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

Regional Reference Centres of the National Surveillance System for Acute flaccid paralysis

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number1532
JournalBMC Public Health
Volume19
Issue number1
DOIs
Publication statusPublished - Nov 15 2019

Fingerprint

Poliomyelitis
Paralysis
Italy
Hospital Records
Myelitis
Encephalomyelitis
Neuritis
Muscular Diseases
Encephalitis
Sicily
International Classification of Diseases
Databases

Keywords

  • Acute flaccid paralysis
  • Hospital discharge records
  • National surveillance system
  • Polio

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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. / Regional Reference Centres of the National Surveillance System for Acute flaccid paralysis.

In: BMC Public Health, Vol. 19, No. 1, 1532, 15.11.2019.

Research output: Contribution to journalArticle

@article{5b0d3c498fa94a47897469fc75527772,
title = "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",
abstract = "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.",
keywords = "Acute flaccid paralysis, Hospital discharge records, National surveillance system, Polio",
author = "{Regional Reference Centres of the National Surveillance System for Acute flaccid paralysis} and Paola Stefanelli and Stefania Bellino and Stefano Fiore and Stefano Fontana and Concetta Amato and Gabriele Buttinelli and Filippo Ansaldi and Sandro Binda and Laura Pellegrinelli and Guglielmo Bonaccorsi and Chiara Lorini and Silvio Brusaferro and Barbara Camilloni and Benita Capannolo and Cristiana Mancini and Valter Carraro and Paolo Castiglia and Antonella Arghittu and D’errico, {Marcello Mario} and {De Stefano}, Carlo and Alfredo Foc{\`a} and Cinzia Germinario and Angela Larocca and Giammanco, {Giovanni M.} and {De Grazia}, Simona and Grasso, {Guido Maria} and Daniela Lombardi and Francesca Russo and Giuseppina Napoletano and Francesca Zanella and Silvia Spertini and Licia Veronesi and Paola Affanni and Maria Triassi and Francesca Pennino and Francesco Vairo",
year = "2019",
month = "11",
day = "15",
doi = "10.1186/s12889-019-7617-0",
language = "English",
volume = "19",
journal = "BMC Public Health",
issn = "1471-2458",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - 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

AU - Regional Reference Centres of the National Surveillance System for Acute flaccid paralysis

AU - Stefanelli, Paola

AU - Bellino, Stefania

AU - Fiore, Stefano

AU - Fontana, Stefano

AU - Amato, Concetta

AU - Buttinelli, Gabriele

AU - Ansaldi, Filippo

AU - Binda, Sandro

AU - Pellegrinelli, Laura

AU - Bonaccorsi, Guglielmo

AU - Lorini, Chiara

AU - Brusaferro, Silvio

AU - Camilloni, Barbara

AU - Capannolo, Benita

AU - Mancini, Cristiana

AU - Carraro, Valter

AU - Castiglia, Paolo

AU - Arghittu, Antonella

AU - D’errico, Marcello Mario

AU - De Stefano, Carlo

AU - Focà, Alfredo

AU - Germinario, Cinzia

AU - Larocca, Angela

AU - Giammanco, Giovanni M.

AU - De Grazia, Simona

AU - Grasso, Guido Maria

AU - Lombardi, Daniela

AU - Russo, Francesca

AU - Napoletano, Giuseppina

AU - Zanella, Francesca

AU - Spertini, Silvia

AU - Veronesi, Licia

AU - Affanni, Paola

AU - Triassi, Maria

AU - Pennino, Francesca

AU - Vairo, Francesco

PY - 2019/11/15

Y1 - 2019/11/15

N2 - 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.

AB - 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.

KW - Acute flaccid paralysis

KW - Hospital discharge records

KW - National surveillance system

KW - Polio

UR - http://www.scopus.com/inward/record.url?scp=85075050854&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85075050854&partnerID=8YFLogxK

U2 - 10.1186/s12889-019-7617-0

DO - 10.1186/s12889-019-7617-0

M3 - Article

C2 - 31730455

AN - SCOPUS:85075050854

VL - 19

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 1532

ER -