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Tramuto F, Marotta C, Stefanelli P, Cernigliaro A, Maida CM, Silenzi A, Angeloni U, Di Naro D, Randazzo G, Guzzetta V, Barone T, Brusaferro S, Severoni S, Rezza G, Vitale F, Mazzucco W. SARS-CoV-2 genomic surveillance of migrants arriving to Europe through the Mediterranean routes. J Glob Health 2024; 14:05017. [PMID: 38963881 PMCID: PMC11223754 DOI: 10.7189/jogh.14.05017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
Background The implementation genomic-based surveillance on emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in low-income countries, which have inadequate molecular and sequencing capabilities and limited vaccine storage, represents a challenge for public health. To date, there is little evidence on molecular investigations of SARS-CoV-2 variants in areas where they might emerge. We report the findings of an experimental SARS-CoV-2 molecular surveillance programme for migrants, refugees, and asylum seekers arriving to Europe via Italy through the Mediterranean Sea. Methods We descriptively analysed data on migrants collected at entry points in Sicily from February 2021 to May 2022. These entry points are integrated with a network of laboratories fully equipped for molecular analyses, which performed next-generation sequencing and used Nextclade and the Pangolin coronavirus disease 2019 (COVID-19) tools for clade/lineage assignment. Results We obtained 472 full-length SARS-CoV-2 sequences and identified 12 unique clades belonging to 31 different lineages. The delta variant accounted for 43.6% of all genomes, followed by clades 21D (Eta) and 20A (25.4% and 11.4%, respectively). Notably, some of the identified lineages (A.23.1, A.27, and A.29) predicted their introduction into the migration area. The mutation analysis allowed us to identify 617 different amino acid substitutions, 156 amino acid deletions, 7 stop codons, and 6 amino acid insertions. Lastly, we highlighted the geographical distribution patterns of some mutational profiles occurring in the migrants' countries of origin. Conclusions Genome-based molecular surveillance dedicated to migrant populations from low-resource areas may be useful for forecasting new epidemiological scenarios related to SARS-CoV-2 variants or other emerging pathogens, as well as for informing the updating of vaccination strategies.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ‘G. D’Alessandro’, University of Palermo, Italy
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Claudia Marotta
- General Directorate of Health Prevention, Ministry of Health, Rome, Italy
| | - Paola Stefanelli
- National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | | | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ‘G. D’Alessandro’, University of Palermo, Italy
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Andrea Silenzi
- General Directorate of Health Prevention, Ministry of Health, Rome, Italy
| | - Ulrico Angeloni
- General Directorate of Health Prevention, Ministry of Health, Rome, Italy
| | - Daniela Di Naro
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Giulia Randazzo
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Valeria Guzzetta
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Teresa Barone
- Department of Laboratory Diagnostics, Local Health Unit of Palermo, Palermo, Italy
| | - Silvio Brusaferro
- National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
- University of Udine, Udine, Italy
| | - Santino Severoni
- Health and Migration Programme (PHM), World Health Organization, Geneva, Switzerland
| | - Gianni Rezza
- General Directorate of Health Prevention, Ministry of Health, Rome, Italy
- Vita – Salute San Raffaele University, Milan, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ‘G. D’Alessandro’, University of Palermo, Italy
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ‘G. D’Alessandro’, University of Palermo, Italy
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
- Division of Biostatistics & Epidemiology Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - SAMI-Surv CollaborationAlbaDavideAmodioEmanueleCasuccioAlessandraCostantinoClaudioFruscioneSantoImmordinoPalmiraRestivoVincenzoSavatteriAlessandraD’AgostinoNadiaLa MiliaDanielePecoraroLauraPulvirentiClaudioStabileDomenicoCesariCarloZichichiSalvatoreLo PrestiAlessandraGrazianoGiorgioScondottoSalvatoreRealeStefanoScibettaSilviaVitaleFabrizioBarracoChiaraMistrettaGiuseppaPalmeriGiuliaRizzoAntonina PatriziaSparacoAntoninoAgnoneAnnalisaCascioFrancescoDi QuartoDaniela LauraMigliorisiCarmeloD’AmatoStefaniaCucchiaraValentinaGenoveseDarioFrisciaGiuseppeIacolinoGiorgiaSpotoVittorioZappiaMario
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties ‘G. D’Alessandro’, University of Palermo, Italy
