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At least 73 records · Page 4Linked to original sources
PubMed2001

Perinatal deaths and insufficient antenatal care in Latvia.

OBJECTIVE: A national audit on perinatal deaths was performed to assess the quality of antenatal care, and to suggest measures for improved antenatal care. MATERIAL AND METHODS: Medical records of all the perinatal deaths in Latvia in the years 1995-1996 have been studied. Non-attenders and attenders of antenatal care were characterized by socio-economic and medical variables: maternal age, parity, history of perinatal outcome, health status and behavioral hazards during the index pregnancy, length of gestation and birth weight. The Nordic-Baltic perinatal death classification was used. RESULTS: In 85 of 442 cases (19%) of perinatal deaths women had not taken advantage of antenatal care provided for them. Non-attenders were more likely to be smokers (p<0.001) and alcohol abusers (p<0.005), above 35 years of age (p<0.005), and had higher parity (p<0.001). Non-attenders more often had systemic diseases and pregnancy complications. Neonatal complications, such as congenital syphilis (p<0.05) and other infections (p<0.05), were more common among non-attenders. There was no difference in rates of preterm birth and low birth weight between attenders and non-attenders. CONCLUSIONS: One fifth of mothers with perinatal death did not attend ANC, and in some women who attended ANC, lack of intervention was related to the perinatal death.

Adult↗
PubMed2004

Prevalence and control of hypertension in Latvia.

The analysis of four epidemiological Data bases (Dbases)-randomized populations of Latvia (country), Riga (city), Kuldiga (countryside) and Dbase of WHO questionnaire 'Hypertension and control' is presented. Extremely high prevalence of arterial hypertension (AH) is demonstrated in three samples of population. Close relationship between overweight and AH, hypercholesterol and AH in city and village population is shown. Our research provides the data about the relationship between the prevalence of AH and socioeconomic factors (education, income per capita, marital status and occupation) as well. The analyses of blood pressure (BP) measurement rate in population reveals it to be unacceptably low. Most widely prescribed antihypertensive drugs are diuretics and ACEIs. The analysis of drug intake demonstrates the low rate of regular pharmacological treatment. An opinion of physicians on drug intake pattern of their patients is far from reality. Only 17.5% of hypertensives among those with drug intake have their target BP <140/90 mmHg.

Antihypertensive Agents↗
PubMed2002

Aneurysmal subarachnoid hemorrhage in Baltic population: experience from Latvia (1996-2000).

Better knowledge of clinical epidemiology and course of aneurysmal subarachnoid hemorrhage (ASAH) is essential for dedicated planning of the need for services. The aim of the study was to obtain a picture of epidemiology and clinical course of ASAH in Riga City (the capital of Latvia). A retrospective population-based study included residents of Riga City who suffered their first ASAH during a 5-year period from the beginning of 1996 till the end of 2000. The total number of ASAH events in the population during the study period was 292, of which 56 (19%) were fatal before reaching the hospital. There was no significant difference between age-specific incidence rates in men and women. The mean ASAH rates per 100 000 per year were 10.3 for age-adjusted incidence (in the population aged 20-79 years) and 7.2 for crude incidence. The mean age-adjusted case fatality rates were 57% for all ASAH events and 45% for those who survived admission. Our data suggest that incidence of ASAH in Baltic population can be recognized as average compared with other European regions. However, the case fatality rate of ASAH in the study population was higher than those of SAH reported from MONICA Collaborating Centers.

Adolescent↗
PubMed2000

Confidentiality and disclosure of HIV infection: HIV-positive persons' experience with HIV testing and coping with HIV infection in Latvia.

The objective of the study was to explore retrospectively HIV-infected individuals' experience with HIV testing, counselling and the issue of confidentiality in the Latvian context. A qualitative study using grounded theory approach and based on semi-structured in-depth interviews was implemented. Thirteen HIV-positive individuals above 18 were selected, using purposeful sampling, from the 63 HIV-positive individuals registered in Latvia between 1987 and 1997. HIV-infected people are worried that doctors sometimes disrespect confidentiality. Confidentiality was found to be a basic prerequisite for building trusting relationships between an HIV-infected individual and a doctor within the counselling process from the first visit to follow-up counselling and as one of the most important factors of the formation and proper functioning of the physician-patient relationship. Trusting relationships will not be established in situations when an HIV-infected individual is not seen by a doctor as a human being with needs, worries and without understanding his or her situation. Breaches of confidentiality should be seen as shortsighted and can diminish the public's trust in physicians. Counselling should be sensitive to the cultural, historical traditions and prevailing public health practices, social values and political differences in attitude toward the importance of treating someone as a private individual.

