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PubMed1997

Incidence of and risk factors for hepatitis A in Italy: public health indications from a 10-year surveillance. SEIEVA Collaborating Group.

BACKGROUND/AIMS: This study aimed to evaluate the incidence of and risk factors for acute viral hepatitis A (HAV) in Italy. METHODS: Data were from a surveillance system for type-specific acute viral hepatitis (SEIEVA). To estimate the association of hepatitis A cases with the potential risk factors (Odds Ratios) and the proportion of all hepatitis A cases attributable to a given risk factor (population attributable risk), hepatitis B cases were used as controls. Independent predictors of HAV were estimated by conditional multiple logistic regression. RESULTS: During the period 1985-1994, 25553 viral hepatitis cases were reported. Of these, 6408 (25%) were due to hepatitis A (HAV). HAV incidence declined from 10/100000 in 1985 to 2/100000 in 1987. Since 1991, however, an increase in HAV has been observed. The majority of cases were 15-24 years old; the incidence was higher in males and in subjects residing in southern Italy. Only one death (0.02%) was observed. Shellfish consumption was the most frequently reported risk factor (62%). The proportion of cases reporting personal contact with an icteric case, travel to a high-medium endemic areas, and family contact with a child attending a day-care centre (household of day-care child) was 17%, 19% and 15%, respectively. The results of multivariate analysis showed that shellfish consumption (OR=2.6; 95% CI=2.4-2.9), travel to endemic areas for people residing in northern and central Italy (OR=5.4; 95% CI=4.6-6.2) and household of day-care child (OR=1.2; 95% CI=1.03-1.4), were all types of exposure independently associated with HAV. The estimates of population-attributable risk show that shellfish consumption explained as many as 42.2%, travel to high-medium endemic areas for people residing in northern and central Italy 24.2%, and household of day-care child only 1.4% of all acute hepatitis A cases in Italy. CONCLUSIONS: These findings indicate that HAV in Italy is mainly a food-borne disease. Vaccination against hepatitis A is strongly recommended for travellers to endemic areas.

Adolescent↗
PubMed2003

The burden of COPD in Italy: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible, and progressive lung function decline. In Italy, an estimated 2.6 million men and women have COPD, and the disease causes around 18 000 deaths each year. In addition to mortality, morbidity from COPD results in substantial use of secondary healthcare resources. The burden of COPD in Italy may be due to the underdiagnosis of the disease by healthcare professionals, particularly in the early stages of the disease, and a lack of awareness among physicians of recommended treatment practices. In an attempt to address the need for information on the burden of COPD, a large-scale international survey, Confronting COPD in North America and Europe, assessed clinical outcomes, use of healthcare resources and loss of productivity in the workplace, and the economic cost of this disease in Italy and six other countries. In Italy, the economic analysis of the survey data showed that the mean annual cost of COPD to the healthcare system was Euro 1261.25 per patient Indirect costs were estimated at Euro 47.29 per patient, bringing the societal cost of the disease to Euro 1308.54 per patient. Three-quarters of the direct per patient cost of COPD in Italy were accounted for by inpatient hospitalizations (Euro 963.10), suggesting that interventions aimed at preventing exacerbations could alleviate the burden of COPD in Italy. The high impact of COPD on the Italian healthcare system is also likely to be a consequence of the underdiagnosis and undertreatment of the disease, suggesting that costs may be reduced by increasing the utilization of spirometry as a diagnostic tool, and improving physician adherence to treatment guidelines. Patients with severe COPD and other comorbidities showed higher costs (Euro 6366 and Euro 1861, respectively) than patients with mild disease (Euro 441) or no comorbidities (Euro 1021), underlying the importance of smoking cessation interventions to prevent disease progression.

Absenteeism↗
PubMed2005

Income inequality and mortality in Italy.

