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Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.Data was collected in the period 2016-2017 from a probability sample of the general population, 18-49 years old, at respondents' homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.Cilji raziskave so bili oceniti prevalenco poročanih spolno prenesenih okužb (SPO) v življenju ter nekaterih drugih okužb spolovil in sečil ter opisati zdravstveno oskrbo SPO.Podatki so bili zbrani v obdobju 2016–2017 v verjetnostnem vzorcu prebivalcev, starih 18–49 let, na njihovih domovih s kombinacijo računalniško podprtega anketiranja in samoizpolnjevanja vprašalnikov z občutljivejšimi vprašanji. Analizirani so bili s statističnimi metodami, ki upoštevajo stratifikacijo, kopičenje pri vzorčenju in uteženost podatkov.Približno vsaka deseta spolno izkušena oseba je poročala, da je že imela bolezenske težave na spolovilih in sečilih, ki bi lahko bile posledica SPO, vendar je med njimi le manjši delež poročal, da jim je zdravnik že postavil diagnozo SPO. Med spolno izkušenimi je manj moških (2,4 %) kot žensk (6,7 %) poročalo, da jim je zdravnik že postavil diagnozo vsaj ene SPO (klamidijske okužbe, gonoreje, nespecifičnega uretritisa, sifilisa, genitalnih bradavic, genitalnega herpesa ali hepatitisa B) (p0,001). Med bakterijskimi so bile najpogostejše klamidijske okužbe (moški: 0,8 %; ženske: 3,1 %) in med virusnimi genitalne bradavice (moški: 0,7 %; ženske: 3,0 %). Ženske, ki so imele v življenju najmanj 10 spolnih partnerjev, in tiste, ki so bile že prisiljene v spolne odnose, so imele višji obet za vsaj eno diagnozo SPO v življenju. Večino zadnjih epizod SPO pri ženskah so zdravili ginekologi, pri moških pa dermatovenerologi. Približno polovica jih je poročala, da so jim svetovali glede varnejše spolnosti, in večina, da so o diagnozi SPO obvestili vse svoje spolne partnerje ali večino. O diagnozi trihomoniaze ni poročal noben spolno izkušen moški in le 0,9 % spolno izkušenih žensk in o diagnozi sramnih uši 0,2 % moških in 0,6 % žensk. Vsaki tretji ženski (33,6 %) je zdravnik že postavil diagnozo glivičnega vnetja nožnice (kandida), medtem ko je bila diagnoza bakterijske vaginoze veliko redkejša (3,3 %). Da so že imele vnetje v mali medenici, pa je poročalo 1,5 % spolno izkušenih žensk.Naše ocene prevalence poročanih SPO v vsem življenju v verjetnostnem vzorcu spolno izkušenih prebivalcev Slovenije, moških in žensk, starih 18–49 let, nakazujejo pomembno breme SPO. Razlika v poročani pogostosti diagnoz SPO med moškimi in ženskami je bila predvidoma vsaj delno posledica tega, da imajo ženske neposreden dostop do specialistične obravnave SPO pri ginekologu na primarni ravni, medtem ko moškim specialistična obravnava SPO pri dermatovenerologu ni dosegljiva brez napotitve izbranega osebnega zdravnika. Rezultati bodo v pomoč pri poučenem načrtovanju nacionalnih politik in strategij preprečevanja ter obvladovanja SPO.

