Immunization Coverage Evaluation for the Period of years 2012-2016 in Korce-Albania

Objective: The objective of this study was to evaluate vaccination coverage retrospectively from birth to 14 year-old children for the period of years 2012-2016, considering also some factors that influence vaccine uptake. Methods: Immunization coverage is the proportion of the number of children vaccinated and those scheduled for vaccination. In this study, this value was calculated referring to the national immunization schedule against diphtheria, tetanus, pertussis, Hepatitis B, mumps, rubella and measles for the district of Korça. Results: Vaccine coverage levels referring to this district for MMR vaccine resulted to be 97.4% and for Hepatitis B vaccine resulted to be always above 98%. As for the third dose of the DTP-HepB-Hib vaccine, the average value was found to be 96%. Conclusion: The 2015-2016 period showed an increase in vaccine coverage values for the DTP vaccine. Also, during this period there was a noticeable drop in the coverage levels for the third booster dose of the penta-valent vaccine (DTP-Hep.B-Hib). Vaccine coverage values analyzed for the year 2016 showed a non-optimal continuity regarding to the fourth booster dose of TT/ Td vaccine

Factors associated with adverse events following immunization in Albanian children: An analysis of the national database of adverse events after immunization

Background: Adverse events following immunization are a major concern which is influencing vaccination coverage all over the world. It is therefore important to evaluate the reporting of this events and factors associated with their occurrence in order to prevent them. Methods: The national database of adverse events following immunization in Albanian children was de-identified and transferred to the IBM® SPSS version 21. (SPSS Inc, USA). Every medical information was re-entered using the Medical Dictionary for Regulatory Activities (MedDRA) terms. The dose-based reporting rates are calculated always taking in consideration the number of administered vaccines instead of the number of distributed ones, which is an advantage of the Albanian reporting system Results: During a thirteen year period (2003-2015) there have been 307 AEFI cases reported for a total of 7,713,325 doses of vaccines administered. That regarded 106 females and 134 males. Most of the events have been reported during 2004. Most of thecases were non-serious (78,8%). Most of the cases were treated at ambulatory setting (72.55), followed by hospital treatment (24.3%) and no treatment (2.6%). Most of the cases were recorded in infants aged < 4 months. Conclusion: During the 13 year period, there were no severe events. The completeness and accuracy of information in the Albanian vaccine safety surveillance system still need to improve.&nbsp

Adverse Events Following Administration of DTwP Containing Vaccines in Albanian Children from 2003 to 2015

The Albanian vaccination program started in 1960. DTwP vaccine was introduced to the immunization schedule since the beginning and was produced in the country until the establishment of EPI (Expanded Program on Immunization – EPI) in 1993, at the Department of Epidemiology of the Institute of Public Health (IPH). From that time the vaccines were procured by UNICEF. Until 2003, the reporting of adverse events after vaccination was not made through a standard reporting form. The adverse events reporting system was implemented in 2003 through the introduction of individual reporting forms to the primary health care centers. Although the surveillance system was a passive one, the collection of data by IPH was made on monthly base and when a signal was detected further investigations were undertaken. The pertussis component of Diphtheria, Tetanus, Pertussis (DTwP) vaccine is the whole inactivated cell of Bordetella Pertussis. The aim of this study is to analyze the rate of adverse events following DTwP administration in Albanian children from 2003 to 2015

Factors Driving Vaccine Hesitancy rrelated to vaccination of children with Covid-19 vaccine among Albanian parents

A validated questionnaire composed of 33 elements was used for the purpose of this study The subjects of this study were parents of children aged 0-18 years old . Inclusion criteria were:albanian parents who understood and spoke well albanian, parents of children aged 0-18 years old, parents aged 18 years old and over. Exclusion criteria were: parents aged less than 18 years old, albanian parents who didn’t understand well albanian language, parents of children aged more than 18 years old

Knowledge, practice and approaches of health professionals to adverse events following immunization and their reporting in Albania

In Albania, the reporting of an adverse events following immunization (AEFI) is done not only by immunization providers but also from clinicians providing clinical treatment of AEFI in health posts, health centers and private or public hospitals. The AEFI reporting system in Albania has started in 2001 with the establishment of National Regulatory Authority of Vaccines in the Institute of Public Health. The most important problems of passive surveillance systems include underreporting, deficiency and inaccuracy of information. A structured questionnaire containing 68 questions constructed from immunization experts constituted the study tool. The questionnaire addressed health professionals working at child consultant’s facilities and primary health centers in the district of Tirana. There were a total of 102 health professional interviewed. The majority of the respondents working at health centers in the district of Tirana in general, had poor knowledge levels on AEFI surveillance. The lowest score were received in knowledge about the role of different stakeholders involved in AEFI surveillance. The number of years practicing the profession did not influence in the total score of “practice and attitude toward reporting and managing an AEFI”. Although the majority of health care professionals have encountered an AEFI during their practice (72/102, 70,5%), only half of them have never reported an AEFI (37/102, 36,2%). Barriers to reporting included lack of interest, unclear definition of AEFI and lack of awareness of what to report. Nevertheless, the main reason for not reporting was because a respondent thought he or she had not observed an AEFI in the last years (44,1%). Majority of the respondents did not have any training about AEFI (68,6%, 70/102). From this study it is concluded that it is necessary to develop training and educational programs in order to increase awareness of all health professionals involved in child health toward reporting of adverse events following immunization. It is necessary to build feedback systems to give information on AEFI. This study shows the influence of knowledge, perceptions and practices of health care workers in the surveillance of adverse events following immunization. Thus, information generated from this study might be valuable for the public health regulators to generate new guidelines about AEFI surveillance and update existing information