BACKGROUND: The relationship between income inequality and health remains controversial in terms of whether or not it exists and, if so, its extent and the mechanisms involved. This study examines the relationship between income inequality, as indicated by the Gini coefficient, and mortality in Italy. METHODS: Cross-sectional ecological study on the 57,138,489 inhabitants living in the 95 provinces existing in Italy in 1994. Multivariate weighted regression analysis of total and age-specific mortality, income inequality, gender, and interaction between income inequality and median income or geographical area. RESULTS: A positive association between income inequality and total mortality was observed for both genders in provinces with a low per capita income and in Southern and Central Italy. The effect was present for infants and for persons over 24 years of age; it was marked for the elderly, particularly women. A negative association with mortality was observed for males living in the North-west. Interactions between income inequality and median income, and between income inequality and geographical area were found. CONCLUSION: In Italy, the relationship between income inequality and health is mixed and not universal, in so far as a positive association was observed only in provinces with lower absolute income. Elderly persons living in Southern Italy represent the population subgroup most vulnerable to unequal income distribution. Income inequality can, in part, explain the historically higher mortality among women in Southern Italy compared to women in the North. These results indicate that income inequality affects the health of population subgroups differentially.

Adolescent↗
PubMed1994

An age and period reconstruction of the HIV epidemic in Italy.

BACKGROUND: The majority of AIDS cases in Italy are among intravenous drug users (68%) and homosexual men. An age, period and cohort (APC) model is presented and used to reconstruct the HIV epidemics in Italy. Projections of AIDS-related conditions (ARC) and AIDS cases are attempted based on a hypothesis of minima and an endemic hypothesis. METHODS: The model is a generalization of the usual back-calculation method which considers age, competitive mortality, susceptible population and therapy effects. Estimates of the HIV epidemic in Italy are obtained using Italian AIDS counts (corrected for delay in reporting), and an incubation time distribution (estimated from data of an Italian cohort), which was found to be dependent on the age at infection. The impact of AZT therapy, introduced in Italy in mid1987, is evaluated using a modification of the incubation time distribution dependent on period of infection. RESULTS: The estimated number of new infections in Italy declined after 1987, although the number of new AIDS cases has continued to rise, albeit less steeply in recent years. When delay in the progression to AIDS due to therapy is taken into account, the estimated number of people infected in mid1990 increases from 52,000 to 67,000, with approximately 12% of subjects already in the ARC stage. The age at maximum risk of infection is 25 years in males and 23 years in females. CONCLUSIONS: Using a hypothesis of no more HIV infections after 1990, AIDS counts would be still rising in Italy up to 1993 as a result of past infections and of the long incubation period.

AIDS-Related Complex↗
PubMed1983

Prevalence of hepatitis B markers in Italy.

Among 5005 Navy recruits aged 18-26 years from all sections of Italy, whose blood was tested in 1981, regional prevalence of serologic markers for hepatitis B was higher in southern Italy and in the Italian islands as compared with northern Italy and central Italy (4.3% vs. 2.3% for hepatitis B surface antigen (HBsAg) and 23.5% vs. 10.5% for any B marker). Social-demographic variables such as region, family size, and education were associated with hepatitis B as were the more traditionally associated variables related to blood or medical care such as history of intravenous injection, history of blood transfusion, or exposure to hospital. Number of siblings was positively related and educational attainment inversely related to prevalence of hepatitis B markers. The prevalence of HBsAg among Italian males aged 18-26 years with residence in southern Italy or in the Italian islands, whose education was limited to lower middle school, and who were from a family of eight siblings or more, is 14.6%. These are among the highest prevalence rates for hepatitis B antigen ever reported for a general population group in Europe. Good correlation exists between incidence of reported cases of hepatitis and prevalence of markers in the different regions of Italy.

Adolescent↗
PubMed1993

Regional and national variation in lung cancer mortality in Italy and Czechoslovakia.

In developed countries lung cancer mortality has been shown to be related to lifestyle, occupational and environmental aspects, diet, and other factors which may vary widely from one region to another. To investigate inter-area differences in lung cancer mortality and cigarette smoking a descriptive study has been carried out in three areas of Italy and two republics of Czechoslovakia. The highest death rates from lung cancer were found in the Czech Republic and Northern Italy, for both sexes. Analysis of age-specific rates by birth cohort, comparing all five areas, showed the greatest differences in trends between Slovakia and Northern Italy in men, and between the Czech Republic and Southern Italy in women. The lowest rates were observed in Southern Italy throughout the period under study, particularly among women. Making allowance for the latency period between the onset of exposure and the development of the disease, data on the occurrence of lung cancer could be interpreted looking at previous smoking habits. An imperfect overlap between the trend of cigarette smoking and the corresponding lung cancer mortality pattern was present in Northern and Southern Italy, a finding suggesting that even non-smoking-related factors could have played a significant role in lung cancer aetiology.

