Compulsory and recommended vaccination in Italy: evaluation of coverage and non-compliance between 1998-2002 in Northern Italy

BACKGROUND: Since vaccinations are an effective prevention tool for maintaining the health of society, the monitoring of immunization coverage allows us to identify areas where disease outbreaks are likely to occur, and possibly assist us in predicting future outbreaks. The aim of this study is the investigation of the coverage achieved for compulsory (diphtheria, tetanus, polio, hepatitis B,) and recommended (pertussis, Haemophilus influenzae, measles-mumps-rubella) vaccinations between 1998 and 2002 in the municipality of Bologna and the identification of the subjects not complying with compulsory and recommended vaccinations. METHODS: The statistics regarding vaccinal coverage were elaborated from the data supplied by the Bologna vaccinal registration system (1998–2000) and the IPV4 program (2001–2002). To calculate the coverage for compulsory vaccinations and cases of non-compliance reference was made to the protocol drawn up by the Emilia Romagna Regional Administration. The reasons for non-compliance were divided into various categories RESULTS: In Bologna the levels of immunization for the four compulsory vaccinations are satisfactory: over 95% children completed the vaccinal cycle, receiving the booster for anti-polio foreseen in their 3(rd )year and for anti-dyphteria, tetanus, pertussis at 6 years. The frequency of subjects with total non-compliance (i.e. those who have not begun any compulsory vaccinations by the age of one year) is generally higher in Bologna than in the region, with a slight increase in 2002 (2.52% and 1.06% in the city and the region respectively). The frequency of the anti-measles vaccination is higher than that of mumps and rubella, which means that the single vaccine, as opposed to the combined MMR (measles-mumps-rubella) was still being used in the period in question. The most common reason for non compliance is objection of parents and is probably due to reduction of certain diseases or anxiety about the possible risks. CONCLUSION: In Bologna the frequency of children aged 12 and 24 months who have achieved compulsory vaccination varied, in 2002, between 95% and 98%. As regards recommended vaccinations the percentage of coverage against Haemophilus influenzae is 93.3%, while the levels for measles, mumps and pertussis range from 84% to approx. 92%. Although these percentages are higher if compared to those obtained by other Italian regions, every effort should be made to strengthen the aspects that lead to a successful vaccinal strategy

Compulsory and recommended vaccination in Italy: evaluation of coverage and non-compliance between 1998-2002 in Northern Italy

Abstract Background Since vaccinations are an effective prevention tool for maintaining the health of society, the monitoring of immunization coverage allows us to identify areas where disease outbreaks are likely to occur, and possibly assist us in predicting future outbreaks. The aim of this study is the investigation of the coverage achieved for compulsory (diphtheria, tetanus, polio, hepatitis B,) and recommended (pertussis, Haemophilus influenzae, measles-mumps-rubella) vaccinations between 1998 and 2002 in the municipality of Bologna and the identification of the subjects not complying with compulsory and recommended vaccinations. Methods The statistics regarding vaccinal coverage were elaborated from the data supplied by the Bologna vaccinal registration system (1998–2000) and the IPV4 program (2001–2002). To calculate the coverage for compulsory vaccinations and cases of non-compliance reference was made to the protocol drawn up by the Emilia Romagna Regional Administration. The reasons for non-compliance were divided into various categories Results In Bologna the levels of immunization for the four compulsory vaccinations are satisfactory: over 95% children completed the vaccinal cycle, receiving the booster for anti-polio foreseen in their 3rd year and for anti-dyphteria, tetanus, pertussis at 6 years. The frequency of subjects with total non-compliance (i.e. those who have not begun any compulsory vaccinations by the age of one year) is generally higher in Bologna than in the region, with a slight increase in 2002 (2.52% and 1.06% in the city and the region respectively). The frequency of the anti-measles vaccination is higher than that of mumps and rubella, which means that the single vaccine, as opposed to the combined MMR (measles-mumps-rubella) was still being used in the period in question. The most common reason for non compliance is objection of parents and is probably due to reduction of certain diseases or anxiety about the possible risks. Conclusion In Bologna the frequency of children aged 12 and 24 months who have achieved compulsory vaccination varied, in 2002, between 95% and 98%. As regards recommended vaccinations the percentage of coverage against Haemophilus influenzae is 93.3%, while the levels for measles, mumps and pertussis range from 84% to approx. 92%. Although these percentages are higher if compared to those obtained by other Italian regions, every effort should be made to strengthen the aspects that lead to a successful vaccinal strategy.</p

