Central European Journal of Public Health - Latest articles

Correction to: Comparing step count strategies: the impact of walking on cardiometabolic health in women with obesity (Vol. 34, Pg 80, 2026)Erratum

Merve Kal, Nazime Cebi, Meral Kucuk Yetgin

Cent Eur J Public Health 2026, 34(3):216 | DOI: 10.21101/cejph.a9217  

The authors regret that the name of the university was omitted in the Funding section.

Digital dementia in adults: an assessment of digital generations

İnci Arikan, Buse Turan, Muammer Yilmaz, Ömer Faruk Tekin

Cent Eur J Public Health 2026, 34(3):209-215 | DOI: 10.21101/cejph.a8850

Objectives: This study was conducted to examine the level of digital dementia (DD) in adults and related socio-demographic and smartphone addiction factors. Methods: The study was conducted between June and September 2025 in western Türkiye and included individuals who applied to selected family health centres. Data were collected using a researcher-developed questionnaire consisting of socio-demographic information, behaviour-related items, the Digital Dementia Scale Adult Form (DDAF) and Smartphone Addiction Scale (SAS). This study evaluated participants according to digital generations. Results: The mean DDAF score was 40.56 ± 21.18 among digital...

Epidemiology of ankle fractures: stability and change over two decades

Jan Frühauf, Václav Vaněček, Petr Fojtík, Michal Tuček, Anna Horňáková

Cent Eur J Public Health 2026, 34(3):203-208 | DOI: 10.21101/cejph.a8913

Objectives: Ankle fractures are common lower-limb injuries with substantial effects on mobility and healthcare needs. This study characterised the demographic and morphological distribution of dislocated ankle fractures and compared the findings with a cohort treated approximately two decades earlier. Methods: This retrospective study included 436 adults with dislocated ankle fractures treated at the Military University Hospital Prague between 2018 and 2020. Age, sex, laterality, fracture morphology, medial structure involvement, posterior malleolar and syndesmotic injuries, treatment type, and body mass index (BMI) were analysed. Aggregate results...

Chronic low back pain: assessment of mental distress, quality of life and pain-related activity patterns

Lucie Sikorová, Andrea Polanská, Renáta Zoubková, Jan Divák, Alena Mátlová, Michal Parma

Cent Eur J Public Health 2026, 34(3):196-202 | DOI: 10.21101/cejph.a8736

Objectives: The aim of this study was to assess mental health, quality of life, and patterns of physical activity in patients with chronic low back pain (CLBP), to compare these outcomes across socio-demographic factors, and to evaluate their relationship with subjectively perceived pain. Methods: A quantitative descriptive cross-sectional study was conducted. The research sample included 151 patients with chronic low back pain treated at a Pain Management Centre. Data were collected using the Numeric Rating Scale, Hospital Anxiety and Depression Scale, WHOQOL-BREF questionnaire, Patterns of Activity Measure-Pain scale, and the International Physical...

Paracetamol overdose: systematic review of case reports and national toxicological data (2018–2023)

Jana Mlíchová, Ondřej Šimandl, Kateřina Kotíková, Karolína Šimůnková, Carla Torre, Zoltán Paluch, Eva Kmoníčková

Cent Eur J Public Health 2026, 34(3):191-195 | DOI: 10.21101/cejph.a8897

Objectives: Paracetamol is widely used as an analgesic and antipyretic, but its accessibility also makes it a frequent drug in overdose cases. Increasing rates of intentional paracetamol poisoning, particularly among adolescents, raise public health concerns. This study aimed to examine recent patterns of paracetamol overdose and identify risk groups for intentional self-poisoning. Methods: A systematic review of published case reports (2018–2023) describing paracetamol overdose was conducted using PubMed, Scopus, Web of Science, and the Cochrane Library. Additionally, a retrospective analysis of telephone inquiries to the Czech Toxicological...