AIDS Serodiagnosis↗
PubMed2000

Diphtheria in Latvia, 1986-1996.

After nearly two decades without a diphtheria case in Latvia, the disease reappeared in 1986. From 1990 to 1996, case counts were highest among adults 40-49 years of age, school-aged children, and adolescents. Nonetheless, the average annualized incidence of disease was highest among infants and preschoolers. In August 1995, mass vaccination efforts began to provide adults 25-60 years of age with at least one dose of vaccine. By the end of the year, a 77% coverage rate was achieved, resulting in a decrease of reported diphtheria cases by 1996. From February to September 1997, special outreach efforts were focused on hard-to-reach populations; as a result, by June 1997, 55% of adults had received three doses of vaccine. While decreases in the incidence of and morbidity from diphtheria have occurred, additional efforts still need to be concentrated on improving vaccination coverage in adults and children <2 years of age and in reducing mortality from diphtheria.

Adolescent↗
PubMed2004

Rapid epidemic spread of HIV type 1 subtype A1 among intravenous drug users in Latvia and slower spread of subtype B among other risk groups.

To investigate the rapid HIV epidemic in Latvia, 97 newly detected individuals were sampled in 2000-2001. To establish the molecular epidemiology we sequenced the env V3 and gag p17 regions of the HIV genome and compared them with reference sequences using phylogenetic analyses. As expected, the vast majority (n = 88; 91%) were intravenous drug users (IDUs) from the Riga region. Also, the majority of the investigated individuals (n = 93; 96%) were found to carry a subtype A1 virus that may have entered the Latvian IDU population several times. In addition, one IDU was infected with CRF03_AB and three other individuals, who had been infected through sexual contacts, carried subtype B virus. Thus, subtype A1 dominates the Latvian epidemic and is strongly associated with the IDU risk group. Although some spread of subtype A1 has occurred in the heterosexual group, subtype B dominates among homosexually and heterosexually infected individuals.

Disease Outbreaks↗
PubMed2003

Rabies in wildlife in Latvia.

In the Baltic States, lyssaviruses are often detected in wildlife and presumed to constitute an important public health hazard. In order to decrease rabies incidence and eradicate wildlife reservoirs, a national rabies eradication program has been in place. Since 1970 a vaccination program in dogs and cats has been executed, and in 1991 oral vaccination of foxes was started. However, due to an insufficient budget, the latter was not done regularly and nationwide before 2000. Now, the program in force consists of compulsory vaccination of all dogs and cats, and a tetracycline marker vaccine oral vaccination program of foxes in the whole country. In 2001, 151 of 285 (53%) fox jaws were tested positive for tetracycline. All animals showing rabies-like symptoms were killed and tested for rabies. In this way, 250-400 cases of rabies per year were diagnosed in wildlife. To molecularly characterize the prevalent lyssaviruses in wildlife, lyssavirus RNA of 25 recent rabies positive samples, collected in the year 1999, was amplified by RT-PCR. Direct sequencing of the RT-PCR-amplified products of the virus' nucleoprotein encoding region and subsequent sequence analyses resulted in a 99.3-100% homology between isolates and a 99.0-100% similarity with a 1995 genotype I, classical rabies virus (RABV) raccoon dog isolate from Estonia. These results confirmed that RABV is endemic in wildlife in Latvia and should be considered a serious public health threat. To successfully eradicate the wildlife reservoirs, the national rabies eradication program must be continued, and it may need to be intensified.

Animals↗
PubMed2004

Association between health behaviour and self-reported health in Estonia, Finland, Latvia and Lithuania.

BACKGROUND: The aim of the present study is to examine the associations of the selected health behaviours (daily smoking, frequent strong alcohol use, consumption of fresh vegetables less than 3 days a week and leisure time physical activity less than two/three times a week) to the self-assessed health after adjustment to the age and education in Estonia, Finland, Latvia and Lithuania. METHODS: Data from cross-sectional surveys carried out in all the above-mentioned countries were used. The methodology and questionnaires of the surveys were standardized between the participating countries within the Finbalt Health Monitor System. Logistic regression was used to assess the effect of self-perceived health status on prevalence of health behaviours. RESULTS: In Finland both women and men rated their health better than both genders in all the Baltic countries. In Finland self-assessment of health is significantly associated with most health behaviours, but in the Baltic counties the associations are weak or unstable. CONCLUSION: The results suggest that in Finland as in many other stable countries self-assessed health status was related to health behaviours and can be used as an indicator of health behaviours. In the Baltic countries, factors other than health behaviours may be more relevant to the self assessment of health status.

