Tijekom trajanja pandemije stavovi o cijepljenju protiv COVID-19 su se mijenjali, a ta je podjela bila
izraženija što je tijek pandemije dulje trajao. Imali smo priliku čuti razna mišljenja i stavove ...o cijepljenju.
Sudjelovali smo u mnogim raspravama koje su rezultirale iznošenjem i pozitivnih i negativnih stavova o
cijepljenju protiv koronavirusa.
Cilj ovoga istraživanja bio je utvrditi postoje li razlike u stavovima o bolesti COVID-19 između
studenata sestrinstva koji su cijepljeni i onih koji nisu, te procijeniti kakvo je povjerenje prema odlukama
Nacionalnog stožera. Istraživanje je provedeno od 4. travnja do 4. svibnja 2022. godine.
Kako bi se odgovorilo na postavljena pitanja, u istraživanju je korišten modificirani mjerni instrument
stvoren na temelju modela zdravstvenog vjerovanja (eng. Health Beliefs model -HBM) tvrtke Wang et al.
(2021.).
U istraživanju je sudjelovao 271 ispitanik, studenti Preddiplomskog i Diplomskog studija sestrinstva u
Republici Hrvatskoj iz Varaždina, Osijeka, Zagreba, Rijeke, Pule, Splita i Zadra, od čega je bilo 231
(85,2%) studentica i 40 (14,8%) studenata.
Rezultati istraživanja pokazuju da studenti koji su se cijepili, situaciju s COVID-om procjenjuju
ozbiljnijom. Za njih je dobrobit cijepljenja veća, manje je zapreka za cijepljenje i manje odbijaju cijepljenje
od studenata koji se nisu cijepili. Nadalje, studentice izražavaju više zabrinutosti i prepreka u odnosu na
studente, ali razlike u pogledu razine obrazovanja nisu dobivene. Studenti koji su se cijepili drže da bi
obitelj, prijatelji, struka, Vlada i mediji trebali zagovarati i preporučiti cijepljenje, u odnosu na studente koji
se nisu cijepili.
Važno pitanje odnosilo se na ispitivanje povjerenja prema Nacionalnom stožeru. Ispitanici su pokazali
relativno nisku razinu povjerenja, a oni studenti koji su cijepljeni imali su više povjerenja u zdravstvene
stručnjake, medije i članove Vlade.
Drukčiji pristup osobama kod kojih postoji zabrinutost u pogledu učinkovitosti i sigurnosti cjepiva i
mogućih nuspojava, trebalo bi biti jedna od aktivnosti usmjerenih prema toj populaciji, kako bi oni mogli
donijeti odluke na temelju objektivno stečenog znanja i informacija koje donosi znanost.
Dugotrajna infekcija visokorizičnim tipovima humanog papiloma virusa (HPV-a) glavni je čimbenik nastajanja premalignih i malignih lezija vrata maternice. Učinkovita prevencija i kontrola bolesti ...zahtijeva poznavanje epidemioloških karakteristika populacije, provođenje metoda probira te otkrivanja bolesti u što ranijem stadiju odnosno predstadiju invazivne bolesti. Dijagnostičke metode koje se koriste u cilju probira uključuju citološke metode – PAPA test, mikrobiološka testiranja, HPV testiranje, HPV genotipizaciju i kolposkopiju. Korištenje novih dijagnostičkih testova zahtijeva preispitivanje uloge svih razina probira odnosno dijagnosticiranja. Usporedom smjernica različitih stručnih društava za probir i dijagnosticiranje premalignih i malignih lezija vrata maternice, kolposkopija je metoda koja određuje daljnji smjer. Cilj je ovog rada propitati važnost i ulogu kolposkopije u dijagnostici i praćenju premalignih i malignih promjena vrata maternice u sinergiji s drugim dijagnostičkim metodama.
