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Veronese N, Di Gennaro F, Frallonardo L, Ciriminna S, Papagni R, Carruba L, Agnello D, De Iaco G, De Gennaro N, Di Franco G, Naro L, Brindicci G, Rizzo A, Bavaro DF, Garlisi MC, Santoro CR, Signorile F, Balena F, Mansueto P, Milano E, Giannitrapani L, Fiordelisi D, Mariani MF, Procopio A, Lattanzio R, Licata A, Vernuccio L, Amodeo S, Guido G, Segala FV, Barbagallo M, Saracino A. Real life experience on the use of Remdesivir in patients admitted to COVID-19 in two referral Italian hospital: a propensity score matched analysis. Sci Rep 2024; 14:9303. [PMID: 38654033 DOI: 10.1038/s41598-024-59957-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
Remdesivir (RDV) was the first Food and Drug Administration (FDA)-approved medication for COVID-19, with discordant data on efficacy in reducing mortality risk and disease progression. In the context of a dynamic and rapidly changing pandemic landscape, the utilization of real-world evidence is of utmost importance. The objective of this study is to evaluate the impact of RDV on patients who have been admitted to two university referral hospitals in Italy due to COVID-19. All patients older than 18 years and hospitalized at two different universities (Bari and Palermo) were enrolled in this study. To minimize the effect of potential confounders, we used propensity score matching with one case (Remdesivir) and one control that never experienced this kind of intervention during hospitalization. Mortality was the primary outcome of our investigation, and it was recorded using death certificates and/or medical records. Severe COVID-19 was defined as admission to the intensive care unit or a qSOFAscore ≥ 2 or CURB65scores ≥ 3. After using propensity score matching, 365 patients taking Remdesivir and 365 controls were included. No significant differences emerged between the two groups in terms of mean age and percentage of females, while patients taking Remdesivir were less frequently active smokers (p < 0.0001). Moreover, the patients taking Remdesivir were less frequently vaccinated against COVID-19. All the other clinical, radiological, and pharmacological parameters were balanced between the two groups. The use of Remdesivir in our cohort was associated with a significantly lower risk of mortality during the follow-up period (HR 0.56; 95% CI 0.37-0.86; p = 0.007). Moreover, RDV was associated with a significantly lower incidence of non-invasive ventilation (OR 0.27; 95% CI 0.20-0.36). Furthermore, in the 365 patients taking Remdesivir, we observed two cases of mild renal failure requiring a reduction in the dosage of Remdesivir and two cases in which the physicians decided to interrupt Remdesivir for bradycardia and for QT elongation. Our study suggests that the use of Remdesivir in hospitalized COVID-19 patients is a safe therapy associated with improved clinical outcomes, including halving of mortality and with a reduction of around 75% of the risk of invasive ventilation. In a constantly changing COVID-19 scenario, ongoing research is necessary to tailor treatment decisions based on the latest scientific evidence and optimize patient outcomes.
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Affiliation(s)
- Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Francesco Di Gennaro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Luisa Frallonardo
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy.