Hesitancy toward Childhood Vaccinations: Preliminary Results from an Albanian Nursing Staff's Investigation

Healthcare professionals are important models for their patients since their individual knowledge and attitudes toward vaccination can influence the patient's willingness to adhere to vaccination campaigns. After developing a structured questionnaire, it was administered to a sample of nursing staff working in public vaccination centers in Albania (December 2020-January 2021), in order to conduct a preliminary investigation aimed at describing knowledge, attitudes, beliefs, and hesitancy toward childhood vaccinations. Among the sample of nurses involved in the administration of vaccines (n.64, 92% females), most of them were confident about vaccines and favorable to childhood vaccinations (90%). However, when specifically investigating beliefs, nearly a quarter of the sample showed to be hesitant; 22% were unsure or partially agreed that vaccines might cause conditions such as autism and multiple sclerosis. A high risk of hesitancy was identified in the youngest staff especially when their work experience was below 10 years or when they graduated less than 10 years before (OR: 5.3, CI: 1.4-19.5; and OR: 4.2 CI: 1.2-14.6). Similarly, a low acceptance rate (54%) was detected for future childhood SARS-CoV-2 vaccines among the nurses, which is a sign of high levels of vaccine hesitancy. With regard to knowledge about childhood vaccine contraindications, none of the nurses identified all the ten correct answers, while only 13% answered at least six questions correctly. These preliminary results highlight the need of investigating more Albanian nursing staff's knowledge and attitudes toward child vaccinations, therefore investing in tailored training. Due to the ongoing Covid-19 pandemic and the roll-out of mass vaccination, the role of healthcare workers remains crucial and needs more support to manage the changing public opinion as well as quickly evolving vaccine technologies

Maternal and Perinatal Outcomes of Pregnant Patients with Coronavirus Disease 2019: Data from a University Hospital Setting in Tirana, Albania, May 2020 to November 2021

Scientific evidence suggests an increased risk of maternal and obstetric complications in pregnant patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study is aimed at evaluating perinatal and maternal outcomes among patients with coronavirus disease 2019 (COVID-19) in a university hospital setting. This was a prospective cohort study of 177 pregnant women with confirmed SARS-CoV-2 infection at a tertiary hospital between May 2020 and November 2021. Both symptomatic and asymptomatic women with a positive reverse transcription-polymerase chain reaction test result at any time during pregnancy were included in this study. For the purpose of this study, we classified COVID-19 cases into two groups: mild and severe cases. The two groups were then compared to predict how the clinical presentation of COVID-19 affected adverse maternal and perinatal outcomes. Gestational age≥20 weeks at the time of infection was significantly associated with the occurrence of severe forms of the disease (relative risk (RR) 3.98, p=0.01). Cesarean section was the preferred mode of delivery, with 95 women (62.1%) undergoing surgery. A total of 149 neonates were delivered to women who had confirmed SARS-CoV-2 infection at any time during the course of pregnancy of which thirty-five (23.5%) were admitted to the neonatal intensive care unit (NICU). Severe forms of COVID-19 increased the risk of premature delivery (RR 6.69, p<0.001), emergency cesarean delivery (RR 9.4, p<0.001), intensive care hospitalization (RR 51, p<0.001), and maternal death (RR 12.3, p=0.02). However, severe forms of SARS-CoV-2 infection are not directly responsible for low birth weight or the need for neonatal resuscitation. Our findings suggest that pregnant women presenting with severe COVID-19 disease are at an increased risk of adverse maternal and perinatal outcomes, such as premature delivery, cesarean section, admission to the ICU, and maternal death. Infection after the 20th week of gestation increases the risk of developing severe forms of the disease

Sex Hormone-Binding Globulin (SHBG) Reduction: The Alarm Bell for the Risk of Non-Alcoholic Fatty Liver Disease in Adolescents with Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) represents an endocrine condition affecting 5–18% of adolescents, frequently in association with obesity, metabolic alterations, and liver dysfunction. In this study, we aimed to evaluate the prevalence and risk factors for developing non-alcoholic fatty liver disease (NAFLD) in a cohort of PCOS adolescents. Thirty-two girls were assessed for anthropometric and biochemical markers: total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), glucose, insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (γGT). In addition, LH, FSH, 17β-Estradiol (E2), prolactin, testosterone (T), free testosterone, delta 4-androstenedione (D4 A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding protein (SHBG) were also evaluated. All subjects underwent liver ultrasound to detect NAFLD. Our data demonstrated that PCOS adolescents complicated with NAFLD accounted for 37.5%, and those with obesity and lower SHBG were more predisposed to developing NAFLD. Moreover, SHBG showed a negative correlation with several parameters such as blood pressure, body mass index, waist circumference, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR). Our results demonstrated that the assessment of SHBG may allow the identification of PCOS adolescents at risk for developing NAFLD and metabolic alterations