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Maffeo M, Mazziotta F, Pierini E, Della Valle PG, Gramegna M, Tirani M, Crottogini L, Odone A, Castaldi S, Cereda D. Infectious diseases other than Covid-19 in 2020, a report from Lombardy Region. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Non pharmaceutical interventions (NPIs) put in place to reduce the spread of Sars-Cov-2 had an impact also on other infections. Aim of this research is to describe the incidence of other infections and vaccination coverage rate (VCR) in Lombardy region from 2018 to 2020.
Methods
We analysed data coming from the regional surveillance system of notifiable infectious diseases and vaccination registry from 2018 to 2020.
Results
13206 infectious diseases' cases were notified in 2020 compared to 36847 in 2019 and 42610 in 2018, this corresponding to, respectively, a 64.1% and 69% decrease. Some interesting data:
measles; 24 cases in 2020, 542 in 2019 and 220 in 2018, with an incidence rate (IR) per 100.000 respectively of 0,2; 5,4 and 2,2; chicken pox; 2357 cases in 2020, 13478 in 2019 and 19463 in 2018 (IR 23,5; 134,3; 193,9) tubercolosis; 586 in 2020, 857 in 2019 and 945 in 2018 (IR 5,8; 8,6; 9,4) invasive bacterial diseases; 378 in 2020, 890 in 2019 and 882 in 2018 (IR 3,7;8,8;8,7) infectious diarrhea; 2080 in 2020, 3716 in 2019 and 4347 in 2018 (IR 20,7; 37,1; 43,3) legionellosis cases; 806 in 2020, 1051 in 2019 and 1096 in 2018 (IR 8; 10,5; 10,9) arbovirus infections (chikunguya, dengue, west nile, zika) were 118, in 2020, 126 in 2019 and 8 in 2018 (IC 1,2; 1,3; 0,1)
In 2020 VCR at 24 months of age remained above 95% for hexavalent and measles-mumps-rubella vaccination while there was a decline for others vaccines.
Conclusions
During the COVID-19 outbreak in 2020 there was a decline in all notified infectious diseases compared to the previous years, likely due to massive NPIs adoption, as well as, possibly, to decreased access to care and preventive services that caused difficulties to the surveillance system to detect notifiable infectious diseases. VCRs were still high for most important vaccines while there was a decline for other vaccines as evidence of the impact of the pandemic on vaccination activities.
Key messages
NPIs had a deep impact on the reduction of airborne diseases. The decline for non-airborne infections is likely due to NPIs and limitations in the access to the healthcare system.
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Affiliation(s)
- M Maffeo
- Department Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - F Mazziotta
- Department Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - E Pierini
- Department Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - PG Della Valle
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - M Gramegna
- DG Welfare, Lombardy Region, Milan, Italy
| | - M Tirani
- DG Welfare, Lombardy Region, Milan, Italy
| | | | - A Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - S Castaldi
- Department Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - D Cereda
- DG Welfare, Lombardy Region, Milan, Italy
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Castrofino A, Del Castillo G, Grosso F, Barone A, Gramegna M, Galli C, Tirani M, Castaldi S, Pariani E, Cereda D. Influenza surveillance system and Covid-19. Eur J Public Health 2020. [PMCID: PMC7543513 DOI: 10.1093/eurpub/ckaa165.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The clinical presentation of symptomatic SARS-CoV-2 not only includes viral pneumonia, but also milder illness overlapping with influenza-like illness (ILI), allowing a potential tracking of the infection in the framework of the national influenza surveillance system (SS). By comparing the data recorded by the influenza SS in 2019-20 season to those collected for the previous years, we want to evaluate whether the implementation of ILI SS could succeed in early detection and monitoring of Covid-19 diffusion. We analyzed the data recorded by the influenza SS and we compared the distribution of ILI incidence rate by week for 2017-18, 2018-19 and 2019-20 season in order to understand whether the SS detected any abnormality coinciding with Covid-19 outbreak. The distribution of ILI cases in the three seasons presented a similar pattern up to the 9th week; after then, a reduction in the ILI incidence rate was observed in the 2017-18 and the 2018-19 season while an increase was detected for 2019-20. During 2019-20 season, three major characteristics stand out: i) at the beginning of Covid-19 epidemic (7th-9th week) 9,17/1000 cases were reported; ii) during the recognition of the COVID-19 outbreak (9th-10th week) 6,36/1000 cases; iii) during the spread of Covid-19 (10th-11th week) an unexpected increase to 7,72/1000 cases. Additionally, their geographical distribution was concentrated in the areas known to be most affected by the epidemic. The influenza SS enabled us to detect the introduction and distribution of COVID-19. Implementation of the system should be prioritized in order to early identify new waves of Covid-19 but also any future novel respiratory pathogen. In order to empower the SS, it would be advisable to increase the population coverage about 2% which is the actual standard.
