Biomedical subjects

T Stroffolini

Publications and source records attributed to T Stroffolini.

At least 127 records · Page 7Linked to original sources

PubMed1991

A high degree of exposure to hepatitis A virus infection in urban children in Cameroon.

In January 1989, the prevalence of antibodies to hepatitis A virus (anti-HAV) was determined by ELISA in 702 apparently healthy children 5-14 years old in Kumba City, Cameroon. Children were recruited from those attending six different primary schools, representative of the socio-demographic characteristics of the inhabitants, using a systematic random sampling. The overall IgG anti-HAV prevalence was 96.9%, reaching 100% by the age of 11 years. In primary school beginners the prevalence was very high, 94.0%, contrary to what has been observed in developed countries. The anti-HAV prevalence was not associated with family size, but was related to parent's occupation, children from the lower class having a 5.9 fold risk (C.I. = 1.9-18.3) of past exposure to HAV. These results suggest a persistently high prevalence of anti-HAV in children despite improving hygienic conditions. The spread of HAV in this population may be the result of domestic water and/or food contamination.

Adolescent↗

PubMed1991

Hepatitis-C virus infection in Italy: a multicentric sero-epidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver).

To assess possible geographical differences in the spread of hepatitis-C virus (HCV), the prevalence of antibodies against HCV (anti-C-100-3) was investigated in various adult population groups in 29 centres in Italy. Anti-HCV was positive in 375 out of 28,433 voluntary blood donors (1.3%): prevalence was higher in southern Italy (1.51%) than in the northern regions (1.28%), but the difference was not statistically significant. Anti-HCV prevalence was similar in the north and south in post-transfusion chronic hepatitis (91%), haemophiliacs (73%), intravenous drug users (70%), and haemodialysis patients (28%), where parenteral contacts are obvious, and in HBsAg carriers (14%), a group with evidence of previous parenteral contamination. In contrast, anti-HCV prevalences were found to be significantly higher in the south than in the north and central Italy among patients with hepatocellular carcinoma (HCC) (73 vs 59%), cryptogenic liver disease (67 vs 58%), autoimmune chronic hepatitis (72 vs 44%) and alcoholic liver disease (51 vs 34%). These results indicate a very high circulation of HCV in Italy, with maximum incidence in the south and in the islands. They suggest that its spread in the community can occur through inapparent parenteral routes as observed for hepatitis-B (HBV) and hepatitis-delta viruses (HDV) and possibly facilitated by poorer social-demographic and life-style factors.

Adult↗

PubMed1991

Meningococcal disease in Italy in 1990.

The incidence of meningococcal disease in Italy in 1990 was 0.5/100,000 in the general population and 0.7/100,000 in army recruits. The highest proportion of cases (32%) was seen in subjects 1-4 years old. The sex ratio was 1.0 Serogroup B constituted 72% of the isolates; 16% belonged to group A and 12% belonged to group C. The proportion of strains resistant to suphonamides was 56%, while no strain was resistant to minocycline or rifampicin. Two secondary cases, but no comprimary cases occurred among civilians. The predominance of serogroup B and the further decline in military cases constitute the findings of major interest.

Adolescent↗

PubMed1991

Prevalence of Toxoplasma gondii antibodies among children and teenagers in Italy.

Between 1987 and 1989, the prevalence of antibodies to Toxoplasma gondii was determined by ELISA in serum samples from 1,494 apparently healthy subjects, 3-18 years old. Subjects were selected by a systematic cluster sampling from five geographical areas in Italy. The overall prevalence of antibodies was 17.9%, increasing from 4.7% in 4-6 year olds to 28.4% in 17-18 year olds (P less than 0.01). A slight predominance was observed among males (18.2% vs. 17.5% in females), as well as among subjects residing in Southern Italy and the Islands (21.9% vs. 19.2% in subjects residing in the North), but neither difference was statistically significant. Toxoplasma infection was associated with sociodemographic factors. Subjects belonging to a household with six or more persons had a 1.8-fold risk (C.I. 95% = 1.3-2.6) and subjects whose fathers had less than six years of schooling had a 2.7-fold rosk (C.I. 95% = 1.8-3.9) of previous exposure to toxoplasma infection. Considering the large proportion (70%) of young women entering childbearing age without toxoplasma antibodies, it appears that the risk of congenital toxoplasmosis will not be negligible in Italy in forthcoming years.

