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Parker R.D.,University of South Carolina | Ruutel K.,National Institute for Health Development
AIDS and Behavior | Year: 2011

Estonia has the second highest adult HIV prevalence in Europe of 1.3%. The primary transmission is among injecting drug users (IDU), who account for 56-90% of HIV infections (Report on the Global AIDS Epidemic: UNAIDS/WHO, July 2008 and Platt et al. AIDS 20(16):2120-2123, 2006). Of those persons newly diagnosed, 50.4% reported injecting drugs in the last 12 months, 16.3% of these reported IDU as the sole risk factor and 31.2% reported IDU among other risk factors. In this sample (n = 790) 170 persons reported a high risk behavior and 51 persons received a positive result through rapid testing. The largest proportion (35.29%) was among persons reporting high risk heterosexual intercourse and second (33.33%) among persons sharing injecting equipment. Covariates in a logistic regression model indicate that male sex (OR = 2.57, 95% CI 1.00-6.59), non-Estonian ethnicity (OR = 2.68, 95% CI 1.46-4.93), higher education (OR = 0.56, 95% CI 0.40-0.80), and high risk heterosexual intercourse (OR = 2.68, 95% CI 1.19-6.02) are statistically significant in predicting a positive HIV status. © 2010 Springer Science+Business Media, LLC.

Denissov G.,National Institute for Health Development
Scandinavian Journal of Public Health | Year: 2015

Aims and methods: Being easily available and having good coverage and comparability, official mortality statistics are used very widely. This in turn is because the definitions of mortality and methods of pertinent data collection are coordinated worldwide by the World Health Organization. In Estonia, registered cerebrovascular mortality has dropped 50% since 2000. A less dramatic decrease has been observed in nearly all EU Member States. To find out if this development can be explained by changing certification and coding practices, we counted all mentions of cerebrovascular diseases in the Estonian Causes of Death Registry database between 2004 and 2013 and analyzed the selection of the underlying cause of death. Results: We found that the sharp decrease in registered cerebrovascular mortality was by a half due to an increased selection of hypertension as the underlying cause of death. In cases where a cerebrovascular disease was mentioned and selected the underlying cause of death, the mean number of diagnoses per record was 2.45, in cases where a cerebrovascular disease was mentioned, but hypertension selected the underlying cause of death, the mean number of diagnoses was 3.15. Conclusions: The choice of the underlying cause of death registered in official statistics depends on the level of details provided in a death certificate, as well as updates to coding rules and use of modern quality assurance instruments in data production. © Associations of Public Health in the Nordic Countries Regions.

Littvay L.,Central European University | Metneki J.,National Institute for Health Development | Tarnoki A.D.,Semmelweis University | Tarnoki D.L.,Semmelweis University
Twin Research and Human Genetics | Year: 2013

The first Hungarian Twin Registry was established in Budapest in 1970 through the mandatory reporting of multiple-births. In the 1980s a second, volunteer adult registry was also founded. Unfortunately, both registries ceased to exist in the 1990s. Efforts started in 2006 to revive a Hungarian twin registry. The team spearheading this effort reports here on this progress. Currently, the voluntary Hungarian Twin Registry consists of 310 adult twin pairs and multiplets. Current research focuses on cardiovascular and respiratory health and yielded multiple awards and publications. Efforts are on the way to expand into social, psychological, and obesity studies. Copyright © The Authors 2012.

Liivlaid H.,National Institute for Health Development | Uuskula A.,University of Tartu
Sexually Transmitted Infections | Year: 2013

Objective To describe and compare sexual behaviour patterns in 1996 (before the explosion of the HIV epidemic in 2000) and 2006, and the correlates of highrisk sexual behaviour in Estonia. Methods Data on selected sexual behaviour characteristics were obtained by interviewing a probability sample of the adult population in Estonia in 1996 and 2006. Results Data were available from 2441 sexually experienced women and 1994 men, and 3005 women and 2812 men in the year 2006. There were no changes in the proportion of sexually experienced adults, frequency of intercourse, or same gender sexual relationships. There was an increase in sex under the age of 16 (women: 8.4% vs 14.1% adjusted OR (AOR) 2.05 (1.67 to 2.53); men: 21.9% vs 28.0% AOR 1.58 (1.35 to 1.84)). From 1996 to 2006, the proportion reporting intercourse with a casual partner in the previous 12 months decreased significantly for women (10.7% vs 6.0% AOR 0.54 (95% CI 0.41 to 0.72)) and men, (24.0% vs 16.5% AOR 0.71 (0.59 to 0.85)) in parallel with a decrease in those reporting never using condoms during intercourse with a casual partner (for women: 49.3% vs 19.2% AOR 0.27 (0.14 to 0.51); and men: 35.4% vs 20.2% AOR 0.37 (0.25 to 0.56)). In 2006, the odds for not always using condoms in intercourse with casual partners increased significantly with age (eg, ≤24 vs ≥45: AOR 3.46 (1.68 to 7.13)), and were higher among those widowed/divorced/separated (AOR 2.35 (CI 1.20 to 4.60)). Conclusions From 1996 to 2006, a significant reduction in high-risk sexual behaviour has occurred in Estonia across all age groups and genders.

Pettersson J.H.-O.,Uppsala University | Golovljova I.,National Institute for Health Development | Vene S.,Public Health Agency of Sweden | Jaenson T.G.T.,Uppsala University
Parasites and Vectors | Year: 2014

Background: In northern Europe, the tick-borne encephalitis virus (TBEV) of the European subtype is usually transmitted to humans by the common tick Ixodes ricinus. The aims of the present study are (i) to obtain up-to-date information on the TBEV prevalence in host-seeking I. ricinus in southern and central Sweden; (ii) to compile and review all relevant published records on the prevalence of TBEV in ticks in northern Europe; and (iii) to analyse and try to explain how the TBE virus can be maintained in natural foci despite an apparently low TBEV infection prevalence in the vector population. Methods. To estimate the mean minimum infection rate (MIR) of TBEV in I. ricinus in northern Europe (i.e. Denmark, Norway, Sweden and Finland) we reviewed all published TBEV prevalence data for host-seeking I. ricinus collected during 1958-2011. Moreover, we collected 2,074 nymphs and 906 adults of I. ricinus from 29 localities in Sweden during 2008. These ticks were screened for TBEV by RT-PCR. Results: The MIR for TBEV in nymphal and adult I. ricinus was 0.28% for northern Europe and 0.23% for southern Sweden. The infection prevalence of TBEV was significantly lower in nymphs (0.10%) than in adult ticks (0.55%). At a well-known TBEV-endemic locality, Torö island south-east of Stockholm, the TBEV prevalence (MIR) was 0.51% in nymphs and 4.48% in adults of I. ricinus. Conclusions: If the ratio of nymphs to adult ticks in the TBEV-analysed sample differs from that in the I. ricinus population in the field, the MIR obtained will not necessarily reflect the TBEV prevalence in the field. The relatively low TBEV prevalence in the potential vector population recorded in most studies may partly be due to: (i) inclusion of uninfected ticks from the 'uninfected areas' surrounding the TBEV endemic foci; (ii) inclusion of an unrepresentative, too large proportion of immature ticks, compared to adult ticks, in the analysed tick pools; and (iii) shortcomings in the laboratory techniques used to detect the virus that may be present in a very low concentration or undetectable state in ticks which have not recently fed. © 2014 Pettersson et al.; licensee BioMed Central Ltd.

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