bluuebunny/crossref_metadata_2025 huggingface dataset:
Global health education in Europe: an insight into the student’s perspective
Authors: Oyedele I , Pagano M , Ferrante L , Serazzi F , Ertmer J , Lopedote L , Barbic F , Stranges S
Published: October 2024

Background

As the world grows ever connected, more importance is placed on aptness in Global Health. For medical students, incorporating social, environmental, cultural, and global issues in the curriculum is pivotal to their success as future medical professionals. In spite of this, students are dissatisfied with ongoing pedagogy. In review of existing evidence, we discovered that there is no set standard for European medical schools to follow in Global Health teaching. This is evidenced by variation in the course requirement and in the topical content covered. Consequently, students have self-perceived and actual gaps in their Global Health knowledge. Another point highlighted in our research was that despite the importance students have placed on Global Health education, they have viewed it as less relevant in comparison to other aspects of Medicine. To improve this lack of engagement, students have made suggestions that could potentially have a positive impact on teaching methods if they were to be implemented.

Objectives

Our background review and evidence gaps inspired us to conduct an online survey in our university. Examining this, together with reviewing existing evidence on student opinions and experiences from all over Europe, will give us the opportunity to uncover student sentiment towards Global Health education.

Results

Our survey is underway; its results will be discussed in our presentation.

Conclusions

In analysing existing survey results and in executing a survey in our medical school, we have gained some insight and understanding into the perspectives, knowledge gaps, and suggestions of medical students as concerns their Global Health education in Europe. These should be considered in forming and refining the Global Health curriculum of European medical schools.

Key messages

• Explore the attitudes and opinions of European students towards Global Health education.

• The medical student’s perspective should be considered to guide a better-suited education in Global Health across Europe; this is of the utmost importance in a now globalised world.
Public health resilience and recovery in Ukraine: Academic partnerships to improve population health
Authors: Aaronson W , Kolker J , Tomosky A , Fenchak A , Chapailo Y , Detsyuk O , Terenda N , Yurochko T , Smiyanov V , Savchuk R
Published: October 2024

Background

Strengthening the public health workforce is among top priorities for the transformation of Ukraine’s public health system. As part of the USAID Public Health System Recovery and Resilience Activity, an Academic Partnership Collaborative brought together three Ukrainian universities (National University Kyiv-Mohyla Academy, I. Horbachevsky Ternopil National Medical University, Sumy State University), two American universities (Temple University and Drexel University), and the All-Ukrainian Association of Public Health Specialists (UPHA) to enhance the competencies of public health graduates in Ukraine.

Objectives

The collaborative focuses on strengthening the Ukrainian universities’ public health curricula and the teaching and research competencies of the Ukrainian faculty, making the curricular changes in Ukraine better aligned with US and European academic standards. The university partners are collaborating with the newly established UPHA in building partnerships with peer organizations in the US (American Public Health Association) and Europe (EuPHA) and sharing advancements in public health education with the broader community of public health practitioners in Ukraine to enhance their competencies to improve population health and align with European systems of public health.

Results

We have established linkages among all partners via an initial meeting in Uzhhorod, Ukraine in April 2024. We anticipate results by November 2024 to include curriculum review recommendations, coaching on prioritized topics for the Ukrainian partners, faculty development plans, and the establishment of continuing professional development programs in collaboration with UPHA.

Conclusions

Through this partnership, selected Ukrainian universities will have an enhanced and sustainable capacity to train the public health workforce and will become leading examples for other public health programs to simulate and collaborate with beyond the project.

Key messages

• Ukraine’s resilience and recovery relies upon the strength of the current and future public health workforce; mechanisms for building public health training are essential to a healthy population.

• A collaborative process of strategic activities among American and Ukrainian universities and professional associations can be effective in building a resilient public health system in Ukraine.
Field Visits as a Pedagogical Tool to Understand Health Determinants
Authors: Morais Vilaça I , Sampaio Viana D , Ramos Castro M , Vicente A , Martins Machado C , França B , Pratas Valente C , Leão T
Published: October 2024

Background

Medical education often focuses on curative medicine, neglecting health determinants. Field visits, common in other educational contexts, enhance understanding of these factors. We aim to offer insights into pedagogical methods applicable to similar educational settings.

Objectives

Medical students completing an internship at the Gaia-Espinho Public Health Unit participated in field visits to enhance their understanding of health determinants. Guided through two economically distinct areas within a walkable distance of 2km, students documented health determinants through notes and photos. Discussions were held on-site and after visits integrating the real-world experience with theoretical frameworks. An inductive thematic analysis of students’ satisfaction and pedagogical effectiveness of the activity was performed on the internship reports from the 2023/2024 academic year.

Results

Out of 18 internship reports, 10 described the activity as positive and enriching, of which six highlighted it as a crucial part of the internship. Thirteen reports noted that the activity led to new perceptions about health determinants, and nine highlighted its practical value. Nine students included photos in their reports, bike paths being the most featured. Seventeen provided a clear description and listed the determinants they were able to detect. Discussions highlighted sensory experiences that are uniquely discernible through physical site visits including unpleasant odours, loud noises, and the cooling effect of blue areas on hot days. Three did not provide any evaluative comments, but correctly listed the determinants identified.