Adolescent↗

PubMed1990

An outbreak of hepatitis A in young adults in central Italy.

Between September, 1988 and January, 1989 a common source outbreak of 47 cases of serologically confirmed hepatitis A occurred in a town of central Italy. Thirty-eight cases were primary, three co-primary and six secondary. The highest age-specific attack rate was seen in subjects aged 15-24 years (120 per 100,000); the mean age of cases was 24.6 years and the median age was 22 years. A matched triplet case-control study showed significant association between the disease and consumption of either raw mussels (41% of cases, compared with 10% of controls; P less than 0.0001) or a single brand of mineral water (63% of cases, compared with 41% of controls; P less than 0.05). The mean age of the cases reflects the shift in primary susceptibility to the infection from younger to older age groups, a finding which has recently been demonstrated by several seroepidemiological surveys in Italy.

Adolescent↗

PubMed1990

Changing patterns of hepatitis A virus infection in children in Palermo, Italy.

In 1988 in Palermo, Italy, the prevalence of antibodies to hepatitis A virus (anti-HAV) in a sample of 490 children 6-13 years old was 10.6%; it increased from 6.3% among children 6-10 years old to 14.7% in children 11-13 years old (P less than 0.01). Compared with findings from a survey conducted in 1978 in the same area, the results of the present study show a significant (P less than 0.01) reduction in the anti-HAV prevalence in both age groups. Anti-HAV prevalence was inversely related to the father's years of education and positively related to the family size. Children of fathers with less than 6 years of schooling had a 3.2-fold risk (C.I. 95% = 1.3-8.1), and children with five or more members in their households had a 2.7-fold risk (C.I. 95% = 1.1-6.4) of previous exposure to hepatitis A virus (HAV) infection. Our findings indicate that exposure of children in Palermo to HAV is decreasing significantly, probably because of improvements in socio-economic conditions during recent years; however socio-demographic factors appear to be important determinants of infection.

Adolescent↗

PubMed1990

Trends in meningococcal disease in Italy in 1988.

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.

Adolescent↗

PubMed1990

Vaccination campaign against meningococcal disease in army recruits in Italy.

A high attack rate (17.3/100,000) of meningococcal disease in army recruits in Italy, with 95% of the cases due to serogroup C, constituted the motivating factors to make bivalent serogroup A + C meningococcal vaccination compulsory by law for army recruits starting January 1987. Because the vaccine was given only to the new recruits entering the army, full coverage was not achieved until January 1988. Nearly 900,000 subjects (300,000 yearly) were vaccinated between January 1987 and December 1989. There were no reports of any untoward reactions to the vaccine. Of the 300,000 recruits in service each year, 52, 21, 15, 5 and 4 cases of the disease occurred in 1985, 1986, 1987, 1988 and 1989, respectively (P less than 0.001). Of the 24 cases occurring since the start of the vaccination, only two (due to serogroup C) were attributable to vaccine failure. The remaining cases were in unvaccinated recruits (15 cases) or were due to serogroups other than A or C (7 cases). The cumulative incidence of meningococcal serogroup C in the 600,000 vaccinated recruits during the period 1988-89 was 0.2/100,000 (1 case amongst 600,000 recruits), while the corresponding figure in the 600,000 unvaccinated recruits during the period 1985-6 was 11.3/100,000 (68 cases amongst 600,000 recruits) (P less than 0.001). The protective efficacy of the vaccine in 1987 was 91.2% (12 cases of meningococcal serogroup A and C disease from an average of 150,000 unvaccinated recruits observed for 1 year, and 1 case from the corresponding average of 150,000 vaccinated ones). In 1988 and in 1989 this figure could not be calculated because all recruits were vaccinated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Age-specific prevalence of hepatitis B virus infection among children in an endemic area in southern Italy.

