Enver ROSHI | Faculty of Medicine, University of Tirana (original) (raw)

Papers by Enver ROSHI

International journal of biomedicine, Mar 1, 2024

Background: While there is acknowledgment of the vital role of factors such as the status of hist... more Background: While there is acknowledgment of the vital role of factors such as the status of histological grades and hormone receptor (HR) in shaping targeted treatment strategies for breast cancer (BC), comprehensive research that unifies the study of imaging features with the evaluation of HR characteristics and histopathological data is notably absent in Albania, creating a critical research gap that this study endeavors to fill. This study aimed to investigate the imaging characteristics observed in ultrasound and the possible correlations between expression levels of HRs in ductal and lobular types of BC to elucidate potential prognostic and therapeutic implications. Methods and Results: This descriptive study, conceived as a series of cases, leveraged a prospective approach to scrutinize the dynamics of the study population over four years (2019-2023) in the Mother Teresa University Hospital Center and a private oncology clinic in Tirana. The convenience sampling strategy enlisted 238 female patients (mean age 60.5±12.5 years) diagnosed with BC who had been tested for HRs and consented to participate. Diagnostic imaging was facilitated using a Chison US equipped with a 10 MH linear probe. The results were adjudged based on the BI-RADS tumor classification. HR markers were discerned through rigorous immunohistochemical analyses. Utilizing SPSS version 21.0, statistical analyses incorporated a variety of tests, including Spearman's rho to assess correlations between hormonal receptors and imaging morphological characteristics and ordinal logistic regression to evaluate the relationships between hormonal receptors and cancer grades. Analyzing the localization of the tumor revealed that a slightly higher proportion had it on the left side, accounting for 52.9% compared to 47.1% on the right side. Regarding the BI-RADS classification observed through echographic examination, a vast majority were classified as BI-RADS 5 (92.8%), followed by a smaller percentage distributed amongst BI-RADS 4 (5.9%), BI-RADS 3 (0.84%), and BIRADS 6 (0.42%). Examining the cancer grades determined that 68.3% were at Grade 2, whereas Grades 1 and 3 were noticeably less common, standing at 1.7% and 30.2%, respectively. Estrogen receptor (ER) and progesterone receptor (PgR) sensitivity were high in most patients, exhibiting 77.7% and 70.6% positivity, respectively, alongside a notable presence of high Ki67 levels in 75.2% of the individuals. The investigation into HER2 status demonstrated that a significant number were negative (76.1%), as opposed to 17.6% being positive and 6.3% equivocal. Remarkably, 5.5% of the patients had a triple-negative status upon biopsy evaluation. The Spearman's rho correlations displayed a moderate positive correlation between ER and PgR (rho=0.563) and a weak negative correlation between ER and Ki67 (rho=-0.343) (P<0.05 in both cases). PgR and Ki67 show a weak negative correlation (rho=-0.353, P<0.05), suggesting a tendency for higher PgR values to correspond with lower Ki67 values. The ordinal logistic regression analysis identified a statistically significant negative relationship between the ER variable and the outcome variable, denoted by a coefficient of-2.137, P<0.05. Additionally, Ki67 showcased a positive relationship with the outcome, as indicated by a coefficient of 5.150, P<0.05. Conclusion: This study delineates the nuanced relationships between biomarkers such as ER, PgR, and Ki67 in different types of infiltrative cancers, pointing to a complex interplay that necessitates further exploration while also noting the independence of BI-RADS imagery in these correlations.

Rapporti ISTISAN - Istituto Superiore di Sanità, 2016

This short report aims to bring evidence from modern psychometric methods to bear on a popularly ... more This short report aims to bring evidence from modern psychometric methods to bear on a popularly deployed questionnaire in interprofessional education (IPE) assessment. Specifically, three interrelated problems raised against the Readiness for Interprofessional Learning Scale (RIPLS) are examined in a study with 280 medical and nursing student participants. Firstly, findings support RIPLS overall reliability, but fail to support subscale reliabilities. Secondly, findings indicate a strong, general factor underlying the RIPLS that supports unidimensional interpretations. Thirdly, findings support the RIPLS potential sensitivity to changes with appropriate lower ranges for our pre-training student sample. Recommendations for refinement to the RIPLS include: use of more appropriate reliability indices; factor generalizability; and a subset of items. More generally, refinement is possible, whereas RIPLS disuse or continued misuse with problematic scales is likely to hinder progress in the field of IPE.

