Implementation of Newborn Hearing Screening in Albania.

Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity hospitals, hence nurses and midwives could perform screening, and screening rooms and logistic support were supplied. Adoption among screeners was good. Referral rates decreased steadily, reflecting increasing skill. Occasionally, screening was repeated during a screening step, contrary to the protocol. NHS in Albania was implemented successfully, though LTFU was high. It is important to have effective data tracking and supervision throughout the screening.

May Measurement Month 2019: an analysis of blood pressure screening results from Albania.

This article discusses the results of the May Measurement Month (MMM) 2019 campaign, which contributed to a third round of MMM hypertension screening campaigns carried out in Albania, a transitional country in the Western Balkans. The hypertension screening campaign in Albania was carried out during the period 1-31 May 2019 in 30 sites in many districts of the country. Overall, 19 154 participants aged ≥18 years were included (approximately 68% of these were women), with an overall mean age of 47.0 ± 15.3 years. Blood pressure (BP) was measured with OMRON sphygmomanometers (Omron Healthcare, Kyoto, Japan). Hypertension was defined as systolic BP ≥140 mmHg, or diastolic BP ≥90 mmHg, or on treatment for hypertension. Self-reported data consisted of height and weight, pre-existing conditions, including smoking status and alcohol consumption. Overall, the proportion of participants with hypertension was 38.6%. Less than two-thirds (64.7%) of hypertensive individuals were aware of their condition. Also, less than half (48.3%) of participants on antihypertensive medication had controlled BP (<140/90 mmHg). The most sizable correlations of high BP were with known hypertension status, use of antihypertensive medication, and obesity. The MMM campaign contributes to routine hypertension screening in Albania. Hence, health professionals and policymakers in Albania should act on the findings of MMM screening campaigns and continue its support as a valuable tool for early detection of hypertension in the general population.

Correlates of Lifetime Physical Abuse Among Schoolchildren Aged 15 Years in Post-communist Albania.

Aim: Our aim was to assess the prevalence and correlates of lifetime physical abuse among schoolchildren in Albania, a post-communist country in South Eastern Europe which is currently undergoing a rapid socioeconomic transition. Methods: The third wave of Health Behavior in School-Aged Children (HBSC) in Albania was conducted in 2017-18 including a nationwide representative sample of 1,708 schoolchildren aged 15 years (54% girls; response rate: 95%). Children were asked to report on lifetime physical abuse and a wide range of socio-demographic factors, lifestyle factors and health status characteristics. Binary logistic regression was used to assess the independent association of lifetime physical abuse with covariates. Results: Overall, the prevalence of lifetime physical abuse was about 32% (30% in boys vs. 32% in girls). In multivariable-adjusted logistic regression models, independent positive correlates of lifetime physical abuse among Albanian schoolchildren included lifetime smoking (OR = 1.5, 95% CI = 1.1-2.2), lifetime alcohol consumption (OR = 1.6, 95%CI = 1.2-2.1), irritability (OR[dailyvs.rarely/never] = 2.0, 95%CI = 1.3-3.0), and especially lifetime witnessed domestic violence (OR = 4.2, 95%CI = 2.2-7.9). Conversely, a higher score on life satisfaction was inversely related to lifetime physical abuse (P < 0.01). Conclusion: Our study provides novel evidence about the magnitude and selected independent correlates of lifetime physical abuse among schoolchildren in Albania, a country still embedded in an everlasting transition which is associated with tremendous changes in family structure, community links and societal norms and values. Irrespective of a wide range of sociodemographic factors and health characteristics, lifetime smoking, alcohol consumption, irritability, a lower score on life satisfaction and, particularly, witnessed domestic violence were strong and significant correlates of lifetime physical abuse among Albanian schoolchildren aged 15 years.

Health literacy and body mass index: a population-based study in a South-Eastern European country.

