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1.
Biomed Res Int ; 2019: 6764154, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355274

RESUMO

Objective. The study aimed to assess the impact of HPV immunization campaigns organizational aspects, the characteristics of immunization program (vaccination targets and type of offer), and communicative strategies adopted by four Italian administrative regions on vaccination coverage observed. Methods. From November 2017 to March 2018, regional and Local Health Units (LHUs) representatives were invited to complete an online survey including 54 questions evaluating vaccination invite systems, access systems to vaccination centres, reminder and recall systems, and adverse events surveillance. An overall descriptive analysis was conducted. Since observed vaccine coverage (VC) obtained in females (2002-2004 birth cohorts) was lower than objectives fixed by the Italian Ministry of Health, variables were assessed using the national VC mean obtained in the 2003 girls birth cohort as outcome. Results. Twenty-six LHUs belonging to 4 Northern and Southern Italian regions participated in the study. Organizational aspects significantly related to VC lower than the national mean were access to vaccine centres without appointment and parents' reservation as appointment planning system. Recall systems for both the first and the second dose, including the appointment in the invitation letter, the availability of regional immunization registry, and education of healthcare workers on universal HPV immunization strategies, instead, were related to higher VC. As regards preadolescent immunization strategies, both VC obtained in girls and boys were far from the Ministerial goals. Only 20% of LHUs introduced multicohort female strategies while all LHUs adopted copayment targeting both men and women. Immunizations strategies targeting subjects at risk were implemented only in half of participating LHUs. Conclusions. VC observed in participating LHUs are largely lower than the national objectives in all anti-HPV vaccine targets. Both organizational and educational strategies have to be implemented to improve the VC goals.


Assuntos
Papillomaviridae/imunologia , Infecções por Papillomavirus/epidemiologia , Vacinas contra Papillomavirus/uso terapêutico , Vacinação , Adulto , Feminino , Humanos , Programas de Imunização , Itália/epidemiologia , Masculino , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/imunologia
2.
Epidemiol Prev ; 43(1): 71-75, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31111716

RESUMO

ESCULAPIO Project, funded by the Centre for Disease Prevention and Control (CCM) of the Italian Ministry of Health, for the program 2013, aims at increasing awareness on vaccine preventable infectious diseases (VPID) and vaccination in different targets of population and at spreading the culture of prevention by the development of information/training interventions on VPID. In Tuscany Region (Central Italy), educational courses on VPID in high schools were organized and students were stimulated to prepare informative materials on VPID for lower grade school pupils. Educational games for school pupils were realized in Liguria Region (Northern Italy) with the aim to increase awareness and knowledge of vaccination among primary school children, their families, and teachers. The Sicilian Operative Unit (OU) developed and validated a questionnaire to collect data on the main factors influencing vaccine uptake in a population from Southern Italy and spreading information on vaccines to the general population. Aim of the activities performed in Apulia Region (Southern Italy) was to collect, directly from the public, a set of issues to which people were more "sensitive," in order to perceive the dimension of informative needs and the misinformation in the field of vaccinations. A toll-free telephone line to answer questions on VPID was also the aim of the Apulian activities. The objective of the OU of Sardinia (Southern Italy) was to increase knowledge on VPID and adherence to immunization campaigns in health care workers (HCW) by realizing traditional and e-learning training courses and initiatives of health promotion in healthcare and hospital setting. Interventions to promote vaccinations in maternal and child health services and outreach interventions in case of parental non-compliance with vaccination schedules were performed in the Veneto Region (Northern Italy), with the aim to reach a particular subgroup of the general population: new or future parents. The activities of Veneto Region aimed also at realizing individual interviews with parents and/or home visit, if considered useful, for families not respondents to the active ordinary call.


