A. Plenary Lectures 2

A. PLENARY LECTURES 2 PUBLIC HEALTH INSTITUTE NIŠ ИНСТИТУТ ЗА ЈАВНО ЗДРАВЉЕ НИШ FACULTY OF MEDICINE NIŠ МЕДИЦИНСКИ ФАКУЛТЕТ НИШ SERBIAN MEDICAL SOCIETY OF NIŠ СРПСКО ЛЕКАРСКО ДРУШТВО ПОДРУЖНИЦА НИШ 49. DAYS OF PREVENTIVE MEDICINE 49. ДАНИ ПРЕВЕНТИВНЕ МЕДИЦИНЕ INTERNATIONAL CONGRESS МЕЂУНАРОДНИ КОНГРЕС BOOK OF PAPERS AND ABSTRACTS ЗБОРНИК РАДОВА И РЕЗИМЕА НИШ , 2015. Editor in Chief Уредник Asst. Prof. dr Aleksandar Višnji ć Technical Editor Технички уредник dipl. ing. Stefan Bogdanovi ć Publisher Издавач Public Health Institute Niš - Институт за јавно здравље Ниш Faculty of Medicine Niš, University of Niš - Медицински факултет у Нишу , Универзитет у Нишу Serbian Medical Society of Niš - Српско лекарско друштво подружница Ниш For publisher За издавача Asst. Prof. dr Miodrag Stojanovi ć All abstracts are published in the book of abstracts in the form in which they were submitted by the authors, who are responsible for their content. Сви сажеци су публиковани у зборнику резимеа у облику у коме су достављени од стране аутора, који су одговорни за њихов садржај. The content of this publication is available online at www.izjz-nis.org.rs Садржај ове публикације је доступан на интернет адреси www. изјз -нис .орг .рс By decision on Accreditation (153-02-416/2015-01 from 03.03.2015.) of Health Council of Serbia continuous health education programme, “49. DAYS OF PREVENTIVE MEDICINE” is accredited as an international congress. Одлуком о акредитацији (153-02-416/2015-01 од 03.03.2015. године ) програма континуиране здравствене едукације Здравственог савета Србије , “49. ДАНИ ПРЕВЕНТИВНЕ МЕДИЦИНЕ ” акредитовани су као међународни конгрес . ISBN 978 -86 -915991 -4-0 49TH DAYS OF PREVENTIVE MEDICINE BOOK OF PAPERS AND ABSTRACTS 22.-25. SEPTEMBER 2015. NIŠ, SERBIA TABLE OF CONTENTS A. PLENARY LECTURES …………………………………………………………………... 9-17 B. MICROBIOLOGY SESSION …………………………………………………………….. 18-35 C. HYGIENE WITH MEDICAL ECOLOGY SESSION ……………………………………. 36-106 C-1 NUTRITION AND HEALTH……………………………………………….... 36-71 C-2 ENVIRONMENT AND HEALTH………………………………………........ 72-106 D. HEALTH PROMOTION SESSION ………………………………………………………. 107-134 E. CURRENT PARASITOSIS SESSION ………………………………………………….... 135-147 F. EPIDEMIOLOGY SESSION ……………………………………………………………... 148-206 F-1 THEORETICAL AND PRACTICAL PROBLEMS OF COMMUNICABLE DISEASE EPIDEMIOLOGY…………………………...…... 148-174 F-2 THEORETICAL AND PRACTICAL PROBLEMS OF MASS CHRONICAL NON-COMMUNICABLE DISEASE EPIDEMIOLOGY.... 175-206 G. SOCIAL MEDICINE SESSION ………………………………………………………….. 206-232 A. PLENARY LECTURES PLENARY LECTURES PUBLIC HEALTH CHALLENGES OF POPULATION MIGRATIONS ON GLOBAL AND LOCAL LEVELS- THREATS, RISKS AND CHALLENGES FOR PUBLIC HEALTH? Dragan Ili ć, Institute of Public Health Serbia „Dr Milan Jovanovi ć Batut“ Migration, whether it is voluntary or forced, is becoming more common all over the world. People migrate in large numbers faster and further than ever before in history. This is happening at a time when many countries are not well prepared to deal with shifts in demographics, and when the politics and standpoints on migration and immigration are only now forming. Migrants represent a vulnerable group for many reasons, especially because of the problems regarding the access to the health system, and because of discrimination, language, cultural barriers, legal status and other economic and social difficulties. Country’s unfavorable migration policy towards this group can have significant consequences on public health. Health implications of an unfavorable migration policy are numerous, and in many cases the percentage of the sick and the deceased in relation to the migration is continually rising. From the public health point of view, this will have serious consequences for migrants/refugees, for their families that were left behind, but also for the communities to which the refugees came. Of course, migrations are not a new phenomenon. During all the periods of the development of civilization people have been on the move, from nomadic shepherds all over the world who routinely move to this day, to the United States of America, Canada and Australia which were founded thanks to the immigrants. Around 200 million people all over the world have the desire and the idea to cross the border every year. Migration became the integral and inevitable part of the global social and economic development. What is even more important is that the possibility of migration is becoming an increasingly significant part of the worldview of people who are living in growing poverty. In certain regions, people are encouraged to seek opportunities elsewhere, while politicians are simultaneously trying to stop the immigration with the excuse of or with the aim of protecting public health. War, natural catastrophes, and complicated emergency