BACKGROUND: The relationship of health literacy (HL) with objective measures including anthropometric measurements remains an under-researched topic to date. OBJECTIVE: To assess the association between body mass index (BMI) and HL among Albanian adults. METHODS: A cross-sectional study was conducted in Tirana, Albania, in 2012-2014 including a population-based sample of 1154 individuals aged ≥18 years. HL was assessed by the use of HLS-EU-Q instrument. Anthropometrics included measurement of weight and height based on which BMI was calculated. Information on socio-demographic characteristics was also collected. Logistic regression was employed to assess the independent association of BMI and HL controlling all socio-demographic factors. RESULTS: One-fifth of the participants reported an inadequate HL level, whereas almost one-third (31%) reported an excellent HL level. About 41% of study participants were overweight and further 22% were obese. In multivariate analysis, there was evidence of a strong and significant association between BMI and HL: the odds of overweight/obesity were two times higher (OR = 2.0, 95% CI = 1.3-3.1) among inadequate HL individuals compared with excellent HL participants. CONCLUSION: Our findings, pertinent to a transitional country in the South East Europe, point to a strong, consistent and highly significant association between BMI and HL, irrespective of a wide array of socio-demographic characteristics.

May Measurement Month 2018: an analysis of blood pressure screening results from Albania.

This article reports on May Measurement Month (MMM) 2018, which consisted of the 2nd round of the hypertension screening campaign conducted in Albania, a former communist country in South Eastern Europe. The hypertension screening campaign in Albania was conducted during the period 13-31 May 2018. Overall, there were eight sites from seven districts of the country involving 7046 participants aged ≥18 years (61% women and 39% men; overall mean age 46.8 ± 15.7 years). Blood pressure was measured with OMRON sphygmomanometers (Omron Healthcare, Kyoto, Japan). Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg, or on treatment for hypertension. Self-reported information included height and weight, diabetes, smoking status, and alcohol intake. The proportion of participants with hypertension was 37.2% of whom only 52.1% exhibited awareness. Furthermore, only a quarter of hypertensive individuals were properly treated and controlled. Significant predictors of high SBP and/or high DBP included a previous diagnosis of hypertension, being on antihypertensive medication, frequent alcohol intake, and being overweight and obese. The MMM 2018 campaign in Albania had a unique value for early detection of hypertension, particularly among younger adults. Policymakers and decision-makers in Albania and elsewhere should also rely on the MMM screening campaigns which have a great potential for prevention and control of hypertension in the general population.

Mothers' perceptions of universal newborn hearing screening in transitional Albania.

The universal newborn hearing screening (UNHS) component of the multi-center EUSCREEN project is being piloted in Albania since January 1st 2018. The aim of this study was to explore mothers' perceptions about various elements of UNHS in Albania. A cross-sectional study was carried out in the three sites of UNHS in Albania, namely in Tirana, Kukës and Pogradec during May-June 2019. During this period 512 consecutively approached mothers giving birth to included maternity hospitals were interviewed face-to-face about different aspects of UNHS. Basic socio-demographic and socioeconomic information was also collected. Mean age of participating mothers was 28.6 years ± 5.5 years. The overwhelming majority (93%) of mothers knew what their baby was being tested for, 33% were aware that hearing screening was offered in maternity hospital, 94% were very satisfied/satisfied with UNHS and about 62% were very stressed/stressed waiting for screening results, with significant sociodemographic and socioeconomic differences. The main information source about UNHS was screening staff in the maternity hospitals where mothers gave birth, reported in 67% of cases. All mothers (100%) agreed on the importance of early detection of newborn hearing problems, all mothers were willing to be informed early if their newborn baby had a hearing problem and all mothers were willing to contribute financially for testing the hearing of their newborn baby. These findings should guide information and education campaigns about UNHS in Albania. The public willingness to financially support neonatal hearing testing should be considered as an opportunity to achieve universal newborn hearing screening in the country.

Implementation of a neonatal hearing screening programme in three provinces in Albania.

