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1.
The Czech Republic, together with Slovakia and Poland, forms a region within Central-Eastern Europe in which the values of life expectancy at birth have been increasing during the period of transformation. However, the tempo of mortality reduction has differed spatially within the territory of the Czech Republic, as have other outcomes of the transformation process. This paper discussed possible socio-economic explanations of regional differences in the tempos of mortality change between 1990/91 and 1995/96. Standardized mortality rates for males aged 0-64 years specified for the three most frequent causes of death were examined by means of the regression and correlation analysis.  相似文献   

2.
Tularaemia, a zoonosis of veterinary and public health importance, commonly occurs in the Czech Republic as well as other countries of Northern Hemisphere. The objective of this study was to analyse the environmental conditions of distribution of natural foci of tularaemia and their long-term persistence in the Czech Republic. A geographic information system has been used for this purpose. A new variable (x t), the mean number of natural foci in a specific area, has been suggested for the evaluation of diseases occurring in natural foci. Comparing two 15-year periods, a close correlation between the geographic distribution and numbers of natural foci of tularaemia in the Czech Republic in 1971–1985 and 1986–2000 (r = 0.91, n = 1814, t = 92.50, p = 0.01) was found. Natural foci of tularaemia have been persistent, but not stationary, over the period of 30 years and the geographic area of their occurrence has not been considerably growing or diminishing in the Czech Republic. The highest numbers of natural foci of tularaemia were in habitats of alluvial forests (x t = 7.20), geographic areas of up to 200 m of elevation above sea (x t = 9.18), 8.1–10.0 °C of mean annual air temperature (x t = 6.24), 450–700 mm of mean annual precipitation (x t = 2.84), and 2001–2200 hour of mean annual sunshine duration (x t = 8.77). It was proved that tularaemia persists in specific areas of natural foci, the general environmental conditions of which can be defined and make it possible to predict the occurrence of tularaemia in other areas of suitable conditions.  相似文献   

3.
Neonatal mortality in the Czech Republic during the transition   总被引:7,自引:0,他引:7  
OBJECTIVES: To identify factors underlying the reduction in neonatal mortality in the Czech Republic during the 1990s and to identify scope for further improvements. DESIGN: Examination of trends in birth weight and birth weight specific neonatal mortality in the Czech Republic and comparison with figures from Sweden, which has one of the lowest neonatal mortality rates in Europe. SETTING: The Czech Republic. SUBJECTS: All singleton births occurring in the Czech Republic in 1989-1991 and 1994-1995, with a comparison group of all singleton births in Sweden in 1989-1991. MAIN OUTCOME MEASURES: Neonatal mortality rate. RESULTS: Despite a slight worsening in the birth weight distribution, the neonatal mortality rate in the Czech Republic fell from 5.6 to 3.8 per thousand live births. This was due to an improvement in the survival of infants at all birth weights but especially amongst the lightest. Eighty percent of the overall improvement was due to greater survival among those under 2500 g. Comparison with Swedish birth weight specific rates indicates that, for the country as a whole, only small additional gains are likely as a result of improved survival at a given birth weight but, instead, a reduction in the proportion of low birth weight babies would have a much greater effect. Regional analysis indicates that the improvements have been much greater in Prague than in the rest of the country. CONCLUSIONS: An effective strategy to reduce neonatal mortality in the Czech Republic should have two elements. The first is to address the socio-economic determinants of low birth weight. The second is to reduce regional inequalities in the quality of neonatal care. This should, however, be supplemented by more detailed investigation to identify specific amenable factors.  相似文献   

4.
BACKGROUND: The political and social transition in central and eastern Europe has been generally associated with widening educational differences in life expectancy. However, interpretation of these findings is complicated because the size of educational categories within the population has also changed. It is therefore important to disentangle these two phenomena. SETTING: The Czech Republic, Estonia, the Russian Federation and, as a western European reference, Finland, in two periods, 1988-89 and 1998-99. METHODS: Life tables were calculated in three categories: university; secondary; and less than secondary education. Changes in life expectancy were decomposed into contributions of population composition and within-category mortality. RESULTS: In Finland and the Czech Republic improvements are seen in all educational groups, with only a slight widening of the educational differences. Over 80% of the total life expectancy increase is attributable to improved mortality within educational categories. In Estonia and Russia, less favourable overall trends coincide with a dramatic widening of the educational gap. A decrease in life expectancy in those with low and middle education has been compensated for, to a small degree in Russia but a greater extent in Estonia, by improvements among those with higher education and by the improved population composition. For highly educated Estonians, the gains were seen at all ages, the greatest at age > or =60 years. In Russia mortality increased in those <60 years although compensated for by improvements at older ages. CONCLUSIONS: Russia and Estonia exhibit much less equitable transitions compared with the Czech Republic. Analyses of trends in health inequalities should capture the changing population composition. In Russia and Estonia an improved educational structure prevented an even greater decline in life expectancy. The highly educated Estonians can potentially catalyse a wider health progress.  相似文献   

5.
Air pollution is severe in some areas of Central and EasternEurope but the quality and representativeness of measurementsare not consistent. Studies in the Czech Republic and Polandhave shown an impact of air pollution on overall mortality,post-neonatal mortality and lung cancer. Estimates in this papersuggest that air pollution may cause up to 3% of all-cause,all-age mortality in the Czech Republic, which is some 9% ofthe mortality gap between this country and Western Europe. Theimpact in other countries of Central and Eastern Europe is probablysmaller.  相似文献   

