The Prevalence of High-Risk Human Papillomavirus in Hungary-A Geographically Representative, Cross-Sectional Study.

Background: The estimated age-standardized incidence and mortality rates of cervical cancer in Hungary are substantially higher than the European average. In many countries, human papillomavirus (HPV) testing is the first-line method of cervical cancer screening in women >30 years. According to the European guidelines, evidence-based improvement of a national prevention strategy requires the monitoring of representative data. Methods: ThinPrep cervical samples were collected over a period of 8 months at 84 sampling sites, including 4,000 eligible samples with valid laboratory results from the screening target population of females aged 25-65 years, with addresses in the representative geographic area (19 counties and four major settlement types). Genotyping of high-risk HPV (hrHPV) was performed using the Confidence HPV-X (Neumann Diagnostics) and Linear Array HPV Genotyping (Roche) tests. Demographic data were collected using a questionnaire, enabling the analysis of hrHPV genotype distribution by age, geography, education, and HPV vaccination. Results: Overall, 446 samples were hrHPV-positive, showing a prevalence of 11.15% (9.73% age-representative), similar to the world average, higher than the European average, and lower than the Eastern-European average. After age standardization, no significant geographic differences were found, except for low hrHPV prevalence in villages (p = 0.036) and in those with elementary education (p = 0.013). Following genotypes 16 and 31, in order of frequency, certain non-vaccine hrHPV genotypes (HPV51, 66, 56) showed unexpectedly higher prevalence than international data. Conclusion: Our study provides the first geographically representative genotype-specific hrHPV prevalence baseline database in Hungary to support policy-making efforts. Significant correlations with demographic data have transferable conclusions.

[Regional inequalities of health status of pregnant women in Hungary - Long-term series analysis]. / Területi egyenlotlenségek hosszú idosoros elemzése a várandós nok egészségi állapotát vizsgálva.

INTRODUCTION: Monitoring the health status of populations is essential for good health policy decisions. This is particularly true in maternal and child health where targeted and timely interventions may have long-term consequences. AIM: Our objective was to describe changes in the health status of pregnant women at the national and county level during the period of 1997-2012. METHOD: Data were extracted from the mandatory annual reports of district nurses responsible for primary maternal care. Information on the smoking status of expecting mothers, special care during pregnancy, pregnant women entering into maternity care after 28 weeks of pregnancy, borne woman without district nurse care were analysed using Microsoft Excel and STATA 13.0. RESULTS: The mean prevalence of smoking was 13.8% among pregnant women during the investigation period. The ratio of smoking pregnant women was higher (p<0.01) in Borsod-Abaúj-Zemplén, Nógrád, Heves, Szabolcs-Szatmár-Bereg, and Somogy counties. The ratio of pregnants requiring special care was higher (p<0.01) than the national average in Somogy, Szabolcs-Szatmár-Bereg, Borsod-Abaúj-Zemplén and Nógrád counties. More, than 1% of the pregnant women entered into care only after the 28th week of the pregnancy. Women who were registered by district nurses and gave birth less than 1% did not participate in pregnant nursing. CONCLUSION: National data hide significant regional disparities within the country which should be amended by targeted interventions, taking into account the large regional inequalities in the country. Orv Hetil. 2017; 158(29): 1131-1142.

Distribution Characteristics and Combined Effect of Polymorphisms Affecting Alcohol Consumption Behaviour in the Hungarian General and Roma Populations.