Stile di vita e obesit\ue0 nell\u2019adolescente

Introduzione Nell\u2019ambito di un ampio studio auxologico sulla popolazione adolescente bolognese condotto in collaborazione tra Universit\ue0 e Dipartimento di Cure Primarie (A.U.S.L.,citt\ue0 di Bologna) \ue8 stato analizzato l\u2019influenza di uno stile di vita attivo o inattivo sull\u2019accrescimento dell\u2019adolescente, con particolare riferimento all\u2019incidenza di sovrappeso e obesit\ue0. Metodi Il campione totale \ue8 costituito da 746 individui di et\ue0 compresa fra gli 11 e i 14 anni (397 maschi e 349 femmine). Tramite intervista diretta \ue8 stato richiesto ai soggetti di indicare se praticassero sport, quale tipo di sport, quante ore di allenamento settimanale e da quanto tempo sostenessero questo ritmo e, inoltre, quante ore trascorressero davanti al computer o alla televisione. Sono state rilevate caratteristiche antropometriche fondamentali quali peso, statura e pannicoli adiposi bicipitale e sottoscapolare. E\u2019 stato calcolato l\u2019indice di massa corporea (kg/m2) e i soggetti sono stati classificati con i cut off per l\u2019Italia settentrionale di Cacciari et al. (2002). Tramite il t di student si sono verificate le eventuali differenze esistenti nelle caratteristiche antropometriche in relazione allo stile di vita. Risultati Dall\u2019analisi delle ore trascorse davanti alla televisione e/o al computer emerge una differenza di stile di vita tra i due sessi. Infatti, mentre nei maschi le percentuali si equivalgono nelle tre categorie, una vasta maggioranza delle femmine rientra nella seconda fascia (3-4 ore) e una minima parte nella terza fascia. I maschi del nostro campione praticano, in media, pi\uf9 ore di attivit\ue0 fisica durante la settimana rispetto alle coetanee, confermando quanto gi\ue0 osservato in letteratura (Malina et al., 2004). La percentuale pi\uf9 elevata di soggetti si ha nella fascia fra 3 e 4 ore di allenamento settimanale per il sesso maschile, fra 1 e 2 ore per le femmine. Una percentuale elevata dei soggetti pratica almeno uno sport e la maggioranza di loro ha iniziato a praticare sport poco dopo il compimento del sesto anno di vita. Fino ai 13 anni non si evidenziano differenze significative fra sportivi e non sportivi, ma si sottolineano comunque valori medi superiori in statura e valori medi inferiori nello spessore delle pliche sottocutanee per i soggetti praticanti un\u2019attivit\ue0 fisica. A 14 anni per entrambi i sessi le differenze antropometriche in relazione alla pratica sportiva divengono significative ai test statistici. Considerando la pratica sportiva non si evidenziano differenze tra sportivi e non sportivi rispetto alle ore trascorse davanti alla televisione. Si riscontrano, invece, differenze nelle percentuali di sovrappeso e obesit\ue0, maggiori, per entrambi i sessi, fra i soggetti che non praticano sport. Tale dato risulta particolarmente evidente se vengono considerate, ad esempio, le due categorie estreme, ossia chi pratica meno di 2 ore di allenamento settimanale e chi pratica sport per pi\uf9 di 4 ore. Risultati analoghi si ottengono dall\u2019analisi delle ore trascorse davanti alla televisione, da cui emerge che i soggetti maggiormente inattivi (>4 ore) presentano le percentuali di sovrappeso pi\uf9 elevate. Discussione e conclusioni Tenuto conto del ridotto numero di ore dedicato alla pratica sportiva durante l\u2019orario scolastico, l\u2019attivit\ue0 fisica regolare extra scolastica si conferma un mezzo adatto a favorire la crescita in senso integrato. I risultati mostrano un\u2019interazione positiva fra sport e accrescimento in relazione a una minore incidenza di sovrappeso e obesit\ue0 fra i ragazzi regolarmente attivi e un\u2019interazione negativa fra inattivit\ue0 e crescita in relazione alla maggior percentuale di sovrappeso riscontrata nei soggetti sedentari