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Grant
Agency: European Commission | Branch: FP7 | Program: CP-IP | Phase: HEALTH-2007-2.3.2-10 | Award Amount: 14.12M | Year: 2009

This proposal will establish an integrated and synergistic network to address the challenge of multiple drug resistant tuberculosis (MDR-TB) facing the EU. The objective will be attained through the establishment of a European consortium of expert partners with extensive experience in the conduct of basic and clinical research relating to MDR-TB, TB control and epidemiology. This Consortium will achieve this by: Conducting an extensive and focused programme of basic/clinical research to improve the diagnosis and management of MDR-TB Develop a broad training curriculum leading to the creation of a new generation of scientists and clinicians expert in the management of drug resistant TB Create field sites across the EU with the capacity for evaluating new diagnostic systems and novel drug therapies on behalf of European industry and government Establish a unified and robust quality assurance mechanism for the accurate and rapid diagnosis of drug resistance and develop appropriate safety standard for European health care workers Improving our understanding of the transmission of MDR-TB at the molecular level and host-related risk factors for its development, The Consortium will disseminate its findings and analyses widely to the benefit of specialists, general health care staff, EU governments, NGOs and health policy makers. This will provide researchers and clinicians with appropriate knowledge and improved tools to fight MDR-TB, and assist European industry in the development of new diagnostics and treatments. Consortium outputs will assist governments in the development and implementation of appropriate health and social policies to limit and control the spread of MDR-TB within the member states of the EU. Internationally, these objectives will assist countries bordering the EU and international agencies such as the WHO and ECDC in reducing the impact of drug resistance.


Grant
Agency: European Commission | Branch: H2020 | Program: COFUND-EJP | Phase: SC1-PM-05-2016 | Award Amount: 74.06M | Year: 2017

The overarching goal of the European Human Biomonitoring Initiative (HBM4EU) is to generate knowledge to inform the safe management of chemicals and so protect human health. We will use human biomonitoring to understand human exposure to chemicals and resulting health impacts and will communicate with policy makers to ensure that our results are exploited in the design of new chemicals policies and the evaluation of existing measures. Key objectives include: Harmonizing procedures for human biomonitoring across 26 countries, to provide policy makers with comparable data on human internal exposure to chemicals and mixtures of chemicals at EU level; Linking data on internal exposure to chemicals to aggregate external exposure and identifying exposure pathways and upstream sources. Information on exposure pathways is critical to the design of targeted policy measures to reduce exposure; Generating scientific evidence on the causal links between human exposure to chemicals and negative health outcomes; and Adapting chemical risk assessment methodologies to use human biomonitoring data and account for the contribution of multiple external exposure pathways to the total chemical body burden. We will achieve these objectives by harmonizing human biomonitoring initiatives in 26 countries, drawing on existing expertise and building new capacities. By establishing National Hubs in each country to coordinate activities, we will create a robust Human Biomonitoring Platform at European level. This initiative contributes directly to the improvement of health and well-being for all age groups, by investigating how exposure to chemicals affects the health of different groups, such as children, pregnant women, foetuses and workers. We will also investigate how factor such as behavior, lifestyle and socio-economic status influence internal exposure to chemicals across the EU population. This knowledge will support policy action to reduce chemical exposure and protect health.


The I-MOVE\ Consortium includes European Union (EU) Public Health Institutes, SME and Universities. It aims at measuring and comparing the effectiveness (VE) and impact (VI) of influenza and Pneumococcal vaccines and vaccination strategies a in the elderly population in Europe. The goal is to develop a sustainable platform of primary care practices, hospitals and laboratory networks that share validated methods to evaluate post marketing vaccine performances. The objectives are to identify, pilot test, and disseminate in EU the best study designs to measure, on a real time basis, VE (direct effect) and the VI of vaccination programmes (indirect and overall effect) against laboratory confirmed cases of influenza (types/subtypes) and pneumococcal disease (serotypes), and clinical outcomes. Cost effectiveness analysis will be conducted. Results will allow to understand factors affecting specific VE, the duration of protection of influenza and pneumococcal vaccines, the interaction between vaccines, the role of repeated vaccinations, the occurrence of serotype replacement (pneumococcus); identify vaccine types and brands with low VE; guide the decision of the WHO committees on vaccine strain selection (influenza); provide robust benefit indicators (VE and VI) and cost benefit and effectiveness results; guide vaccination strategies (schedules, doses, boosters). This EU member state collaboration will respond to questions that require studies based on large sample sizes and sharing of expertise that cannot be achieved by one country alone. It will allow the best methods to be used and results to benefit to all EU countries whatever their current public health achievements. Results will be shared with international partners.