| | - Stefano Ciriminna
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Roberta Papagni
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Luca Carruba
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Diletta Agnello
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Giuseppina De Iaco
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Nicolò De Gennaro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Giuseppina Di Franco
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Liliana Naro
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Gaetano Brindicci
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Angelo Rizzo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Davide Fiore Bavaro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Maria Chiara Garlisi
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Carmen Rita Santoro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Fabio Signorile
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Flavia Balena
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Pasquale Mansueto
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Eugenio Milano
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Lydia Giannitrapani
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Deborah Fiordelisi
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Michele Fabiano Mariani
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Andrea Procopio
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Rossana Lattanzio
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Anna Licata
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Laura Vernuccio
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Simona Amodeo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Giacomo Guido
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Francesco Vladimiro Segala
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
| | - Mario Barbagallo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Annalisa Saracino
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), Clinic of Infectious Diseases, University of Bari "Aldo Moro", Piazza Giulio Cesare N. 11 Cap, 70124, Bari, Italy
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Dominguez LJ, Veronese N, Di Bella G, Cusumano C, Parisi A, Tagliaferri F, Ciriminna S, Barbagallo M. Mediterranean diet in the management and prevention of obesity. Exp Gerontol 2023; 174:112121. [PMID: 36792040 DOI: 10.1016/j.exger.2023.112121] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
The current pandemic of obesity represents a major global public health problem, mainly due to its association with chronic non-communicable disabling conditions and with increased mortality. Population aging increases the chances of non-communicable chronic diseases allowing a longer exposure to risk factors for these disabling conditions. Obesity is a major risk factor contributing to pathological aging. Numerous epidemiological studies have shown that the risk of death due to cardiovascular disease and cancer increases progressively as overweight and obesity rise. Nutrition research is now focused on the effects of combinations of foods in dietary patterns instead of those of single nutrients or foods. The dietary model with the largest body of evidence of health benefit is that traditionally followed by inhabitants of some Mediterranean countries. There is evidence confirming the inverse association of adhering to Mediterranean diet with overweight and obesity. Four meta-analyses of randomized controlled trials, including up to 16 trials, have shown a greater reduction of body weight and BMI with MedDiet compared to other diets, while a meta-analysis of 7 prospective cohort studies, found a reduced risk of becoming obese and gaining weight over time associated with a higher adherence to MedDiet. This narrative review examines studies reporting inverse associations of a higher adherence to the MedDiet with overweight/obesity and with age-associated chronic diseases related to obesity.
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Affiliation(s)
- Ligia J Dominguez
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Claudia Cusumano
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
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Ragusa FS, Solimando L, Mandalà C, Masnata R, Ciulla G, Ciriminna S, La Blasca F, Mansueto P, Veronese N, Barbagallo M. Association between multidimensional prognostic index (MPI) and infections in a population of older people affected by COVID-19. Aging Clin Exp Res 2023; 35:1139-1143. [PMID: 36964868 PMCID: PMC10039674 DOI: 10.1007/s40520-023-02386-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Only limited studies analyzed a possible relationship between frailty and infections. Our aim was to investigate the possible association between higher multidimensional prognostic index (MPI) values, a tool for evaluating multidimensional frailty, and the prevalence of infectious diseases, including antibiotics' cost and the prevalence of MDR (multidrug resistance) pathogens. METHODS Older patients, affected by COVID-19, were enrolled in the hospital of Palermo over four months. RESULTS 112 participants (mean age 77.6, 55.4% males) were included. After adjusting for potential confounders, frailer participants had a higher odds of any positivity to pathogens (prevalence: 61.5%, odds ratio = 15.56, p < 0.0001) compared to a prevalence of 8.6% in more robust, including MDR, and a higher costs in antibiotics. CONCLUSIONS Higher MPI values, indicating frailer subjects, were associated with a higher prevalence of infections, particularly of MDR pathogens, and a consequent increase in antibiotics' cost.