- Clinical Epidemiology Unit and Regional Reference Laboratory of Western Sicily for the Emergence of COVID-19, University Hospital ‘P. Giaccone’, Palermo, Italy
- General Directorate of Health Prevention, Ministry of Health, Rome, Italy
- National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
- Regional Health Authority of Sicily, Palermo, Italy
- Department of Laboratory Diagnostics, Local Health Unit of Palermo, Palermo, Italy
- University of Udine, Udine, Italy
- Health and Migration Programme (PHM), World Health Organization, Geneva, Switzerland
- Vita – Salute San Raffaele University, Milan, Italy
- Division of Biostatistics & Epidemiology Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
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2
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Brusca I, Barrale M, Zarcone M, Fruscione S, Onida R, De Bella DD, Alba D, Belluzzo M, Uasuf CG, Cammilleri G, Costa A, Ferrantelli V, Savatteri A, Cannizzaro E, Calamusa G, Lacca G, Maida CM, Pipitone S, D'Atria A, Palomba M, Costantino C, Mattiucci S, Mazzucco W. Basophil Activation Test in the Diagnosis of Anisakis Allergy: An Observational Study from an Area of High Seafood Consumption in Italy. Pathogens 2023; 12:777. [PMID: 37375467 DOI: 10.3390/pathogens12060777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The rising popularity of undercooked or raw seafood containing larvae of the Anisakis parasite has led to issues of public health concern due to allergic manifestations. We conducted an observational study on the use of an innovative Anisakis allergy diagnostic algorithm in a convenience sample of 53 allergic outpatients recruited in Western Sicily, between April 2021 and March 2022. We included individuals with an anamnesis suggestive of IgE sensitization to Anisakis reporting clinical manifestation in the last month due to allergic reactions after eating fresh fish, or in subjects at high exposure risk with sea products while abstaining from fish ingestion, excluding those with documented fish sensitization. Outpatients were tested via Skin Prick Test, IgE-specific dosage and Basophil Activation Test (BAT). Twenty-six outpatients were diagnosed with Anisakis, while 27 with Chronic Urticaria (CU). We found a seven-fold excess risk for Anisakis (p4) positivity in the Anisakis allergic outpatients, as compared to the CU ones. BAT showed the best diagnostic accuracy (92.45%) and specificity (100%), while specific IgE to Ascaris (p1) documented the best sensitivity (92.31%) but a very low specificity (37.04%). In conclusion, our findings may represent a potentially useful contribution to the future development of updated clinical guidelines.
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Affiliation(s)
- Ignazio Brusca
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | - Maria Barrale
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | - Maurizio Zarcone
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Santo Fruscione
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Rosa Onida
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | | | - Davide Alba
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Miriam Belluzzo
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Carina Gabriela Uasuf
- Allergy Disease Center, Institute of Translational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy
| | | | - Antonella Costa
- Experimental Zooprophylactic Institute of Sicily, 90129 Palermo, Italy
| | | | | | | | | | - Guido Lacca
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | | | - Salvatore Pipitone
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Alida D'Atria
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Marialetizia Palomba
- Department of Ecological and Biological Sciences, Tuscia University, 01100 Viterbo, Italy
| | | | - Simonetta Mattiucci
- Department of Public Health and Infectious Diseases, Section of Parasitology, Sapienza-University of Rome, University Hospital "Policlinico Umberto I", 00185 Rome, Italy
| | - Walter Mazzucco
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
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First detection of SARS-CoV-2 A.23.1 sub-lineage in migrants arriving to Italy via the Mediterranean Sea and public health implications. Travel Med Infect Dis 2021; 43:102142. [PMID: 34280534 PMCID: PMC8284064 DOI: 10.1016/j.tmaid.2021.102142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022]
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4
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Tramuto F, Reale S, Lo Presti A, Vitale F, Pulvirenti C, Rezza G, Vitale F, Purpari G, Maida CM, Zichichi S, Scibetta S, Mazzucco W, Stefanelli P. Genomic Analysis and Lineage Identification of SARS-CoV-2 Strains in Migrants Accessing Europe Through the Libyan Route. Front Public Health 2021; 9:632645. [PMID: 33937168 PMCID: PMC8082074 DOI: 10.3389/fpubh.2021.632645] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/15/2021] [Indexed: 12/03/2022] Open