Conclusions

Field visits may enhance medical students’ understanding of health determinants, being recognized as an engaging pedagogical tool. Potential biases in assessments that rely on student satisfaction reports must be considered. Findings support the continuation and expansion of visits in other Public Health internships.

Key messages

• Field visits, used as a pedagogical tool, may enhance medical students’ ability to understand health determinants.

• User Field visits provide a new perspective on previously acquired theoretical knowledge regarding prevention.
Fairer Training in public health, the UK FPH example
Authors: Latif S , Fardon R , Chappel D , Vusirikala A
Published: October 2024

Background

Public Health (PH) advocates for health equity and social justice. The UK Faculty of Public Health (FPH) is committed to tackling inequalities across the public health career pathway. The Fair Training project is a multi-phased programme which focuses on fair recruitment into PH, reducing differential attainment during PH training and postgraduate examinations.

Objectives

• Analyse available data from various sources; • Identify gaps in fair training culture and any biases; • Identify where support or interventions may best be focussed to minimise disadvantages; • Identify improvements in data that could be used to monitor actions; • Identify areas of good practice. Variables explored were demographic characteristics e,g, age, sex, ethnicity, disability status, professional background, candidate status (UK or overseas), place of primary qualification.

Results

Results show that candidates from ethnic minority backgrounds, those who are older, from international medical graduate backgrounds and backgrounds other than medicine are under-represented at the end of recruitment. Multivariable analysis of the diplomate exam shows that an attainment gap exists across increase with age, and those from black, Asian or white other ethnicity, professional background other than medicine, and overseas candidates. For the membership exam, multivariable analysis shows the attainment gap persists across those of increasing age and black ethnicity.

Conclusions

Recognising differential attainment as a structural problem requires organisational and individual leadership. Recommendations include an action plan to ensure: • Equality of opportunity for learning and career progression; • Collaborative working to eliminate discrimination in the design of education; • Ensure that training and the working environment are inclusive and diverse; • Inform future PH workforce planning; • Share good practice. FPH will implement the recommendations and share with other organisations and countries.

Key messages

• Structural causes of differential attainment during recruitment and training in public health do exist and should be mitigated.

• FPH aims to promote Fair Training and excellence in public health practice.
The Critical Role of Perceived Academic Institutional Support among Students in a Divided Society
Authors: Satran C , Idilbi N , Arieli D , Ali-Saleh O , Halperin O
Published: October 2024

Background

To promote health equity, nursing schools must foster student diversity and develop future nurses’ abilities to care for patients from different backgrounds. Although academic experiences play an essential role in promoting multiculturalism, in Israel, where the Jewish-Arab divide is deep and central, this could be challenging. This study examined the attitudes of Israeli Jewish and Arab nursing students concerning their interactions across group lines.

Methods

In December 2022, 362 undergraduate students completed a survey on the association between cultural intelligence (CQ), satisfaction with the college’s support, and intergroup social interaction.

Results

The findings revealed that (1) Arab students (minority group) demonstrated higher CQ, especially regarding awareness of cultural differences and motivation for intercultural encounters; (2) Arab students perceived the intergroup encounter with Jewish students as closer and warmer than Jewish students; (3) Arab students’ satisfaction with the college’s support was higher than that of Jewish students; (4) Structural Equation Modeling revealed that (χ2/df=1.61, CFI=.970, TLI=.955, NFI=.927, RMSEA=.041) the support provided by the educational academic setting serves as a primary explanatory factor in the association between CQ and social distance.

Conclusions

Educational institutions should ensure their students feel supported to facilitate closer social interactions. This emphasizes the importance of proactive measures to encourage diversity and cultural competence in nursing education. Such efforts may positively impact the students’ mental health and enhance patient care.

Key messages

• To foster student social interaction in divided societies, academia must ensure a high sense of support.

• Proactive nursing education promoting diversity and cultural competence may benefit student mental health and patient care.
Exploring PrEP awareness among addiction service professionals: an Italian cross-sectional study
Authors: Lo Moro G , Rosset L , Varì M G , Scaioli G , Balestra R , Lucchini A , Bert F , Siliquini R
Published: October 2024

Background

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy. Since 2023, in Italy, PrEP has been subject to reimbursement, making it freely available to individuals who meet specific criteria, including those who engage in substance use during sexual activity (chemsex). In this context, all healthcare professionals (HCPs) in Addiction Departments and Services (ADS) play a crucial role from the intake interview in identifying potential PrEP candidates, providing an essential gateway to services. Thus, this study primarily aimed to explore the knowledge of ADS professionals regarding PrEP.

