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Contoli B, Tosti ME, Asta F, Minardi V, Marchetti G, Casigliani V, Scarso S, Declich S, Masocco M. Exploring COVID-19 Vaccination Willingness in Italy: A Focus on Resident Foreigners and Italians Using Data from PASSI and PASSI d'Argento Surveillance Systems. Vaccines (Basel) 2024; 12:124. [PMID: 38400108 PMCID: PMC10893094 DOI: 10.3390/vaccines12020124] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
(1) The COVID-19 pandemic exacerbated health disparities, both between foreign and autochthonous populations. Italy was one of the European countries that was the most affected by the COVID-19 pandemic; however, only limited data are available on vaccine willingness. This study aims to assess the propensity of foreign and autochthonous populations residing in Italy to be vaccinated and the relative associated factors. (2) Data were collected and analysed from the two Italian surveillance systems, PASSI and PASSI d'Argento, in the period of August 2020-December 2021. The data include those of the Italian resident adult population over 18 years old. A multinomial logistic regression model, stratified by citizenship, was used to assess the associations of sociodemographic, health, and COVID-19 experience variables with vaccination attitudes. (3) This study encompassed 19,681 eligible subjects. Considering the willingness to be vaccinated, foreign residents were significantly less certain to get vaccinated (49.4% vs. 60.7% among Italians). Sociodemographic characteristics, economic difficulties, and trust in local health units emerged as factors that were significantly associated with vaccine acceptance. Having received the seasonal flu vaccine was identified as a predictor of COVID-19 vaccine acceptance among foreign and Italian residents. (4) This study underscores the significance of tailoring interventions to address vaccine hesitancy based on the diverse characteristics of foreign and Italian residents. This research offers practical insights for public health strategies, highlighting the importance of tailored educational campaigns, improved communication, and nuanced interventions to enhance vaccine acceptance and uptake within both populations.
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Affiliation(s)
- Benedetta Contoli
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy; (B.C.); (V.M.); (M.M.)
| | - Maria Elena Tosti
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.E.T.); (G.M.); (S.S.); (S.D.)
| | - Federica Asta
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy; (B.C.); (V.M.); (M.M.)
| | - Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy; (B.C.); (V.M.); (M.M.)
| | - Giulia Marchetti
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.E.T.); (G.M.); (S.S.); (S.D.)
| | - Virginia Casigliani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Salvatore Scarso
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.E.T.); (G.M.); (S.S.); (S.D.)
- Department of Public Health and Infectious Diseases, Sapienza Università di Roma, 00185 Rome, Italy
| | - Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.E.T.); (G.M.); (S.S.); (S.D.)
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy; (B.C.); (V.M.); (M.M.)
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Milano A, Robbiati C, Declich S, Calistri P, Pediconi O, Amato L, Paronyan L, Avetisyan L, Manucharyan A, Avetisyan G, Yesayan T, Gevorgyan A, Markosyan T, Dente MG. Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia. Trop Med Infect Dis 2024; 9:22. [PMID: 38251220 PMCID: PMC10819525 DOI: 10.3390/tropicalmed9010022] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Due to several factors, such as environmental and climate changes, the risk of health threats originating at the human-animal-environment interface, including vector-borne diseases (VBDs) and zoonoses, is increasing. Low-resource settings struggle to counter these multidimensional risks due to their already-strained health systems and are therefore disproportionally affected by the impact caused by these changes. Systemic approaches like One Health (OH) are sought to strengthen prevention and preparedness strategies by addressing the drivers of potential threats with a multidisciplinary and multisectoral approach, considering the whole system at the human-animal-environment interface. The integration of OH in national plans can be challenging due to the lack of effective coordination and collaboration among different sectors. To support the process of knowledge coproduction about the level of OH integration in prevention and preparedness strategies against health threats in Armenia, a situation analysis was performed on Crimean-Congo hemorrhagic fever/virus and anthrax (identified by local stakeholders as priorities to be addressed with the OH approach), and actions to strengthen the national OH system were identified with the support of a OH conceptual framework. The study highlighted that multidisciplinary and multisectoral efforts towards prevention and preparedness against VBDs and zoonoses threats need to be strengthened in Armenia, and priority actions to integrate the OH approach were identified.
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Affiliation(s)
- Alessia Milano
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Robbiati
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Declich
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
| | - Paolo Calistri
- National Reference Centre for Veterinary Epidemiology, Programming, Information and Risk Analysis (COVEPI), Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Ombretta Pediconi
- Training and Project Management Unit, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Laura Amato
- National Reference Centre for Veterinary Epidemiology, Programming, Information and Risk Analysis (COVEPI), Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Lusine Paronyan
- Zoonotic and Parasitic Diseases Epidemiology Department, National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Lilit Avetisyan
- National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Arsen Manucharyan
- Reference Laboratory Center Reference Laboratory of Episootology, Ectoparasitology and Entomology, National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Georgi Avetisyan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | - Tigran Yesayan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | - Arman Gevorgyan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | | | - Maria Grazia Dente
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
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3
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Robbiati C, Milano A, Declich S, Di Domenico K, Mancini L, Pizzarelli S, D'Angelo F, Riccardo F, Scavia G, Dente MG. One health adoption within prevention, preparedness and response to health threats: Highlights from a scoping review. One Health 2023; 17:100613. [PMID: 37588423 PMCID: PMC10425384 DOI: 10.1016/j.onehlt.2023.100613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction As the COVID-19 pandemic has demonstrated, the complexity of factors involved in the emergence of health threats requires a holistic One Health (OH) approach to enhance the effectiveness of prevention, preparedness, and response (PPR) strategies. Therefore, we conducted a scoping review to explore how the OH approach has been adopted in the context of PPR strategies to health threats, and the challenges and benefits deriving from its integration. Methods We defined the research questions and a strategy to guide the peer-reviewed and grey literature search to identify relevant articles and documents (identification). We assessed them for eligibility according to predefined criteria (screening) and finally included the ones that answered the research questions (inclusion). We performed a descriptive and thematic analysis of the results. Results A total of 138 records were included in the review (57 from the peer-reviewed literature and 81 from the grey literature). The OH approach was mainly adopted in prevention strategies, particularly within the governance area. Human and animal health were the most integrated disciplines in the OH approach, while environmental and social sciences were the less integrated. The most targeted threats were antimicrobial resistance and zoonoses, with the African region being the most represented. Conducive factors for the adoption of OH PPR strategies were identified in resolutions and guidance emanating from international organisations. Discussion The global governance of OH should utilise conducive factors, such as international resolutions and guidance, to enhance the adoption of multisectoral and multi-actor PPR strategies, that focus on national and international priorities and neglected threats, such as environmental hazards and pandemic risk. Integrated frameworks and metrics for the implementation and evaluation of OH PPR strategies need to be consolidated to contribute to the growing body of evidence supporting the adoption of the OH approach.
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Affiliation(s)
- Claudia Robbiati
- Istituto Superiore di Sanità (Italian National Institute of Health), National Center for Global Health, Rome, Italy
- Public Health and Infectious Diseases Dept., Sapienza University of Rome, Italy
| | - Alessia Milano
- Istituto Superiore di Sanità (Italian National Institute of Health), National Center for Global Health, Rome, Italy
- Public Health and Infectious Diseases Dept., Sapienza University of Rome, Italy
| | - Silvia Declich
- Istituto Superiore di Sanità (Italian National Institute of Health), National Center for Global Health, Rome, Italy
| | - Kevin Di Domenico
- Public Health and Infectious Diseases Dept., Sapienza University of Rome, Italy
- Istituto Superiore di Sanità (Italian National Institute of Health), Environment and Health Dept., Rome, Italy
| | - Laura Mancini
- Istituto Superiore di Sanità (Italian National Institute of Health), Environment and Health Dept., Rome, Italy
| | - Scilla Pizzarelli
- Istituto Superiore di Sanità (Italian National Institute of Health), Knowledge Unit (Documentation, Library), Rome, Italy
| | - Franca D'Angelo
- Istituto Superiore di Sanità (Italian National Institute of Health), National Center for Global Health, Rome, Italy
| | - Flavia Riccardo
- Istituto Superiore di Sanità (Italian National Institute of Health), Infectious Diseases Dept., Rome, Italy
| | - Gaia Scavia
- Istituto Superiore di Sanità (Italian National Institute of Health), Food Safety, Nutrition and Veterinary Public Health Dept., Rome, Italy
| | - Maria Grazia Dente
- Istituto Superiore di Sanità (Italian National Institute of Health), National Center for Global Health, Rome, Italy
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Scarso S, Marchetti G, Russo ML, D’Angelo F, Tosti ME, Bellini A, De Marchi C, Ferrari C, Gatta A, Caminada S, Papaevgeniou N, Dalma N, Karnaki P, Marceca M, Declich S. Access to Vaccination for Newly Arrived Migrants: Developing a General Conceptual Framework for Understanding How to Improve Vaccination Coverage in European Countries. Int J Public Health 2023; 68:1605580. [PMID: 37609078 PMCID: PMC10440383 DOI: 10.3389/ijph.2023.1605580] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Objectives: Access to vaccination for newly arrived migrants (NAMs) is a relevant concern that requires urgent attention in EU/EEA countries. This study aimed to develop a General Conceptual Framework (GCF) for understanding how to improve vaccination coverage for NAMs, by characterizing and critically analyzing system barriers and possible strategies to increase vaccination. Methods: A theoretical conceptualization of the GCF was hypothesized based on conceptual hubs in the immunization process. Barriers and solutions were identified through a non-systematic desktop literature review and qualitative research. The GCF guided the activities and facilitated the integration of results, thereby enriching the GCF with content. Results: The study explores the vaccination of NAMs and proposes strategies to overcome barriers in their vaccination process. It introduces a framework called GCF, which consists of five interconnected steps: entitlement, reachability, adherence, achievement, and evaluation of vaccination. The study also presents barriers and solutions identified through literature review and qualitative research, along with strategies to enhance professionals' knowledge, improve reachability, promote adherence, achieve vaccination coverage, and evaluate interventions. The study concludes by recommending strategies such as proximity, provider training, a migrant-sensitive approach, and data collection to improve vaccination outcomes for NAMs. Conclusion: Ensuring equitable access to healthcare services, including vaccination, is crucial not only from a humanitarian perspective but also for the overall public health of these countries.
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Affiliation(s)
- Salvatore Scarso
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Giulia Marchetti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Laura Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Franca D’Angelo
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Arianna Bellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Caterina Ferrari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Nikoletta Papaevgeniou
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Nadia Dalma
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Pania Karnaki
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Silvia Declich
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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5
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Mazzalai E, Giannini D, Tosti ME, D’Angelo F, Declich S, Jaljaa A, Caminada S, Turatto F, De Marchi C, Gatta A, Angelozzi A, Marchetti G, Pizzarelli S, Marceca M. Risk of Covid-19 Severe Outcomes and Mortality in Migrants and Ethnic Minorities Compared to the General Population in the European WHO Region: a Systematic Review. J Int Migr Integr 2023; 24:1-31. [PMID: 36647529 PMCID: PMC9833641 DOI: 10.1007/s12134-023-01007-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
The Covid-19 pandemic has had a major impact on migrants and ethnic minorities (MEMs). Socio-economic factors and legal, administrative and language barriers are among the reasons for this increased susceptibility. The aim of the study is to investigate the impact of Covid-19 on MEMs compared to the general population in terms of serious outcomes. We conducted a systematic review collecting studies on the impact of Covid-19 on MEMs compared to the general population in the WHO European Region regarding hospitalisation, intensive care unit (ICU) admission and mortality, published between 01/01/2020 and 19/03/2021. Nine researchers were involved in selection, study quality assessment and data extraction. Of the 82 studies included, 15 of the 16 regarding hospitalisation for Covid-19 reported an increased risk for MEMs compared to the white and/or native population and 22 out of the 28 studies focusing on the ICU admission rates found an increased risk for MEMs. Among the 65 studies on mortality, 43 report a higher risk for MEMs. An increased risk of adverse outcomes was reported for MEMs. Social determinants of health are among the main factors involved in the genesis of health inequalities: a disadvantaged socio-economic status, a framework of structural racism and asymmetric access to healthcare are linked to increased susceptibility to the consequences of Covid-19. These findings underline the need for policymakers to consider the socio-economic barriers when designing prevention plans. Supplementary Information The online version contains supplementary material available at 10.1007/s12134-023-01007-x.
