Prevalence of SARS-CoV-2-specific antibodies in a sample of the Lithuanian population-based study in Spring 2023.

Objectives: Despite positive trends in SARS-CoV-2 epidemiology, seroprevalence surveys remain an important tool for estimating the magnitude of the COVID-19 pandemic. This study aimed to investigate the prevalence of IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins in a sample of the Lithuanian population (N = 517) and evaluate how the pattern of seropositivity correlates with the levels of SARS-CoV-2 infection and vaccination. Methods: Study participants (aged 18-88 years) filled in the questionnaire self-reporting their demographic-social variables, health status, and SARS-CoV-2-related status. The anti-S and anti-N IgG levels were estimated using a microarray ELISA test. Results: After several pandemic waves and vaccination campaign, the seroprevalence of SARS-CoV-2-specific IgG in the analyzed sample was 97.87 % by March-May 2023. We determined the 96.91 % prevalence of anti-S and 58.03 % prevalence of anti-N IgG. The majority of study participants (71.18 %) had hybrid immunity induced by vaccination and SARS-CoV-2 infection. 20.3 % of study participants were anti-N IgG positive without reporting any previous symptoms or a positive SARS-CoV-2 test. A decline of anti-N IgG positivity within 9 months after infection was observed. Conclusions: This study demonstrates high total seroprevalence in March-May 2023 in all age groups indicating a widely established humoral immunity against SARS-CoV-2 in Lithuania.

SARS-CoV-2 Seroprevalence in Lithuania: Results of National Population Survey.

SUMMARY BACKGROUND: Betacoronavirus SARS-CoV-2 has spread in early 2020 worldwide just in several months. The official statistics are consistently collected, but this is mainly based on symptomatic reports. This study was aimed to estimate the seroprevalence of SARS-CoV-2 infection in Lithuanian population. MATERIALS AND METHODS: Study was conducted during August-September 2020 in 6 municipalities of Lithuania. The sample comprised 3087 adult participants from the general population (mean age 53.7 years, 64% female). SARS-CoV-2 antibodies were assessed using AMP IgM/IgG Rapid Test, other data were based on self-report. Seroprevalence was assessed as a crude estimate and as adjusted by sensitivity-specificity of the test. RESULTS: The crude seroprevalence in the total sample was 1.9%, the adjusted - 1.4%, ranging from 0.8% to 2.4% across municipalities. Among seroprevalent cases, 67.2% had IgG, 29.3% had IgM, and 3.5% had both IgG and IgM. An increased risk for seropositive test was observed among people who reported having had close contacts with SARS-CoV-2 positives (OR=5.49, p<0.001). At the borderline significance were female gender (OR=1.75, p=0.082) and non-smoking status (OR=2.95, p=0.072). Among the seropositive participants, 69.0% reported having had no COVID-19 symptoms since 1 March 2020, while 31.0% reported having had at least one of the symptoms. CONCLUSIONS: The SARS-CoV-2 seroprevalence in Lithuanian sample in August-September 2020 was 1.4%, ranging from 0.8% to 2.4% across municipalities. Given the overall official data, by the end of study (11 September 2020) the total COVID-19 rate in Lithuania was 117.5 per 100,000 population or 0.12%. This suggests more than 10 times higher prevalence of virus across the population than the official estimates.

Inequalities in Life Expectancy by Education and Its Changes in Lithuania during 2001-2014.

Background and Objectives: Reduction of health inequalities is a highly important task in public health policies worldwide. In Lithuania, inequalities in life expectancy (LE) by education level are among the greatest, compared to other European countries. However, studies on inequalities in LE by level of education over a long-term period are quite scarce in Lithuania. The aim of the study was to analyze inequalities in life expectancy by education and its changes in Lithuania during 2001-2014. Materials and Methods: Information on deaths (in population aged ≥30 years) was obtained from Statistics Lithuania. Life expectancy at age 30 (LE30) and 95% confidence intervals (CIs) were calculated using life tables. Inequalities in LE30 were assessed using rate differences. Joinpoint regression analysis was used to assess the trends and inequalities of LE30 during 2001-2014. Results: During 2001-2014, LE30 in males and females with post-secondary education was higher than in those with up-to-secondary education (p < 0.05). Among males and females, LE30 increased in both education groups, except for males with up-to-secondary education. Among individuals with post-secondary education, LE30 started increasing earlier and more quickly than in those with up-to-secondary education. Over the analyzed period, greater differences in LE30 between post-secondary and up-to-secondary education groups were found among males. Differences in LE30 due to different educational background were statistically significantly, increasing across the sexes with a more rapid increase for females than for males. During 2001 and 2014, the highest number of years of LE30 lost in both education groups was due to cardiovascular diseases. Conclusions: Throughout the period of 2001-2014, life expectancy in Lithuania in the post-secondary education group was statistically significantly longer and was increasing more rapidly compared to the up-to secondary education group. Inequalities in life expectancy by level of education significantly increased among both males and females.