BackgroundTo inform prevention and control of sexually transmitted infections (STIs), we need reliable prevalence estimates.AimOne objective of the Slovenian National Survey of Sexual Lifestyles, Attitudes and Health was to estimate the prevalence of STIs with

Background To inform prevention and control of sexually transmitted infections (STIs), we need reliable prevalence estimates. Aim One objective of the Slovenian National Survey of Sexual Lifestyles, Attitudes and Health was to estimate the prevalence of STIs with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis. Methods Data were collected between October 2016 and July 2017 in a probability sample of the general population aged 18–49 years. Computer-assisted face-to-face interviewing and self-completion of questionnaires were used. Respondents were invited to provide urine samples to be tested for STIs. Results Of 1,929 survey participants, 1,087 individuals provided urine samples which were tested confidentially for C. trachomatis and a subset (n = 1,023) were tested anonymously for the other STIs. The prevalence of C. trachomatis was 0.5% (95% confidence interval (CI): 0.1–1.8) in men and 1.7% (95% CI: 0.9–3.2) in women. Age-specific prevalence was the highest among individuals aged 18–24 years, 2.8% (95% CI: 0.7–10.6) in men and 4.7% (95% CI: 1.7–12.3) in women. N. gonorrhoea was not detected. Prevalence of M. genitalium was 0.5% (95% CI: 0.1–2.2) in men and 0.3% (95% CI: 0.1–1.1) in women; the highest prevalence was among men aged 25–34 years (1.1%; 95% CI: 0.2–7.5) and women aged 35–49 years (0.5%; 95% CI: 0.1–2.0). T. vaginalis was detected in the sample from one woman (0.2%; 95% CI: 0.1–1.2). Conclusion The substantial prevalence of C. trachomatis among young adults suggests gaps in testing, diagnosis and treatment.

The coronavirus disease (COVID-19) global pandemic is ongoing, with Europe and the Americas the current epicentres of transmission. As at 1 January, 2021, over 82 million cases and 1.8 million deaths have been reported globally [1,2]. In Europe alone, the number of cases reported has now passed 26 million, with over 580,000 laboratory-confirmed COVID-19 deaths [3,4]. As many COVID-19 cases and deaths may not be confirmed by virological testing, and as the pandemic causes a range of indirect and collateral harms, the officially reported figures of laboratory-confirmed COVID-19 cases and deaths represent only a part of the total disease, mortality and overall public health burden associated with the pandemic. Here we report some noteworthy estimates of a marked increase in excess all-cause mortality in Europe coinciding with a steep second wave of COVID-19 in many countries since September 2020.

BackgroundThe availability of data generated from different sources is increasing with the possibility to link these data sources with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and artificial intelligence (AI) in routine public health activities, to identify the related estimated health indicators (i.e., outcome and intervention indicators) and health determinants of non-communicable diseases and the obstacles to linking different data sources.MethodWe performed a survey across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI).ResultsThe use of data linkage and AI at national institutes of public health, health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health, health information and statistics. Using linked data, 46 health outcome indicators, 34 health determinants and 23 health intervention indicators were estimated in routine. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to routine data linkage for public health surveillance and research.ConclusionsOur results highlight that the majority of European countries have integrated data linkage in their routine public health activities but only a few use AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development. Building analytical capacity and raising awareness of the added value of data linkage in national institutes is necessary for improving the use of linked data in order to improve the quality of public health surveillance and monitoring activities.

Background The availability of data generated from different sources is increasing with the possibility to link these data sources together. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and the artificial intelligence (AI) in routine public health activities, and to identify the related health outcome and intervention indicators and determinants of health for non-communicable diseases. Method We performed a survey across European countries to explore the current practices applied by national institutes of public health and health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or the AI). Results The use of data linkage and the AI at national institutes of public health and health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health and health information and statistics. Using linked data, 46 health outcome indicators related to seven health conditions, 34 indicators related to determinants and 23 to health interventions were estimated in routine. Complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to link different data sources in routine for public health surveillance and research. Conclusions Our results highlight that the majority of European countries have integrated data linkage in routine public health activities but a few use the AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development process. Building analytical capacity and awareness of the added value of data linkage in national institutes is necessary for improving the utilization of linked data in order to improve the monitoring of public health activities.