Investigative Ophthalmology & Visual Science, 2019

The Albanian population is rapidly aging (in 2020, almost 15% of the population was ≥65 years) as... more The Albanian population is rapidly aging (in 2020, almost 15% of the population was ≥65 years) as a result of a steady increase in life expectancy (74.4 years in men and 78.7 years in women in in 2021), a gradual decrease in fertility rate (1.6 children per woman of childbearing age in 2020), and emigration of particularly young adults. This demographic transition experienced in the past three decades has inevitably led to a significant change in the epidemiological profile of the Albanian population, characterized by a remarkable shift towards non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD), cancer, chronic respiratory diseases, and diabetes. The main risk factors in the Albanian population consist of high blood pressure (top risk factor, accounting for about 34% of the overall mortality), nutritional-related risks (second, constituting about 25% of the overall mortality), and smoking (third risk factor, accounting for about 20% of the overall mortality). The national "Health Strategy, Albania 2021-2030" is a political document of the Albanian government that aims to define and achieve the objectives of the program for the protection and improvement of the health of the Albanian population.

Materia socio-medica, 2015

The aim of this study was to describe the distribution of demographic factors and socioeconomic c... more The aim of this study was to describe the distribution of demographic factors and socioeconomic characteristics among primary health care users diagnosed with osteoarthritis in Albania, a transitional country in the Western Balkans. Methods: This study included all individuals diagnosed with osteoarthritis during January 2013-December 2014 in selected primary health care centers in Tirana, the capital city of Albania. Overall, 1179 adult individuals were diagnosed with osteoarthritis (521 men and 658 women) during this time period. The overall mean age of study participants was 59.0±10.1 years (60.1±10.6 years in men and 58.1±9.6 years in women). The diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding demographic factors and socioeconomic characteristics among participants diagnosed with osteoarthritis. Results: In multivariable-adjusted logistic regression models, female gender was inversely associated with the age-group (OR=0.67, 95%CI=0.47-0.95) and educational level (OR=0.39, 95%CI=0.25-0.61), but positively related to rural birthplace (OR=1.47, 95%CI=1.14-1.89) and unemployment (OR=1.40, 95%CI=1.02-1.92) of the patients diagnosed with osteoarthritis. Conclusion: Our findings provide novel evidence about the distribution of demographic factors and socioeconomic characteristics among adult individuals diagnosed with osteoarthritis in primary health care services in Albania. Future studies should assess the distribution of the major risk factors for osteoarthritis among adult men and women in transitional Albania.

DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2019

Aim: Our objective was to assess the current and the required level of leadership competencies am... more Aim: Our objective was to assess the current and the required level of leadership competencies among male health professionals in Albania, a country which is characterized by an intensive process of emigration of the health workforce in the past few decades. Methods: This was a cross-sectional study carried out in Albania in June-November 2018 including a nationwide representative sample of 132 male health professionals working at different health institutions at both central and local level in Albania (mean age: 41.4±10.1 years; overall response rate: 88%). A structured 52-item questionnaire was administered to all male health professionals aiming at self-assessing the current level and the required (necessary) level of leadership competencies for their actual job positions. Answers for each item of the instrument ranged from 1 ("minimal competency level") to 5 ("maximal competency level"). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated for both the current and the required leadership competency levels. Paired sample t-test was used to compare the overall mean scores and the subscale mean scores of the current level and the required level of leadership competencies among male health professionals. Results: Mean value of the overall summary score of the instrument was lower for the current leadership competency level compared with the required leadership competency level (137.6±8.7 vs. 140.7±21.2, respectively; P=0.02). Mean difference between the required and the current level of leadership competencies was higher for male health professionals working in top managerial positions and those working in urban areas of Albania. Conclusion: This study informs about the current and the required level of leadership competencies among male health professionals in Albania, a transitional country in the Western Balkans. Policymakers and decision-makers in Albania and other countries in the European region should be aware of the existing gap between the required and the current level of leadership competencies among health professionals operating at all levels.

