Epidemiologia & Prevenzione最新文献

{"title":"[The health of immigrants in Italy: the viewpoint of the Italian National Institute for Health, Migration and Poverty (INMP)].","authors":"Anteo Di Napoli, Martina Ventura, Alessio Petrelli","doi":"10.19191/EP24.4-5.S1.109","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.109","url":null,"abstract":"<p><p>The foreign population accounts for 8.6 percent (about 5 million) of the total number of residents, so it is necessary to monitor their health status. Foreigners have standardized mortality rates of about half that of Italians. In terms of hospitalization, rates and causes of hospitalization differ substantially due to the younger average age of foreigners. In particular, a much higher burden of hospitalizations in obstetrical care is observed among foreign women. Maternal and child health is a major concern for foreigners, especially for pregnancy care, which is also reflected in worse health outcomes for newborns.Difficulties in accessing and using basic and specialized territorial services are confirmed by the higher proportion of ordinary emergency hospitalizations among foreigners, the higher risk of being hospitalized for causes that could be treated in an outpatient setting, and the higher frequency of access to emergency rooms with a white/green triage code.The pandemic exacerbated health inequalities because it affected the most disadvantaged social strata of the population, including immigrants, more severely in terms of infection and outcomes.Immigrants could become the least healthy part of the population, similar to what is observed in countries with a longer tradition of migration, even in a country like Italy, where access to care is universally guaranteed.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"25-28"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy assistance for foreign women in Trentino Region (Northern Italy): retrospective cohort epidemiological study.","authors":"Riccardo Pertile, Stefania Poggianella, Fabrizio Taddei, William Mantovani","doi":"10.19191/EP24.4-5.A733.095","DOIUrl":"https://doi.org/10.19191/EP24.4-5.A733.095","url":null,"abstract":"<p><strong>Objectives: </strong>to identify any differences between Italian and foreign women in the access to prenatal care, including the number and appropriate scheduling of visits, the execution of diagnostic, blood, and microbiological tests and the use of specific healthcare services.</p><p><strong>Design: </strong>retrospective cohort epidemiological study, based on the monitoring of current information flows.</p><p><strong>Setting and participants: </strong>data extrapolated from the Birth Attendance Certificate information flow of the Autonomous Province of Trento (Northern Italy) between 2012 and 2016. A total of 23,165 women with data regarding citizenship were included in the analysis.</p><p><strong>Main outcomes measures: </strong>outcome variables used to assess appropriateness of antenatal care were medically assisted procreation techniques, use of invasive prenatal diagnosis, gestational age at the first appointment, total number of appointments and ultrasounds during pregnancy, blood and microbiological tests taken, and participation in antenatal classes.</p><p><strong>Results: </strong>data indicates a significant difference in the use of chorionic villus sampling, testing for Cytomegalovirus, and vaginal-rectal swab for the detection of group B streptococcus, which are lower in the foreign population. Furthermore, there is a statistically significant difference in the gestational age at which the first appointment is attended, in the total number of visits, and in the number of ultrasounds performed during pregnancy as well as in participation in antenatal classes.</p><p><strong>Conclusions: </strong>this study reveals significant differences in access and use of pregnancy assistance between foreign and Italian women. There are also differences in terms of social determinants of health, with a concentration of unemployment and low education in the foreign population. It is therefore necessary to identify the factors that can potentially create health inequalities, considering the socioeconomic determinants and the specific needs of migrant women.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"309-319"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The response of Turin volunteers (Piedmont Region, Northern Italy) during the SARS-CoV-2 pandemic].","authors":"Luisa Mondo, Silvia Pilutti, Marilena Bertini, Mirela Rau","doi":"10.19191/EP24.4-5.S1.123","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.123","url":null,"abstract":"<p><p>Voluntary associations played a decisive role during the SARS-CoV-2 pandemic. This contribution reports on the experience of the Torino Street Care project, whose members carried out swabs in informal facilities, visits, drug distribution, reading examinations, and orientation interviews. They also provided social, legal, or bureaucratic help, distributed food and collaborated in the vaccination campaign. These activities enabled a relationship of trust to be created with the migrant population in the Piedmont Region (Northern Italy), also thanks to the clarity and the precision of the communication the volunteers had with the people they welcomed.