OBJECTIVES: The EUSCREEN study compares the cost-effectiveness of paediatric hearing screening programmes and aims to develop a cost-effectiveness model for this purpose. Alongside and informed by the development of the model, neonatal hearing screening (NHS) is implemented in Albania. We report on the first year. METHODS: An implementation plan was made addressing objectives, target population, screening protocol, screener training, screening devices, care pathways and follow up. NHS started January 1st, 2018 in four maternity hospitals: two in Tirana, one in Pogradec and one in Kukës, representing both urban and rural areas. OAE-OAE-aABR was used to screen well infants in maternity hospitals, whereas aABR-aABR was used in neonatal intensive care units and in mountainous Kukës for all infants. Screeners' uptake and attitudes towards screening and quality of screening were assessed by distributing questionnaires and visiting the maternity hospitals. The result of screening, diagnostics, follow up and entry into early intervention were registered in a database and monitored. RESULTS: Screeners were keen to improve their skills in screening and considered NHS valuable for Albanian health care. The number of "fail" outcomes after the first screen was high initially but decreased to less than 10% after eight months. In 2018, 11,507 infants were born in the four participating maternity hospitals, 10,925 (94.9%) of whom were screened in the first step. For 486 infants the result of screening was not registered. For the first screen, ten parents declined, eight infants died and one infant was discharged before screening could be performed. In 1115 (10.2%) infants the test either could not be performed or the threshold was not reached; 361 (32,4%) of these did not attend the second screen. For the third screen 31 (34.4%) out of 90 did not attend. Reasons given were: parents declined (124), lived too far from screening location (95), their infant died (11), had other health issues (7), or was screened in private clinic (17), no reason given (138). CONCLUSIONS: Implementation of NHS in Albania is feasible despite continuing challenges. Acceptance was high for the first screen. However, 32.4% of 1115 infants did not attend the second screen, after a "fail" outcome for the first test.

Trend and Correlates of Leadership Competencies Among Female Health Professionals in Albania.

Aim: Our aim was to assess the trends and correlates of the leadership competency level of female health professionals in Albania, a transitional country in the Western Balkans, based on a standardized international instrument. Methods: Two nationwide cross-sectional studies were conducted in Albania in 2014 (first wave; n = 105 women) and subsequently in 2018 (second wave; n = 121 women). A structured questionnaire was administered to all female participants aiming at self-assessing the current level of leadership competencies and the required (desirable) level of leadership competencies for their current job position. The questionnaire consisted of 52 items pertinent to eight domains. Answers for each item of the instrument ranged from 1 ("minimal competency level") to 5 ("maximal competency level"). Overall summary scores (range: 52-260) were calculated for both the current and the required leadership competency levels in both survey rounds, based on which the gap in leadership competency level was also computed (required minus current competency level). Binary logistic regression was used to assess the correlates of the gap in leadership competency level among study participants. Results: In multivariable-adjusted logistic regression models, there was evidence of a positive association between the gap in leadership competency level and: workplace in urban areas (OR = 3.2, 95%CI = 1.6-6.6); work experience (OR[for 1 year increment] = 1.1, 95%CI = 1.0-1.2); first round of the survey conducted in 2014 (OR = 2.1, 95%CI = 1.0-4.3); and, particularly, a high managerial job position/level (OR = 3.8, 95%CI = 1.6-9.3). Conversely, there was an inverse relationship with the age of women (OR[for 1 year increment] = 0.9, 95%CI = 0.8-1.0). Conclusion: Our study provides useful evidence about trends over time and selected correlates of the gap in leadership competencies among female health professionals in Albania. Policymakers and decision-makers in Albania and other countries should be aware of the unmet need for leadership training of female health professionals at all levels.

Association between Nephrolithiasis, Hypertension and Obesity in Polycystic Kidney Disease.

AIM: We aim to define the correlations between nephrolithiasis, hypertension, age and obesity in patients with autosomal dominant polycystic kidney disease (ADPKD) in Albania. MATERIAL AND METHODS: We included 100 patients with autosomal dominant polycystic kidney from 2011 to 2014. The patients underwent X-ray and renal ultrasonography. We performed the metabolic evaluation of blood and urine. RESULTS: The patients with renal stones had a higher level of mean systolic and diastolic blood pressure compared with patients without stones (155 ± 12 mmHg vs. 145 ± 8 mmHg, and 105 ± 0.9 mmHg vs. 92 ± 1.28 mmHg, respectively). Patients with renal stones were older (47 ± 15 vs. 38 ± 5 years), had a higher prevalence of obesity [body mass index (BMI): 28 ± 2.4 vs. 25.7 ± 0.6], had higher levels of total cholesterol level (220 ± 5 mg/dl vs. 203 ± 4 mg/dl) as well as triglyceride levels (160 ± 9 mg/dl vs. 126 ± 4 mg/dl), compared with no renal stone individuals. CONCLUSION: ADPKD patients with renal stones in our study had a higher mean level of systolic and diastolic blood pressure, BMI and cholesterol and triglycerides levels compared with individuals without renal stones.