Spirometry and end-tidal carbon dioxide changes during chest compressions with PPE: a simulation randomized crossover study

Patrik Cmorej, Petr Bureš, Ondřej Kounovský, Alena Kohlová, Danka Boguská, Dana Rebeka Ralbovská, Karel Hrach, Robin Šín, Jaroslav Pekara

Cent Eur J Public Health 2026, 34(3):185-190 | DOI: 10.21101/cejph.a8785

Objectives: Personal protective equipment (PPE) use in prehospital emergency care has increased significantly since the coronavirus pandemic onset in 2019. Few studies have been published on the PPE effects on spirometry parameters and end-tidal carbon dioxide (Et-CO₂). This study aimed to determine whether PPE use affects spirometric parameters and Et-CO₂ during chest compressions. Methods: This was a randomized crossover simulation study with 35 emergency medical service providers who performed 20 minutes of intermittent chest compressions on a mannikin (five 2 min cycles alternated by 2 min of rest). Two iterations were completed...

Blood heavy metal levels and bone turnover markers in Korean elementary school children

Kiook Baek, Chulyong Park

Cent Eur J Public Health 2026, 34(3):177-184 | DOI: 10.21101/cejph.a8682

Objectives: Although the health effects of heavy metal exposure in children are well documented, their impact on bone metabolism is less understood. Bone turnover markers such as serum C-terminal telopeptide of type I collagen (CTX) and serum Procollagen type I N-terminal propeptide (P1NP) can help assess skeletal effects. This study aimed to evaluate the relationship between blood concentrations of mercury (Hg), lead (Pb), and cadmium (Cd) and bone turnover markers in children. Methods: We conducted a cross-sectional study of 221 elementary school children aged 11–13 years attending four schools around a municipal incinerator, one of which served...

Impact of COVID-19 on breast cancer screening: time series analysis of pre-pandemic, pandemic and post-pandemic periods

Gökhan Mert Özyurt, Sarhun Zirek, Duygu Kolukisa, Cemil Yüksel, Mutlay Keskin

Cent Eur J Public Health 2026, 34(3):171-176 | DOI: 10.21101/cejph.a8451

Objectives: This study aimed to evaluate the impact of the COVID-19 pandemic on breast cancer screening activity, cancer detection rates, and stage at diagnosis by comparing pre-pandemic, pandemic, and post-pandemic periods. Methods: This retrospective cross-sectional study included women who underwent breast cancer screening between March 2018 and February 2024. The study period was divided into three phases: pre-pandemic (March 2018 – February 2020), pandemic (March 2020 – February 2022), and post-pandemic (March 2022 – February 2024). Screening activity, including mammography and breast ultrasonography examinations, cancer detection...

Safety profile of the COVID-19 vaccine in chronic vs. non-chronic populations: evidence from a retrospective cohort study

Fitim Alidema, Arieta Hasani Alidema

Cent Eur J Public Health 2026, 34(3):167-170 | DOI: 10.21101/cejph.a8953

This retrospective cohort study evaluated the safety profile of COVID-19 vaccination after the administration of three doses among 1,000 participants in Kosovo, including 600 individuals with chronic diseases and 400 without chronic conditions. Data were collected from medical records and standardized questionnaires on post-vaccination adverse events. Overall, 68.5% of participants reported at least one adverse effect, with a higher incidence among those with chronic diseases (74.3%) compared with non-chronic individuals (59.7%, p = 0.01). The most common reactions were mild and transient, including local injection site pain (39.2%), fatigue (27.6%),...

Physician's recommendation as a key determinant of influenza vaccination uptake during pregnancy: a prospective observational study

Asiye Uzun, Saliha Büşra Aksu, Güneş Topçu, Seda Özmen Sever, Güzin Zeren Öztürk

Cent Eur J Public Health 2026, 34(3):160-166 | DOI: 10.21101/cejph.a9024  

Objectives: Influenza infection is associated with substantial maternal morbidity and mortality during pregnancy; however, influenza vaccination uptake remains low. Physician's recommendations have been identified as one of the key determinants of vaccination rates. This study was conducted to evaluate the effect of physician's recommendation on influenza vaccination rates among pregnant women and to examine factors associated with vaccination behaviour. Methods: This prospective observational study included 356 pregnant women aged 18-50 years with a gestational age of ≥12 weeks who were receiving prenatal care at a tertiary-care hospital in...