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"124-126"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health impact assessment: strengthening epidemiology training and skills].","authors":"Francesco Forastiere, Lucia Bisceglia","doi":"10.19191/EP24.4-5.090","DOIUrl":"https://doi.org/10.19191/EP24.4-5.090","url":null,"abstract":"","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"280-283"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The study of migrant and immigrant population from the syndemic point of view].","authors":"Fulvio Ricceri","doi":"10.19191/EP24.4-5.S1.108","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.108","url":null,"abstract":"<p><p>The study of health of migrant and immigrant populations is of particular interest and actual in recent years, and there is a lack of research assessing aspects of aging of permanently resident immigrants, chronic non-communicable diseases, multimorbidity, and study of second generations. This contribution proposes to describe the relationship between health and immigration and their association with frailty through the anthropological concept of syndemics. Syndemics represents a set of closely interconnected and mutually enhancing health problems, significantly influencing the overall health status of a population. This occurs within the context of a perpetual pattern of harmful social conditions. Among the syndemics described in the literature, the most interesting in this area is the one concerning the increased frailty due to the interaction among diabetes, depression, immigration, and social distress, called VIDDA (Violence, Immigration, Depression, Diabetes, and Abuse), first identified in Mexican immigrant women in the United States. The main limitation of using the syndemic approach to study the health of immigrant populations is the difficulty in moving from the anthropological, primarily qualitative approach to the epidemiological-quantitative approach. Despite this, the epidemiological study of immigrant populations could benefit from the syndemic approach, because it can better describe complex causal relationships and provide evidence for modification of the clinical approach.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"21-24"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Training of operators in the care of immigrants: a public health tool for containing the effects of the COVID-19 pandemic in this population group].","authors":"Achille Cernigliaro, Antonino Sparaco, Fulvio Ricceri, Cristina Canova, Daniela Falconeri, Salvatore Scondotto","doi":"10.19191/EP24.4-5.S1.119","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.119","url":null,"abstract":"<p><p>The COVID-19 pandemic has modified the burden of disease in the population in various ways, depending on different social and economic conditions. Consequently, the pandemic has amplified health disparities, especially among the frail populations. During the pandemic, the incidence among immigrants showed a one- or two-week delay compared to natives, possibly due to delays in diagnosis and access to treatment. Health Authorities had to think new intervention strategies. As part of a project to contain the spread of SARS-CoV-2 among immigrants in Italy, training emerged as a strategic intervention objective. The training included project areas that assessed the impact of the pandemic and public health intervention on immigrants and incorporated best practices from local experiences. The training was addressed to healthcare and social workers and aimed at building institutional networks and skills in caring for vulnerable people. Additionally, the training course was designed to be adaptable and applicable in other emergency contexts.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"101-105"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treating and caring for migrant populations suffering from infectious diseases: the experience of the hub&spoke network set up by the Civico Benfratelli ARNAS Hospital in Palermo (Sicily Region, Southern Italy)].","authors":"Tullio Prestileo, Lucia Siracusa, Laura Verdone, Giuseppe La Rosa, Federica Zimmerhofer, Maria Grazia Mazza, Salvatore Corrao","doi":"10.19191/EP24.4-5.S1.122","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.122","url":null,"abstract":"<p><p>This paper describes the experience carried out in a general hospital, implemented in collaboration with a city network of associations involved in the care of migrant populations. Considering the vulnerability of these populations, the difficulty of access to healthcare facilities, and the linguistic and cultural barriers, an organisational model was designed characterised by the concentration of highly complex care (hub centre) supported by a network of peripheral reception centres (spoke centres) responsible for selecting patients and sending them to the centre of reference with the aim of offering screening for sexually transmitted infections, tuberculosis, taking charge of pathologies, including non-infectious ones, treatment, and follow-up. The effectiveness of the model was measured in relation to the continuum of care and its effectiveness with reference to the Joint Commission International guidelines.