Annali dell'Istituto superiore di sanita最新文献

Introduction: We aimed at evaluating hepatitis C virus (HCV) prevalence and treatment referral outcomes in a large population of drug users in Northern Italy.

Material and methods: Each participant underwent a quick capillary blood test. Positive participants underwent HCV RNA quantification. HCV RNA positive subjects were referred to treatment and evaluated immediately at the end of treatment and at 3 and 6 months after treatment.

Results: Of the 636 participants tested, 244 were positive. Intravenous drug use was more frequent among subjects who tested positive for HCV antibodies (99%). Among subjects who tested positive, 68% were HCV-RNA positive while 32% were negative. Among people referred to treatment, nearly 30% did not show up while 70% completed the treatment with success. Over 99% of people who started direct-acting antiviral agent (DAA) have a sustained response.

Discussion: We observed a significant higher prevalence of HCV positive subjects among people who inject drugs (99%) and we observed a high success rate for HCV treatment engagement.

Conclusions: Rapid testing for HCV represents a potential tool for HCV screening among high-risk groups.

Introduction: Nontuberculous mycobacteria (NTM) are environmental mycobacteria which may cause pulmonary and extrapulmonary diseases. These organisms are difficult to treat due to their intrinsic drug-resistance. In Italy, no major nationwide study on NTM epidemiology and drug susceptibility was performed.

Methods: Data on the epidemiology of 7,469 NTM clinical isolates identified in Italy in 2016-2020 and on the minimum inhibitory concentrations (MICs) of 1,506 of these strains were analysed.

Results: Overall, 63 species were identified in 42 hospital laboratories located in 16 out of 20 regions, with Mycobacterium avium complex (MAC) being the most frequently isolated, followed by M. gordonae, M. xenopi, M. abscessus. The MICs of 12 drugs for MAC, M. xenopi, M. kansasii, M. abscessus, M. fortuitum and M. chelonae were interpreted for clinical significance (susceptible, intermediate, resistant) based on the guidelines published by the Clinical and Laboratory Standards Institute in November 2018.

Conclusions: Our data are in line with other nationwide studies and may be of value for further update of microbiological and clinical guidelines.

Introduction: Health systems worldwide have heterogenous capacities and financing characteristics. No clear empirical evidence is available on the possible outcomes of these characteristics for population wellbeing.

Aim: The study aims to provide empirical insight into health policy alternatives to support the development of health system architecture to improve population wellbeing.

Method and results: We developed an unsupervised neural network model to cluster countries and used the Human Development Index to derive a wellbeing model. The results show that no single health system architecture is associated with a higher level of population wellbeing. Strikingly, high levels of health expenditure and physical health capacity do not guarantee a high level of population wellbeing and different health systems correspond to a certain wellbeing level.

Conclusions: Our analysis shows that alternative options exist for some health system characteristics. These can be considered by governments developing health policy priorities.

Objectives: Gender differences in caregiving may determine social and/or health inequalities among family caregivers (FCs). This study aimed to analyse gender specific differences of burden and quality of life (QoL) in FCs belonging to ten different rare diseases (RD).

Methods: Burden levels and QoL data, derived from a sample of 210 FCs of RD patients, were analysed by student t-test, Anova and Kruskal-Wallis followed by multiple comparisons and evaluation of factors, including sex, by correlation and multiple regression analyses.

Results: FCs caring for Prader Willi, X-fragile, mucopolysaccharidosis and epidermolysis bullosa patients showed significant higher levels of burden as compared to other RDs. Burden is related to FC's QoL and can be down modulated by the reduction of the number of hours/week devoted to care and by the improvement of patient's QoL. No gender-specific burden differences were observed among all FCs. However, female FCs devoted to care significant more numerous hours/week than men and perceived more emotional/physical burden and poorer psychological health than males. Women, who are more frequently early retired from work, not occupied or homemakers than men, suffered more burden as compared to men in the same conditions.

Conclusions: This study showed gender specific differences in RD caregiving, which are important for planning personalized health prevention policies.

