An analysis of respondent driven sampling with Injection Drug Users (IDU) in Albania and the Russian Federation. (33/90)

Injection drug users in Tirana, Albania and St. Petersburg, Russia were recruited into a study assessing HIV-related behaviors and HIV serostatus using Respondent Driven Sampling (RDS), a peer-driven recruitment sampling strategy that results in a probability sample. (Salganik M, Heckathorn DD. Sampling and estimation in hidden populations using respondent-driven sampling. Sociol Method. 2004;34:193-239). This paper presents a comparison of RDS implementation, findings on network and recruitment characteristics, and lessons learned. Initiated with 13 to 15 seeds, approximately 200 IDUs were recruited within 8 weeks. Information resulting from RDS indicates that social network patterns from the two studies differ greatly. Female IDUs in Tirana had smaller network sizes than male IDUs, unlike in St. Petersburg where female IDUs had larger network sizes than male IDUs. Recruitment patterns in each country also differed by demographic categories. Recruitment analyses indicate that IDUs form socially distinct groups by sex in Tirana, whereas there was a greater degree of gender mixing patterns in St. Petersburg. RDS proved to be an effective means of surveying these hard-to-reach populations.  (+info)

Conventional risk factors and acute coronary syndrome during a period of socioeconomic transition: population-based case-control study in Tirana, Albania. (34/90)

AIM: To assess the association between conventional risk factors and acute coronary syndrome in Albania, a transitional country in Southeast Europe. METHODS: A population-based case-control study was conducted in Tirana in 2003-2006. A total of 467 consecutive patients with nonfatal acute coronary syndrome were recruited. There were 370 men with mean+/-standard deviation (SD) age of 59.1+/-8.7 years and 97 women with mean+/-SD age of 63.3+/-7.1 years. The control group comprised a population-representative sample of Tirana residents. In the control group, there were 469 men with mean+/-SD age of 53.1+/-10.4 years and 268 women aged 54.0+/-10.9 years. A structured questionnaire on demographic, socioeconomic, psychosocial factors, and health behaviors was administered. Physical measurements included anthropometrics and blood pressure. Venous blood and adipose tissue aspirations from the gluteal region were frozen-stored for future analysis. Multivariable-adjusted logistic regression was used to assess the independent associations of conventional risk factors with acute coronary syndrome. RESULTS: Upon adjustment for covariates, family history of coronary heart disease was found to be a strong predictor of acute coronary syndrome in both men (odds ratio [OR], 3.70; 95% confidence interval [CI], 2.58-5.30) and women (OR, 4.53; 2.40-8.57). Waist-to-hip ratio in men (OR, 4.03; 2.83-5.73) and obesity in women (OR, 3.31; 1.54-7.14) were strongly associated with acute coronary syndrome. In men, but not in women, there was a significant association with hypertension and current smoking (P=0.011 and P<0.001, respectively). Diabetes was not significantly independently associated in either sex. CONCLUSION: Classical risk factors predicted coronary heart disease in Albania, similarly as in the rest of the world, although associations with family history and anthropometric indices were stronger. These findings are resulting largely from the heterogeneous adoption of lifestyles conducive to increased coronary risk in transitional countries, and they point to the urgent need for targeted public health interventions.  (+info)

The health effects of emigration on those who remain at home. (35/90)

