The COVID-19 pandemic has significantly affected Albania, with over 319959 cases and 3625 deaths by December 2023. Despite a national vaccination campaign initiated in January 2021, only 44.1% of the eligible population had completed the full vaccination regimen by late 2023. In this study, we aim to estimate the effectiveness of COVID-19 vaccines in preventing severe outcomes and in assessing association of prior SARS-CoV-2 infection among adults hospitalized with COVID-19 in Albania. A test-negative case-control study was conducted using SARI sentinel surveillance data from July 2022 to July 2023. The study included 1858 hospitalized SARI patients aged 18 and older, with 410 testing positive for SARS-CoV-2 (cases) and 1448 testing negative (controls). Vaccine effectiveness was calculated using logistic regression, adjusting for age, sex, comorbidities, and hospital stay duration. The overall adjusted vaccine effectiveness (VE) for preventing hospitalization was 30.1% for those fully vaccinated with two doses and 31.4% for those with a booster. VE against severe outcomes was 30.6%, increasing to 37.8% after a booster. The highest VE was observed in patients aged 80 and above, reaching 52.5% after a booster. Prior SARS-CoV-2 infection combined with vaccination was associated with higher VE to 76.2%. However, many VE estimates had wide confidence intervals overlapping zero, indicating considerable uncertainty and lack of statistical significance in some subgroup results. This study provides real-world evidence of an association between COVID-19 vaccination, particularly with booster doses, and lower odds of severe outcomes. VE was highest among elderly patients and in those with prior SARS-CoV-2 infection, emphasizing the importance of booster campaigns in vulnerable populations.

IntroductionCritical questions remain about COVID-19 vaccine effectiveness (VE) in real-world settings, particularly in middle-income countries. We describe a study protocol to evaluate COVID-19 VE in preventing laboratory-confirmed SARS-CoV-2 infection in health workers (HWs) in Albania, an upper-middle-income country.Methods and analysisIn this 12-month prospective cohort study, we enrolled HWs at three hospitals in Albania. HWs are vaccinated through the routine COVID-19 vaccine campaign. Participants completed a baseline survey about demographics, clinical comorbidities, and infection risk behaviours. Baseline serology samples were also collected and tested against the SARS-CoV-2 spike protein, and respiratory swabs were collected and tested for SARS-CoV-2 by RT-PCR. Participants complete weekly symptom questionnaires and symptomatic participants have a respiratory swab collected, which is tested for SARS-CoV-2. At 3, 6, 9 months and 12 months of the study, serology will be collected and tested for antibodies against the SARS-CoV-2 nucleocapsid protein and spike protein. VE will be estimated using a piecewise proportional hazards model (VE=1−HR).Baseline dataFrom February to May 2021, 1504 HWs were enrolled. The median age was 44 (range: 22–71) and 78% were female. At enrolment, 72% of participants were seropositive for SARS-CoV-2. 56% of participants were vaccinated with one dose, of whom 98% received their first shot within 4 days of enrolment. All HWs received the Pfizer BNT162b2 mRNA COVID-19 vaccine.Ethics and disseminationThe study protocol and procedures were reviewed and approved by the WHO Ethical Review Board, reference number CERC.0097A, and the Albanian Institute of Public Health Ethical Review Board, reference number 156. All participants have provided written informed consent to participate in this study. The primary results of this study will be published in a peer-reviewed journal at the time of completion.Trial registration numberNCT04811391.

Background Since influenza often presents non-specifically in infancy, we aimed to assess the extent to which existing respiratory surveillance platforms might underestimate the frequency of severe influenza disease among infants. Methods The Influenza and Respiratory Syncytial Virus in Infants (IRIS) study was a prospective observational study done at four hospitals in Albania, Jordan, Nicaragua, and the Philippines. We included acutely ill infants aged younger than 1 year admitted to hospital within 10 days or less of illness onset during two influenza seasons (2015-16 and 2016-17) in Albania, Jordan, and Nicaragua, and over a continuous 34 week period (2015-16) in the Philippines. We assessed the frequency of influenza virus infections by real-time RT-PCR (rRT-PCR) and serology. The main study outcome was seroconversion, defined as convalescent antibody titres more than or equal to four-fold higher than acute sera antibody litres, and convalescent antibody titres of 40 or higher. Seroconverison was confirmed by haemagglutination inhibition assay for influenza A viruses, and by hemagglutination inhibition assay and microneutralisation for influenza B viruses. Findings Between June 27, 2015, and April 21,2017,3634 acutely ill infants were enrolled, of whom 1943 were enrolled during influenza seasons and had complete acute-convalescent pairs and thus were induded in the final analytical sample. Of the 1943 infants, 94 (5%) were influenza-positive by both rRT-PCR and serology, 58 (3%) were positive by rRT-PCR-only, and 102 (5%) were positive by serology only. Seroconversion to at least one of the influenza A or B viruses was observed among 196 (77%) of 254 influenza-positive infants. Of the 254 infants with influenza virus, 84 (33%) only had non-respiratory dinical discharge diagnoses (eg, sepsis, febrile seizures, dehydration, or other nonrespiratory viral illness). A focus on respiratory diagnoses and rRT-PCR-confirmed influenza underdetects influenzaassociated hospital admissions among infants by a factor of 2.6 (95% CI 2.0-3.6). Findings were unchanged when syndromic severe acute respiratory infection criteria were applied instead of clinical diagnosis. Interpretation If the true incidence of laboratory-confirmed influenza-associated hospital admissions among infants is at least twice that of previous estimates, this substantially increases the global burden of severe influenza and expands our estimates of the preventive value of maternal and infant influenza vaccination programmes. Copyright (C) 2019 Elsevier Ltd. All rights reserved.