Abstract
Many African countries, representing the origin of the majority of refugees, asylum-seekers, and other migrants, toward regions bordering on the Mediterranean area, are experiencing sustained local transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sicily is one of the main entry gates of migrants crossing into Europe. We conducted a pilot study, based on the full-genome sequencing of SARS-CoV-2 strains isolated from migrants coming to Sicily by crossing the Mediterranean Sea, with the aim to investigate the viral genome polymorphism and to describe their genetic variations and the phylogenetic relationships. On June 21, a nongovernmental organization vessel rescued 210 migrants crossing the Mediterranean Sea from Libya to Sicily. Of them, 13.4% tested positive for SARS-CoV-2. Eighteen whole genome sequences were obtained to explore viral genetic variability. All but one of the sequences clustered with other viral African strains within the lineage A, whereas only one intermixed among B.1 lineage genomes. Our findings documented that most of the investigated migrants acquired SARS-CoV-2 infection before landing in Sicily. However, SARS-CoV-2 transmission during travel or in overcrowded Libyan immigrant camps and/or illegal transport boats could not be ruled out. SARS-CoV-2 molecular surveillance on migrants arriving in Europe through the Sicilian gate may improve the knowledge of global SARS-CoV-2 transmission dynamic also in light of the emergence of new variants.
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Affiliation(s)
- Fabio Tramuto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
- Regional Reference Laboratory of Western Sicily for the Emergency of COVID-19, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
| | - Stefano Reale
- Molecular Biology Area, Zoo-prophilactic Experimental Institute of Sicily “A. Mirri”, Palermo, Italy
| | | | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
- Regional Reference Laboratory of Western Sicily for the Emergency of COVID-19, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
| | - Claudio Pulvirenti
- Uffici di sanità marittima, aerea e di frontiera (USMAF) – Servizi Assistenza Sanitaria Naviganti (SASN) Sicily, Ministry of Health, Directorate-General for Health Prevention, Rome, Italy
| | - Giovanni Rezza
- Directorate-General for Health Prevention, Ministry of Health, Rome, Italy
| | - Fabrizio Vitale
- Molecular Biology Area, Zoo-prophilactic Experimental Institute of Sicily “A. Mirri”, Palermo, Italy
| | - Giuseppa Purpari
- Virological Diagnostic Area, Zoo-prophilactic Experimental Institute of Sicily “A. Mirri”, Palermo, Italy
| | - Carmelo Massimo Maida
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
- Regional Reference Laboratory of Western Sicily for the Emergency of COVID-19, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
| | - Salvatore Zichichi
- Uffici di sanità marittima, aerea e di frontiera (USMAF) – Servizi Assistenza Sanitaria Naviganti (SASN) Sicily, Ministry of Health, Directorate-General for Health Prevention, Rome, Italy
| | - Silvia Scibetta
- Molecular Biology Area, Zoo-prophilactic Experimental Institute of Sicily “A. Mirri”, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
- Regional Reference Laboratory of Western Sicily for the Emergency of COVID-19, Clinical Epidemiology Unit, University Hospital “Paolo Giaccone”, Palermo, Italy
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, United States
| | - Paola Stefanelli
- Department of Infectious Diseases, National Health Institute, Rome, Italy
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5
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The Role of Vaccination and Screening in Limiting the Worldwide Disease Burden of Preventable Female Cancers: A Review. WOMEN 2020. [DOI: 10.3390/women1010002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Cancer represents one of the most common causes of death worldwide. Among women, breast cancer is the most diagnosed cancer and the principal cause of death due to malignant disease, while cervical cancer ranks fourth for both incidence and mortality. The present review aims to analyze the epidemiology of cervical and breast cancer (incidence, mortality, survival rates, and trends). Moreover, the most important primary and secondary preventive strategies (reduction of risk factors, exposure, vaccination, cancer screening) intended to reduce the future burden of cervical and breast cancer, that should be adopted actively and free of charge, were discussed in accordance to more recent and evidence-based findings.
