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 language | English |
|---|---|
| Article number | 1532 |
| Journal | BMC Public Health |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Nov 15 2019 |
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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 journal › Article
}
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 -