Introduction: This review aims to synthesise the studies that have estimated the prevalence of perinatal depression in Italy, summarising the results of the existing literature based on their quality.

Materials and methods: Systematic searches were conducted in four major databases, and a random effect meta-analysis was performed to achieve the pooled variance of perinatal depression.

Results: The pooled prepartum risk of depression prevalence was 20.2% (CI 95% 15.3-24.5) while the postpartum risk of depression prevalence was 27.5% (CI 95% 17.8-37.3) for an Edinburgh Postnatal Depression Scale (EPDS) cut-off score ≥9 and 11.1% (CI 95% 6.0-16.2) for an EPDS cut-off score ≥12. Significant publication bias was found and was determined by the presence of a small study with a low prevalence and a large study with a high prevalence.

Conclusion: The prevalence of perinatal risk of depression is similar to that reported in other countries. The high prevalence of prepartum risk suggests the need to activate specific prevention actions during this period.

Background: Post-acute COVID-19 consequences are gaining global recognition. This study explores Long COVID characteristics and associated mental health impact/s among the highly vaccinated adult population of Malta.

Methods: A social media survey gathered demographics, vaccination, and COVID-19 data. Generalised Anxiety Disorder and Patient Health Questionnaire-9 assessment tools were used for anxiety and depression. Quantitative analyses were performed.

Results: 41% reported Long COVID, mostly female, 30-39 years, absence of chronic disease/s and vaccinated. Shortness of breath commonest persistent symptom among males, and fatigue for females. Significantly higher depression scores were present in Long COVID cohort compared to no persistent symptoms (p=0.001) and never acquiring COVID-19 (p=<0.01). A significant higher anxiety scores was present for Long COVID cohort than never acquiring COVID-19 (p=<0.01).

Conclusions: Long COVID occurs even in healthy individuals and vaccinated, while exacerbating mental health burdens. Urgent action is required to manage Long COVID and preventing the sequela.

Introduction: Ports are strategic areas of economic importance, but they are also very critical contexts. Many Italian ports are included in contaminated sites of concern for remediation, with the presence of pressure factors that overload the burden capacity of local ecosystems and communities.

Aim: The aim of this study is to characterize Italian seaport areas through a general theoretical path on the theme of ports-sustainability-local communities, identifying the ports located in municipalities included in contaminated sites studied by the SENTIERI Project (Epidemiological Study of Residents in Italian Contaminated Sites). Many of the selected ports, are being part of complex industrial areas, where, in addition to the port area, there are other sources of environmental contamination potentially harmful to health.

Results: Excesses risk were observed for mesothelioma and for respiratory diseases, pathologies for which there is epidemiological evidence of an excess of risk associated with residence in port areas.

Discussion: The strong environmental pressures that characterize these areas make it necessary to adopt adequate environmental and health protection measures.

Background: Although there are ongoing blood donation campaigns in Nigeria, the prevalence of voluntary blood donation is about 10% and there is limited information about the determinants of blood donation behavior, especially across rural-urban geographic areas. This study examines the rural-urban differences in willingness to donate blood.

Method: A cross-sectional study addressing adults from three rural and three urban communities was performed in 2021 to evaluate willingness, knowledge, attitude and practice of blood donation.

Results: A total of 287 individuals were surveyed. Most of the respondents across all communities have never donated blood (72%). Females aged 18-25, highly educated, and from urban communities were more incline to donate blood compared to their counterparts. The main reasons for not donating blood for rural dwellers were: never thought of it (39% vs 34.7%) and no one asked (34.4% vs 17%); fear of needles was declared mostly by urban dwellers (21.8% vs 12.5%) (p=0.02).

Conclusions: Willingness to donate blood varies across rural and urban communities and is influenced by socio-demographic characteristics. The gap between willingness to donate and actual blood donation has consequences for the establishment of blood transfusion services. Targeted public health interventions are required to enhance awareness and knowledge and modify attitudes towards blood donation.