Journal of Forensic Medicine, 2006

To describe the prevalence of intimate partner violence and associated factors among married wome... more To describe the prevalence of intimate partner violence and associated factors among married women in Albania. Cross sectional study. Tirana, the capital city of Albania. A representative sample of 1039 married women aged 25-65 living in Tirana and recorded in the 2001 census. Questionnaire on intimate partner violence and social and demographic characteristics of the women and their husbands. Women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s experience within the past year of being hit, slapped, kicked, or otherwise physically hurt by the husband. More than a third (37%, 384/1039) of women had experienced violence. Risk was greatest among women aged 25-34 (odds ratio 1.47, 95% CI 1.04 to 2.09), women with tertiary education (3.70, 2.04 to 6.67), women in white collar jobs (4.0, 1.59 to 10.0), women with least educated husbands (5.01, 2.91 to 8.64), and women married to men raised in rural areas (3.31, 2.29 to 4.80). Women were at higher risk if they were more educated than their husbands (4.76, 2.56 to 9.09). In transitional Albania, the risk of spousal violence is high, and more empowered women are at greater risk.

Materia socio-medica, 2015

Writing a Biographical Lexicon of Public Health is not easy. Public health has its own unique his... more Writing a Biographical Lexicon of Public Health is not easy. Public health has its own unique history and comes through antiquity to our modern society. From ensuring clean and safe environmental and living conditions and the control of infectious diseases, to addressing the causes of non-communicable diseases, through health promotion and addressing the wider determinants of health, public health has sought to tackle health threats over the decades and centuries. In today's World, public health is high on the political agenda, at local, national and international levels and progress is only possible through inter-sectorial cooperation. Public Health could not be successful itself without public health professionals.

International journal of scientific research, Oct 1, 2014

Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic morbidity and mortalit... more Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic morbidity and mortality. The aim of this study is understand the role of risk factors for occurrence of COPD. A case control study was carried out at Dispensary of Tirana district over the two year period January 2012-December 2013 were included in the study. Cases were recruited from newly diagnosed outpatient cases of mild, moderate or severe COPD. Controls were obtained from outpatients consulting for various extrapulmonary problems. All patients answered a standardized questionnaire after obtaining informed consent. Age ≥60yrs, smoking, environmental tobacco smoking (ETC) exposure at home and exposure to solid fuel smoke at home are significant independent risk factors for COPD. Public health implications should include promotional campaigns to quit smoking and measures to ameliorate the indoor levels of air pollution.

British journal of medicine and medical research, Oct 22, 2013

Aims: Our aim was to assess the prevalence of diabetes mellitus through self-reports and measurem... more Aims: Our aim was to assess the prevalence of diabetes mellitus through self-reports and measurement of fasting glucose level in a representative sample of Albanian adults residing in Tirana. Study Design: Cross-sectional study. Place and Duration of Study: The survey was conducted in urban Tirana during April-July 2012. Methods: A population-based sample of 795 individuals aged ≥18 years was included in this study (60% women; overall mean age: 50.3±18.7 years; response rate: 79.5%). Finger stick method was used to measure fasting glucose level in all participants. Furthermore, weight and height were measured. Data on socio-demographic and socioeconomic factors were also collected. General linear model was used to assess the association of mean glucose level with demographic and socioeconomic characteristics and anthropometric indices.

Injury Prevention, Sep 1, 2010

Aim Our aim was to assess the prevalence and socioeconomic determinants of violence against child... more Aim Our aim was to assess the prevalence and socioeconomic determinants of violence against children in postcommunist Albania. Methods A survey was conducted in 2008 including 388 children aged 14-18 years (184 girls and 204 boys) who were users of health services in four districts of Albania: Shkoder, Elbasan, Tirana and Vlora. A structured questionnaire was administrated including information on occurrence and type of experienced domestic violence (physical, psychological and emotional), as well as sociodemographic and socioeconomic characteristics of children and their parents. Results Forty-three per cent of the children included in the survey reported they suffered at least one type of domestic violence, mainly perpetrated by their mothers. Psychological

International Journal of Neonatal Screening

Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 an... more Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity...

Management in Health, 2019

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the fut... more BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among ...

Investigative Ophthalmology & Visual Science, 2017

Journal of Public Health, 2013

Background Patient satisfaction with the quality of primary health care (PHC) in Kosovo has not b... more Background Patient satisfaction with the quality of primary health care (PHC) in Kosovo has not been previously reported. Our aim was to assess the level and socioeconomic correlates of satisfaction of PHC users (also referred to as patients' evaluation) in Kosovo, a transitional country in the Western Balkans. Methods A cross-sectional study was conducted in 2010 in Gjilan region, Kosovo, including a representative sample of 1039 PHC users (87% response). Patients' evaluation of PHC services was assessed through EUROPEP, a 23-item instrument tapping different aspects of medical encounter. Results Mean age of survey participants (56% females) was 41 + 16 years. About 50% of the participants were satisfied with the overall quality of medical services, doctor-patient relationship and organization of care. Younger (below median age), urban and employed PHC users reported a significantly higher satisfaction level with the overall health encounter quality. Conversely, there were no sex or educational differences. Conclusions Considerably fewer PHC users in Kosovo were satisfied with the overall medical encounter compared with their European counterparts. This new and useful evidence may support health professionals and policy makers for improving the quality of PHC in Kosovo, a country struggling and mainstreaming all energies in order to get international recognition.