Adult HPV vaccination (27–45 years): who benefits, when to offer, and how to counsel

Marek Broul, Pavel Dlouhý, Aneta Hujová, Michaela Liegertová

Cent Eur J Public Health 2026, 34(3):155-159 | DOI: 10.21101/cejph.a8941

Objectives: The aim of the study was to translate major international recommendations and the current evidence base into a practical approach for counselling adults aged 27-45 years about human papillomavirus (HPV) vaccination. Methods: We conducted a targeted narrative review of guidance from the World Health Organization, the European Centre for Disease Prevention and Control and US public health sources that frame HPV vaccination in mid-adults as shared clinical decision-making. We prioritised systematic reviews, randomised trials and recent evidence syntheses relevant to mid-adult vaccination and vaccination after cervical excisional treatment....

Editorial. Defining public health as a basis for expressing the subject coverage of a scientific journal

Milan Tuček

Cent Eur J Public Health 2026, 34(2):71  

Correction to: Trends in sexual initiation and contraception use among Czech adolescents between 2002–2022 (vol. 33, pg 255, 2025)Erratum

Anna Ševčíková, Vít Suchý, Peter Kolarčik, Lukas Blinka

Cent Eur J Public Health 2026, 34(2):149-150 | DOI: 10.21101/cejph.a9122  

We would like to submit the following correction to our recently published paper due to an error in the Table 1.

Perceptions of dental amalgam use and regulation among health and science students and academic staff in the Czech Republic: a cross-sectional study

Lenka Vavřičková, Jan Schmidt, Anna Krejčová, Anna Horňáková, Milan Tuček, Martin Kapitán

Cent Eur J Public Health 2026, 34(2):141-148 | DOI: 10.21101/cejph.a8978

Objectives: This study assessed perceptions of health and science students and academic staff regarding the health risks, environmental impact, and regulation of dental amalgam (DA). As DA faces increasing restrictions, understanding the views of students and academic staff is essential for evaluating educational and policy readiness. Methods: A cross-sectional survey was distributed to 1,230 participants in the Czech Republic. The questionnaire explored awareness of mercury exposure from DA, health and environmental concerns, and familiarity with regulations. Responses were statistically compared across disciplines. Results: Overall, 35.8% of respondents...

Examining the psychometric properties of the Czech versions of Illinois Bully Scale

Štěpán Komrska, Alžběta Váňová, Martin Dolejš, Jaroslava Suchá

Cent Eur J Public Health 2026, 34(2):135-140 | DOI: 10.21101/cejph.a8731

Objectives: The main objective of the study was to adapt and verify the psychometric properties of the Illinois Bully Scale (IBS) in Czech adolescents. Methods: The analysis utilized quantitative data from 1,321 respondents, aged 12 to 14 years, who were enrolled in 7th grade of lower secondary or grammar school. Descriptive and inferential statistics, including chi-square tests and Mann-Whitney U tests, were used to examine group differences. Results: The IBS demonstrated strong internal consistency and construct validity across all subscales (Victim: 0.84, Bully: 0.80, Fight: 0.79, total IBS: 0.87). Boys and elementary school students reported significant...

Cytisine for smoking cessation in clinical practice: a retrospective analysis of early outcomes in Türkiye

Feyzanur Erdem, Hatice Rümeysa Selvi, Ayşe Didem Esen, Mahnur Mahdum, Begüm Yildirim Erence, Muhammed Nezir Çetin, Erdoğan Öz, Seçil Arica

Cent Eur J Public Health 2026, 34(2):129-134 | DOI: 10.21101/cejph.a8654

Objectives: Smoking remains a major global public health problem, and pharmacological therapies are central to cessation strategies. Cytisine, a plant-derived alkaloid, has recently been introduced in Türkiye as a smoking cessation aid. This study aimed to evaluate the early effectiveness and cessation outcomes of cytisine in a Turkish population. Methods: This retrospective observational study included 289 patients who were prescribed cytisine at a smoking cessation clinic between March and May 2024. Socio-demographic characteristics, smoking history, nicotine dependence, treatment duration, and smoking cessation outcomes at 1 month and 6 months were...

