ABSTRACT
Introduction: The recent surge in migration to and within the European Union and European Economic Area has brought the development of migration policy, including health policy, to the forefront of regional priorities. While migrants, in general, do not pose a health threat to the host population, specific subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases. To support public health policies in this area, the Emergency Preparedness and Management' working group of the Italian Society of Hygiene, Preventive Medicine and Public Health has conducted a systematic narrative review with the aim to comprehensively analyze the infectious disease risk within the refugee and asylum seeker populations in EU, EEA, and EU-applicant countries. Methods: Forty-two studies were systematically selected from scientific articles in the MEDLINE/PubMed database from January 1, 2008, to June 1, 2023. The infectious risk associated with each infectious disease among refugees and asylum seekers, as well as the strategies to prevent and control outbreaks, was collected from all available studies. Results: The congregate living conditions in refugee camps, transit centers, and temporary housing facilities make this population particularly vulnerable to infectious diseases. As such, implementing stringent hygiene and preventive measures is critical to safeguarding the health of refugees and reducing the risk of outbreaks that may affect both the refugee population and the host communities. Conclusion: Effective vaccination and preventive strategies for migrants, refugees, and asylum seekers are vital for public health and the well-being of these populations. They should be delivered as part of universal health care. By addressing barriers and implementing tailored programs, we can ensure equitable access to vaccines and protect the health of these vulnerable individuals.
ABSTRACT
Infectious diseases are a major public health concern. In recent decades, there has been a succession of bacterial and viral diseases, which when added to the endemic diseases found in certain areas of the world, can become a global health problem. In emergency medicine we talk a lot about Mass Casualty Incident (MCI) preparedness, but the main focus today is bio-preparedness. Therefore, especially after the Ebola experience, much investment has been made in the development of Biocontainment Units (BCUs). At present, in Italy there are no national realities that have experimented the construction of a completely new biocontainment units detached from the Emergency Department (ED) RNPP-funded. Given this, the project of the Azienda Ospedaliero-Universitaria Pisana (AOUP) is to make renovations on existing ED structure and build an entire new facility for biocontainment.
Subject(s)
Emergency Service, Hospital , Humans , Italy/epidemiologyABSTRACT
BACKGROUND: Readmissions are hospitalizations following a previous hospitalization (called index hospitalization) of the same patient that occurred in the same facility or nursing home. They may be a consequence of the progression of the natural history of a disease, but they may also reveal a previous suboptimal stay, or ineffective management of the underlying clinical condition. Preventing avoidable readmissions has the potential to improve both a patient's quality of life, by avoiding exposure to the risks of re-hospitalization, and the financial well-being of health care systems. METHODS: We investigated the magnitude of 30 day repeat hospitalizations for the same Major Diagnostic Category (MDC) in the Azienda Ospedaliero Universitaria Pisana (AOUP) over the period from 2018 to 2021. Records were divided into only admissions, index admissions and repeated admission. The length of the stay of all groups was compared using analysis of variance and subsequent multi-comparison tests. RESULTS: Results showed a reduction in readmissions over the period examined (from 5.36% in 2018 to 4.46% in 2021), likely due to reduced access to care during the COVID-19 pandemic. We also observed that readmissions predominantly affect the male sex, older age groups, and patients with medical Diagnosis Related Groups (DRGs). The length of stay of readmissions was longer than that of index hospitalization (difference of 1.57 days, 95% CI 1.36-1.78 days, p < 0.001). The length of stay of index hospitalization is longer than that of single hospitalization (difference of 0.62 days, 95% CI 0.52-0.72 days, p < 0.001). CONCLUSIONS: A patient who goes for readmission thus has an overall hospitalization duration of almost two and a half times the length of the stay of a patient with single hospitalization, considering both index hospitalization and readmission. This represents a heavy use of hospital resources, about 10,200 more inpatient days than single hospitalizations, corresponding to a 30-bed ward working with an occupancy rate of 95%. Knowledge of readmissions is an important piece of information in health planning and a useful tool for monitoring the quality of models of patient care.
ABSTRACT
BACKGROUND: Healthcare-associated infections (HAI) are closely related to several factors, such as prolonged hospital stay in high-risk areas and intensive care units, potentially predisposing underlying conditions. It has also been demonstrated that HAI incidence may be related to non-respected standards of assistance, such as not adequately cleaned structures or medical devices contaminated by environmental bacteria and multidrug resistant enterobacteria. OBJECTIVE: In this case it has been carried on an efficacy evaluation of a microionization system using potassium peroxymonosulfate (KMPS) for outpatient clinics indoor air disinfection. MATERIAL AND METHODS: Two outpatient clinics (AMB-1 and AMB-2) were treated with KMPS (1% and 2% concentration), at the end of routinary clinic activities. Microbial sampling of air (settle plates) and surfaces (contact plates) were submitted before and after sanitizing, checking total microbial load at 37°C, possible opportunistic pathogens and moulds. RESULTS: Sanitizing system at 1% concentration was efficient in mesophilic bacteria reduction (max 83%). Moreover, total abatement of Klebsiella pneumoniae in AMB1 and Acinetobacter lwoffi in AMB2 has been seen, both on surfaces. Regarding air samplings, 89% moulds reduction has been seen, as observed on surfaces. Scaling up concentration to 2%, mesophilic bacteria reduction was ≥ 94%, both in air and on surfaces of the outpatient clinics. Same results have also been seen on moulds, whose maximum reduction was 97%. DISCUSSION: Comparing results at different concentrations it has been observed that 2% KMPS induces an higher average reduction of mesophilic bacteria and moulds than 1%. BACKGROUND: In this regard, microbial reduction percentage, either on surfaces or in the air, can be considered positive for outpatient clinics and healthcare settings indoor decontamination.
