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We report an increase in the incidence of measles in a population with consistently high and improving immunisation coverage in Ferrara province, northern Italy. During the first six months of 2010, 19 cases were confirmed, 10 of which were hospitalised. General practitioners, paediatricians and local healthcare authorities were alerted about the outbreak and asked to notify all suspected cases. We need to further increase immunisation coverage and to maintain and implement the monitoring system.

Since 1996, the Emilia-Romagna Region has been promoting screening programmes for cervical cancer, selecting resident women aged 25-64 as a target population. This analysis concerns a second round of screening performed in the city of Ferrara and its province. A total of 103,971 women were invited to be screened, but only 55.51% of them arrived on the day of the scheduled screening. We therefore decided to investigate the reasons for this lack of participation using preliminary findings from the local screening program registry. These indicated that non-attendance was related to variables such as area of residence and age, and significant differences were observed between localities, with a consistently greater participation in industrial neighbourhoods and their surroundings than in rural areas. In order to elucidate these observations further, a crosssectional survey, placing special emphasis on setting, area of residence, age and level of education, was performed by structured telephone questionnaire, in order to identify the reasons behind non-attendance. Approximately 94% of the contacted women agreed to be interviewed, thereby demonstrating that a telephone interview is a valid means of collecting data in such cases. It should be noted that, among the women unwilling to respond to the questionnaire, a marked increase in percentage was observed for those resident in rural areas, of whom approximately 50% fell into the under-40 age group. The results of the survey indicated, as demonstrated by several previous studies, that age and the area of residence are both determining factors in the decision or not to participate in a screening programme. It was also observed that women who had completed the lower and upper secondary school education were shown to pay greater attention to health matters than those who had not., Journal of Preventive Medicine and Hygiene, Vol 48, No 4 (2007)

Background: Variations in the prevalence of respiratory symptoms according to geo-climatic factors could provide important clues to the knowledge of the aetiology of asthma. Methods: Geo-climatic variations in the prevalence of current asthma, allergic rhinitis and chronic cough, and phlegm were assessed on a random sample of 18 873 subjects (response rate = 72.7%) from different climatic regions of Italy. An ecological analysis, supported by robust statistical methods, was employed to investigate potential trends. Results: The prevalence of all symptoms was significantly heterogeneous throughout the peninsula. Only asthma-like symptoms showed a north–south trend: the prevalence increased at a decreasing latitude [odds ratio (OR) varies from 0.92 to 0.96, P

È ormai riconosciuto che bassa condizione socio-economica e limitato sviluppo culturale possono agire negativamente sul benessere individuale e sul livello di salute collettiva e determinano criticità nell’accesso alle cure, fenomeni che appaiono prevedibili, prevenibili e correggibili per migliorare la qualità e l’efficienza del sistema sanitario. Nell’area ferrarese sono presenti situazioni di svantaggio relativo non riconosciute e di difficile individuazione, il cui miglioramento si tradurrebbe in un beneficio sia per la condizione individuale che per la collettività.Obiettivi: la direzione sanitaria ed il Dipartimento di Sanità Pubblica dell’Azienda USL e l’Università degli Studi di Ferrara hanno dato vita al progetto “Osservatorio sulle disuguaglianze” allo scopo di sperimentare nuove modalità informative, più agili e tempestive delle rilevazioni censuarie, per individuare aree geografiche e/o fasce di popolazione verso le quali promuovere azioni di contrasto alle disuguaglianze in salute.Metodi: l’osservatorio prevede inizialmente tre sottoprogetti: 1. accesso agli screening femminili per definire i determinanti socio-ambientali e culturali delle donne non rispondenti; 2. salute neonati che, sulla base del nuovo certificato di assistenza al parto (CEDAP), mira a valutare situazioni di disuguaglianza in una fascia di età molto fragile; 3. coinvolgimento di medici di medicina generale (MMG), aderenti volontariamente all’indagine, nella raccolta sistematica di informazioni utili a monitorare il fenomeno delle disuguaglianze nella popolazione ferrarese. Risultati: l’attività dell’osservatorio è iniziata nell’aprile 2003 con l’elaborazione di un questionario da presentare alle donne non aderenti allo screening dei tumori del collo uterino e con la valutazione delle modalità di somministrazione del questionario (postale o telefonico) avvalendosi della collaborazione di tecnici della comunicazione.Conclusioni: a sperimentazione di nuove modalità informative per indagare la relazione tra svantaggio sociale e salute appare di fondamentale interesse per favorire opportune strategie di promozione della salute includendo un orientamento razionale delle risorse economiche e un miglioramento in efficacia e qualità del livello assistenzile.

The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings.This study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000.The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis.The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men, P.001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years, P.001) and a shorter duration of the disease (5.6 vs 16.1 years, P.001) than patients with current asthma. The probability of remission was strongly (P.001) and inversely related to the age at onset (62.8% and 15.0% in the10- andor =20-years age-at-onset groups, respectively).With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population.

Summary Rationale and objectives Response to mailed epidemiological surveys has decreased in recent decades. Since subjects with respiratory symptoms are usually early responders to surveys performed in Southern Europe, this trend could bias prevalence estimates. The present study aimed at evaluating the impact of non-response bias on prevalence estimates of respiratory symptoms and smoking habits. Methods In 9 centres, participating in the Italian Study on Asthma in Young Adults (ISAYA), random samples of people aged 20–45 years were administered a mailed questionnaire between 1998 and 2000. Non-responders were contacted again first by mail and then by phone. Cumulative response percentage was 30.5%, 52.4% and 72.7% (18,873/25,969), respectively, after the 1st, 2nd and 3rd contact. Results The prevalence of self-reported current asthma, asthma-like symptoms, and chronic cough/phlegm was more than halved from the first contact (5.6%, 17.8%, 14.6% respectively) to the third contact (2.7%, 6.4%, 6.9%). This pattern was less pronounced when considering allergic rhinitis and past asthma, whose prevalence decreased, respectively, from 21.5% to 15.6% and from 3.5% to 2.6%. At the same time the proportion of current smokers increased from 29.2% to 38%, while the proportion of ex-smokers decreased from 16.5% to 10.1%. In a multinomial logistic model current asthma, asthma-like symptoms, chronic cough/phlegm and smoking habits, and to a lower extent past asthma and allergic rhinitis, were significant predictors of late response. Conclusions In Italy when response percentage is low, the prevalence of current asthma, chronic cough/phlegm and ex-smokers is overestimated, while the proportion of current smokers is underestimated.