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Affiliation(s)
- Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Elena Tosti
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Franca D’Angelo
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Declich
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Aurora Angelozzi
- Department for Organisational Development, Local Health Unit Roma 1, Rome, Italy
| | - Giulia Marchetti
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Scilla Pizzarelli
- Knowledge Unit, Documentation and Library, Istituto Superiore di Sanità, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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6
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Tosti ME, Marchetti G, Scarso S, D'Angelo F, Russo ML, Marceca M, Karnaki P, Papaevgeniou N, Declich S. Five-hub General Conceptual Framework to improve the vaccination coverage for newly arrived migrants. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.032] [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
Within the Project “Increased Access for Newly Arrived Migrants-AcToVax4NAM” (Grant n 101018349, 3rd EU Health Programme), a General Conceptual Framework (GCF) was developed for understanding how to improve vaccination coverage for Newly Arrived Migrants (NAM), by characterizing and critically analysing system barriers and possible solutions to increase vaccination
Methods
A logical pathway was hypothesized based on conceptual hubs in the immunization process. The identification of barriers and solutions was carried on by: a) non-systematic revision of scientific and grey literature, institutions and relevant websites, and documents suggested by Consortium Partners; b) qualitative research conducted in each Consortium Country. The GCF was used as a guide for the above mentioned activities and organize results into the GCF itself to enrich it with content
Results
5 conceptual hubs were identified: ENTITLEMENT to vaccination, REACHABILITY of people to be vaccinated, ADHERENCE to vaccination, ACHIEVEMENT of vaccination, EVALUATION of the intervention. All hubs are linked sequentially, starting with Entitlement without which the process cannot take place. Hubs are connected: if vaccination does not take place, it’s important to go back to the previous hubs to understand the barriers. Reachability-Adherence-Achievement are closely related because some approaches are cross-cutting, such as proximity interventions which, in addition to allowing the system to approach NAM, promote adherence and thus possibility of completing the process. Other strategies may be implemented with different purposes: training aims to foster a culturally competent approach to facilitate adherence and avoid vaccination hesitancy, but also to improve competence in the entire process and lead to vaccination completion
Conclusions
The proposed GCF facilitates identification of barriers and possible solutions to the effective achievement of immunization, at all stages of the process
Key messages
• The GCF can be the basis for the creation of country-specific flow-charts through which to test strategies aimed at increasing immunization coverage in NAM.
• The GCF will be useful at EU level, to facilitate both the harmonisation of approaches and interventions and the evaluation of comparable approaches.
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Affiliation(s)
- ME Tosti
- National Centre for Global Health, Italian National Institute of Health , Rome, Italy
| | - G Marchetti
- National Centre for Global Health, Italian National Institute of Health , Rome, Italy
- Italian Society for Migration Medicine , Rome, Italy
| | - S Scarso
- National Centre for Global Health, Italian National Institute of Health , Rome, Italy
- Italian Society for Migration Medicine , Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - F D'Angelo
- National Centre for Global Health, Italian National Institute of Health , Rome, Italy
| | - ML Russo
- Italian Society for Migration Medicine , Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - M Marceca
- Italian Society for Migration Medicine , Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - P Karnaki
- Institute of Preventive Medicine, Environmental and Occupational Health Prolepsis , Athens, Greece
| | - N Papaevgeniou
- Institute of Preventive Medicine, Environmental and Occupational Health Prolepsis , Athens, Greece
| | - S Declich
- National Centre for Global Health, Italian National Institute of Health , Rome, Italy
- Italian Society for Migration Medicine , Rome, Italy
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Declich S, De Ponte G, Marchetti G, Dente MG, Tosti ME, Tavoschi L, Lopalco PL, Russo ML, Marceca M. Life-course vaccinations for migrants and refugees: Drawing lessons from the COVID-19 vaccination campaigns. J Glob Health 2022; 12:03064. [PMID: 36181721 PMCID: PMC9526476 DOI: 10.7189/jogh.12.03064] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giulia Marchetti
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Grazia Dente
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Elena Tosti
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | | | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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8
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Dente M, Riccardo F, Declich S, Milano A, Robbiati C, Agrimi U, Mantovani A, Morabito S, Scavia G, Cubadda F, Villa L, Monaco M, Mancini L, Carere M, Marcheggiani S, Lavazza A, Farina M, Dar O, Villa M, Coggi PT, Brusaferro S. Strengthening preparedness against global health threats: A paradigm shift based on One Health approaches. One Health 2022; 14:100396. [PMID: 35686149 PMCID: PMC9171516 DOI: 10.1016/j.onehlt.2022.100396] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
The implementation of preparedness strategies to prevent and mitigate the impact of global health threats poses several challenges. It should promptly identify cross-cutting drivers of pandemic threats, assess context-specific risks, engage multiple stakeholders, and translate complex data from multiple sources into accessible information for action. This requires a coordinated, multidisciplinary and multisectoral effort engaging systems that, most of the time, work in isolation. The One Health (OH) approach promotes the collaboration and communication among different disciplines and sectors, and could be applied across the preparedness phases at national and international level. We discuss here gaps and needs in preparedness strategies, which can benefit from the OH approach, and a set of actionable recommendations, as shared with the G20–2021 with a dedicated Policy Brief. The discussion adds to the current debate about OH operationalization and promotes a paradigm shift towards coordinated prevention and preparedness strategies for early assessment and management of global health threats.
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Jaljaa A, Caminada S, Tosti ME, D'Angelo F, Angelozzi A, Isonne C, Marchetti G, Mazzalai E, Giannini D, Turatto F, De Marchi C, Gatta A, Declich S, Pizzarelli S, Geraci S, Baglio G, Marceca M. Risk of SARS-CoV-2 infection in migrants and ethnic minorities compared with the general population in the European WHO region during the first year of the pandemic: a systematic review. BMC Public Health 2022; 22:143. [PMID: 35057781 PMCID: PMC8771174 DOI: 10.1186/s12889-021-12466-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Migrants and ethnic minorities have suffered a disproportionate impact of the COVID-19 pandemic compared to the general population from different perspectives. Our aim was to assess specifically their risk of infection in the 53 countries belonging to the World Health Organization European Region, during the first year of the pandemic. METHODS We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42021247326). We searched multiple databases for peer-reviewed literature, published on Medline, Embase, Scisearch, Biosis and Esbiobase in 2020 and preprints from PubMed up to 29/03/2021. We included cross-sectional, case-control, cohort, intervention, case-series, prevalence or ecological studies, reporting the risk of SARS-CoV-2 infection among migrants, refugees, and ethnic minorities. RESULTS Among the 1905 records screened, 25 met our inclusion criteria and were included in the final analysis. We found that migrants and ethnic minorities during the first wave of the pandemic were at increased exposure and risk of infection and were disproportionately represented among COVID-19 cases. However, the impact of COVID-19 on minorities does not seem homogeneous, since some ethnic groups seem to be more at risk than others. Risk factors include high-risk occupations, overcrowded accommodations, geographic distribution, social deprivation, barriers to access to information concerning preventive measures (due to the language barrier or to their marginality), together with biological and genetic susceptibilities. CONCLUSIONS Although mixed methods studies will be required to fully understand the complex interplay between the various biological, social, and cultural factors underlying these findings, the impact of structural determinants of health is evident. Our findings corroborate the need to collect migration and ethnicity-disaggregated data and contribute to advocacy for inclusive policies and programmatic actions tailored to reach migrants and ethnic minorities.
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Affiliation(s)
- Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Elena Tosti
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Franca D'Angelo
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Aurora Angelozzi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Giulia Marchetti
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Silvia Declich
- National Health Institute, National Centre for Global Health, Rome, Italy
| | - Scilla Pizzarelli
- National Health Institute; Knowledge Service, Documentation and Library, Rome, Italy
| | - Salvatore Geraci
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- Caritas of Rome, Health Area, Rome, Italy
| | - Giovanni Baglio
- Italian Society of Migration Medicine (SIMM), Rome, Italy
- AGENAS, Research and International Relations Office, Rome, Italy
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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10
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Declich S, Dente MG, Tosti ME, De Ponte G, Marchetti G, Tavoschi L, Lopalco PL, Russo ML, Marceca M. Vaccinations for migrants during and beyond the COVID-19 pandemic. Eur J Public Health 2021. [PMCID: PMC8574742 DOI: 10.1093/eurpub/ckab165.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Abstract
Issue
Migrants have suboptimal vaccination coverage compared to the general population in destination countries due to several factors
-administrative barriers or lack of legal entitlements to health -health system barriers (language, lack of cultural sensitivity and community engagement capacity, vaccination costs) -lack of trust in the health system and misconceptions about vaccines due to misinformation or beliefs
Problem
Countries should develop national policies and ensure an inclusive, free of charge and proactive vaccination offer to migrants, irrespective of their legal status; and to extend this approach beyond the current pandemic and the sole COVID-19 vaccine
Results
To achieve COVID-19 global herd immunity all population groups, including migrants, needs to access vaccination. Tailored vaccination strategies, once devised, shall be applied to routine national vaccination plan to tackle health inequalities
Lessons
The following actions shall be implemented at national level
Action 1. Develop tailored and equitable approaches for PH vaccination services targeting migrants through:
-free of charge access -decentralization and outreach capacity of the health system -innovative service delivery models (mobile clinics, combined health services, mass vaccination) -health personnel and migrants participatory approach and engagement strategies
Action 2. Increase staff engagement through: -increasing health personnel's difference sensitivity -strengthening health personnel's communication capacities
Action 3. Increase migrants' health and vaccine literacy through:
-establishing vaccine literacy education programmes and strategies -offering health promotion educational interventions
Action 4. Monitor progress of inclusive vaccination offer by: -setting strategic goals, targets and indicators for national vaccination plans -expanding immunization information systems to monitor vaccination coverage, with appropriate disaggregation by migration status core variables
Key messages
Explicitly and proactively include migrants and displaced communities in vaccination plans and set up, test and implement new approaches in primary prevention and vaccination services. Extend this approach beyond the current pandemic and the sole COVID-19 vaccine in order to enhance preparedness to present and future health threats.
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Affiliation(s)
- S Declich
- National Centre Global Health, National Institute of Health, Rome, Italy
| | - MG Dente
- National Centre Global Health, National Institute of Health, Rome, Italy
| | - ME Tosti
- National Centre Global Health, National Institute of Health, Rome, Italy
| | - G De Ponte
- SIMM, ItalianSociety for Migrant Health, Rome, Italy
| | - G Marchetti
- National Centre Global Health, National Institute of Health, Rome, Italy
| | - L Tavoschi
- Department of Translational Research on New Technologies, University of Pisa, Pisa, Italy
| | - PL Lopalco
- Department of Translational Research on New Technologies, University of Pisa, Pisa, Italy
| | - ML Russo
- SIMM, ItalianSociety for Migrant Health, Rome, Italy
| | - M Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- SIMM, ItalianSociety for Migrant Health, Rome, Italy
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11
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Spadea T, Fano V, Piovesan C, Rusciani R, Salamina G, Greco G, Colaiocco G, Ramigni M, Declich S, Petrelli A, Pezzotti P, Fabiani M. Early childhood vaccination coverage and timeliness by macro-area of origin in children born to foreign women residing in Italy. Public Health 2021; 196:138-145. [PMID: 34214751 DOI: 10.1016/j.puhe.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/25/2021] [Revised: 05/03/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Country of origin might affect vaccine uptake in children born to immigrants. We aimed to evaluate differences in childhood vaccination coverage (VC) and timeliness by macro-area of origin of foreign mothers residing in Italy. STUDY DESIGN Multicentre retrospective birth cohorts. METHODS We analysed data of 23,287 children born in 2009-2014 to foreign women in the cities of Rome, Turin and Treviso. We retrieved data through record-linkage of the population, vaccination and birth registries. We estimated VCs at different ages for vaccines against tetanus, measles and meningococcal group-C, using the Kaplan-Meier method. Factors associated with vaccine uptake were evaluated using multilevel Poisson models. RESULTS Estimates of VC at any age and for all antigens were significantly lower in children born to women from Asia and higher in children born to women from Africa, as compared to other macro-areas. Similar differences by area of origin were observed for timeliness; independently of mother's sociodemographic characteristics and neonatal outcomes, the probability of delay vaccination after 2 years of age for each antigen was highest in children born to women from Asia. The risk of missed vaccination for all antigens was significantly higher in children born to younger and unemployed women. CONCLUSIONS Factors related to area of origin (e.g., cultural habits, language skills) are likely to affect parents' decision to vaccinate their children. These factors, as well as sociodemographic characteristics, should be adequately investigated and addressed to increase vaccine uptake in foreign children, especially those born to Asian women.