Knezevic Z.,Zavrtnica 3 | Serdar M.,Hrvatski Zavod Za Javno Zdravstvo
Arhiv za Higijenu Rada i Toksikologiju | Year: 2011

This review presents methods for the assessment of acute and chronic risk from pesticide residues in food. Multiple pesticide residues can often be found in food. Currently, there is no internationally accepted procedure for the assessment of cumulative exposure to multiple pesticide residues in food. Therefore, risk assessment is based on toxicological evaluation of single compounds in a food matrix. The international estimation of short-term intake model (IESTI) has been used to calculate acute intake. IESTI is based on "the worst-case scenario" and addresses the possibility that consumers sometimes eat large amounts of a food item, and such a large amount might contain residues at highest levels. However, it should take into account uneven distribution of pesticide residues in food. Chronic exposure is based on a deterministic approach, analogous to the calculation of the theoretical maximum daily intake.


By the Croatian accession to the European Union, a legal framework related to the use of nutrition and health claims on foods was adopted, as well as rules on informing consumers about food. Since milk and dairy products are traditionally positioned as healthy and nutritionally valuable products, adjusting to the new legislation is challenging for the dairy industry. After the evaluation process of health claims for nutrients naturally present in milk and dairy products, as well as those added in the production process, the European Food Safety Authority (EFSA) confirmed the beneficial effect of many active substances and established their recommended doses and effects. By the adoption of Commission Regulation (EU) No 432/2012 of 16 May 2012 a list of permitted health claims made on foods other than those referring to the reduction of disease risk and to children’s development and health was established. Also claims related to the impact of specific nutrients on the development and health of children were authorised by certain EU regulations. Nutrients in milk and dairy products related to nutrition and health claims are calcium, vitamin D, protein, yogurt culture, but also some active substances that are added to products such as different types of fibre, phytosterols and omega-3 fatty acids. By development of dairy products with special characteristics, such as those for specific population groups, it is possible to add nutrition claims which, for example, indicate a low energy value. This paper presents possibilities of application of nutrition and health claims on different types of products. © 2015, Hrvatska Mljekarska Udruga. All rights reserved.


Aleraj B.,Hrvatski Zavod za Javno Zdravstvo | Tomic B.,Hrvatski Zavod za Javno Zdravstvo
Acta Medica Croatica | Year: 2011

The article gives a critical review of the main epidemiological features of allergic diseases, their frequency, distribution and etiologic background as well as the possibilities of prevention and control, based on current literature. Statistical data for Croatia, collected by the Croatian National Institute of Public Health, are used to present actual epidemiological situation in Croatia. Basic descriptive epidemiological methods were used to express age and sex distribution, etc. In comments and review of preventive measures, our own epidemiological experiences and experience acquired on creating the national programs of health measures were used. The genesis of allergies usually implies the influence of various potent environmental allergens such as proteins or smaller molecules attached to proteins (haptens) through repeat or continuous exposure by contact, alimentary or respiratory route, and parenteral route as most efficient (mucous membrane exposure is similar to parenteral exposure). In addition, almost all substances from our environment may, under certain circumstances, become allergens and produce allergic reaction. Individual constitution that is inherited also plays a role. Allergic diseases are present all over the world, however, with variable frequency. Response to an allergen is generally the same, causing distinct allergic diseases like urticaria, anaphylactic shock, asthma, etc., while the main allergens can be different. It is estimated that 30%-40% of all people have some type or manifestation of allergy. According to our Institute data, in Croatia hospitalization was mostly required for allergic urticaria and allergic asthma, followed by Quincke's edema. Optimal treatment and appropriate healthcare structure are essential for efficient control and prevention of allergic diseases. The main direct elements are as follows: well organized emergency service for anaphylactic and other severe conditions; health education expected from all levels of healthcare system; allergology outpatient services available; and sufficient hospital capacities. An indirect yet important element is optimal drug prescribing and usage practice. Other specific public health measures include: pollen air concentration monitoring by public health institutes; information on particular allergen presence and intensity via public media; and control of potential allergen emission into the environment, especially air. People will, as always, find ways to adapt themselves and cope with allergies, with medical profession helping them by identifying the reasons causing allergic diseases and developing successful measures of treatment, prevention and control.


Nemeth Blazic T.,Hrvatski zavod za javno zdravstvo | Pavlic J.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2013

The paper presents the epidemiological situation in Croatia regarding HIV/AIDS from the beginning of HIV/AIDS surveillance to date. The paper alse describes the activities of the centers for free-of-charge and anonymous counseling and testing for HIV (HIV counseling centers) that were founded in 2003 offering their services at the Croatian National Institute of Public Health (CNIPH), County Public Health Institutes in Pula, Rijeka, Split, Zadar, Osijek, Slavonski Brod, Dubrovnik and Korčula, Prison hospital in Zagreb and the University Hospital for Infectious Diseases "Dr. Fran Mihaljević". In the period 1986-2012, the Registry of HIV/AIDS patients at the Epidemiology Service of the CNIPH recorded 1017 persons infected with HIV, of whom 371 developed AIDS. In the same period, 187 persons died of AIDS. In Croatia, HIV/AIDS is registered almost exclusively among high risk population, with homosexual route being the most dominant route of transmission. The annual incidence of HIV infection amounts to about 12-17 per million inhabitants, which categorizes Croatia as a country with a low level incidence of HIV (57/1 million was the average for EU/EEA countries in 2011). From 2003 until 2012, HIV counseling centers in Croatia have provided 37 509 counseling sessions for 20 804 clients and conducted HIV testing for 20 106 persons, during which 181 persons with HIV-infection were detected and referred to further care and therapy.


