8 research outputs found

    Key dimensions for the prevention and control of communicable diseases in institutional settings. a scoping review to guide the development of a tool to strengthen preparedness at migrant holding centres in the EU/EEA

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    Migrant centres, as other institutions hosting closed or semi-open communities, may face specific challenges in preventing and controlling communicable disease transmission, particularly during times of large sudden influx. However, there is dearth of evidence on how to prioritise investments in aspects such as human resources, medicines and vaccines, sanitation and disinfection, and physical infrastructures to prevent/control communicable disease outbreaks. We analysed frequent drivers of communicable disease transmission/issues for outbreak management in institutions hosting closed or semi-open communities, including migrant centres, and reviewed existing assessment tools to guide the development of a European Centre for Disease Prevention and Control (ECDC) checklist tool to strengthen preparedness against communicable disease outbreaks in migrant centres. Among articles/reports focusing specifically on migrant centres, outbreaks through multiple types of disease transmission were described as possible/occurred. Human resources and physical infrastructure were the dimensions most frequently identified as crucial for preventing and mitigating outbreaks. This review also recognised a lack of common agreed standards to guide and assess preparedness activities in migrant centres, thereby underscoring the need for a capacity-oriented ECDC preparedness checklist tool

    National immunization policies and practices targeting asylum seekers, refugees and irregular migrants in EU/EEA countries

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    Background of the study: Migrants represent a potential vulnerable group and adequate health protection, including vaccine preventable diseases prevention, should be ensured. Objective: The aim of this survey was to map national immunization policies and practices targeting asylum seekers, refugees and irregular migrants in EU/EEA countries. Method: A web-based cross-sectional survey was conducted in 28 EU and 2 EEA (Iceland, Norway) countries within the ECDC funded Vaccine European New Integrated Collaboration Effort (VENICE) Project. Summary of Results: All countries but the Czech Republic completed the survey and 28 countries (all except Romania) offer vaccination to migrants. A national regulation/legal framework supporting migrant immunization is available in 24/28 countries, of which for 9 it is specifically established for migrants. All the vaccinations included in the National Immunization Plan appropriate for age are offered to child and adolescent migrants in 26 countries and to adult migrants in 14 countries. Priority is given to polio, DT and MMR vaccines. Vaccinations are mainly given at holding and/or community level and only 5 countries vaccinate at entry level. A vaccination card is delivered to migrants in 23/28 countries for children/adolescent and 24/28 countries for adults. Methods of recording individual data vary highly across countries: for children/adolescents and adults, respectively, 15 and 12 countries use an electronic database, 5 and 4 use only paper registry, 2 and 2 use both electronic and paper registries, while 6 and 10 countries do not record information at all. Individual data are not made available from the sites where vaccinations are delivered to other local or national centers or institutions in 14/28 countries. Overall, 19 countries reported to have experienced vaccine shortages, but this shortage was not due to provision of vaccinations to migrants, contrary to some rumours. Conclusions: Although policies about immunization of migrants are available in most of EU/EEA countries, there are important differences as to their objectives and implementation. Also methods of recording and transmitting data vary within and across countries. As migrants move, it would be important to share data and practices among countries to avoid unnecessary re-vaccination and better respond to migrants' immunization needs. OR

    Politiche e strategie di offerta vaccinale ai migranti nei paesi dell’UE e EEA

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    Introduzione e obiettivi: I migranti sono considerati un gruppo potenzialmente vulnerabile. I motivi che li hanno spinti a partire, la complessità e la precarietà che caratterizzano il loro percorso migratorio, il sovraffollamento nei centri di accoglienza, insieme alle difficoltà di accesso ai servizi sanitari nei paesi ospitanti, possono peggiorare il loro stato di salute. Parte di loro proviene da paesi in cui i programmi vaccinali non sono completamente garantiti o sono stati interrotti. Inoltre, la documentazione relativa al loro stato immunitario non è generalmente disponibile all’arrivo in Europa perché non è stata portata oppure è stata perduta nel percorso migratorio. In considerazione di questi aspetti, il progetto VENICE (Vaccine European New Integrated Collaboration Effort), coordinato dall’Istituto Superiore di Sanità, in collaborazione con l’ECDC (Europeran Centre for Disease Prevention and Control), ha avviato un’indagine finalizzata a descrivere le politiche e le strategie di offerta vaccinale ai richiedenti asilo, rifugiati e migranti irregolari nei paesi dell’UE/EEA. Metodi/azioni: I dati vengono raccolti attraverso un questionario online, sviluppato attraverso SurveyMonkey, che indaga i seguenti aspetti: leggi e regolamenti che supportano l’offerta vaccinale per i migranti; strategie di immunizzazione previste per bambini/adolescenti e per adulti; modalità di raccolta dei dati relativa all’immunizzazione dei migranti; difficoltà emerse e sfide segnalate dai vari paesi. Dopo una fase ‘pilota’, che ha coinvolto referenti in Italia, Grecia, Malta, Croazia, Slovenia, Portogallo, Germania e Svezia, a gennaio 2018 il questionario è stato inviato ai membri del network VENICE dei 28 paesi dell’UE e di 3 paesi EEA e la raccolta dati è in corso. Risultati: In occasione del Convegno verranno presentate e comparate le politiche e le strategie vaccinali offerte dai paesi partecipanti, con particolare attenzione per quelle rivolte ai minori, tenendo in considerazione i loro diversi sistemi sanitari. Si verificherà inoltre se vi sono differenze tra i paesi considerati di primo arrivo, di transito o di destinazione anche in base al numero di migranti entrati negli ultimi anni. Conclusioni: Considerata la potenziale vulnerabilità della popolazione target, è importante che i paesi cooperino per garantire una offerta che permetta una copertura vaccinale adeguata e completa anche per i migranti che si spostano tra i paesi UE/EEA. La conoscenza delle differenti politiche sanitarie, le loro differenze ed eventuali uniformità, rappresenta una risorsa strategica per migliorare la salute dei migranti. Infine, questa indagine può permettere di identificare aree di difficoltà comuni dove lo sviluppo di linee guida di carattere tecnico a livello Europeo potrà sostenere e complementare gli sforzi a livello nazionale