Methods

In 2024, an ongoing nationwide cross-sectional study has been conducted in Italy, enrolling a convenience sample of HCPs employed in ADS. The online questionnaire comprised items assessing knowledge regarding PrEP, training on PrEP, and experiences related to daily practice. The primary outcome was the awareness of PrEP existence, while secondary outcomes included knowledge regarding reimbursement.

Results

Preliminary analyses were conducted based on 269 questionnaires. Participants had a median age of 52 years (IQR=45-59). Physicians represented 26.0% of the sample, followed by nurses (23.0%). Awareness of PrEP stood at 43.5%, while knowledge of the existence of reimbursement conditions was at 29.9%. A vast majority (93.7%) felt inadequately informed, while 97.0% believed HCPs in ADS should receive training. Physicians demonstrated significantly higher awareness of PrEP existence, whereas there were no significant differences in reimbursement knowledge compared with other HCPs.

Conclusions

Intermediate findings revealed substantial gaps in PrEP awareness and reimbursement knowledge. These results emphasize the critical importance of tailored education and training programs to bridge these gaps and facilitate effective PrEP implementation in diverse healthcare settings, ultimately advancing HIV prevention efforts and promoting equitable access to care.

Key messages

• Substantial knowledge gaps about PrEP among healthcare professionals working in Addiction Departments and Services in Italy were highlighted.

• Effective PrEP implementation hinges on empowering professionals with the necessary expertise to identify and support PrEP candidates, underscoring the critical role of tailored education initiatives.
Pertussis seroprevalence and related factors in 15-49 years old women in Mersin, Turkey
Authors: Uguz B E , Bugdayci R
Published: October 2024

Background

Pertussis is an acute, contagious respiratory disease with high mortality and morbidity, especially in early infancy. If the mother is immune to pertussis, infants too young to be vaccinated are protected against pertussis infection after birth by maternal immunity. This study aimed to investigate pertussis seroprevalence and associated factors in women aged 15-49 years.

Methods

The cross-sectional study was conducted on women aged 15-49 years in Mersin city between December 2023 and February 2024. A total of 352 women from family health centres in four central districts of Mersin were included in the study. In this study, anti PT-IgG levels in blood samples were investigated by enzyme-linked immunosorbent assay ELISA method. In the analysis of the data, descriptive statistics, chi-square analysis, and binary logistic regression analysis were used. The results were presented at a 95% confidence interval, at a significance level of p < 0.05.

Results

Anti-PT IgG seropositivity was detected in 150 (%42.6) of the women. In seven (2%) of women, the anti-PT IgG value was greater than 100, indicating an acute infection. Individuals who did not receive or could not recall having received school vaccinations were found to be 2.18 times more likely to be seropositive than those who had received vaccinations at school. Individuals residing in the same household with a healthcare professional were found to be 1.78 times more likely to be seropositive than those who did not.

Conclusions

Half of our region’s newborns lack protection from whooping cough. Maternal immunization with pertussis-containing vaccines is crucial. Many countries have safely used such vaccines for years. Replacing Td with Tdap in Turkey’s pregnancy immunization can better shield mothers and newborns from pertussis.

Key messages

• Maternal immunization is crucial for protecting newborns from pertussis, reducing mortality and morbidity.

• Addressing vaccination disparities is vital to ensure community-wide protection against pertussis, saving lives.
Interventions to prevent Neonatal Healthcare-associated Infection: a systematic review of RCT
Authors: Reale C , Pistollato A , Ceparano M , Migliara G , Marzuillo C , Villari P , Baccolini V
Published: October 2024

Background

Healthcare-acquired infections (HAI) in neonatal intensive care unit (NICU) specifically refer to infections that occur in newborn infants within the healthcare environment. Preterm infants, often more vulnerable to infections, in the NICU may be exposed to various medical interventions, devices, and environments that can increase the risk of infections. This systematic review aims to evaluate the effectiveness of interventions proposed to prevent neonatal healthcare-associated infections.

Methods

PubMed, Scopus and Web of Science databases were searched to identify any RCT study coming from high income countries, published from 2004, that investigated the efficacy of any intervention to prevent HAI in NICU. All type of HAI were considered.

Results

A total of seven studies were included (2 from USA, 5 from UE). Three studies focused on: administration of donor milk; probiotic Bifidobacterium breve; intravenous Staphylococcus aureus immune globulin; all failed to demonstrate any protective action. Of the four remaining studies that investigate different aspect of the vascular catheterization process only two lead a a statistical significant reduction of HAI. Garland et al. demonstrate in 85 neonates how vancomycin-heparin lock solution is capable to reduce catheter related blood stream infection (CRBSI) 8/43 neonates (18.6%) in the control group vs 0/42 in the vancomycin-heparin-lock group (P = 0.006). Bertini et al. demonstrate in 86 preterm infants how utilization of AgION catheter in Umbelical vein catheterization (UVC) lead to CRBSI rate reduction (2 vs. 22%; p = 0.005), shorter hospital stay (p = 0.04), lower case fatality rate due to Blood stream infection (p = 0.01).