Acta Scientific Medical Sciences, Feb 1, 2023

This study aimed to shed light on the prevalence and epidemiology of aberrant renal vessels in a ... more This study aimed to shed light on the prevalence and epidemiology of aberrant renal vessels in a group of patients diagnosed with hydronephrosis in Albania. Material and Methods: This is a case-series study of 81 patients diagnosed with hydronephrosis and showing up at the Urology Service of the University Hospital Center "Mother Teresa", in Tirana, during the years 2010-2014. All patients were examined in order to confirm the hydronephrosis diagnosis and to potentially detect the presence of aberrant renal vessels. Basic socio-demographic data were collected and the chi square test was used to assess their distribution among patients with and without aberrant renal vessels. Results: The mean age of participating patients was 27.7 years ± 13.78 years, 51.9% males, 53.1% residing in urban areas, 42% unemployed. The patients came all over the country as demonstrated by the distribution of them according to country's prefectures. The overall prevalence of aberrant vessels in patients with hydronephrosis was 42%, the prevalence of aberrant renal arteries was 29.6%, and the prevalence of aberrant renal veins was 18.5%. About 32% of patients with hydronephrosis had one type of aberrant renal vessel (artery or vein) and 9.9% had both types of aberrant renal vessel (both artery and vein). In 9.9% of cases aberrant vessels were located in the right kidney, in 30.9% of the participants they were located in the left kidney and in 1.2% of all participants the aberrant vessels were present in it both kidneys simultaneously (bilateral). No significant differences in the prevalence of aberrant renal vessels were detected by gender, age and place of residence of participants. Conclusions: The epidemiology of aberrant renal vessels among patients with hydronephrosis in Albania is comparable to literature reports. The epidemiology of accessory renal vessels can help professionals in the field to suspect and seek evidence of these structures in their patients, since these health conditions are quite frequent and could interfere with the relevant surgical procedures.

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the fut... more BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among ...

BACKGROUND: The aim of our study was to validate an international instrument addressing the leade... more BACKGROUND: The aim of our study was to validate an international instrument addressing the leadership competency level of public health professionals in Albania, a post-communist country in the Western Balkans.METHODS: A sample of 53 public health professionals operating at different levels were interviewed twice in May 2014 in Tirana (25 men and 28 women; median age: 44 years, inter-quartile range: 35-55 years). A structured questionnaire was administered [and subsequently re-administered after two weeks (test-retest)] to all participants aiming at self-assessing the current level of leadership competencies and the required/desirable level of leadership competencies for their current job position. The questionnaire included 52 items organized into 8 subscales/domains. Answers for each item of the tool ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated fo...

We aimed to assess the prevalence and socioeconomic and behavioral correlates of obesity in adult... more We aimed to assess the prevalence and socioeconomic and behavioral correlates of obesity in adult population of Albania, a transitional country in the western Balkans. Methods: A cross-sectional study was conducted in 2007-2009 in the Albanian capital, including a sex-stratified random sample of 997 Tirana residents aged 25-65 years (83% response). A structured interview included data on demographic and socioeconomic characteristics and lifestyle factors. Physical examination included measurement of height, weight, and hips and waist circumferences. Binary logistic regression was used to assess the association of obesity with covariates. Results: Half of participants were overweight, and about 30% were obese (36% women and 24% men). Obesity was positively associated with age, but inversely related to education and economic level. Almost every day drinkers were more likely to be obese compared to non-drinkers (OR=2.2, 95% CI=1.4-2.9). Fat and carbohydrate intake were both positively associated with obesity (for fat intake OR [low-moderate vs. high intake]=3.1, 95%CI=2.0-4.2) and for carbohydrate intake OR [low-moderate vs. high intake]=2.8; 95%CI=1.9-3.3). Conclusions: Our findings indicate that overweight and obesity pose serious public health concerns in this post-communist country. Health professionals and policy makers should focus particularly on the modifiable risk factors as an effective means of controlling the burden of obesity in Albania.

