ABSTRACT
OBJECTIVES: To evaluate the effectiveness and the frequency of use of a pulsed xenon ultraviolet light-emitting no-touch portable device (PX-UV), applied after perform current cleaning, in reducing environmental bacterial burden and the presence of pathogens on surfaces in the operating rooms at the Policlinico University Hospital of Foggia. DESIGN: Prospective before-and-after study with a follow up duration of four months, from May to August 2019. SETTING AND PARTICIPANTS: Two operating rooms of an Orthopaedic and a Neurosurgical ward in a 780-bed university hospital in the District of Foggia, Italy (about 600,000 inhabitants). MAIN OUTCOME MEASURES: According to the hygienic standards proposed by the Italian Workers Compensation Authority (ISPESL), the total and the average bacterial load and the presence of six pathogens were evaluated between pre- and post- PX-UV use combined with routine manual cleaning. RESULTS: The PX-UV system was applied at five distinct time points: t1: start of the experiment, t2: after 28 days, t3: after 13 days, t4: after 7 days, and t5: after 8 days (t2-t5: 28 days in total). About 16-min of PX-UV cycle showed significant reduction in the level of environmental contamination by decreasing the mean colony count by 87.5%, compliant with the standard (5< X ≤15 CFU per plat). Staphylococcus aureus and Acinetobacter baumannii that had been isolated in some of the samplings before PX-UV were no longer detected after t1, t2 and t5 treatments. Before PX-UV, the mean colony count was similar between t1 and t2 (p>0.05); after t3 and t4 treatments, it was lower before t5 in both the Orthopaedic and Neurosurgical operating rooms (= -97% and -75%, respectively; p<0,01). CONCLUSIONS: Implication for practice: PX-UV could supplement the standard cleaning process in reducing the microbial burden in the operating rooms and potentially achieving lower healthcare-associated surgical site infections rates.
Subject(s)
Cross Infection , Disinfection , Humans , Italy , Operating Rooms , Prospective Studies , XenonABSTRACT
We report the epidemiology of food-borne botulism in Puglia, Italy, between 1977-2017, using surveillance data and Experts' personal observations. As the disease is rare, the diagnosis is often missed or delayed, and cases are initially misdiagnosed. This was the case of a family outbreak of botulism in the 1970s.
Subject(s)
Botulism/epidemiology , Disease Outbreaks , Food Microbiology , Adolescent , Aged, 80 and over , Botulism/diagnosis , Female , Humans , Italy/epidemiology , Middle Aged , Young AdultABSTRACT
Combination vaccines represent a valuable technological innovation in the field of infectious disease prevention and public health, because of their great health and economic value from the individual, societal, and healthcare system perspectives. In order to increase parents' and healthcare professionals' confidence in the vaccination programs and maintain their benefits to society, more information about the benefits of innovative vaccination tools such as combination vaccines is needed. Purpose of this work is an examination of available hexavalent vaccines, that protect against Diphtheria, Tetanus, Pertussis, Poliomyelitis, Hepatitis B and Haemophilus influenzae type b infections. From the epidemiological updates of vaccine preventable diseases to the vaccine development cycle, from the immunogenicity of antigenic components to the safety and co-administration with other vaccines, several aspects of available hexavalent vaccines are discussed and deepened. Also a number of practical considerations on schedules, age of employment, strategies for vaccination recovery, vaccination in at-risk births are issued, based on the recommendations of Italian Ministry of Health, Italian Society of Pharmacology (SIF), Italian Society for Pediatrics (SIP), Italian Federation of Family Paediatricians (FIMP) and Italian Society of Hygiene, Preventive Medicine and Public Health (SItI).