Assuntos
Controle de Doenças Transmissíveis/métodos , Comunicação em Saúde , Cobertura Vacinal , Programas Governamentais , Humanos , Itália
3.
Biomed Res Int ; 2019: 7168949, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31008110

RESUMO

Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). This cross-sectional study aimed to determine the prevalence of macrolide-resistant M. pneumoniae strains in a convenience series of 234 adult hospitalised and nonhospitalised subjects with a diagnosis of CAP in January 2013 to April 2015 in South Italy. Methods: Respiratory samples were subjected to real-time PCR. In M. pneumoniae-positive samples, domain V of 23S rRNA was sequenced to detect resistance-conferring point mutations. P1 major adhesion protein typing and multiple loci variable-number tandem repeat analysis (MLVA) were also performed. Results: Of the 234 samples, 15 (6.4%) were positive for M. pneumoniae. Three of these had a macrolide-resistant genotype: two and one had A2063G and A2064G mutations, respectively. Fourteen of the 15 strains were subtyped: half had subtype 1 and half had subtype 2. Eight strains underwent MLVA profiling: one each had the J, A, and Z type. The remainder was unclassifiable. Conclusions: This novel discovery of macrolide-resistant M. pneumoniae strains in adults with CAP in Italy suggests that there may be increasing circulation of these strains in the population. To facilitate rapid optimization of the antibiotic strategy in Italy, macrolide resistance should be monitored by a surveillance system that is based on molecular methods.


Assuntos
Infecções Comunitárias Adquiridas/tratamento farmacológico , Farmacorresistência Bacteriana/genética , Macrolídeos/uso terapêutico , Pneumonia por Mycoplasma/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/genética , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Genótipo , Humanos , Itália/epidemiologia , Macrolídeos/efeitos adversos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Repetições Minissatélites/genética , Mutação , Mycoplasma pneumoniae/efeitos dos fármacos , Mycoplasma pneumoniae/genética , Mycoplasma pneumoniae/patogenicidade , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/genética , Pneumonia por Mycoplasma/microbiologia , Adulto Jovem
4.
Ig Sanita Pubbl ; 74(3): 265-277, 2018.
Artigo em Italiano | MEDLINE | ID: mdl-30235467

RESUMO

The aim of this study was to describe preliminary performance indicators of the cervical cancer screening and HPV vaccination integrated strategy, offered to women aged 25 years residing in the province of Foggia (Apulia, Italy). During the two-year period 2015-16, receiving HPV vaccination, first dose and/or the full vaccination series, was significantly associated with compliance to screening (p<0,0001) in the first two birth cohorts (1991 and 1992 cohorts) targeted by this integrated strategy.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adulto , Detecção Precoce de Câncer , Feminino , Humanos , Itália , Programas de Rastreamento , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Vacinação
5.
Eur J Cancer Care (Engl) ; 27(5): e12905, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30178893

RESUMO

We aimed to assess the cervical cancer burden and performance of screening programme over the last decade in Apulia, Italy. Data from Hospital Discharge, Causes of Death and of Outpatient Services registries were analysed to estimate the disease burden, and data collected by the screening information system were used to evaluate the performance of the programme. We computed annual hospitalisation, incidence and mortality rates and number of outpatient services prescriptions for the follow-up of preneoplastic/neoplastic lesions. Indicators as proposed by the National Centre for Screening Monitoring were computed to describe the screening performance. Hospitalisation rates declined from 47 in 2001 to 28 per 100,000 in 2014, incidence from 10.3 in 2004 to 6.0 per 100,000 in 2014 and mortality from 1.4 in 2001 to 1.0 per 100,000 in 2010. Prescriptions increased from 3,333 in 2006 to 4,968 in 2010, then decreased to 3,634/year in 2012-2014. Actual extension of screening increased from 10.8% in 2007 to 62% in 2014; compliance with the invitation was 32%/year. In the last decade, we observed a reduction in the cervical cancer burden as early effect of screening implementation.


Assuntos
Detecção Precoce de Câncer , Programas de Rastreamento/organização & administração , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/estatística & dados numéricos , Adulto , Antineoplásicos/uso terapêutico , Neoplasia Intraepitelial Cervical/diagnóstico , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Itália/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem
6.
Front Public Health ; 6: 37, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29503815

