Is it too expensive to fight cancer? Analysis of incremental costs and benefits of the Croatian National Plan Against Cancer.

This cost-effectiveness study analyses the expected impacts of activities proposed by the Croatian National Plan Against Cancer (NPAC) on cancer incidence and survival rates, as related to their respective costs. We evaluated the impact of the NPAC on two main outcomes, namely, reduced incidence and the improved survival of cancer patients, expressed as life years gained (LYGs), which enabled the calculation of incremental cost-effectiveness ratios (ICERs) in the form of cost per LYG. In the analysis of costs, we considered both the direct costs of NPAC activities as well as the wider indirect societal costs of cancer, thus permitting the calculation of the ICER both from the narrower national health insurer's perspective (accounting only for the direct costs) and the wider societal perspective (accounting both for the direct and indirect costs).

Mycobacterium shimoidei-cavitary pulmonary disease with favorable outcome.

We report a case of cavitary pulmonary disease caused by Mycobacterium shimoidei in 67-year-old female with history of asthma. Even though susceptibility testing was not available, choice of treatment regimen (streptomycin, rifampicin, ethambutol, and clarithromycin), based on a few cases with favorable outcome reported in the literature, resulted with an excellent clinical, microbiological, and radiological response. This is the first report of pulmonary disease caused by M.

Successful Treatment of Disseminated Bacillus Calmette-Guérin Disease in an HIV-Infected Child with a Linezolid-Containing Regimen.

Upon HIV infection diagnosis, an 8-month-old boy was transferred for evaluation of worsening respiratory distress requiring mechanical ventilation. pneumonia (PCP) was diagnosed; the boy also had a nonhealing ulcer at the site of vaccination with Statens Serum Institut (Danish strain) Bacillus Calmette-Guérin (BCG) vaccine and associated axillary lymphadenopathy. PCP treatment resulted in weaning from mechanical ventilation.

Neglected disease in mentally ill patients: Major tuberculosis outbreak in a psychiatric hospital.

As tuberculosis incidence decreases, the possibility of overlooking the disease increases, especially in vulnerable populations. We describe here a major tuberculosis outbreak among mentally ill patients in Croatia, focusing on 1 regional hospital where most patients were hospitalized. The outbreak emphasizes the vulnerability of mentally ill patients to tuberculosis infection and the complexity of infection control measures in psychiatric institutions.

A Snapshot of Drug-Resistant M. tuberculosis Strains in Croatia.

Tuberculosis caused by resistant M. tuberculosis strains poses a serious threat as it requires prolonged and costly treatment and has high mortality rate. In order to investigate resistance to antituberculous drugs in Croatia, we analysed all resistant M.

[Which tuberculin skin test hyperreactive child should be treated with -our experience].

Since persons with latent tuberculosis infection (LTBI) represent a huge reservoir of potential tuberculosis (TB) disease, accurate diagnosis and treatment of LTBI is essential for TB control and eradication. The aim was to assess the diagnostic value of determination of interferon-gamma release assay in school children with hyperreactive tuberculin skin test (TST) reaction. A total of 120 BCG-vaccinated children were investigated due to a hyperreactive TST results.

Discordance Between Tuberculin Skin Test and Interferon-γ Release Assay in Children Younger Than 5 Years Who Have Been Vaccinated With Bacillus Calmette-Guérin.

Background: Interferon-γ release assays (IGRAs) offer the possibility of improved detection of latent tuberculosis infection (LTBI).

Objective: To analyze discordant tuberculin skin testing (TST) and IGRA results in ethnic Croatian children as old as 5 years for whom there is documented exposure to an adult with active tuberculosis (TB) and who have been vaccinated with Bacillus Calmette-Guérin.

Methods: In specimens from our cohort individuals, we tested the performances of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test and TST and analyzed discordant results.

Mycobacterium marinum Infection of the Hand in an Immunocompromised Aquarium Hobbyist.

M. marinum, a nontuberculous mycobacterium, is a rare human pathogen widely distributed in the aquatic environment. In the previous century, epidemics took place due to inadequately chlorinated swimming pool water.

Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011.

Laboratory confirmation of paediatric tuberculosis (TB) is frequently lacking. We reviewed the range of routine laboratory tests and their performance in different biological samples used to diagnose active TB in children. A questionnaire-based survey was conducted among the European Reference Laboratory Network for TB followed by collection of routine laboratory data on 10,549 paediatric samples tested in 2007 to 2011 at six reference laboratories (in Croatia, Germany, Italy, Latvia, Lithuania and the United Kingdom (UK)).

Inventory study of non-tuberculous mycobacteria in the European Union.

Background: Since non-tuberculous mycobacteria (NTM) disease is not notifiable in most European Union (EU) and European Economic Area (EEA) countries, the epidemiological situation of the >150 NTM species is largely unknown. We aimed to collect data on the frequency of NTM detection and NTM species types in EU/EEA countries.