Conclusions

Among the proposed methodology only the one acting on the catheterization process provide a statistical significant reduction of HAI onset. Widespread observation of proposed protocol may results in reduction of HAI in NICU.

Key messages

• Modfiication on the catheterization process provide a statistical significant reduction of HAI onset.

• Knowing these measures assure reduction of HAI.
Evaluation of Covid-19 risk perception and psychological status of transplant patients
Authors: Baran A , Bağcı N , Aslan M , Akbulut S
Published: October 2024

Background

Liver transplant patients are in the more at-risk group in terms of COVID-19 infection and mortality due to both immunosuppressive treatment and underlying chronic diseases. The aim of this study was to evaluate the COVID-19 risk perception, compliance with preventive measures, and psychosocial status of liver transplant patients.

Methods

This descriptive cross-sectional survey study included 311 patients who underwent liver transplantation between 2002 -2021 and presented to the outpatient clinic for routine controls. Data were collected via a questionnaire administered through face-to-face interviews. The questionnaire form used to collect the data of the study included a demographic and clinical characteristics form, the Short Depression-Happiness Scale, the COVID-19 Prevention Guidelines Compliance Scale, and the COVID-19 Risk Perception Scale. The Mann-Whitney U, the Kruskal-Wallis test and Spearman’s Rho correlation analysis were used in statistical analyses.

Results

The median age of the transplant patients who participated in the study was 56 (18-76) years. Of the transplant patients, 84.9% stated that they had COVID-19 vaccination. There was a statistically significant, very weak relationship between the scores of the Brief Depression-Happiness Scale and the COVID-19 Compliance with Preventive Measures Scale (r = 0.132; p = 0.02), and a weak, significant relationship in the same direction between the scores of the COVID-19 Compliance with Preventive Measures Scale and the COVID-19 Risk Perception Scale (r = 0.344; p = 0.001).

Conclusions

The vaccination rates of the patients were high. As the depression status of the patients decreases, their compliance with preventive measures increases, and as their compliance with preventive measures increases, their risk perception increases.

Key messages

• Since transplant patients are a vulnerable group, their vaccination status is important in terms of mortality risk.

• Psychological factors such as depression-happiness scores influence adherence to COVID-19 preventive measures among transplant patients.
Methodological framework for early detection of dengue outbreaks in Tanzania
Authors: Belau M , Boenecke J , Ströbele J , Himmel M , Dretvic D , Mustafa U-K , Ahmad A A , Kreppel K S , May J , Becher H
Published: October 2024

Background

Dengue fever is a major public health problem because it is a widespread and rapidly transmitted mosquito-borne viral disease. We developed a framework for early detection of dengue outbreaks in Tanzania, starting with detection of suspected and/or confirmed cases, followed by site-specific risk characterization, both useful for planning and prioritizing outbreak interventions or epidemic preparedness.

Methods

Our initial focus was on the identification and categorization of indicators that are specifically tailored to the early detection and classification of outbreak events. The framework was then evaluated using (i) available cases with syndromic and laboratory-confirmed disease information from ProMED emails using decision tree analysis, and (ii) available historical dengue epidemic data at the local level from 2019 with 6,795 confirmed cases using negative binomial regression analysis adjusted for month and area.

Results

The laboratory-confirmed diagnosis (dengue yes or no) was consistent with the results of the suspected case classification algorithm for clinically defined syndromic cases. There was strong evidence of an increase in dengue cases with higher site-specific risk (rate ratio = 2.51 (95% CI = [1.76, 3.58])) when regressing confirmed dengue cases in 2019 as the dependent variable and site-specific risk as the independent variable.

Conclusions

The rapid dengue outbreak risk assessment developed may be useful in controlling the epidemic in Tanzania. The suspected case classification algorithm can be a very useful tool to better assess whether a potential dengue case is present and thus requires laboratory confirmation. The framework can be used to rapidly predict the risk of dengue outbreaks, which is useful for planning and prioritizing interventions or for epidemic preparedness.

Key messages

• Framework for a novel rapid risk assessment for early detection of dengue outbreaks in Tanzania.

• Framework relevant to epidemic preparedness.
Enhancing digital health competencies: insights from european human resources for health
Authors: Maia M R , Paulo M S , Lapão L V
Published: October 2024

Background

Mixed-skills for digital health transformation are critical for human resources for health (HRH). This study aimed to inform the design of new training programmes that address soft, hard and digital health skills.

Methods

Using a mixed-methods design science approach, focus groups were conducted by invitation and with informed consent, online or in-person. A script was prepared with key questions for orientation and facilitation, addressing the topics of current situation, desired situation, desired skills, practical and organisational needs to implement continuous training in healthcare. The collected data were analysed using Nvivo.