RESUMO

Background: Vaccine-preventable diseases among high-risk patients are a public health priority in high-income countries. Most national immunization programs have included vaccination recommendations for these population groups but they remain hard-to-reach and coverage data are poorly available. In a pilot study, we developed and tested an automated approach for identifying individuals with underlying medical conditions to feed an immunization information system (IIS). Methods: We reviewed published recommendations on medical conditions that indicate vaccination against influenza, pneumococcal disease, meningococcal disease, hepatitis A, and hepatitis B. For each medical condition, we identified the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure codes, the user fee exempt codes and the Anatomical Therapeutic Chemical Classification System codes and we reported these data in correspondence tables. Using these tables, we extracted three lists of patients recorded in three current data sources between 2001 and 2010 in the Apulia region of Italy: the hospital discharge registry, the user fee exempt registry, and the drug prescription registry. Using a unique personal identification number, we linked these three lists of patients with the regional IIS (2012 database), obtaining a list of patients with chronic diseases eligible for vaccination. We tested completeness, sensitivity, and positive predictive value (PPV) of this approach by asking a sample of 28 general practitioners (GPs) to evaluate the matching between a sublist of patients with clinical recommendations for influenza vaccination and the GPs individual subjects medical records. Results: We included a total of 1,204,496 subjects with underlying medical conditions eligible to receive any of the aforementioned vaccinations. Of these, 9% were identified in all three data sources, 18% in two sources, and 73% in one source. The completeness of this automated process in identifying GPs high-risk patients eligible for influenza vaccination was 88.9% [95% confidence intervals (95% CI): 88.1-89.8%], with a sensitivity of 69.2% (95% CI: 67.7-70.6%) and a PPV of 85.7% (95% CI: 84.4-86.8%). Conclusion: The high completeness of the methodology used for identifying high-risk patients in current data sources encouraged us to apply this approach for feeding the regional IIS.

7.
BMJ Open ; 8(3): e019034, 2018 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-29581200

RESUMO

OBJECTIVES: Current strategies to prevent adult pneumococcal disease have been recently reviewed in Italy. We did a postlicensure study to estimate the direct vaccine effectiveness (VE) of the 13-valent pneumococcal conjugate vaccine (PCV13) against adult pneumococcal community-acquired pneumonia (pCAP). STUDY DESIGN: Between 2013 and 2015, a 2-year prospective cohort study of adults with CAP was conducted in the Apulia region of Italy where the average vaccine uptake of PCV13 was 32% among adults ≥65 years. The test-negative design was used to estimate VE against all episodes of confirmed pCAP and vaccine-type (VT)-CAP. VE in a subgroup of patients managed in the community was also estimated using a matched case-control design. VE was calculated as one minus the OR times 100%. RESULTS: The overall VE of PCV13 was 33.2% (95% CI -106.6% to 82%) against pCAP irrespective of serotype and 38.1% (95% CI -131.9% to 89%) against VT-CAP in the cohort of adults ≥65 years. The VE was 42.3% (95% CI -244.1% to 94.7%) against VT-CAP in the age group at higher vaccine uptake. For the subgroup of cases managed in the community, the overall VE against disease due to any pneumococcal strain was 88.1% (95% CI 4.2% to 98.5%) and 91.7% (95% CI 13.1% to 99.2%) when we controlled for underlying conditions. CONCLUSIONS: Although our results are non-significant, PCV13 promises to be effective against all confirmed pCAP already with modest levels of uptake in the population of adults ≥65 years of age. Larger studies are needed to confirm the direct vaccine benefits.


Assuntos
Vacinas Pneumocócicas/normas , Pneumonia Pneumocócica/prevenção & controle , Adulto , Idoso , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/prevenção & controle , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/imunologia , Prevalência , Estudos Prospectivos , Estações do Ano , Streptococcus pneumoniae/imunologia , Vacinas Conjugadas
8.
Open AIDS J ; 12: 6-10, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29576814

RESUMO

Background: HIV infection is a known prothrombotic condition but factors involved are still controversial. A role for antiretrovirals, especially protease inhibitors, was advocated. Objectives: The study aimed to analyze the levels of anticoagulant proteins in virally suppressed HIV-infected subjects treated with different anti-retroviral regimens. Materials and Methods: Forty-four patients were included in the study. C and PS, D-Dimers and Fibrinogen levels were determined as well as APC-resistance. PROS1 gene was sequenced in a group of patient. Results: Twelve of the 44 subjects (27%) showed reduced levels of PS, while lower levels of PC were found only in 2 patients (4,5%). No difference in the mean values of PC and PS was found stratifying the study population by antiretroviral regimen administrated (p>0.05).Three patients had higher levels of D-Dimer concentrations and in two of these patients, an association between higher D-Dimer values and lower levels of PS was observed; but however no correlation was found by statistical analysis.PROS1 gene analysis was performed in 26 of the 44 HIV-1 patients and the subjects with low levels of PS had mutation in the fifteen exon of PROS 1 gene. While among individuals with normal levels, this mutation was observed only in 8/18 (44%) of the cases (p=0,0072). Conclusion: The majority of patients with low PS levels also had mutations in the fifteen exon of PROS 1 gene. Genetic determinants, deserving further investigations, rather than antiretrovirals might cause PS deficiency in HIV-1 positive patients.