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6
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Massaquoi TA, Burke RM, Yang G, Lakoh S, Sevalie S, Li B, Jia H, Huang L, Deen GF, Beynon F, Sahr F. Cross sectional study of chronic hepatitis B prevalence among healthcare workers in an urban setting, Sierra Leone. PLoS One 2018; 13:e0201820. [PMID: 30096162 PMCID: PMC6086405 DOI: 10.1371/journal.pone.0201820] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Hepatitis B is a serious public health problem across sub-Saharan Africa. Sierra Leone has no national hepatitis B strategy plan or high quality estimates of prevalence. Healthcare workers are perceived as an at-risk group for hepatitis B. We assessed the prevalence of hepatitis B among healthcare workers at two hospital sites in Freetown, Sierra Leone. METHODS In October 2017, healthcare workers were offered voluntary testing for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc), hepatitis B e antigen (HBeAg) and hepatitis B e antibody (anti-HBe) using rapid lateral flow assay for all samples, followed by Enzyme Immunosorbent Assay to confirm positive results. Participants completed a questionnaire about knowledge, attitudes and practices concerning hepatitis B. HBsAg positive participants were invited to a clinic for further assessment. RESULTS Overall, 447 participants were tested for hepatitis B. Most (90.6%, 405/447) participants were nurses, 72.3% (323/447) were female and 71.6% (320/447) were 30 years or older. The prevalence of chronic hepatitis B (HBsAg positivity) was 8.7% (39 / 447, 95% CI 6.3-11.7%). There was no significant difference in prevalence by sex, age group, site of work or type of job. None of the 66.7% (26 / 39) of participants with chronic hepatitis B who attended the clinic met the 2015 WHO criteria to start treatment for hepatitis B on the basis of cirrhosis. Most participants (96.9% 432 / 446) stated that they were worried about their risk of hepatitis B at work. CONCLUSIONS Hepatitis B is highly prevalent among healthcare workers in Sierra Leone. It is unclear whether this reflects high community prevalence or is due to occupational risk. No participants with chronic hepatitis B needed to start treatment. In order to achieve the WHO target of elimination of viral hepatitis by 2030, introduction of birth dose vaccine for infants and catch-up vaccines for healthcare workers and healthcare students, together with a national hepatitis B screen and treat programme is advisable for Sierra Leone.
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Affiliation(s)
- Thomas A. Massaquoi
- 34 Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone
- * E-mail: (TAM); (LH)
| | - Rachael M. Burke
- Centre for Global Health and Health Partnerships, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- Kings Sierra Leone Partnership, Connaught Hospital, Freetown, Sierra Leone
| | - Guang Yang
- Chinese Military Medical Expert Group in Sierra Leone, 302 Military Hospital, Beijing, China
| | - Suliaman Lakoh
- University Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | - Stephen Sevalie
- 34 Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone
| | - Bo Li
- Chinese Military Medical Expert Group in Sierra Leone, 302 Military Hospital, Beijing, China
| | - Hongjun Jia
- Chinese Military Medical Expert Group in Sierra Leone, 302 Military Hospital, Beijing, China
| | - Lei Huang
- Chinese Military Medical Expert Group in Sierra Leone, 302 Military Hospital, Beijing, China
- * E-mail: (TAM); (LH)
| | - Gibrilla F. Deen
- University Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | - Fenella Beynon
- Centre for Global Health and Health Partnerships, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- Kings Sierra Leone Partnership, Connaught Hospital, Freetown, Sierra Leone
| | - Foday Sahr
- 34 Military Hospital, Wilberforce Barracks, Freetown, Sierra Leone
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Marotta C, Giaquinto C, Di Gennaro F, Chhaganlal KD, Saracino A, Moiane J, Maringhini G, Pizzol D, Putoto G, Monno L, Casuccio A, Vitale F, Mazzucco W. Pathways of care for HIV infected children in Beira, Mozambique: pre-post intervention study to assess impact of task shifting. BMC Public Health 2018; 18:703. [PMID: 29879951 PMCID: PMC5992883 DOI: 10.1186/s12889-018-5646-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/31/2018] [Indexed: 11/25/2022] Open