Results

Focus groups (14) had 87 participants (Norway, Latvia, Belgium, Italy and Portugal): 26 healthcare professionals (nurses, midwives, nutritionists, pharmacists, assistants and doctors); 27 managers or directors of hospitals and care centres; 34 experts (digital health specialists, researchers, technical officers, members of professional societies and national authorities). Real needs were identified, with 2 direct sub-themes that were best related to each other (Pearson coefficient, p > 0.40 - cluster analysis):

1. ‘Current situation’: Cybersecurity (eg. privacy, law and ethics); Time (work time versus private time, p = 0.69); Type (informal versus formal training, p = 0.32); Programmes (graduation, continuing education and post-graduation levels).

2. ‘Desired situation: Desired skills (eg. digital - basic ICT, data analysis, soft - communication, emotional intelligence, and hard skills - medication administration, catheters, ECG, vital signs, telehealth - digital stethoscope); Learning design and objectives (eg. collective learning, simulations, location - peer-to-peer and hybrid); Emergency care and the link between primary and secondary levels of care were considered important.

Conclusions

These findings of convergence among HRH inform Program design process to support the training programs and course syllabus design.

Key messages

• The identified needs and priorities inform Program design further to support Digital Health Transformation training programs and course syllabus design.

• Real needs points to Current and Desired situation, where HRH give important insights that need to be considered to engage people to perform training courses.
Do the prevention procedures work in reducing infections?
Authors: Viti F , Perinti R , Cartocci A , Lazzeri G , Nante N
Published: October 2024

Introduction

Healthcare-associated infections (HCAIs) pose significant challenges in healthcare settings. Poor environmental hygiene contributes to HCAI. This study aims to evaluate and to assess the effectiveness of HCAI containment practices in nursing homes (NH).

Methods

The study examined infection prevention procedures in eight NHs supervised by the Multidisciplinary Commission of the Tuscany South-East Local Health Authority of Italy. Infection frequencies were obtained from NHs management and compliance with preventive procedures was assessed by inspection reports. Infection prevention protocols, including cleaning and disinfection procedures, were referenced from ministerial guidelines for hospital and territorial facilities. Comparisons was done whit Mann-Whitney test, using STATA.

Results

In 2023 more frequent infections were SARS-CoV-2 (19.5%), urinary tract infections (17%), pharyngitis (15.7%), influenza-like syndromes (ILI) (15%), and pneumonia (9%). Compared to 2022, significant improvements were observed in legionellosis surveillance, laundry, sanitary procedures, instrument disinfection, and hairdressing services. Non-compliance to specific procedures revealed differences in infectious onset like cleaning process verification with fungal infections (P = 0.01; M = 2,5), gastrointestinal infections (P = 0.04; M = 1.5); cleaning sanitary pans with Clostridium Difficile gastrointestinal infections (P = 0.04; M = 2); instrument disinfection with gastrointestinal infections (P = 0.04; M = 1.5) conjunctivitis (P = 0.01; M = 8); laundry procedures with pneumonia (P = 0.04; M = 18) and ILI (P = 0.04; M = 35).

Conclusions

These findings emphasize the importance of well-defined procedures in reducing HCAIs. While preventive measures demonstrate efficacy, continuous efforts are necessary for their consistent implementation. Continuous monitoring and stakeholder engagement are essential for developing sustainable strategies in preventing healthcare-associated infections.

Key messages

• Healthcare-associated infections are a significant complication in the healthcare sector and require effective practices in nursing homes.

• Prevention measures are effective, but continuous and collaborative effort is needed to ensure their uniform implementation and develop more effective strategies in preventing HCAI.
ESPRIT study, analysis of the results of the pre-intervention survey in upper secondary schools
Authors: Gazzetta S , Brunelli L , Comar M , Suligoi B , Salfa M C , Gianfrilli D , Sesti F , Casuccio A , Ferro P ,   ESPRIT study collaboration group
Published: October 2024

Background

Sexually transmitted infections are a major public health problem, and their number is increasing in Italy. However, affective sexuality education is not yet part of the curricula. Therefore, a project entitled ESPRIT was launched, involving 3 regions (Friuli-Venezia Giulia, Lazio and Sicily), the IRCSS ‘Burlo Garofolo’ and the Istituto Superiore di Sanità, and implemented with the technical and financial support of the Ministry of Health - CCM.

Methods

A multicenter prospective intervention study was designed involving public upper secondary school students (grade 10-11). All target groups completed a KAP (knowledge, attitude, practice) questionnaire before and after participation in the educational intervention to measure its effectiveness. The questionnaires from the first phase were collected between January and April 2024, and the results were analyzed using R statistical software.

Results

The analysis of the overall results (463 students in total; female 58%, male 39%, other 2%; FVG 49%, Lazio 25%, Sicily 26%) showed that the group of upper secondary school students, targeted by peer education answered the knowledge part correctly by 56.6±13.8% on average. Applying the Kruskal-Wallis test showed that the percentage was significantly higher for females than males (p-value=0.005) and for licei students compared to technical and vocational schools (p-value=0.000). In terms of to attitudes, only 17% of students talked at length about sexually transmitted infections, and in 86.6% of cases, the interlocutors were friends or peers.

