Monitoring HPV Prevalence and Risk Cofactors for Abnormal Cytology in the Post-Vaccination Period among Croatian Women.

The incidence and mortality rate of cervical cancer in Croatia remains a health challenge despite screening efforts. Besides the persistent infection with HPV, the development of cancer is also associated with some cofactors. The goal of this study was to assess circulating HPV genotypes and risk factors for the development of cervical precancer after almost 16 years from the onset of HPV vaccination in Croatia. In this study, a total of 321 women attending gynecological care were evaluated. Relevant medical and demographic information, including cytology, were collected. HPV genotyping was performed by PCR. Comparing the HPV types found in circulation in the pre-vaccination (1999-2015) and post-vaccination periods (2020-2023), a statistically significant reduction in HPV 31 was noted, while the overall prevalence increased in the post-vaccination period. Besides the expected HPV positivity as a risk factor, the history of smoking was associated with LSIL or worse cytology at enrollment. For the first time, this population study revealed a statistically significant shift in the HPV genotype in the post-vaccination period, as well as the confirmation of risk factors for the development of abnormal cytology among Croatian women.

Breastfeeding Promotion and the Results of the Maternity Ward - a Friend of Children Initiative Implementation in Bjelovar-Bilogora County in 2018.

BACKGROUND: Breastfeeding has a beneficial effect on the overall health system of the child and the mother. After six months of age, it is recommended to introduce complementary feeding in parallel and to continue breastfeeding for at least one year of the child's life. Maternal education is one of the key tasks of medical staff during pregnancy and especially during lactation. OBJECTIVE: The main objectives of the study is to determine the essential features of female respondents with regard to previous pregnancies, births and health visitors visits after birth; to determine the percentage of women whose lactation was started in hospital and who exclusively breastfed; to determine the differences in child's diet during a health visitor visit at two, four, six, nine and twelve months in regards to female respondents' age. METHODS: The study has been conducted as a cross-sectional study. 571 women who gave birth in General Hospital of Bjelovar took part in the survey and the reviewing was continued by Health Visiting Service of Bjelovar-Bilogora County in 2018. The tools for data collection were IT system of General Hospital of Bjelovar, case histories as well as Health Visiting Service IT system. RESULTS: Most of the female respondents are of the average age of 30 years. The study was conducted on a highly educated sample. 461 respondents have a certain form of education. Older respondents are considerably more educated (62 %). Single respondents and extramarital respondents are considerably of younger age. Older respondents predominantly live in the town, have more previous pregnancies and children compared to younger respondents. Lactation was started with 98.8 % respondents in hospital, and 96.7 % exclusively breastfed. The mothers of older ages breastfeed longer. CONCLUSION: Older, educated, employed, married, town residential female respondents decide upon breastfeeding and exclusively breastfeeding. Older respondents have more experience with previous pregnancies and lactation. The study has confirmed that older mothers breastfeed longer, while younger mothers more often reach for milk alternatives.