International journal of biomedicine, Mar 1, 2024

Background: While there is acknowledgment of the vital role of factors such as the status of hist... more Background: While there is acknowledgment of the vital role of factors such as the status of histological grades and hormone receptor (HR) in shaping targeted treatment strategies for breast cancer (BC), comprehensive research that unifies the study of imaging features with the evaluation of HR characteristics and histopathological data is notably absent in Albania, creating a critical research gap that this study endeavors to fill. This study aimed to investigate the imaging characteristics observed in ultrasound and the possible correlations between expression levels of HRs in ductal and lobular types of BC to elucidate potential prognostic and therapeutic implications. Methods and Results: This descriptive study, conceived as a series of cases, leveraged a prospective approach to scrutinize the dynamics of the study population over four years (2019-2023) in the Mother Teresa University Hospital Center and a private oncology clinic in Tirana. The convenience sampling strategy enlisted 238 female patients (mean age 60.5±12.5 years) diagnosed with BC who had been tested for HRs and consented to participate. Diagnostic imaging was facilitated using a Chison US equipped with a 10 MH linear probe. The results were adjudged based on the BI-RADS tumor classification. HR markers were discerned through rigorous immunohistochemical analyses. Utilizing SPSS version 21.0, statistical analyses incorporated a variety of tests, including Spearman's rho to assess correlations between hormonal receptors and imaging morphological characteristics and ordinal logistic regression to evaluate the relationships between hormonal receptors and cancer grades. Analyzing the localization of the tumor revealed that a slightly higher proportion had it on the left side, accounting for 52.9% compared to 47.1% on the right side. Regarding the BI-RADS classification observed through echographic examination, a vast majority were classified as BI-RADS 5 (92.8%), followed by a smaller percentage distributed amongst BI-RADS 4 (5.9%), BI-RADS 3 (0.84%), and BIRADS 6 (0.42%). Examining the cancer grades determined that 68.3% were at Grade 2, whereas Grades 1 and 3 were noticeably less common, standing at 1.7% and 30.2%, respectively. Estrogen receptor (ER) and progesterone receptor (PgR) sensitivity were high in most patients, exhibiting 77.7% and 70.6% positivity, respectively, alongside a notable presence of high Ki67 levels in 75.2% of the individuals. The investigation into HER2 status demonstrated that a significant number were negative (76.1%), as opposed to 17.6% being positive and 6.3% equivocal. Remarkably, 5.5% of the patients had a triple-negative status upon biopsy evaluation. The Spearman's rho correlations displayed a moderate positive correlation between ER and PgR (rho=0.563) and a weak negative correlation between ER and Ki67 (rho=-0.343) (P<0.05 in both cases). PgR and Ki67 show a weak negative correlation (rho=-0.353, P<0.05), suggesting a tendency for higher PgR values to correspond with lower Ki67 values. The ordinal logistic regression analysis identified a statistically significant negative relationship between the ER variable and the outcome variable, denoted by a coefficient of-2.137, P<0.05. Additionally, Ki67 showcased a positive relationship with the outcome, as indicated by a coefficient of 5.150, P<0.05. Conclusion: This study delineates the nuanced relationships between biomarkers such as ER, PgR, and Ki67 in different types of infiltrative cancers, pointing to a complex interplay that necessitates further exploration while also noting the independence of BI-RADS imagery in these correlations.

Rapporti ISTISAN - Istituto Superiore di Sanità, 2016

This short report aims to bring evidence from modern psychometric methods to bear on a popularly ... more This short report aims to bring evidence from modern psychometric methods to bear on a popularly deployed questionnaire in interprofessional education (IPE) assessment. Specifically, three interrelated problems raised against the Readiness for Interprofessional Learning Scale (RIPLS) are examined in a study with 280 medical and nursing student participants. Firstly, findings support RIPLS overall reliability, but fail to support subscale reliabilities. Secondly, findings indicate a strong, general factor underlying the RIPLS that supports unidimensional interpretations. Thirdly, findings support the RIPLS potential sensitivity to changes with appropriate lower ranges for our pre-training student sample. Recommendations for refinement to the RIPLS include: use of more appropriate reliability indices; factor generalizability; and a subset of items. More generally, refinement is possible, whereas RIPLS disuse or continued misuse with problematic scales is likely to hinder progress in the field of IPE.