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Affiliation(s)
- T Spadea
- Regional Epidemiology Unit, Asl TO3 Piedmont Region, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy.
| | - V Fano
- Department of Prevention, Asl RM2, Via Maria Brighenti 23, 00159, Rome, Italy
| | - C Piovesan
- Department of Prevention, Ulss 2 Marca Trevigiana, Via S. Ambrogio di Fiera 37, 31100, Treviso, Italy
| | - R Rusciani
- Regional Epidemiology Unit, Asl TO3 Piedmont Region, Via Sabaudia 164, 10095, Grugliasco, Turin, Italy
| | - G Salamina
- Department of Hygiene and Public Health, Asl Città di Torino, Via Della Consolata 10, 10122, Turin, Italy
| | - G Greco
- Department of Hygiene and Public Health, Asl Città di Torino, Via Della Consolata 10, 10122, Turin, Italy
| | - G Colaiocco
- Department of Prevention, Asl RM2, Via Maria Brighenti 23, 00159, Rome, Italy
| | - M Ramigni
- Department of Prevention, Ulss 2 Marca Trevigiana, Via S. Ambrogio di Fiera 37, 31100, Treviso, Italy
| | - S Declich
- National Centre for Global Health, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy
| | - A Petrelli
- National Institute for Health, Migration, and Poverty (INMP), Via di S. Gallicano 25, 00153, Rome, Italy
| | - P Pezzotti
- Infectious Diseases Department, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - M Fabiani
- Infectious Diseases Department, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161, Rome, Italy
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12
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Crawshaw AF, Deal A, Rustage K, Forster AS, Campos-Matos I, Vandrevala T, Würz A, Pharris A, Suk JE, Kinsman J, Deogan C, Miller A, Declich S, Greenaway C, Noori T, Hargreaves S. What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants? J Travel Med 2021; 28:6189154. [PMID: 33772312 PMCID: PMC8083646 DOI: 10.1093/jtm/taab048] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023]
Abstract
Migrants have been disproportionately impacted by COVID-19 and emerging evidence suggests they may face barriers to COVID-19 vaccination. Participatory approaches and engagement strategies are urgently needed to strengthen uptake, alongside innovative delivery mechanisms and sharing of best practice, to ensure migrants are better consider within countries’ existing vaccine priority structures.
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Affiliation(s)
- Alison F Crawshaw
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
| | - Anna Deal
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK.,Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, WC1E 7HT London, UK
| | - Kieran Rustage
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
| | - Alice S Forster
- Department of Behavioural Science and Health, University College London, WC1E 6BT London, UK
| | - Ines Campos-Matos
- Health Improvement Division, Public Health England, SE1 8UG London, UK and UCL Collaborative Centre for Inclusion Health, University College London, WC1E 6BT London, UK
| | - Tushna Vandrevala
- Department of Psychology, Kingston University London, Kingston KT2 7LB, UK
| | - Andrea Würz
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Anastasia Pharris
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Jonathan E Suk
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - John Kinsman
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Charlotte Deogan
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Anna Miller
- Policy & Advocacy Division, Doctors of the World UK, part of the Médicins du Monde network, E14 5AA London, UK
| | - Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Roma RM, Italy
| | - Chris Greenaway
- Department of Medicine, McGill University Montreal, H3A 1A1 Quebec, Canada
| | - Teymur Noori
- Disease Programmes (AW, AP, JK, CD, TN); Public Health Functions (JES), European Centre for Disease Prevention and Control, Stockholm SE-Solna, Sweden
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, SW17 0RE London, UK
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13
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Fabiani M, Mateo-Urdiales A, Andrianou X, Bella A, Del Manso M, Bellino S, Rota MC, Boros S, Vescio MF, D'Ancona FP, Siddu A, Punzo O, Filia A, Brusaferro S, Rezza G, Dente MG, Declich S, Pezzotti P, Riccardo F. Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system. Eur J Public Health 2021; 31:37-44. [PMID: 33416859 PMCID: PMC7851886 DOI: 10.1093/eurpub/ckaa249] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees. METHODS We analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. RESULTS We analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33-1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07-1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01-1.75). CONCLUSIONS A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.
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Affiliation(s)
- Massimo Fabiani
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Alberto Mateo-Urdiales
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Xanthi Andrianou
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Antonino Bella
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Stefania Bellino
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria C Rota
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Boros
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria F Vescio
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Andrea Siddu
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Ornella Punzo
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Antonietta Filia
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | | | - Giovanni Rezza
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Maria G Dente
- Centro Nazionale per la Salute Globale, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Declich
- Centro Nazionale per la Salute Globale, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
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14
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Dente MG, Resti CV, Declich S, Putoto G. The Reported Few Cases and Deaths of Covid-19 Epidemic in Africa Are Still Data Too Questionable to Reassure About the Future of This Continent. Front Public Health 2021; 9:613484. [PMID: 33614582 PMCID: PMC7892606 DOI: 10.3389/fpubh.2021.613484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/07/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Maria Grazia Dente
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Silvia Declich
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Putoto
- Planning and Operational Research Department, Doctors With Africa Collegio Aspiranti e Medici Missionari (CUAMM), Padova, Italy
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15
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Abstract
Abstract
Background
The Universal Health Coverage (UHC) proposes that an ideal health system must be able to extend the health coverage to the whole population (universality), to guarantee all the necessary services (globality) and to do it without additional direct costs for the people (free of charge). The achievement of the UHC represents the target 3.8 of the Sustainable Developed Goals. The World Health Organization and the World Bank have developed an index to monitor the UHC (an algorithm that contains 16 indicators of essential health services), while for financial protection they rely on the incidence of catastrophic expenditure on health (percentage of families in which the living expenses for health without reimbursement exceed the10% of consumption).
Objectives
To strengthen the Italian operators' knowledge about the accessibility to health services in Italy and in countries around the world utilizing the UHC index and the incidence of catastrophic expenditure.
Results
The National Center for Global Health of the Italian National Institute of Health (ISS) collected the documents and the data already produced and validated by the international scientific community. ISS in collaboration with the Department of Public Health and Infectious Disease of Sapienza University of Rome developed a workshop training program to bring the UHC concepts at national level in a simplified manner. This was developed in order to encourage a reflection and to strengthen the understanding of the complexity of the UHC. The framework and the program of the workshop will be presented during the conference.
Conclusions
Studying the UHC means focusing on the inequalities in health care. To increase the sensibility of professionals may be a resource to promote the health coverage for all in the national territory.
Key messages
Encouraging the discussion between professionals is possible to understand the complexity of the UHC. The achievement of the UHC may happen only through the improving of the knowledge about it.
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Affiliation(s)
- G Marchetti
- National Center for Global Health, Italian National Institute of Health, Rome, Italy
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
| | - M Simonelli
- National Center for Global Health, Italian National Institute of Health, Rome, Italy
| | - M G Dente
- National Center for Global Health, Italian National Institute of Health, Rome, Italy
| | - M Marceca
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
| | - S Declich
- National Center for Global Health, Italian National Institute of Health, Rome, Italy
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16
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Declich S, DePonte G, Russo ML, Marchetti G, Dente MG, Punzo O, Marceca M. Turning constraints into resources: the experience of TRAIN4M&H training program on migrants’ health. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.164] [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: 11/13/2022] Open
Abstract
Abstract
Background
The tender TRAIN4M&H (Provision of training for first-line health professionals and law enforcement officers working at local level with migrants and refugees, and training of trainers- contract 20167204), funded by the EC-DG SANTE under the 3rd EU HP, intended to conduct training programme in all EU/EEA countries for health professionals, law enforcement officers an social workers in front-line countries and coach trainers in the others.
Objectives
Training was aimed at reinforcing skills, improving understanding and positive attitudes, and promoting a holistic approach in the work with migrants. The boundaries set by the tender included a short training duration; exclusive use of pre-existing and validated training materials; different professional targets. Italian National Health Institute and Sapienza University of Rome designed the training programme. Criteria for content selection and methodological choices were submitted for consultation to an inter-professional Expert Group in two steps.
Results
Given the limited training timeframe, the delivery of specialised content could not be the focus of this training. It was decided therefore to transform the target requirement into added value, by mixing the target groups into multi-professional classes. This bring a diversity of understandings into the classroom and enhance communication between sectors. The training included also topics such as “context of migration” and “intercultural competences” to create common ground for multi-professional exchange. Similarly, the need to adapt to different EU/EEA contexts argued for a modular structure where Units are selected by the Local Trainer based on a training needs assessment questionnaire sent to trainees beforehand. All materials are on EU Health Policy Platform's Agora (webgate.ec.europa.eu/hpf/).
Conclusions
Training on migrants' health is a complex process, requiring the engagement of learners from their previous experiences and an interdisciplinary approach.
Key messages
Inter-professional training programme can be used for the adult trainings especially in case of a cross-sectoral topic as migrants’ health is. Inter-professional training is a strategy that can guide coherently content design, outcome identification and the choice of evaluations tools.
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Affiliation(s)
- S Declich
- Italian National Institute of Health, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
| | - G DePonte
- Italian Society of Migration Medicine, Rome, Italy
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
| | - M L Russo
- Italian Society of Migration Medicine, Rome, Italy
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
| | - G Marchetti
- Italian National Institute of Health, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
| | - M G Dente
- Italian National Institute of Health, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
| | - O Punzo
- Italian National Institute of Health, Rome, Italy
| | - M Marceca
- Italian Society of Migration Medicine, Rome, Italy
- Public Health and Infectious Disease Department, Sapienza University of Rome, Rome, Italy
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17
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Marchetti G, Giambi C, Del Manso M, Ranghiasci A, Nacca G, Dente MG, Marceca M, Adel Ali K, Declich S. National immunization policies and practices for migrants in EU/EEA countries. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.865] [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: 11/12/2022] Open
Abstract
Abstract
Background
Migrants represent a potential vulnerable group and adequate health protection, including vaccine preventable diseases prevention, should be ensured. The aim of this survey was to map national immunization policies and practices targeting asylum seekers, refugees and irregular migrants in EU/EEA countries.
Methods
A web-based cross-sectional survey was conducted in 28 EU and 2 EEA countries within the ECDC funded Vaccine European New Integrated Collaboration Effort (VENICE) Project in the period January-April 2018.
Results
All countries but one completed the survey and 28 countries offer vaccination to migrants. A national regulation/legal framework supporting migrant immunization is available in most countries. This is specifically established for migrants' health services for 5, part of the National Immunization Programme (NIP) for 15 and both for 3 countries. All the vaccinations included in the NIP appropriate for age are offered to children/adolescents in 27 countries and to adults in 13. In 15 countries offering only certain vaccinations to adults, priority is given to DT, MMR and polio. Vaccinations are mainly given at holding/community level and only 5 countries vaccinate at entry level. A vaccination card is delivered in 23/28 countries to children/adolescents and 24/28 to adults. Recording of individual data vary highly: for children/adolescents and adults, respectively, 15 and 12 countries use an electronic database, 5 and 4 use only paper registry, 2 and 3 use both electronic and paper registries, while 6 and 9 countries do not record information at all. Individual and aggregated data are not made available from the sites where vaccinations are delivered to other local or national institutions in 13 and 15 countries.