Subject(s)
Communicable Disease Control , Consensus , Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage , Diphtheria-Tetanus-Pertussis Vaccine/supply & distribution , Hepatitis B Vaccines/administration & dosage , Hepatitis B Vaccines/supply & distribution , Patient Safety , Poliovirus Vaccine, Inactivated/administration & dosage , Poliovirus Vaccine, Inactivated/supply & distribution , Drug Industry , Female , Humans , Italy , Male , PregnancyABSTRACT
INTRODUCTION: In Italy, vaccination against seasonal influenza has been recommended for the elderly since 1980, but coverage is still far below the WHO minimum target level of 75%. Effective interventions to improve influenza vaccination should take into account socioeconomic determinants of inequalities in vaccine uptake. This study aimed to assess differences in vaccination coverage, by socioeconomic status, among people ≥ 65 years of age residing in the Foggia municipality, Italy. METHODS: A Socio-Economic-Health Deprivation Index (SEHDI) was constructed by using a multivariate analysis model. The resident population, for census block, was classified in 5 deprivation groups. Differences in demographic and socioeconomic indicators, the standardized mortality ratios (SMRs), and the average vaccination coverage among deprivation groups were evaluated with the linear F-test. The association between census variables and influenza vaccination coverage, in each deprivation group, was assessed using the Pearson bivariate correlation. RESULTS: The SEHDI allowed to identify factors related to ageing, housing, household size and composition, and education. Forty percent of people residing in the Foggia municipality lived in conditions of socioeconomic and health deprivation. Belonging to families with 3 or 4 members was associated with increased coverage rates. In the most deprived group, vaccination uptake was positively associated with the dependency ratio. CONCLUSIONS: The results of this study have shown that there is still large room for improving influenza vaccination coverage among subjects belonging to the most deprived areas. Surveillance of trends in influenza vaccine uptake by socioeconomic groups is a feasible contribution to implementing effective, tailored to the frail older persons, vaccine utilization programs.
Subject(s)
Influenza, Human/prevention & control , Poverty , Social Class , Vaccination Coverage/trends , Aged , Censuses , Cities , Databases, Factual , Female , Humans , Influenza Vaccines/administration & dosage , Italy , Male , SeasonsABSTRACT
BACKGROUND: According to recent estimates, cervical cancer is worldwide the second most common cancer in females and the fourth overall. The number of deaths for cervical cancer is around 7.5% of all female cancer deaths. Cervical cancer is the only tumour with a known necessary cause, the HPV infection and, globally, HPV is the most common sexually transmitted infection. Two major approaches for cervical cancer prevention have been designed: primary prevention by HPV vaccination and secondary prevention by screening. The aim of our study is to design an overview of epidemiology, cost of the therapies and cost of prevention measures (screening and vaccines) 9 years after the introduction of anti-HPV vaccination in the Apulia Regional Immunization Program. STUDY DESIGN: Retrospective observational study. METHODS: To describe the epidemiology of cervical cancer, we analysed data from the Apulia regional archive of hospital discharge forms (SDO). We considered all records referred to cervical cancer using the ICD 9 code 180.xxx both in primary and secondary diagnosis, for the years 2007-2016. Subjects living in Apulia have been considered. Costs of hospitalization were computed considering generated Diagnosis Related Groups (DRG). To describe the Apulian screening program, we analysed data from Regional Screening Data warehouse; the cost of the single test was established according to the Tariff List from the Ministry of Health. Finally, vaccination data were extracted by Regional Immunization Database and official ex-factory price has been used to calculate the costs of immunization program. RESULTS: From 2007 to 2016, an important decrease in the incidence rate of cervical cancer in Apulia has been noted, ranging from 43.7 per 100,000 residents in 2007 to 21.0 per 100,000 residents in 2016. From an economic point of view, a clear reduction (39%) is observed in hospitalization costs over time. Total costs of prevention programs increased over time and globally exceed 54,000,000, with a decreasing trend for vaccine prophylaxis and an increasing trend for screening. CONCLUSIONS: The incidence and costs of cervical cancer in Apulia, although already significantly decreasing, likely will be further reduced since 2027-2032, when we can observe the effects of vaccine prophylaxis on the burden of disease; on this occasion it will be also possible to quantify the actual cost-effectiveness of the vaccine. In our opinion, in the future the Apulia healthcare executives should enhance and improve the active screening test offer, without underestimating the importance of sexual education in young people, especially in those who have not had sexual debut yet.
