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Arghittu A, Castiglia P, Dettori M. Family Medicine and Primary Healthcare: The Past, Present and Future. Healthcare (Basel) 2023; 11:2128. [PMID: 37570369 PMCID: PMC10418407 DOI: 10.3390/healthcare11152128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
As defined by the World Health Organisation in the conference held in Alma Ata, Kazakhstan, in 1978, "Primary health care is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination" [...].
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Affiliation(s)
- Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.A.); (P.C.)
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.A.); (P.C.)
- University Hospital of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.A.); (P.C.)
- University Hospital of Sassari, 07100 Sassari, Italy
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
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Arghittu A, Dettori M, Castiglia P. First Year of Special Issue "New Insights in Vaccination and Public Health": Opinions and Considerations. Vaccines (Basel) 2023; 11:600. [PMID: 36992184 PMCID: PMC10058197 DOI: 10.3390/vaccines11030600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023] Open
Abstract
Disease prevention and control is the foundation of public health [...].
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Affiliation(s)
- Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- University Hospital of Sassari, 07100 Sassari, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- University Hospital of Sassari, 07100 Sassari, Italy
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Ahmad H, Sanef SA, Shahabudin WZ, Mohtar N, Hassan MR, Jeffree MS, Lukman KA, Ghazi HF, Syed Abdul Rahim SS. Socioecological Challenges of Polio Supplementary Immunization Activities (SIAs) in the Asia-Pacific Region: A Systematic Review. J Environ Public Health 2023; 2023:4801424. [PMID: 36747498 DOI: 10.1155/2023/4801424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/29/2023]
Abstract
Background Polio supplementary immunization activities (SIAs) are one of the polio eradication pillars in the Global Polio Eradication Initiative (GPEI) that increased the immunization coverage and made progress towards polio eradication. However, socioecological challenges faced during SIAs contribute to suboptimal campaign quality. The aim of this review is to identify the reported challenges during polio supplementary immunization activities (SIAs) and associated improvement strategies based on the socioecological model (SEM). Methods Articles were searched from three databases which were WOS, Scopus, and PubMed. The systemic review identified the primary articles related to SIA that focused on the impact of immunization coverage, challenges, and improvement strategies. The inclusion criteria were open access English articles that were published between 2012 and 2021 and conducted in the Asia region. Results There are nine articles described and explained regarding some form of supplementary immunization activities (SIAs) in their findings across Asia region. The majority of studies selected reported on post vaccination coverage and revealed a multifaceted challenge faced during SIAs which are widely diverse range from the microlevel of interpersonal aspects up to the macrolevel of government policy. Upon further analysis, the intervention at community level was the most dominant strategies reported during the SIA program. Conclusions An effective SIAs program provides the opportunity to increase the national capacity of the polio immunization program, reducing inequities in service delivery and offering additional public health benefits in controlling polio outbreaks in both endemic and nonendemic countries. Strengthening routine immunization (RI) programmes is also important for the sustainability of SIA's programs. Despite the challenges and hurdles, many Asian countries exhibited great political willingness to boost polio immunization coverage through SIA efforts.
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Kissova R, Pastuchova K, Lengyelova V, Svitok M, Mikas J, Klement C, Bopegamage S. History of the Wastewater Assessment of Polio and Non-Polio Enteroviruses in the Slovak Republic in 1963-2019. Viruses 2022; 14:1599. [PMID: 35893665 PMCID: PMC9331368 DOI: 10.3390/v14081599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 12/13/2022] Open
Abstract
We describe the genesis of poliovirus (PV) and non-polio enterovirus (NPEV) surveillance program of sewage wastewaters from its inception to the present in the Slovak Republic (SR). Sampling procedures and evolution of the methodology used in the SR for the detection of PVs and NPEVs are presented chronologically. For statistical data processing, we divided our dataset into two periods, the first period from 1963 to 1998 (35 years), and the second period from 1999 to 2019 (21 years). Generalized additive models were used to assess temporal trends in the probability of occurrence of major EV serotypes during both periods. Canonical correspondence analysis on relative abundance data was used to test temporal changes in the composition of virus assemblages over the second period. The probability of occurrence of major viruses PV, coxsackieviruses (CVA, CVB), and Echoviruses (E)) significantly changed over time. We found that 1015 isolated PVs were of vaccine origin, called "Sabin-like" (isolates PV1, PV2, PV3). The composition of EV assemblages changed significantly during the second period. We conclude that during the whole period, CVB5, CVB4, and E3 were prominent NPEVS in the SR.