HIV mortuary surveillance system in Kyiv, Ukraine, July–December 2021

Carlie L. Sulpizio, Roksolana Kulchynska, Violetta Martsynovska, Anna Meteliuk, Lyudmyla Dobrovolska, Nataliia Bugaienko, Irina Andrianova, Petro Kuzyk, Daryna Krenytska, Marianna Azarskova, Nataliya Podolchak, Ezra Barzilay, Hammad Ali

Cent Eur J Public Health 2026, 34(2):123-128 | DOI: 10.21101/cejph.a8708

Objectives: In Ukraine, accurate HIV mortality data are lacking due to limited information on HIV-related deaths. This study focuses on Kyiv to track HIV-related deaths among undiagnosed individuals living with HIV and evaluate HIV programming for cause-of-death identification. Methods: Five mortuaries in Kyiv were selected to participate (July–December 2021) with cadavers from people aged 18+ years. HIV status was determined through serology; patient files were examined for prior diagnosis and treatment. Bivariate analyses were conducted to assess HIV status and select characteristics and chi-square or Fisher's exact tests were used, as appropriate,...

Awareness of community about patient safety, medical errors and patient engagement: a cross-sectional study

Emel Filiz

Cent Eur J Public Health 2026, 34(2):117-122 | DOI: 10.21101/cejph.a8463

Objective: Preventable medical errors are recognized as an important public health problem. The aim of this study was to evaluate the awareness of adults in the community about patient safety, medical errors and patient participation; and to determine their experiences of medical errors. Methods: Adults older than 18 years living in the Konya city centre in Türkiye were included in the study. The implementation of the questionnaire took approximately two months, and a total of 780 valid questionnaires were obtained. Participants were asked questions about their views and attitudes towards medical errors. In addition, participants' engagement in behaviours...

Transmission of infectious agents in healthcare settings: a systematic review of healthcare-associated infections

Renata Trajerová, Ladislav Štěpánek

Cent Eur J Public Health 2026, 34(2):111-116 | DOI: 10.21101/cejph.a8870

Objectives: This study aimed to systematically analyse original research publications to provide a comprehensive assessment of the transmission chain of healthcare-associated infections (HAIs). The review focused on identifying transmission routes, sources of pathogen detection, and the predominant microorganisms detected in healthcare environments. Methods: A systematic review was performed following PRISMA methodology. Relevant studies were searched in PubMed and Scopus databases using predefined keywords. Results: Forty-four original studies published in English between January 2015 and July 2025 were included. Indirect transmission was reported...

Pathogen occurrence and antimicrobial resistance in long-term care units before and after the COVID-19 pandemic: an analysis from a Polish district hospital (2017–2023)

Rafał Kuczma, Szymon Barwiński, Barbara Symula, Katarzyna Jermakow

Cent Eur J Public Health 2026, 34(2):105-110 | DOI: 10.21101/cejph.a8932

Objectives: The study aimed to analyse trends in pathogen occurrence and antimicrobial resistance patterns in two long-term care (LTC) units operating within a Polish district hospital from 2017 to 2023, with a particular focus on changes across the COVID-19 pandemic. Methods: A retrospective observational study was conducted using epidemiological and microbiological data from two LTC units (nursing home and inpatient hospice) in Poland. Isolation rates (per 1,000 patient-days) for ESKAPE pathogens and Clostridioides difficile were analysed. The pre-pandemic period (2017-2019) was compared with the pandemic/post-pandemic period (2020-2023) using rate...

Association between air pollution and paediatric intestinal intussusception in Seoul, Korea: a time-series regression approach

Kiook Baek

Cent Eur J Public Health 2026, 34(2):98-104 | DOI: 10.21101/cejph.a8806

Objectives: The impact of air pollution on gastrointestinal diseases remains unclear. This study examines the association between air pollutants and paediatric intussusception incidence. Methods: Using data from the Health Insurance Review and Assessment Service (HIRA), we analysed daily intussusception cases in Seoul (2009-2019). Air pollutants, including particulate matter (PM₁₀), ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO), and sulphur dioxide (SO₂), were assessed alongside temperature. A generalized linear model with a negative binomial link function evaluated the relationship between each...