Aleraj B.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2013

Based on regular communicable disease reporting, outbreak reports and vaccination coverage reports collected routinely and monitored by the Epidemiology Service of the Croatian National Institute of Public Health, an overview of the epidemiological situation in Croatia in 2012 is described. Diseases of low hygienic standard of living (typhoid fever, bacillary dysentery, hepatitis A) were rare, as well as diseases covered by the national systematic immunization program (measles, rubella, mumps, tetanus, etc.) some even eradicated (polio, diphtheria). Classical sexually transmitted diseases (gonorrhoea, syphilis) were also rare. The incidence and prevalence of HIV/AIDS was in 2012 still comparatively low. Tuberculosis incidence was in favourable decline although the rates were still significant. Salmonellosis cases were still frequently recorded, although showing a decrease in the recent years. Vaccination coverage is constantly very high, which ensures a good control over vaccine preventable diseases in the future. There were no outbreaks of waterborne diseases related to public water supply, nor foodborne disease outbreaks. Since the limited autochthonous transmission episode of the dengue fever in Croatia in 2010, there were no such cases recorded in 2012. However, for the first time in Croatia, a few clinical (central nervous system) cases of the West Nile fever were diagnosed in 2012. Overall, it can be concluded that the epidemiological situation in 2012 was generally favourable. However, since there is still a number of potential risk factors present in our country, neighbouring countries and the rest of the World, such as inadequate sanitation in some areas of the country, increased risk for vector-borne diseases due to significant population of vectors present, especially mosquitos, and increased number of human cases of vector-borne diseases in European countries, more intense globalized travel of people, animals and goods, as well as climate change, the situation can still be described as potentially unstable. Therefore, further implementation of all established preventive and control measures according to good medical standards and respective national and EU legislation is required. © 2013, University Hospital of Infectious Diseases. All rights reserved.


Aleraj B.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2011

The Epidemiology Service of the Croatian National Institute of Public Health brings an overview of the epidemiological situation in Croatia in 2010 based on national communicable diseases notification network, outbreak reporting network and vaccination coverage surveillance network data. The epidemiology situation in 2010 was assessed as rather favorable having in mind the following: diseases of poverty, pore sanitation and low education (typhoid fever, shigellosis, and hepatitis A) were rare and sporadic. Diseases included in the national mass immunization program were completely depressed (measles, rubella, mumps, whooping cough, tetanus) and even eliminated or eradicated (diphtheria, poliomyelitis). AIDS incidence remained low and stationary twenty five years since the first registered case. Classical sexually transmitted diseases, gonorrhoea, syphilis were under control, showing low incidence. However, the situation can also be assessed as potentially unstable, owing to certain potentially risk factors such as locally insufficient sanitation especially regarding waste disposal, still present war damages, postwar migrations, migrations related to economic, tourist reasons, etc, as well as a globally increased risk of emerging and reemerging diseases. In addition there were potential risks connected with international traffic combined with global warming, causing current widespread of new mosquito species Aedes albopictus capable of transmitting several tropical viral diseases like dengue, chikungunya etc., in a number of European countries including Croatia. Therefore, further systematic work on implementation of all preventive and control measures is essential, in order to maintain and improve current favorable situation, which makes Croatia fully comparable to other developed countries.


Borislav A.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2010

An overview and assessment of the current epidemiological situation in Croatia in 2009 is presented by the Epidemiology service of the Croatian National Institute of Public Health, based on the national communicable diseases notification network, outbreak reporting network and vaccination coverage surveillance network data. The situation is assessed as rather favorable having in mind the following: diseases of poverty, pore sanitation and low education (typhoid fever, shigellosis, and hepatitis A) are rare and sporadic. Diseases included in national mass immunization program are completely depressed (measles, rubella, mumps, whooping cough, tetanus) and even eliminated or eradicated (diphtheria, poliomyelitis). AIDS incidence remains low and stationary twenty four years since the first registered case. Classical sexually transmitted diseases, gonorrhoea, syphilis are under control, showing low incidence. However, the situation is also assessed as potentially unstable, owing to certain risk factors like locally insufficient sanitation especially regarding waste disposal, still present war damages, significant migrations postwar, economic, tourist etc, as well as a global increased risk of emerging diseases like pandemic flu etc. In addition there are potential risks connected with international traffic combined with global warming, causing current widespread of new mosquito species Aedes albopictus capable of transmitting several tropical viral diseases like dengue, chikungunya etc. in a number of European countries including Croatia. Therefore, further systematic work on implementation of all preventive and control measures is essential, in order to maintain and improve current favorable situation, which makes Croatia fully comparable to developed countries.

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