Conclusions

The results of the first phase show differences between the sexes and between the different types of educational institutions. The current level of knowledge still leaves much room for intervention and improvement. Analyzing the results of the follow-up phase will allow us to understand the effectiveness of the peer education intervention.

Key messages

• Adolescents’ knowledge of sexually transmitted infections needs to be improved.

• Gender and the type of school attended affect the level of knowledge.
Estimating the impact of the COVID-19 vaccination programme in Ireland: December 2021-March 2023
Authors: Marron L , Mateo-Urdiales A , O’Donnell J , Robinson E , Domegan L
Published: October 2024

Background

In Autumn 2023, COVID-19 booster vaccines were offered to all those aged ≥50 years in Ireland. There was concern that vaccine fatigue would impact uptake. We aimed to quantify the direct impact of the COVID-19 vaccination programme on averted outcomes in individuals aged ≥50 years, during a period of Omicron variant dominance, to inform vaccination strategy and public health communication.

Methods

We conducted a retrospective observational study from December 2021 to March 2023 in Ireland. We considered as averted outcomes symptomatic SARS-CoV-2 presentations to primary care, emergency department (ED) presentations, hospitalisations, intensive care unit (ICU) admissions and deaths due to COVID-19. We used an adapted formula from other vaccine impact published studies, including national data on notified outcomes, vaccine coverage data and vaccine effectiveness (VE) estimates, sourced from the WHO’s live systematic VE review, to estimate the count and prevented fraction of outcomes in ≥ 50-year-olds averted by the COVID-19 vaccination programme. The number of expected outcomes in the absence of vaccination was calculated by summing the counts of outcomes observed and outcomes averted.

Results

Between December 2021 and March 2023, the COVID-19 vaccination programme averted 48,551 symptomatic presentations to primary care (36% of expected), 9,517 ED presentations (53% of expected), 102,160 hospitalisations (81% of expected), 3,303 ICU admissions (89% of expected) and 15,985 deaths (87% of expected).

Conclusions

During Omicron dominance, the COVID-19 vaccination programme averted symptomatic and severe outcomes, including deaths due to COVID-19, underscoring the benefits of COVID-19 vaccination. In the context of vaccine fatigue emerging as an important public health issue in Ireland and internationally, these findings can inform future COVID-19 booster vaccination programmes and communication about the reason for and importance of COVID-19 vaccination.

Key messages

• The COVID-19 vaccination programme in Ireland prevented illness and death in people aged ≥50-years. Vaccination therefore protected population health and the healthcare system.

• These findings can be used to inform future COVID-19 vaccination policies, planning for winter, pandemic preparedness and communisation about the importance of ongoing COVID-19 vaccination programmes.
Factors associated with mosquito-borne disease protective behaviour in metropolitan France
Authors: Ocampo-Alvarado J , Dussault J , Mueller J
Published: October 2024

Background

Mosquito-borne diseases (MBD) are increasing and expanding their range throughout metropolitan France. Promoting individual protective behaviour is imperative, but research on its determinants is limited to southern regions. This study examines factors influencing MBD protective behaviour in the metropolitan French population.

Methods

2,087 subjects responded to a self-administered online questionnaire in November 2023. The analysis plan was pre-registered. We fitted two mixed effects models to estimate the frequency and count of protective behaviours across sociodemographic groups and to identify which factors predict protective behaviour.

Results

Frequency of protective behaviour is significantly positively associated with getting bitten by mosquitoes often (β = 3.39; 95% CI: 3.10, 3.69) and sometimes (β = 1.54; 95% CI: 1.31, 1.76) compared to almost never, perceived MBD threat (β = 0.11; 95% CI: 0.06, 0.15), and having financial difficulties (β = 0.23; 95% CI: 0.02, 0.43). Count of protective behaviours is associated with getting bitten by mosquitoes often (β = 0.39; 95% CI: 0.30, 0.49) and sometimes (β = 0.14; 95% CI: 0.05, 0.23), perceived MBD threat (β = 0.02; 95% CI: 0.00, 0.03), MBD knowledge (β = 0.06; 95% CI: 0.04, 0.08), and having a chronic disease (β =  0.08; 95% CI: 0.02, 0.14). Models were adjusted for place of residence, education, and age. No associations were found between sex, having experienced an MBD, or confidence in public authorities to manage health crises.

Conclusions

This study provides the first insights into MBD protective behaviour and its associated factors considering all metropolitan French regions. Our results highlight several factors which may inform MBD prevention communication and policies focused on increasing individual protective behaviour.

Key messages

• People often bitten by mosquitoes are more likely to engage in more frequent and a higher number of mosquito-borne disease protective behaviour than people almost never bitten by mosquitoes.

• Higher perceived mosquito-borne diseases threat is associated with more frequent and a higher number of mosquito-borne disease protective behaviour.
Uncovering Prognostic Clinical Phenotypes in Children and Adolescents with SARS-CoV-2 Infection
Authors: Shi Y , Strobl R , Berner R , Armann J , Scheithauer S , Grill E
Published: October 2024

Background

Characterizing clinical phenotypes is important for classifying patients, predicting disease outcomes, and adapting treatment. We aimed to identify distinct clinical phenotypes among hospitalized children and adolescents with SARS-CoV-2 infection and to evaluate variations in prognosis across these phenotypes.