Adult↗
PubMed1998

CTX-M-5, a novel cefotaxime-hydrolyzing beta-lactamase from an outbreak of Salmonella typhimurium in Latvia.

At a children's hospital in Riga, Latvia, isolates identified as Salmonella typhimurium were found to be resistant to expanded-spectrum cephalosporins. Two of the resistant strains were analyzed for the mechanism of cephalosporin resistance. Isoelectric focusing revealed a common beta-lactamase with a pI of 8.8. In addition, one of the strains produced a pI 7.6 beta-lactamase. A transconjugant producing only the pI 7.6 enzyme was susceptible to expanded-spectrum cephalosporins; therefore, this enzyme was most likely SHV-1. Transformants producing only the pI 8.8 beta-lactamase were resistant to cefotaxime and aztreonam but were susceptible or intermediate to ceftazidime. A substrate profile determined spectrophotometrically with purified enzyme revealed potent activity against cefotaxime, with a relative kcat value of 95 (benzylpenicillin equal to 100). The enzyme showed lower relative kcat values for ceftazidime (3.3) and aztreonam (9.3). In addition, the enzyme was inhibited by clavulanate, sulbactam and tazobactam, with 50% inhibitory concentrations of 19, 100, and 3.4 nM, respectively. These results indicated the presence of an unusual extended-spectrum beta-lactamase. The gene expressing the pI 8.8 beta-lactamase was cloned. Nucleotide sequencing revealed a beta-lactamase gene that differs from the gene encoding CTX-M-2, which also originated from S. typhimurium, by 11 nucleotides, 4 of which result in amino acid substitutions: Ala27Thr, Val230Gly, Glu254Ala, and Ile278Val. These results indicated the presence of a novel extended-spectrum beta-lactamase, designated CTX-M-5, that specifically confers resistance to cefotaxime.

Amino Acid Sequence↗
PubMed2002

Mutations in the rpoB and katG genes leading to drug resistance in Mycobacterium tuberculosis in Latvia.

To characterize the genetic basis of drug resistance in Mycobacterium tuberculosis in Latvia, mutations involved in rifampin (rpoB gene) and isoniazid (katG gene) resistance in DNA from 19 drug-susceptible and 51 multidrug-resistant M. tuberculosis complex isolates were analyzed. The most frequent rpoB gene mutations found by the Line Probe assay were the S531L (14 of 34 isolates), D516V (7 of 34), H526D (4 of 34), and D516Y plus P535S (4 of 34) mutations. Direct sequencing of seven isolates with unclear results from Line Probe assay showed the presence of the L533P mutation and the Q510H plus H526Y (1 of 34) and D516V plus P535S (4 of 34) double mutations, neither of which has been described previously. Single-strand conformation polymorphism analysis showed strand mobility differences between the rifampin-susceptible and -resistant samples for the D516V, H526D, and D516Y plus P535S mutations but not for the S531L mutation. Nucleotide substitution at codon 315 (AGC-->ACC) of the katG gene was found in 48 of 51 multidrug-resistant samples by sequencing. Furthermore, katG gene restriction fragment length polymorphism analysis with endonuclease AciI confirmed the nucleotide change in codon 315.

Antitubercular Agents↗
PubMed2002

Drugs in the postsocialist transitions of Estonia, Latvia, Lithuania and Poland.

The article discusses problems related to illicit drugs in Poland, Lithuania, Latvia and Estonia against the background of the postsocialist transitions of the 1990s. Besides the drug problem, the political and market reforms of the 1990s were accompanied by a surfacing of a variety of social problems, some of which had already been present during the authoritarian socialist regimes. Gaining reliable and comparable statistics on drug-related harm has become very difficult due to changes in treatment system and health statistics. Nevertheless, all available evidence suggests that the use of illicit drugs has grown rapidly in all four countries, it now being close to the Western European level. As a result of international impulses rather than domestic interest, strictly restrictive drug policies have been adopted. Drug problems are aggravated by a marginalisation of a large part of the populations. Accordingly, their reduction may require a more general revision of the four countries' economic and social policies.

