Kosovar Refugee Assessments in Montenegro and A1bania

Following NATO bombings on the 24th of March 1999, Serbian armed forces provoked a massive population exodus of ethnic Albanians living in Kosovo, an autonomous province of Federal Republic of Yugoslavia. In June 1999, UNHCR reparted that 600,000 Kosovars had found refuge in neighbouring countries. ln order to assess the situation of Kosovar refugees, two surveys were carried out in Rozaje, Republic of Montenegro, and in Kukes, Albania, in April 1999. The main goal was to assess human rights violations. This paper describes the results of these surveys.Suite aux bombardements de l'OTAN du 24 mars 1999, les forces armées serbes ont déclenché un exode massif des populations de souche albanaise du Kosovo, une province autonome de la République Fédéralede Yougoslavie. En juin 1999, le Haut Commissariat de l'ONU pour les Réfugiés rapportait que 600,000 kosovars avaient trouvé refuge dans les nations avoisinantes. Dans le but d'évaluer la situation des réfugiés kosovars, deux enquêtes ont été menées à Rozaje, République du Monténégro, et à Kikes, Albanie, en avril 1999. Le but principal des enquêtes était de prendre la mesure des violations aux droits humains. Cet article décrit le résultat de ces enquêtes

A pilot sentinel surveillance system to monitor treatment and treatment outcomes of chronic hepatitis B and C infections in clinical centres in three European countries, 2019

Hepatitis B; Hepatitis C; SurveillanceHepatitis B; Hepatitis C; VigilanciaHepatitis B; Hepatitis C; VigilànciaBackgroundThe World Health Organization European Action Plan 2020 targets for the elimination of viral hepatitis are that > 75% of eligible individuals with chronic hepatitis B (HBV) or hepatitis C (HCV) are treated, of whom > 90% achieve viral suppression.AimTo report the results from a pilot sentinel surveillance to monitor chronic HBV and HCV treatment uptake and outcomes in 2019.MethodsWe undertook retrospective enhanced data collection on patients with a confirmed chronic HBV or HCV infection presenting at one of seven clinics in three countries (Croatia, Romania and Spain) for the first time between 1 January 2019 and 30 June 2019. Clinical records were reviewed from date of first attendance to 31 December 2019 and data on sociodemographics, clinical history, laboratory results, treatment and treatment outcomes were collected. Treatment eligibility, uptake and case outcome were assessed.ResultsOf 229 individuals with chronic HBV infection, treatment status was reported for 203 (89%). Of the 80 individuals reported as eligible for treatment, 51% (41/80) were treated of whom 89% (33/37) had achieved viral suppression. Of 240 individuals with chronic HCV infection, treatment status was reported for 231 (96%). Of 231 eligible individuals, 77% (179/231) were treated, the majority of whom had received direct acting antivirals (99%, 174/176) and had achieved sustained virological response (98%, 165/169).ConclusionTreatment targets for global elimination were missed for HBV but not for HCV. A wider European implementation of sentinel surveillance with a representative sample of sites could help monitor progress towards achieving hepatitis control targets.The study was supported by the European Centre for Disease Prevention and Control (ECDC) as part of the contract “Sentinel surveillance of hepatitis B and C in the EU/EEA – feasibility, assessment, protocol development and pilot (NP/2019/OCS/10528)”

Los límites fronterizos como aglutinadores de actividad en el territorio. La frontera del Bidasoa.

Universidad Pablo de OlavideMinisterio de Ciencia e Innovación CSO2009-06819-EUniversidad de Granada 1975-200

Effectiveness of pertussis vaccination in pregnancy to prevent hospitalisation in infants aged <2 months and effectiveness of both primary vaccination and mother's vaccination in pregnancy in infants aged 2-11 months

Background PERTINENT is an active hospital-based surveillance system for pertussis in infants. In 2019, four of the six participating European countries recommended pertussis vaccination in pregnancy. Among infants aged 14 days before symptom onset. We excluded infants with unknown maternal or PV status or with mothers vaccinated =14 days before delivery. We calculated pooled VE as 100 * (1-odds ratio of vaccination) adjusted for study site, onset date in quarters and infants’ age group. Results Of 829 infants presenting with pertussis-like symptoms, 336 (41%) were too young for PV. For the VE in pregnancy analysis, we included 75 cases and 201 controls. Vaccination in pregnancy was recorded for 9 cases (12%) and 92 controls (46%), adjusted VE was between 75% [95%CI: 35–91%] and 88% [95%CI: 57–96%]. Of 493 infants eligible for PV, we included 123 cases and 253 controls. Thirty-one cases and 98 controls recorded both PV with = 1 dose and vaccination in pregnancy, adjusted VE was between 74% [95%CI: 33–90] and 95% [95%CI: 69–99]; 27 cases and 53 controls recorded PV only, adjusted VE was between 68% [95%CI: 27–86] and 94% [95%CI: 59–99]. Conclusion Our findings suggest that vaccination in pregnancy reduces pertussis incidence in infants too young for PV. In infants aged 2–11 months, PV only and both PV and vaccination in pregnancy provide significant protection against severe pertussis.Peer ReviewedPostprint (published version

A rare finding of plasma cell leukaemia with hairy-cell morphology.