Breakfast Skipping Is an Independent Predictor of Obesity but not Overweight Among Children in a Southeastern European Population.

AIM: To assess the association of breakfast skipping with overweight and obesity among children in Albania, a post-communist country in the Western Balkans, which is undergoing a long and difficult political and socioeconomic transition towards a market-oriented economy. METHODS: A nationwide cross-sectional study was carried out in Albania in 2013 including a representative sample of 5810 children aged 7.0 - 9.9 years (49.5% girls aged 8.4 ± 0.6 years and 51.5% boys aged 8.5 ± 0.6 years; overall response rate: 97%). Children were measured for height and weight, and body mass index (BMI) calculated. Cut-off BMI values of the World Health Organization (WHO) and the International Obesity Task Force (IOTF) were used to define overweight and obesity in children. Demographic data were also collected. RESULTS: Upon adjustment for age, sex, and place of residence, breakfast skipping was positively related to obesity (WHO criteria: OR = 1.5, 95% CI = 1.3-1.9; IOTF criteria: OR = 1.9, 95% CI = 1.4-2.5), but not overweight (OR = 1.1, 95% CI = 0.9-1.3 and OR = 1.1, 95% CI = 0.9-1.4, respectively). Furthermore, breakfast skipping was associated with a higher BMI (multivariable-adjusted OR = 1.05, 95% CI = 1.02-1.07). CONCLUSIONS: Our findings point to a strong and consistent positive relationship between breakfast skipping and obesity, but not overweight, among children in this transitional southeastern European population. Future studies in Albania and other transitional settings should prospectively examine the causal role of breakfast skipping in the development of overweight and obesity.

Distribution of Risk Factors in Male and Female Primary Health Care Patients with Osteoarthritis in Albania.

AIM: We aimed to describe the distribution of the main risk factors among primary health care users diagnosed with osteoarthritis in Albania, a post-communist country in South Eastern Europe. METHODS: Our study involved all individuals who were diagnosed with osteoarthritis over a two-year period (January 2013 - December 2014) in several primary health care centers in Tirana, the Albanian capital. On the whole, during this two-year period, 1179 adult individuals were diagnosed with osteoarthritis (521 men aged 60.1±10.6 years and 658 women aged 58.1±9.6 years). According to the criteria of the American College of Rheumatology, the diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding the major risk factors among individuals diagnosed with osteoarthritis. RESULTS: In multivariable-adjusted logistic regression models, female gender was inversely associated with smoking (OR=0.39, 95%CI=0.27-0.56), alcohol intake (OR=0.08, 95%CI=0.06-0.10), overweight but not obesity (OR=0.65, 95%CI=0.46-0.91 and OR=0.74, 95%CI=0.46-1.18, respectively), weight lifting (OR=0.38, 95%CI=0.22-0.66) and heavy physical exercise (OR=0.69, 95%CI=0.46-1.03). Conversely, female gender was positively related to genetic factors (OR=2.17, 95%CI=1.55-3.04) and preexisting inflammatory diseases (OR=1.53, 95%CI=0.93-2.53). CONCLUSION: This study offers useful evidence about the distribution of the main risk factors for osteoarthritis in adult individuals diagnosed with osteoarthritis in Albania. This information may support health professionals and decision-makers in Albania for evidence-based health planning and policy formulation in order to control the toll of osteoarthritis in this transitional society.

Demographic and Socioeconomic Characteristics Among Primary Health Care Users Diagnosed with Osteoarthritis in Albania.

