Evaluation of a standardised protocol to measure the disease burden of respiratory syncytial virus infection in young children in primary care.

BACKGROUND: A better understanding of the burden of respiratory syncytial virus (RSV) infections in primary care is needed for policymakers to make informed decisions regarding new preventive measures and treatments. The aim of this study was to develop and evaluate a protocol for the standardised measurement of the disease burden of RSV infection in primary care in children aged < 5 years. METHODS: The standardised protocol was evaluated in Italy and the Netherlands during the 2019/20 winter. Children aged < 5 years who consulted their primary care physician, met the WHO acute respiratory infections (ARI) case definition, and had a laboratory confirmed positive test for RSV (RT-PCR) were included. RSV symptoms were collected at the time of swabbing. Health care use, duration of symptoms and socio-economic impact was measured 14 days after swabbing. Health related Quality of life (HRQoL) was measured using the parent-proxy report of the PedsQL™4.0 generic core scales (2-4 years) and PedsQL™4.0 infant scales (0-2 years) 30 days after swabbing. The standardised protocol was evaluated in terms of the feasibility of patient recruitment, data collection procedures and whether parents understood the questions. RESULTS: Children were recruited via a network of paediatricians in Italy and a sentinel influenza surveillance network of general practitioners in the Netherlands. In Italy and the Netherlands, 293 and 152 children were swabbed respectively, 119 and 32 tested RSV positive; for 119 and 12 children the Day-14 questionnaire was completed and for 116 and 11 the Day-30 questionnaire. In Italy, 33% of the children had persistent symptoms after 14 days and in the Netherlands this figure was 67%. Parents had no problems completing questions concerning health care use, duration of symptoms and socio-economic impact, however, they had some difficulties scoring the HRQoL of their young children. CONCLUSION: RSV symptoms are common after 14 days, and therefore, measuring disease burden outcomes like health care use, duration of symptoms, and socio-economic impact is also recommended at Day-30. The standardised protocol is suitable to measure the clinical and socio-economic disease burden of RSV in young children in primary care.

HIV awareness: a kap study among students in Italy reveals that preventive campaigns still represent a public health priority.

BACKGROUND: Improving knowledge about HIV/AIDS among young people is crucial for preventing new infections. The aim of the study was to investigate knowledge, attitudes and practices regarding HIV infection among students attending university courses related to the healthcare professions, in order to better target future preventive and informative HIV campaigns tailored for young people. STUDY DESIGN: A knowledge, attitude and practices study was conducted among university students attending the following university courses in Bari (Southern Italy): Medicine and Surgery (MS), Dentistry and Dental Prostheses, Health Assistance, Motor Activities and Sports Sciences, Sciences and Technology of Herbal and Health Products, Nursing, Biomedical Laboratory Techniques, and Dietetics. METHODS: Students completed a self-administered questionnaire designed to assess their knowledge/attitudes re/ HIV and their own sexual practices. The general part of the questionnaire requested information about age, gender, nationality, religion and marital status. The second part included questions asking about knowledge, attitude and practices with respect to HIV, which required true/false answers or graduated answers (reported as agree, quite agree, quite disagree, and disagree). RESULTS: Four hundred students were invited to fill in the questionnaire. The response rate was 91.2% (n=365). Almost all students were aware that HIV is transmitted through sexual intercourse and blood, but only 34% knew that breastfeeding is a route of transmission. Of the respondents, 86.8% referred to previous sexual intercourse (25.8% reported using a condom in all cases of sexual intercourse, 43.5% in most cases, 18.6% rarely and 12.1 never). Sexual intercourse with casual partners was reported by 37.5% of these students and 63.9% of them did not always use a condom. CONCLUSIONS: The results of the study show that knowledge about some aspects of HIV is insufficient even though the students participating in the present study are students attending university courses related to the healthcare professions. Moreover, high-risk behaviors as the lack of the use of condom during sexual intercourse with casual partners are also common among interviewed students. Programs aimed at providing information that can prevent/reduce transmission of HIV in young people and new strategies to improve knowledge should be stressed as a public health priority.

Surveillance of new HIV infections/diagnoses in Puglia region (south Italy), years 2007-2011.

BACKGROUND: The aim of the study is to describe temporal trend, distribution and characteristics of new HIV infections detected in Puglia Region in years 2007-2011. METHODS: Case surveillance data for all individuals newly diagnosed with HIV infection in these years were analysed. Risk factors associated with late presentation at diagnosis were analysed by multivariate logistic analysis. RESULTS: In the years 2007-2011 a total of 632 new diagnoses of HIV infection were notified. 573 (90,7%) of all cases were residents (83,8% Italians, 16,2% migrants). Among residents, 76,8% were males (median age 36 years), 23,2% females (median age 30 years). On the whole, 58,3% were late presenters (LP) and 40,8% were subjects with advanced HIV disease (AHD). At multivariate analysis, older age and being a migrant were risk factors significantly associated with late presentation at diagnosis. CONCLUSIONS: Clinical-epidemiological analysis of new HIV diagnosis/infections in Puglia shows a high proportion of LP and AHD. The results of the study strongly suggest the need to promote access to counselling and screening services of subjects at high risk of late presentation for a better targeting of information campaigns.