Estonia↗
PubMed1993

Morbidity and mortality in Estonia, Latvia and Lithuania in the 1980's.

The purpose of the present study was to examine the general morbidity and mortality rates in the three Baltic republics--Estonia, Latvia and Lithuania during a decade before the collapse of the Soviet Union. Official statistical data were used to compare morbidity and mortality rates. A method of standardization and life table functions were employed. Soviet morbidity statistics were predominantly descriptive, and based mainly on crude rates registered cases of illness during a year per 100,000 population. The death rates during the Soviet period are a better indicator of the health of the populations than more specific health indicators. A general deterioration of the ecological, social and economic situation in the Baltic republics at the end of the 1980s and early 1990s may have resulted in the mortality rising and aborted any trends to increasing life expectancy in the next few years thus requiring more radical reforms in health and social policy. The study demonstrates a noticeable difference in mortality rates between demographic and socio-economic groups in the Baltic states.

Absenteeism↗
PubMed2005

Ethnic intermarriage in times of social change: the case of Latvia.

We gain insight into the dynamics of ethnic intermarriage in times of social change by studying marriages between Latvians and Russians (including Belarussians and Ukrainians) that occurred in Latvia before and after independence from the Soviet Union. Before independence, ethnic intermarriage was already rather common, involving about 17% of the marriages annually. Since independence, intermarriage between Russians and Latvians has increased substantially. Part of this increase can be explained by selective emigration, but at least half of it may be due to integrative processes. Although there were more marriages between Russian men and Latvian women before independence, the gender pattern reversed after independence. Intermarriage levels were the highest among the less educated, children of mixed couples, partners with similar educational levels, and people in the countryside.

Adult↗
PubMed2005

Multidrug-resistant tuberculosis detection, Latvia.

To improve multidrug-resistant tuberculosis (MDR-TB) detection, we successfully introduced the rpoB gene mutation line probe assay into the national laboratory in Latvia, a country with epidemic MDR-TB. The assay detected rifampin resistance with 91% sensitivity and 96% specificity within 1 to 5 days (vs. 12-47 days for BACTEC).

Antitubercular Agents↗
PubMed2001

Emergency child mental health services in Latvia.

This paper describes emergency child mental health services in Latvia. The paper defines child mental health emergency and outlines which professionals are involved in evaluation and where evaluations occur. The described follow-up services are only now developing, with the majority of children still receiving minimal mental health services in shelters or detention centers. Recommendations for more training of professionals, specific protocols and an integrated system of care are made.

Adolescent↗
PubMed2002

[Occupational medicine in Latvia].

New system of occupational medicine in Latvia is under development already for 10 years. The biggest efforts have been invested in creation of legal basis harmonized to the legislation of EU and extensive training of specialists. The State Labour Inspectorate was established, the Institute of Occupational and Environmental Health and other medical institutions have been reorganised. A new system of information is under construction; as well as new hygienic standards are being elaborated.

Adult↗
PubMed2006

Healthcare associated infections in university hospitals in Latvia, Lithuania and Sweden: a simple protocol for quality assessment.

Surveillance of healthcare associated infections is an overlooked parameter of good clinical practice in most healthcare institutions, due to the workload demanded in the absence of adequate IT-systems. The aim of the present study was to investigate whether a simple protocol could be used to estimate the burden of healthcare associated infections in three university hospitals in Huddinge in Sweden, Riga in Latvia and Vilnius in Lithuania and form the basis for initiating a long term follow up system. The medical records of all patients receiving antibiotics were reviewed according to a standardised protocol, focusing on the indications for the drugs and on the frequency of hospital acquired infection (HAI) in a point-prevalence survey. Only comparable specialties were included. The proportion of patients treated with antibiotics (prophylaxis not included) were 63/280 (22%) in Huddinge, 73/649 (11%) in Riga and 99/682 (15%) in Vilnius. The proportion of admitted patients treated for a HAI were 15%, 3% and 4%, respectively, (both comparisons Huddinge versus other centres P <0.001). Surgical site infections were most common, followed by infections with an onset more than 2 days after admission without any of the other registered risk factors present. Our inexpensive and simple method showed that healthcare associated infections were a significant problem among patients admitted to Huddinge. The figures obtained can be used for further discussion and form a baseline for follow up at the local level. The comparison of figures between centres was far less relevant than the process the study created.

Anti-Bacterial Agents↗