9.
Vaccine ; 36(6): 779-787, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29325822

RESUMO

In Italy, in 2016, we conducted a cross-sectional survey to estimate vaccine hesitancy and investigate its determinants among parents of children aged 16-36 months. Data on parental attitudes and beliefs about vaccinations were collected through a questionnaire administered online or self-administered at pediatricians' offices and nurseries. Parents were classified as pro-vaccine, vaccine-hesitant or anti-vaccine, according to self-reported tetanus and measles vaccination status of their child. Multivariable logistic regression was used to investigate factors associated with hesitancy. A total of 3130 questionnaires were analysed: 83.7% of parents were pro-vaccine, 15.6% vaccine-hesitant and 0.7% anti-vaccine. Safety concerns are the main reported reason for refusing (38.1%) or interrupting (42.4%) vaccination. Anti-vaccine and hesitant parents are significantly more afraid than pro-vaccine parents of short-term (85.7 and 79.7% vs 60.4%) and long-term (95.2 and 72.3% vs 43.7%) vaccine adverse reactions. Most pro-vaccine and hesitant parents agree about the benefits of vaccinations. Family pediatricians are considered a reliable source of information by most pro-vaccine and hesitant parents (96.9 and 83.3% respectively), against 45% of anti-vaccine parents. The main factors associated with hesitancy were found to be: not having received from a paediatrician a recommendation to fully vaccinate their child [adjusted odds ratio (AOR): 3.21, 95% CI: 2.14-4.79], having received discordant opinions on vaccinations (AOR: 1.64, 95% CI: 1.11-2.43), having met parents of children who experienced serious adverse reactions (AOR: 1.49, 95% CI: 1.03-2.15), and mainly using non-traditional medical treatments (AOR: 2.05, 95% CI: 1.31-3.19). Vaccine safety is perceived as a concern by all parents, although more so by hesitant and anti-vaccine parents. Similarly to pro-vaccine parents, hesitant parents consider vaccination an important prevention tool and trust their family pediatricians, suggesting that they could benefit from appropriate communication interventions. Training health professionals and providing homogenous information about vaccinations, in line with national recommendations, are crucial for responding to their concerns.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pais , Aceitação pelo Paciente de Cuidados de Saúde , Vacinação , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Itália , Masculino , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância em Saúde Pública , Fatores Socioeconômicos , Inquéritos e Questionários , Vacinação/estatística & dados numéricos
10.
Vaccine ; 36(8): 1072-1077, 2018 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29358055

RESUMO

Since 2013, World Health Organization (WHO) recommended that adverse events following immunization (AEFIs) should be evaluated by a standardized algorithm for causality assessment, however the use of WHO procedure is rarely adopted. In Italy, AEFIs (classified only by temporal criteria) are registered in the National Drug Authority (AIFA) database, but causality assessment is not mandatory. Every year AIFA publishes the AEFIs report, that doesn't contain information about causal correlation between events and vaccines. From AIFA database, we selected AEFIs following human papillomavirus vaccination (HPV) reported in Apulia (about 4,000,000 inhabitants) during 2008-2016. For serious AEFIs, we applied WHO causality assessment criteria; for cases hospitalized, we repeated the assessment getting additional information from health documentation. In 2008-2016, 100 HPV AEFIs (reporting rate: 17.8 per 100,000 doses) were registered of which 19 were serious (rate: 3.4 per 100,000 doses) and 12 led to hospitalization. After causality assessment, for 9 AEFIs the classification was "consistent causal association to immunization", for 3 indeterminate, for 5 "inconsistent causal association to immunization" and for 2 not-classifiable. Among hospitalized patients, 5 AEFIs were consistent, 5 inconsistent, 1 not-classifiable and 1 indeterminate; adding information from health documentation, the results were similar except for indeterminate and not classifiable AEFIs that turned into "not consistent". Only half of severe AEFIs could be associated with vaccination and this suggests that AIFA report provides a incomplete picture of HPV vaccine safety, with a risk for readers to confound "post hoc" and "propter hoc" approach without considering the causality assessment results. In the view of the systematic use of WHO causality assessment algorithm in the AEFI surveillance, the efforts of Public Health must be focused on the improvement of the quality of the information provided to reduce conclusions inter-observer variability; the routine follow-up of reports, also to collect additional information, must be guaranteed.