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.

Background: Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research.

Changes in public attitudes towards confidential adolescent sexual and reproductive health services in Lithuania after the introduction of new legislation: findings from the cross-sectional surveys conducted in 2005 and 2012.

BACKGROUND: In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual and reproductive healthcare (SRH) by comparing data from surveys administered in 2005 and 2012. METHODS: For both surveys, the participants were random samples of the Lithuanian residents aged 16 to 74. A 23-item questionnaire was used in 2005 and complemented with 2 items in 2012. Linear regression analysis was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables. RESULTS: The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005 to 73% in 2012. Regardless of their belief in the importance of confidentiality, in 2012 respondents more often indicated positive outcomes on the relations between the physician and the minor patient, such as increased trust of the adolescent in the physician and more frequent visits to physicians. However, study participants who believed that adolescents would find confidentiality important in 2012 were less optimistic about potential positive outcomes of further legal consolidation of adolescents' right to confidentiality than in 2005. Younger respondents were the most optimistic about potential outcomes if laws were enacted to further protect adolescent confidentiality. CONCLUSIONS: This study uncovers the dynamics of public attitudes towards the socially and ethically sensitive issue of adolescent SRH. Our study suggests that legislation could be a factor prompting changes in public opinion, but not sufficient in and of itself for its social acceptance.

Space weather and human deaths distribution: 25 years' observation (Lithuania, 1989-2013).

BACKGROUND: Human health is affected by space weather component [solar (SA), geomagnetic (GMA), cosmic ray (CRA) - neutrons, space proton flux] activity levels. The aim of this study was to check possible links between timing of human (both genders) monthly deaths distribution and space weather activity. METHODS: Human deaths distribution in the Republic of Lithuania from 1989 to 2013 (25 years, i.e., 300 consecutive months) was studied, which included 1,050,503 deaths (549,764 male, 500,739 female). Pearson correlation coefficients (r) and their probabilities (p) were obtained for years: months 1-12, sunspot number, smoothed sunspot number, solar flux (2800 MGH, 10.7 cm), adjusted solar flux for SA; A, C indices of GMA; neutron activity at the earth's surface (imp/min) for CRA. The cosmophysical data were obtained from space science institutions in the USA, Russia and Finland. The mentioned physical parameters were compared with the total number of deaths, deaths from ischemic heart disease (n=376,074), stroke (n=132,020), non-cardiovascular causes (n=542,409), accidents (n=98,805), traffic accidents (n=21,261), oncology (n=193,017), diabetes mellitus (n=6631) and suicide (n=33,072). RESULTS: Space factors were interrelated as follows for the considered period: CRA was inversely related to SA and GMA, CRA/SA (r=-0.86, p>0.0001), CRA/GMA (r=-0.70, p<0.0001); SA and GMA were correlated (r=0.50, p<0.0001). The total deaths distribution was inversely related to SA (r=-0.31, p<0.0001) and correlated with CRA (neutron) activity (r=0.234, p<0.0001). Ischemic heart disease (IHD) deaths (most at home) show a drop yearly (r=-0.2551), more for men. It was correlated with GMA for the total IHD population and men. Stroke deaths were inversely related to SA (r=-0.38, p<0.0001) and correlated with CRA (r=0.41, p<0.0001) and year (r=0.49, p<0.0001), showing a steady rise. The IHD/stroke deaths ratio was negatively correlated with the years of observation (r=-0.754, p=0.0001). Non-cardiovascular deaths were inversely related to SA (r=-039, p<0.0001) and correlated with CRA (r=0.263, p<0.0001). Oncology deaths that now are dominating in many places were inversely related to SA (r=-0.475, p<0.0001) and correlated with CRA (r=0.426, p<0.0001). Suicide showed a drop with years (r=-0.29, p<0.0001), possibly related to excessive immigration of young population (18-34 years) in the last decade and correlated with two of three GMA indices. Traffic accidents were correlated with SA and GMA (r=0.392-0.461, p<0.0001) and inversely related to CRA (r=-0.436). CONCLUSIONS: Most groups of deaths are related to space weather component activity. Extreme levels of activities of both groups (SA, GMA, and opposite CRA - neutron) are related to some health risks. In the considered period, there were relatively few GMA storms and low GMA was dominating, accompanied by higher CRA (neutron) activity. The ways of action of the components of space weather on the human body need additional studies. There is a special need for the prevention of rising cerebral vascular accidents and oncology malignancies as the causes of death.