Longitudinal changes in health-related quality of life in working-age adults one year after ischaemic stroke: findings from the FRAILTY study

Elena Gurková, Daniel Šaňák, Daniela Bartoníčková, Šárka Šaňáková, Lenka Štureková, David Franc, Jana Zapletalová, Petra Divišová

Cent Eur J Public Health 2026, 34(2):88-97 | DOI: 10.21101/cejph.a8809

Objectives: Limited evidence exists on how working-age adults perceive the impact of ischaemic stroke (IS) during the first months post-event, and longitudinal data on health-related quality of life (HRQoL) are scarce. The aim of the study was to examine 12-month changes in HRQoL, functional outcomes, cognitive function, and psychosocial sequelae in working-age adults after IS, and to explore age-related differences (< 50 vs. ≥ 50 years). Methods: In this prospective cohort study, 220 patients aged 18-65 years with first-ever IS were assessed before hospital discharge, 3-, 6-, and 12-month post-discharge. Measures included the Stroke Impact...

Comparing step count strategies: the impact of walking on cardiometabolic health in women with obesity

Merve Kal, Nazime Cebi, Meral Kucuk Yetgin

Cent Eur J Public Health 2026, 34(2):80-87 | DOI: 10.21101/cejph.a8661

Objectives: This study aims to compare the effect of 10 thousand steps per day (10TSPD) and 3 thousand steps per 30 minutes (30M3TS) supported by medical nutritional therapy on body composition, 6-minute walking distance (6MWT), cardio-metabolic parameters comprising insulin, glucose, glycohaemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), low density lipoprotein (LDL), high density lipoprotein (HDL), and total cholesterol in women with obesity. Methods: Thirty women with obesity supported by individual-specific medical nutrition therapy were divided into two groups with a target (10TSPD) at a frequency of 3-5 days/week...

Economic cost of excess body weight among adults in Estonia

Johann Saavaste, Aleksei Baburin, Mall Leinsalu, Rainer Reile

Cent Eur J Public Health 2026, 34(2):72-79 | DOI: 10.21101/cejph.a8761

Objectives: High disease burden related to excess body weight (EBW) poses a substantial burden to healthcare systems globally. This study aims to assess the economic impact of EBW in Estonia, where over 60% of adult population are overweight or obese. Methods: Using population attributable fraction approach, this cost-of-illness study included 29 health conditions associated with overweight and obesity. The annual costs were calculated from the health care/government perspective for the year 2021 using individual level and administrative data. The direct costs were defined as a sum of treatment and medication costs, sickness benefits and care leave,...

Unusual occurrence of temporo-spatial cluster of human prion disease in northern part of central SlovakiaLetter to the Editor

Pavol Skáčik, Štefan Sivák, Egon Kurča

Cent Eur J Public Health 2026, 34(1):67-68 | DOI: 10.21101/cejph.a8670  

Objectives: Clusters of human prion diseases have been reported in several endemic regions, notably in Slovakia, Italy, Chile, and Israel, predominantly linked to genetic forms (E200K mutation). Isolated temporo-spatial clusters that include sporadic forms are rarely documented and remain poorly understood. This report describes a unique cluster of prionopathies observed in northern central Slovakia. Methods: Between July 2021 and March 2022, three definitive cases of prion disease were identified in two neighbouring rural villages, Pribovce and Rakovo, in the Martin District of Slovakia. The villages, located within a radius of approximately three...

Degree of fatigue in individual parts of the body of professional tree climbers after the performance of their work – a survey

Luboš Staněk

Cent Eur J Public Health 2026, 34(1):59-66 | DOI: 10.21101/cejph.a8381  

Objectives: Work of an arborist – tree climbing – is a dangerous activity associated with great physical effort, influenced by incorrect body posture and significantly stressed individual parts of the body. This research was initiated with the objective to draw attention to this hitherto little explored issue connected with ergonomics of the work of tree climbers. The goal of the research was to gather information about the fatigue of individual parts of the human body in professional tree climbers who access trees using so-called rope techniques (ascent to the tree crown, movement in the tree crown, descent from the tree crown) by means...