In 1989 the prevalence of hepatitis B virus markers was studied by radioimmunoassay in a sample of 1,426 healthy children, 3 to 11 years old, attending kindergarten and the primary schools in a large urban area of the Apulia Region in Southern Italy, where the hepatitis B surface antigen (HBsAg) prevalence among pregnant women is 5.6%. The overall prevalence of any hepatitis B virus marker was 3.4%, increasing from 1.7% in 3- to 5-year-old children to 5% in 10- to 11-year-old children (P less than 0.002). Prevalence was not associated with the father's years of schooling (odds ratio, 1.98; confidence interval, 95% (0.9 to 4.6] or with the family size (odds ratio, 2.96; confidence interval, (0.7 to 11.8]. The overall HBsAg prevalence was 0.8, a rate that was lower than the 5.6% found in pregnant women. The finding of only 12 HBsAg-positive children of the 1,426 tested, despite 80 of them being born to HBsAg-positive carrier mothers (on the basis of the 5.6% HBsAg prevalence among pregnant women), is probably attributable to the low proportion (5%) of hepatitis B e antigen positivity among the HBsAg-positive carrier mothers in the study area. The observed low HBV infection rate in younger age groups, which confirms recent studies in other areas of Italy, appears to be the result of several factors: improved socioeconomic conditions; decreased family size; and increased use of disposable syringes in the last few years.

Age Factors↗

PubMed1990

Genomic fingerprints and phenotypic characteristics of strains of Neisseria meningitidis causing disease in Italy.

Since 1984 a change in the epidemiological pattern of meningococcal disease in Italy has occurred with a predominance of Neisseria meningitidis of serogroup C (76%), serotype 2a and a high proportion of strains resistant to sulfonamides (71%). To better understand the epidemiology of the group C N. meningitidis strains responsible for the disease over the last five years in Italy, we studied the DNA fingerprinting of 62 strains in combination with serotyping and sulfonamide susceptibility testing. The results show that the phenotypical features as well as the fingerprints of the strains studied were similar, suggesting the spread of a single clone in the patients studied. This is in agreement with the circulation of strains typical of epidemic situations, despite the decreasing incidence of the disease in Italy during the examined period.

DNA, Bacterial↗

PubMed1990

The effect of meningococcal group A and C polysaccharide vaccine on nasopharyngeal carrier state.

The effect of Neisseria meningitidis group A and C polysaccharide vaccine on nasopharyngeal carriage was studied in Italian army recruits. Throat swabs were cultured for N. meningitidis at the time of vaccination (one week after entry to service) and again three weeks later in a follow-up cohort of 98 men. At the first survey the overall carriage rate was 32% with 9% of isolates due to serogroup C, none to serogroup A and 17% to serogroup Y. At the second survey the overall carriage rate reached 52% (P less than 0.01); no isolate belonged to serogroup A or C, while serogroup Y reached 40% (P less than 0.01). The cumulative carriage rate was 65%. Out of the 64 carriers during the whole study period, only 7 (11%) belonged to the same serogroup during the two different surveys. The vaccination appears to influence the carriage rate of meningococcal specific serogroups. The inhibition of serogroups A and C is, however, offset by an increased prevalence of meningococci belonging to serogroup Y.

Bacterial Vaccines↗

PubMed1990

Meningococcal carriage and vaccination in army recruits in Italy.