Methods

The DGPI (German Society of Pediatric Infectious Diseases) registry serves as a nationwide, prospective registry for children and adolescents hospitalized with a SARS-CoV-2 infection in Germany. We applied hierarchical clustering and integrated variables such as sex, SARS-CoV-2-related symptoms, pre-existing comorbidities, clinically relevant coinfection, and SARS-CoV-2 risk factors to describe distinct clinical phenotypes. Subsequently, we applied a multinomial logistic regression model to examine the association between these phenotypes and discharge status.

Results

The DGPI registry encompassed 6983 patients and facilitated the identification of six distinct phenotypes for children and adolescents with SARS-CoV-2. Phenotype A had a similar symptom pattern as the total sample. Predominant symptoms of patients with other phenotypes were gastrointestinal (95.9%, B), asymptomatic (95.9%, C), lower respiratory tract (49.8%, D), lower respiratory tract and ear, nose and throat (86.2% and 41.7%, E), and neurological (99.2%, F). Patients with phenotype C had lower odds of residual symptoms (OR: 0.10 [0.06, 0.15]) than those with phenotype A, whereas patients with phenotype D and E had higher odds of residual symptoms (OR: 1.33 [1.11, 1.59] and 1.91 [1.65, 2.21], respectively) than those with phenotype A. Patients with phenotype D were significantly more likely (OR: 4.00 [1.95, 8.19]) to have an unfavorable outcome, compared to patients with phenotype A.

Conclusions

We could show that the identified phenotypes could facilitate early risk assessment and aid in tailoring individualized patient management strategies.

Key messages

• Six distinct clinical phenotypes existed in children and adolescents with SARS-CoV-2 infection.

• Phenotypes could assist in risk evaluation and help personalize patient care.
Preventive interventions on vector-borne diseases related to climate change: an Umbrella review
Authors: Fevola G , Valz Gris A , Ricciardi W , Gualano M R
Published: October 2024

Background

Vector-borne diseases (VBDs) are a global challenge to public health, being influenced by ecological factors and climate change. Despite the several preventive public health interventions that can be implemented, the evidence of their impact is still fragmented. An organic overview of the current evidence can provide relevant information on the effectiveness of these actions.

Methods

We conducted an umbrella review following the PRIOR checklist. Relevant reviews were searched using PubMed and Cochrane databases. We considered eligible all systematic reviews published in English between 2013 and 2023, containing meta-analysis on public health interventions aimed at reducing incidence, prevalence, or the burden of disease of VBDs, without demographic restrictions.

Results

We screened 1971 records. 51 reviews were included. 38 reported outcomes targeting Malaria, 9 Dengue, 2 Yellow Fever, 1 Leishmaniasis,1 Zika, 1 Chikungunya, 1 Crimean-Congo haemorrhagic fever, 1 Lyme disease and 1 Schistosomiasis. Several interventions were assessed worldwide. 18 reviews considered chemoprophylaxis, 9 net/curtains, 8 vaccines, 6 repellents, 3 housing interventions, 2 community participation, 2 MTaT and 2 oral supplementations. Authors stated conclusions are favourable to the interventions assessed for the 73%, but the certainty level is mostly considered low.

Conclusions

Public health preventive interventions are fundamental in responding to the threat of VBDs, but their impact may vary depending on several factors. Further research must provide more effective interventions and strategies, with a cohesive presentation of their evidence.

Key messages

• Effective reduction of VBDs burden requires a combination of interventions that must be tailored to local ecological, social, and epidemiological factors.

• Evidence presented in this umbrella review can inform evidence-based policies and programs aimed at combating VBDs at local, national, and global levels.
Risk perception survey for healthcare-associated infections in a large teaching hospital in Rome
Authors: Paolini R , Fei G , Carlomagno L , De Santis A , Orlandi S , De Giusti M
Published: October 2024

Background

Healthcare-associated infections (HAIs) are the main complications of hospitalization. The goal of the study was to enhance awareness, improve risk perception, and facilitate measures to reduce the outcomes of HAIs. A bottom-up approach, in which the healthcare workers involved play a key role, can be adopted to decrease the spread of HAIs. Therefore, a survey was conducted in a large teaching hospital in Rome from 2019 to 2023, excluding 2020 due to COVID-19.

Methods

A longitudinal study was conducted in all integrated care departments with beds. The data was collected using a standardized, anonymous, self-administered questionnaire for healthcare workers. The questionnaire consisted of 61 items assessing socio-professional features, knowledge of HAIs, attitudes and barriers to hygiene compliance, self-analysis of professional behavior and advice for new interventions. The study lasted 21 days between November and December, which is considered a period of normal care activity. A multivariable logistic regression model was built. Statistical analyses were performed with STATA 18.0.