Subject(s)
Papillomavirus Infections/prevention & control , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/prevention & control , Child , Costs and Cost Analysis , Diagnosis-Related Groups , Female , Hospitalization/economics , Hospitalization/statistics & numerical data , Humans , Incidence , Italy/epidemiology , Male , Mass Screening/economics , Mass Screening/methods , Middle Aged , Papillomaviridae/isolation & purification , Papillomavirus Infections/complications , Papillomavirus Infections/diagnosis , Papillomavirus Vaccines/economics , Primary Prevention/economics , Retrospective Studies , Secondary Prevention/economics , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/virology , Vaccination/economicsABSTRACT
BACKGROUND: Both Bovine herpesvirus (BoHV-1) and Bubaline herpesvirus (BuHV-1) have been reported to cross the species barrier. Antibody seroconversion in glycoprotein E (gE) blocking ELISA during BuHV-1 infection has been documented. Recent diagnostic efforts have focused on the development and application of discriminatory tests to distinguish between infections with BoHV-1 and BuHV-1. OBJECTIVE: To evaluate the impact and distribution of these two infections in water buffalo farms in two regions (Piedmont (n = 3) and Campania (n = 10), Italy) where infectious bovine rhinotracheitis control programs have been implemented. ANIMALS AND METHODS: Sampling was carried out on 13 buffalo farms comprising 1089 animals using specific gE-indirect ELISA's test able to discriminate among BoHV-1 and BuHV-1 infections. RESULTS: 59.0% of animals reacted positive to ELISA (irrespective of whether BoHV-1 or BuHV-1 antigen was used) and 86.4% of these were reactive to BuHV-1 only, whereas 11.8% showed absorbance values for both antigens and were classified as inconclusive. There was a statistically significant age-related difference in BuHV-1 infection rates but not in overall individual (47% vs. 58%) or herd prevalence (100% vs. 90%) of infection between the two regions. CONCLUSION: The low percentage of sera reactive to BoHV-1 (1.8%, 12/643) indicates that BuHV-1 may be the main circulating alphaherpesvirus infection in Mediterranean water buffalo in the two study areas. Since Bubalus bubalis is included in Directive 64/432/EEC on animal health problems affecting intra-community trade in bovine animals, diagnostic testing with nonspecific ELISA for BoHV-1 infection in buffalo may yield false-positive reactions. This scenario could lead to economic losses and hamper buffalo trade and movement, particularly for reproduction purposes.
Subject(s)
Buffaloes , Herpesviridae Infections/veterinary , Herpesviridae/isolation & purification , Animals , Antibodies, Viral/blood , Cattle , Enzyme-Linked Immunosorbent Assay/veterinary , Herpesviridae/classification , Herpesviridae Infections/epidemiology , Herpesviridae Infections/virology , Herpesvirus 1, Bovine/classification , Herpesvirus 1, Bovine/isolation & purification , Infectious Bovine Rhinotracheitis/epidemiology , Infectious Bovine Rhinotracheitis/virology , Italy/epidemiology , PrevalenceSubject(s)
Aging , Diet/standards , Hygiene/standards , Nutritional Status , Health Status , Humans , Italy , Public Health/standardsABSTRACT
BACKGROUND: Surveillance represents a key strategy to control type 1 diabetes mellitus (T1DM). In Italy, national data are missing. This study aimed at evaluating the incidence of T1DM in subjects <18 year olds in Apulia (a large southeastern region, about 4,000,000 inhabitants) and assessing the sensitivity of the regional Registry of Childhood-Onset Diabetes (RCOD) in the 2009-2013 period. METHODS: We performed a retrospective study matching records from regional Hospital Discharge Registry (HDR), User Fee Exempt Registry (UFER), and Drugs Prescription Registry (DPR) and calculated T1DM incidence; completeness of each data source was also estimated. In order to assess the RCOD sensitivity we compared cases from the registry to those extracted from HDR-UFER-DPR matching. RESULTS: During 2009-2013, a total of 917 cases (about 184/year) in at least one of the three sources and an annual incidence of 25.2 per 100,000 were recorded, lower in infant, increasing with age and peaked in 5- to 9-year-olds. The completeness of DPR was 78.7%, higher than that of UFER (64.3%) and of HDR (59.6%). The RCOD's sensitivity was 39.05% (360/922; 95% CI: 34.01%-44.09%). CONCLUSIONS: Apulia appeared as a high-incidence region. A full, active involvement of physicians working in paediatric diabetes clinics would be desirable to improve the RCOD performance.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Adolescent , Age Distribution , Child , Child, Preschool , Diabetes Mellitus, Type 1/diagnosis , Female , Humans , Incidence , Infant , Italy/epidemiology , Male , Registries , Retrospective Studies , Time FactorsABSTRACT
In this work, we identified for the first time hepatitis E virus (HEV) in a pet house rabbit, an adult 7 years old female of domestic rabbit (Oryctolagus cuniculus). Importantly, the resulting phylogenetic tree showed that the HEV strain identified in the pet house rabbit was closely related to a human HEV sequence; this finding reawakens concerns regarding the zoonotic risk represented by HEV in animals and expands to house rabbit the spectrum of potential source of infection for humans. Potential for domestic transmission of HEV to humans should be taken into account.