The effect of Neisseria meningitidis group A and C polysaccharide vaccine on nasopharyngeal carriage was studied in the training center for army medical officers in Florence. Nasopharyngeal swabs were cultured for N. meningitidis at the time of vaccination (one week after entry to service) and again seven weeks later in a follow-up cohort of 171 men. During the two surveys the overall carriage did not showed significant difference (respectively 16% and 12%); while the percentage of isolates belonging to the serogroup C showed a significant reduction from 6% to 0.6% (P less than 0.01). No increased prevalence of meningococci belonging serogroups other than A or C was observed during the two surveys. The cumulative carriage was 20%. Out of the 35 carriers during the whole study period, only 5 (14%) belonged to the same serogroup. These findings show that meningococcal vaccine may inhibit the nasopharyngeal carriage of group specific meningococci in army recruits.

Bacterial Vaccines↗

PubMed1990

Five years of vaccination campaign against hepatitis B in Italy in infants of hepatitis B surface antigen carrier mothers.

The programme of the current vaccination campaign against hepatitis B in Italy considers the newborn of hepatitis B surface antigen (HBsAg) positive mothers to be high priority. Pregnant women are screened for HBsAg during the third trimester of pregnancy. All newborn of HBsAg positive women, regardless of the mother's status of hepatitis Be antigen (HBeAg), are given a single dose of hepatitis B immune globulin within 24h after birth and the first dose of hepatitis B vaccine within 7 days after birth. During the period 1984-1988 the percentage of pregnant women screened for HBsAg increased from 32% in 1984 to 71% in 1988 (P less than 0.001). The prevalence of HBsAg positive mothers was stable, ranging from 2.2% to 2.5%, but with wide regional differences (range 0.3%-6.4%). The screening compliance of pregnant women has been significantly better (P less than 0.01) in regions at a lower (less than 5%) HBsAg carrier rate. The percentage of children born to carrier mothers, who received active plus passive immunization, ranged from 75% to 85%. The number of infants immunized as percentage of those expected to be immunized (applying the observed prevalence of carrier mothers to the total number of deliveries by year) increased from 29% in 1984 to 62% in 1988 (P less than 0.01). No serious side effects were reported.

Carrier State↗

PubMed1990

Age-specific prevalence of hepatitis B virus infection among teenagers in Sardinia.

In 1989, the prevalence of hepatitis B virus (HBV) markers was studied using Elisa method in a sample of 1357 healthy high school 14-19 year old teenagers in Sardinia. The overall prevalence of any HBV marker was 4.7%, increasing from 3.6% among 14-16 year old teenagers to 5.7% in 17-19 year olds. The overall prevalence of hepatitis B surface antigen (HBsAg) was 1.1%, similar in both age groups. A slight male preponderance was observed (5% versus 4.4% for any HBV marker and 1.7% versus 0.6% for HBsAg, respectively). The prevalence of any HBV marker was not associated with the family size (O.R. 1.5; CI 95% = 0.6-4.5), but it was inversely related to the number of years of education received by the father. Teenagers whose fathers had received less than six years of schooling had a 2.3 fold risk (CI 95% = 1.1-5.2) of previous exposure to HBV infection. Comparing these findings with recent results in children and adults in the same area, a cohort effect is likely evident.

Adolescent↗

PubMed1990

Prevalence of hepatitis B markers among teen-agers in Friuli.

In 1989, the prevalence of hepatitis B virus (HBV) markers was studied by Elisa in 421 healthy teen-agers, 17-19 year old, in Udine, Friuli. The prevalence of any HBV marker was 2.4%, with a male predominance (3.8% vs. 0.5%). The prevalence of hepatitis B surface antigen (HBsAg) was 0.5% (2/421); both subjects were anti-Hbc IgM negative, with AST/ALT values in the normal levels, and males. The prevalence of any HBV marker was not associated with largest family size, nor with lowest father's years of schooling. These findings suggest a very low exposure to HBV infection in such area.

Adolescent↗

PubMed1989

Clearance of hepatitis B virus DNA and pre-S surface antigens in patients with markers of acute viral replication.