The aim of this paper is to introduce the digitalization process and its effects on better reach of the target population. Progress in the digitalization and e-health tools worldwide enables new ...opportunities in prevention, diagnostics and treatment for people living with HIV (PLHIV) and people in the risk of HIV infection, hepatitis C (HCV) and other sexually transmitted infections (STIs), especially in the context of the COVID-19 pandemic. The system already used for voluntary counselling and testing (VCT) at the CheckPoint Centre Zagreb run by the non-governmental organization (NGO) Croatian Association for HIV and Viral Hepatitis (CAHIV) was upgraded and adapted (due to the COVID-19 prevention epidemiological measures) and developed for implementation of the pilot project of feasibility and acceptability of home HIV self-testing (HIVST) among men who have sex with men (MSM) in Zagreb. A special feature of the HIVST mobile application enables an innovative approach in collecting clients' test result feedback. This paper presents the method of use digitalization of the VCT and HIVST activities to support and increase availability of screening testing. Described procedures of new technologies application in VCT services and preliminary results of the HIVST pilot project indicate that technology-delivered interventions can contribute and improve access and utilisation of HIV/STI prevention and care services.
HIV testing plays a critical role in preventing the spread of the virus and identifying infected individuals in need of care. Voluntary counseling and testing centers (VCTs) not only conduct testing ...but they also provide counseling. Since a proportion of people who test negative for HIV on their previous visit will return for retesting, the frequency of retesting and the characteristics of those who retest may provide insights into the efficacy of testing and counseling strategies. In this cross-sectional, retrospective study of 1,482 VCT clients in Croatia in 2010, 44.3% had been tested for HIV before. The rate of repeat HIV testing is lower in Croatia than in other countries. Men who have sex with men (MSM) clients, those with three or more sexual partners in the last 12 months, consistent condom users with steady partners, and intravenous drug users were more likely to be repeat testers. This finding suggests that clients presenting for repeat HIV testing are those who self-identify as being at a higher risk of infection. Our data showed that testing positive for HIV was not associated with repeat testing. However, the effects of repeat testing on HIV epidemiology needs to be explored.
The HIV pandemic impacts the lives of millions and despite the global coordinated response, innovative actions are still needed to end it. A major challenge is the added burden of coinfections such ...as viral hepatitis, tuberculosis and various sexually transmitted infections in terms of prevention, treatment and increased morbidity in individuals with HIV infection. A need for combination prevention strategies, tailored to high-risk key populations arises and technology-based interventions can be a valuable asset. The COVID-19 pandemic challenged the delivery of existing services and added stress to existing public health and clinical structures but also highlighted the potential of exploiting technical solutions for interventions regarding infectious diseases. In this paper we report the design process, results and evaluation findings from the pilots of 'RiskRadar'--a web and mobile application aiming to support combination prevention, testing and linkage to care for HIV, viral hepatitis, various sexually transmitted infections and tuberculosis. RiskRadar was developed for the INTEGRATE Joint Action's aim to improve, adapt and pilot innovative digital tools for combination prevention. RiskRadar was designed iteratively using informed end-user-oriented approaches. Emphasis was placed on the Risk Calculator that enables users to assess their risk of exposure to one or more of the four disease areas, make informed decisions to seek testing or care and adjust their behaviours ultimately aiming to harm/risk reduction. RiskRadar has been piloted in three countries, namely Croatia, Italy and Lithuania. RiskRadar has been used 1347 times across all platforms so far. More than 90% of users have found RiskRadar useful and would use it again, especially the Risk Calculator component. Almost 49.25% are men and 29.85% are in the age group of 25-34. The application has scored 5.2/7 in the User Experience Questionnaire, where it is mainly described as "supportive" and "easy-to-use". The qualitative evaluation of RiskRadar also yielded positive feedback. Pilot results demonstrate above average satisfaction with RiskRadar and high user-reported usability scores, supporting the idea that technical interventions could significantly support combination prevention actions on Sexually Transmitted Infections.
The aim of this study was to determine self-reported human papillomavirus (HPV) vaccination status among emerging adults in Croatia, intention to get the HPV vaccine among unvaccinated individuals ...and correlates of HPV vaccine hesitancy.