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Affiliation(s)
- Francesco Saverio Ragusa
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
| | - Luisa Solimando
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Caterina Mandalà
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Roberta Masnata
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Gregorio Ciulla
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Stefano Ciriminna
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Francesco La Blasca
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Pasquale Mansueto
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Mario Barbagallo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
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Dominguez LJ, Veronese N, Ciriminna S, Pérez-Albela JL, Vásquez-López VF, Rodas-Regalado S, Di Bella G, Parisi A, Tagliaferri F, Barbagallo M. Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 15:nu15061304. [PMID: 36986033 PMCID: PMC10053795 DOI: 10.3390/nu15061304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. The present systematic review and meta-analysis aim to investigate the impact of serum Mg on the risk of incident fractures. A systematic search was conducted using several databases including PubMed/Medline and Scopus from inception to 24 May 2022, including observational studies investigating serum Mg and the incidence of fractures considered as outcomes. Abstract and full-text screenings, data extractions, and risk of bias assessments were conducted by two investigators independently. Any inconsistencies were resolved by consensus with a third author. The Newcastle–Ottawa Scale was used to assess the study quality/risk of bias. Among 1332 records initially screened, 16 were retrieved as full-texts; of them, four papers were included in the systematic review with a total of 119,755 participants. We found that lower serum Mg concentrations were associated with a significantly higher risk of incident fractures (RR = 1.579; 95%CI: 1.216–2.051; p = 0.001; I2 = 46.9%). Our systematic review with meta-analysis suggests a strong association of serum Mg concentrations with incident fractures. Further research is needed to confirm our results among other populations and to assess whether serum Mg is potentially relevant in the prevention of fractures, which continue to increase and represent a significant health burden due to the associated disability.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
- Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy
- Correspondence: or
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | | | | | | | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
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Maggi S, Veronese N, Burgio M, Cammarata G, Ciuppa ME, Ciriminna S, Di Gennaro F, Smith L, Trott M, Dominguez LJ, Giammanco GM, De Grazia S, Costantino C, Vitale F, Barbagallo M. Rate of Hospitalizations and Mortality of Respiratory Syncytial Virus Infection Compared to Influenza in Older People: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10122092. [PMID: 36560501 PMCID: PMC9783561 DOI: 10.3390/vaccines10122092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Respiratory Syncytial Virus (RSV) is commonly regarded as an infection typical of children, but increasing literature is showing its importance in older people. Since the data regarding the impact of RSV are still limited for older people, the aim of this systematic review and meta-analysis is to compare the rate of hospitalization and mortality between RSV and influenza in this population. A systematic literature search until 15 June 2022 was done across several databases and including studies reporting incidence rate and cumulative incidence of hospitalization and mortality in RSV and influenza affecting older people. Among 2295 records initially screened, 16 studies including 762,084 older participants were included. Compared to older patients having influenza, patients with RSV did not show any significant different risk in hospitalization (either cumulative or incidence rate). Similar results were evident for mortality. The quality of the studies was in general good. In conclusion, our systematic review and meta-analysis showed that the rate of hospitalization and mortality was similar between RSV and influenza in older adults, suggesting the importance of vaccination for RSV in older people for preventing negative outcomes, such as mortality and hospitalization.
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Affiliation(s)
- Stefania Maggi
- Consiglio Nazionale delle Ricerche, Neuroscience Institute, 35100 Padova, Italy
| | - Nicola Veronese
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
- Correspondence:
| | - Marianna Burgio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Giorgia Cammarata
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Maria Elena Ciuppa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Stefano Ciriminna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Francesco Di Gennaro
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Mike Trott
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Ligia J. Dominguez
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
- School of Medicine and Surgery, University of Enna “Kore”, 94100 Enna, Italy
| | - Giovanni M. Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Simona De Grazia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Claudio Costantino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Mario Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
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Giammanco G, Ciriminna S, Barberi I, Titone L, Lo Giudice M, Biasio LR. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill 2009; 14:19321. [PMID: 19728978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence.
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Affiliation(s)
- G Giammanco
- Department of Hygiene, University of Catania, Italy.
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Giammanco G, Ciriminna S, Barberi I, Titone L, Lo Giudice M, Biasio LR. Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years. Euro Surveill 2009. [DOI: 10.2807/ese.14.35.19321-en] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence. Overall, the programme achieved its target, with 87.5% vaccine coverage for the birth cohort 2005 and 90.2% for adolescents born in 1995 and 1996. Varicella surveillance data obtained from a total of 28,188 children (0-14 years-old) monitored by family paediatricians showed a decline in incidence rates from 95.7 (95% confidence interval (CI): 72.2-126.8) for 1,000 person-years (PY) in 2004 to 9.0 (95% CI: 6.4-12.6) for 1,000 PY in 2007. In Europe, the only similar experience is the routine childhood varicella vaccination programme in Germany that started in 2004 with a single dose at the age of 11-14 months. The two-cohort universal vaccination programme implemented in Sicily, as well as the network for the surveillance study, can offer a model to other European countries that are considering introducing universal childhood varicella vaccination.