Subject(s)
Animals, Domestic/virology , Hepatitis E virus/isolation & purification , Hepatitis E/veterinary , Rabbits , Zoonoses/virology , Animals , Base Sequence , Disease Vectors , Female , Hepatitis E/transmission , Hepatitis E/virology , Hepatitis E virus/classification , Hepatitis E virus/genetics , Humans , Italy , Phylogeny , Zoonoses/transmissionABSTRACT
Recommendations for vaccination against rotavirus (RV) were issued in Apulia in 2006; the vaccine was free of charge to children who entered day care or nursery school by 1 year of age or those affected by chronic diseases for which diarrhea caused by rotavirus can increase the risk of complications and hospitalization. In 2014, vaccination became available to all healthy children with only a copayment. However, there has not been a significant increase in vaccination coverage. On April 17, 2015, Apulian public health physicians and paediatricians met to share strategies to promote the RV vaccine indications provided in the regional immunization schedule. During the meeting, presentation of data reports were interspersed with discussions that were led with a "bottom-up" approach. The discussants responded to pre-planned questions raised by the participants and encouraged by the discussion.
Subject(s)
Gastroenteritis/diagnosis , Gastroenteritis/prevention & control , Immunization Programs , Pediatrics , Rotavirus Vaccines/administration & dosage , Rotavirus , Vaccination , Child, Preschool , Consensus , Cost-Benefit Analysis , Gastroenteritis/economics , Gastroenteritis/epidemiology , Gastroenteritis/virology , Humans , Immunization Programs/methods , Incidence , Infant , Italy/epidemiology , Length of Stay/statistics & numerical data , Patient Admission/statistics & numerical data , Public Health , Rotavirus/isolation & purification , Rotavirus Vaccines/economics , Vaccination/economics , Vaccination/methodsABSTRACT
Meningococcal disease is an acute, severe bacterial infection caused by Neisseria meningitidis. The most common presentations of invasive meningococcal infection (IMD) are meningitis and sepsis, less common pathologic presentations include focal infections. IMD can develop from initial symptoms to death within 24 hours. As many as 20% of survivors have permanent sequelae. Infants < 1 year of age have the highest incidence and adolescents the highest carriage prevalence. In Italy, the incidence of IMD was 0.25 confirmed cases per 100,000 in 2011, but this may have been considerably underestimated due to under-detection and under-reporting. Recently, we estimated the impact of the MenC universal vaccination on the burden of meningococcal meningitis in Puglia by assessing the completeness of three registration sources (notifications, hospitalizations, and laboratory surveillance). The sensitivity of the three systems was 36.7% (95% CI: 17.5%-57.9%) and registrations lost nearly 28 cases/year in the period 2001- 2013. In the National Surveillance of Invasive Bacterial Diseases, serogroup B accounted for 64.9% of samples serotyped in 2011. Applying this percentage to the total number of hospitalizations for IMD registered in the same year (n = 256), we obtained an estimated 166 episodes attributable to serogroup B. Our work highlights the importance of enhancing surveillance for meningococcal disease and strengthening vaccinations against all preventable serogroups.
Subject(s)
Disease Outbreaks , Food Contamination/statistics & numerical data , Fragaria/virology , Hepatitis A Virus, Human/isolation & purification , Hepatitis A/epidemiology , Seafood/virology , Adolescent , Adult , Aged , Case-Control Studies , Child , Child, Preschool , Disease Notification , Female , Hepatitis A/transmission , Hepatitis A/virology , Hepatitis A Virus, Human/genetics , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Multivariate Analysis , Polymerase Chain Reaction/methods , RNA, Viral/genetics , Retrospective Studies , Sequence Analysis, DNA , Young AdultABSTRACT
OBJECTIVES: To describe an outbreak of acute gastroenteritis in people who had eaten at a hash house in southern Italy. STUDY DESIGN: Case-control study. METHODS: A clinical case of gastroenteritis was defined as a person who had eaten at the hash house from 29 August to 4 September 2011 and who experienced defined gastrointestinal symptoms within 72 hours, or a person with a laboratory-confirmed salmonella infection without symptoms. A convenience sample was enrolled as the control group. Environmental and human samples were collected, and Salmonella infantis was identified by polymerase chain reaction. Univariate analysis was performed for each food type, and multivariate analysis was performed for each food type and demographic variable (gender, age). RESULTS: Twenty-three cases of gastroenteritis were notified between 1 and 4 September 2011, two of which were admitted to the local hospital. Multivariate analysis showed that porchetta [odds ratio (OR) 22.0, 95% confidence interval (CI) 3.2-152.6, z = 3.13, P = 0.002] and roasted meat (OR 14.4, 95% CI 1.7-122.0, z = 2.45, P = 0.014) were associated with gastrointestinal symptoms. Environmental and human isolates exhibited the same sequence type (ST 32). CONCLUSIONS: This experience highlighted that, in the control of a foodborne outbreak, integrated epidemiological and laboratory surveillance enables rapid identification of the source of infection, thus reducing the risk of an epidemic.
