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1.
Epidemiol Prev ; 44(5-6): 378-384, 2020.
Article in English | MEDLINE | ID: covidwho-1134603

ABSTRACT

OBJECTIVES: to assess the completeness and timeliness of Human papillomavirus (HPV) vaccination programme in Friuli Venezia Giulia (FVG) Region (Northern Italy), notably by monitoring 2-dose coverage among girls before they turn 15 years old (referred to as "at 15") in each year between 2009 and 2018 and making a preliminary evaluation of coverage among boys at 13 years in 2016-2018. DESIGN: retrospective study. SETTING AND PARTICIPANTS: for each vaccine recipient, demographic information and history of HPV vaccine uptake from the digital FVG Vaccination Registry updated as of 31.12.2018 were extracted. Numerator data comprised all doses allocated to FVG residents. Age-specific denominators were derived from the FVG census in each examined year. Coverage estimates for the year 2018 were also provided by number of doses. MAIN OUTCOME MEASURES: coverage for a full course of HPV vaccine, defined as 2 doses in girls and boys younger than age 15 years but 3 doses in less young women. RESULTS: In FVG 52,217 females had received >=1 dose since 2008 and 12,152 males since 2015. >=2-dose coverage in girls at 15 increased from 42% in 2009 to 76% in 2015 and slightly declined afterwards (69% in 2018). In 2008, 3-dose coverage was 65%, 74%, and 59% in females aged 16-17, 18-19, and 20-26 years, respectively. In the same year, 2-dose coverage in boys at 13 years was 54%, similar to the coverage in girls at 13 years (57%). CONCLUSIONS: this paper shows the achievements of routine and catch-up HPV vaccination in FVG. While coverage in girls at 15 years of age peaked in 2015 and slightly diminished in subsequent years, the coverage in boys at 13 in 2018 had already approached the coverage in same-age girls (57%). On account of the signs of weakening in girls' coverage, campaigns in support to HPV vaccination must be repeated, especially in favour of the most cost-effective group, i.e., girls before 15 years of age. The heavy burden posed by the COVID-19 emergency on other prevention-related activities makes a better targeted use of HPV vaccination even more necessary.


Subject(s)
Immunization Programs/statistics & numerical data , Papillomavirus Vaccines/administration & dosage , Vaccination Coverage/statistics & numerical data , Adolescent , Adult , Female , Humans , Italy , Male , Young Adult
2.
Epidemiol Prev ; 44(5-6 Suppl 2): 128-135, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068132

ABSTRACT

OBJECTIVES: to investigate the role of gender, age, province of residence, and nursing home residency on the risk of death for residents in the Friuli Venezia Giulia (FVG) Region (Northern Italy) tested positive for Covid-19, considering recovery as a competing event. The secondary objective is to describe the impact of the Covid-19 epidemic in FVG and in the Regions of Northern and Central Italy in terms of incidence and mortality compared to the national data. DESIGN: retrospective cohort study. SETTING AND PARTICIPANTS: resident population in FVG in the period between 29 February and 25 June 2020. MAIN OUTCOME MEASURES: in order to describe the impact of the Covid-19 outbreak in FVG, in terms of incidence and mortality compared to the national data, the standardized incidence (SIR) and mortality (SMR) ratios and their respective 95% confidence intervals (95%CI) were calculated compared to the Italian population for the northern and central Regions of Italy and the autonomous Provinces (PA) of Trento and Bolzano. A retrospective cohort study was conducted on subjects residing in FVG to whom at least one naso-oropharyngeal swab (hereafter, named swab) resulted positive for Covid-19. For each subject included in the cohort, the observation period started with the first positive swab and ended with the first of the following events: death, recovery or censored, which means that at the end of the observation period the subject was still alive and positive. The cause of death was assigned to Covid-19 if a subject had not yet recovered at the time when the event occurred. Cohort members were considered recovered after two negative consecutive swabs. The sub-hazard ratio (SHR) was estimated by applying the regression model of competing risks by Fine and Gray, in which the event of interest was the death caused by Covid-19 and the competing event was recovery. The explanatory variables included in the multiple models are: gender, age at the beginning of the observation period, the Province of residence, and nursing home residency. The cause-specific hazard was estimated using Cox proportional hazard regression. RESULTS: during the observation period, 3,305 cases and 345 deaths were recorded in FVG; SIR and SMR resulted, respectively, equal to 0.64 (95%CI 0.61-0.68) and 0.43 (95%CI 0.37-0.50). The FVG was the Northern Region one with the lowest incidence and mortality. The cohort consisted of 3,121 residents in FVG with at least one swab with a positive Covid-19 result during the study period. The SHR of dying for Covid-19 is equal to 16.13 (95%CI 9.73-26.74) for people with age 70-79 years and 35.58 (95%CI 21.77-58.15) with age >=80 years respect those with age <70 years. It is higher in males (SHR 1.71; 95%CI 1.34-2.17). There is no evidence that being resident in a nursing home affects the SHR (SHR 0.91 and 95%CI 0.69-1.20). As regards the province as an explanatory variable, the sub-hazard of death in the province of Trieste appears to overlap to the sub-hazard of Pordenone used as a reference; for the provinces of Udine and Gorizia the sub-hazards seem lower than the reference. CONCLUSIONS: while other Northern Regions and autonomous Provinces show higher standardized incidence and mortality compared with Italy, FVG and Veneto do not. In FVG, male gender and age are important determinants of death while there is no evidence that the condition of guest in a nursing home increases the sub-hazard of death.


Subject(s)
COVID-19/mortality , Pandemics , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Geography, Medical , Humans , Incidence , Infant , Infant, Newborn , Italy/epidemiology , Male , Middle Aged , Nursing Homes/statistics & numerical data , Proportional Hazards Models , Residence Characteristics , Retrospective Studies , Risk Assessment/statistics & numerical data , Risk Factors , Sex Factors , Young Adult
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