Organisers of a symposium on Croatia’s Demographic Trends held on 28 March were Croatian Academy of Arts and Sciences and Croatian Academy of Medical Sciences.  This important theme was addressed through the lectures taking the socio‑economic and medical viewpoints.  For CNIPH, several staffers participated with their lectures.  Deputy head, Professor Marija Strnad delivered one called ‘Changes in Causes of Mortality in Croatia’s Population’; a lecture ‘Demography and Public Health’ was held by medical deputy head, Professor Slobodan Lang, and one called ‘Socio‑medical Characteristics of Parturient Women in Croatia’ by Pr Urelija Rodin, MD, MSc who heads the Social Medicine Service. 

Working Group for Drafting an Action Plan for Overweight Prevention and Reduction had its first session on 22 March at the Ministry of Health and Social Welfare.  Participating in its workings are our staff members Professor Marija Strnad; Pr Marina Kuzman, MD, MSc; Vlasta Deckovic‑Vukres, MD; Pr Vlasta Hrabak‑Zerjavic, MD, MSc; Katica Antonic Degac, MSc, and Krunoslav Capak, MD, MSc.

INFECTIOUS DISEASE EPIDEMIOLOGY SERVICE

- Head, Prof. Dr Ira Gjenero‑Margan

Our Service staffers attending at Opatija the Second Croatian Gerontology Congress on 9‑12 March were either lecturers or paper and poster co‑authors.  Related to the epidemiology of infectious diseases they were titled ‘Prevention of tetanus in elderly by active immunisation’, ‘Immunisation at higher age’, ‘Tuberculosis in elderly’. 

World Tuberculosis Day, 24 March, was marked at Croatian Medical Association by a conference organised by Croatian Pulmonological Society and by Croatian National Institute of Public Health. 

Domestic professionals noted for this area gave a number of lectures.  There were about 100 conferees, mainly general practitioners, pulmonologists and epidemiologists.  Dr A. Simunovic presented a report on the epidemiology of tuberculosis in Croatia.  The 2005 TB case total was 1,133 unlike in 1981 when it totalled slightly above 4,000.  The new case total per 100,000 also decreased (from 43 in 1992 to 25 in 2005).  At the same time, the European countries with the lowest TB incidence (as Germany, Switzerland, Italy, Greece) reported the rates below 10/100,000 population.  Therefore, the conference indicated the need for medical profession to be continuously sensible of this infectious disease despite the improvement in the indicator.

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

A poster authored by Brkic Bilos I, Hrabak Zerjavic V and Coric T titled ‘Epidemiological survey of injuries in elderly’ was presented at the Second Croatian Gerontological Congress.  Given their high proportion in total mortality and morbidity, injuries pose a significant public health problem among the elderly population too, showing the need for systematic implementation of preventive measures, especially of the prevention of falls as the leading external cause of mortality and morbidity in this age group.

At the marking of 15 March, World Consumers Day, which had as its theme ‘services of public health: realisation of healthier lifestyle’, Pr Vlasta Hrabak‑Zerjavic, MD, MSc, was among the invited lecturers at a conference.  There she presented the Croatian Anti‑Smoking Action Plan Proposal.

In her programme coordinator capacity of the ‘European Tobacco Control Strategy’ and as medical coordinator of the South‑East Europe Health Network, Pr Zerjavic attended a regional gathering for the project ‘Strengthening of Tobacco Control by Raising Health Awareness and Capacities in South‑East Europe, coordinated by Croatia and held on 30‑31 March in Zagreb.  The main debate related to the ratification of the Framework Convention on Tobacco Control.

SOCIAL MEDICINE SERVICE

- Head, Pr Urelija Rodin, MD, MSc

A poster ‘Epidemiology of falls among elderly in Croatia in 2004’ was presented in Opatija at the Second Croatian Congress on Gerontology by Dr S. Mihel whose co‑author was Dr A. Ivicek‑Uhernik; Dr B. Tomic co‑authored the report ‘Four public health problems in the health care of elderly in Croatia’. 

At a Ministry of Health and Social Welfare‑organised Symposium on Telemedicine on Bjelolasica Mountain, Pr Ranko Stevanovic, ScD, presented a report ‘Teleconsultations in primary health care’. 

The Eighth Symposium on Sexually Transmitted Diseases took place in Opatija on 25‑28 March.  Pr Ranko Stevanovic, ScD, attended as a member of its organizing committee and the author of three papers ‘Ways of managing the problem of sexually transmitted diseases and urinary infections in primary medical care’, ‘Informational‑communicational technology (ICT) as a tool in the treatment and prevention of sexually transmitted diseases’, and ‘Incidence of urinary system infections in Croatia and their diagnosis and treatment in primary health care’. 

To help solve the asbestos‑related problems in Croatia, the Association of Croatia’s Independent Trade Unions organised on 24 March in Zagreb a Round Table Conference.  It was attended by representatives of the Ministry of Health and Social Welfare (MHSW); Ministry of Economy, Work and Entrepreneurship; Environmental Protection, Space Planning and Construction Ministry; Ministry for Family, War Veterans and Intergenerational Solidarity, Croatia’s Employers Union; Asbestosis Patients’ Society, State Inspectorate,  Croatian National Institute of Public Health, and other institutions.  The Round Table Conference debated not only the problem areas of diagnosis and treatment of asbestosis, but also the compensation claims filed by the patients having the diseases due to asbestos.  It also discussed the permanent abandonment of asbestos‑based production.  Despite a ban on the use, manufacture and marketing of asbestos products in Croatia, which came into force on 1 January 2006, arising from a European Parliament directive that restricts the manufacture and use of asbestos, such products are still made by Salonit at Vranjic and this until they run out of the stocks acquired earlier.  The size of asbestos‑related problems in Croatia is still unknown, as the monitoring covers the occupational exposure only.  Therefore, the emphasis was placed on public health institutes, which should make an estimate of the exposure to asbestos in the population living in the environs of the factory and establish the number of patients, as well as follow up their subsequent health status.  The monitoring of the health status of occupationally diseased was entrusted to Croatian Institute of Occupational Medicine.  MHSW was charged with drafting the laws to deal with the prevention, diagnosis and treatment of asbestosis; the charge given the Environmental Protection, Space Planning and Construction Ministry involved drawing up a sanitation programme for the Mravinačka kava waste dump.  For its part, the Ministry of Economy, Work and Entrepreneurship was entrusted with the discontinuation of asbestos production and introducing the transition to nonasbestine materials. 