AIM: The aim of this study was to describe the distribution of demographic factors and socioeconomic characteristics among primary health care users diagnosed with osteoarthritis in Albania, a transitional country in the Western Balkans. METHODS: This study included all individuals diagnosed with osteoarthritis during January 2013 - December 2014 in selected primary health care centers in Tirana, the capital city of Albania. Overall, 1179 adult individuals were diagnosed with osteoarthritis (521 men and 658 women) during this time period. The overall mean age of study participants was 59.0±10.1 years (60.1±10.6 years in men and 58.1±9.6 years in women). The diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding demographic factors and socioeconomic characteristics among participants diagnosed with osteoarthritis. RESULTS: In multivariable-adjusted logistic regression models, female gender was inversely associated with the age-group (OR=0.67, 95%CI=0.47-0.95) and educational level (OR=0.39, 95%CI=0.25-0.61), but positively related to rural birthplace (OR=1.47, 95%CI=1.14-1.89) and unemployment (OR=1.40, 95%CI=1.02-1.92) of the patients diagnosed with osteoarthritis. CONCLUSION: Our findings provide novel evidence about the distribution of demographic factors and socioeconomic characteristics among adult individuals diagnosed with osteoarthritis in primary health care services in Albania. Future studies should assess the distribution of the major risk factors for osteoarthritis among adult men and women in transitional Albania.

Insulin resistance in early vs late nutrition and complications of sirs in neurosurgical intensive care unit (ICU).

BACKGROUND: Systemic Inflammatory Response Syndrome (SIRS) is a common complication in neurosurgical diseases in Intensive Care Unit (ICU). Because of associated insulin resistance (IR) the ICU is in dilemma in which stage to start the nutrition to patients and what is the amount of Insulin Unit to control the hyperglycemia. AIM: to define the IR and to compare IR and amount of insulin among ICU patients in "Mother Theresa" University Hospital Center (MTUHC) in Tirana Albania. METHODS: 154 patients with neurosurgical disease and SIRS complications were randomized in two groups: early nutrition 73 patients (47%) and late nutrition 81 (53%) and compared for a number of variables. RESULTS: There was no statistical age and gender difference between the two groups (P>0.05). The amount of insulin units to control the level of glycemia (80-110 mg/dc) was 12.8±7 unit per day in early nutrition and 23.8 ±12.9 units in late nutrition group (p<0.01). No patient in early nutrition group but six (7.4%) patients in late nutrition group developed insulin resistance (p=0.03). CONCLUSIONS: the IR due to the infection complications is higher among late than early nutrition group. Therefore, we suggest that in neurosurgical ICU it would be better to start the nutrition within 72 hours.

INCIDENCE OF ACUTE PANCREATITIS IN ALBANIAN POPULATION.

BACKGROUND: Acute Pancreatitis (AP) is an inflammatory pathology with large regional variations in incidence and etiology. AIM: The aim of the study was to provide a description of the epidemiologic situation of AP in Albanian population, regarding incidence, etiology and severity of the disease. METHODS: We have studied all the files of all patients with acute pancreatitis admitted at the UHC 'Mother Theresa" during an eight year period (2005-2012). THE RESULTS: We had 964 admissions with the diagnosis acute pancreatitis, making an incidence of 5.64 per 100 000 inhabitants per year. Mean age of patients was 54.5 ± 16.93 years old. Among risk factors, alcohol consumption was found in 382 patients (39.6%), gallstone in 362 patients (37.6%), and others in 220 patients (22.8%). CONCLUSION: The incidence of acute pancreatitis in Albania ranges from 3.6 - 5.64 new cases per 100 000 inhabitants per year, with an increasing trend during the last years. The incidence of AP among females almost doubles during 2005-2012. Alcohol consumption is the predominating etiologic factor among young males.

Epidemiology of goiter and benign tumors of the thyroid gland in Albania.