The authors state that there are no conflicts of interest to disclose. This publication was funded by the CNIC. The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovación (MCIN) and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (grant CEX2020- 001041-S funded by MICIN/AEI/10.13039/501100011033).S

Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020

BackgroundInfluenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020.AimTo provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings.MethodsAll studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders.ResultsThere were 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from -58% to 57% (primary care) and -16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only).ConclusionsInfluenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub)type-specific results across studies.Funding statement: ECDC contributed to funding some of the study sites and the coordination of the EU-PC study. WHO/Europe contributed to funding the EU-H study. Epiconcept contributed to funding the EU-H study

Contribution of sex on the underlying mechanism of the gambling disorder severity

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients' sex. A sample of n=512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients' sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care

Estimates of Pandemic Influenza Vaccine Effectiveness in Europe, 2009–2010: Results of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) Multicentre Case-Control Study

Results from a European multicentre case-control study reported by Marta Valenciano and colleagues suggest good protection by the pandemic monovalent H1N1 vaccine against pH1N1 and no effect of the 2009–2010 seasonal influenza vaccine on H1N1

Monitoring COVID‐19 vaccine effectiveness against COVID‐19 hospitalisation and death using electronic health registries in ≥65 years old population in six European countries, October 2021 to November 2022

Background: Within the ECDC-VEBIS project, we prospectively monitored vaccine effectiveness (VE) against COVID-19 hospitalisation and COVID-19-related death using electronic health registries (EHR), between October 2021 and November 2022, in community-dwelling residents aged 65-79 and ≥80 years in six European countries. Methods: EHR linkage was used to construct population cohorts in Belgium, Denmark, Luxembourg, Navarre (Spain), Norway and Portugal. Using a common protocol, for each outcome, VE was estimated monthly over 8-week follow-up periods, allowing 1 month-lag for data consolidation. Cox proportional-hazards models were used to estimate adjusted hazard ratios (aHR) and VE = (1 - aHR) × 100%. Site-specific estimates were pooled using random-effects meta-analysis. Results: For ≥80 years, considering unvaccinated as the reference, VE against COVID-19 hospitalisation decreased from 66.9% (95% CI: 60.1; 72.6) to 36.1% (95% CI: -27.3; 67.9) for the primary vaccination and from 95.6% (95% CI: 88.0; 98.4) to 67.7% (95% CI: 45.9; 80.8) for the first booster. Similar trends were observed for 65-79 years. The second booster VE against hospitalisation ranged between 82.0% (95% CI: 75.9; 87.0) and 83.9% (95% CI: 77.7; 88.4) for the ≥80 years and between 39.3% (95% CI: -3.9; 64.5) and 80.6% (95% CI: 67.2; 88.5) for 65-79 years. The first booster VE against COVID-19-related death declined over time for both age groups, while the second booster VE against death remained above 80% for the ≥80 years. Conclusions: Successive vaccine boosters played a relevant role in maintaining protection against COVID-19 hospitalisation and death, in the context of decreasing VE over time. Multicountry data from EHR facilitate robust near-real-time VE monitoring in the EU/EEA and support public health decision-making.European Centre for Disease Prevention and Control, Grant/Award Numbers ECDC/2021/018, RS/2022/DTS/24104.info:eu-repo/semantics/publishedVersio

I-MOVE multicentre case–control study 2010/11 to 2014/15 : is there within-season waning of influenza type/subtype vaccine effectiveness with increasing time since vaccination?

Influenza vaccines are currently the best method available to prevent seasonal influenza infection. In most European countries one dose (or two doses for children) of seasonal vaccine is given from September to December to the elderly and other target groups for vaccination. In Europe, influenza seasons can last until mid-May (1), and it is expected that vaccination conveys protection on the individual for the duration of the season. In 13/15 reviewed studies on the length of vaccine-induced protection among the elderly, using anti-haemagglutination antibody titres as a proxy for seroprotection levels, seroprotection rates lasted at least >4 months after vaccination (2). However in the 2011-12 influenza season various studies in Europe reported a decrease in influenza vaccine effectiveness (VE) against A(H3N2) over time within the season (3–5). In the United States, a decrease in VE against A(H3N2) with time since vaccination was suggested in the 2007-8 influenza season (6). The observed decrease of VE over time can be explained by viral change (notably antigenic drift) occurring in the season. Drift in B viruses may be slower than in A viruses (7), and A(H3N2) viruses undergo antigenic drift more frequently than A(H1N1)pdm09 viruses (8). The decrease of VE over time can also be explained by a waning of the immunity conferred by the vaccine independently from viral changes. If vaccine-induced protection wanes more rapidly during the season, then depending on the start and duration of the influenza season, the decline of VE may cause increases in overall incidence, hospitalisations and deaths. Changes to vaccination strategies (timing and boosters) may be needed. As anti-haemagglutination antibody titres are not well defined as a correlate of protection (9,10), vaccine efficacy (as measured in trials) or vaccine effectiveness observational studies may be one way to measure vaccine-induced protection. These studies require a large sample size to model VE by time since vaccination and currently, most of the seasonal observational studies lack the precision required to provide evidence for waning immunity. In this study we pooled data across five post-pandemic seasons (2010/11-2014/15) from the I-MOVE (Influenza - Monitoring Vaccine Effectiveness) multicentre case control studies (1,3,11,12), to obtain a greater sample size to study the effects of time since vaccination on influenza type/subtype-specific VE. We measure influenza type/subtype-specific VE by time since vaccination for the overall season, but also in the early influenza phase; under the hypothesis that virological changes are fewer in the early season, but waning of the vaccine effect should be present regardless of time within the influenza phase