Results

There were 384 health workers respondents: female (67.7%) and nurses (56.5%). The most represented areas were internal medicine (37.9%) and surgery (27.3%). The correct frequency of perception of HAIs increased from 33.3% in 2019 to 36.3% in 2023. From 2022 to 2023, the multivariable model showed that physicians (OR 0.48, CI 95% 0.24-0.93, p-value 0.03) and elder staff (OR 1.02, CI 95%, 1.0-1.1, p-value 0.04) seemed to be more aware of the prevalence of HAIs in their ward.

Conclusions

Targeted training days were organized after the study to discuss the data collected. Staff awareness of the prevalence of HAIs in their ward is improving, even if it is complicated to quantify it by attending HAIs training events. The survey has been included as a corporate goal for 2024 as a useful tool to improve awareness of HAIs and to evaluate the effectiveness of ongoing training.

Key messages

• A bottom-up approach, in which healthcare workers assume a pivotal role, can be employed to reduce the spread of HAIs as it serves as a valuable tool to evaluate the efficacy of targeted training.

• The results indicate that the education of healthcare workers is a crucial factor in enhancing awareness of HAIs. Therefore, there is a need to improve the education of younger and non-medical staff.
Enhancing port preparedness in Germany in the event of infectious diseases – a best practice study
Authors: Frese M , Neumann J , Boldt M , Ehlers L , Dirksen-Fischer M , Gueye S , Bäßler J , Harth V , Heidrich J
Published: October 2024

Background

The maritime sector is exposed to specific risks in the area of communicable diseases. In Germany, five ports are designated to enforce the International Health Regulations (IHR) and must have certain core capacities to respond immediately to cross-border health threats. A joint external evaluation conducted by the World Health Organization (WHO) revealed a need to reinforce central structures in Germany. The overarching objective of the study is to harmonize and consolidate the requisite capacities for maritime health security.

Methods

Qualitative interviews (n = 35) at baseline were conducted with various stakeholders, including port medical services, port authorities and other stakeholders. The parameters to be analysed included specific activities and interfaces during infectious incidents, experience with past infection incidents, training and exercise, and the need for action. Furthermore, a document analysis was conducted, during which the existing contingency plans and standard operating procedures were reviewed.

Results

In essence, the initial challenges posed by the COVID-19 pandemic have led to the establishment of well-defined procedures and interfaces between the various stakeholders involved. There is a necessity for enhanced interpersonal communication between the various stakeholders and the implementation of sustainable training practices. Furthermore, greater transparency and standardisation of regulations in international health emergencies is desired.

Conclusions

Given the infrequency of cross-border infection incidents on board ships, targeted preparation within stakeholders is often given a lower priority than other work priorities. The participatory study design is intended to develop comprehensive concepts in collaboration with the IHR ports in the ongoing project. Subsequently, these concepts will be tested in tabletop exercises and incorporated into training formats for public health actors.

Key messages

• The qualitative interview study at baseline revealed a substantial need for sustained communication and training practices among stakeholders for infectious disease preparedness in German IHR ports.

• The document analysis revealed relevant differences in the extent and scope of contingency plans of German ports designated under the International Health Regulations.
Whooping cough – a recurrent epidemic
Authors: Coelho P , Torres C , Gonçalo J , Cordeiro E , Dantas M M , Pimentel J P
Published: October 2024

Background

Whooping cough (WC), or Pertussis, is a vaccine-preventable and highly contagious infectious disease. Although it has a relatively low fatality rate, approximately 13% of reported cases develop secondary bacterial pneumonia. This was because of several recurrent epidemics across Europe in the last decades, with the latest beginning in mid-2023 and still ongoing. The Central Region of Portugal is currently being affected, and this study aims to describe the current epidemic at the regional level.

Methods

Data from epidemiological inquiries of confirmed and probable cases of WC pertaining to the Central Region of Portugal from January 2020 till April 2024 was gathered from the mandatory report national epidemiological surveillance system (SINAVE). Both a temporal comparison of number of cases and a statistical space-time scan with permutation were conducted (software SaTScan v10.)

Results

A comparison by month of reported cases shows an increase in cases from September 2023 until December 2023 followed by an exponential increase from January 2024 until April 2024 denoting an ongoing epidemic. In the statistical space-time analysis of 107 reported cases between September 2023 and April 2024, 8 nonsignificant clusters were identified with different locations involved in non-overlapping periods.

Conclusions

The finding of several unrelated clusters, even though nonsignificant, during a short time period indicates that Pertussis transmission is ongoing at the local level probably through asymptomatic or barely symptomatic cases that act as reservoirs. Clinicians must hold a high clinical suspicion for a timely diagnosis, treatment and report and health authorities must reinforce control measures to limit the spread of this disease.

Key messages

• Pertussis remains a disease of significant concern recurrent outbreaks across Europe show that public health local authorities have an important role in timely management of cases and outbreaks.

• Local level transmission and intervention may play a pivotal role in the epidemiologic dynamic of Pertussis.