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Affiliation(s)
- A Castrofino
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - G Del Castillo
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - F Grosso
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - A Barone
- Welfare Division, ARIA SPA, Milan, Italy
| | - M Gramegna
- DG Welfare, Regione Lombardia, Milan, Italy
| | - C Galli
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - M Tirani
- DG Welfare, Regione Lombardia, Milan, Italy
| | - S Castaldi
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - E Pariani
- Department od Biomedical Sciences for Health, University of Milano, Milan, Italy
| | - D Cereda
- DG Welfare, Regione Lombardia, Milan, Italy
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Tirani M, Odone A, Senatore S, Faccini M, Ciconali G. 4.2-O7Tackling health needs of migrant populations: the experience of the urban area of Milan. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Tirani
- Department of Hygiene and Preventive Medicine, ATS Bergamo, Italy
| | - A Odone
- School of Medicine, University Vita-Salute San Raffaele, Italy
| | - S Senatore
- Department of Preventive Medicine, ATS Città Metropolitana di Milano, Italy
| | - M Faccini
- Department of Preventive Medicine, ATS Città Metropolitana di Milano, Italy
| | - G Ciconali
- Department of Preventive Medicine, ATS Città Metropolitana di Milano, Italy
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Taietti D, Tirani M, Shahi E, Garavelli E, Nobile M, Cereda D, Lanzoni M, Biganzoli E, Castaldi S. Survey on professional training in three Italian. Post-Graduate Schools of Public Health. Ann Ig 2015; 27:623-32. [PMID: 26241107 DOI: 10.7416/ai.2015.2054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In 2005 the European Union (EU) recognized the equivalence within its member states of qualifications conferred by post-graduate schools (PGS) in public health. In Italy, ministerial decree no. 176 of 1st August 2005 defined the training goals and the related training programmes (Training Activities) leading to conferral of the qualification of specialist in Public Health and Preventive Medicine (PHPM). This study aimed to develop and validate an assessment tool for professional training programmes. The purpose has been to identify and evaluate their typical features and, at the same time, to enable comparison between Italian PGSs in PHPMs. METHODS In the first phase, a multiple-choice questionnaire was created, using a Likert scale with scores from 1 to 6. This was prepared by post-graduates attending the Milan PGS. This tool was validated by applying it to a pilot sample of post-graduates attending the Milan PGS in PHPM. Following this, a second round of discussion and validation of the model took place, involving 61 post-graduates attending PGSs in PHPM at the Universities of Palermo, Pisa and Turin. A web platform was used that enabled the survey to be created and managed by defining and managing pre-set interview templates. RESULTS The questionnaire consisted of three sections: Section A - Twenty-eight percent of post-graduates attended their training programme in a university or research centre, 29.8% in a hospital and 35.1% in a Local Health Unit. This training program lasted more than 12 months in 37% of the cases. Section B - The answers were all above pass-level (3 to 4 = satisfactory) except as regards the level of empowerment and the workload, which was judged to be unsatisfactory overall.The skills of the staff present in the facility attended were judged favourably (3.5). Section C - Section C investigates the duration and autonomy of the activities performed during the training programmes aimed at meeting the training requirements set out in ministerial decree no. 176/2005. Among respondents, 87% had taken part in ongoing statistical public health analyses, 81% had given presentations and contributed posters in public health congresses and 79% had planned or implemented an epidemiological survey. CONCLUSIONS A pre-set form for the assessment of training programmes by the post-graduates themselves is a useful tool with which to obtain their feedback. Public health providers must be able to view their training programme as a means of developing the numerous skills the profession requires. Eventually, they must be capable of acting autonomously, and to this end they need to interact with the numerous tutors with whom they come into contact. These latter were judged very favourably by the survey.
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Affiliation(s)
- D Taietti
- Post Graduate School of Public Health, University of Milan, Italy
| | - M Tirani
- Post Graduate School of Public Health, University of Milan, Italy
| | - E Shahi
- Post Graduate School of Public Health, University of Milan, Italy
| | - E Garavelli
- Post Graduate School of Public Health, University of Milan, Italy
| | - M Nobile
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - D Cereda
- UOC Promozione della Salute, Centro Screening, Asl Milano 1, Milan Italy
| | - M Lanzoni
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro", University of Milan Campus Cascina Rosa, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Biganzoli
- Department of Clinical Sciences and Community Health, Unit of Medical Statistics, Biometry and Bioinformatics "Giulio A. Maccacaro", University of Milan Campus Cascina Rosa, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Castaldi
- Quality Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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