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Affiliation(s)
- Renata Kissova
- Department of Medical Microbiology, Regional Public Health Authority Banska Bystrica, Cesta k Nemocnici 25, 97401 Banska Bystrica, Slovakia; (R.K.); (C.K.)
| | - Katarina Pastuchova
- National Reference Laboratory of Poliomyelitis Public Health Authority, Trnavska Cesta, 82102 Bratislava, Slovakia;
| | - Viera Lengyelova
- Department of Medical Microbiology, Regional Public Health Authority Senny Trh, 82009 Kosice, Slovakia;
| | - Marek Svitok
- Faculty of Ecology and Environmental Sciences, Technical University in Zvolen, 96001 Zvolen, Slovakia;
| | - Jan Mikas
- Public Health Authority, Trnavska Cesta, 82102 Bratislava, Slovakia;
| | - Cyril Klement
- Department of Medical Microbiology, Regional Public Health Authority Banska Bystrica, Cesta k Nemocnici 25, 97401 Banska Bystrica, Slovakia; (R.K.); (C.K.)
- Faculty of Public Health, Slovak Medical University, Limbova 12, 83303 Bratislava, Slovakia
| | - Shubhada Bopegamage
- Faculty of Medicine, Enterovirus Laboratory, Institute of Microbiology, Slovak Medical University, Limbova 12, 83303 Bratislava, Slovakia
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Dettori M, Castiglia P. COVID-19 and Digital Health: Evolution, Perspectives and Opportunities. IJERPH 2022; 19:ijerph19148519. [PMID: 35886366 PMCID: PMC9320194 DOI: 10.3390/ijerph19148519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 02/01/2023]
Abstract
Health Communication is key to establishing an empathic relationship between health professionals and their patients. Indeed, the ability to motivate and reassure the patient often determines the success of the therapies proposed. In the past, the relationship between health professionals and patients was centred on treatment and assistance, and health information came in the form of education campaigns based on signage (large posters, etc.). Subsequently, social and cultural changes gave rise to new ways of communicating science: from signage to magazines and television programmes devoted to health issues, through the use of social networks. In particular, fast and cheap access to the Internet and the vast number of app users have made the Web an effective communication tool. Given the potential of technology in the information-seeking process, the use of online channels by health institutions is a valuable tool for divulging medical and scientific knowledge. As a consequence, prompted by the need to provide fast and reliable information to the population, public institutions have adopted such innovative methods as the use of Information and Communication Technologies (ICTs) to convey health-related content. This practice, known as digital health or e-health, provides healthcare information using digital tools (e.g., Websites and social networks), delivered in an easy-to-understand language in order to reach various population groups and bring about better health conditions for all, hence the importance of acquiring and reinforcing communication skills in the healthcare field, where correct and effective communication immediately translates into a benefit for the professionals themselves and for their patients.
