Epidemiologia & Prevenzione最新文献

The present work describes the cumulative coverage curves by country of birth, sex, age, and area of residence of the adult population residing in the province of Reggio Emilia (Emilia-Romagna Region, Northern Italy).The analyses are stratified by country of birth into HDC (Highly Developed Country), mostly Italians, and HMPC (Highly Migration Pressure Country), as a proxy of migrant status, excluding deaths. Vaccinations carried out up to September 2022 and recorded in the information system were considered, including vaccinations performed outside the province. Vaccinations done abroad are not included when the information is incomplete or the type of vaccine is different from those administered in Italy.Vaccination coverage (%) by number of doses and estimated Hazard Ratio (HR) and related 95% confidence intervals (95%CI) are calculated using Cox models, adjusted for age and stratified by sex.A lower vaccination coverage was detected, delayed by a few weeks, among HMPC, but the differences in vaccination coverage are reversed when the different age structure of the two populations is taken into account. From the estimates of the Cox models, a higher propensity to vaccinate was noted among immigrants, in particular among women (women HR: 1.65; CI95% 1.52-1.78; men HR: 1.39; CI95% 1.28-1.52). Women were vaccinated first, but, at the end of the observation period, there were no particular differences in coverage between the two sexes, either among Italians or immigrants. Focusing on the area of origin, a strong propensity for vaccination was noted, particularly among who came from North Africa. In the mountain areas of the province, a lower propensity for vaccination was observed, perhaps explained by the greater distance of the vaccination centers or by a lower acceptability of the vaccine.

Background: the COVID-19 pandemic had important effects on people's health and socioeconomic conditions. Health surveillance systems fail to provide an adequate epidemiological profile of the pandemic in the recently immigrated population. In Piedmont and Emilia-Romagna Region (Northern Italy), a study was conducted in the public and private structures dedicated to the reception of migrants,Objectives: to evaluate the impact of the epidemic on the migrant population assisted in local reception centres.

Design: quantitative analysis based on data collected in reception centres; qualitative analysis which, through 10 focus groups and 35 interviews with operators and migrants, investigated the consequences of the pandemic, their mechanisms, and their explanations.

Setting and participants: users and operators of reception services for migrants in the cities of Turin (Piedmont) and Bologna (Emilia-Romagna).

Main outcomes measures: quantitative analysis: access to services, prevalence of diseases, prevalence of test positivity; qualitative analysis: spread of the virus, organization of services, perceived critical issues and needs, solutions adopted, information received, perceived impact on health, perceived impact on social determinants.

Results: a varied picture emerges. The few data available do not show a greater incidence and severity of the virus compared to the Italian population, despite strong elements of risk linked to precarious living and working conditions being reported. Reception services have implemented more flexible organizational methods, with effective prevention measures. The interruption of care pathways has led to the flare-up of previous pathologies, but getting in touch with services for the pandemic control has also allowed diagnosis and management of unknown diseases. Uncertainty, fear, social withdrawal, and crisis of the migratory project have increased mental disorders.

Conclusions: in this scenario, close collaboration between public and third sector structures has proved fundamental and must be strengthened to overcome access barriers and make services more inclusive and equitable. It is also necessary to develop information systems capable of monitoring the health needs of this 'invisible' population.

Within the prevention programmes of the Italian Ministry of Health, a project aimed to containing the circulation of SARS-CoV-2 virus in the immigrant population in Italy has entrusted to the Regional Health Authority of Sicily Region (Southern Italy). New evidence has been promoted to disseminate and share public health intervention models. The project involved public health institutions across the national territory and was carried out during the COVID-19pandemic. The project reached the general aim through specific objectives, identifying information sources and health indicators, evaluating the impact of COVID-19, and promoting intervention programmes for taking charge immigrant population. Social distancing, although necessary, has further amplified the gap of inequalities in health, confirming major vulnerability for infection. Having filled some knowledge gaps and proposed prevention tools has been useful for the containment of the virus, for a possible resurgence of the phenomenon, for application in other emergency contexts, and for recalibration in new epidemic events.

Objectives: to describe indicators, data sources, and levels of geographical stratification used within the framework of the CCM project "Epidemiological Surveillance and Control of COVID-19 in Metropolitan Urban Areas and for the containment of SARS-CoV-2 circulation in the immigrant population in Italy".

Design: population-based observational study based on data from the Integrated Covid-19 Surveillance System and the archive of hospital discharge records.

Setting and participants: interregional collaborative project. Resident population in 5 Italian Regions (Piedmont, Emilia-Romagna, Tuscany, Lazio, and Sicily).

Main outcomes measures: crude and age-standardized rates of diagnostic test utilization and positivity, hospitalization (in any department and in intensive care unit), and mortality in COVID-19 cases.

Results: starting from the set of 11 indicators from the Italian National Institute for Health, Migration and Poverty (INMP) project "Epidemiology of SARS-CoV-2 Infection (COVID-19) and Use of Health Services in the Immigrant Population and Vulnerable Population Groups in Italy", the five most effective indicators for CCM purposes were identified. The INMP project highlighted higher rates of test access and positivity among Italians compared to foreigners, higher standardized hospitalization rates among foreigners, and higher standardized mortality rates among Italians, with geographical and temporal heterogeneity. The intersection between the DEGURBA (degree of urbanisation) classification and altimetric zones defined five levels of territorial stratification characterized by decreasing population density. Approximately 81% of the population involved in the CCM project resided in the first two levels; 43% of Italians lived in areas with intermediate population density in hilly or plain areas, while 48% of foreigners were concentrated in densely populated areas.