Data were collected via a cross-sectional survey based on a probabilistic national sample. The sample included 1,197 individuals aged 18-25 years (50.6% were women) who were recruited from November 2021 to February 2022 as part of the commercial online panel. Analyses included 981 participants who correctly answered two "attention trap" questions using descriptive statistics and multivariate analyses. The data were
weighted for gender and age and adjusted for clustering effect. To adjust standard errors for the sampling design, multivariate analyses were carried out using the complex samples module in the IBM SPSS 27 statistical software package.
Overall, 18.3% of participants (25.0% of women and 11.7% of men) reported that they were HPV vaccinated, while 21.9% did not know their HPV vaccination status. Of those vaccinated, 65.6% were women. The odds of being HPV-vaccinated were significantly higher among female participants. Among the unvaccinated, 35.4% expressed a willingness to get the vaccine. The odds of vaccination hesitancy were significantly lower among women, participants who reported a higher perceived risk of STIs, those who recognized that HPV could result in cervical cancer, and significantly higher among those who were more religious.
Our findings suggest a need to increase HPV vaccination uptake in Croatia through raising awareness about HPV vaccine effectiveness and also through the implementation of strategies to make vaccination more available.
BackgroundThe World Health Organization European Action Plan 2020 targets for the elimination of viral hepatitis are that > 75% of eligible individuals with chronic hepatitis B (HBV) or hepatitis C ...(HCV) are treated, of whom > 90% achieve viral suppression.AimTo report the results from a pilot sentinel surveillance to monitor chronic HBV and HCV treatment uptake and outcomes in 2019.MethodsWe undertook retrospective enhanced data collection on patients with a confirmed chronic HBV or HCV infection presenting at one of seven clinics in three countries (Croatia, Romania and Spain) for the first time between 1 January 2019 and 30 June 2019. Clinical records were reviewed from date of first attendance to 31 December 2019 and data on sociodemographics, clinical history, laboratory results, treatment and treatment outcomes were collected. Treatment eligibility, uptake and case outcome were assessed.ResultsOf 229 individuals with chronic HBV infection, treatment status was reported for 203 (89%). Of the 80 individuals reported as eligible for treatment, 51% (41/80) were treated of whom 89% (33/37) had achieved viral suppression. Of 240 individuals with chronic HCV infection, treatment status was reported for 231 (96%). Of 231 eligible individuals, 77% (179/231) were treated, the majority of whom had received direct acting antivirals (99%, 174/176) and had achieved sustained virological response (98%, 165/169).ConclusionTreatment targets for global elimination were missed for HBV but not for HCV. A wider European implementation of sentinel surveillance with a representative sample of sites could help monitor progress towards achieving hepatitis control targets.
Sažetak. Kronični hepatitis C (KHC) prepoznat je kao javnozdravstveni problem visokog prioriteta. Svjetska zdravstvena organizacija (SZO) postavila je globalni cilj sniženja smrtnosti za 65% i ...prevalencije za 90% do 2030. godine. Preduvjet za ostvarenje ovog cilja jest otkriće izravno djelujućih antivirusnih lijekova (DAA). Cilj je ovog rada prikazati prva iskustva u liječenju kroničnog hepatitisa C (KHC) trojnom kombinacijom antivirusnih lijekova ombitasvir/paritaprevir/ritonavir + dasabuvir (PrOD) uz dodatak ribavirina. Upotrebom matematičkog modela procijenjeni su prevalencija i broj komplikacija terminalne bolesti jetre ovisno o broju liječenih bolesnika do 2030. godine. Uključeno je 117 bolesnika s infekcijom HCV-om genotipa 1 i genotipa 4 koji su liječeni terapijom PrOD ± RBV. Izlječenje je postignuto u 97% liječenih, bez znatnijih nuspojava i prekida terapije. Liječenjem 450 bolesnika na godinu postigao bi se cilj sniženja smrtnosti za 65%. Pojačanim probirom (screeningom) osoba s rizikom, udruženim epidemiološkim naporima za otkrivanje asimptomatskih bolesnika i njihovim pravodobnim uključivanjem u medicinsku skrb omogućilo bi se da Hrvatska bude među prvim zemljama koja može ostvariti ciljeve SZO-a u kontroli virusnih hepatitisa.
