BACKGROUND Prisons can be a reservoir for infectious diseases,including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),due to the very intimate nature of the living spaces and the large number of people f...BACKGROUND Prisons can be a reservoir for infectious diseases,including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),due to the very intimate nature of the living spaces and the large number of people forced to share them.AIM To investigate the SARS-CoV-2 epidemiology in prisons,this study evaluated the infection incidence rate in prisoners who underwent nasopharyngeal swabs.METHODS This is an observational cohort study.Data collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the results.Nasopharyngeal swab tests for SARS-CoV-2 were performed between 15 February 2021 and 31 May 2021 for prisoners with symptoms and all new arrivals to the facility.Another section included information on the diagnosis of the disease according to the International Classification of Diseases,Ninth Revision,and Clinical Modification.RESULTS Up until the 31 May 2021,79.2%of the prisoner cohort(n=1744)agreed to a nasopharyngeal swab test(n=1381).Of these,1288 were negative(93.3%)and 85 were positive(6.2%).A significant association[relative risk(RR)]was found only for the risk of SARS-CoV-2 infection among foreigners compared to Italians[RR=2.4,95%confidence interval(CI):1.2-4.8].A positive association with SARS-CoV-2 infection was also found for inmates with at least one nervous system disorder(RR=4,95%CI:1.8-9.1).The SARS-CoV-2 incidence rate among prisoners is significantly lower than in the general population in Tuscany(standardized incidence ratio 0.7,95%CI:0.6-0.9).CONCLUSION In the prisoner cohort,screening and rapid access to health care for the immigrant population were critical to limiting virus transmission and subsequent morbidity and mortality in this vulnerable population.展开更多
AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional co...AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.展开更多
AIM To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in 2015.METHODS Tuscan Health administrative data were used to evaluate hepatitis C virus(HCV) inf...AIM To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in 2015.METHODS Tuscan Health administrative data were used to evaluate hepatitis C virus(HCV) infected people known to the Regional Health Service. Residents in Tuscany with a HCV exemption code(070.54) were identified. Using the universal code attributed to each resident, these patients were matched with hospital admission codes identified by the International Classification of Diseases, Ninth Revision(ICD-9), Clinical Modification, and with codes for dispensing drugs to patients by local and hospital pharmacies. Individuals were considered only once. Capture-recapture analysis was used to evaluate the HCV-infected population unknown to the Regional Health Service.RESULTS In total, 14526 individuals were living on 31/12/2015 with an exemption code for HCV. In total, 9524 patients were treated with pegylated interferon + ribavirin and/or direct-acting antiviral drugs during the last 10 years, and 13879 total hospital admissions were noted in the last 15 years. After data linkage, the total number was 25918. After applying the Capture-Recapture analysis, the number of unknown HCV-infected people was 23497. Therefore, the total number of chronic HCVinfected people was 38643, excluding those achieved sustained virological response to previous treatment.CONCLUSION Our results show a prevalence of HCV infected people of 1%. Tuscan administrative data could be useful for calculating health care costs and health planning in the coming years.展开更多
Although a vaccine against hepatitis B virus (HBV) has been available since 1982,the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%.A high rate of chron...Although a vaccine against hepatitis B virus (HBV) has been available since 1982,the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%.A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central Europe.In the Middle East and the Indian subcontinent,the prevalence is 2-5%.Less than 1% of the population of Western Europe and North America is chronically infected.Given the high prevalence of infections (such as hepatitis) among inmates,prison is considered a reservoir for facilitating such infections.Based on these premises,this current review examines and discusses emerging trends in the epidemiology of HBV infection,with particular attention to HBV infection in prison.The hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (23.5%).The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison population.The vaccination was recommended for all inmates,representing an opportunity to prevent HBV infection in a high-risk population.In these subjects,an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection.Therefore,it is necessary to seek collaboration among public health officials,clinicians and correctional authorities to implement a vaccination programme.展开更多
Objective:Street-based female sex workers are more likely to practice unprotected sex with multiple partners increases their risk of infection with sexually transmitted diseases.This study was performed to evaluate th...Objective:Street-based female sex workers are more likely to practice unprotected sex with multiple partners increases their risk of infection with sexually transmitted diseases.This study was performed to evaluate the understanding of and risk factors for sexually transmitted diseases among street-based female sex workers.Methods:A survey consisted of a sociodemographic section and a health section was conducted from June to August in two consecutive years(2012-2013)using an anonymous questionnaire compiled by street-based female sex workers in the area of Florence(Central Italy).A descriptive analysis of sociodemographic,epidemiological,and anamnestic variables was performed using common methods for proportions;associations between variables were assessed using univariate and bivariate logistic regression.Results:Totally 122 street-based female sex workers(mean age,24.1 years;age range,17-45 years)were enrolled,and were from Europe(63.1%)(mainly from Romania[48.4%]and Albania[13.1%]),Africa(31.2%)(specifically Nigeria),and South America(5.7%).Of the 122 street-based female sex workers,63%were married/engaged and 37%were single.More than half had been living in Italy and Florence for more than 1 year;72.8%stated that they possessed a residence permit and the others were illegal migrants.Eighteen(15%)street-based female sex workers also worked in the industry in neighboring European countries.Their level of education was generally high:58.1%had completed secondary school(lower secondary school and upper secondary school).A total of 81.4%stated that they perceived an actual fear of contracting human immunodeficiency virus;in fact,43.3%had never been tested for any sexually transmitted diseases except for human immunodeficiency virus.Conclusion:Despite the long-time involvement of street-based female sex workers in the commercial sex industry,the large numbers of clients and a strong perception of concerns about sexually transmitted diseases.This study confirms a low rate of condom use and blood screening,and corresponding science education and health screening efforts need to be strengthened in this high risk population.展开更多