Subject(s)
Disease Outbreaks , Gastroenteritis/epidemiology , Restaurants , Salmonella Food Poisoning/epidemiology , Salmonella enterica/isolation & purification , Acute Disease , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Case-Control Studies , Child , Disease Notification , Feces/microbiology , Female , Food Analysis/statistics & numerical data , Food Handling/standards , Gastroenteritis/drug therapy , Gastroenteritis/etiology , Humans , Italy/epidemiology , Male , Microbial Sensitivity Tests , Middle Aged , Multivariate Analysis , Odds Ratio , Polymerase Chain Reaction , Population Surveillance , Salmonella Food Poisoning/drug therapy , Salmonella Food Poisoning/etiology , Surveys and Questionnaires , Young AdultABSTRACT
In this study we assessed the seroprevalence of hepatitis E virus (HEV) infection in both the Italian population and immigrants from developing countries in Foggia (Apulia, Southern Italy). The seroprevalence of HEV was determined in 1217 subjects [412 (34%) immigrants and 805 Italian subjects (blood donors, general population, HIV-positive, haemodialysis patients)]. Serum samples were tested for anti-HEV and confirmed by Western blot assay; in positive patients HEV RNA and genotype were also determined. There were 8·8% of patients that were positive to anti-HEV, confirmed by Western blot. The prevalence in immigrants was 19·7%, and in Italians 3·9% (blood donors 1·3%, general population 2·7%, HIV-positive patients 2·0%, haemodialysis patients 9·6%). Anti-HEV IgM was found in 38/107 (35·5%) of the anti-HEV-positive serum samples (34 immigrants, four Italians). This study indicates a higher circulation of HEV in immigrants and Italian haemodialysis patients, whereas a low prevalence of HEV antibodies was seen in the remaining Italian population.
Subject(s)
Hepatitis E/epidemiology , Adult , Aged , Blotting, Western , Emigrants and Immigrants/statistics & numerical data , Female , Hepatitis E virus , Humans , Italy/epidemiology , Male , Middle Aged , Prevalence , Renal Dialysis/statistics & numerical data , Risk Factors , Seroepidemiologic StudiesABSTRACT
Over the last two decades, growing numbers of parents in the industrialized world are choosing not to have their children vaccinated. Trying to explain why this is occurring, public health commentators refer to the activities of an anti-vaccination movement. The aim of this paper is to review the literature about the anti-vaccination movements and to highlight the knowledge and the skills needed for HCWs to fight against their ideas. The main theoretical structures of anti-vaccination ideology in the 19th and 20th centuries are: vaccines cause idiopathic illness; opponents against vaccines accused vaccine partisans to be afraid of the "search after truth," they fear unveiling errors; the vaccination law not only insults every subject of the realm, but also it insults every human being; vaccine immunity is temporary; an alternative healthy lifestyle, personal hygiene and diet stop diseases. Proponents against vaccination now have additional means to communicate their positions to the general public, the Internet in particular. Doctors and HCWs constantly have to face parents and patients who search information about vaccination. A lot of these people have previously found data about vaccinations from a lot of sources, such as papers, media or in websites and in these sources most contents come from anti-vaccine movements. For these reasons doctors and HCWs need to have updated knowledge about the vaccinations and to know the contents proposed by vaccine sceptics. Educating the general public cannot be fully effective unless there is a corresponding provision, enthusiasm and commitment by trained HCWs.