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Affiliation(s)
- Marco Dettori
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- University Hospital of Sassari, 07100 Sassari, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- University Hospital of Sassari, 07100 Sassari, Italy
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Arghittu A, Dettori M, Deriu GM, Soddu S, Manca PC, Carboni AA, Collu I, Palmieri A, Deiana G, Azara A, Castiglia P, Masia MD. Controlling Infectious Risk in Transfusion: Assessing the Effectiveness of Skin Disinfection in Blood Donors. Healthcare (Basel) 2022; 10:healthcare10050845. [PMID: 35627982 PMCID: PMC9141022 DOI: 10.3390/healthcare10050845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 02/01/2023] Open
Abstract
Bacterial infectious risk is a major problem in transfusion medicine. The type of micro-organisms isolated during bacterial contamination of blood products indicates that the donor’s skin is its main source. In this context, the primary measures to reduce this risk are: (a) optimal disinfection of the donor’s arm and (b) satellite bag diversion of the initial volume of blood collected. This work aimed to verify the effectiveness of skin disinfection of the blood donor’s venipuncture site. Two methodological approaches were used: (a) qualitative and quantitative microbiological testing of the skin at the collection site, before and post-disinfection; (b) qualitative microbiological testing of the first deviated blood. Pre-disinfection testing showed skin microbial load values between 3 and >200 CFU/plate. More than two-thirds of the isolates were Gram-positive bacteria (77.8%) of which 57.7% were staphylococci. Among Gram-negative bacteria, Pseudomonadaceae, Enterobacteriaceae, and Acinetobacter spp. were isolated from the blood donors (BDs). Post-disinfection, a 100% reduction in microbial load was observed in 84.4% of BDs. Microbiological testing of the first blood diverted sample revealed the presence of microbial flora in 1.9% samples; of the isolates, 83.3% were non-aureus staphylococci. This study highlights the importance of the correct application of skin disinfection procedures in order to ensure blood safety.
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Affiliation(s)
- Antonella Arghittu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Marco Dettori
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
- Correspondence:
| | - Grazia Maria Deriu
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Serena Soddu
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Pietro Carmelo Manca
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Anna Angela Carboni
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Irene Collu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
| | - Alessandra Palmieri
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giovanna Deiana
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (A.A.); (I.C.); (G.D.)
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
| | - Antonio Azara
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Paolo Castiglia
- University Hospital of Sassari, 07100 Sassari, Italy; (G.M.D.); (S.S.); (P.C.M.); (A.A.C.); (A.P.); (A.A.); (P.C.)
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Maria Dolores Masia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;
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Dettori M, Arghittu A, Castiglia P. Knowledge and Behaviours towards Immunisation Programmes: Vaccine Hesitancy during the COVID-19 Pandemic Era. Int J Environ Res Public Health 2022; 19:4359. [PMID: 35410045 DOI: 10.3390/ijerph19074359] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
Assessing knowledge, attitudes and behaviours towards vaccination is a key strategy when implementing national and international immunisation programmes aimed at improving compliance among the population and thereby increasing vaccination coverage. While vaccination's role as a powerful life-saving weapon in the fight against infectious diseases has been further highlighted following the introduction of the Coronavirus Disease 2019 (COVID-19) vaccine, there is still a discrepancy between the scientific evidence on the effectiveness of vaccines and the perception of the risk attributed to them. Known as "Vaccine Hesitancy" (VH), this phenomenon is the delay in acceptance or refusal of vaccines, despite the availability of services. VH can be found in at least 15% of the worldwide population, and even professional groups tasked with promoting vaccination as a primary prevention measure, e.g., healthcare workers (HCWs), sometimes have doubts regarding vaccination. Since 2014, this Public Health problem has been increasing in 90% of countries worldwide, to the extent that in 2019 it was listed as one of the ten greatest threats to global health by the World Health Organization (WHO). VH has also affected COVID-19 vaccination, hampering the achievement of desired vaccination coverage. Monitoring this trend by studying people's behaviour and attitudes could be a useful tool to aid Public Health, in orienting vaccination policies and designing new health education and continuous training interventions, aimed at both the general public and accountable cohorts, such as HCWs.