文摘BACKGROUND Prisons can be a reservoir for infectious diseases,including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),due to the very intimate nature of the living spaces and the large number of people forced to share them.AIM To investigate the SARS-CoV-2 epidemiology in prisons,this study evaluated the infection incidence rate in prisoners who underwent nasopharyngeal swabs.METHODS This is an observational cohort study.Data collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the results.Nasopharyngeal swab tests for SARS-CoV-2 were performed between 15 February 2021 and 31 May 2021 for prisoners with symptoms and all new arrivals to the facility.Another section included information on the diagnosis of the disease according to the International Classification of Diseases,Ninth Revision,and Clinical Modification.RESULTS Up until the 31 May 2021,79.2%of the prisoner cohort(n=1744)agreed to a nasopharyngeal swab test(n=1381).Of these,1288 were negative(93.3%)and 85 were positive(6.2%).A significant association[relative risk(RR)]was found only for the risk of SARS-CoV-2 infection among foreigners compared to Italians[RR=2.4,95%confidence interval(CI):1.2-4.8].A positive association with SARS-CoV-2 infection was also found for inmates with at least one nervous system disorder(RR=4,95%CI:1.8-9.1).The SARS-CoV-2 incidence rate among prisoners is significantly lower than in the general population in Tuscany(standardized incidence ratio 0.7,95%CI:0.6-0.9).CONCLUSION In the prisoner cohort,screening and rapid access to health care for the immigrant population were critical to limiting virus transmission and subsequent morbidity and mortality in this vulnerable population.
文摘AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.
文摘AIM To evaluate this prevalence in Tuscan populations that was known and unknown to the Tuscan Regional Health Service in 2015.METHODS Tuscan Health administrative data were used to evaluate hepatitis C virus(HCV) infected people known to the Regional Health Service. Residents in Tuscany with a HCV exemption code(070.54) were identified. Using the universal code attributed to each resident, these patients were matched with hospital admission codes identified by the International Classification of Diseases, Ninth Revision(ICD-9), Clinical Modification, and with codes for dispensing drugs to patients by local and hospital pharmacies. Individuals were considered only once. Capture-recapture analysis was used to evaluate the HCV-infected population unknown to the Regional Health Service.RESULTS In total, 14526 individuals were living on 31/12/2015 with an exemption code for HCV. In total, 9524 patients were treated with pegylated interferon + ribavirin and/or direct-acting antiviral drugs during the last 10 years, and 13879 total hospital admissions were noted in the last 15 years. After data linkage, the total number was 25918. After applying the Capture-Recapture analysis, the number of unknown HCV-infected people was 23497. Therefore, the total number of chronic HCVinfected people was 38643, excluding those achieved sustained virological response to previous treatment.CONCLUSION Our results show a prevalence of HCV infected people of 1%. Tuscan administrative data could be useful for calculating health care costs and health planning in the coming years.
文摘Although a vaccine against hepatitis B virus (HBV) has been available since 1982,the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%.A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central Europe.In the Middle East and the Indian subcontinent,the prevalence is 2-5%.Less than 1% of the population of Western Europe and North America is chronically infected.Given the high prevalence of infections (such as hepatitis) among inmates,prison is considered a reservoir for facilitating such infections.Based on these premises,this current review examines and discusses emerging trends in the epidemiology of HBV infection,with particular attention to HBV infection in prison.The hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (23.5%).The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison population.The vaccination was recommended for all inmates,representing an opportunity to prevent HBV infection in a high-risk population.In these subjects,an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection.Therefore,it is necessary to seek collaboration among public health officials,clinicians and correctional authorities to implement a vaccination programme.
文摘Objective:Street-based female sex workers are more likely to practice unprotected sex with multiple partners increases their risk of infection with sexually transmitted diseases.This study was performed to evaluate the understanding of and risk factors for sexually transmitted diseases among street-based female sex workers.Methods:A survey consisted of a sociodemographic section and a health section was conducted from June to August in two consecutive years(2012-2013)using an anonymous questionnaire compiled by street-based female sex workers in the area of Florence(Central Italy).A descriptive analysis of sociodemographic,epidemiological,and anamnestic variables was performed using common methods for proportions;associations between variables were assessed using univariate and bivariate logistic regression.Results:Totally 122 street-based female sex workers(mean age,24.1 years;age range,17-45 years)were enrolled,and were from Europe(63.1%)(mainly from Romania[48.4%]and Albania[13.1%]),Africa(31.2%)(specifically Nigeria),and South America(5.7%).Of the 122 street-based female sex workers,63%were married/engaged and 37%were single.More than half had been living in Italy and Florence for more than 1 year;72.8%stated that they possessed a residence permit and the others were illegal migrants.Eighteen(15%)street-based female sex workers also worked in the industry in neighboring European countries.Their level of education was generally high:58.1%had completed secondary school(lower secondary school and upper secondary school).A total of 81.4%stated that they perceived an actual fear of contracting human immunodeficiency virus;in fact,43.3%had never been tested for any sexually transmitted diseases except for human immunodeficiency virus.Conclusion:Despite the long-time involvement of street-based female sex workers in the commercial sex industry,the large numbers of clients and a strong perception of concerns about sexually transmitted diseases.This study confirms a low rate of condom use and blood screening,and corresponding science education and health screening efforts need to be strengthened in this high risk population.
