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Background: Coronary heart disease (CHD) mortality has declined substantially in the Czech Republic over the last two decades., Design: The purpose of this study was to determine what proportion of this CHD mortality decline could be associated with temporal trends in major CHD risk factors and what proportion with advances in medical and surgical treatments., Methods: The validated IMPACT mortality model was used to combine and analyse data on uptake and effectiveness of CHD management and risk factor trends in the Czech Republic in adults aged 25-74 years between 1985 and 2007. The main sources were official statistics, national quality of care registries, published trials and meta-analyses, and the Czech MONICA and Czech post-MONICA studies., Results: Between 1985 and 2007, age-adjusted CHD mortality rates in the Czech Republic decreased by 66.2% in men and 65.4% in women in the age group 25-74 years, representing 12,080 fewer CHD deaths in 2007. Changes in CHD risk factors explained approximately 52% of the total mortality decrease, and improvements in medical treatments approximately 43%. Increases in body mass index and in diabetes prevalence had a negative impact, increasing CHD mortality by approximately 1% and 5%, respectively., Conclusions: More than half of the very substantial fall in CHD mortality in the Czech Republic between 1985 and 2007 was attributable to reduction in major cardiovascular risk factors. Improvement in treatments accounted for approximately 43% of the total mortality decrease. These findings emphasize the value of primary prevention and evidence-based medical treatment., (© The European Society of Cardiology 2012.)

Background: The number of notified tuberculosis cases in the Czech Republic in 2009 was lower than in 2008. 710 new tuberculosis cases and relapses were reported., Material and Methods: 598 cases were pulmonary tuberculosis and from them 439 were proved pulmonary tuberculosis cases. In 2009 235 smear-positive cases of pulmonary tuberculosis were diagnosed., Results: The incidence of tuberculosis was 6.8/100000 inhabitants in 2009. The percentage of tuberculosis cases diagnosed in foreign-born persons living in the Czech Republic increased from 14.2% in 2003 to 19.2% in 2009., Conclusions: Next targets of tuberculosis control in the Czech Republic must be an active case-finding in the high-risk groups and monitoring of latent tuberculosis infection.

Objectives: To assess longitudinal trends in cardiovascular mortality and population mean blood pressure, prevalence, awareness, treatment, and control of hypertension in a representative Czech population sample from 1985 to 2007/2008., Methods: Source data on mortality rates were provided by the Czech Statistical Office and further processed by the Institute for Health Information and Statistics of the Czech Republic. Six independent cross-sectional population surveys were conducted in 1985, 1988, 1992, 1997/1998, 2000/2001, and 2007/2008 with randomly selected men and women aged 25-64 years and resident in six districts of the Czech Republic (Praha-východ, Benešov, Pardubice, Chrudim, Cheb, and Jindřichův Hradec). The total number of participants was 13 972., Results: Since 1985, there has been a significant continuous, almost linear decline in standardized total, cardiovascular disease, ischemic heart disease, and stroke mortality (P < 0.001).There was a significant downward trend in the population mean SBP (from 133.6 ± 20.2 to 129.5 ± 18.5 mmHg; P < 0.001) and DBP (from 84.1 ± 11.3 to 82.5 ± 10.0 mmHg; P < 0.001) from 1985 to 2007/2008. This was associated with a significant decrease in the prevalence of hypertension only in women (from 42.5 to 37.2%; P < 0.001). Awareness of hypertension increased in both sexes (men, from 41.4 to 68.4%; women, from 58.9 to 71.4%; both P < 0.001) as did the number of individuals on antihypertensive medication (men, from 21.1 to 58.2%, women: from 38.9 to 58.9%; both P < 0.001). Control of hypertension improved significantly (from 3.9 to 24.6%) over the same period., Conclusion: The reduction in population blood pressure and improved hypertension control may have contributed substantially to the decrease in cardiovascular disease mortality in the Czech Republic.

Background: The number of notified tuberculosis cases in the Czech Republic decreased in the year 2007. 871 new tuberculosis cases and relapses were reported in the year 2007 (8.4/100 000 inhabitants)., Methods and Results: 744 cases were pulmonary tuberculosis (7.2/100 000) and from them 506 were definite pulmonary cases (4.9/100 000). In 2007 266 smear-positive cases of pulmonary tuberculosis were diagnosed. The decreasing trend in tuberculosis incidence reported since 1998 has continued. Only 14.7% of new cases of pulmonary tuberculosis were discovered by active case-finding., Conclusions: Next targets of tuberculosis control in the Czech Republic must be an active case-finding in high-risk groups and monitoring of latent tuberculosis infection.

Background: In the Czech Republic the number of all notified tuberculosis cases decreased in the year 2006. 973 (9.5/100,000) all tuberculosis cases of new diseases and relapses were reported. 799 cases (7.8/100,000) were pulmonary tuberculosis and from them 556 cases (5.5/100,000) were definite pulmonary tuberculosis. In 2006 267 cases of smear positive pulmonary tuberculosis were detected. The decrease in tuberculosis notification rate reported in the Czech Republic since 1998 has continued., Methods and Results: The resistance for antituberculotic drugs was 7.4% and MDR-TB cases were detected in 1.4% of all bacteriologically confirmed cases. The low level of resistance, good treatment constitutes presumption of further decline in tuberculosis in the Czech Republic., Conclusions: The majority of tuberculosis cases were diagnosed because of symptoms (74.7%)-passive case-finding. By active case-finding only 11.7% of new pulmonary tuberculosis were detected. In Prague only 6.7% of all pulmonary tuberculosis cases were diagnosed by active case-finding. Next target of tuberculosis control in the Czech Republic will be to increase the percentage of active case-finding in high-risk groups and to monitor latent tuberculosis infection in our population.

Background: The number of notified TB cases decreased in the year 2005, when 1007 new TB cases and relapses were reported (9.9/100,000 inhabitants)., Methods and Results: 838 cases were pulmonary TB (8.2/100,000) and from them 586 were definite pulmonary cases (5.7/100,000). The decreasing trend in TB incidence reported since 1998 has continued. The treatment of definite pulmonary cases notified in 2004 and evaluated in 2005 was effective. Treatment success was in 80.7 % of cases, but failures and interrupted treatment were only 2.5 % of cases. Only 14.7 % new cases of pulmonary TB were found by active case-finding., Conclusions: Next targets of TB control must be an active case-finding in high-risk groups and monitoring latent TB infection.

The high percentage of hospitalized pregnant women in the Czech Republic was analyzed form the cost benefit aspect within the framework of the current transformation of the health services which restricts in-patient care in favour of ambulatory care, as part of the developing market economy. Two internationally accepted indicators of quality of perinatal morbidity-maternal (rate of eclampsia) as well as neonatal (rate of low birth weight infants), i.e. partially preventable prenatal hospitalizations. In a comparative epidemiological study the incidence of these indicators in the Czech Republic was compared with the incidence in Hessen where there is a lower rate of prenatal hospital admissions, while there is a similar system of perinatal care and general perinatal mortality. In the Czech Republic where the cost of hospitalization of pregnant women is higher, the authors found as regards the benefit a lower incidence of the mentioned two indicators and from the economic aspect a lower cost of neonatal intensive care than in Hessen. This saving was fourfold as compared with the higher costs of prenatal hospitalization.