Conclusions
Although policies about immunization of migrants are available in most of EU/EEA countries, there are important differences as to their objectives and implementation, especially methods of recording and transmitting data.
Key messages
Given the survey results and the migrants’ mobility, it is important to share data within and across countries to better respond to migrants' immunization needs. Strengthening partnerships between countries of origin, transit and destination, and sharing documentation may ensure the completion of vaccination series and avoid unnecessary revaccinations.
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Affiliation(s)
- G Marchetti
- Italian National Institute of Health, Rome, Italy
- Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy
| | - C Giambi
- Italian National Institute of Health, Rome, Italy
| | - M Del Manso
- Italian National Institute of Health, Rome, Italy
| | - A Ranghiasci
- Italian National Institute of Health, Rome, Italy
| | - G Nacca
- Italian National Institute of Health, Rome, Italy
| | - M G Dente
- Italian National Institute of Health, Rome, Italy
| | - M Marceca
- Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy
- Italian Society of Migration Medicine, Rome, Italy
| | - K Adel Ali
- European Centre for Disease Prevention and Control, Solna, Italy
| | - S Declich
- Italian National Institute of Health, Rome, Italy
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Amato L, Dente MG, Calistri P, Declich S. Integrated Early Warning Surveillance: Achilles' Heel of One Health? Microorganisms 2020; 8:E84. [PMID: 31936412 PMCID: PMC7022449 DOI: 10.3390/microorganisms8010084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 01/02/2023] Open
Abstract
Emerging and re-emerging infectious diseases and zoonoses indicate the importance of the One Health (OH) approach for early warning. At present, even when surveillance data are available, they are infrequently timeously shared between the health sectors. In the context of the MediLabSecure (MLS) Project, we investigated the collection of a set of surveillance indicators able to provide data for the implementation of integrated early warning systems in the 22 MLS countries of the Mediterranean, Black Sea and Sahel regions. We used an online questionnaire (covering vector, human, and animal sectors), focusing on seven relevant arboviruses, that was submitted to 110 officially appointed experts. Results showed that West Nile virus was perceived as the most relevant zoonotic pathogen, while Dengue virus was the most relevant non-zoonotic pathogen in the study area. Data collection of early warning indicators is in place at a different level for all the investigated pathogens and in almost all the MLS Countries. Further assessments on the reliability of the collection in place and on the feasibility of piloting an integrated early warning system for arbovirus could verify if integrated early warning really represents the Achilles' heel of OH.
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Affiliation(s)
- Laura Amato
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
- Public Health and Infectious Diseases Department, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Grazia Dente
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
| | - Paolo Calistri
- National Reference Center for Veterinary Epidemiology, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ′G.Caporale′, 64100 Teramo, Italy;
| | - Silvia Declich
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (L.A.); (S.D.)
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19
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Giambi C, Del Manso M, Marchetti G, Olsson K, Adel Ali K, Declich S. Immunisation of migrants in EU/EEA countries: Policies and practices. Vaccine 2019; 37:5439-5451. [PMID: 31296374 DOI: 10.1016/j.vaccine.2019.06.068] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 03/30/2019] [Revised: 06/16/2019] [Accepted: 06/22/2019] [Indexed: 12/12/2022]
Abstract
In recent years various EU/EEA countries have experienced an influx of migrants from low and middle-income countries. In 2018, the "Vaccine European New Integrated Collaboration Effort (VENICE)" survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called "migrants" in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants' access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants' access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps.
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Affiliation(s)
- Cristina Giambi
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Martina Del Manso
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Giulia Marchetti
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; Sapienza Università di Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Kate Olsson
- European Centre for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Karam Adel Ali
- European Centre for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden.
| | - Silvia Declich
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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20
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Jourdain F, Samy AM, Hamidi A, Bouattour A, Alten B, Faraj C, Roiz D, Petrić D, Pérez-Ramírez E, Velo E, Günay F, Bosevska G, Salem I, Pajovic I, Marić J, Kanani K, Paronyan L, Dente MG, Picard M, Zgomba M, Sarih M, Haddad N, Gaidash O, Sukhiasvili R, Declich S, Shaibi T, Sulesco T, Harrat Z, Robert V. Towards harmonisation of entomological surveillance in the Mediterranean area. PLoS Negl Trop Dis 2019; 13:e0007314. [PMID: 31194743 PMCID: PMC6563966 DOI: 10.1371/journal.pntd.0007314] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The Mediterranean Basin is historically a hotspot for trade, transport, and migration. As a result, countries surrounding the Mediterranean Sea share common public health threats. Among them are vector-borne diseases, and in particular, mosquito-borne viral diseases are prime candidates as (re)emerging diseases and are likely to spread across the area. Improving preparedness and response capacities to these threats at the regional level is therefore a major issue. The implementation of entomological surveillance is, in particular, of utmost importance. Guidance in designing entomological surveillance systems is critical, and these systems may pursue different specific objectives depending on the disease. The purpose of the proposed review is to draw up guidelines for designing effective and sustainable entomological surveillance systems in order to improve preparedness and response. However, we make it clear that there is no universal surveillance system, so the thinking behind harmonisation is to define evidence-based standards in order to promote best practises, identify the most appropriate surveillance activities, and optimise the use of resources. Such guidance is aimed at policymakers and diverse stakeholders and is intended to be used as a framework for the implementation of entomological surveillance programmes. It will also be useful to collaborate and share information with health professionals involved in other areas of disease surveillance. Medical entomologists and vector control professionals will be able to refer to this report to advocate for tailored entomological surveillance strategies. The main threats targeted in this review are the vectors of dengue virus, chikungunya virus, Zika virus, West Nile virus, and Rift Valley fever virus. The vectors of all these arboviruses are mosquitoes. METHODS Current knowledge on vector surveillance in the Mediterranean area is reviewed. The analysis was carried out by a collaboration of the medical entomology experts in the region, all of whom belong to the MediLabSecure network, which is currently funded by the European Union and represents an international effort encompassing 19 countries in the Mediterranean and Black Sea region. FINDINGS Robust surveillance systems are required to address the globalisation of emerging arboviruses. The prevention and management of mosquito-borne viral diseases must be addressed in the prism of a One Health strategy that includes entomological surveillance as an integral part of the policy. Entomological surveillance systems should be designed according to the entomological and epidemiological context and must have well-defined objectives in order to effect a tailored and graduated response. We therefore rely on different scenarios according to different entomological and epidemiological contexts and set out detailed objectives of surveillance. The development of multidisciplinary networks involving both academics and public authorities will provide resources to address these health challenges by promoting good practises in surveillance (identification of surveillance aims, design of surveillance systems, data collection, dissemination of surveillance results, evaluation of surveillance activities) and through the sharing of effective knowledge and information. These networks will also contribute to capacity building and stronger collaborations between sectors at both the local and regional levels. Finally, concrete guidance is offered on the vector of the main arbovirus based on the current situation in the area.
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Affiliation(s)
- Frédéric Jourdain
- French National Research Institute for Sustainable Development, Research unit MIVEGC IRD-CNRS-Montpellier University, Montpellier, France
| | - Abdallah M. Samy
- Entomology Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Afrim Hamidi
- University of Prishtina, Faculty of Agriculture and Veterinary Sciences, Prishtina, Kosovo
| | - Ali Bouattour
- Université de Tunis El Manar, Institut Pasteur de Tunis, LR11IPT03 Service d’entomologie médicale, Tunis, Tunisia
| | - Bülent Alten
- Hacettepe University, Faculty of Science, Biology Department, Ecology Section, Ankara, Turkey
| | - Chafika Faraj
- Laboratoire d'Entomologie Médicale, Institut National d'Hygiène, Rabat, Morocco
| | - David Roiz
- French National Research Institute for Sustainable Development, Research unit MIVEGC IRD-CNRS-Montpellier University, Montpellier, France
| | - Dušan Petrić
- Faculty of Agriculture, Department of Phytomedicine and Environment Protection, Laboratory for Medical Entomology, University of Novi Sad, Novi Sad, Serbia
| | - Elisa Pérez-Ramírez
- Centro de Investigación en Sanidad Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CISA), Carretera Algete-El Casar, Valdeolmos, Madrid, Spain
| | - Enkeledja Velo
- Control of Infectious Diseases Department, Institute of Public Health, Tirana, Albania
| | - Filiz Günay
- Hacettepe University, Faculty of Science, Biology Department, Ecology Section, Ankara, Turkey
| | - Golubinka Bosevska
- Institute of Public Health of R. Macedonia, Laboratory for virology and molecular diagnostics, Skopje, the Former Yugoslav Republic of Macedonia
| | - Ibrahim Salem
- Ministry of Health, Central public health laboratory, Ramallah, Palestine
| | - Igor Pajovic
- University of Montenegro, Biotechnical Faculty, Podgorica, Montenegro
| | - Jelena Marić
- PI Veterinary Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Khalil Kanani
- Parasitic and Zoonotic Diseases Department, Vector-Borne Diseases programmes manager, MOH, Ramallah, Jordan
| | - Lusine Paronyan
- Epidemiology of Vector borne and Parasitic diseases, National Center for Disease Control and Prevention, Ministry of Health, Yerevan, Armenia
| | - Maria-Grazia Dente
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marie Picard
- French National Research Institute for Sustainable Development, Research unit MIVEGC IRD-CNRS-Montpellier University, Montpellier, France
| | - Marija Zgomba
- Faculty of Agriculture, Department of Phytomedicine and Environment Protection, Laboratory for Medical Entomology, University of Novi Sad, Novi Sad, Serbia
| | - M'hammed Sarih
- Laboratoire des Maladies Vectorielles, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Nabil Haddad
- Laboratory of Immunology and Vector-Borne Diseases, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Oleksandr Gaidash
- State Body “Ukrainian I. I. Mechnikov Research Anti-Plague Institute of Ministry of Health of Ukraine”, Laboratory of Especially Dangerous Infections Epizootology, Odessa, Ukraine
| | - Roena Sukhiasvili
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Silvia Declich
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Taher Shaibi
- Reference Laboratory of Parasites & Vector Borne Diseases, NCDC Libya, and Zoology Department, Faculty of Science, University of Tripoli, Libya
| | - Tatiana Sulesco
- Institute of Zoology, Ministry of Education, Culture and Research, Chisinau, Moldova
| | - Zoubir Harrat
- Laboratoire éco-épidémiologie Parasitaire et Génétique des Populations, Institut Pasteur d’Algérie, Algiers, Algeria
| | - Vincent Robert
- French National Research Institute for Sustainable Development, Research unit MIVEGC IRD-CNRS-Montpellier University, Montpellier, France
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Fabiani M, Fano V, Spadea T, Piovesan C, Bianconi E, Rusciani R, Salamina G, Greco G, Ramigni M, Declich S, Petrelli A, Pezzotti P. Comparison of early childhood vaccination coverage and timeliness between children born to Italian women and those born to foreign women residing in Italy: A multi-centre retrospective cohort study. Vaccine 2019; 37:2179-2187. [PMID: 30902479 DOI: 10.1016/j.vaccine.2019.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/17/2018] [Revised: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Compared to hosting populations, immigrants are usually considered more vulnerable to communicable diseases, many of which are vaccine-preventable. This study aims to estimate vaccination coverage (VC) and timeliness in children born to women from high migratory pressure countries (HMPC) and to evaluate factors affecting differences with children born to Italian women or women from advanced development countries (ITA + ADC). METHODS We retrospectively analysed data of children born in 2009-2014 and resident in areas served by three local health units in the cities of Rome (n = 40,284), Turin (n = 49,600), and Treviso (n = 20,080). Data were retrieved through record-linkage of the population, vaccination, and birth registries. We used the Kaplan-Meier method to estimate VCs at different ages for the 3rd dose of vaccine against tetanus and the 1st dose of vaccines against measles and meningococcal group C. Factors affecting differences in VCs by citizenship were evaluated using log-binomial models. RESULTS In Rome, VCs at 2 years of age were consistently higher in children born to ITA + ADC women than in children born to HMPC women, while differences in VCs by citizenship varied according to antigen and birth-cohort in Turin and Treviso, respectively. Where differences were observed, these were only partially explained by the mother's socio-demographic characteristics, level of utilisation of health-services during pregnancy, and maternal, perinatal, and neonatal outcomes. Finally, we observed a reduction of VCs in recent birth cohorts (2012-14 vs. 2009-11), especially in children born to ITA + ADC women. CONCLUSIONS Differences in VCs by citizenship were not homogeneous and varied according to geographical context, antigen, and birth-cohort. These differences are likely to be also affected by informal barriers (e.g., linguistic and cultural barriers), which should be addressed in implementing strategies to increase vaccine uptake in foreign children. Moreover, our results suggest that effective strategies to promote vaccinations in the autochthonous population are also needed.