Background To inform sexually transmitted infections (STIs) prevention and control, objective of the second National Survey of Sexual Lifestyles, Attitudes and Health was to estimate the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis infections. Methods A survey of the general population aged 18–49 was conducted in 2016–2017. We used stratified two-stage probability sampling from the Central Population Registry. Survey respondents were invited to contribute first void urine specimens for testing for C. trachomatis and unlinked anonymous testing for other STIs to obtain population prevalence estimates. Specimens were tested for C. trachomatis with specific real time PCR targeting both cryptic plasmid and bacterial chromosome. Positive results were confirmed by Sanger sequencing of the amplicon. Other STIs were detected by a commercially available multiplex PCR (FTD Urethritis plus, fast-track Diagnostics). To avoid false negative results, the human house keeping gene was amplified in all tested samples. Results Urine specimens from 452 men and 635 women (56.4% of all survey respondents) were tested for chlamydia. Overall weighted prevalence was 0.5% (95% CI 0.1% to 1.4%) in men and 1.7% (95% CI 0.9% to 3.1%) in women. Age-specific prevalence was the highest among 18–24 years old (men: 2.8%; 95%CI 0.9% to 8.5%; women: 4.7%; 95%CI 1.6% to 10.7%). Urine specimens from 430 men and 593 women (53.0% of all survey respondents), were tested for other STIs. No infections with N. gonorrhoeae were found. Weighted prevalence estimate for M. genitalium was 0.5% (95% CI 0.2% to 1.5%) in men and 0.3% (95% CI 0.0% to 0.9%) in women. Parasite T. vaginalis was detected in one woman only. Corresponding weighted prevalence was 0.2% (95% CI 0.0%–0.9%). Conclusion The prevalence of C. trachomatis infection in the general population of Slovenians aged 18–24 was substantial. The other three STIs were relatively rare. Disclosure No significant relationships.

This analysis of the Slovene health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The health of the population has improved over the last few decades. While life expectancy for both men and women is similar to EU averages, morbidity and mortality data show persistent disparities between regions, and mortality from external causes is particularly high. Satisfaction with health care delivery is high, but recently waiting times for some outpatient specialist services have increased. Greater focus on preventive measures is also needed as well as better care coordination, particularly for those with chronic conditions. Despite having relatively high levels of co-payments for many services covered by the universal compulsory health insurance system, these expenses are counterbalanced by voluntary health insurance, which covers 95% of the population liable for co-payments. However, Slovenia is somewhat unique among social health insurance countries in that it relies almost exclusively on payroll contributions to fund its compulsory health insurance system. This makes health sector revenues very susceptible to economic and labour market fluctuations. A future challenge will be to diversify the resource base for health system funding and thus bolster sustainability in the longer term, while preserving service delivery and quality of care. Given changing demographics and morbidity patterns, further challenges include restructuring the funding and provision of long-term care and enhancing health system efficiency through reform of purchasing and provider-payment systems.

Background: Different types of marital status are associated with different levels of suicidal risk. Aims: To study marital status change and the effect of its recency in relation to suicidal behavior. Methods: Suicide victims (1614) in Slovenia and matched controls (4617) were compared for incidence and recency of marital status change during the last 5 years of their lives. Results: A higher percentage of suicide victims (10.7%) had a marital status change in the last 5 years compared with the controls (5.6%). All types of marital status changes (becoming widowed, getting divorced, getting married) proved to be risk factors for suicidal behavior. Almost half of all marital status changes in suicide victims occurred in the year prior to suicide, whereas marital status changes in the control group were equally distributed over the last 5 years. For recently married and divorced people, the increase in suicide risk depended on age: The risk was higher in older people. Conclusions: Marital status change represents a risk factor for suicidal behavior. The first year after the change is critical for elevated suicidal risk, in particular for older people.

Patient registries are poorly interoperable and as a result data exchange or aggregation across organizations, regions and countries for secondary purposes (i.e. research and public health) is difficult to perform. PARENT Joint Action aims to provide EU Member States with a set of guidelines, recommendations and tools to support setting-up, management and governance of interoperable patient registries, thus helping EU Member States to drive down cost and interoperability risks of patient registries as well as improving secondary us-age of registry data in a cross-border setting.