Investigative Ophthalmology & Visual Science, 2019

The Albanian population is rapidly aging (in 2020, almost 15% of the population was ≥65 years) as... more The Albanian population is rapidly aging (in 2020, almost 15% of the population was ≥65 years) as a result of a steady increase in life expectancy (74.4 years in men and 78.7 years in women in in 2021), a gradual decrease in fertility rate (1.6 children per woman of childbearing age in 2020), and emigration of particularly young adults. This demographic transition experienced in the past three decades has inevitably led to a significant change in the epidemiological profile of the Albanian population, characterized by a remarkable shift towards non-communicable diseases (NCDs), particularly cardiovascular diseases (CVD), cancer, chronic respiratory diseases, and diabetes. The main risk factors in the Albanian population consist of high blood pressure (top risk factor, accounting for about 34% of the overall mortality), nutritional-related risks (second, constituting about 25% of the overall mortality), and smoking (third risk factor, accounting for about 20% of the overall mortality). The national "Health Strategy, Albania 2021-2030" is a political document of the Albanian government that aims to define and achieve the objectives of the program for the protection and improvement of the health of the Albanian population.

Materia socio-medica, 2015

The aim of this study was to describe the distribution of demographic factors and socioeconomic c... more The aim of this study was to describe the distribution of demographic factors and socioeconomic characteristics among primary health care users diagnosed with osteoarthritis in Albania, a transitional country in the Western Balkans. Methods: This study included all individuals diagnosed with osteoarthritis during January 2013-December 2014 in selected primary health care centers in Tirana, the capital city of Albania. Overall, 1179 adult individuals were diagnosed with osteoarthritis (521 men and 658 women) during this time period. The overall mean age of study participants was 59.0±10.1 years (60.1±10.6 years in men and 58.1±9.6 years in women). The diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding demographic factors and socioeconomic characteristics among participants diagnosed with osteoarthritis. Results: In multivariable-adjusted logistic regression models, female gender was inversely associated with the age-group (OR=0.67, 95%CI=0.47-0.95) and educational level (OR=0.39, 95%CI=0.25-0.61), but positively related to rural birthplace (OR=1.47, 95%CI=1.14-1.89) and unemployment (OR=1.40, 95%CI=1.02-1.92) of the patients diagnosed with osteoarthritis. Conclusion: Our findings provide novel evidence about the distribution of demographic factors and socioeconomic characteristics among adult individuals diagnosed with osteoarthritis in primary health care services in Albania. Future studies should assess the distribution of the major risk factors for osteoarthritis among adult men and women in transitional Albania.

DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2019

Aim: Our objective was to assess the current and the required level of leadership competencies am... more Aim: Our objective was to assess the current and the required level of leadership competencies among male health professionals in Albania, a country which is characterized by an intensive process of emigration of the health workforce in the past few decades. Methods: This was a cross-sectional study carried out in Albania in June-November 2018 including a nationwide representative sample of 132 male health professionals working at different health institutions at both central and local level in Albania (mean age: 41.4±10.1 years; overall response rate: 88%). A structured 52-item questionnaire was administered to all male health professionals aiming at self-assessing the current level and the required (necessary) level of leadership competencies for their actual job positions. Answers for each item of the instrument ranged from 1 ("minimal competency level") to 5 ("maximal competency level"). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated for both the current and the required leadership competency levels. Paired sample t-test was used to compare the overall mean scores and the subscale mean scores of the current level and the required level of leadership competencies among male health professionals. Results: Mean value of the overall summary score of the instrument was lower for the current leadership competency level compared with the required leadership competency level (137.6±8.7 vs. 140.7±21.2, respectively; P=0.02). Mean difference between the required and the current level of leadership competencies was higher for male health professionals working in top managerial positions and those working in urban areas of Albania. Conclusion: This study informs about the current and the required level of leadership competencies among male health professionals in Albania, a transitional country in the Western Balkans. Policymakers and decision-makers in Albania and other countries in the European region should be aware of the existing gap between the required and the current level of leadership competencies among health professionals operating at all levels.