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Affiliation(s)
- G Giammanco
- Department of Hygiene, University of Catania, Catania, Italy
| | - S Ciriminna
- Regional Public Health Office, Palermo, Italy
| | - I Barberi
- Department of Paediatric Sciences, University of Messina, Messina, Italy
| | - L Titone
- Department of Infectious Diseases, University of Palermo, Palermo, Italy
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D'Alessandro D, Ciriminna S, Rossini A, Bossa MC, Fara GM. Requests of medical examinations after pneumococcal & influenza vaccination in the elderly. Indian J Med Res 2004; 119 Suppl:108-14. [PMID: 15232174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND & OBJECTIVES There are no specific recommendations about pneumococcal vaccination (PV) in Italy. There are limited data on the requests of medical examination or hospitalization due to side effects of pneumococcal vaccination. In the present study we present our analyses on the requests of medical examination due to side effects of pneumococcal vaccination (PV) in 29,086 elderly aged >/=65 yr. METHODS Vaccination with influenza vaccine (IV) alone or in association with PV was offered during the IV campaign in the winter 1999-2000 in 8 counties of Sicily. General practitioners (GPs) provided the vaccination and, 72 h later, recorded local and systemic side effects by a telephonic interview with the waccinees. GPs recorded also the requests of medical treatments. RESULTS A total of 16,601 subjects (57.1%) were vaccinated with IV alone and 12,485 (42.9%) with the association IV+PV. Adverse effects were reported by 14.7 per cent of vaccinees. Out of 4,289 subjects with side effects, 305 (7.1%) looked for a medical examination. The factors associated with a significantly increased risk for medical examination after vaccination were symptoms duration >72 h (OR 2.04; 95% CI 1.38-3.01; P=0.0002); local induration (OR 3.26; 95% CI 2.07-5.13; P<0.0001); general malaise (OR 2.05; 95% CI 1.34-3.13; P=0.0009); fever >/=38 degrees C (OR 3.34; 95% CI 1.90-5.86; P<0.0001); myalgia (OR 2.80; 95% CI 1.46-5.37; P=0.0018) and dyspnea (OR 37.86; 95% CI 9.65-148.60; P=0.0001). INTERPRETATION & CONCLUSION The few requests for medical examination and the low rate of adverse effects confirmed the tolerability and safety of PV+IV; GPs consultation were related to the severity and duration of symptoms, but independent of the type of vaccine administered.
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Ciriminna S, Cuccia M. ["Herd immunity" after administration of Pneumococcal conjugate vaccine and its impact on vaccination campaigns]. Ann Ig 2002; 14:39-42. [PMID: 12638363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Parallel to the diffusion of conjugated pneumococcal vaccine in children, several studies have shown a reduction of the incidence of invasive pneumococcal disease both in the vaccinated and in the unvaccinated. Such an observation is not a surprise if one considers that a similar phenomenon has taken place also after the mass introduction of Hib vaccine, at its turn a conjugated polysaccharide vaccine. Another observation is that also the carriage of vaccinal pneumococci was reduced in both the vaccinated and the unvaccinated, while in some cases the carriage of non-vaccinal serotypes, definitely less pathogenic, could be increased.
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D'Alessandro D, Bevilacqua M, Carreri V, Ciriminna S, Crovari P, De Stefano Caraffa D, Faggioli A, Fara GM, Ferro A, Greco D, Grilli G, Lizioli A, Navarra M, Pantosti A, Pompa MG, Ragni P, Roveri P, Salmaso S, Todisco T. [The Working Group on the Prevention of S. pneumoniae Infections in Italy. The final report]. Ann Ig 1999; 11:341-50. [PMID: 10520528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- D D'Alessandro
- Dip. di Architettura ed Urbanistica per l'Ingegneria, Università La Sapienza di Roma
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Ciriminna S. [Anti-influenza and antipneumococcal vaccinations in the Sicily area]. Ann Ig 1999; 11:329-33. [PMID: 10520526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- S Ciriminna
- Assessorato Regionale Sanità, Ispettorato Regionale Sanitario, Palermo
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