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"117-123"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of the SARS-CoV-2 epidemic on the immigrant population by urbanisation degree in five Italian Regions (Piedmont, Emilia-Romagna, Tuscany, Lazio, and Sicily)].","authors":"Nicola Caranci, Valentina Adorno, Letizia Bartolini, Alice Corsaro, Teresa Spadea, Raffaella Rusciani, Chiara Di Girolamo, Laura Cacciani, Nera Agabiti, Francesco Profili, Caterina Milli, Caterina Silvestri, Achille Cernigliaro, Martina Ventura, Anteo Di Napoli, Alessio Petrelli, Paolo Giorgi Rossi","doi":"10.19191/EP24.4-5.S1.113","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.113","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;according to the literature, socially disadvantaged strata of the population, including immigrants, have been more vulnerable to the risk of SARS-CoV-2 infection due to greater exposure and less opportunity to protect themselves, and to COVID-19 complications due to metabolic and clinical risk factors as well as to healthcare access barriers. Two Italian projects - coordinated by the Italian National Institute for Health, Migration and Poverty and the Italian National Centre for Disease Prevention and Control - set up an epidemiological surveillance to monitor the temporal trends of the SARS-CoV-2 pandemic in five Italian regions using validated indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;to identify differences between Italians and immigrants in terms of the epidemic evolution and its health consequences, and to investigate possible differences by urbanisation degree and region of residence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;cross sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;resident population in five Italian regions: Piedmont, Emilia-Romagna, Tuscany, Lazio, and Sicily.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes measures: &lt;/strong&gt;frequencies of positive tests, routine hospitalisations, and deaths related to COVID-19 were collected, with respect to the period between 22.02.2020 and 31.01.2021. Data were aggregated by week, region, degree of urbanisation, gender, age (5-year classes), and citizenship (Italian/foreigner). Crude and standardised rates of the outcomes considered were calculated, stratified by gender, citizenship, region, and aggregated by pandemic macro-period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;the study population counts approximately about 23 million residents as of 01.01.2020 (9.4% immigrants). During the period of interest, 1,542,458 cases of infection were recorded, whereas hospitalisations amounted to 175,979, and deaths to 44,867. Lower crude rates of hospitalisations and deaths were observed among immigrants compared to Italians. The age-standardised hospitalisation rates, on the other hand, showed an opposite trend and were significantly higher among immigrants, due to the excess observed in urban areas, especially in periods of epidemic peak, both for males (weekly mean standardised rate: 34.6 per 1,000 of foreign residents vs 24.3 of Italians over the period October 2020-January 2021) and females (23.2 vs 15.1 over the period February-April 2021). These differences seem to be more pronounced in the central regions and tend to disappear for residents in scarcely populated areas. Standardised mortality rates were higher among immigrants, both men and women, from October 2020 and more markedly in February-April 2021 among men.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;the impact of COVID-19 was stronger among immigrants in relation to hospitalisation, especially during epidemic peak periods and in some regions. The difference in the impact on mortality was smaller. There is some heterogeneity ","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"49-59"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Italian Association of Epidemiology: How has the demographic, educational, and occupational profile of members changed in recent years].","authors":"Michele Marra, Elena Farina, Francesca Mataloni, Cristina Canova, Michele Carugno, Davide Petri, Lorenzo Richiardi, Francesco Venturelli, Francesca Zambri, Carla Ancona","doi":"10.19191/EP24.4-5.A795.100","DOIUrl":"https://doi.org/10.19191/EP24.4-5.A795.100","url":null,"abstract":"<p><p>In recent years, the number of members of the Italian Association of Epidemiology (AIE) has increased considerably, and their profile has undergone many changes. The aim of this work is to describe the characteristics of the members, with particular attention to those who have been continuously enrolled. To evaluate these characteristics, the data from membership forms submitted to the Association and information available on the new website in the personal profile area (period 2016-2024) were used. The characteristics considered were: gender, age, education, and job position of the member, Region, and type of affiliated institution. Members with at least three registrations during the period considered, including at least one in the last three years (2022-2024), are considered continuous members.In 2024, AIE counts 557 members, of whom 340 (61.0%) are female and 182 (32.7%) are under 35 years old. This data confirms the growing trend observed since 2015, when the number of members was just