Health profile of the urban community members in Lithuania: do socio-demographic factors matter?

BACKGROUND AND OBJECTIVE: Objective of the study was to explore self-perceived health status, health determinants and its associations with socio-demographic factors among urban community members in Lithuania. MATERIALS AND METHODS: Data were obtained from a European survey on urban health, conducted as part of the EURO-URHIS 2 project. The postal questionnaire survey of 3200 adults from Kaunas and Siauliai (Lithuania) was conducted in 2010. A total of 1407 valid questionnaires were analyzed. Statistical analysis was carried out by using SPSS 17.0 inside Complex Sample module that takes design effects into account. RESULTS: Younger respondents (aged 19-64 years) perceived most of the health status indicators better than the older ones (65+ years), while they were less likely to report healthy lifestyle and less often perceived their neighborhood as being socially cohesive than the older ones. Men less frequently experienced psychological problems, indicated regular contacts with friends and/or family and had a greater tendency to be overweighed and obese, daily smokers and drinkers compared to women. Those having secondary or lower educational level perceived most of the health status indicators worse than those with university educational level. Respondents living with a partner less often experienced psychological problems than those living alone. Respondents who indicated having enough money for daily expenses more often perceived their health and health determinants better. CONCLUSIONS: The results of this study demonstrate associations between socio-demographic factors and self-perceived health status, lifestyle and factors of living environment among urban community members in Lithuania.

Preparedness of Lithuanian general practitioners to provide mental healthcare services: a cross-sectional survey.

BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase their involvement in the field. METHODS: In this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services in primary care. RESULTS: The response rate was 52.2%. Three-quarters of the GPs agreed that they feel responsible for the management of mental health problems, but only 8.8% of them agreed that "My knowledge in mental healthcare is sufficient". Psychiatrists were identified as the mental healthcare team specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health services in primary care. Other strategies mentioned were policy level and managerial measures as well as strengthening the teamwork approach in mental healthcare. CONCLUSIONS: This study found a low self-reported competence of GPs in mental healthcare and low collaboration among GPs and other specialists in providing mental healthcare. For the situation to improve in the country, these findings point to a need for strategies to improve GPs' expertise and teamwork in mental healthcare.

Mortality of Lithuanian population over 2 decades of independence: critical points and contribution of major causes of death.

UNLABELLED: The aim of the study was to analyze trends in overall mortality and mortality from major causes of death, detect differences in cut points, and estimate the contribution of the major causes of death to the changes in overall mortality throughout 2 decades of independence in Lithuania (1991-2000 and 2001-2010). MATERIAL AND METHODS: Overall mortality and mortality from cardiovascular diseases, cancer, and external causes were analyzed for the periods of 1991-2000 and 2001-2010. Joinpoint analysis was used to identify the best-fitting points wherever a statistically significant change in mortality occurred, and analysis of components was applied for the assessment of the contribution of major causes of death. RESULTS: The 1991-1994 period was identified as the most negative in terms of increasing mortality from all major causes of death, while the 2007-2010 period was most favorable, when the most significant decline in overall mortality was observed (4.84% per year for males and 4.41% per year for females). External causes contributed most to the growing overall mortality in 1991-1994 both for males and females (37.20% and 25.29%, respectively). Since 2007, all major causes contributed positively to the declining overall mortality of the Lithuanian population. The most significant contribution was made by cardiovascular diseases and external causes. CONCLUSIONS: Despite the considerable transformations of socioeconomic situation and economic crisis, it is likely that Lithuania is entering into the stage of positive health development. For assuring this trend in the future, investments in sustainable health and social developments are inevitable.

Alcohol-related injuries and alcohol control policy in Lithuania: effect of the year of sobriety, 2008.