Abstract
Background In 2013, Mozambique implemented task-shifting (TS) from clinical officers to maternal and child nurses to improve care for HIV positive children < 5 years old. A retrospective, pre-post intervention study was designed to evaluate effectiveness of a new pathway of care in a sample of Beira District Local Health Facilities (LHFs), the primary, local, community healthcare services. Methods The study was conducted by accessing registries of At Risk Children Clinics (ARCCs) and HIV Health Services. Two time periods, pre- and post-intervention, were compared using a set of endpoints. Variables distribution was explored using descriptive statistics. T-student, Mann Whitney and Chi-square tests were used for comparisons. Results Overall, 588 HIV infected children (F = 51.4%) were recruited, 330 belonging to the post intervention period. The mean time from referral to ARCC until initiation of ART decreased from 2.3 (± 4.4) to 1.1 (± 5.0) months after the intervention implementation (p-value: 0.000). A significant increase of Isoniazid prophylaxis (O.R.: 2.69; 95%CI: 1.7–4.15) and a decrease of both regular nutritional assessment (O.R. = 0.45; 95%CI: 0.31–0.64) and CD4 count at the beginning of ART (O.R. = 0.46; 95%CI: 0.32–0.65) were documented after the intervention. Conclusions Despite several limitations and controversial results on nutrition assessment and CD4 count at the initiation of ART reported after the intervention, it could be assumed that TS alone may play a role in the improvement of the global effectiveness of care for HIV infected children only if integrated into a wider range of public health measures.
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Affiliation(s)
- Claudia Marotta
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del vespro, 133, 90127, Palermo, Italy.
| | - Carlo Giaquinto
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | | | - Kajal D Chhaganlal
- Center for Research in Infectious Diseases, Faculty of Health Sciences, Catholic University of Mozambique, Beira, Mozambique
| | | | - Jorge Moiane
- Center for Research in Infectious Diseases, Faculty of Health Sciences, Catholic University of Mozambique, Beira, Mozambique
| | | | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa, Beira, Mozambique
| | - Giovanni Putoto
- Operational Research Unit, Doctors with Africa, Padova, Italy
| | - Laura Monno
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
| | - Alessandra Casuccio
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del vespro, 133, 90127, Palermo, Italy
| | - Francesco Vitale
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del vespro, 133, 90127, Palermo, Italy
| | - Walter Mazzucco
- Department of Science for Health Promotion and Mother to Child Care "G. D'Alessandro", University of Palermo, via del vespro, 133, 90127, Palermo, Italy
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Lazarus JV, Sperle I, Spina A, Rockstroh JK. Are the testing needs of key European populations affected by hepatitis B and hepatitis C being addressed? A scoping review of testing studies in Europe. Croat Med J 2017; 57:442-456. [PMID: 27815935 PMCID: PMC5141462 DOI: 10.3325/cmj.2016.57.442] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim To investigate whether or not key populations affected by hepatitis B and hepatitis C are being tested sufficiently for these diseases throughout the European region. Methods We searched MEDLINE and EMBASE for studies on HBV and HCV testing in the 53 Member States of the World Health Organization European Region following PRISMA criteria. Results 136 English-language studies from 24 countries published between January 2007 and June 2013 were found. Most studies took place in 6 countries: France, Germany, Italy, the Netherlands, Turkey, and the United Kingdom. 37 studies (27%) addressed HBV, 46 (34%) HCV, and 53 (39%) both diseases. The largest categories of study populations were people who use drugs (18%) and health care patient populations (17%). Far fewer studies focused on migrants, prison inmates, or men who have sex with men. Conclusions The overall evidence base on HBV and HCV testing has considerable gaps in terms of the countries and populations represented and validity of testing uptake data. More research is needed throughout Europe to guide efforts to provide testing to certain key populations.