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Affiliation(s)
- Massimo Fabiani
- Infectious Diseases Department, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy.
| | - Valeria Fano
- Local Health Unit 2 (Asl RM2), Via Filippo Meda 35, 00157 Rome, Italy
| | - Teresa Spadea
- Epidemiology Unit, Local Health Unit 3 (Asl TO3), Via Sabaudia 164, 10095 Grugliasco, Turin, Italy
| | - Cinzia Piovesan
- Department of Prevention, Local Health Unit 2 (Ulss 2 Marca Trevigiana), Via S. Ambrogio di Fiera 37, 31100 Treviso, Italy
| | - Egisto Bianconi
- Local Health Unit 2 (Asl RM2), Via Filippo Meda 35, 00157 Rome, Italy
| | - Raffaella Rusciani
- Epidemiology Unit, Local Health Unit 3 (Asl TO3), Via Sabaudia 164, 10095 Grugliasco, Turin, Italy
| | - Giuseppe Salamina
- Local Health Unit (Asl Città di Torino), Via San Secondo 29, 10128 Turin, Italy
| | - Gregorio Greco
- Local Health Unit (Asl Città di Torino), Via San Secondo 29, 10128 Turin, Italy
| | - Mauro Ramigni
- Department of Prevention, Local Health Unit 2 (Ulss 2 Marca Trevigiana), Via S. Ambrogio di Fiera 37, 31100 Treviso, Italy
| | - Silvia Declich
- National Centre for Global Health, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy
| | - Alessio Petrelli
- National Institute for Health, Migration, and Poverty (INMP), Via di S. Gallicano 25, 00153 Rome, Italy
| | - Patrizio Pezzotti
- Infectious Diseases Department, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy
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Dente MG, Riccardo F, Bolici F, Colella NA, Jovanovic V, Drakulovic M, Vasic M, Mamlouk H, Maazaoui L, Bejaoui M, Zakhashvili K, Kalandadze I, Imnadze P, Declich S. Implementation of the One Health approach to fight arbovirus infections in the Mediterranean and Black Sea Region: Assessing integrated surveillance in Serbia, Tunisia and Georgia. Zoonoses Public Health 2019; 66:276-287. [PMID: 30724030 PMCID: PMC6850493 DOI: 10.1111/zph.12562] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/21/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
Background In the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter‐sectoral collaboration; however, no standardized methodology exists to study One Health surveillance. Methods We designed a situation analysis study to document how integration of laboratory/clinical human, animal and entomological surveillance of arboviruses was being implemented in the Region. We applied a framework designed to assess three levels of integration: policy/institutional, data collection/data analysis and dissemination. We tested the use of Business Process Modelling Notation (BPMN) to graphically present evidence of inter‐sectoral integration. Results Serbia, Tunisia and Georgia participated in the study. West Nile Virus surveillance was analysed in Serbia and Tunisia, Crimea‐Congo Haemorrhagic Fever surveillance in Georgia. Our framework enabled a standardized analysis of One Health surveillance integration, and BPMN was easily understandable and conducive to detailed discussions among different actors/institutions. In all countries, we observed integration across sectors and levels except in data collection and data analysis. Data collection was interoperable only in Georgia without integrated analysis. In all countries, surveillance was mainly oriented towards outbreak response, triggered by an index human case. Discussion The three surveillance systems we observed prove that integrated surveillance can be operationalized with a diverse spectrum of options. However, in all countries, the integrated use of data for early warning and inter‐sectoral priority setting is pioneeristic. We also noted that early warning before human case occurrence is recurrently not operationally prioritized.
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Affiliation(s)
| | | | | | | | - Verica Jovanovic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Mitra Drakulovic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Milena Vasic
- Institute of Public Health "Dr Milan Jovanović Batut", Belgrade, Serbia
| | - Habiba Mamlouk
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | - Latifa Maazaoui
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | - Mondher Bejaoui
- Ministère de la Santé Publique/Direction des soins de santé de base, Tunis, Tunisia
| | | | - Irine Kalandadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Paata Imnadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
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Fabiani M, Di Napoli A, Riccardo F, Gargiulo L, Declich S, Petrelli A. [Differences in influenza vaccination coverage among subgroups of adult immigrants residing in Italy at risk for complications (2012-2013)]. Epidemiol Prev 2018; 41:50-56. [PMID: 28929727 DOI: 10.19191/ep17.3-4s1.p050.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to evaluate differences in influenza vaccination coverage (IVC) in immigrants at risk for influenza-related complications, according to their area of origin and length of stay in Italy. DESIGN cross-sectional survey conducted on the sample of foreign citizens included in the survey on health conditions and use of health services of the Italian resident population (Italian national institute of statistics, 2012-2013). SETTING AND PARTICIPANTS analysis conducted on 885 foreign adult citizens (≥18 years) at risk for influenza-related complications (elderly residents ≥65 years and residents with specific chronic diseases). MAIN OUTCOME MEASURES vaccination coverage ratios (VCR) comparison between long-term immigrants (≥10 years) and recent immigrants (<10 years), and between non-African and African immigrants, adjusted by demographic and socioeconomic characteristics and level of health services utilization. RESULTS IVC among immigrants was 15.6%, significantly higher in long-term immigrants (18.3%) compared to recent immigrants (10.2%) (VCR: 1.79; 95%CI 1.21-2.66), and in non-African immigrants (17.1%) compared to African immigrants (9.4%) (VCR: 1.82; 95%CI 1.04-3.17). After adjusting on the basis of demographic and socioeconomic characteristics and for level of health services utilization between the compared subgroups, the difference in IVC according to the length of stay was greatly reduced (VCR: 1.41; 95%CI 0.94- 2.10), while IVC difference reduction according to area of origin was less relevant (VCR: 1.66; 95%CI 0.95-2.91). CONCLUSIONS demographic and socioeconomic characteristics and level of health services utilization explained part of the difference in IVC between the compared subgroups, particularly between long-term and recent immigrants. The difference in IVC between African immigrants and immigrants from other areas remained quite pronounced even after adjusting on the basis of these factors. This suggests that IVC, especially in African immigrants, is affected by other informal barriers, such as cultural and linguistic barriers, that need to be addressed when planning effective immunization access strategies.
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Affiliation(s)
- Massimo Fabiani
- Centro nazionale di epidemiologia, sorveglianza e promozione della salute (CNESPS), Istituto superiore di sanità, Roma.
| | - Anteo Di Napoli
- Istituto nazionale per la promozione della salute delle popolazioni migranti e per il contrasto delle malattie della povertà (INMP), Roma
| | - Flavia Riccardo
- Centro nazionale di epidemiologia, sorveglianza e promozione della salute (CNESPS), Istituto superiore di sanità, Roma
| | | | - Silvia Declich
- Centro nazionale di epidemiologia, sorveglianza e promozione della salute (CNESPS), Istituto superiore di sanità, Roma
| | - Alessio Petrelli
- Istituto nazionale per la promozione della salute delle popolazioni migranti e per il contrasto delle malattie della povertà (INMP), Roma
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Dalla Zuanna T, Del Manso M, Giambi C, Riccardo F, Bella A, Caporali M, Dente M, Declich S. 4.10-P15Policies and practices targeting immunisation of newly arrived migrants in Italy. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.154] [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: 11/12/2022] Open
Affiliation(s)
| | | | - C Giambi
- Istituto Superiore di Sanità, Rome, Italy
| | - F Riccardo
- Istituto Superiore di Sanità, Rome, Italy
| | - A Bella
- Istituto Superiore di Sanità, Rome, Italy
| | - M Caporali
- Istituto Superiore di Sanità, Rome, Italy
| | - M Dente
- Istituto Superiore di Sanità, Rome, Italy
| | - S Declich
- Istituto Superiore di Sanità, Rome, Italy
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Giambi C, Del Manso M, Dalla Zuanna T, Riccardo F, Bella A, Caporali M, Baka A, Čakš Jager N, Melillo T, Mexia R, Petrović G, Declich S. 4.10-P16National immunization strategies targeting migrants in six European countries. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.155] [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: 11/12/2022] Open
Affiliation(s)
- C Giambi
- Istituto Superiore Di Sanità, Rome, Italy
| | | | - T Dalla Zuanna
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Italy
| | - F Riccardo
- Istituto Superiore Di Sanità, Rome, Italy
| | - A Bella
- Istituto Superiore Di Sanità, Rome, Italy
| | - M Caporali
- Istituto Superiore Di Sanità, Rome, Italy
| | - A Baka
- Hellenic Center for Disease Control and Prevention, Greece
| | - N Čakš Jager
- National Institute of Public Health, Ljubljana, Slovenia
| | - T Melillo
- Ministry for Health, Infectious Disease Prevention and Control Unit, Malta
| | - R Mexia
- Instituto Nacional de Saude Doutor Ricardo Jorge, Portugal
| | - G Petrović
- Croatian Institute of Public Health, Zagreb, Croatia
| | - S Declich
- Istituto Superiore Di Sanità, Rome, Italy
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26
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Tosti M, Baglio G, Marceca M, D'Angelo F, Ferrigno L, Eugeni E, Declich S, Pajno C, Marrone R, Rosso A, Geraci S. 7.5-O4Italian guideline on “health checks and protection pathways for migrants on arrival and while hosted in reception centres”. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.265] [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: 11/14/2022] Open
Affiliation(s)
- M Tosti
- Istituto Superiore di Sanità, Rome, Italy
| | - G Baglio
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - M Marceca
- Società Italiana di Medicina delle Migrazioni, Italy
| | - F D'Angelo
- Istituto Superiore di Sanità, Rome, Italy
| | - L Ferrigno
- Istituto Superiore di Sanità, Rome, Italy
| | - E Eugeni
- Società Italiana di Medicina delle Migrazioni, Italy
| | - S Declich
- Istituto Superiore di Sanità, Rome, Italy
| | - C Pajno
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - R Marrone
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti e per il contrasto delle malattie della Povertà, Italy
| | - A Rosso
- ”La Sapienza” University, Rome, Italy
| | - S Geraci
- Società Italiana di Medicina delle Migrazioni, Italy
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Dente MG, Riccardo F, Nacca G, Ranghiasci A, Escadafal C, Gaayeb L, Jiménez-Clavero MA, Manuguerra JC, Picard M, Fernández-Pinero J, Pérez-Ramírez E, Robert V, Victoir K, Declich S. Strengthening Preparedness for Arbovirus Infections in Mediterranean and Black Sea Countries: A Conceptual Framework to Assess Integrated Surveillance in the Context of the One Health Strategy. Int J Environ Res Public Health 2018. [PMID: 29534445 PMCID: PMC5877034 DOI: 10.3390/ijerph15030489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In the context of One Health, there is presently an effort to integrate surveillance of human, animal, entomological, and environmental sectors. This aims to strengthen the prevention of, and preparedness against, arbovirus infections, also in the light of environmental and climate changes that could increase the risk of transmission. However, criteria to define integrated surveillance, and to compare different systems, still need to be identified and tested. We conducted a scoping review to identify and examine surveillance systems for West Nile virus (WNV), chikungunya virus (CHKV), dengue virus (DENV), and Rift Valley fever virus (RVFV), which involve human, animal, entomological, and environmental sectors. We analyzed findings using a conceptual framework we developed for this purpose. The review highlights that the criteria proposed in the conceptual framework to describe integrated surveillance are consistently reported in the context of studies and programs related to integrated surveillance of the selected arboviral diseases. These criteria can facilitate the identification and description of operationalized One Health surveillance.