Adult↗
PubMed2005

Has the relation between income inequality and life expectancy disappeared? Evidence from Italy and top industrialised countries.

OBJECTIVE: To investigate the relation between income inequality and life expectancy in Italy and across wealthy nations. DESIGN AND SETTING: Measure correlation between income inequality and life expectancy at birth within Italy and across the top 21 wealthy countries. Pearson correlation coefficients were calculated to study these relations. Multivariate linear regression was used to measure the association between income inequality and life expectancy at birth adjusting for per capita income, education, and/or per capita gross domestic product. DATA SOURCES: Data on the Gini coefficient (income inequality), life expectancy at birth, per capita income, and educational attainment for Italy came from the surveys on Italian household on income and wealth 1995-2000 and the National Institute of Statistics information system. Data for industrialised nations were taken from the United Nations Development Program's human development indicators database 2003. RESULTS: In Italy, income inequality (beta = -0.433; p<0.001) and educational attainment (beta = 0.306; p<0.001) were independently associated with life expectancy, but per capita income was not (beta = 0.121; p>0.05). In cross national analyses, income inequality had a strong negative correlation with life expectancy at birth (r = -0.864; p<0.001). CONCLUSIONS: In Italy, a country where health care and education are universally available, and with a strong social safety net, income inequality had an independent and more powerful effect on life expectancy at birth than did per capita income and educational attainment. Italy had a moderately high degree of income inequality and an average life expectancy compared with other wealthy countries. The cross national analyses showed that the relation between income inequality and population health has not disappeared.

Adult↗
PubMed1999

The concept of 'glomerulonephritis'. the fascinating history of evolution and emergence of a specialist's nosology focus on Italy and Torino.

Though the term 'nephritis' first appeared in the 19th century, this word did not bear the same meaning as it does today; indeed, for many years it was used to indicate 'renal diseases' (in the sense of Bright's disease) in a larger sense. This review summarizes the long gestation of the concept of 'glomerulonephritis' from the prehistory of medicine up to the beginning of the second half of the 20th century with emphasis on Italy and, in particular, on Torino, which was the capital of the Kingdom of Italy from 1861 to 1865. To the best of our kowledge, this is the first study reporting an epidemiology survey of Bright's disease in Italy from 1880 up to 1960. Towards the end of the 19th century, Bright's disease accounted for 26 deaths/year/10(5) population (in comparison with more than 200 from tuberculosis) in Italy, roughly paralleling that reported in the USA. At the beginning of the 20th century, Bright's disease was the seventh cause of death (almost 1% of total deaths) in Italy. Furthermore, in Italy, as elsewhere, autopsy studies showed a higher percentage of deaths attributed to Bright's disease (5-7%) in comparison with those obtained from vital statistics. In 1960, just before the beginning of renal replacement therapy, Bright's disease accounted for 15.7 deaths/year/10(5) population (= 1.46% of all deaths), roughly paralleling that reported in the United Kingdom (13.8/10(5) population = 1.25% of deaths). Probably, it was difficult to recognize the real incidence of chronic renal diseases leading to death in the 1960s, and vital statistics were able to furnish only approximate estimates. However, noteworthy is the fact that these values were very close to those estimated as being the annual need for renal replacement therapy (10-20 cases/year/10(5) population).

Glomerulonephritis↗
PubMed2004

Skin reactivity to histamine and codeine in unselected 9-year-old children from Italy, Poland and Libya.

BACKGROUND: Previous studies have shown that histamine skin reactivity (the dimensions of a skin wheal elicited by a prick with histamine 10 mg/ml) in unselected school children has increased in Italy during the past two decades and is higher in Italy than in Poland. Hence this variable can probably be influenced by a changing or different lifestyle. The aim of this study was to compare skin reactivity to histamine and codeine (a marker of histamine releasability from mast cells) in schoolchildren from countries with different lifestyles. METHODS: Six previously unstudied unselected populations of 9-year-old schoolchildren (two each from Poland, Italy, and Libya; n = 863 subjects; 49.0% males) were pricked with two concentrations of histamine (10 and 1 mg/ml) and codeine (90 and 9 mg/ml). RESULTS: The higher concentrations of both pharmacologic agents tested yielded significantly different wheal areas in the three countries: Poland < Italy < Libya (histamine, 11.8, 16.1 and 20.7 mm2; codeine, 9.2, 13.2 and 16.2 mm2; p < 0.001 for all comparisons). The lower concentrations elicited almost matching results. Histamine wheal areas correlated closely with areas elicited by codeine in the same individual: angular coefficients of the histamine to codeine regression lines were 0.535, Italy; 0.551, Libya; 0.612, Poland; and 0.581 for the whole population. More histamine was needed to produce a wheal in Poland than in Libya: a 20-mm2 wheal required an injected histamine concentration of about 8.8 mg/ml in Libya, 29.5 mg/ml in Italy and 102.1 mg/ml in Poland. CONCLUSION: More studies are necessary to explain the observed international differences in skin histamine reactivity and their effect on the prevalence of positive allergen skin tests.