Methods: Officially nominated national tuberculosis reference laboratories of all EU/EEA countries were asked to provide information on: laboratory routines for detection and identification of NTM, including drug sensitivity testing (DST) methods; data on the number and type of NTM species identified; coverage and completeness of the provided data on NTM; type and number of human specimens tested for NTM; and number of specimens tested for Mycobacterium tuberculosis complex and NTM.

First insights into the molecular epidemiology of tuberculosis in Croatia during a three-year period, 2009 to 2011.

Background: Mycobacterium tuberculosis still represents a serious cause of morbidity and mortality worldwide. The aim of this study was to determine the transmission rate and genetic lineages of M. tuberculosis circulating in Croatia during a 3-y period, between 2009 and 2011.

Geographical distribution and clinical relevance of non-tuberculous mycobacteria in Croatia.

Setting: The clinical relevance of non-tuberculous mycobacteria (NTM) in Croatia is unknown.

Objective: To estimate the isolation rate of NTM, record geographical differences and assess the burden of pulmonary NTM disease in Croatia.

Design: Nationwide retrospective cohort study of all Croatian residents with NTM isolated by culture in the period from 2006 to 2010.

The role of interferon-gamma release assay in tuberculosis control.

Tuberculosis is still one of the major global public health threats. Countries with low incidence must focus on exhausting the reservoir of future cases by preventing reactivation. Therefore, it is important to identify and effectively treat those individuals who have latent tuberculosis infection and who may develop active disease.

[Comparison of new and old tests for the diagnosis of latent tuberculosis infection (quantiferon and TST)].

Tuberculosis (TB) is the second most common contagious disease, caused by Mycobacterium tuberculosis (M. tuberculosis). Besides a rare laryngeal tuberculosis, pulmonary tuberculosis is the only one contagious form of the disease, although it can affect any organ of the human body.

Epidemiological patterns of tuberculosis in Croatia in the period 1996-2005.

The last comprehensive publication on tuberculosis in Croatia and the earliest impact of war, besides the yearly routine reports, was done in 1996 in Croatian. We were, therefore, interested to explore incidence trends and to highlight the early post-war tuberculosis epidemiological patterns in the next ten years period (1996-2005). A retrospective analysis of epidemiological data on all registered tuberculosis cases in Croatia searching the databases of 21 Croatian Public Health Institutes and the National Tuberculosis Registry was made.

[Significance of laboratory statistics in tuberculosis control in Medimurje County].

Unlabelled: Microbiological diagnosis of tuberculosis is the axis of any national tuberculosis control program. Tuberculosis notification rate in Medimurje County has been equivalent to the national average, except in 2009 when it (23/100,000) surpassed the national rate of 19.3/100,000.

[Childhood tuberculosis: an ancient disease in the youngest generation in the 21st century from epidemiological point of view].

Childhood tuberculosis (TB) has distinct epidemiological and clinical features. TB burden in children worldwide and in Croatia, the risk of infection and disease, as well as disease characteristics, sources of infection in children, diagnostic difficulties, impact of HIV on pediatric tuberculosis, limits of BCG-vaccine and program implications are discussed in this paper. Children younger than 15 years account for 15%-20% of global TB burden, which is often associated with severe TB-related morbidity and mortality.

Mycobacterium xenopi pulmonary disease - epidemiology and clinical features in non-immunocompromised patients.

Objectives: The genus Mycobacterium has more than 120 well-characterized species. Although the incidence of tuberculosis has decreased over the studied period, other, non-tuberculous mycobacteria (NTM) are isolated more often. Since, Mycobacterium xenopi is the most frequent NTM isolate in Croatia we studied its epidemiology and clinical relevance.

[Infections due to nontuberculous mycobacteria].

The best known members of genus Mycobacterium belong to M. tuberculosis complex. Other mycobacteria are known as nontuberculous mycobacteria (NTM).

Mycobacterium caprae in cattle and humans in Croatia.

Setting: This paper describes an outbreak of human and related bovine tuberculosis (TB) caused by Mycobacterium caprae in Croatia. A 13-year-old boy clinically presented enlargement of cervical lymph node with consecutive isolation of M. caprae.

Mycobacterial infection of pigs in Croatia.

During a five-year period (2000 to 2004) 74,342 pigs were tested by the intradermal tuberculin test in Croatia. Of them, 248 (0.33%) pigs were positive and 91 (0.

[Drug-resistant tuberculosis: resistance mechanisms and drug susceptibility of Mycobacterium tuberculosis].

Mycobacterium (M.) tuberculosis is the most common individual causative agent of infectious disease in the world. It is responsible for 26% of preventable deaths in adulthood.

[Drug resistant tuberculosis: ten years of surveillance in Croatia].

Drug resistant and multidrug resistant tuberculosis is a consequence of human activity. Resistant strains of M. tuberculosis are mainly prevalent in regions with weak national TB programs or poor socioeconomic environment.