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Affiliation(s)
- Maria Grazia Dente
- Istituto Superiore di Sanità, 00161 Rome, Italy; (F.R.); (G.N.); (A.R.); (S.D.)
- Correspondence: ; Tel.: +39-064-990-4265
| | - Flavia Riccardo
- Istituto Superiore di Sanità, 00161 Rome, Italy; (F.R.); (G.N.); (A.R.); (S.D.)
| | - Gloria Nacca
- Istituto Superiore di Sanità, 00161 Rome, Italy; (F.R.); (G.N.); (A.R.); (S.D.)
| | - Alessia Ranghiasci
- Istituto Superiore di Sanità, 00161 Rome, Italy; (F.R.); (G.N.); (A.R.); (S.D.)
| | - Camille Escadafal
- Institut Pasteur, 75015 Paris, France; (C.E.); (L.G.); (J.-C.M.); (K.V.)
- FIND (Foundation for Innovative New Diagnostics), 1202 Geneva, Switzerland
| | - Lobna Gaayeb
- Institut Pasteur, 75015 Paris, France; (C.E.); (L.G.); (J.-C.M.); (K.V.)
| | - Miguel Angel Jiménez-Clavero
- Centro de Investigación en Sanidad Animal-Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CISA), 28040 Madrid, Spain; (M.A.J.-C.); (J.F.-P.); (E.P.-R.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | - Marie Picard
- Institut de Recherche pour le Développement (IRD), UMR Mivegec IRD-CNRS-Univ. Montpellier, 34394 Montpellier CEDEX 5, France; (M.P.); (V.R.)
| | - Jovita Fernández-Pinero
- Centro de Investigación en Sanidad Animal-Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CISA), 28040 Madrid, Spain; (M.A.J.-C.); (J.F.-P.); (E.P.-R.)
| | - Elisa Pérez-Ramírez
- Centro de Investigación en Sanidad Animal-Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA-CISA), 28040 Madrid, Spain; (M.A.J.-C.); (J.F.-P.); (E.P.-R.)
| | - Vincent Robert
- Institut de Recherche pour le Développement (IRD), UMR Mivegec IRD-CNRS-Univ. Montpellier, 34394 Montpellier CEDEX 5, France; (M.P.); (V.R.)
| | - Kathleen Victoir
- Institut Pasteur, 75015 Paris, France; (C.E.); (L.G.); (J.-C.M.); (K.V.)
| | - Silvia Declich
- Istituto Superiore di Sanità, 00161 Rome, Italy; (F.R.); (G.N.); (A.R.); (S.D.)
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Giambi C, Del Manso M, Dalla Zuanna T, Riccardo F, Bella A, Caporali MG, Baka A, Caks-Jager N, Melillo T, Mexia R, Petrović G, Declich S. National immunization strategies targeting migrants in six European countries. Vaccine 2018; 37:4610-4617. [PMID: 29426661 DOI: 10.1016/j.vaccine.2018.01.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 10/31/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 01/23/2023]
Abstract
Over the last three years an unprecedented flow of migrants arrived in Europe. There is evidence that vaccine preventable diseases have caused outbreaks in migrant holding centres. These outbreaks can be favored by a combination of factors including low immunization coverage, bad conditions that migrants face during their exhausting journey and overcrowding within holding facilities. In 2017, we conducted an online survey in Croatia, Greece, Italy, Malta, Portugal and Slovenia to explore the national immunization strategies targeting irregular migrants, refugees and asylum seekers. All countries stated that a national regulation supporting vaccination offer to migrants is available. Croatia, Italy, Portugal and Slovenia offer to migrant children and adolescents all vaccinations included in the National Immunization Plan; Greece and Malta offer only certain vaccinations, including those against diphtheria-tetanus-pertussis, poliomyelitis and measles-mumps-rubella. Croatia, Italy, Malta and Portugal also extend the vaccination offer to adults. All countries deliver vaccinations in holding centres and/or community health services, no one delivers vaccinations at entry site. Operating procedures that guarantee the migrants' access to vaccination at the community level are available only in Portugal. Data on administered vaccines is available at the national level in four countries: individual data in Malta and Croatia, aggregated data in Greece and Portugal. Data on vaccination uptake among migrants is available at national level only in Malta. Concluding, although diversified, strategies for migrant vaccination are in place in all the surveyed countries and generally in line with WHO and ECDC indications. Development of procedures to keep track of migrants' immunization data across countries, development of strategies to facilitate and monitor migrants' access to vaccinations at the community level and collection of data on vaccination uptake among migrants should be promoted to meet existing gaps.
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Affiliation(s)
- Cristina Giambi
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Martina Del Manso
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Teresa Dalla Zuanna
- Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padova, Via Loredan, 18, 35131 Padova, Italy.
| | - Flavia Riccardo
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Antonino Bella
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | | | - Agoritsa Baka
- Hellenic Center for Disease Control and Prevention, 3-5, Agrafon Str, 151 23 Maroussi, Attica, Greece.
| | - Nuska Caks-Jager
- National Institute of Public Health, Zaloška 29, 1000 Ljubljana, Slovenia.
| | - Tanya Melillo
- Ministry for Health, Infectious Disease Prevention and Control Unit, 58, The Emporium, C. Debrockdorff Street, Msida, Malta.
| | - Ricardo Mexia
- Instituto Nacional de Saude Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal.
| | - Goranka Petrović
- Croatian Institute of Public Health, Rockefellerova 7, 10 000 Zagreb, Croatia.
| | - Silvia Declich
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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Puzelli S, Rizzo C, Fabiani C, Facchini M, Gaibani P, Landini MP, Gagliotti C, Moro ML, Rangoni R, Piccolomini LL, Finarelli AC, Tamba M, Rezza G, Declich S, Donatelli I, Castrucci MR. Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013. Emerg Infect Dis 2018; 22:1512-3. [PMID: 27434025 PMCID: PMC4982161 DOI: 10.3201/eid2208.160246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Dente MG, Riccardo F, Bejaoui M, Fabiani M, Lausevic D, Declich S, on behalf of the EpiSouth Working G. Contribution of Regional Networks to the Control of Cross-Border Public Health Threats: EpiSouth in the Mediterranean Region and Southeast Europe. Health Secur 2017. [DOI: 10.1089/hs.2016.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giambi C, Bella A, Filia A, Del Manso M, Nacca G, Declich S, Rota MC. Erratum to: Underreporting of congenital rubella in Italy, 2010-2014. Eur J Pediatr 2017; 176:1145. [PMID: 28695269 DOI: 10.1007/s00431-017-2962-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Cristina Giambi
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Antonino Bella
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Antonietta Filia
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Martina Del Manso
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Gloria Nacca
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Silvia Declich
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Maria Cristina Rota
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
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Giorgi Rossi P, Riccardo F, Pezzarossi A, Ballotari P, Dente MG, Napoli C, Chiarenza A, Velasco Munoz C, Noori T, Declich S. Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review. Int J Environ Res Public Health 2017; 14:ijerph14070720. [PMID: 28678172 PMCID: PMC5551158 DOI: 10.3390/ijerph14070720] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/22/2017] [Accepted: 06/30/2017] [Indexed: 02/07/2023]
Abstract
We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations.
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Affiliation(s)
- Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Flavia Riccardo
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Annamaria Pezzarossi
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Paola Ballotari
- Interinstitutional Epidemiology Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
- Arcispedale Santa Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy.
| | - Maria Grazia Dente
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Christian Napoli
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Antonio Chiarenza
- Research and Innovation Unit, AUSL Reggio Emilia, 42122 Reggio Emilia, Italy.
| | - Cesar Velasco Munoz
- European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
- IS Global, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, 08036 Barcelona, Spain.
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), 17183 Stockholm, Sweden.
| | - Silvia Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
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Giambi C, Bella A, Filia A, Del Manso M, Nacca G, Declich S, Rota MC. Underreporting of congenital rubella in Italy, 2010-2014. Eur J Pediatr 2017; 176:955-962. [PMID: 28551878 DOI: 10.1007/s00431-017-2935-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/08/2017] [Accepted: 05/15/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED In accordance with the goals of the World Health Organization Regional Committee for Europe, the Italian national Measles and Rubella Elimination Plan 2010-2015 aimed to reduce the incidence of congenital rubella cases to <1 case/100,000 live births by 2015. In Italy, a passive national surveillance system for congenital rubella and rubella in pregnancy is active since 2005. We estimated the degree of underreporting of congenital rubella, performing a capture-recapture analysis of cases detected through two independent sources: the national surveillance system and the national hospital discharge database, in the years 2010-2014. We found that 6 out of 11 cases tracked in the retrospective case-finding from hospital registries had not been notified to the surveillance system, and we estimated a degree of underreporting of 53% for the period 2010-2014. This approach showed to be simple to perform, repeatable, and effective. CONCLUSION In order to reduce underreporting, some actions aimed at strengthening surveillance procedures are needed. The adoption on a routine basis of the review of hospital discharge registries for case-finding, monthly zero-reporting, and actions to train and sensitize all the specialists involved in the care of pregnant women and the newborns to notification procedures are recommended. What is Known • In Italy, the incidence of congenital rubella was below the WHO target of 1/100,000 live births in 2005-2015, except for two peaks in 2008 and 2012 (5 and 4/100,000, respectively). • Further efforts are required to improve congenital rubella surveillance so that it is more sensitive and specific. The WHO proposes retrospective case-finding from hospital records as an alternative approach to detect infants with congenital rubella. What is New • Underreporting of congenital rubella in Italy was 53% in 2010-2014. • Hospital discharge registries resulted to be an appropriate source to detect congenital rubella cases.
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Affiliation(s)
- Cristina Giambi
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Antonino Bella
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Antonietta Filia
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Martina Del Manso
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Gloria Nacca
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Silvia Declich
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Maria Cristina Rota
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
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Riccardo F, Manso MD, Caporali MG, Napoli C, Linge JP, Mantica E, Verile M, Piatti A, Pompa MG, Vellucci L, Costanzo V, Bastiampillai AJ, Gabrielli E, Gramegna M, Declich S. Event-Based Surveillance During EXPO Milan 2015: Rationale, Tools, Procedures, and Initial Results. Health Secur 2017; 14:161-72. [PMID: 27314656 PMCID: PMC4931307 DOI: 10.1089/hs.2015.0075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
More than 21 million participants attended EXPO Milan from May to October 2015, making it one of the largest protracted mass gathering events in Europe. Given the expected national and international population movement and health security issues associated with this event, Italy fully implemented, for the first time, an event-based surveillance (EBS) system focusing on naturally occurring infectious diseases and the monitoring of biological agents with potential for intentional release. The system started its pilot phase in March 2015 and was fully operational between April and November 2015. In order to set the specific objectives of the EBS system, and its complementary role to indicator-based surveillance, we defined a list of priority diseases and conditions. This list was designed on the basis of the probability and possible public health impact of infectious disease transmission, existing statutory surveillance systems in place, and any surveillance enhancements during the mass gathering event. This article reports the methodology used to design the EBS system for EXPO Milan and the results of 8 months of surveillance. More than 21 million participants attended EXPO Milan from May to October 2015, making it one of the largest protracted mass gathering events in Europe. Given the expected national and international population movement and health security issues associated with this event, Italy fully implemented, for the first time, an event-based surveillance system focusing on naturally occurring infectious diseases and the monitoring of biological agents with potential for intentional release. This article reports the methodology used to design the event-based surveillance system for EXPO Milan and the results of 8 months of surveillance.