Country level policies and practices of testing and care for HIV, viral hepatitis and sexually transmitted infections are lagging behind European recommendations on integration across diseases. ...Building on previous experiences and evidence, the INTEGRATE Joint Action arranged four national stakeholder meetings. The aim was to foster cross-disciplinary and cross-disease collaborations at national level as a vehicle for strengthened integration of testing and care services. This article presents the methodology and discusses main outcomes and recommendations of these meetings. Local partners in Croatia, Italy, Lithuania and Poland oversaw the planning, agenda development and identification of key persons to invite to ensure that meetings addressed main challenges and issues of the respective countries. Invited national stakeholders represented policy and public health institutions, clinical settings, testing sites and community organisations. National experts and experts from other European countries were invited as speakers and facilitators. Main topic discussed was how to increase integration across HIV, viral hepatitis and sexually transmitted infections in testing and care policies and practice; tuberculosis was also addressed in Lithuania and Italy. The agendas reflected national contexts and the meetings provided a forum to engage stakeholders knowledgeable of the national prevention, testing and care systems in interaction with international experts who shared experiences of the steps needed to achieve integration in policies and practice. The evaluations showed that participants found meetings relevant, important and beneficial for furthering integration. Of the respondents 78% agreed or strongly agreed that there was a good representation of relevant national stakeholders, and 78% that decision/action points were made on how to move the agenda forward. The importance of securing participation from high level national policy makers was highlighted. Outcomes were nationally tailored recommendations on integrated policies and strategies, diversification of testing strategies, stigma and discrimination, key populations, cost effectiveness, surveillance and funding. Shifting from single to multi-disease approaches require collaboration among a broad range of actors and national multi-stakeholder meetings have proven excellent to kick-start this. Face-to-face meetings of key stakeholders represent a unique opportunity to share cross-sectoral perspectives and experiences, identify gaps in national policies and practices and agree on required next steps.
To determine the prevalence of genital Chlamydia trachomatis (chlamydia) infection, knowledge about chlamydia and experience of previous testing for chlamydia, we carried out a national ...probability-based survey in emerging adults aged 18-25 years in Croatia in 2021-2022. Participants (n = 1197), members of a national online panel, completed a web-based questionnaire that collected information on socio-demographics, sexual behaviours and knowledge about sexually transmitted infections (STIs). Urine specimens from a sample of sexually experienced participants were self-collected and tested for chlamydia using Cobas 4800 CT/NG test. To achieve broad representativeness of the emerging adult population in the country, we applied post-hoc weighting for gender and age. Multivariable ordinary least squares linear regression was used to determine correlates of knowledge about chlamydia infection and binomial logistic regression to assess correlates of the willingness to test for chlamydia. Among 448 participants who sent in their urine specimens chlamydia prevalence was 2.5% (95% CI 1.2-5.1) in women and 1.0% (0.3-3.2%) in men. A total of 8.0% of women and 4.7% men reported testing for chlamydia prior to the survey. About a quarter of the sample was characterized by not answering correctly any of the six questions related to knowledge about chlamydia, while only 9.6% had five or six correct answers. In the multivariable analysis, significantly higher odds of willingness to test for chlamydia were found in females compared to males (OR = 1.34, p = 0.024), those with better knowledge about the infection (OR = 1.11, p = 0.005), and those with lower religiosity (OR = 0.91, p = 0.017). In conclusion, prevalence of chlamydia in emerging adults in Croatia is considerable. Efforts to control this infection should focus on primary prevention and targeted testing combined with effective case management strategies.
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