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Castiglia P, Arghittu A. New Insight in Vaccination and Public Health: A Commentary from Special Issue Editors. Vaccines (Basel) 2022; 10:vaccines10020183. [PMID: 35214641 PMCID: PMC8875389 DOI: 10.3390/vaccines10020183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 01/27/2023] Open
Affiliation(s)
- Paolo Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
- University Hospital of Sassari, 07100 Sassari, Italy
- Correspondence: (P.C.); (A.A.)
| | - Antonella Arghittu
- University Hospital of Sassari, 07100 Sassari, Italy
- Correspondence: (P.C.); (A.A.)
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Chikako TU, Seidu AA, Hagan JE, Aboagye RG, Ahinkorah BO. Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12-23 Months in Ethiopia. Int J Environ Res Public Health 2021; 18:ijerph182211820. [PMID: 34831576 PMCID: PMC8624229 DOI: 10.3390/ijerph182211820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
Background: The re-introduction of polio among children aged 12–23 months is likely to occur in Ethiopia due to the low vaccination rates against poliovirus. The study sought to examine the predictors of incomplete vaccination against polio among children aged 12–23 months in Ethiopia. Methods: The data used were obtained from the 2016 Ethiopia Demographic and Health Survey. Binary and Bayesian logistic regressions were used for the data analysis, with parameters estimated using classical maximum likelihood and the Bayesian estimation method. Results: The results revealed that 43.7% of the children were not fully vaccinated against polio in Ethiopia. Maternal age, educational level, household wealth index, exposure to mass media, place of residence, presence of nearby healthy facility, counseling on vaccination, and place of delivery were significant determinants of incomplete polio vaccination among children aged between 12 and 23 months in Ethiopia. Conclusion: Considerable numbers of children are not fully vaccinated against polio in Ethiopia. Individual and contextual factors significantly contributed to incomplete polio vaccination among children in the country. Therefore, the government and other stakeholders should pay particular attention to maternal education to increase mothers’ educational level in all regions and give training and counseling in all urban and rural parts of the country on child vaccination to overcome the problem of children’s incomplete polio vaccination and/or vaccination dropout.
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Affiliation(s)
- Teshita Uke Chikako
- Wondo Genet College of Forestry and Natural Resource, Hawassa University, Hawassa P.O. Box 05, Ethiopia;
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
- Department of Estate Management, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast TF0494, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 100131, 33501 Bielefeld, Germany
- Correspondence:
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana;
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia;
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Pellegrinelli L, Galli C, Primache V, Bubba L, Buttinelli G, Stefanelli P, Pariani E, Binda S. Emerging Non-Polio Enteroviruses recognized in the framework of the Acute Flaccid Paralyses (AFP) surveillance system in Northern Italy, 2016-2018. Int J Infect Dis 2021; 106:36-40. [PMID: 33771675 DOI: 10.1016/j.ijid.2021.03.057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Acute Flaccid Paralyses Surveillance (AFPS) monitors the emergence of polioviruses and can track Non-Polio Enteroviruses (NPEVs). We report AFPS activity in the Lombardy region (Northern Italy) from 2016 to 2018. METHODS Fecal and respiratory samples were collected from children <15 years who met the WHO definition of an AFP case, analyzed by virus isolation in cell cultures (RD/L20B) and by a one-step real-time RT-PCR assay specific for the 5'-noncoding-region of NPEV. NPEV-positive specimens were further analyzed by sequencing a fragment of the VP1 gene. RESULTS 36 AFP cases (89 stool and 32 respiratory samples) were reported with an incidence of 1.1/100'000, 0.9/100'000, 0.6/100'000 children <15 years in 2016, 2017, 2018, respectively. Poliovirus was not identified, whereas NPEVs were detected in 19.4% (7/36) of AFP cases. The presence of one Echovirus-25 (2016), two EV- and D68 (2016 and 2018), one EV-A71 (2016), and one Echovirus-30 (2016) sharing high nucleotide identity with NPEVs detected in Europe was identified. CONCLUSION The absence of polio was confirmed. The unpredicted detection of emerging EV-D68, EV-A71, and E-30 sharing high sequence nucleotide similarity with viruses involved in the latest outbreaks, provided valuable and up-to-date information, emphasizing the importance of monitoring NPEVs through AFPS.