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Giambi C, Del Manso M, Dente MG, Napoli C, Montaño-Remacha C, Riccardo F, Declich S, Network For The Control Of Cross-Border Health Threats In The Mediterranean Basin And Black Sea For The ProVacMed Project. Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea. Int J Environ Res Public Health 2017; 14:E459. [PMID: 28441361 PMCID: PMC5451910 DOI: 10.3390/ijerph14050459] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 11/16/2022]
Abstract
Background: The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods: In 2015-2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results: Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions: Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations.
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Affiliation(s)
- Cristina Giambi
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299, 00161 Rome, Italy.
| | - Martina Del Manso
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299, 00161 Rome, Italy.
| | - Maria Grazia Dente
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299, 00161 Rome, Italy.
| | - Christian Napoli
- Department of Medical Surgical Sciences and Traslational Medicine, "Sapienza" University of Rome, Via di Grottarossa, 1035/1039, 00189 Rome, Italy.
| | - Carmen Montaño-Remacha
- Department of Epidemiology, Andalusian Regional Ministry of Health, Avenida de la innovaciòn s/n, 41020 Sevilla, Spain.
| | - Flavia Riccardo
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299, 00161 Rome, Italy.
| | - Silvia Declich
- National Center for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299, 00161 Rome, Italy.
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Escadafal C, Gaayeb L, Riccardo F, Pérez-Ramírez E, Picard M, Dente MG, Fernández-Pinero J, Manuguerra JC, Jiménez-Clavero MÁ, Declich S, Victoir K, Robert V. Risk of Zika virus transmission in the Euro-Mediterranean area and the added value of building preparedness to arboviral threats from a One Health perspective. BMC Public Health 2016; 16:1219. [PMID: 27914465 PMCID: PMC5135781 DOI: 10.1186/s12889-016-3831-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 11/12/2016] [Indexed: 12/20/2022] Open
Abstract
In the alarming context of risk of Zika virus (ZIKV) transmission in the Euro-Mediterranean area, there is a need to examine whether capacities to detect, diagnose and notify ZIKV infections in the region are in place and whether ongoing capacity-building initiatives are filling existing gaps. The MediLabSecure network, created in 2014, comprises 55 laboratories of virology and medical entomology and 19 public health institutions in 19 countries in the Balkans, North-Africa, the Middle-East and the Black Sea regions. It aims to set up awareness, risk assessment, monitoring and control of emerging and re-emerging vector-borne viruses. We here examine the actions and strategies that MediLabSecure has been implementing and how they will contribute to the prevention and control of the ZIKV threat in the Euro-Mediterranean area. Capacity-building for arbovirus diagnostics is a major objective of the project and follows a methodological rather than disease-driven approach. This enables the implementation of laboratory trainings on techniques that are common to several arboviruses, including ZIKV, and putting into action appropriate diagnostic tools in the target region. Moreover, by its One Health approach and the interaction of its four sub-networks in human virology, animal virology, medical entomology and public health, MediLabSecure is fostering intersectoral collaboration, expertise and sharing of information. The resulting exchanges (methodological, communication and operational) across disciplines and across countries, dedicated research on intersectoral collaboration and increasing diagnostic capacities are providing new paths and tools to public health professionals to face emerging viral threats such as a ZIKV epidemic in the Euro-Mediterranean region.
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Affiliation(s)
| | | | - Flavia Riccardo
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | - Elisa Pérez-Ramírez
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Centro de Investigación en Sanidad Animal (INIA-CISA), Madrid, Spain
| | - Marie Picard
- Institut de Recherche pour le Développement, MIVEGEC Unit, IRD 224 - CNRS 5290 - UM, Montpellier, France
| | - Maria Grazia Dente
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | - Jovita Fernández-Pinero
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Centro de Investigación en Sanidad Animal (INIA-CISA), Madrid, Spain
| | | | - Miguel-Ángel Jiménez-Clavero
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Centro de Investigación en Sanidad Animal (INIA-CISA), Madrid, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Silvia Declich
- Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Rome, Italy
| | | | - Vincent Robert
- Institut de Recherche pour le Développement, MIVEGEC Unit, IRD 224 - CNRS 5290 - UM, Montpellier, France
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Fabiani M, Riccardo F, Di Napoli A, Gargiulo L, Declich S, Petrelli A. Differences in Influenza Vaccination Coverage between Adult Immigrants and Italian Citizens at Risk for Influenza-Related Complications: A Cross-Sectional Study. PLoS One 2016; 11:e0166517. [PMID: 27832186 PMCID: PMC5104396 DOI: 10.1371/journal.pone.0166517] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 10/31/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Due to their increased vulnerability, immigrants are considered a priority group for communicable disease prevention and control in Europe. This study aims to compare influenza vaccination coverage (IVC) between regular immigrants and Italian citizens at risk for its complications and evaluate factors affecting differences. METHODS Based on data collected by the National Institute of Statistics during a population-based cross-sectional survey conducted in Italy in 2012-2013, we analysed information on 42,048 adult residents (≥ 18 years) at risk for influenza-related complications and with free access to vaccination (elderly residents ≥ 65 years and residents with specific chronic diseases). We compared IVC between 885 regular immigrants and 41,163 Italian citizens using log-binomial models and stratifying immigrants by area of origin and length of stay in Italy (recent: < 10 years; long-term: ≥ 10 years). RESULTS IVC among all immigrants was 16.9% compared to 40.2% among Italian citizens (vaccination coverage ratio (VCR) = 0.42, 95% confidence interval (CI): 0.36-0.49). Adjusting for sex, age and area of residence, this difference was greatly reduced but remained statistically significant (VCR = 0.71, 95 CI: 0.61-0.81). Further adjustment for socio-economic factors (education, occupation, family composition and economic status) and a composite indicator of health-services utilization did not affect the difference (VCR = 0.78, 95% CI: 0.68-0.90). However, after adjustments, only long-term immigrants from Africa (VCR = 0.49, 95% CI: 0.28-0.85) and recent immigrants (VCR = 0.58, 95% CI: 0.43-0.78) showed a significantly different IVC compared to Italian citizens. CONCLUSIONS Differences in demographic characteristics, socio-economic conditions and health-services utilization explained the reduced IVC in most long-term immigrants compared to Italian citizens. By contrast, these differences did not explain the reduced IVC in long-term immigrants from Africa and recent immigrants. This suggests that IVC in these sub-groups is affected by other informal barriers (e.g., cultural and linguistic) that need to be investigated to promote effective immunization access strategies.
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Affiliation(s)
- Massimo Fabiani
- National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy
- * E-mail:
| | - Flavia Riccardo
- National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | | | - Silvia Declich
- National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Italian National Institute of Health (ISS), Rome, Italy
| | - Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
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Affiliation(s)
- Flavia Riccardo
- National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
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Filia A, Bella A, Cadeddu G, Milia MR, Del Manso M, Rota MC, Magurano F, Nicoletti L, Declich S. Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014. Emerg Infect Dis 2016. [PMID: 26196266 PMCID: PMC4517735 DOI: 10.3201/eid2108.141105] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a measles outbreak in Sardinia, Italy, that originated in a cruise ship passenger. The outbreak showed extensive nosocomial transmission (44 of 80 cases). To minimize nosocomial transmission, health care facilities should ensure that susceptible health care workers are vaccinated against measles and should implement effective infection control procedures.
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Conte A, Candeloro L, Ippoliti C, Monaco F, De Massis F, Bruno R, Di Sabatino D, Danzetta ML, Benjelloun A, Belkadi B, El Harrak M, Declich S, Rizzo C, Hammami S, Ben Hassine T, Calistri P, Savini G. Spatio-Temporal Identification of Areas Suitable for West Nile Disease in the Mediterranean Basin and Central Europe. PLoS One 2015; 10:e0146024. [PMID: 26717483 PMCID: PMC4696814 DOI: 10.1371/journal.pone.0146024] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 12/12/2015] [Indexed: 11/18/2022] Open
Abstract
West Nile virus (WNV) is a mosquito-transmitted Flavivirus belonging to the Japanese encephalitis antigenic complex of the Flaviviridae family. Its spread in the Mediterranean basin and the Balkans poses a significant risk to human health and forces public health officials to constantly monitor the virus transmission to ensure prompt application of preventive measures. In this context, predictive tools indicating the areas and periods at major risk of WNV transmission are of paramount importance. Spatial analysis approaches, which use environmental and climatic variables to find suitable habitats for WNV spread, can enhance predictive techniques. Using the Mahalanobis Distance statistic, areas ecologically most suitable for sustaining WNV transmission were identified in the Mediterranean basin and Central Europe. About 270 human and equine clinical cases notified in Italy, Greece, Portugal, Morocco, and Tunisia, between 2008 and 2012, have been considered. The environmental variables included in the model were altitude, slope, night time Land Surface Temperature, Normalized Difference Vegetation Index, Enhanced Vegetation Index, and daily temperature range. Seasonality of mosquito population has been modelled and included in the analyses to produce monthly maps of suitable areas for West Nile Disease. Between May and July, the most suitable areas are located in Tunisia, Libya, Egypt, and North Cyprus. Summer/Autumn months, particularly between August and October, characterize the suitability in Italy, France, Spain, the Balkan countries, Morocco, North Tunisia, the Mediterranean coast of Africa, and the Middle East. The persistence of suitable conditions in December is confined to the coastal areas of Morocco, Tunisia, Libya, Egypt, and Israel.
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Affiliation(s)
- Annamaria Conte
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Luca Candeloro
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Carla Ippoliti
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Federica Monaco
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Fabrizio De Massis
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Rossana Bruno
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Daria Di Sabatino
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Maria Luisa Danzetta
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Abdennasser Benjelloun
- Société de Produits Biologiques et Pharmaceutiques vétérinaires (Biopharma), Rabat, Morocco
- Laboratory of Microbiology and Molecular Biology, University Mohamed V, Faculty of Science, Rabat, Morocco
| | - Bouchra Belkadi
- Laboratory of Microbiology and Molecular Biology, University Mohamed V, Faculty of Science, Rabat, Morocco
| | - Mehdi El Harrak
- Société de Produits Biologiques et Pharmaceutiques vétérinaires (Biopharma), Rabat, Morocco
| | - Silvia Declich
- Istituto Superiore di Sanità, Reparto Epidemiologia delle Malattie Infettive, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome, Italy
| | - Caterina Rizzo
- Istituto Superiore di Sanità, Reparto Epidemiologia delle Malattie Infettive, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome, Italy
| | - Salah Hammami
- Ecole Nationale de Médecine Vétérinaire de Sidi Thabet (ENMV), Sidi Thabet, Tunisia
| | - Thameur Ben Hassine
- Ecole Nationale de Médecine Vétérinaire de Sidi Thabet (ENMV), Sidi Thabet, Tunisia
| | - Paolo Calistri
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
| | - Giovanni Savini
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, Teramo, Italy
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Magurano F, Baggieri M, Bordi L, Lalle E, Chironna M, Lazzarotto T, Amendola A, Baldanti F, Ansaldi F, Filia A, Declich S, Iannazzo S, Pompa MG, Bucci P, Marchi A, Nicoletti L. Measles in Italy: Co-circulation of B3 variants during 2014. J Med Virol 2015; 88:1081-5. [PMID: 26496509 DOI: 10.1002/jmv.24416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 11/09/2022]
Abstract
In 2013, the majority of the WHO/EUR countries reported an annual incidence of >1 case per one million population indicating that the elimination target is far from being met. Thus, there is the urgent need to uncover and analyze chains of measles virus (MV) transmission with the objective to identify vulnerable groups and avoid possible routes of introduction of MV variants in the European population. The analysis of molecular epidemiology of MV B3 strains identified in 2014 has shown that four different variants co-circulated in Italy, including the strain that caused a cruise-line ship outbreak at the beginning of the year.