6.
Associations between mortality and air pollution in central Europe   总被引:2,自引:0,他引:2  
Increased mortality has been observed in association with elevated concentrations of air pollutants in European cities and in the United States. We reassessed the effects of particulate matter in Central Europe. Mortality and air pollution data were obtained for a highly polluted region of the Czech Republic and a rural region in Germany. Poisson regression analyses were conducted considering trend, season, meteorology, and influenza epidemics as confounders in both a parametric and a nonparametric approach. The Czech Republic had a 3.8% increase in mortality [95% confidence interval (CI), 0.8-6.9%] in association with 100 microg/m(3) total suspended particles (TSP) (lagged 2 days) for the time period 1982-1994. During the last 2 years of study, 68% of the TSP consisted of particulate matter [less than/equal to] 10 microm in aerodynamic diameter (PM(10)). An increase of 100 microg/m(3) TSP (lagged 1 day) was associated with a 9.5% increase in mortality (CI, 1.2-18.5%) and 100 microg/m(3) PM(10 )(lagged 1 day) showed a 9.8% increase in mortality (CI, 0.7-19.7%). We found no evidence for an association between mortality and particulate matter in the rural area in Germany at the Czech border. Data from the coal basin in the Czech Republic suggested an increase in mortality associated with the concentration of particulate matter in a highly polluted setting in Central Europe that is consistent with the associations observed in other western European cities and in the United States.  相似文献   

7.
Over recent decades, the epidemiology of hepatitis A has changed in most European countries: the age of infection has been shifting towards older age groups. In view of this evolution and the central location of the Czech Republic in Europe, we wanted to assess current anti-hepatitis A seroprevalence. We determined the anti-hepatitis A seroprevalence among three different groups: military personnel between 1991–1995, prior to their deployment as UN troops, civilians participating in a national serological survey in 1996 and volunteers for vaccine clinical trials in 1996. The anti-HAV prevalence <20 years of age was about 4%; in the age cohort 40–49 it ranged between 47 and 51%. Only over the age of 60 years was the seroprevalence rate >85%. The risk of acquiring HAV is low for younger age groups. We could demonstrate some regional differences with higher rates in some age strata for the North Bohemian region and the lowest rates in East Bohemia and Prague. Compared to archived sera from a previous serological survey in 1984 we demonstrate a shift towards low endemicity. For the first time it is shown that an Eastern European country, i.e. the Czech Republic, is a country with a low endemicity for HAV. Substantial parts of the population are or will be at an increased risk of HAV infection and active immunisation against HAV should be considered.  相似文献   

8.
IntroductionSimulation studies showed that generic antiretroviral (ARV) drug utilization could lead to significant cost reduction of HIV treatment in developed world. This study aimed to quantify ARV utilization and costs in European countries between 2006 and 2015. We also assessed the impact of generic ARV drug utilization on cost reduction in real-life.MethodsARV drug utilization in 14 European countries (France, Italy, Germany, Denmark, Netherlands, Norway, Sweden, Finland, Iceland, Croatia, Czech Republic, Estonia, Latvia, and Lithuania) were analysed using defined daily dose (DDD)/1000 inhabitants/year. ARV drug cost was estimated in million euro/year and euro/1000 inhabitants/year. The impact of generics on cost reduction was assessed in three countries: France, Denmark, and Czech Republic, using four parameters: expected savings, observed savings, brand price-reduction savings and overall savings.ResultsBetween 2006 and 2015, median ARV drug utilization increased from 234 DDDs per 1000 inhabitants per year (IQR 124–388) to 385 (229–670). The median cost increased from €3751/1000 inhabitants/year (1109–4681) to €9158 (3269–10,646). Between 2013 and 2015, overall savings of €0.9, €1.6, and €33.7 million were respectively observed in Denmark, Czech Republic, and France.ConclusionOverall savings observed in real-life from generic ARV drugs in Denmark were related to high rate of low-price generic utilization, contrarily to France and Czech Republic where these were more related to brand price-reduction than generic utilization itself.  相似文献   

9.
A sharp decline in cardiovascular mortality has been observed over the last 15 years in the Czech Republic. This article compares epidemiological data of infection incidence and seropositivity (which may have influenced the decline) with coronary heart disease (CHD) mortality. No association between the change in CHD mortality and infections was found. In conclusion, the influence of a single infection on atherogenesis is improbable.  相似文献   

10.
OBJECTIVE: To address the issue of infant mortality as an important health indicator, we systematically analyzed trends in infant mortality in five central and eastern European (CEE) countries (the Czech Republic, Hungary, Poland, Slovakia and Slovenia). METHODS: Infant mortality rates (per 1,000 live births) and trends were computed using the World Health Organization database, as well as selected European databases. RESULTS: In 1990, mortality rates in most CEE countries were appreciably higher than the mean European Union value of 9.2/1,000 (up to 14.8/1,000 in Hungary and 19.4/1,000 in Poland). However, between 1990 and 2001, infant mortality decreased substantially in all CEE countries, and in 2001 the rates in the Czech Republic (4.0/1,000) and Slovenia (4.3/1,000) were lower than the EU average of 4.6/1,000. DISCUSSION: Infant mortality is an important indicator of the improvements in health observed in CEE countries over the last decade.  相似文献   

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