Assuntos
Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/efeitos adversos , Vacinação/efeitos adversos , Adolescente , Algoritmos , Causalidade , Criança , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Vacinas contra Papillomavirus/administração & dosagem , Organização Mundial da Saúde , Adulto Jovem
11.
Clin Respir J ; 12(2): 418-424, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27421948

RESUMO

INTRODUCTION: Today, an increasing interest is being addressed to the viral etiology of lung tumors. As a consequence, research efforts are currently being directed to the identification of the new viruses involved in lung carcinogenesis toward which the screening programs could be directed. OBJECTIVES: The aim of this study was to investigate the airways colonization by the Epstein-Barr virus (EBV) and Citomegalovirus (CMV) in patients affected by lung cancer using, as a respiratory non-invasive sample, the exhaled breath condensate (EBC). METHODS: About 70 lung-cancer patients and 40 controls were enrolled. All subjects underwent bronchial brushing and EBC collection. EBV-DNA and CMV-DNA were evaluated in both samples by real-time PCR assay. RESULTS: They were able to detect EBV and CMV in the EBC. An increase of the EBV positivity in non-small cell lung cancer (NSCLC) patients compared with controls and of the CMV in advanced stages of lung cancer were observed. The association of the positivity of the cytology and the CMV test (in EBC or brushing) slightly increased the sensitivity of malignant diagnosis. CONCLUSION: EBV and CMV resulted detectable in the EBC. In consideration of the potential involvement of these viruses in lung cancer, which was confirmed in this study, future studies in this direction were supported.


Assuntos
Testes Respiratórios/métodos , Carcinoma Pulmonar de Células não Pequenas/virologia , Citomegalovirus/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Neoplasias Pulmonares/virologia , Pulmão/virologia , Infecções Respiratórias/virologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Citomegalovirus/genética , Citomegalovirus/crescimento & desenvolvimento , Expiração/fisiologia , Feminino , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/crescimento & desenvolvimento , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Fumar/epidemiologia , Carga Viral
12.
Vaccine ; 35(46): 6297-6301, 2017 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-28988865

RESUMO

In Italy, Hib conjugate vaccine was introduced for infants in 1999 and included in the DTaP-HBV-IPV-Hib combination in 2001, with an uptake of 83.4% in 2002, >90% by 2005, and >95% by 2011. We estimated the impact of Hib vaccination on hospitalizations for H. influenzae invasive disease in children <5years. Age-specific hospitalization rates and hospitalization risk ratios (HRRs) with 95%CI during 2001-2013 were calculated performing time-series analysis. The number of cases reported to the national surveillance of invasive bacterial diseases was compared to the number of hospitalizations between 2007-2013. Hospitalization rates declined from 2.3 in 2001 to 0.9×100,000 in 2002 (HRR=0.4, 95%CI=0.3-0.6, p<0.05) among children 1-4years and from 5.4 in 2001 to 2.4×100,000 in 2005 (HRR=0.4, 95%CI=0.2-0.9, p<0.05) among infants. During 2007-2013: 401 cases were reported, 242 were typed, 12.4% were by serotype b; 861 hospital admissions were recorded. Applying the percentage of typed b strains retrieved from the surveillance to the number of hospitalizations for invasive H. influenzae disease, an estimated 107 episodes could be attributable to serotype b. These findings provided reassuring data on the impact of Hib vaccination on the burden of hospitalization for invasive disease in Italian children.