As part of the MHSW projects ‘Survey of Quality and Ensuree/Patient Satisfaction with Health Services in Primary Care’ and ‘Survey of Quality and Ensuree/Patient Satisfaction with Health Services in Inpatient Care’ questionnaires have been finished.  A poster has also been presented to the media to familiarise patients with the project aim of conducting the survey in the entire health system; it announced the project start date too.

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

Two symposia organised by Croatian Medical Chamber and Croatian Medical Association and run by Croatian Society for Infectious Diseases took place on 4 and 18 March in Zagreb and Osijek respectively.  Their common theme was titled “Avian influenza - an introduction to new influenza pandemic?”  In his lecture about the present situation, Dr Vladimir Drazenovic, the head of our Virology Department, focused on the threat posed by ‘bird flu’, pharmacotherapy with neuroaminidase inhibitors, immunisation and all other topical concerns.  A continuous training course, which can be taken freely and is worth 11 credits, is being organised under the same title by Croatian Medical Chamber.  It will take place on 8 April 2006 at the Infectious Disease Clinic.  Course taker registration is obligatory and should be mailed to apavelic@bfm.hr.  

Very unusually compared to its 20‑year average, the onset, this year, of influenza epidemic came exceptionally late: as late as 13 March 2006.  According to our virologic indicators, we are now in the third week from the onset of the outbreak and the number of positive samples shows a declining trend.  Subtyping has shown all the samples so far to be subtype A virus A/H3N2.  The number of positive samples demonstrated until now and their dynamics indicate that a milder outbreak might be involved this season.

A Symposium on Bacterial Resistance to Antibiotics was held on 17‑18 March in Zagreb.  It was organised by Croatian Academy of Medical Sciences and by Croatian Medical Association’s Croatian Society for Medical Microbiology with Parasitology.  So far, this triennial has taken place for the fifth time in succession.  It marked the 10^th anniversary of the activity of the Monitoring Board for Bacterial Resistance to Antibiotics.  Also taking part in Symposium organisation were two international organisations: International Society of Chemotherapy, and Alliance for Prudent Use of Antibiotics, evidence of the international importance of that field.  In addition to acknowledged international and domestic professionals in this area, CNIPH’s representative Dr Vera Katalinic‑Jankovic also took part.  Her presentation was titled ‘Resistant mycobacteria’.  Given the daily accommodation of bacteria to antibiotics and the importance of proper choice of antimicrobial therapy, the Symposium has assembled physicians of many specialties.       

Dr V. Katalinic‑Jankovic presented on behalf of this Service a lecture ‘Detecting the Routes of Tuberculosis Transmittal’ at a conference marking the World Tuberculosis Day. 

Dr S. Ljubin Sternak and Dr Z. Persic attended the Eighth Symposium on Sexually Transmitted Diseases and Urogenital Infections in Opatija.  Dr Sternak gave a lecture ‘Microbiological Diagnosis of Chlamydia trachomatis prostatitis’ and Dr Persic presented a poster ‘Antibiotic  sensitivity of Ureaplasma urealyticum’.  The lecture and the poster were informative and instructive for microbiologists and family physicians and likewise for clinicians, gynaecologists and urologists.

On 29 March at a conference at the Infectious Disease Clinic, the head of our Service’s Mycology Department, Assist. Prof. E. Mlinaric‑Missoni held a lecture ‘Diagnosis and therapy of invasive fungal infections’ describing the fundamental and most recent guidelines and developments in the area of invasive mycotic infections.

ENVIRONMENTAL HEALTH SERVICE

- Head, Krunoslav Capak, MD, MSc

An international symposium on national supporting of Codex Alimentarius standards named ‘Enhancing participation in Codex’ had been organised by Environmental Health Service in cooperation with FAO and held on 21-23 March.

K. Capak, MSc; Professor Antoinette Kaic‑Rak (WHO representative); Dr Nenad Lamar (Ministry of Health and Social Welfare representative) and Mrs Mary Kenny (FAO representative) held the opening speech.  The workshop dealt with the following topics: raising country awareness through their contributions to the international standards necessary for the implementation of Codex Alimentarius standards; better understanding of the Codex Commission structure and operation; recognising the issues needing to be considered and elaborated when setting up a National Codex; debating the usefulness of the Codex standard in a national food safety programme in comparison to the EU; encouraging deeper strengthening of the national Codex through enhanced information and interrelating of measures within the South‑East Europe subregion.  It also covered the topics of obtaining feedback on the measures taken in the subregion and about future courses on this subject.  The workshop was run by professional educators from the European Commission, Codex’s European Office for Public Health, FAO’s Food Standards and Quality Department, and from the office for the implementation of Codex in international trade.  Conferees from six countries of the subregion have contributed to the exceptionally good acceptance of the workshop.  With their closing speeches Mate Brstilo, DVM, director of the Veterinary Office at the Ministry of Agriculture, Forestry and Water Management, Marijan Katalenic, MSc, head of CNIPH’s Food Safety Department, and Mrs. Mary Kenny, the FAO representative, have ended the workshop.