AIM: The aim of this study was to describe the demographic characteristics and disease patterns among patients with thyroid nodular abnormalities (goiter) and benign tumors of the thyroid gland in Albania, a transitional country in South Eastern Europe. METHODS: Our study included all patients diagnosed with goiter and/or benign tumors of the thyroid gland who were hospitalized at the University Hospital Center (UHC) "Mother Teresa" in Tirana between 2004 and 2012 (N=2258). All patients underwent the same examination and interviewing procedures. Demographic characteristics included gender, age, and place of residence. Binary logistic regression was used to compare the demographic characteristics between patients with benign tumors of the thyroid gland and those with goiter. RESULTS: Overall, there were 2204 patients with goiter and 54 patients with benign tumors of the thyroid gland hospitalized at UHC over the period 2004-2012. There was no evidence of statistically significant differences in demographic characteristics (age, gender, or place of residence) between patients with benign tumors of the thyroid gland and those with goiter. CONCLUSIONS: Our study provides useful evidence on the epidemiology of benign tumors of the thyroid gland and the thyroid nodular abnormalities (goiter) in the Albanian population. Future studies in Albania should assess the main determinants of thyroid gland disorders and compare them with findings pertinent to other similar populations.

Public health aspects of the family medicine concepts in South eastern europe.

INTRODUCTION: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. AIM: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. RESULTS: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward family medicine and primary prevention interventions. The population is not enough educated for complicated enforcement for and prevention of diseases that have a heavy burden on the budget. Health insurance and payment of health services is often a problem, because the patients must be treated regardless of their insurance coverage and financial situation. The decrease in production and economic growth, as well as low gross national income in the countries with economic crisis, lead to the inability of treatment for a large number of the population. Such situation a system leads to additional debts and loans to healthcare system. Measures implemented for provision of acute curative care largely did not lead to improvements in the health status of the population. Educational and preventive measures, as well as higher standards for quality and accessibility of health care services for entire population in each country, especially those struggling are bound to joining the European Union and their implementation must start. The most A large number of medical institutions are is inefficient in health education and health promotion and must work to educate patients and families and increase the quality of preventive health services. Modernization of health care delivery and joining the European Union by increasing overall economic stability of countries is one of the primary goals of all countries in Southeast Europe.

Prison health in transitional Albania.

AIM: The information about prisoners' health in transitional countries including Albania is limited. The aim of our study was to assess the health status and its correlates among adult prisoners in Albania, a post-communist country in Southeast Europe. METHODS: This was a cross-sectional study conducted in 2013 including 401 prisoners in Albania [290 (72%) males and 111 (28%) females]. All participants were administered an anonymous and structured questionnaire including information on self-perceived health status, health-related problems, lifestyle factors (smoking, alcohol intake and drug use) and demographic and socioeconomic characteristics (age, sex, educational attainment and income level). Binary logistic regression was used to assess the association between self-reported health status and covariates. RESULTS: Overall, 173 (43.1%) of prisoners included in this study reported a poor health status, with a clear predominance of the female gender (P < 0.01). Overall, 28.1% of prisoners reported the presence of at least one disease. The overall prevalence of smoking, excessive alcohol consumption and drug use were 59.1%, 34.9% and 10.2%, respectively. Upon multivariable-adjustment, poor self-perceived health status was positively associated with female gender (OR = 2.01, 95% CI = 1.41-2.96), smoking (OR = 1.58, 95% CI = 1.29-2.04), excessive alcohol consumption (OR = 1.71, 95% CI = 1.38-2.13) and the presence of diseases (OR = 1.86, 95% CI = 1.52-2.87). CONCLUSION: This study provides important information about the health status among Albanian prisoners. There is an urgent need for Albania to make a significant progress in health services provision for prisoners, which constitute a particularly vulnerable population subgroup.

Prevalence and factors associated with congenital malformations in tirana, Albania, during 2011-2013.

