Infection prevention and control in healthcare facilities in Albania

Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated.     Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants.         Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled.   Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care

Infection prevention and control in healthcare facilities in Albania

  Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated.     Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants.         Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled.   Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care

Solitary Cecal Diverticulitis During Surgery for Acute Appendicitis.

Background: Caecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. The diagnosis is not always easy and in the majority of cases, it is usually made at laparotomy. The aim of the present study is to retrospectively report our personal experience with solitary caecal diverticulitis, to determine its incidence in patients presenting as an acute abdomen, as well as identify the symptoms and clinical features that may aid in making a pre-operative diagnosis. And to compare this with a review of the literature, focusing on the surgical treatment and also on the indication of appendectomy in the presence of caecal diverticulitis not requiring surgery. Materials and methods: Data was collected in patients hospitalized for acute appendicitis or acute abdomen, in the surgical emergency unit of University Hospital Center "Mother Teresa" of Tirana, in a period of 3 years (2015-2017). Sex, age, duration of symptoms, preoperative diagnosis, management, intraoperative findings, histologic examination, length of hospital stay and complications of allpatients affected by solitary caecal diverticulitis were reviewed. Results: In the study period, 15 patients presented with a solitary caecal diverticulitis. Most of patients had pain in the right iliac fossa, with a duration of 2–6 days. All patients presented with abdominal pain, additional symptoms were nausea, vomiting and fever. The mean white blood cell count was from 8500-19.200/mm3, while the remaining laboratory results were normal. There were no specific findings on abdominal X-ray or ultrasonography. Intraoperative findings ranged from localized /circumscript peritonitis to generalised peritonitis due to acute diverticulitis and a normal appendix. Surgery ranged from diverticulum resection accompanied to appendectomy, to ileocaecal resection, and right hemicolectomy. Conclusions: Cecal diverticulitis should be included in the differen­tial diagnosis of the cases with pain in the right lower quadrant. Preoperative diagnosis of caecal diverticulitis cannot always be made, since the signs and symptoms are similar to acute appendicitis, but is impor­tant in order to decide how to manage this condition.Diverticulectomy and incidental appendectomy are the preferred method of treatment in uncomplicated cases. Right hemicolectomy is a recommended treatment option in complicated patients or those suspicious for tumor during surgery

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

The readiness of emergency and trauma care in low- and middle-income countries: a cross-sectional descriptive study of 42 public hospitals in Albania

BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed. Assessment subcategories included the following: (1) specialized training and/or certifications possessed by healthcare providers, (2) interventions performed in the ER, and (3) patient management strategies. RESULTS: Across the 42 ERs surveyed, less than half (37.1–42.5 %) of physicians and one third of nurses (7.1–26.0 %) working in the ERs received specialized trauma training. About half (47.9–57.1 %) of the ER physicians and one fifth of the nurses (18.3–22.9 %) possessed basic life support certification. This survey demonstrated some significant differences in the emergency medical care provided between primary, secondary, and tertiary hospitals across Albania (the significance level was set at 0.05). Specifically, these differences involved spinal immobilization (p = 0.01), FAST scan (p = 0.04), splinting (p = 0.01), closed reduction of displaced fractures (p = 0.02), and nurses performing cardiopulmonary resuscitation (CPR) (p = 0.01). Between 50.0 and 71.4 % of the facilities cited a combined lack of training and supplies as the reason for not offering interventions such as rapid sequence induction, needle thoracotomy, chest tube insertion, and thrombolysis. Mass casualty triage was utilized among 39.1 % primary hospitals, 41.7 % of secondary, and 28.6 % of tertiary. CONCLUSIONS: The emergency services in Albania are currently staffed with inadequately trained personnel, who lack the equipment and protocols to meet the needs of the population

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together