Journal of Forensic Medicine, 2006

To describe the prevalence of intimate partner violence and associated factors among married wome... more To describe the prevalence of intimate partner violence and associated factors among married women in Albania. Cross sectional study. Tirana, the capital city of Albania. A representative sample of 1039 married women aged 25-65 living in Tirana and recorded in the 2001 census. Questionnaire on intimate partner violence and social and demographic characteristics of the women and their husbands. Women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s experience within the past year of being hit, slapped, kicked, or otherwise physically hurt by the husband. More than a third (37%, 384/1039) of women had experienced violence. Risk was greatest among women aged 25-34 (odds ratio 1.47, 95% CI 1.04 to 2.09), women with tertiary education (3.70, 2.04 to 6.67), women in white collar jobs (4.0, 1.59 to 10.0), women with least educated husbands (5.01, 2.91 to 8.64), and women married to men raised in rural areas (3.31, 2.29 to 4.80). Women were at higher risk if they were more educated than their husbands (4.76, 2.56 to 9.09). In transitional Albania, the risk of spousal violence is high, and more empowered women are at greater risk.

Materia socio-medica, 2015

Writing a Biographical Lexicon of Public Health is not easy. Public health has its own unique his... more Writing a Biographical Lexicon of Public Health is not easy. Public health has its own unique history and comes through antiquity to our modern society. From ensuring clean and safe environmental and living conditions and the control of infectious diseases, to addressing the causes of non-communicable diseases, through health promotion and addressing the wider determinants of health, public health has sought to tackle health threats over the decades and centuries. In today's World, public health is high on the political agenda, at local, national and international levels and progress is only possible through inter-sectorial cooperation. Public Health could not be successful itself without public health professionals.

International journal of scientific research, Oct 1, 2014

Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic morbidity and mortalit... more Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic morbidity and mortality. The aim of this study is understand the role of risk factors for occurrence of COPD. A case control study was carried out at Dispensary of Tirana district over the two year period January 2012-December 2013 were included in the study. Cases were recruited from newly diagnosed outpatient cases of mild, moderate or severe COPD. Controls were obtained from outpatients consulting for various extrapulmonary problems. All patients answered a standardized questionnaire after obtaining informed consent. Age ≥60yrs, smoking, environmental tobacco smoking (ETC) exposure at home and exposure to solid fuel smoke at home are significant independent risk factors for COPD. Public health implications should include promotional campaigns to quit smoking and measures to ameliorate the indoor levels of air pollution.

British journal of medicine and medical research, Oct 22, 2013

Aims: Our aim was to assess the prevalence of diabetes mellitus through self-reports and measurem... more Aims: Our aim was to assess the prevalence of diabetes mellitus through self-reports and measurement of fasting glucose level in a representative sample of Albanian adults residing in Tirana. Study Design: Cross-sectional study. Place and Duration of Study: The survey was conducted in urban Tirana during April-July 2012. Methods: A population-based sample of 795 individuals aged ≥18 years was included in this study (60% women; overall mean age: 50.3±18.7 years; response rate: 79.5%). Finger stick method was used to measure fasting glucose level in all participants. Furthermore, weight and height were measured. Data on socio-demographic and socioeconomic factors were also collected. General linear model was used to assess the association of mean glucose level with demographic and socioeconomic characteristics and anthropometric indices.

Injury Prevention, Sep 1, 2010

Aim Our aim was to assess the prevalence and socioeconomic determinants of violence against child... more Aim Our aim was to assess the prevalence and socioeconomic determinants of violence against children in postcommunist Albania. Methods A survey was conducted in 2008 including 388 children aged 14-18 years (184 girls and 204 boys) who were users of health services in four districts of Albania: Shkoder, Elbasan, Tirana and Vlora. A structured questionnaire was administrated including information on occurrence and type of experienced domestic violence (physical, psychological and emotional), as well as sociodemographic and socioeconomic characteristics of children and their parents. Results Forty-three per cent of the children included in the survey reported they suffered at least one type of domestic violence, mainly perpetrated by their mothers. Psychological

International Journal of Neonatal Screening

Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 an... more Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity...

Management in Health, 2019

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the fut... more BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among ...

Investigative Ophthalmology & Visual Science, 2017

Journal of Public Health, 2013

Background Patient satisfaction with the quality of primary health care (PHC) in Kosovo has not b... more Background Patient satisfaction with the quality of primary health care (PHC) in Kosovo has not been previously reported. Our aim was to assess the level and socioeconomic correlates of satisfaction of PHC users (also referred to as patients' evaluation) in Kosovo, a transitional country in the Western Balkans. Methods A cross-sectional study was conducted in 2010 in Gjilan region, Kosovo, including a representative sample of 1039 PHC users (87% response). Patients' evaluation of PHC services was assessed through EUROPEP, a 23-item instrument tapping different aspects of medical encounter. Results Mean age of survey participants (56% females) was 41 + 16 years. About 50% of the participants were satisfied with the overall quality of medical services, doctor-patient relationship and organization of care. Younger (below median age), urban and employed PHC users reported a significantly higher satisfaction level with the overall health encounter quality. Conversely, there were no sex or educational differences. Conclusions Considerably fewer PHC users in Kosovo were satisfied with the overall medical encounter compared with their European counterparts. This new and useful evidence may support health professionals and policy makers for improving the quality of PHC in Kosovo, a country struggling and mainstreaming all energies in order to get international recognition.