BACKGROUND: The health effects of emigration on relatives staying behind has received little attention in the recent literature. Our aim was to assess the association of spouse and offspring emigration with acute coronary syndrome (ACS) in Albania, a country which is undergoing a particularly rapid socio-economic transition accompanied by intensive emigration. METHODS: A population-based case-control study, conducted in Tirana, Albania, in 2003-06, included 467 non-fatal consecutive ACS patients (370 men, 97 women; 88% response) and 737 population-representative controls (469 men, 268 women; 69% response) aged 35-74 years. Information on emigration of family members and financial support, socio-demographic characteristics and conventional coronary risk factors was obtained by a structured questionnaire and examination. Associations of emigrational variables with ACS were assessed by logistic regression. RESULTS: Forty five percent of female and 25% of male patients, and 17 and 15% of controls, respectively, reported emigration of a close family member. These were younger and of lower education, income and social status than controls without emigrants. Forty nine percent of patient emigrants vs 76% of control emigrants remitted funds. Excess risk of ACS was confined to individuals whose emigrant relatives did not remit monies home [multivariable-adjusted odds ratio (OR) = 10.8, 95% confidence interval (CI) = 2.6-44.8 in women, and OR = 2.0, 95% CI = 0.9-4.3 in men; P for sex-interaction = 0.03] and was attributable largely to spouse emigration. CONCLUSIONS: Our findings, which require confirmation, suggest that emigration of close family, but especially of spouses, coupled with non-remittance of financial support is associated with marked health effects in the spouse or parent left behind, and that women are more vulnerable than men.  (+info)

High-resolution molecular epidemiology and evolutionary history of HIV-1 subtypes in Albania. (36/90)

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Religious affiliation and acute coronary syndrome: a population-based case-control study in Tirana, Albania. (37/90)

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Hospitalization of children with sickle cell disease in a region with increasing immigration rates. (38/90)

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Prevalence of a family history of atopic disease among 3 generations of atopic respiratory patients in Tirana, Albania. (39/90)

BACKGROUND AND OBJECTIVE: Having relatives with allergic disease is associated with an increased risk of such disease, but children without a significant genetic predisposition account for much of the increase in asthma prevalence. The aim of this study was to investigate whether the prevalence of a reported family history of allergy has increased among atopic respiratory patients diagnosed in Outpatient Service No. 3 in Tirana in recent decades. METHODS: We evaluated the records of 693 atopic respiratory patients sensitized to mites (n = 480) or pollen (n = 218) or both (n = 5) to detect reports of allergic disease among their close relatives. Patients were classified in 3 groups: those born in 1959 or earlier, those born between 1960 and 1979, and those born between 1980 and 2003. The chi2 test was used for statistical comparisons. RESULTS: The prevalence of a family history of allergy among those born before 1960 (42.7%) was nearly 2-fold greater than the prevalence among those born between 1960 and 1979 (25.3%) or between 1980 and 2003 (23.1%) (P < .001). CONCLUSIONS: Younger generations of atopic respiratory patients report a family history of allergic disease about half as frequently as older ones. It is possible that massive introduction of antibiotics such as penicillin and streptomycin in the late 1960s and early 1970s for use against respiratory or gastrointestinal infections has increased survival for a considerable number of young children, switching the gene thesaurus of successive adult populations to an allergy-predisposing genotype.  (+info)

Factors associated with fatal traffic accidents in Tirana, Albania: cross-sectional study. (40/90)

AIM: To assess the prevalence of fatal road traffic accidents in Tirana, Albania, and describe their determinants. METHODS: This cross-sectional study included all road traffic accidents recorded by the Traffic Police Department of Tirana district for the period 2000-2005. A structured questionnaire included information about the type of traffic accident (fatal vs non-fatal event), year of event, age and sex of the responsible party, reason of accident, location and time of event, and the type of vehicle involved. Multivariable-adjusted binary logistic regression analysis was used to assess the predictors of fatal road traffic accidents. RESULTS: Overall, there were 1578 recorded road traffic accidents in Tirana district during 2000-2005. Of these, 272 (17%) were fatal. Multivariable-adjusted models showed that younger age (OR, 3.97; 95% CI, 2.28-6.91), high speed (OR, 2.54; 95% CI, 1.62-3.98), and especially alcohol consumption (OR, 6.15; 95% CI, 3.54-10.66) were strong and significant predictors of fatal accidents. Fatal accidents were more prevalent on intercity roads (OR, 4.25; 95% CI, 3.11-5.82) and involved especially vans and trucks (OR, 4.12; 95% CI, 2.34-7.24). CONCLUSION: Young age, high speed, and alcohol are predictors of fatal road traffic accidents in Tirana district. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.  (+info)