Trends of recreational water quality in Albania's coastal during 2016-2020.

Water quality impairment is a substantial environmental hazard which impacts a wide variety of stakeholders and interests, particularly those who participate in outdoor water-based recreational activities. Recreational bathing water qualities are highly vulnerable to microbial pollution from municipal sewage, industrial effluents, agriculture run-off and river discharges. Fecal contamination impairs water quality and potentiates human health risks. The aim of this study was to see the 5-year trend of microbiological quality of recreational bathing waters in Albania. Every year we collected 1,071 samples taken 30 centimeters below the water's surface at least one meter deep. Assessment of bacterial load of the coastal waters was done nine times for every point, for the Escherichia coli and Intestinal enterococci, according to the methods ISO 7899-1 and ISO 9308-3. Bathing water assessment is to be classified according the categories indicated in the Directive 2006/7/EC and recommendations of WHO/UNEP-2010. Microbial Water Quality Assessment Category (cfu/100 ml water) done in 119 monitoring points were: During 2016, Excellent 53%, Sufficient 23%, Good 9% and Poor 15%. In 2017, Excellent 68%, Sufficient 15%, Good 6% and Poor 10%. During 2018, Excellent 82.4%, Sufficient 13%, Good 0.9% and Poor 3.7%. During 2019, Excellent 89%, Sufficient 2.5%, Good 6% and Poor 2.5%. During 2020 Excellent 89.9%, Sufficient 5%, Good 0.9%, and Poor 4.2%. Based on the above assessment, it is noticed a significant increase of microbial quality of recreational bathing waters in Albania due to investments in the sewerage system and better waste water treatment.

Understand My Language, to Understand My Pain: Challenges of Neurological Evaluation Among Refugees.

The increasing number of migrants and refugees entering Albania during the last decade has been a challenge to the medical service of the country. Many of the migrants arrive from remote areas of Middle East or other Asian regions, heading toward northern Europe, deprived from medical assistance during their tormenting journey. An exacerbation of previous m"unicodeedical conditions is expected and is related to the hardship of traveling conditions. The medical professionals working in migration medicine have little, if any, training on the field and need to familiarize themselves with a variety of previously unknown conditions. Empathy, necessary on an individual basis, may not be sufficient in itself; the burden of medically treating migrants needs a holistic and multidisciplinary approach.

Surveillance for severe acute respiratory infections (SARI) in hospitals in the WHO European region - an exploratory analysis of risk factors for a severe outcome in influenza-positive SARI cases.

BACKGROUND: The 2009 H1N1 pandemic highlighted the need to routinely monitor severe influenza, which lead to the establishment of sentinel hospital-based surveillance of severe acute respiratory infections (SARI) in several countries in Europe. The objective of this study is to describe characteristics of SARI patients and to explore risk factors for a severe outcome in influenza-positive SARI patients. METHODS: Data on hospitalised patients meeting a syndromic SARI case definition between 2009 and 2012 from nine countries in Eastern Europe (Albania, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Romania, Russian Federation and Ukraine) were included in this study. An exploratory analysis was performed to assess the association between risk factors and a severe (ICU, fatal) outcome in influenza-positive SARI patients using a multivariate logistic regression analysis. RESULTS: Nine countries reported a total of 13,275 SARI patients. The majority of SARI patients reported in these countries were young children. A total of 12,673 SARI cases (95%) were tested for influenza virus and 3377 (27%) were laboratory confirmed. The majority of tested SARI cases were from Georgia, the Russian Federation and Ukraine and the least were from Kyrgyzstan. The proportion positive varied by country, season and age group, with a tendency to a higher proportion positive in the 15+ yrs age group in six of the countries. ICU admission and fatal outcome were most often recorded for influenza-positive SARI cases aged > 15 yrs. An exploratory analysis using pooled data from influenza-positive SARI cases in three countries showed that age > 15 yrs, having lung, heart, kidney or liver disease, and being pregnant were independently associated with a fatal outcome. CONCLUSIONS: Countries in Eastern Europe have been able to collect data through routine monitoring of severe influenza and results on risk factors for a severe outcome in influenza-positive SARI cases have identified several risk groups. This is especially relevant in the light of an overall low vaccination uptake and antiviral use in Eastern Europe, since information on risk factors will help in targeting and prioritising vulnerable populations.

Behavioral risk factors and prevalence of HIV and other STIs among female sex workers in Tirana, Albania.

The paper presents the results of the research and a comparative analysis of findings on key indicators for the study population. The study instrument was a standardized behavior study questionnaire provided in the Family Health International published manual (Family Health International, 2000). The target group was female sex workers working in Tirana. The prevalence of biological infections was low. HIV was detected in one case. Syphilis and Hepatitis B rates resulted to be respectively 6.5% and 7.6%. The median age of the study participants is 28 years. Almost 38% of the participants were illiterate, and more than half belong to the Roma community. Almost 50% of the respondents had received money in exchange of sex for the first time 18 years earlier. Almost 65% of respondents reported two or more different sex partners in the last seven days, while almost 30% referred five or more. Condom use at last sex with a paying client was reported by almost 68%. Consistent condom use with paying clients in the last month was reported by almost 35% of the respondents.