Acta Scientific Medical Sciences, Feb 1, 2023

This study aimed to shed light on the prevalence and epidemiology of aberrant renal vessels in a ... more This study aimed to shed light on the prevalence and epidemiology of aberrant renal vessels in a group of patients diagnosed with hydronephrosis in Albania. Material and Methods: This is a case-series study of 81 patients diagnosed with hydronephrosis and showing up at the Urology Service of the University Hospital Center "Mother Teresa", in Tirana, during the years 2010-2014. All patients were examined in order to confirm the hydronephrosis diagnosis and to potentially detect the presence of aberrant renal vessels. Basic socio-demographic data were collected and the chi square test was used to assess their distribution among patients with and without aberrant renal vessels. Results: The mean age of participating patients was 27.7 years ± 13.78 years, 51.9% males, 53.1% residing in urban areas, 42% unemployed. The patients came all over the country as demonstrated by the distribution of them according to country's prefectures. The overall prevalence of aberrant vessels in patients with hydronephrosis was 42%, the prevalence of aberrant renal arteries was 29.6%, and the prevalence of aberrant renal veins was 18.5%. About 32% of patients with hydronephrosis had one type of aberrant renal vessel (artery or vein) and 9.9% had both types of aberrant renal vessel (both artery and vein). In 9.9% of cases aberrant vessels were located in the right kidney, in 30.9% of the participants they were located in the left kidney and in 1.2% of all participants the aberrant vessels were present in it both kidneys simultaneously (bilateral). No significant differences in the prevalence of aberrant renal vessels were detected by gender, age and place of residence of participants. Conclusions: The epidemiology of aberrant renal vessels among patients with hydronephrosis in Albania is comparable to literature reports. The epidemiology of accessory renal vessels can help professionals in the field to suspect and seek evidence of these structures in their patients, since these health conditions are quite frequent and could interfere with the relevant surgical procedures.

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the fut... more BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among ...

BACKGROUND: The aim of our study was to validate an international instrument addressing the leade... more BACKGROUND: The aim of our study was to validate an international instrument addressing the leadership competency level of public health professionals in Albania, a post-communist country in the Western Balkans.METHODS: A sample of 53 public health professionals operating at different levels were interviewed twice in May 2014 in Tirana (25 men and 28 women; median age: 44 years, inter-quartile range: 35-55 years). A structured questionnaire was administered [and subsequently re-administered after two weeks (test-retest)] to all participants aiming at self-assessing the current level of leadership competencies and the required/desirable level of leadership competencies for their current job position. The questionnaire included 52 items organized into 8 subscales/domains. Answers for each item of the tool ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated fo...

We aimed to assess the prevalence and socioeconomic and behavioral correlates of obesity in adult... more We aimed to assess the prevalence and socioeconomic and behavioral correlates of obesity in adult population of Albania, a transitional country in the western Balkans. Methods: A cross-sectional study was conducted in 2007-2009 in the Albanian capital, including a sex-stratified random sample of 997 Tirana residents aged 25-65 years (83% response). A structured interview included data on demographic and socioeconomic characteristics and lifestyle factors. Physical examination included measurement of height, weight, and hips and waist circumferences. Binary logistic regression was used to assess the association of obesity with covariates. Results: Half of participants were overweight, and about 30% were obese (36% women and 24% men). Obesity was positively associated with age, but inversely related to education and economic level. Almost every day drinkers were more likely to be obese compared to non-drinkers (OR=2.2, 95% CI=1.4-2.9). Fat and carbohydrate intake were both positively associated with obesity (for fat intake OR [low-moderate vs. high intake]=3.1, 95%CI=2.0-4.2) and for carbohydrate intake OR [low-moderate vs. high intake]=2.8; 95%CI=1.9-3.3). Conclusions: Our findings indicate that overweight and obesity pose serious public health concerns in this post-communist country. Health professionals and policy makers should focus particularly on the modifiable risk factors as an effective means of controlling the burden of obesity in Albania.