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Affiliation(s)
- Jeffrey V Lazarus
- Jeffrey V Lazarus, CHIP, Rigshospitalet, University of Copenhagen, Oster Allé 56, 5th floor, DK-2100 Copenhagen O, Denmark,
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Greenaway C, Thu Ma A, Kloda LA, Klein M, Cnossen S, Schwarzer G, Shrier I. The Seroprevalence of Hepatitis C Antibodies in Immigrants and Refugees from Intermediate and High Endemic Countries: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0141715. [PMID: 26558905 PMCID: PMC4641717 DOI: 10.1371/journal.pone.0141715] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/12/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV) infection is a significant global health issue that leads to 350,000 preventable deaths annually due to associated cirrhosis and hepatocellular carcinoma (HCC). Immigrants and refugees (migrants) originating from intermediate/high HCV endemic countries are likely at increased risk for HCV infection due to HCV exposure in their countries of origin. The aim of this study was to estimate the HCV seroprevalence of the migrant population living in low HCV prevalence countries. METHODS Four electronic databases were searched from database inception until June 17, 2014 for studies reporting the prevalence of HCV antibodies among migrants. Seroprevalence estimates were pooled with a random-effect model and were stratified by age group, region of origin and migration status and a meta-regression was modeled to explore heterogeneity. RESULTS Data from 50 studies representing 38,635 migrants from all world regions were included. The overall anti-HCV prevalence (representing previous and current infections) was 1.9% (95% CI, 1.4-2.7%, I2 96.1). Older age and region of origin, particularly Sub-Saharan Africa, Asia, and Eastern Europe were the strongest predictors of HCV seroprevalence. The estimated HCV seroprevalence of migrants from these regions was >2% and is higher than that reported for most host populations. CONCLUSION Adult migrants originating from Asia, Sub-Saharan Africa and Eastern Europe are at increased risk for HCV and may benefit from targeted HCV screening.
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Affiliation(s)
- Christina Greenaway
- Division of Infectious Diseases, Jewish General Hospital, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | - Ann Thu Ma
- Department of Internal Medicine, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | | | - Marina Klein
- Division of Infectious Diseases, McGill University Health Center, McGill University, Montreal, Canada
| | - Sonya Cnossen
- Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Guido Schwarzer
- Institute of Medical Biometry and Statistics, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Research Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
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Khyatti M, Trimbitas RD, Zouheir Y, Benani A, El Messaoudi MD, Hemminki K. Infectious diseases in North Africa and North African immigrants to Europe. Eur J Public Health 2015; 24 Suppl 1:47-56. [PMID: 25107998 DOI: 10.1093/eurpub/cku109] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The epidemiological transition has reduced infectious diseases mortality in most European countries, yet increased migrant influx risks importing diseases. All reported prevalence rates must be considered on a case-by-case basis depending on the disease in question, respective European Union (EU) country and migratory patterns at work. Tuberculosis has seen a re-emergence in Europe and is concentrated among migrants. Migrants arriving from North Africa (NA) and sub-Saharan Africa (SSA) carry higher rates of hepatitis C and B than the local EU population. The human immunodeficiency virus (HIV) impact of NA migrants to Europe is very low but a hallmark of the HIV epidemic is the penetration and circulation of non-B strains, recombinant forms and HIV-drug-resistant profiles through SSA migrants using NA as a transit point into Europe. Leishmaniasis is a re-emerging zoonotic disease prevalent to Southern Europe although not specifically isolated in migrant groups. Although not endemic in NA countries, malaria represent S: a risk in terms of re-emergence in Europe through transitory migrants arriving from SSA with the destination to Europe. Schistosomiasis has been largely eliminated from NA. High migrant flux into European countries has resulted in changing patterns of communicable disease and collectively requires a continuous surveillance. World Health Organization guidelines recommend targeted screening and preventative vaccination, followed by integration of migrants into the local health-care systems allowing for long-term treatment and follow-up. Finally, effective public health campaigns as a form of prevention are essential for the mitigation of disease dissemination in the migrant pool and for second-generation children of migrants.
