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

Syndromic surveillance in early detection of outbreaks of infectious diseases

Aim: Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania.Methods: Syndromic surveillance is a primary health care-facility- and emergency room (ER)-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. It is based on weekly notifications of nine syndromes by over 1,600 General Practitioners (GPs) in the 36 districts of Albania. Data is aggregated by district epidemiologists (DE) and centralized by the national Institute of Public Health.Results: A syndrome is “a set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.” In the context of syndromic surveillance, a syndrome is a set of non-specific pre-diagnosis medical and other information that may indicate the release of a bioterrorism agent or natural disease outbreak.Since its inception, syndromic surveillance has mainly focused on early event detection: gathering and analysing data in advance of diagnostic case confirmation to give early warning of a possible outbreak.Conclusion: The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus they have the potential to significantly advance and modernize the practice of public health surveillance

Syndromic surveillance in early detection of outbreaks of infectious diseases

Aim: Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania.   Methods: Syndromic surveillance is a primary health care-facility- and emergency room (ER)-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. It is based on weekly notifications of nine syndromes by over 1,600 General Practitioners (GPs) in the 36 districts of Albania. Data is aggregated by district epidemiologists (DE) and centralized by the national Institute of Public Health. Results: A syndrome is “a set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.”  In the context of syndromic surveillance, a syndrome is a set of non-specific pre-diagnosis medical and other information that may indicate the release of a bioterrorism agent or natural disease outbreak. Since its inception, syndromic surveillance has mainly focused on early event detection: gathering and analysing data in advance of diagnostic case confirmation to give early warning of a possible outbreak. Conclusion: The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus they have the potential to significantly advance and modernize the practice of public health surveillance

Screening for viral Hepatitis Bin theRoma community in Tirana, Albania

Aim:According to the previous studies conducted in Albania involving Roma communities and in general populations,the prevalence of HBV was 13% and 7%-9%,respectively.Due to this high prevalence of HBV and difficulties accessing adequate healthcare, a screening was performed in some areas where Roma populations live. The aim of this study was to assessthe prevalence of HBV in the Roma population in Albania in order to make evidence-based recommendations for increasing the awareness of the population about this disease and increase the access to the vaccination.Methods: A cross-sectional study was conducted in threerural areas and in four urban areas in Tirana districtwith known limited population movement. OpenEpi was used to calculate the sample size.The laboratory methods used consisted ofthe immune chromatographic method, Rapid Test and ELISA.Results: 27 outof 174 specimens tested positive for HBV. The prevalence of HBsAg was 15.5% (95%CI=10.8%-21.6%).The age-related positivity ofHBsAg was 10.6% for the age-group 19-24 years,19.4% for the age 25-44 years and 11.8% for the age 45-59 years.Of the positive cases, 15were females and 12 were males. The areas with the highest positivity rate for HBsAg were Tufina(24%), Health Care Center no.8 (23.1%) andSauk (15.4%).Conclusion: A higher prevalence of HBV was found among Roma population in Tirana district compared to the general population. The age-group25-44 years, males,and people residing in Tufina area showed a higher HBsAgpositivity rate.Improvement of the sentinel surveillance,increase of the awareness about the disease, promotion of vaccination and healthy behaviour, are the recommended actions that should target the Roma populatio

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

Screening for viral Hepatitis B in the Roma community in Tirana, Albania

Aim: According to the previous studies conducted in Albania involving Roma communities and in general populations, the prevalence of HBV was 13% and 7%-9%, respectively. Due to this high prevalence of HBV and difficulties accessing adequate healthcare, a screening was performed in some areas where Roma populations live. The aim of this study was to assess the prevalence of HBV in the Roma population in Albania in order to make evidence-based recommendations for increasing the awareness of the population about this disease and increase the access to the vaccination. Conclusion: A higher prevalence of HBV was found among Roma population in Tirana district compared to the general population. The age-group 25-44 years, males, and people residing in Tufina area showed a higher HBsAg positivity rate. Improvement of the sentinel surveillance, increase of the awareness about the disease, promotion of vaccination and healthy behaviour, are the recommended actions that should target the Roma population

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

Syndromic surveillance in early detection of outbreaks of infectious diseases

Aim: Motivated by the threat of infectious diseases and bioterrorism, syndromic surveillance systems are being developed and implemented around the world. The aim of the study was to describe the early warning surveillance system in Albania.   Methods: Syndromic surveillance is a primary health care-facility- and emergency room (ER)-based syndromic surveillance system aiming at detecting outbreaks and undertaking public health actions. It is based on weekly notifications of nine syndromes by over 1,600 General Practitioners (GPs) in the 36 districts of Albania. Data is aggregated by district epidemiologists (DE) and centralized by the national Institute of Public Health.   Results: A syndrome is “a set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.”  In the context of syndromic surveillance, a syndrome is a set of non-specific pre-diagnosis medical and other information that may indicate the release of a bioterrorism agent or natural disease outbreak. Since its inception, syndromic surveillance has mainly focused on early event detection: gathering and analysing data in advance of diagnostic case confirmation to give early warning of a possible outbreak.   Conclusion: The system is useful for detecting and responding to natural disease outbreaks such as seasonal and pandemic flu, and thus they have the potential to significantly advance and modernize the practice of public health surveillance. &nbsp

CBRN Centres of Excellence Newsletter - Volume 16

CBRN Centres of Excellence NewsletterJRC.A.7-Euratom Coordinatio