac from CNIPH also took the Course.  In its practical, use was made of the MIRU-VNTR gene typing of M. tuberculosis by agarose gel method and sequencing.  The theoretical part of the Course consisted of lectures on the subjects of infective cycle, genetic diversity and epidemiology of tuberculosis, use of molecular epidemiology methods and identification of genetic families.  There was a special focus on international databases for genotypes, with course takers being spurred to provide their own data obtained at national reference laboratories.

ENVIRONMENTAL HEALTH SERVICE

- Head, Krunoslav Capak, MD, MSc

A seminar for institute of public health associates named “Food Safety by Application of an HACCP Principle‑Based Preventive Self‑Control Procedure” took place in Rijeka on 16-17 June 2005.  It was organised by CNIPH, by Teaching Institute of Public Health of the Primorsko-Goranska County and by Croatian Food Agency on the educational premises of the County Institute in Rijeka.  The health ministry representative for this area, graduate lawyer Ivo Afric, also worked in the Seminar’s consultative committee.  Characteristically, a new concept of completely ensured food safety poses the HACCP system as the pillar of the whole system.  The basic elements of the system are not new; they were in use long ago.  However, the approach is new, essentially making an intricate administrative shift from the reactive control of the final product towards the preventive proactive control during the process.  The Workshop explicated the meaning of HACCP (hazard analysis and control of critical points) in relation to quality systems present in the subjects in dealing with food.  Good Hygienic Practice (GHP) systems and standard operative procedures as part of the HACCP are preconditions for the implementation of HACCP.  Within future implemental regulations harmonised with the European legislation the staffs of CNIPH and of county public health institutes hold an important position.  As future executors, the staffs of these institutes were trained via the workshop to supervise the implementation of the seven basic principles of HACCP in food handlers.  They were familiarised with the planning of the development of HACCP plans, product specifications, with every stage for the implementation of the system having been worked out by means of the decision tree.  An illustrative account of the HACCP system establishment, underlined through the presented flow diagram the key role and the responsibility of institute staff/executors in this complex joint undertaking that ensures the country’s health safety of foods.  Krunoslav Capak, MD, MSc attended the Seminar as a lecturer in the capacity of an epidemiologic and environmental health specialist.