above 300, considering that each year there is a quota of new members amounting to about 30%. A total of 382 members can be considered continuous. Over 90% of these members work in 8 Regions (Lazio, Piedmont, Emilia-Romagna, Lombardy, Tuscany, Veneto, Puglia, and Sicily), while the other regions are scarcely or not represented at all. Over time, and with the arrival of new members, the Association is shifting towards the academic world, while the proportion of professionals working in public health institutions has decreased. Members are overall highly educated; however, while older cohorts have predominantly a medical and biological education, younger cohorts increasingly have statistical/mathematical education. Seventy percent of the members have a permanent contract, 5% have a fixed-term contract, and 13% have an atypical contract. Precarious contracts tend to be lower among medical graduates and remain higher in other health professions and non-health-related degrees.AIE is dealing with a period of dynamism and openness, marked by the increase in the number of the members and the transformation of their occupational and educational profile. It is crucial to support and promote the ongoing positive changes, such as the wider geographic representativeness and the entry of new recruits, also facilitated by multiple activities carried out by AIE, including congresses, working groups, webinars, training courses, and collaborations with other scientific societies. At the same time, it might be useful to open a discussion on the meaning and consequences of the increase of academic members and the reduction, at least in relative terms, of individuals coming from public health. Finally, it will be necessary to approach some critical issues, such as the still poor multidisciplinarity and the persistence of job insecurity, especially among graduates in educational pathways that still do not fit into the professional profiles recognized by the NHS.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"378-388"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of delayed healthcare access and stigma associated with pandemic SARS-CoV-2 infec-tion: findings from a pilot study in the immigrant population in Catania (Sicily Region, Southern Italy).","authors":"Martina Barchitta, Carlo Colloca, Gabriele Giorgianni, Mario Cuccia, Valentina Pantaleo, Elisabetta Campisi, Claudia Ojeda-Granados, Martina Manoli, Antonio Leonardi, Achille Cernigliaro, Stefania D'Amato, Antonella Agodi","doi":"10.19191/EP24.4-5.S1.118","DOIUrl":"https://doi.org/10.19191/EP24.4-5.S1.118","url":null,"abstract":"<p><strong>Background: </strong>the Coronavirus disease 2019 (COVID-19) pandemic may have aggravated existing social and healthcare inequalities among particular population groups, such as ethnic minorities, who showed increased susceptibility to SARS-CoV-2 infection.</p><p><strong>Objectives: </strong>to characterize risk profiles or determinants of delayed healthcare access, as well as knowledge, risk perception, behaviour, and social stigma concerning SARS-CoV-2 infection in the immigrant population in the city of Catania (Sicily Region, Southern Italy).</p><p><strong>Design: </strong>pilot, descriptive study.</p><p><strong>Setting and participants: </strong>the immigrant population in Catania.</p><p><strong>Main outcomes measures: </strong>an ad-hoc questionnaire was prepared and administered to the participants of the target population. In addition, a web-based data collection platform and a web-based survey addressed to healthcare providers were developed.</p><p><strong>Results: </strong>74 immigrant subjects (mean age: 39 years) voluntarily compiled the questionnaire with varying response rates per question: 77% of the participants were male, 59.5% were from Africa, 29.7% from Asia, 6.7% from South America, and 4.1% did not specify their origin. Fifty-three percent (35/66 responses) found it easy to access healthcare services. However, 25.8% (17/66 responses) found it difficult to understand written information concerning their health. Regarding vaccination services, 67.3% of subjects (35/62 responses) had no difficulty in receiving information on mandatory vaccinations and/or vaccination centres in Italy, and 79.7% (51/64 responses) were vaccinated against COVID-19. In relation to other primary prevention issues, 71.4% of participants (45/63 responses) stated they did not know or had never been tested for HIV, 64.4% (38/59 responses) declared they had not heard of or knew nothing about antibiotic resistance, and 30.4% (21/69 responses) had not heard or knew nothing about antibiotic use.</p><p><strong>Conclusions: </strong>health services seem to be accessible and effective among the immigrant population in Catania. However, identified determinants of delayed healthcare access included factors concerning mainly health literacy and possibly the socioeconomic status of the population studied. Primary prevention issues that need to be addressed due to low awareness or stigmatization among the immigrant population include antibiotic use and resistance, and infectious diseases such as HIV/AIDS.</p>","PeriodicalId":50511,"journal":{"name":"Epidemiologia & Prevenzione","volume":"48 4-5","pages":"90-100"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}