Assuntos
Vacina contra Difteria, Tétano e Coqueluche/imunologia , Infecções por Haemophilus/prevenção & controle , Vacinas Anti-Haemophilus/imunologia , Haemophilus influenzae tipo b/imunologia , Vacinas contra Hepatite B/imunologia , Hospitalização , Vacina Antipólio de Vírus Inativado/imunologia , Fatores Etários , Pré-Escolar , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Feminino , Vacinas Anti-Haemophilus/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Humanos , Lactente , Recém-Nascido , Itália/epidemiologia , Masculino , Meningite por Haemophilus/epidemiologia , Vacina Antipólio de Vírus Inativado/administração & dosagem , Medição de Risco , Sepse/epidemiologia , Vacinas Combinadas/administração & dosagem , Vacinas Combinadas/imunologia
13.
Aging Clin Exp Res ; 29(4): 771-779, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28608255

RESUMO

BACKGROUND: Herpes zoster (HZ) has a relevant impact on the population in terms of incidence and complications. AIMS: The aim of this study was to estimate the HZ-related hospitalization rates in Italy in the period 2001-2013, and to evaluate the trend of hospitalizations in the course of time pointing out any differences between regions that have or have not introduced universal childhood varicella immunization (UVI). METHODS: A retrospective analysis was conducted on hospital discharge records contained in the national database of the Ministry of Health for the period January 2001-December 2013. The comparison of hospitalization rates of "pilot" versus "not pilot" regions was performed taking into account as "pilot" regions the three that first introduced UVI (Sicily, Veneto, and Apulia). The average annual percentage change in hospitalization rates was used to highlight any significant change in time trends. RESULTS: In the period 2001-2013, 93,808 HZ-related hospitalizations were registered altogether. Complicated HZ was diagnosed in 53.2% of cases; a relevant part (32.5%) of hospitalizations involved subjects with at least one co-morbidity. In the three Italian "pilot" regions, a greater decrease of HZ-related hospitalization rates occurred in comparison to other regions. DISCUSSION: A good understanding of the epidemiology of HZ disease is required to assess the overall impact of the varicella immunization programs and to establish the most appropriate health strategies against HZ. CONCLUSIONS: The data obtained confirm the epidemiological impact of HZ and its complications and the need of a preventive approach.


Assuntos
Vacina contra Herpes Zoster/imunologia , Herpes Zoster/epidemiologia , Programas de Imunização/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
BMC Res Notes ; 10(1): 216, 2017 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-28629409

RESUMO

BACKGROUND: Migrants in Italy are prevalently young adults, with a higher risk of sexual transmitted infections (STI) and HIV infection. Promoting consistent as well as correct use of condoms could reduce failure rate due to their improper use. The aim of our study was to evaluate Condom Use Skills among a migrant population recently landed in Italy, hosted in a government center for asylum seekers. METHODS: The study sample was composed of 80 male migrants. Sanitary trained interviewers submitted a questionnaire to participants to investigate age, provenience, marital status, educational level and knowledge about transmission and prevention of HIV/STI. Then, we assessed participants' level of condom use skill with the Condom Use Skills (CUS) measure by using a wooden penile model. The interviewer filled in a checklist and assigned 1 point for correct demonstration of each behavior that may prevent condom failure during sex. RESULTS: Participants' median age was 26 years and the sample was composed of 54 migrants from sub-Saharan Africa and 26 from Middle East. Most of them were married, with a lower middle level of education, up to 8 or 5 years. Half of the sample achieved the highest score in the questionnaire and our CUS showed a large number of people with middle high score classes. The Spearman's rho was 0.30, therefore answers to the questionnaire and CUS score appeared correlated (p < 0.05). In the multivariate model, to have a higher CUS score resulted to be associated to be older than 26 years (p < 0.05), with a higher level of education (p = 0.001), and a higher score in the questionnaire (p < 0.05). There were no significant differences in the level of CUS between single or married men and between African and Middle Asian migrants of the sample. CONCLUSIONS: Our study shows that educational level influences the quality of knowledge and awareness about STI/AIDS and contribute to correct condom use. Since the half of participants had a low educational level and linguistic problems, the risk of missing campaigns messages or misunderstanding informative materials increases. Direct observation of condom-application on penile model may offer realistic assessment of application skills in these individuals.