Subject(s)
Parents/psychology , Refusal to Participate , Vaccination , Health Knowledge, Attitudes, Practice , Health Promotion , Humans , InternetABSTRACT
BACKGROUND: A point prevalence survey (PPS) was conducted in Italy in 2010, as part of the first European PPS in Long Term Care Facilities (LTCFs), conducted within the HALT Project. METHODS: The PPS was aimed at estimating the prevalence of infections, antimicrobial resistance, and antibiotic use and to assess the status of infections control programs in this setting. RESULTS: Ninety two LTCFs, located in 11 different Italian regions, participated to the study: 9391 residents were enrolled, 9285 of whom were eligible according to the study criteria. The prevalence of residents with signs/symptoms of infection was 6.5% (606 residents); 438 residents were on antimicrobial treatment (4.7%) and 526 had signs/symptoms (5.7%) but in 324 residents only (3.5/100 residents) the infection satisfied the modified McGeer criteria and was considered confirmed. The most frequent infection site was the respiratory tract (1.27/100 residents). Mostly of the antibiotics were prescribed for respiratory tract infections (42.8% of the antibiotics) and for urinary tract infections (26.6%). The most frequently prescribed classes were quinolones, followed by penicillin plus beta-lactamase inhibitor and 3rd generation cephalosporins. Few infection had a microbiological confirmation, but among the 143 isolated microorganisms 24% were multidrug resistant. CONCLUSIONS: The burden of infections and antimicrobial resistance in LTCFs is significant and infection control and surveillance program are urgently needed.
Subject(s)
Cross Infection/epidemiology , Drug Resistance, Bacterial , Health Surveys , Homes for the Aged/statistics & numerical data , Institutionalization/statistics & numerical data , Long-Term Care , Nursing Homes/statistics & numerical data , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Bacteria/isolation & purification , Bacteriological Techniques/statistics & numerical data , Cross Infection/drug therapy , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Drug Utilization/statistics & numerical data , Female , Homes for the Aged/organization & administration , Humans , Infection Control/organization & administration , Italy/epidemiology , Long-Term Care/organization & administration , Male , Nursing Homes/organization & administration , Population Surveillance , Prevalence , Risk Factors , Surveys and QuestionnairesABSTRACT
BACKGROUND: The objective of this study is to describe the knowledge and skills of managers working in health organizations in the Region of Puglia (South of Italy) on the principles and tools of clinical governance. METHODS: A KAP (Knowledge, Attitudes and Practice) survey was conducted using a questionnaire. The target population of the survey was represented by Hospital Directors and Managers of local health care structures (Primary Care Districts, Public Health Departments, and Mental Health Departments). RESULTS: 92 managers participated at the study (response rate was 90.2%). 98.9% of respondents reported being aware of the concept of clinical governance and believe that clinical governance is an appropriate strategy for the continuous improvement in quality of services. 96.7% of respondents had heard of Evidence Based Practice and 80.6% reported using the method of EBP in nursing practice. The availability of guidelines for consultation was reported by 54.9% of respondents. Of those interviewed, 79.8% knew about Health Technology Assessment. 95.5% reported they have heard of clinical audit and 98.9% knowing the concept of risk management. CONCLUSION: In our survey, an high value judgment about clinical governance was reported by medical managers. The lower attitudes towards the use of the tools of clinical governance highlights an important discrepancy with respect to knowledge and opinions, which becomes more evident in community care structures. Above and beyond training managers, it is also necessary to change training methods used on all health personnel, which should be oriented towards EBM in order to build an adaptable organizational climate.
Subject(s)
Clinical Governance , Health Facility Administrators/psychology , Health Knowledge, Attitudes, Practice , Management Audit , Professional Competence , Attitude of Health Personnel , Clinical Audit , Evidence-Based Practice , Female , Health Care Surveys , Hospital Administrators/psychology , Humans , Italy , Male , Mental Health Services/organization & administration , Middle Aged , Practice Guidelines as Topic , Primary Health Care/organization & administration , Public Health Administration , Quality Assurance, Health Care , Risk Management , Surveys and Questionnaires , Technology Assessment, BiomedicalABSTRACT
HPV type-specific distribution was evaluated in genital samples collected from 151 women from West Africa and Horn of Africa, living in the Asylum Seeker Center in Bari Palese (Italy), undergoing voluntary screening correlated with cytological abnormalities. HPV-DNA was assayed by Linear Array HPV genotyping test. HPV DNA was detected in 39.1 % of the women, 42.5 % of which had multiple infection and 69.5 % had high-risk HPV infection. Age-prevalence rates evidenced a peak of HPV infection in women ≤ 20 years of age (53.1 %). HPV 53 and 16 were the most common viral types (13.5 and 12.0 % respectively). Abnormal Pap test results were found in 4.4 % of women with known cytological result. Although a prevalence of HPV positive women higher in African than in European women was expected, the differing rate between residents and migrants African women must be investigated in future studies.