Search PubMed⌕ Search

Biomedical subjects

T Stroffolini

Publications and source records attributed to T Stroffolini.

At least 127 records · Page 7Linked to original sources
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↗
PubMed1989

Trends in meningococcal disease in Italy 1987.

Meningococcal disease in Italy decreased 29% in 1987 from the previous year. The highest number of cases was seen in the 1-4 year-old age group (27%). The frequency in army recruits was 5/100,000, still higher than the 0.57/100,000 in the general population, but less than the 7/100,000 reported in the previous year. Sixty-three percent of the isolates belonged to serogroup C while serogroup B constituted 25%. The proportion of strains resistant to sulphonamides was 52.6%. Six strains were resistant to rifampin and none to minocyclin. No secondary cases occurred. These results are consistent with the trends reported in Italy in 1986. There were two findings of interest in 1987: the absence of secondary cases, attributable to the appropriate administration of chemoprophylaxis; and the decrease in military cases, reflecting the use of bivalent serogroup (A + C) meningococcal polysaccharide vaccine in all new military recruits since January 1987.

Cohort Studies↗
PubMed1989

Meningococcal disease in Italy.

In 1985, nationwide surveillance of meningococcal disease aimed at establishing appropriate guidelines for prophylaxis started in Italy. The incidence of disease was 1.1/100,000 in 1985 and 0.6/100,000 in 1987. This decreasing trend was particularly evident among military recruits (from 17.3/100,000 in 1985 to 5/100,000 in 1987), reflecting the use of bivalent serogroup (A + C) meningococcal polysaccharide vaccine in all new recruits since January 1987. The age distribution of cases was statistically different from that observed during the 1970s (P less than 0.001), with a shift towards older age groups. Men have been in the majority (516 vs. 358, P less than 0.0000001). Group C has been the most common serogroup encountered (72.2%), while only 18% of the isolates belonged to serogroup B. Among military recruits, serogroup C accounted for 92% (81/88) of the cases. The proportion of strains resistant to sulphonamides was 67%, while only 3% strains were resistant to rifampicin and to minocycline. Reduced susceptibility to ampicillin and to penicillin was observed in 3 and 4% strains respectively. Nine secondary cases were all due to failure in the administration of chemoprophylaxis (sulphonamide given in seven cases, prophylaxis not attempted in two cases). Immunisation of all new military recruits and effective chemoprophylaxis of close contacts of cases are the major guidelines provided by the National Meningitis Surveillance Programme.

Age Factors↗
PubMed1989

Hepatitis A virus infection in children in Sardinia, Italy.

The prevalence of antibody to hepatitis A virus (anti-HAV) in a sample of 1662 Sardinian children aged 3 to 11 years was estimated by ELISA. The overall anti-HAV prevalence was 3.8 per cent; it increased from zero among children of 3 to 7.2 per cent in children of 11 years. A slight male predominance was observed (4 versus 3.6 per cent). Anti-HAV prevalence was inversely related to the number of years of education received by the father and positively related to the number of households in the sample. Children whose fathers had received less than six years of schooling, had a 6.2-fold risk (Cl 95 per cent = 2.6-15.3) and children with five or more households under one roof had a 2.6-fold risk (Cl 95 per cent = 1.4-5.0) of previous exposure to hepatitis A virus (HAV) infection. These findings suggest that exposure of Sardinian children to hepatitis A virus is relatively low, probably because of improvements in socioeconomic conditions in recent years in the island. However, overcrowding and poor education in the father of schooling appear to be important determinants of infection.

Child↗
PubMed1987

A one year survey of meningococcal disease in Italy.

For the last ten years, meningococcal disease has been endemic in Italy with an annual average of 900 cases (rate of 1.6/100,000). The age specific attack rate has been highest for children under one year of age, and the majority of cases have been due to serogroup B. During 1985, the epidemiology of meningococcal disease changed substantially: twice as many cases were observed in males as in females. There was a shift toward older age groups, with the highest number of cases occurring in the 15-24 year old age group (25%). The frequency in army recruits was 17.3/100,000, as opposed to 1/100,000 for the general population. Serogroup C caused the majority of cases (75.8% of the isolates). The proportion of strains resistant to sulfonamides was 71.1%, while only one strain was resistant to rifampin and none to minocycline. Seven secondary cases occurred (2%): in five, chemoprophylaxis was inappropriate (sulfonamide), and in two, no drug was given. A single co-primary case was seen. We conclude that in Italy, the use of sulfa drugs as chemoprophylactic agents is not warranted at present, compulsory vaccination of army recruits with bivalent vaccine (A + C) is advisable, and the shift in age distribution of cases and the high predominance of serogroup C increases the need for careful surveys.

Adolescent↗