This paper presents the causative agent of the epidemic of the influenza in our country during the season 20092010. It also shows the effectiveness of the molecular diagnosis for Influenza virus by the means of the real-time PCR method in comparative of classical virological ones. Also in this paper we have presented the antigenic characterization of this virus which caused the pandemic during 2009-2010 years. We have collected and processed with several diagnostic methods like imunoflorescent assay, rapid tests, isolation and molecular method 409 samples. These were collected by the means of a Sentinel Surveillance throughout Albania, (tampon nasalpharyngeal) from people suspected of influenza in different ages. To isolate the virus of influenza we have used two methods: the method of isolation of influenza in the cell line of MDCK and also the isolation of the viral RNA by the means of the molecular method. The identifications of the isolates were carried out through the reactions of the hem agglutination inhibition and we have used also the method of Immunofluorescence and rapid test for the antigen detection of influenza virus. The results of the virus analyses are given in the relevant figures. The positive isolates were sent to the International Center of Influenza in London to be confirmed and also to have a further genetic analysis through molecular methods. From these tests performed during the season 2009-2010, it came out that our country was affected by one strain of influenza type A, AH1N1 variant A/California/2009/11. This strain circulated in the whole world causing the pandemic of 2009 and was a new variant deriving from the fusion of 4 strains of Influenza a process which occurred in pigs. These variants have affected the majority of the countries in Europe and in the world.

Due to the ease of cross-continent spread of infectious diseases, the 2009 influenza AH1N1 (H1N1) affected many countries. This observational prospective study looked at Albanian patients admitted with 2009 H1N1 at the ICU of the Department of Infectious Diseases at the University Hospital Center of Tirana, from November 2009 to March 2010. Demographic data, symptoms, comorbidities, and clinical outcomes were collected from each patient. The number of days spent in the ICU was recorded for each patient along with their radiological and laboratory findings, and outcome at discharge. Critical illness occurred in 31 patients admitted with confirmed 2009 H1N1. The median age of patients was 35 years. Five (16.1%) patients required endotracheal intubation; noninvasive oxygen therapy (NIV) was used in 15 (48.4%) patients via nasal tube; and continuous positive airway pressure (CPAP) and pressure support ventilation (PSV) oxygen masks were used in 11 (35.5%) patients. All patients were treated with oseltamivir. Four patients admitted and treated did not survive. Critical illness in the setting of 2009 H1N1 admitted in the ICU predominantly affected young adults. NIV could play a role in treating 2009 influenza H1N1 infection-related hypoxemic respiratory failure that was associated with severe hypoxemia, pneumonia, requirement for prolonged mechanical ventilation, and the frequent use of antiviral therapy.

Contamination of water by bacterial pollution is a serious public health concern and it's so important monitoring of the actual pathogens. The microbiological analysis of water used in four slaughter houses was assessed using standard and contemporaneous microbiological techniques. This study is performed from July to June, 2008-2009, in Microbiological Laboratory, Albania. Values obtain for the bacteriological count show that TBC and TCC in summer were significantly higher than other seasons. Results from the microbiological analysis indicated that all the samples collected were highly contaminated with pathogenic organisms, Escherichia coli having the highest observed prevalence (29%) while Enterobacter aerogenes had the least observed prevalence (2%) among the encountered isolates. Highest mean bacterial count observed during the study was 8,0 x 10 5 CFU/100 ml. Recorded pH and average temperature values ranged between 6.6-7.2 and 18,9 0 C-17,15 0 C respectively.