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Affiliation(s)
- Meriem Khyatti
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | | | - Yassine Zouheir
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Abdelouaheb Benani
- 1 Laboratory of Onco-Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | | | - Kari Hemminki
- 2 Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Stornaiuolo G, Cuniato V, Cuomo G, Nocera E, Brancaccio G, De Rosa M, Pontarelli A, Grasso G, Danzi G, Grossi A, Natale RF, Gaeta GB. Active recruitment strategy in disadvantaged immigrant populations improves the identification of human immunodeficiency but not of hepatitis B or C virus infections. Dig Liver Dis 2014; 46:62-6. [PMID: 24148806 DOI: 10.1016/j.dld.2013.08.126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 07/26/2013] [Accepted: 08/03/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Barriers to access medical screening and care may underestimate the number of diseased subjects among immigrant populations. AIMS To evaluate the prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus infections among immigrants recruited in a disadvantaged area. METHODS The study enrolled all subjects seen between 1999 and 2009 at an on-site health and family counselling centre for immigrants. During the first 6 years of the study a pro-active recruitment was performed using a mobile unit. RESULTS Overall 2681 subjects were enrolled (median age: 31 years; 52.8% males; 82.3% from Sub-Saharan Africa; 13.9% of the women were sex workers). A total of 206 subjects (7.6%) were hepatitis B surface antigen-positive, 84 (3.6%) were anti-hepatitis C virus-positive, 129 (5%) were anti-human immunodeficiency virus-positive, 84 (3.1%) were drug users, and 436 (16.3%) were alcohol abusers. The prevalence of hepatitis B surface antigen and anti-hepatitis C virus remained consistent throughout the study period, while the prevalence of human immunodeficiency virus significantly decreased. At multivariate analysis, hepatitis B virus infection was associated with male gender, hepatitis C virus infection with drug addiction, and human immunodeficiency virus infection was associated with female gender, drug addiction, and active recruitment. CONCLUSIONS An active recruitment strategy should be considered to reach disadvantaged populations at high risk of human immunodeficiency virus infection.
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Affiliation(s)
| | - Vincenzo Cuniato
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Gianluca Cuomo
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Espedito Nocera
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Giuseppina Brancaccio
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Maddalena De Rosa
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Agostina Pontarelli
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy
| | - Giovanni Grasso
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Gaetano Danzi
- Unit of Pathology, G. Moscati Hospital, Aversa, Italy
| | - Alessandra Grossi
- Faculty of Communication Sciences, Institute for Public Communication-ICP, Swiss Italian University, Lugano, Switzerland
| | - Renato F Natale
- Social Medical Voluntary Association "Jerry Essan Masslo", Castelvolturno, Caserta, Italy
| | - Giovanni B Gaeta
- Viral Hepatitis Unit, Department of Internal Medicine, Second University, Naples, Italy.
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Falquetto TC, Endringer DC, Andrade TUD, Lenz D. Hepatitis C in prisoners and non-prisoners in Colatina, Espírito Santo, Brazil. BRAZ J PHARM SCI 2013. [DOI: 10.1590/s1984-82502013000400013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of the present work was to compare hepatitis C prevalence, genotypes, and risk factors between prisoners and non-prisoners in the city of Colatina, Espírito Santo, Brazil. This cross-sectional study involved approximately 1,600 residents and 730 prisoners, all of whom were living in Colatina. The percentage of individuals who tested positive for anti-HCV was 0.1% (2/1,600) in the non-prisoner group and 1.0% (7/730) in the prisoner group, confirming a higher risk of hepatitis C in the latter group. The percentage of subjects who progressed to HCV-RNA negative was 11.1% (1/9), confirming the high probability of evolution to chronicity. Genotype 1 was the most predominant genotype found. Factors associated with increased risk of hepatitis C were being male, being institutionalized, having an income of less than three minimum wages, having low educational attainment, and using injected drugs. Alcohol use, pain in the liver, migraine, and reported history of hepatitis were markedly associated with hepatitis C. The prison population tested positive for anti-HCV at a higher rate than the non-prison population.
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