Atherosclerosis and dementia development: an epidemiological case-control study

Veronika Koutná, Ladislav Štěpánek, Martina Kovalová, Ondřej Machaczka, Petr Ambroz, Anna Zatloukalová, Eva Mrázková, Michal Bar, Martin Roubec, Petra Bártová, Richard Novobilský, Martin Sabela, Pavlína Kušnierová, David Stejskal, Lucie Faldynová, Sylwia Walczysková, Lukáš Školoudík, Libor Šimůnek, Petra Šolínová, David Školoudík, Jana Janoutová, Vladimír Janout

Cent Eur J Public Health 2026, 34(1):53-58 | DOI: 10.21101/cejph.a8574  

Objectives: With increasing life expectancy, the prevalence of atherosclerosis and dementia is expected to rise in the future and as such represents a public health threat. This study focused on analysis of atherosclerosis risk factors and the protective factors of leisure-time activities in the development of dementia. Methods: The sample comprised 1,298 participants that were selected from university hospitals and outpatient clinics between 2019-2023. All participants completed a questionnaire and medical data were obtained. We used logistic regression to identify dementia risk factors and we also compared the leisure-time protective factors between...

Correlation between waist-to-height ratio and other anthropometric indices in the Bosnian elderly

Asija Začiragić, Amela Dervišević, Orhan Lepara, Amila Huremović, Amina Valjevac

Cent Eur J Public Health 2026, 34(1):47-52 | DOI: 10.21101/cejph.a8533  

Objectives: The objective of the present study was to explore whether gender differences exist in waist-to-height ratio (WtHR) values and to assess the correlation between WtHR and other obesity indicators after categorising older adults of Bosnian descent based on the presence or absence of abdominal obesity. Methods: The study included 151 inhabitants of the Geriatric Centre in Sarajevo, Bosnia and Herzegovina, aged 65 years and older (66 males and 85 females). Anthropometric indices and blood pressure values were measured by standard methods. WtHR was calculated using the following formula: waist circumference (WC) (cm)/height (cm). Differences...

Trends in Amanita phalloides intoxications in the Czech Republic: how many antidotes are needed?

Daniela Pelclová, Tomáš Navrátil, Eva Kieslichová, Jaroslav Klán, Peter Ondra, Šárka Daňková, Tomáš Májek, Ľubica Bihary

Cent Eur J Public Health 2026, 34(1):40-46 | DOI: 10.21101/cejph.a8787  

Objectives: In Central Europe, mushroom poisoning is a public health problem as the Czech Republic belongs to the countries with the highest proportion of mushroom pickers. The trends in A. phalloides intoxications, their treatment and outcome were investigated in verified cases, as several antidotes are recommended and their effect is still under discussion. Methods: Mushroom intoxications in 2010–2024 were searched in the database of the Czech Toxicological Information Centre (TIC) and the Institute of Health Information and Statistics. Intoxications with amatoxins in 2019–2024 were analysed. Results: Mushroom-related consultations of...

Human health risk assessment of trihalomethanes in outdoor swimming pool waters in Montenegro

Dijana Đurović, Nevena Cupara, Irena Nikolić, Milena Tadić, Jelka Vuković

Cent Eur J Public Health 2026, 34(1):33-39 | DOI: 10.21101/cejph.a8555  

Objectives: This paper deals with the characterization of outdoor swimming pool waters to study the occurrence of trihalomethanes (THMs) and to assess the health risk of THMs exposure for three population groups (male, female, and children). The concentration of total THMs and individual species (chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform) were monitored during the seven months of 2022 in outdoor swimming pools in the coastal area of Montenegro. Methods: A total of 73 water samples from outdoor swimming pools were collected and tested for the content of THMs using an Agilent 7890 A GC. Carcinogenic and non-carcinogenic...