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Fontana S, Cimini D, Marinelli K, Gori G, Moroni V, Bagnarelli P, Collini L, Pagani E, Masi E, Buttinelli G, Fiore S, Amato C, Carraro V, Stefanelli P. Survey of diagnostic and typing capacity for enterovirus infection in Italy and identification of two echovirus 30 outbreaks. J Clin Virol 2021; 137:104763. [PMID: 33711692 DOI: 10.1016/j.jcv.2021.104763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Enterovirus infections can cause a variety of illnesses, ranging from asymptomatic infections to severe illness and death. AIM To support polio eradication activities, in February 2019, the WHO Regional Reference Laboratory for polio in Italy, at the National Institute of Public Health (Istituto Superiore di Sanità), promoted an investigation on non-polio enterovirus laboratory capacity, with the support of the Italian Ministry of Health. The aim was to collect data on the assays used routinely for diagnostic purposes and to characterize enterovirus outbreaks strains by sequence analysis of the Viral Protein 1 region. METHODS A questionnaire was administered to public health laboratories through all Italian Regions for 2018 and subsequently, an electronic form for lab-confirmed enterovirus infection reported from February 2019 to January 2020, including patients clinical characteristics, and laboratory data was distributed through 25 laboratories participating the survey. RESULTS Overall, a homogenous laboratory capacity for enterovirus infection diagnosis was found and 21,000 diagnostic tests were retrospectively reported in 2018. Then, in 2019, two outbreaks of Echovirus 30 were identified and confirmed by molecular analyses. CONCLUSION These results underline the need monitor the circulation of non-polio enterovirus to ascertain the real burden of the disease in the country.
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Barbadoro P, Luciani A, Ciotti M, D’Errico MM. Two-Source Capture-Recapture Method to Estimate the Incidence of Acute Flaccid Paralysis in the Marches Region (Italy). Int J Environ Res Public Health 2020; 17:ijerph17249400. [PMID: 33333947 PMCID: PMC7765411 DOI: 10.3390/ijerph17249400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 12/11/2022]
Abstract
A combination of high infant immunization coverage and surveillance of acute flaccid paralysis (AFP) cases, plays a critical role in polio eradication. This study aimed to estimate the incidence of AFP, to evaluate the completeness of AFP ascertainment during the years, age groups and gender, and to define the main associated diagnosis among children aged under 15 in the Marches region of Italy. Analysis was performed on data from the active AFP surveillance system and the hospital discharge records in the 2006-2014 period. The two-source capture-recapture method was applied. After cross-validation, 30 AFP compatible conditions as defined by the WHO were identified, with an incidence estimate of 1.91 cases of AFP per 100,000 children under 15 years (95% CI = 1.4-2.6/100,000). Guillain-Barrè syndrome was the most common diagnosis. A significant difference (p < 0.05) has been registered in the estimated probability of case ascertainment in females. The reasons for the lower reporting of cases in females are unknown. Specific research and the implementation of a more sensitive surveillance system are essential in verifying potential inequalities and to succeed in the polio eradication initiative.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
- Infection Control Unit, AOU Ospedali Riuniti di Ancona, via Conca, 60126 Torrette di Ancona, Italy
- Correspondence: ; Tel.: +39-712-206-200; Fax: +39-71-2206032
| | - Aurora Luciani
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
| | - Matteo Ciotti
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
| | - Marcello Mario D’Errico
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 6, 60121 Ancona, Italy; (A.L.); (M.C.); (M.M.D.)