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Affiliation(s)
- Fabio Magurano
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy
| | - Melissa Baggieri
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy
| | - Licia Bordi
- Laboratory of Virology, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - Eleonora Lalle
- Laboratory of Virology, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - Maria Chironna
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Tiziana Lazzarotto
- DIMES, Operative Unit of Clinical Microbiology, Laboratory of Virology St. Orsola-Malpighi General Hospital, University of Bologna, Bologna, Italy
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fausto Baldanti
- Department of Microbiology and Virology, Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Antonietta Filia
- Infectious Diseases Epidemiology Unit, National Institute of Health, Rome, Italy
| | - Silvia Declich
- Infectious Diseases Epidemiology Unit, National Institute of Health, Rome, Italy
| | - Stefania Iannazzo
- Infectious Diseases and International Prophylaxis Office, Ministry of Health, Rome, Italy
| | - Maria Grazia Pompa
- Infectious Diseases and International Prophylaxis Office, Ministry of Health, Rome, Italy
| | - Paola Bucci
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy
| | - Antonella Marchi
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy
| | - Loredana Nicoletti
- Department of Infectious Parasitic and Immune-Mediated Diseases, National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy
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Pezzarossi A, Ballotari P, Declich S, Dente M, Flavia R, Karki T, Napoli C, Noori T, Chiarenza A, Rossi PG. Literature review to define a framework to monitor infectious diseases in migrants in Europe. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Riccardo F, Dente MG, Kärki T, Fabiani M, Napoli C, Chiarenza A, Giorgi Rossi P, Munoz CV, Noori T, Declich S. Towards a European Framework to Monitor Infectious Diseases among Migrant Populations: Design and Applicability. Int J Environ Res Public Health 2015; 12:11640-61. [PMID: 26393623 PMCID: PMC4586696 DOI: 10.3390/ijerph120911640] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/06/2015] [Accepted: 09/09/2015] [Indexed: 12/25/2022]
Abstract
There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and performed a systematic literature review in order to identify whether those factors well reflected the reported risk factors for infectious disease in these populations. Following this, the feasibility of applying this framework to relevant available EU/EEA data sources was assessed. The proposed multidimensional framework is well suited to capture the complexity and concurrence of these risk factors and in principle applicable in the EU/EEA. The authors conclude that adopting a multi-dimensional framework to monitor infectious diseases could favor the disaggregated collection and analysis of migrant health data.
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Affiliation(s)
- Flavia Riccardo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for disease Prevention and Control (ECDC), Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
| | - Maria Grazia Dente
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
| | - Tommi Kärki
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for disease Prevention and Control (ECDC), Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
| | - Massimo Fabiani
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
| | - Christian Napoli
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
| | - Antonio Chiarenza
- Research and Innovation Unit AUSL (Azienda Unità Sanitaria Locale) Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, AUSL (Azienda Unità Sanitaria Locale) Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Cesar Velasco Munoz
- European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11a, 171 83 Stockholm, Sweden.
| | - Silvia Declich
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health (Istituto Superiore di Sanità, ISS), viale Regina Elena, 299-00161 Rome, Italy.
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Riccardo F, Shigematsu M, Chow C, McKnight CJ, Linge J, Doherty B, Dente MG, Declich S, Barker M, Barboza P, Vaillant L, Donachie A, Mawudeku A, Blench M, Arthur R. Interfacing a biosurveillance portal and an international network of institutional analysts to detect biological threats. Biosecur Bioterror 2015; 12:325-36. [PMID: 25470464 DOI: 10.1089/bsp.2014.0031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Early Alerting and Reporting (EAR) project, launched in 2008, is aimed at improving global early alerting and risk assessment and evaluating the feasibility and opportunity of integrating the analysis of biological, chemical, radionuclear (CBRN), and pandemic influenza threats. At a time when no international collaborations existed in the field of event-based surveillance, EAR's innovative approach involved both epidemic intelligence experts and internet-based biosurveillance system providers in the framework of an international collaboration called the Global Health Security Initiative, which involved the ministries of health of the G7 countries and Mexico, the World Health Organization, and the European Commission. The EAR project pooled data from 7 major internet-based biosurveillance systems onto a common portal that was progressively optimized for biological threat detection under the guidance of epidemic intelligence experts from public health institutions in Canada, the European Centre for Disease Prevention and Control, France, Germany, Italy, Japan, the United Kingdom, and the United States. The group became the first end users of the EAR portal, constituting a network of analysts working with a common standard operating procedure and risk assessment tools on a rotation basis to constantly screen and assess public information on the web for events that could suggest an intentional release of biological agents. Following the first 2-year pilot phase, the EAR project was tested in its capacity to monitor biological threats, proving that its working model was feasible and demonstrating the high commitment of the countries and international institutions involved. During the testing period, analysts using the EAR platform did not miss intentional events of a biological nature and did not issue false alarms. Through the findings of this initial assessment, this article provides insights into how the field of epidemic intelligence can advance through an international network and, more specifically, how it was further developed in the EAR project.
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Giambi C, Del Manso M, D’Ancona F, De Mei B, Giovannelli I, Cattaneo C, Possenti V, Declich S. Actions improving HPV vaccination uptake – Results from a national survey in Italy. Vaccine 2015; 33:2425-31. [DOI: 10.1016/j.vaccine.2015.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 03/27/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
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Giambi C, Filia A, Rota MC, Del Manso M, Declich S, Nacca G, Rizzuto E, Bella A. Congenital rubella still a public health problem in Italy: analysis of national surveillance data from 2005 to 2013. ACTA ACUST UNITED AC 2015; 20. [PMID: 25953272 DOI: 10.2807/1560-7917.es2015.20.16.21103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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]
Abstract
In accordance with the goal of the World Health Organization Regional Office for Europe, the Italian national measles and rubella elimination plan aims to reduce the incidence of congenital rubella cases to less than one case per 100,000 live births by the end of 2015. We report national surveillance data for congenital rubella and rubella in pregnancy from 2005 to 2013. A total of 75 congenital rubella infections were reported; the national annual mean incidence was 1.5/100,000 live births, including probable and confirmed cases according to European Union case definition. Two peaks occurred in 2008 and 2012 (5.0 and 3.6/100,000 respectively). Overall, 160 rubella infections in pregnancy were reported; 69/148 women were multiparous and 38/126 had had a rubella antibody test before pregnancy. Among reported cases, there were 62 infected newborns, 31 voluntary abortions, one stillbirth and one spontaneous abortion. A total of 24 newborns were unclassified and 14 women were lost to follow-up, so underestimation is likely. To improve follow-up of cases, systematic procedures for monitoring infected mothers and children were introduced in 2013. To prevent congenital rubella, antibody screening before pregnancy and vaccination of susceptible women, including post-partum and post-abortum vaccination, should be promoted. Population coverage of two doses of measles-mumps-rubella vaccination of ≥ 95% should be maintained and knowledge of health professionals improved.
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Affiliation(s)
- C Giambi
- Communicable Disease Epidemiology Unit, National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanita, Rome, Italy
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Fortuna C, Baggieri M, Marchi A, Benedetti E, Bucci P, Del Manso M, Declich S, Iannazzo S, Pompa MG, Nicoletti L, Magurano F. Measles in Italy, laboratory surveillance activity during 2010. Ann Ist Super Sanita 2014; 50:341-4. [PMID: 25522074 DOI: 10.4415/ann_14_04_08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The European Regional Office of the World Health Organization (WHO/Europe) developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. This study describes the measles laboratory surveillance activity performed by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità) during 2010. METHODS Urine, oral fluid and capillary blood samples from 211 suspected measles cases arrived to the NRL from different regions of Italy for confirmation of the clinical diagnosis. Serological and/or molecular assays were performed; after molecular detection, positive samples were sequenced and genotyped. RESULTS AND DISCUSSION 85% (180/211) of the specimens were confirmed as measles cases and 139 of these were analyzed phylogenetically. The phylogenetic analysis revealed a co-circulation of D4 and D8 genotypes for the reviewed period.
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Affiliation(s)
- Claudia Fortuna
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy
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Baggieri M, Fortuna C, Ansaldi F, Chironna M, Marchi A, Bucci P, Benedetti E, Del Manso M, Declich S, Nicoletti L, Magurano F. Genotyping of circulating measles strains in Italy in 2010. Ann Ist Super Sanita 2014; 50:345-50. [PMID: 25522075 DOI: 10.4415/ann_14_04_09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The European Regional Office of the World Health Organization developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. In Italy, laboratory surveillance activity is implemented by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità, Rome). The role of the National Reference Laboratory is to strengthen surveillance systems through rigorous case investigation and laboratory confirmation of suspected sporadic cases and outbreaks. Genetic characterization of wild-type measles virus is an essential component of the laboratory-based surveillance. This study describes the molecular characterization of measles virus strains isolated during 2010. METHODS Dried blood spots, urine and oral fluid samples were collected from patients with a suspected measles infection. Serological tests were performed on capillary blood, and viral detection was performed on urine and oral fluid samples through molecular assay. Positive samples were sequenced and phylogenetically analysed. RESULTS AND DISCUSSION The phylogenetic analysis showed a co-circulation of genotypes D4 and D8, and sporadic cases associated to genotypes D9 and B3. Then, molecular epidemiology of measles cases permitted to establish that D4 and D8 were the endemic genotypes in Italy during 2010.
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Affiliation(s)
- Melissa Baggieri
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, Istituto Superiore di Sanità, Rome, Italy
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Giambi C, D'Ancona F, Del Manso M, De Mei B, Giovannelli I, Cattaneo C, Possenti V, Declich S. Exploring reasons for non-vaccination against human papillomavirus in Italy. BMC Infect Dis 2014; 14:545. [PMID: 25410754 PMCID: PMC4233085 DOI: 10.1186/s12879-014-0545-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 10/06/2014] [Indexed: 11/28/2022] Open
Abstract
Background In Italy, free-of-charge HPV vaccination is offered to 11-year-old girls since 2007. The National Immunization Plan established the target coverage at a minimum of 70%; it should increase to 95% within 3-year time frame. In 2012, four year after the introduction of HPV vaccination, coverage was stable at 69%. We conducted a national cross-sectional study to explore barriers to vaccination in Italy. Methods Vaccination services selected, through the immunization registries, a sample of unvaccinated girls born in 1997 or 1998 and posted to their families a 23-items questionnaire inquiring barriers to vaccination, HPV knowledge, source of information on HPV, perception of risk of contracting HPV, advice from consulted health professionals on HPV vaccination. Results We analysed 1,738 questionnaires. Main barriers were fear of adverse events (reported by 80% of families), lack of trust in a new vaccine (76%), discordant information received by health professionals (65%) and scarce information on HPV vaccination (54%). Overall, 54% of families replied correctly to more than half of 10 questions exploring knowledge on HPV vaccination. Families with a high knowledge score were more likely to live in Northern and Central Italy, be Italian, have a high educational level, include a mother who attended cervical screening regularly and consult more information sources. Although paediatricians/general practitioners and gynaecologists were considered the most trusted source of information by 79% and 61% of respondents, they were consulted only by 49% and 31%. Among parents who discussed vaccination with a physician, 28% received discordant advices and 31% received the recommendation of accepting vaccination. Conclusions Fear of adverse events, discordance of information and advices from physicians, and scarce information were the more commonly reported barriers to HPV vaccination. Health professionals played a key role as information providers, thus they must be better trained to provide clear notions. Training needs to include the development of communication skills; transparent discussion about the pros and cons of vaccination may reduce fear of adverse events and increase trust in vaccination. The creation of a public health network around vaccination would allow sharing information and attitudes on vaccinations, so that homogeneous messages could reach the target population. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0545-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cristina Giambi
- Communicable Disease Epidemiology Unit; National Centre for Epidemiology, Surveillance and Health Promotion; Istituto Superiore di Sanità, Viale Regina Elena 299; 00161, Rome, Italy.
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