Control of congenital toxoplasmosis in Italy: The project of the Istituto Superiore di Sanità

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Surveillance of acute flaccid paralysis in Italy: 1996-1997.

The last case of poliomyelitis due to transmission of indigenous wild poliovirus occurred in Italy in 1982. To achieve the certification of the eradication of poliomyelitis in Italy, an active surveillance of acute flaccid paralysis (AFP) in the population aged less than 15 years was set up following the World Health Organization (WHO) guidelines. The survey started in 1996 with a pilot study involving 4 out of 21 regions, and was gradually extended to a national level in 1997. The two-year survey identified five patients with diagnosis of vaccine associated paralytic poliomyelitis (VAPP). Polioviruses type 2 and 3 Sabin-like were isolated and characterized in three of them. In the remaining two cases, samples were collected late after the onset of symptoms, and poliovirus could not be isolated. No wild polioviruses were detected during the survey. The rate of non-polio AFP found in Italy in 1997 was 0.61 cases per 100,000, which is lower than the level of 1.0 case per 100,000 considered as acceptable by the WHO. This was mainly due to the delay in organizing the hospital network and starting the active search of AFP cases in the largest and most densely populated regions. Therefore, the overall rate of AFP found in Italy underestimates the global effectiveness of the program, which however will be better evaluated in the next few years. This study is the first systematic attempt to determine the rate of AFP in Ital

Epidemiologia delle paralisi flaccide acute in Italia: 1996-1998

The World Health Organization (WHO) programme for "Global eradication of Poliomyelitis" established since 1988 has achieved substantial goals, and paralytic poliomyelitis, already eradicated from the Americas, has also become a rare disease in many other parts of the world. The goal is realistic and could be reached during the first decade of the third millennlum. To achieve the certification of the eradication of poliomyelitis in a country, it must be verified that no paralync poliomyelitis due to wild poliovirus occurs over an extended period of time in the context of an active surveillance of Acute Flaccid Paralysis (AFP). In Italy the active AFP surveillance started in 1996 as a pilot study, and was gradually extended at national level in 1997. The rate of non-polio AFP found was 0.61 cases per 100,000 in 1997 and 0.67 in 1998. The values were lower than the rate of l case per 100,000, in the population aged less than 15 years, considered acceptable by the WHO. However, during the three year survey seven cases of vaccine associated paralytic poliomyelitis (VAPP) were identified and no wild poliovirus was detected. The underestimation of AFP cases in 1997 was particularly due to the delay in organizing the regional hospital network In 1998 an improvement of the biological samples collection has been evidenced. This study is the first systematic attempi to determine the rate of AFP in Italy

Risk factors for congenital hypothyroidism: results of a population case-control study (1997-2003).

none26noneMedda E; Olivieri A; Stazi MA; Grandolfo ME; Fazzini C; Baserga M; Burroni M; Cacciari E; Calaciuria F; Cassio A; Chiovato L; Costa P; Leopardi D; Martucci M; Moschini L; Pagliardini S; Parlato G; Pignoro A; Pinchera A; Sala D; Sava L; Stoppioni V; Tancredi F; Valentini F; Vigneri R; Sorcini M;Medda E; Olivieri A; Stazi MA; Grandolfo ME; Fazzini C; Baserga M; Burroni M; Cacciari E; Calaciuria F; Cassio A; Chiovato L; Costa P; Leopardi D; Martucci M; Moschini L; Pagliardini S; Parlato G; Pignoro A; Pinchera A; Sala D; Sava L; Stoppioni V; Tancredi F; Valentini F; Vigneri R; Sorcini M

Risk factors for congenital hypothyroidism: results of a population case-control study

OBJECTIVE: To identify risk factors for permanent and transient congenital hypothyroidism (CH). DESIGN: A population-based case-control study was carried out by using the network created in Italy for the National Register of Infants with CH. METHODS: Four controls were enrolled for each new CH infant; 173 cases and 690 controls were enrolled in 4 years. In order to distinguish among risk factors for permanent and transient CH, diagnosis was re-evaluated 3 years after enrollment when there was a suspicion of transient CH being present. Familial, maternal, neonatal and environmental influences were investigated. RESULTS: An increased risk for permanent CH was detected in twins by a multivariate analysis (odds ratio (OR) = 12.2, 95% confidence interval (CI): 2.4-62.3). A statistically significant association with additional birth defects, female gender and gestational age >40 weeks was also confirmed. Although not significant, an increased risk of CH was observed among infants with a family history of thyroid diseases among parents (OR = 1.9, 95% CI: 0.7-5.2). Maternal diabetes was also found to be slightly associated with permanent CH (OR = 15.7, 95% CI: 0.9-523) in infants who were large for gestational age. With regard to transient CH, intrauterine growth retardation and preterm delivery were independent risk factors for this form of CH. CONCLUSION: This study showed that many risk factors contribute to the aetiology of CH. In particular, our results suggested a multifactorial origin of CH in which genetic and environmental factors play a role in the development of the disease

Surveillance of acute flaccid paralysis in Italy: 1996-1997. AFP Study Group. Acute flaccid paralysis.

The last case of poliomyelitis due to transmission of indigenous wild poliovirus occurred in Italy in 1982. To achieve the certification of the eradication of poliomyelitis in Italy, an active surveillance of acute flaccid paralysis (AFP) in the population aged less than 15 years was set up following the World Health Organization (WHO) guidelines. The survey started in 1996 with a pilot study involving 4 out of 21 regions, and was gradually extended to a national level in 1997. The two-year survey identified five patients with diagnosis of vaccine associated paralytic poliomyelitis (VAPP). Polioviruses type 2 and 3 Sabin-like were isolated and characterized in three of them. In the remaining two cases, samples were collected late after the onset of symptoms, and poliovirus could not be isolated. No wild polioviruses were detected during the survey. The rate of non-polio AFP found in Italy in 1997 was 0.61 cases per 100,000, which is lower than the level of 1.0 case per 100,000 considered as acceptable by the WHO. This was mainly due to the delay in organizing the hospital network and starting the active search of AFP cases in the largest and most densely populated regions. Therefore, the overall rate of AFP found in Italy underestimates the global effectiveness of the program, which however will be better evaluated in the next few years. This study is the first systematic attempt to determine the rate of AFP in Italy