Assuntos
Preservativos/ética , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , África , Educação em Saúde , Humanos , Itália , Masculino , Estado Civil , Oriente Médio , Modelos Anatômicos , Pênis/anatomia & histologia , Pênis/fisiologia , Sexo Seguro , Comportamento Sexual , Migrantes/educação
15.
Hum Vaccin Immunother ; 13(8): 1937-1941, 2017 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-28463582

RESUMO

Influenza vaccination is strongly recommended for Italian healthcare professionals, but vaccine coverage is low. Since 2012, vaccination is also offered to medical students as part of the National Immunization Plan; however, few Medical Schools has implemented the plan so far. To study determinants of vaccination compliance, we conducted a survey among medical students at the University of Bari, where influenza vaccination has been actively offered since 2013. Information was obtained by means of an online anonymous questionnaire administered in April 2014. We enrolled 669 students, 383 (57%) vaccinated; 54% were female and the average age was 23.9 ± 4.9 y. Determinants of getting vaccinated were analyzed in a multivariate logistic model. Receiving invitation from the University (aOR = 3.8; 95%CI = 1.2-12.3; p = 0.026), the opinion that vaccine is safe (aOR = 2.8; 95%CI = 1.5-5.0; p = 0.001) and useful (aOR = 3.4; 95%CI = 1.7-6.7; p<0.0001), a specific training about influenza vaccination during the course (aOR = 1.5; 95%CI = 1.1-2.1; p = 0.043), and considering himself as at a major risk of influenza complication (aOR = 1.8; 95% CI = 1.1-2.9; p = 0.001) were significantly associated with vaccine acceptance. Active invitation and training are confirmed as key actions (as in children vaccination strategies) and, according to our results, they could be routinely used to promote vaccination in hard-to-reach groups such as healthcare workers.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza , Estudantes de Medicina/psicologia , Vacinação/psicologia , Estudos de Casos e Controles , Educação Médica , Feminino , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Humanos , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Itália , Modelos Logísticos , Masculino , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Vacinação/efeitos adversos
16.
Parasit Vectors ; 10(1): 107, 2017 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-28241860

RESUMO

We report a Trichinella britovi outbreak investigated during February-March 2016 in southern Italy. The source of infection was meat from infected wild boars that were illegally hunted and, hence, not submitted to post-mortem veterinary inspection. Thirty persons reported having eaten raw dried homemade sausages; five cases of trichinellosis were confirmed. Wild game meat consumers need to be educated about the risk for trichinellosis.


Assuntos
Surtos de Doenças , Carne Vermelha/parasitologia , Sus scrofa/parasitologia , Triquinelose/epidemiologia , Triquinelose/transmissão , Adulto , Animais , Feminino , Humanos , Itália/epidemiologia , Masculino , Alimentos Crus/parasitologia , Fatores de Risco , Trichinella/efeitos dos fármacos , Trichinella/isolamento & purificação , Triquinelose/tratamento farmacológico , Triquinelose/parasitologia , Zoonoses
17.
Hum Vaccin Immunother ; 13(2): 369-375, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28215120

RESUMO

The ESCULAPIO Project aims at increasing awareness on vaccine preventable infectious diseases (VPID) and vaccinations in different target populations and to spread the culture of prevention. Information/training interventions on VPID have been developed and health promotion activities for the general population, students and their parents, teachers and health care workers (HCWs) were set up. In Tuscany, educational courses on VPID in high schools were organized and students were stimulated to prepare informative materials on VPID for lower grade school pupils. In Liguria, an educational card game (named 'Vaccine at the Fair') was presented to children of primary schools. Stands in shopping centers were used in Palermo to distribute the regional vaccination schedule and gadgets, also providing indications on reliable websites where to find correct information on vaccinations. A music video played by health care workers (HCWs) was created and used in the University Hospital of Cagliari to promote the anti-flu vaccination campaign in HCWs. In Apulia, meetings with the general population were organized to collect controversial issues about vaccinations and a national call center was launched to create a direct line from the general population to experts in vaccines and vaccination strategies. In Veneto, meetings in the birth centers and home visits for subjects refusing vaccination have been organized. All activities are useful and effective tools to increase knowledge about VPID and confidence in vaccination, which are crucial aspects in order to increase vaccine uptake. The project was funded by the Italian Ministry of Health, Center for Disease Prevention and Control (CCM) in 2013.


Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Comunicação em Saúde/métodos , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem , Vacinas/imunologia , Adolescente , Feminino , Humanos , Itália , Masculino , Instituições Acadêmicas , Adulto Jovem
18.
Hum Vaccin Immunother ; 13(2): 399-404, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27925843

RESUMO

Herpes Zoster (HZ) and its main complication, post-herpetic neuralgia (PHN), represent important public health issues because of their relevant burden among older adults. However, data on the epidemiology of HZ and PHN in Italy are very limited. A population-based study was performed by seeking for cases of HZ and PHN, occurred in the period 2013-2015, in the clinical charts of 56 General Practitioners working in 4 Italian Regions (Liguria, Puglia, Toscana and Veneto). The main objective of the study was to estimate the incidence of HZ and the proportion of PHN (at 1 and 3 mo from the onset of HZ; PHN1 and PHN3) among people aged ≥ 50 y. Overall, 598 cases of HZ were identified over 93,146 person-years of observation, thus corresponding to an overall incidence of 6.42 (IC95%: 5.93 - 6.95) HZ cases per 1,000 person-years. The incidence of HZ increased with age and was higher in female than in male. In total, 22.7%, 12.7%, and 2.4% of HZ cases suffered PHN at 1 and 3 mo and 1 y from the onset of acute episode. The proportions of these complications significantly increased with age, with the peak occurring in people aged ≥ 85 y. Four per cent of patients suffered ophthalmic zoster. The study provided an update of the epidemiological burden of HZ and PHN in Italy, confirming the relevant burden of the disease in the elderly population. The study was funded by the Italian Ministry of Health, Center for Disease Prevention and Control (CCM) in 2013.


Assuntos
Herpes Zoster/complicações , Herpes Zoster/epidemiologia , Neuralgia Pós-Herpética/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
19.
Hum Vaccin Immunother ; 13(2): 405-411, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27925856

RESUMO

Herpes zoster (HZ) is a very relevant pathology among elderly people (≥ 60 years of age), with a considerable disease burden and loss of quality of life. In the last years a new vaccine against HZ became available in Italy. Therefore, the Italian decision makers are now confronted with the decision whether that vaccination should be implemented. Pharmaco-economic analyses represent useful tools to value the feasibility of new immunization programs and their sustainability. To this aim, an ad hoc population model was developed in order to value the clinical and economic impact of HZ vaccination program for the elderly in Italy. Particularly, different immunization scenarios were modeled: vaccination of 60 years-old subjects (single cohort strategy), simultaneous vaccination of people aged 60 and 65 years (double cohort strategy) and, lastly, immunization of people aged 60, 65 and 70 years (triple cohort strategy), thus leading to the vaccination of 5, 10 and 15 cohorts during the first 5 years of the program. The mathematical model valued the clinical impact of vaccination on the number of HZ, post-herpetic neuralgia (PHN) and ophthalmic HZ. The results of the analysis show that, in Italy, a cohort-based HZ vaccination program in elderly could have a relevant impact on the reduction of clinical cases and a favorable economic profile for the National Health Service (NHS), as already foreseen in other countries. In addition, further benefits could be obtained when extending the study period beyond the 5-year horizon of our analysis.


Assuntos
Análise Custo-Benefício , Vacina contra Herpes Zoster/economia , Herpes Zoster/economia , Herpes Zoster/prevenção & controle , Vacinação/economia , Idoso , Idoso de 80 Anos ou mais , Feminino , Herpes Zoster/epidemiologia , Vacina contra Herpes Zoster/administração & dosagem , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Proteínas , Vacinação/estatística & dados numéricos
20.
J Cancer ; 7(15): 2266-2269, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27994663

RESUMO

Our research group demonstrated, in a precedent study, the prognostic power of the 3p microsatellites alterations (MAs) detectable in exhaled breath condensate (EBC) in NSCLC patients. The analysis of genetic markers in the EBC might have precious clinical and economic consequences when inserted in diagnostic and follow up programs for lung cancer. The aim of this study was to evaluate the prognostic value of a new panel of MAs in the EBC of patients with NSCLC. We enrolled 45 NSCLC patients during a period of 36 months and the follow-up period was 156 weeks. We analyzed MAs for eight markers in EBC samples: D3S2338, D3S1266, D3S1300, D3S1304, D3S1289, D5S2094, D3S1313, and AFMa305ye1. Our study showed that the presence of more than 2 simultaneous MAs reduces outcome in NSCLC patients. The new panel of eight microsatellites markers proposed in EBC samples could have a potential clinical role in assessing survival in lung cancer patients.

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