ArticleBMC public health2019
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.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Socioecological Challenges of Polio Supplementary Immunization Activities (SIAs) in the Asia-Pacific Region: A Systematic Review.Journal of environmental and public health · 2023Pooled it
- A review on health system-based surveillance for acute flaccid paralysis: technological advancements, challenges, and outlooks.Journal of health, population, and nutrition · 2025Review
- Vaccination, Public Health and Health Communication: A Network of Connections to Tackle Global Challenges.Vaccines · 2025Article
- Family Medicine and Primary Healthcare: The Past, Present and Future.Healthcare (Basel, Switzerland) · 2023Article
- First Year of Special Issue "New Insights in Vaccination and Public Health": Opinions and Considerations.Vaccines · 2023Article
- COVID-19 and Digital Health: Evolution, Perspectives and Opportunities.International journal of environmental research and public health · 2022Article
- Controlling Infectious Risk in Transfusion: Assessing the Effectiveness of Skin Disinfection in Blood Donors.Healthcare (Basel, Switzerland) · 2022Article
- Knowledge and Behaviours towards Immunisation Programmes: Vaccine Hesitancy during the COVID-19 Pandemic Era.International journal of environmental research and public health · 2022Article
- New Insight in Vaccination and Public Health: A Commentary from Special Issue Editors.Vaccines · 2022Article
- Bayesian Analysis of Predictors of Incomplete Vaccination against Polio among Children Aged 12-23 Months in Ethiopia.International journal of environmental research and public health · 2021Article
- Web-based analysis on the role of Digital Media in Health Communication: the experience of VaccinarSinSardegna Website.Acta bio-medica : Atenei Parmensis · 2021Article
- Two-Source Capture-Recapture Method to Estimate the Incidence of Acute Flaccid Paralysis in the Marches Region (Italy).International journal of environmental research and public health · 2020Article
- Immunity status against tetanus in young migrants: a seroprevalence study.Acta bio-medica : Atenei Parmensis · 2020Article
- Reorganization of Active Surveillance of Acute Flaccid Paralysis (AFP) in Emilia-Romagna, Italy: a two-step Public Health intervention.Acta bio-medica : Atenei Parmensis · 2020Article
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7 authors.
Funding
Abstract
backgroundAcute 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.
methodsAFP 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).
resultsOver 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.
conclusionsAFP 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.
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