Child↗
PubMed1981

alpha 1-antitrypsin phenotype and gene distribution in Southern Italy.

Sera from 150 individuals from Southern Italy were screened for alpha 1-antitrypsin (alpha 1AT) types. The frequencies of the Pi alleles were compared with those found in Northern Italy and Central/Southern Italy. The PiS frequency in our sample (0.02667) was lower than that found in Central/Southern Italy (0.0670) but matched with the result obtained in Northern Italy (0.0297). The gene frequencies for subtypes of M in Northern and Southern Italy are presented.

Female↗
PubMed2003

Antibacterial resistance in Streptococcus pneumoniae and Haemophilus influenzae from Italy and Spain: data from the PROTEKT surveillance study, 1999-2000.

Antibacterial resistance was evaluated among Streptococcus pneumoniae (n=252) and Haemophilus influenzae (n=202) from two centres in Spain (Barcelona and Madrid) and two centres in Italy (Genoa and Catania) collected during 1999-2000 as part of the ongoing PROTEKT (Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin) international surveillance program. Pneumococcal nonsusceptibility to penicillin G was found to be considerably higher in Spain (53.4%) than in Italy (15.1%), whereas erythromycin A resistance was higher in Italy (42.9%) than in Spain (28.6%). Among macrolide-resistant isolates investigated for resistance genes, the prevalence of mefA was higher among isolates from Italy (20/51, 39.2%) than among Spanish isolates (2/38, 5.3%). All other macrolide-resistant isolates possessed ermB. Telithromycin possessed good anti-pneumococcal activity against isolates from both countries (MIC90 0.03 mg/L [Spain]; 0.25 mg/L [Italy]), irrespective of resistance to other antibacterials. Beta-lactamase production among H. influenzae was low: Spain, 10.9%; Italy, 1.8%. With the exception of ampicillin and co-trimoxazole, all H. influenzae isolates were highly susceptible to the antibacterials tested, and all were inhibited by telithromycin at a concentration of < or = 2 mg/L. The findings of PROTEKT 1999-2000 highlight the importance of local resistance patterns in guiding the choice of empirical antibacterials for community-acquired respiratory tract infections.

Anti-Bacterial Agents↗
PubMed1998

Detection of HGE agent-like Ehrlichia in Ixodes ricinus ticks in northern Italy by PCR.

Little is known about the distribution of Human Granulocytic Ehrlichiosis (HGE) in Europe and even less is known in Italy, where no case of clinically documented HGE has been reported. In a previous study we reported the presence of Ehrlichia DNA in Ixodes ricinus ticks from Central Italy. By the use of an Ehrlichia-specific PCR we found that 24% of the ticks were positive. Furthermore, we demonstrated a simultaneous coinfection of the same tick by both, Borrelia burgdorferi and Ehrlichia phagocytophila. Since the Friuli-Venezia Giulia region (North-east of Italy) is endemic for Lyme borreliosis (LB) and the geographic distribution of HGE usually overlaps that of LB, we decided to carry out a survey concerning the presence of Ehrlichia spp. in a recreational area near Trieste where the presence of Lyme borreliosis and Borrelia burgdorferi sensu lato in ticks is well demonstrated. Ticks were analyzed in pools (because a low infection rate was expected): eleven samples out of 93 were found positive by Ehrlichia-PCR. Subsequent sequence analysis of some of the positive PCR products revealed a high homology with the HGE agent Ehrlichia (only one base substitution in almost 450 bp sequenced). These findings add new and interesting data on the Ehrlichia epidemiology in Italy. By now we have demonstrated the presence of two distinct granulocytic ehrlichiae in Italiyn ticks by the aid of a PCR-based analysis: Ehrlichia phagocytophila in Central Italy and an HGE-like Ehrlichia in the north-eastern Italy, in a region close to Slovenia where the first reported case of HGE in Europe occurred.