AIMS: Harmful alcohol drinking habits, even among Roma children and adolescents, are more common than in the majority population. The aim of the study was to evaluate the genetic susceptibility of Roma to hazardous alcohol consumption compared to the Hungarian general population. METHODS: A total of 1273 samples from the population of segregated Hungarian Roma colonies and 2967 samples from the Hungarian general population were genotyped for 25 polymorphisms. Differences in genotype and allele distributions were investigated. Genetic risk scores (GRS) were generated to estimate the joint effect of individual single-nucleotide polymorphisms (SNPs). After unweighted and weighted GRS were calculated the distribution of scores in study populations was compared. RESULTS: The allele frequencies differed significantly between the study populations for 17 SNPs (P < 0.002), but the genetic alterations that predispose to or protect against harmful alcohol consumption were not overrepresented in the Roma population. The distribution of unweighted GRS in Roma population was left shifted compared to general population (P = 0.0013). The median weighted genetic risk score was lower among the subjects of Roma population compared to the subjects of general population (0.53 vs 0.65, P = 3.33 × 10-27) even after adjustment for confounding factors. CONCLUSIONS: Differences in alcohol consumption habits between the Hungarian Roma and Hungarian general populations do not appear to be linked to genetic constitution, this behaviour may occur as a result of different cultural values and environmental exposures. Population-based measures to tackle the fundamental drivers of consumption, which take account of cultural acceptability, are needed to reduce harmful alcohol consumption in the Roma population.

High Prevalence of Smoking in the Roma Population Seems to Have No Genetic Background.

INTRODUCTION: The prevalence of smoking in Romani of both genders is significantly higher than in the general population. Our aim was to determine whether a genetic susceptibility contributes to the high prevalence of smoking among Roma in a study based on data collected from cross-sectional surveys. METHODS: Twenty single nucleotide polymorphisms known to be closely related to smoking behavior were investigated in DNA samples of Hungarian Roma (N = 1273) and general (N = 2388) populations. Differences in genotype and allele distribution were investigated. Genetic risk scores (GRSs) were generated to estimate the joint effect of single nucleotide polymorphisms in genes COMT, CHRNA3/4/5, CYP2A6, CTNNA3, DRD2, MAOA, KCNJ6, AGPHD1, ANKK1, TRPC7, GABRA4, and NRXN1. The distribution of scores in study populations was compared. Age, gender, and body mass index were considered as confounding factors. RESULTS: Difference in allele frequencies between the study populations remained significant for 16 polymorphisms after multiple test correction (p < .003). Unexpectedly, the susceptible alleles were more common in the general population, although the protective alleles were more prevalent among Roma. The distribution of unweighted GRS in Roma population was left shifted compared to general population (p < .001). Furthermore, the median weighted GRS was lower among the subjects of Roma population compared to the subjects of general population (p < .001) even after adjustment for confounding factors. CONCLUSIONS: The harmful smoking behavior of the Roma population could not be accounted for by genetic susceptibility; therefore, interventions aimed at smoking prevention and cessation should focus on cultural and environmental factors. IMPLICATIONS: This is the first study designed to determine whether genetic background exists behind the harmful behavior of the smoking of the Roma population. Although the frequencies of susceptible and protective alleles strongly differ between the Hungarian Roma and general populations, it is shown that calculated GRSs being significantly higher in the general population, which do not support the hypothesis on the genetic susceptibility of the Roma population. Interventions aimed at smoking cessation in the Roma population should preferentially target cultural and environmental factors.

Prevalence of metabolic syndrome among Roma: a comparative health examination survey in Hungary.

OBJECTIVES: The objective of our study was to compare the health status of the Roma people with that of the general population in Hungary. METHODS: A health examination survey to define the prevalence of metabolic syndrome and its components was performed in a representative random sample (n = 646) of the Roma population aged 20-64 years living in segregated colonies, and data were compared with that obtained in a representative random sample (n = 1819) of the Hungarian population. RESULTS: The risks for central obesity, hypertension and raised triglyceride level among Roma adults were not different from the Hungarian references, while raised fasting plasma glucose or known type 2 diabetes mellitus (OR = 2.65, 95%CI 1.90-3.69), reduced HDL cholesterol level or treated lipid disorder (OR = 2.15, 95%CI 1.65-2.79) were significantly more frequent in all age groups in the Roma sample. The prevalence of metabolic syndrome (OR = 1.37, 95%CI 1.03-1.83) was also significantly higher among Roma than in the general Hungarian population. CONCLUSIONS: Besides tackling the socio-economic determinants of the poor health of Roma people, specific public health interventions considering increased genetic susceptibility to metabolic disturbances are needed to improve their health status.