Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction

被引：12

作者：

Stefanelli, Paola ^{[1
]}

Bellino, Stefania ^{[1
]}

Fiore, Stefano ^{[1
]}

Fontana, Stefano ^{[1
]}

Amato, Concetta ^{[1
]}

Buttinelli, Gabriele ^{[1
]}

Ansaldi, Filippo ^{[2
]}

Binda, Sandro ^{[3
]}

Pellegrinelli, Laura ^{[3
]}

Bonaccorsi, Guglielmo ^{[4
]}

Lorini, Chiara ^{[4
]}

Brusaferro, Silvio ^{[5
]}

Camilloni, Barbara ^{[6
]}

Capannolo, Benita ^{[7
]}

Mancini, Cristiana ^{[7
]}

Carraro, Valter ^{[8
]}

Castiglia, Paolo ^{[9
]}

Arghittu, Antonella ^{[9
]}

D'Errico, Marcello Mario ^{[10
]}

De Stefano, Carlo ^{[11
]}

Foca, Alfredo ^{[12
]}

CinziaGerminario ^{[13
]}

Larocca, Angela ^{[13
]}

Giammanco, Giovanni M. ^{[14
]}

De Grazia, Simona ^{[14
]}

Grasso, Guido Maria ^{[15
]}

DanielaLombardi ^{[16
]}

Russo, Francesca ^{[17
]}

Napoletano, Giuseppina ^{[17
]}

Zanella, Francesca ^{[17
]}

Spertini, Silvia ^{[18
]}

Veronesi, Licia ^{[19
]}

Affanni, Paola ^{[19
]}

Triassi, Maria ^{[20
]}

Pennino, Francesca ^{[20
]}

Vairo, Francesco ^{[21
]}

机构：

[1] Natl Inst Hlth, Dept Infect Dis, Rome, Italy

[2] Univ Genoa, Dipartimento Sci Salute, Genoa, Italy

[3] Univ Milan, Dipartimento Sci Biomed Salute, Milan, Italy

[4] Univ Firenze, Dipartimento Sci Salute, Florence, Italy

[5] Univ Udine, Dipartimento AreaMed, Udine, Italy

[6] Univ Perugia, Dipartimento Med, Perugia, Italy

[7] ASL 1 Abruzzo, Dipartimento Prevenz, Laquila, Italy

[8] Azienda Prov Serv Sanit, Dipartimento Prevenz, Trento, Italy

[9] Univ Sassari, Azienda Osped Univ, Dipartimento Sci Med Chirurg & Sperimentali, Sassari, Italy

[10] Univ Politecn Marche, Dipartimento Sci Biomed Sanita Pubbl, Ancona, Italy

[11] Osped San Carlo Borromeo Milano, Potenza, Italy

[12] Univ Magna Grecia Catanzaro, Dipartimento Sci Med, Catanzaro, Italy

[13] Univ Bari Aldo Moro, Dipartimento Sci Biomed & Oncol Umana, Bari, Italy

[14] Univ Palermo, Dipartimento Promoz Salute Maternoinfantile Med I, Palermo, Italy

[15] Univ Molise, Dipartimento Med & Sci Salute, Campobasso, Italy

[16] SeREMI ASL AL, Alessandria, Italy

[17] Vet Reg Veneto, Direzione Prevenz, Sicurezza Alimentare, Venice, Italy

[18] Azienda Sanit Alto Adige, Dipartimento Prevenz, Bolzano, Italy

[19] Univ Parma, Dipartimento Med & Chirurg, Parma, Italy

[20] Univ Federico II, Dipartimento Sanita Pubbl, Naples, Italy

[21] Ist Nazl Malattie Infett Lazzaro, SERESMI, Rome, Italy

来源：

BMC PUBLIC HEALTH | 2019年 / 19卷 / 01期

关键词：

Acute flaccid paralysis; Hospital discharge records; National surveillance system; Polio; ERADICATION; WORLDWIDE;

D O I：

10.1186/s12889-019-7617-0

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Acute flaccid paralysis (AFP) surveillance has been adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Hereby, to evaluate the completeness of the ascertainment of AFP cases in Italy, a hospital-discharges based search was carried out. Methods AFP cases occurring between 2007 and 2016 among children under 15 years of age were searched in the Italian Hospital Discharge Records (HDR) database using specific ICD-9-CM diagnostic codes. AFP cases identified between 2015 and 2016 were then compared with those notified to the National Surveillance System (NSS). Results Over a 10-year period, 4163 hospital discharges with diagnosis of AFP were reported in Italy. Among these, 956 (23.0%) were acute infective polyneuritis, 1803 (43.3%) myopathy, and 1408 (33.8%) encephalitis, myelitis and encephalomyelitis. During the study period, a decreasing trend was observed for all diagnoses and overall the annual incidence rate (IR) declined from 5.5 to 4.5 per 100,000 children. Comparing NSS with HDR data in 2015-2016, we found a remarkable underreporting, being AFP cases from NSS only 14% of those recorded in HDR. In particular, the acute infective polyneuritis cases reported to NSS accounted for 42.6% of those detected in HDR, while only 0.9% of myopathy cases and 13.1% of encephalitis/myelitis/encephalomyelitis cases have been notified to NSS. The highest AFP IRs per 100,000 children calculated on HDR data were identified in Liguria (17.4), Sicily (5.7), and Veneto (5.1) Regions; regarding the AFP notified to the NSS, 11 out of 21 Regions failed to reach the number of expected cases (based on 1/100,000 rate), and the highest discrepancies were observed in the Northern Regions. Overall, the national AFP rate was equal to 0.6, therefore did not reach the target value. Conclusions AFP surveillance data are the final measure of a country's progress towards polio eradication. The historical data obtained by the HDR have been useful to assess the completeness of the notification data and to identify the Regions with a low AFP ascertainment rate in order to improve the national surveillance system.

引用

页数：8

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