29 research outputs found
National Immunization programme in rural area of Mozambique; evaluation of immunization coverage rates in child population accessed to a health service
Vaccine preventable diseases still weigh on mortality in the world and especially in children population. Vaccine protection is not uniformly guaranteed being
rural areas and low- income population the most disadvantaged. Aim of the study was to verify the children coverage in a rural district in Mozambique where government
fixed and mobile health facilities are supported by an Italian ONG (Medicus Mundi Italia). On a sample of 787 accessing children born from 2015 to 2017,
the proportion of fully vaccinated (for BCG, Polio 1-3, DTP/HepB/Hib 1-3, PCV 1-3, measles first dose) by one year of age was 80.4% (95% CI 76.6-83.7), by 23 months it was 91% (95% CI 88-93%). However, in a contest where health care can be not easily accessible, the rate of missed opportunities of vaccination (children accessing to the health service at an age proper for administration of a certain vaccine dose but not vaccinated by the evaluating health operator) (MOV) was high for the intramuscular measles second dose (54%). Such a risk was higher in fixed health centre, lower during activity of mobile equipe (79% vs 46%; p value 0.01). Therefore, despite good immunization coverage, there are still margins to intensify strategies for not missing children vaccine opportunities
Acute respiratory distress syndrome in Plasmodium vivax malaria in traveler returning from Venezuela.
Respiratory symptoms and signs are reported in
4% to 18% of the cases with uncomplicated
Plasmodium falciparum malaria and are also a major
feature in severe malaria. Plasmodium vivax malaria
seldom results in pulmonary damage, and pulmonary
complications are exceedingly rare. We report
a case of Acute Respiratory Distress Syndrome
(ARDS) complicating infection with P vivax malaria
from Venezuela
Addressing tuberculosis in vulnerable populations in Europe: the E-Detect-TB project and its activities in Brescia
In line with the 2030 Agenda for Sustainable Development (Sustainable Development Goal n. 3, Target 3.3) the European Union financed the action entitled “early detection and integrated management of tuberculosis in Europe: E-DETECT TB”. Within the E-DETECT TB project, we conducted a retrospective cohort analysis of active TB and latent tuberculosis infection (LTBI) screening among consecutive asylum seekers resettled in Brescia, Italy in 2015 and 2016. Of 2,904 asylum seekers 2,567 (88.4%) were evaluated for TB, 62 (2.4 %) were positive at symptoms screening, 27 (43.6%) had follow-up investigations and four had TB (28.6% of prevalent TB cases). Active TB screening yield was 155/100,000 persons. TB prevalence and incidence rates were 545 / 100,000 persons and 220 / 100,000 individuals / person-years respectively. The prevalence of LTBI was 36.6% (843/2,303). Of 843 individuals with a positive TST, 430 (51.0%) did not complete evaluation procedures. Arrival during high influx period and originating from Africa continent were factors negatively associated to the completion of LTBI screening. Symptom-based screening performed poorly for TB detection. LTBI screening and treatment uptake losses were mainly attributable to the defragmentation of health care services. We are currently evaluating an electronic-health (e-Heath) device, a mobile application to record demographic and clinical data during consultations (named EDETECT-TB App). Rationale is that the data sharing among health care-services and clinicians involved in screening activities could significantly reduce losses of both patients and clinical data
Antenatal care in migrant and resident women in northern Italy: the case of Toxoplasma screening
Toxoplasmosi in gravidanza. I limiti dello screening intergravidico
9nonenoneCATTARUZZA MS; ODOLINI S; BIGONI S; RODARI P; ANGELI A; FRUSCA T; BONFANTI C; TOMASONI LR; CASTELLI FCattaruzza, Ms; Odolini, Silvia; Bigoni, S; Rodari, P; Angeli, A; Frusca, Tiziana; Bonfanti, Carlo; Tomasoni, Lr; Castelli, Francesc
Accesso allo screeening HIV in gravidanza nel distretto anitario di Nanoro, Burkina Faso, Africa Occidentale
Retention in care of newly diagnosed HIV patients. Similarities and differences among Italian health system and mobile-TARV strategy in Morrumbene, Mozambique
Despite the progress in HIV care, adherence remains critical. The aim of this study was to assess similarities and differences in LTFU (loss to follow up) rates
among new HIV diagnosis in the Italian and Mozambican settings in order to identify possible risk factors and promote targeted interventions.
A retrospective study was conducted on new HIV diagnosis in the HIV Clinic of Brescia (2015-2018) and in rural communities in Mozambique (2017-2018).
A lack of contact of >12 months in Brescia and of >2 months in Morrumbene defined LTFU patients. Demographic characteristics, risk factors, pregnancy status,
WHO clinical stage and immuno-virological parameters were recorded. 7.4% of new diagnosis in HIV clinic in Brescia were LTFU. Young people, females
and Africans are more likely to be lost (p<.05). In Morrumbene the LTFU rate was 25.6% and being young and pregnant was significantly associated with HIV
care attrition (p 200/ÎĽl were significantly associated with failed retention in care. Retention in care of HIV patients represents a difficult step of HIV care. Educational projects focusing on fragile populations, counselling after HIV diagnosis and rapid cART initiation seem to be essential to guarantee a long-lasting adherence to HIV care
Anti-malarial chemoprophylaxis by cotrimoxazole in HIV-infected pregnant women in West Africa.
Antenatal Screening for Mother to Child Infections in Immigrants and Residents: The Case of Toxoplasmosis in Northern Italy
In Italy, serological screening is recommended to prevent congenital toxoplasmosis as part of the antenatal care protocol. Our study investigates (1) adherence to screening among Italian and migrant women and (2) specific T. gondii seroprevalence among hospitalized puerperas in Brescia and Udine, in northern Italy. All migrants (Group B) and a random Italian sample (Group A) filled in a questionnaire. Serological screening was rated as adequate when performed before conception or by the 12th week of gestation, and periodically repeated during pregnancy whenever negative. Nine hundred and twenty-two (922) puerperas were enrolled (Group A: 743; Group B: 179). Mean gestational age at first antenatal visit was 9.3 week, significantly more delayed in migrants (11.2w vs 8.9w; P < 0.0001). Toxoplasmosis was mentioned as a potential vertically transmitted infection by 380/922 (41.2%), but only by 13.4% of migrants (P < 0.0001). Anti-Toxoplasma IgG-Ab tested positive in 319/892 (35.8%), while the information was missing for 9 and 21 women resulted untested. Patients from northern Africa had an higher (AOR 3.63%; P = 0.002), while Asian patients a lower (AOR 0.33; P = 0.045) probability of being immune. A late screening was recorded in 115/848 (13.6%) women (Group A: 9.35%; Group B: 31.9%; P < 0.0001) and 82.1% of eligible migrants were not correctly monitored for toxoplasmosis during pregnancy. A late toxoplasma serological test in migrant women precludes the timely application of preventive measure and may represent an indicator of suboptimal antenatal care