ABSTRACT
Introduction: The number of migrants living in Europe is growing rapidly. The PROTECT project is a national study conducted among refugees and migrants in the Lazio region, Italy from February 2018 to September 2021 to evaluate their otolaryngological, dental, and ophthalmic health status. This article reports the results of this study with a special focus on otolaryngological conditions and diseases. Materials and methods: A total of 3023 participants were included in the project. Data on the participants' demographic factors, migration status, and otolaryngological history were collected using a questionnaire. Each patient underwent clinical ear, nose, and throat examination, and the main otolaryngological conditions and diseases were noted. Results: nearly two-thirds of participants were males (68.1%). The mean age was 31.6 +/- 13.1. Most of the participants were born in Nigeria, followed by Bangladesh, Pakistan, Somalia, Mali, and Gambia. The prevalence of chronic noise exposure was 5.2%. Unilateral hearing loss was reported by 6.5% of the subjects, and bilateral hearing loss by 3.6%. The most frequent symptoms reported in the questionnaire were snoring (10.4%), nasal obstruction (5.9%), vertigo (5.0%), otalgia (4.5%), and tinnitus (4.2%). At the clinical examination, the most frequent findings were nasal septum deviation (25.2%), ear wax (6.5%), hypertrophic palatine tonsils (5.3%), and tympanic membrane perforation (1.3%). Conclusions: the PROTECT project allowed for the evaluation of otolaryngological, dental, and ophthalmological conditions in over 3000 migrants, giving them the possibility to access specialist care.
ABSTRACT
Purpose : Assessment of corneal sensitivity (CS) allows to identify alterations of ocular surface sensory innervation associated with several conditions including neurotrophic keratopathy (NK) and dry eye disease (DED). Currently, Cochet-Bonnet (CB) esthesiometer represents the standard for measuring CS. A novel, single-use corneal esthesiometer (KeraSense™) has been developed. The aim of this study is to evaluate the accuracy, reproducibility, and repeatability of the KeraSense™ in comparison to CB. Methods : 26 healthy subjects (60±13 years of age) and 41 patients (60±17 years of age) with NK (N=16), diabetes (N=14) and dry eye (N=11) were included. CS was assessed in all subjects with KeraSense™ (Dompé Farmaceutici SPA, Milan, Italy) and CB. KeraSense™ assesses CS by disposable devices of fixed nylon thread lengths: 15, 35 and 55 mm. Repeatability and reproducibility of KeraSense™ were assessed by comparing results of 3 different measurements by the same masked investigator and by two different physicians, respectively. Sensibility, specificity, and accuracy for the diagnosis of NK have also been evaluated. Results : CB evaluation showed that patients with NK had significant (P<0.001) decrease of CS (30±23 mm) when compared with healthy subjects (59±1 mm), and with patients with DM (57±5 mm) and dry eye (58±2 mm). KeraSense™ showed repeatability and reproducibility, respectively with 100% agreement between different measurements and 99.6% concordance between different operators (Kappa index interrater agreement P<0.001). Corneal sensitivity values assessed by KeraSense™ were significantly associated with CB values (ANOVA P<0.001). A 55mm KeraSense™ value was adequate to exclude an NK diagnosis, while all patients with a KeraSense™ value of 0 or 15mm had NK. KeraSense™ response at 35mm showed good sensitivity and specificity to discriminate the presence of NK. Conclusions : KeraSense™ showed significant association with CB assessment and represents an expeditious and accurate device to assess CS without need of calibration, and being single-use, ensuring better safety also in the context of SARS-Cov2 outbreak.