AIM: Congenital Malformations (CMs) represent a challenge especially for developing countries. Data about CMs in Albania are rather scarce. In this context, our aim was to assess the prevalence and factors associated with CMs in Tirana, the capital of Albania. METHODS: Information on all CMs at birth during 2011-2013 was retrieved from the National CM Surveillance System. For each CM case, three controls (babies born without CM) were retrieved as well. Overall, 831 cases and 2522 controls were included in this study. The prevalence was calculated using the total number of live births in Tirana during the same period. Binary logistic regression was used to determine the factors associated with CMs adjusting for a number of covariates. RESULTS: The three-year prevalence of CMs was 23.41 per 1,000 live births. The most affected body systems were the musculoskeletal, cardiovascular and genital systems. CMs were more prevalent among male babies. Advanced mothers' age, lower education, unemployment status and lower gestational age were all positively associated with increased likelihood of CMs. CONCLUSIONS: Socio-demographic factors of mothers are linked to CMs in Albania. Future surveys are needed in Albania in order to establish determinants of CMs at a national level.

Correlates of hypertension among adult men and women in kosovo.

AIM: We aimed to assess the independent socioeconomic, behavioral and psychosocial correlates of hypertension among the adult population of Kosovo. METHODS: This was a cross-sectional study carried out in Pristina in 2012-2013 which included a large representative sample of 1793 consecutive primary health care users aged ≥35 years (mean age: 51.2±6.7 years; 52.5% women; overall response: 95%). Systolic and diastolic blood pressure was measured, whereas demographic and socioeconomic characteristics (age, sex, marital status, place of residence, education, employment status and income), lifestyle factors (smoking, alcohol intake, physical exercise and dietary fat intake) and psychosocial factors (hostility and reaction to transition) were assessed through a structured questionnaire. Multivariable-adjusted binary logistic regression was used to assess the independent "predictors" of hypertension. RESULTS: Upon simultaneous adjustment in a backward stepwise elimination procedure for all socioeconomic characteristics, lifestyle factors and psychosocial factors, significant positive correlates of hypertension were older age (OR=1.03, 95%CI=1.01-1.05), male gender (OR=1.41, 95%CI=1.19-1.58), a lower educational attainment (OR=1.36, 95%CI=1.08-1.67), smoking (OR=1.53, 95%CI=1.28-2.16), physical inactivity (OR=1.98, 95%CI=1.46-2.74) and hostility (OR=1.42, 95%CI=1.17-2.08). CONCLUSIONS: Findings from this study conducted in transitional Kosovo are generally in line with previous reports from the Western Balkan countries and beyond. Decision-makers and policymakers should be aware of the rising trend and socioeconomic, behavioral and psychosocial determinants of hypertension in post-war Kosovo.

Evaluation of thrombocytopenia in systemic lupus erythematosus and correlation with different organs damages.

INTRODUCTION: Thrombocytopenia is highly prevalent among patients with Systemic Lupus Erythematous(SLE) and at the same time it has been reported that a correlation exists between Thrombocytopenia and organ damage. The aim of this study is to highlight the correlation between Thrombocytopenia and the clinical manifestations of SLE. OBJECTIVES: The objective is to show the clinical manifestations and organ damage of Systemic Lupus Erythematous (SLE) patients who have been found to have Thrombocytopenia. METHODS: A retrospective study was conducted examining all patient charts diagnosed and treated for SLE at the Rheumatology Service of Mother Teresa Hospital Centre. All the data were collected from discharged patient charts. The data included were Anti DNA,AAN,C3 , thrombocytopenia, leucopenia, and organ damage. Data were taken from 2009 to 2013. The classification criteria of the American College of Rheumatology was used for all patients regarding the diagnosis. RESULTS: Out of 330 patients, 12 (3.64%) are men and 318 (96.3%) women. 73 of all patients have thrombocytopenia as cases and 257 patients had SLE without thrombocytopenia, which was considered as the control group. AAN 68(93.1%), Anti DNA 50 (64.3%) , low value of C3 46 (63%), and leucopenia were higher in thrombocytopenic patients compared with control group (p<0.05) 48 (65.7%) of thrombocytopenic patients develop lupus nephritis, 10 (13.6%) were with pulmonary involvement, and 42 (57.5%) had leukopenia. CONCLUSION: Thrombocytopenia is not directly associated with any disease activity, organ damage and mortality, but it should be considered as a prognostic factor which may help identifying a category of patients whose disease course can be aggravated.