Animals↗
PubMedDate not supplied

[Trends in mortality from primary pleural tumor and incidence of pleural mesothelioma in Italy: a particularly serious situation].

We present: a) an analysis of the past mortality from Primary Pleural Tumors (PPT) occurred in Italy between 1968 and 1992 by an age-cohort-period model, using a Poisson regression model, estimating the risk of dying by birth cohort, the Lifetime Cumulative risk (25-84 years) by birth cohort, the risk by calendar period and testing the full model (age-cohort-period effects); b) a summary of the incidence of mesothelioma as recorded in Italy by Cancer Registries and Mesothelioma Registries. The highest Lifetime Cumulative Risk of dying from TTP is recorded for the birth cohort 1946-'50 (6.2 per thousand among males, 1.64 among females). Whereas the risk by birth cohort becomes flat among females born after 1936, among males the risk is increasing up to the youngest birth cohorts. By calendar period, the highest risk of dying is observed in the last period (1991-'92). The inclusion in the full model of the calendar period term increases significantly the goodness-of-fit of the model among females, but not among males. The highest incidence of mesothelioma in both genders registered by 150 Cancer Registries all over the world is currently recorded among the population of Genoa and Trieste, where large ship-building plants are located. Even higher incidence mesothelioma rates have been recently recorded in other areas of Italy. The trend in PPT mortality in Italy could have been influenced, but not explained, by the increased awareness over time of the disease, but it fits well with the pattern occurring in most industrialized countries of western Europe, with the unprotected industrial use of asbestos which occurred in Italy, and also with the gender characteristics of the work-force employed in asbestos-exposing activities. A ban of asbestos use has been introduced in Italy in 1992. However, considering that asbestos seems to act as an initiator for mesothelioma, the trend in male mortality for PPT will not peak until two or three decades.

Adult↗
PubMed2002

Recent findings of Phlebotomus neglectus Tonnoir, 1921 in Italy and its western limit of distribution.

During the sand fly season of 2001, sand flies were collected in two different regions of Italy to investigate the northern distribution of Phlebotomus neglectus. The study areas were two provinces of northern Italy, Ivrea and Verona, in Piedmont and Veneto regions respectively. Sticky traps and CDC miniature light traps were used both inside and outside domestic and peri-domestic environments. Sand flies were also collected in domestic resting sites with mouth and electric aspirators. Of 1,295 sand fly specimens collected, 855 were from the Veneto region and 440 were from the Piedmont region. Five species of the genera Phlebotomus and Sergentomyia were identified. S. minuta (66.3%) was the most abundant sand fly followed by P. perniciosus (22.2%), P. neglectus (10.3%) and P. papatasi (1.2%). Only one specimen of P. mascittii was caught in Piedmont region. P. neglectus was found in 9 out of 15 (60%) of the sites where sand flies were found with a prevalence of 1.5% to 45.8%; the highest value was recorded in Piedmont region. P. neglectus was mostly associated with peridomestic and domestic sites. The results confirm previous observations on the presence of P. neglectus in northern Italy and suggest that this species is probably widespread in the area. From a review of all previous published and unpublished records of P. neglectus, it appears that this species is present in only two areas of the country, namely in the regions of Friuli Venezia Giulia, Veneto and Piedmont in northern Italy and the regions of Calabria, Apulia and Sicily in southern Italy. The apparent absence of P. neglectus in Central Italy is discussed and the resulting settlement through two probable migration routes from the East is analysed.

Altitude↗
PubMedDate not supplied

Area variations in birthweight- and cause of death--specific neonatal mortality rates in Italy.