- Infection Control Unit, AOU Ospedali Riuniti di Ancona, via Conca, 60126 Torrette di Ancona, Italy
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Affanni P, Colucci ME, Capobianco E, Bracchi MT, Zoni R, Viani I, Caruso L, Carlone L, Arcuri C, Veronesi L. Immunity status against tetanus in young migrants: a seroprevalence study. Acta Biomed 2020; 91:77-84. [PMID: 32275271 PMCID: PMC7975914 DOI: 10.23750/abm.v91i3-s.9438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Thanks to the highly effective vaccine, tetanus became sporadic in high-income countries with well-established primary childhood immunization programs, but it is common in low-income countries. The migrants, leaving countries with poor immunization programs or where vaccinations have been interrupted, may represent a new risk group for tetanus in host countries. A seroprevalence study was conducted to estimate the immunological status against tetanus in young migrants without vaccination documentation. METHODS After a careful assessment by vaccination services of the Local Health Authority, all migrants recently arrived in Italy were included in the serosurvey. Titers of anti-tetanus toxoid were measured using a commercial ELISA kit. Subjects were stratified by age and by WHO region. Antibody titers <0.10 IU/ml were considered to be seronegative, between 0.10 and 1.00 IU/ml as intermediate protection, and >1.00 IU/ml high protection. RESULTS From January 2004 to December 2019, 2,326 blood samples were collected. Mean age was 13.9 years with no differences between WHO regions. The percentage of the subjects without protective antibodies was 22.3%, with an intermediate level was 45.2%, with high titer was 32.5%. Among migrant coming from African and Eastern Mediterranean WHO regions, the highest percentages of seronegative titers and, at the same time, the low percentages of high protective levels were found. Titers decreased with age. CONCLUSIONS The significant proportion of seronegative migrants and the decrease of protective titers increasing age, confirm the importance of the evaluation of the immunological status to employ the appropriate vaccination strategy.
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Affiliation(s)
| | | | | | | | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Isabella Viani
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Luca Caruso
- Department of Medicine and Surgery, University of Parma, Italy.
| | | | - Carlo Arcuri
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Italy.
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Palandri L, Morgado M, Colucci ME, Affanni P, Zoni R, Mezzetta S, Bizzarro A, Veronesi L. Reorganization of Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public Health intervention. Acta Biomed 2020; 91:85-91. [PMID: 32275272 PMCID: PMC7975913 DOI: 10.23750/abm.v91i3-s.9436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM OF THE WORK The International Health Regulations Emergency Committee declared in 2014 that poliovirus circulation is a public health emergency of international concern. In 2017 and 2018 Italy was classified at intermediate risk of poliovirus reintroduction based on suboptimal poliovirus surveillance. Acute flaccid paralysis active surveillance is the gold standard in the polio eradication process. The aims of this study were to investigate the causes of reduced acute flaccid paralysis case reporting in Emilia-Romagna in the last few years (step 1) and to study a public health intervention to restore an adequate level of acute flaccid paralysis surveillance in that region (step 2). METHODS In the first step a context analysis was performed by analysing the 2015-2017 Hospital Discharge Registers in Emilia-Romagna with the ICD-9-CM differential diagnosis codes for acute flaccid paralysis. Data from context analysis was then used to plan a new regional collaborative network of acute flaccid paralysis active surveillance. RESULTS The active surveillance network was, at the end of the study, composed by 49 doctors from both hospital administrations and clinical wards from 4 University Hospitals and 7 Local Health Authorities throughout the Region. In 15 months, 7 acute flaccid paralysis cases have been reported; 85,7% received a full clinical and virological investigation and 83,3% completed the 60 day's follow-up. The mean response to each e-mail was 48,5% (SD 7,5%). CONCLUSIONS In 2019, the Emilia-Romagna's active surveillance system reached the sensitivity, completeness of case investigation and follow-up required to achieve the minimum levels for certification standard surveillance.
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Affiliation(s)
- Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Mariana Morgado
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Maria Eugenia Colucci
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Paola Affanni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Roberta Zoni
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
| | - Sandra Mezzetta
- Department of Medicine and Surgery, University of Parma, Italy. Reference Centre for Polio and AFP surveillance in Emilia-Romagna.
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