AIMS: To evaluate the changes in mortality and the years of potential life lost (YPLL) due to alcohol-related injuries, as well as the impact of alcohol-related injuries on life expectancy during the period of the implementation of comprehensive alcohol control policy in Lithuania. METHODS: Data on deaths from injuries (ICD-10 codes V01-Y98) of the able-bodied population (aged 15-64 years) during 2006-2009 were obtained from the Lithuanian Department of Statistics. Age-standardized rates of alcohol-related mortality and YPLL per 100, 000 population due to injuries and the impact of alcohol-related injuries on life expectancy were calculated. The results of forensic autopsies were the basis for the alcohol-attributable fraction. RESULTS: The age-standardized YPLL/100,000 of the able-bodied population due to alcohol-related injuries was 2285.6 (4067.5 for males and 573.6 for females) in 2009. In 2009, YPLL/100,000 due to alcohol-related injuries declined by 16.3%, while due to alcohol-related traffic accidents by 51.2% when compared with 2006. However, YPLL/100, 000 due to alcohol-related suicides increased among males. A 15 to 64-year-old decedent lost an average of 21.2 years of life due to alcohol-related injuries (21.6 years on average per male and 19.1 per female). The impact of alcohol-related injuries on life expectancy decreased from 1.14 years (1.86 for males and 0.34 for females) in 2006 to 0.97 years (1.62 for males and 0.26 for females) in 2009. CONCLUSION: The positive changes in YPLL due to alcohol-related injuries and the impact of alcohol-related injuries on life expectancy indicate successful implementation of evidence-based alcohol control measures.

Evaluation of leadership competencies of executives in Lithuanian public health institutions.

BACKGROUND AND OBJECTIVE. Lithuanian and international public health experts emphasize the importance of leadership in public health. The aim of this study was to explore the self-assessed level of leadership competencies of executives in Lithuanian public health institutions. MATERIAL AND METHODS. Data were collected in a cross-sectional survey of executives of Lithuanian public health institutions in 2010. The total number of returned questionnaires was 55 (response rate, 58.5%). Respondents were asked about their competencies in leadership, teamwork, communication, and conflict management. The evaluation was carried out by analyzing the answers provided in the survey, which used a 5-point rating scale. In addition, the Belbin Team-Role Self-Perception Inventory and the Thomas-Kilmann Conflict Mode Instrument were used. RESULTS. The results showed that respondents were reserved or limited in their individual capacities through this evaluation of their leadership competencies. The mean score was 3.47 (SD, 0.71). Skills in competency areas of communication, teamwork, and conflict management were scored higher (3.73 [SD, 0.67], 3.73 [SD, 0.62], and 3.53 [SD, 0.63], respectively). Most of executives preferred to choose action-oriented roles (76.2%). The most common role was "implementer" (69.1%). "Avoiding" (52.7%) was the most common conflict solving strategy. The results showed that 89.1% of executives wanted to improve teamwork; 83.6%, leadership competencies; 81.8%, communication; and 80.0%, conflict management. CONCLUSIONS. The study results suggest that the executives of Lithuanian public health institutions evaluate their leadership competencies moderately. These results indicate the value of leadership training for public health executives.

Trends in avoidable mortality in Lithuania during 2001-2008 and their impact on life expectancy.

UNLABELLED: The process of the restructuring of health care system in Lithuania demonstrates the need to continue the monitoring of changes in avoidable mortality. OBJECTIVE: To assess the level of avoidable mortality as well as its changes over time in Lithuania during 2001-2008 and to define the impact of avoidable mortality on life expectancy. MATERIAL AND METHODS: The mortality data were taken from the Lithuanian Department of Statistics. Twelve avoidable causes of deaths (treatable and preventable) were analyzed. Mortality trends were assessed by computing the average annual percent change (AAPC). The shortening of average life expectancy was computed from survival tables. RESULTS: During the period 2001-2008, the avoidable mortality was increasing more significantly (AAPC 3.0%, P<0.05) than the overall mortality (AAPC 1.7%, P<0.05) in the population aged 5-64 years. The increasing trend was mainly determined by mortality from preventable diseases (AAPC 4.6%, P<0.05). The avoidable causes of death reduced the life expectancy by 1.77 years (preventable by 1.12 and treatable by 0.63 years). Diversity in trends in mortality of different avoidable causes was disclosed. A declining trend in mortality caused by chronic rheumatic heart disease and lung cancer was observed for males (AAPC -22.6% and -2.1%, respectively; P<0.05). However, the mortality caused by liver cirrhosis was increasing for both genders (AAPC 16.1% for males and 17.6% for females, P<0.01) and that caused by tuberculosis - only for females (AAPC 7.8%, P<0.05). CONCLUSIONS: An increasing trend in avoidable mortality was observed. Deaths caused by the diseases that could have been prevented had the greatest impact on the increasing mortality and decreasing life expectancy.