WHO meeting on community control of stroke and hypertension: Copenhagen, Geneva, 8-16 November 1972: stroke control programme in Zagreb, Yugoslavia

• WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SAmE WHO MEETING ON COMMUNITY CONTROL OF STROKE AND HYPERTENSION Copenhagen/Geneva. 8-16 November 1972 cvo/s/72.~ ENGLISH ONLY STROKE OONTROL PROGRAMME IN ZAGREB. YUGOSLAVIA by s. Dogan Neuroloska Klinika Zagreb, Yugoslavia The Centre for Cerebrovascular Diseases in Zagreb has a group of physicians specializing in different fields (neurology. internal medicine, ophthalmology. pathology. general practice, laboratory medicine) and others (psychologists. biochemists. social workers. physiotherapists, nurses, etc.) collaborating in different progr8Jlll'les related to cerebrovascular diseases. The out-patient department is the nucleus of the Centre, but much of the work is also performed in the hospitals. The activities of the Centre are varied. and a large part of its efforts is directed towards epidemiology. The registration of patients with acute cerebrovascular accident started last year in Zagreb (about 700 OOO inhabitants). Patients living in a defined area of the town (population of 110 OOO) have been selected for follow-up. The first "filter" for registration is the town's emergency medicine unit where most of the acute oases are seen and then transferred to one of the hospitals or sent home. Further registration is done in the three departments of neurology of the general hospitals. or by general practitioners in the area for patients who stay at home. The collected data are sent every 10 days to WHO in Geneva. In order to follow-up (every 3 weeks. 3 months and every year) patients efficiently the area is divided into six sections, each of which is the responsibility of one of the collaborators in the Centre. All the collaborators meet once a month in order to co- ordinate the activities of the Centre. Neurologists from other towns frequently attend these meetings. We believe that in spite of all our efforts the registration doesn't cover all cerebrovascular disease patients. We estimate that about l~ of them escape detection for different reasons (inaccurate diagnosis. unequal co-operation with the three departments of neurology of the town hospitals, patients sent to the departments of internal medicine, etc.). The follow-up of patients who have been at home since the beginning of the disease or after discharge from hospital, encounters different difficulties especially when the patient's address is incorrect or when the patients temporarily leave the town. The same is true for persons who die at home. For these reasons, we also collect information from town offices (addresses of patients, register of those who died). The issue of this document does not constitute formal publication. It should not be reviewed, abstracted or quoted without the agreement of the World Health Organization. Authors alone are responsible for views expressed in signed articles. Ce document ne constitue pas une publication. II ne doit faire l'objet d'aucun compte rendu ou r4'1sum4'1 ni d'aucune citation sans l'autorisation de !'Organisation Mondiale de la Sante. Les opinions exprimees dana les articles aignea n'engagent que leura auteur&. CVD/S/72.'?IJ page 2 In order to keep the patients interested in collaboration with the Centre. home nursing and treatment is organized for them and a layman society is now being established. In the period from 1 February to 15 September 1972. 710 clear-cut.cerebrovaacular accidents were recorded from Zagreb. out of which 91 patients belong to the study area. Owing to initial difficulties a number of patients have not been included. but more complete registration can be expected in the future. F.ducation is also one of the aims of the Centre. The first seminar and scientific meeting was held in December 1971 in Zagreb. Three more brief seminars have been held in collaboration with the general practitioners. More meetings are planned for the future. some ot them with nurses and social workers. We also try to extend the activities of the Centre to other districts and smaller towns in Croatia. An important part of the Centre's work is the treatment of patients with cerebro- vaacular accident. Good facilities exist for neurological and cardiovascular examinations. ophthalmologic examinations. laboratory examinations (including examination of glucose. metabolism. lipids. coagulation factors. etc.). In the Centre we also examine "healthy" persons in later middle-age and record findings which may be risk factors. These persons will be followed up every year. Collaborating expert groups and institutions are interested in research projects on the care of acute cases. pathology. and psychology in connection with the stroke programne. These projects are going to start this autumn. supported by the City Council of Zagreb and the Research Council of Croatia.