situations are destroying the social and cultural infrastructure and are effecting more and more people than ever before, because as the world population rises and becomes more concentrated the number of people who are in danger and who are affected by these events is continually rising. Despite the time and effort spent on resolutions and preventions of conflicts, in the last 15 years over 36 countries all over the world were involved in a certain type of conflict. These conflicts are collectively responsible for the deaths of over 60 million people. Many refugees will lose their citizenship and roof over their heads for years to come and, in some cases, only the future generations will be ble to hope for a better status. What happens to the public health risks and the health risks of people in the migration process? International border traffic has been connected to the spread of infectious diseases for a long time. The need to reach the highest levels of health protection while minimizing obstacles in migration of people and international trade of goods and services has become the leading principle which is regulated by the International Health Regulations (2005). The connection between population migration, travel and the occurrence of diseases has historical roots, but it still affects the course of modern medicine. Traditional medical approaches which deal with migrants’ health have focused on recognizing and indentifying certain diseases, or the health issues in the migrant 9 A. PLENARY LECTURES population at the time and place of their arrival with the aim of protecting the native population by forming quarantines or centers where migrants would be isolated. Similar procedures are still used in the contemporary concept of immigration through medical screenings and the border patrol practices with the intention to decrease the public health threats or to mitigate the potential impact on health care services. There are two approaches to the epidemiological analysis of diseases among migrants in the countries which accept migrants. The first approach is to analyze migrants’ health and health risks during the migration process itself, and the second approach is to assess the development of health risks during the migrants’ stay. The reference population for the first analytical approach is the regular population, the host country, while the reference group for the second approach can be the resident population but also the comparison cohorts in the place of migrants’ origin. Even in the cases of effective medical screenings on the border crossings, viral diseases with a shirt incubation period can remain unnoticed because the disease has not yet manifested itself clinically. While the quarantine principle is still in place, the International Health Regulations also recommend an urgent international report as well as an urgent response to the resulting situation which represents a public health threat. Health indicators point to the fact that migrants in Europe are at a greater risk of numerous diseases than the resident population in those countries, that is, migrants fall ill more frequently than the native population especially from contagious diseases but also from chronic noncommunicable diseases and conditions. Tuberculosis is the disease of the impoverished, and it is endemic in most of the developing countries where migrants come most often. The frequency of the new cases of tuberculosis infection in 15 counties of the EU has decreased in the last decades from 34.8 cases in 100,000 people in 1974, to less than 14 in 100,000 people. However, the number of new cases among migrants in Denmark has been increasing during the last 5 years; therefore the percentage of tuberculosis cases among the persons born abroad has risen from 18% in 1986 to over 60% in 1996. In the Netherlands, the frequency of tuberculosis cases among immigrants has risen from 45% to over 50%. The situation regarding tuberculosis is similar in Germany and France, and the number of people suffering from tuberculosis is three to six times higher among migrants. Almost the same can be said about the different types of hepatitis. Out of 156,817 registered HIV positive persons in the countries of the EU 60,000 or even 38% are migrants. Immigrants are also more exposed to other types of accidents. Research shows that in Germany immigrant children between the ages of five and nine have more traffic and other types of accidents. Migrants in most European countries do not have the right to health insurance or they do not know either where or how to ask for help. Migrants that come from countries with extreme poverty, those who were forcibly exiled due to war or dangerous environment, those with limited education or language

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