    Strengthening Preparedness for Arbovirus Infections in Mediterranean and Black Sea Countries: A Conceptual Framework to Assess Integrated Surveillance in the Context of the One Health Strategy

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    International audienceIn the context of One Health, there is presently an effort to integrate surveillance of human, animal, entomological, and environmental sectors. This aims to strengthen the prevention of, and preparedness against, arbovirus infections, also in the light of environmental and climate changes that could increase the risk of transmission. However, criteria to define integrated surveillance, and to compare different systems, still need to be identified and tested. We conducted a scoping review to identify and examine surveillance systems for West Nile virus (WNV), chikungunya virus (CHKV), dengue virus (DENV), and Rift Valley fever virus (RVFV), which involve human, animal, entomological, and environmental sectors. We analyzed findings using a conceptual framework we developed for this purpose. The review highlights that the criteria proposed in the conceptual framework to describe integrated surveillance are consistently reported in the context of studies and programs related to integrated surveillance of the selected arboviral diseases. These criteria can facilitate the identification and description of operationalized One Health surveillance

    Enhancing Preparedness for Arbovirus Infections with a One Health Approach: The Development and Implementation of Multisectoral Risk Assessment Exercises

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    International audienceBackground: One Health is receiving attention for arbovirus infection prevention and control and for defining national "intersectoral" priorities. Increasing awareness of intersectoral priorities through multisectorial risk assessments (MRA) is promising, where data are not systematically shared between sectors. Towards this aim, the MediLabSecure project organized three MRA exercises (hereby called exercises): one on West Nile virus, one on Crimean-Congo haemorrhagic fever, and one on Rift Valley fever, assessing the added value of this approach.Methods: The exercises relied on RA methodologies of international organisations. Country representatives of the human and animal virology, medical entomology, and public health sectors (hereby called "sectors") involved in the surveillance of vector-borne diseases participated in the exercises. Background documentation was provided before each exercise, and a guide was developed for the facilitators. All three exercises included technical and methodological presentations and a guided RA directed at bringing into play the different sectors involved. To assess the added value of the approach, each participant was asked to rank the level of perceived benefit of the multisectoral collaboration for each "risk question" included in the exercises.Results: In total, 195 participants from 19 non-EU countries in the Mediterranean and Black Sea regions took part in the exercises. The participants assessed the multisectoral approach as valuable in analysing comprehensively the situation by having access to information and knowledge provided by each of the sectors involved. Sharing of information and discussion facilitated reaching a consensus on the level of risk in each country.Conclusions: Increasing awareness of intersectoral priorities, including cross-border ones, through MRA is relevant to reduce gaps due to unavailability of shared data and information. Given that six out of the ten threats to global health listed by WHO are occurring at the human-animal-environmental interfaces, comprehensive regional RA with a One Health approach made by national authorities can be a relevant added value for the global health security

    Underreporting of congenital rubella in Italy, 2010–2014

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    In accordance with the goals of the World Health Organization Regional Committee for Europe, the Italian national Measles and Rubella Elimination Plan 2010–2015 aimed to reduce the incidence of congenital rubella cases to <1 case/100,000 live births by 2015. In Italy, a passive national surveillance system for congenital rubella and rubella in pregnancy is active since 2005. We estimated the degree of underreporting of congenital rubella, performing a capture-recapture analysis of cases detected through two independent sources: the national surveillance system and the national hospital discharge database, in the years 2010–2014. We found that 6 out of 11 cases tracked in the retrospective case-finding from hospital registries had not been notified to the surveillance system, and we estimated a degree of underreporting of 53% for the period 2010–2014. This approach showed to be simple to perform, repeatable, and effective.Conclusion: In order to reduce underreporting, some actions aimed at strengthening surveillance procedures are needed. The adoption on a routine basis of the review of hospital discharge registries for case-finding, monthly zero-reporting, and actions to train and sensitize all the specialists involved in the care of pregnant women and the newborns to notification procedures are recommended.What is Known• In Italy, the incidence of congenital rubella was below the WHO target of 1/100,000 live births in 2005–2015, except for two peaks in 2008 and 2012 (5 and 4/100,000, respectively).• Further efforts are required to improve congenital rubella surveillance so that it is more sensitive and specific. The WHO proposes retrospective case-finding from hospital records as an alternative approach to detect infants with congenital rubella.Whatis New• Underreporting of congenital rubella in Italy was 53% in 2010–2014.• Hospital discharge registries resulted to be an appropriate source to detect congenital rubella cases
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