To clarify the relationship between the pre-S antigens and other serological markers of hepatitis B virus (HBV) replication, we followed up 27 patients: 21 presented with symptoms of acute hepatitis (two progressed to chronicity) and six suffered from chronic hepatitis. Pre-S1, pre-S2, HBV DNA, IgM antihepatitis core antigen (HBc), hepatitis B e antigen (HBeAg), and anti-HBe were detected in about 200 sera serially collected at different times for at least 6-12 months from the onset of clinical observation. In the early symptomatic phase of acute hepatitis, the pre-S1 and pre-S2 antigens were present in 95% of the cases and correlated well with high levels of alanine-transferase (ALT) and IgM anti-HBc, while HBV DNA was present in the sera of only six (28.6%) patients (P less than 0.0001). This was the first marker to disappear (1 month after the initial stage). All of the HBV DNA-positive patients were also HBeAg positive, whereas no HBeAg-negative subjects were found with serum HBV DNA. In the six chronic patients, pre-S antigens were always present independently of the HBeAg/anti-HBe status; HBV DNA was detected in three of them, even if transiently, and in two of these it reappeared together with pre-S2 epitope. The follow-up data suggest that, in acute hepatitis, the clearance of pre-S antigens can be considered as a prognostic index of clinical resolution and that, in chronic hepatitis, the persistence of pre-S antigens seems to indicate progression of the disease. In particular, pre-S2, in patients in whom it is intermittent, can be considered as an index of reactivation.

Acute Disease↗

PubMed1989

Hepatitis B virus infection in children in Sardinia, Italy.

Possible hepatitis B immunization of all newborns, regardless of the mother's HBsAg status, is a strategy under consideration for selected hyperendemic areas in Italy. Sardinia is one such area. However, in 1987 in Sardinia, the prevalence of hepatitis B markers in children under 11 years was estimated at 1.7% and the prevalence of hepatitis B surface antigen (HBsAg) at 0.2%. A much higher prevalence of HBsAg was recently observed among adults in this area: 8.7% among men and 5.2% among pregnant women. This contrasting pattern is unlikely to be due to bias: the sampling procedures adopted were appropriate and the percentage of refusals was very low (2.2%). The observed low hepatitis B marker prevalence in young age groups might be the result of a cohort effect due to the improved socio-economic conditions and changes in behaviour that have occurred in Sardinia over the last few years. The finding of only 3 HBsAg+ individuals out of 1,826 children tested, in spite of the 5.2% HBsAg prevalence among pregnant women in that region, is probably attributable to the low proportion of HBeAg positive individuals among the HBsAg+ carrier mothers in this area. At present, immunization of all newborns in Sardinia cannot be recommended.

Age Factors↗

PubMed1989

A nationwide vaccination programme in Italy against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers.

In order to prevent hepatitis B virus (HBV) infection of infants of hepatitis B surface antigen (HBsAg)-positive mothers, a nation-wide immunization programme was initiated in Italy in January 1984. During the first 3 years (1984-86), 651,667 out of 1726,000 pregnant women (37.8%) were screened for HBsAg; the percentage of mothers screened increased from 32% in 1984 to 51% in 1986 in 15 of the 21 Italian regions, where data by year were available. HBsAg was present in 15,640 mothers (2.4% of those screened); range by region 0.3-6.4%. All newborns of HBsAg-positive women, regardless of the mother's status of hepatitis Be antigen (HBeAg), were given a single dose (0.5 ml Kg-1) of a hepatitis B immune globulin within 24 h after birth and the first dose of plasma-derived hepatitis B vaccine within 7 days after birth. The immunization coverage rate was 80% in the 3-year period. Protective antibodies were found in greater than 97% of a sample of 1071 infants, immunized from different regions. No serious reactions were observed. On the basis of this field experience, it may be concluded that a nation-wide hepatitis B vaccination programme for infants of HBsAg-carrier mothers would be highly immunogenic and safe. Its implementation, however, requires continuous public education and cooperation from physicians.

Antibodies, Viral↗