Conclusions: sharing the collaborative approach and a research methodology already tested, integrated with the analysis of disaggregated indicators by morphological, functional, and administrative characteristics of the residential territory, allowed for assessing differences in the impact of the pandemic between Italians and foreigners residing in more or less densely populated areas.

During the spread of SARS-CoV-2 virus, contact tracing proved to be a very effective public health tool. Within the local health authority of Trapani (Sicily Region, Southern Italy), contact tracing was managed by physician, prevention technicians, and administrative from the Health Prevention Department who were trained and updated during the evolution of the epidemic. Contact tracing has been extended to migrants who arrived in Trapani with the landings. Extended contact tracing had some critical factors related to language barriers, which reduced the effectiveness of the telephone contacts and psychological counseling during tracing, up to the loss of definition of high or low risk contacts among both migrants and rescuers. The team made up of workers from the Health Prevention Department, the Global Health Center, and Cultural Mediators was important in effectively managing the critical issues. The high number of cases occurred during the outbreak of COVID-19 in January 2022 has shown difficulties to support the contact tracing in this phase.

Objectives: to provide researchers and stakeholders with an overview of the statistical sources of micro data available for estimating and studying the demand for care for dependent older people in Italy.

Design: analysis of questionnaires and variable displays from statistical surveys conducted on the resident population in Italy, selecting datasets that: 1. include at least one question on non-self-sufficiency and the related demand for care; 2. allow to distinguish the population by age groups; 3. are conducted uniformly at the national level and are representative of the population residing in Italy at least at NUTS-1 (nomenclature of statistical territorial units) level of geographic detail; 4. have periodicity character at least for the last ten years (2014-2024); 5. are immediately available for micro-analysis.

Setting and participants: all statistical surveys carried out on the Italian population between 2014 and 2024 that meet the requirements of the survey design. The most recent questionnaire is taken into account.

Main outcomes measures: selected surveys and number of questions identified in the selected surveys related to 9 sets of variables useful for studying the demand for care among dependent older people, including analyses of associations and correlations.

Results: the review identified 8 statistical surveys that can provide useful information for estimating and studying the demand for care for dependent older people, consistent with the objectives and design of the study. Six of these surveys are conducted by the Italian National Institute of Statistics (Istat) (EHIS, EU-SILC, IMF-AVQ, IMF-FSS, IMF-TUS, and ISF); two surveys are carried out by private consortia (ESS and SHARE). Not all groups of variables are simultaneously available in the datasets of the surveys considered, with the exception of the EHIS and SHARE surveys, but with severe limitations. In addition, some surveys allow regional statistics (NUTS-2), but none of them allow analyses at a more detailed territorial level.

Conclusions: no survey provides all the information useful for studying the demand for care of dependent older people, but sources have been identified which already allow demand to be estimated at sub-national level (NUTS-1 or NUTS-2) and correlations and associations with certain sets of variables to be investigated.

Background: the spread of SARS-CoV-2 in the population has amplified the effects of health inequalities, particularly in the most vulnerable groups such as immigrants and refugees. An assessment of the intervention to contain the COVID-19 in these population groups was essential to define new strategies for more equitable, inclusive, and effective health policies to on health.

Objectives: to provide a systematic synopsis of the impact of interventions to contain the spread of SARS-CoV-2 in immigrants.

Methods: data sources included major bibliographic databases. Using a study protocol, already shared with the international scientific community, two independent researchers reviewed the citations, selected and evaluated the interventions studies. Due to the heterogeneity of the interventions, a narrative synthesis was carried out.

Results: three eligible studies were identified. The first study modelled the incidence of the disease in a refugee camp in Greece, based on an intervention of sectorialization of people that accessed to services, the use of masks, the early identification and isolation of cases and their family members, and the limitation of movements within the camp. The second evaluated the impact of preventive pharmacological interventions such as the use of hydroxychloroquine, ivermectin, povidone-iodine, zinc, and vitamin C, in different dosages and combinations, to a group of immigrant workers in a city dormitory in Singapore. The third study evaluated an intervention to increase vaccination coverage within a Latino immigrant community in the United States, moving the location of vaccine supply throughout the most frequented contexts by the immigrant community to access the city services. The results of the first and second studies suggest impacts for some of the proposed interventions even if they have been partially overcome due to the use of mass vaccination. The third showed a reduction in vaccine hesitancy and an increase in vaccination uptake and a snowball effect.

Conclusions: the systematic review identified few heterogeneous studies, preventing any generalization of the results. Probably, the low scientific production does not reflect the successful experiences implemented. In the case of a possible resumption of the epidemic or new emergencies, it will be necessary to rely on indirect evidence and the scientific community should consider more the responsibility to evaluate and make available the experiences gained in the field. A constant monitoring activity of the evidence that will be necessary to updating the results for suggest consolidated prevention measures to for controlling the incidence of COVID-19 in immigrants during a possible resumption of the epidemic and for application in other similarly emergency contexts.