The neonatal mortality rate in Italy is intermediate between the United States and the Northern European countries, but important regional differences exist within the country. On the basis of national data recorded by the Italian National Statistical Institute, birthweight- and cause of death-specific neonatal mortality rates were calculated for the whole country and for Northern, Central, and Southern Italy. The incidence of very low birthweight (500 to 1499 gm) and moderately low birthweight (1500 to 2499 gm) infants is similar in the three areas, whereas the risk of dying in the first month of life is highest in Southern and lowest in Northern Italy. Respiratory distress syndrome/immaturity is the main cause of neonatal death because of very high percent and component rates among very low birthweight infants and (to a lesser extent) among moderately low birthweight infants. Congenital disorders, which mainly affect normal weight newborns, are the second cause of neonatal death. Infants born in Southern Italy run a significantly higher risk of dying in the neonatal period than infants born in Northern Italy in almost all birthweight/cause of death subgroups, with the largest differences for moderately low birthweight infants. A similar but smaller difference is seen when infants born in Central Italy are compared with their Northern counterparts.

Birth Weight↗
PubMed1992

Survival of children with Down syndrome in Italy.

A cohort of 917 Down syndrome (DS) children born in Italy between 1978 and 1984 was studied for survival through the age of 8 years. The highest mortality occurred in the first month of life (7.9%); survival was about 80% at 1 year, 78% at 2 years, and 76% at 5 years, with small decreases thereafter. At the univariate analysis, survival was lower for subjects with congenital heart disease (CHD), birth weight less than 2,500 g, parity of 3 or plus, maternal age greater than or equal to 35 years, and for those born in Southern Italy compared with Northern Italy. No differences in survival were observed by sex and by socioeconomic status. The Cox proportional hazard model was used to evaluate the effect of each variable adjusted for all the others present in the model. Presence of CHD (odds ratio = 3.27; 95% confidence interval (C.I.) 2.31-4.63), birth in the South (odds ratio = 2.69; 95% C.I. 1.91-3.79), and low birth weight (odds ratio = 1.87; 95% C.I. 1.29-2.72) were independently associated with survival. None of the other variables emerged as a statistically significant prognostic factor. Various hypotheses were considered to interpret the unexpected effect of place of birth on survival. Quality of medical care provided in the South of Italy is the most likely determinant of the high mortality observed among children with DS born in that area of Italy. Such differences in survival within the same country could occur in other developed nations as well.

Animals↗
PubMed2003

Psychoanalysis and the Catholic Church in Italy: the role of Father Agostino Gemelli, 1925-1953.

Agostino Gemelli, a Catholic priest, psychiatrist, administrator, and educator, was an important figure in the early history of psychoanalysis in Italy. He was one of the few establishment figures to grapple with Freud's ideas in Italy during the first half of the twentieth century, a period during which Italy, compared to the rest of Europe and to the United States, was relatively impermeable to psychoanalysis. One of the factors that contributed to this was the opposition of the powerful Catholic Church, which identified in psychoanalysis a challenge to its authority. The author argues that Father Gemelli's shifting positions about psychoanalysis between 1925 and 1953 reflected the exigencies of his historical circumstances. Gemelli was able to identify in psychoanalysis an integrated view of the human condition in stark opposition to the brutal reductionism of psychiatry in Italy at that time, but also encountered in it elements intolerable to the Church. Examining specifically what it is that Gemelli could accept of psychoanalysis, and what needed to be rejected, between 1925 and 1953, illustrates the particular challenge posed by psychoanalysis to Catholicism in Italy.

Catholicism↗
PubMedDate not supplied

Baseline seroepidemiology of hepatitis A virus infection among children and teenagers in Italy.

During the period from May 1987 through November 1989, the prevalence of antibodies to hepatitis A virus infection (anti-HAV) was assayed by the ELISA method in the serum samples of 5,507 (54% males, 46% females) apparently healthy subjects three to 19 years old in Italy. Subjects were selected by a systematic cluster sampling in five different geographical areas of Italy. The overall prevalence of anti-HAV was 9.5%; it increased from 2.3% among children three to five-years-old to 16.3% in teenagers 17 to 19 years old (p less than 0.001). A slight preponderance of females was observed (10% versus 9.1%), but the difference was not statistically significant. The prevalence was significantly higher in Southern Italy than in Northern Italy (27.4% versus 4.8%; p less than 0.01). The prevalence of anti-HAV was inversely related to the fathers' years of schooling (O.R. 3.3; 95% C.I. = 2.5-4.2) and positively related to the family size (O.R. 2.4; 95% C.I. = 1.9-3.1). These findings indicate that, today, exposure to HAV infection at a young age in Italy is very low. However, sociodemographic factors are still important determinants in the spread of this infection.

Adolescent↗