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Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal

Although most countries in the WHO European Region were verified in 2017 as having interrupted endemic measles transmission, nine countries were still endemic. Among these, Italy accounted for the second highest number of measles cases reported in Europe in 2017. The elimination of measles is verifi...

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Autores principales: Adamo, Giovanna, Sturabotti, Giulia, Baccolini, Valentina, de Soccio, Pasquale, Prencipe, Grazia Pia, Bella, Antonino, Magurano, Fabio, Iannazzo, Stefania, Villari, Paolo, Marzuillo, Carolina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200208/
https://www.ncbi.nlm.nih.gov/pubmed/30356247
http://dx.doi.org/10.1371/journal.pone.0205147
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author Adamo, Giovanna
Sturabotti, Giulia
Baccolini, Valentina
de Soccio, Pasquale
Prencipe, Grazia Pia
Bella, Antonino
Magurano, Fabio
Iannazzo, Stefania
Villari, Paolo
Marzuillo, Carolina
author_facet Adamo, Giovanna
Sturabotti, Giulia
Baccolini, Valentina
de Soccio, Pasquale
Prencipe, Grazia Pia
Bella, Antonino
Magurano, Fabio
Iannazzo, Stefania
Villari, Paolo
Marzuillo, Carolina
author_sort Adamo, Giovanna
collection PubMed
description Although most countries in the WHO European Region were verified in 2017 as having interrupted endemic measles transmission, nine countries were still endemic. Among these, Italy accounted for the second highest number of measles cases reported in Europe in 2017. The elimination of measles is verified at national level by each country’s National Verification Committee (NVC) through the production of an Annual Status Update (ASU). Since in Italy decentralization has led to an inhomogeneous implementation of immunization strategies among the 21 administrative Regions, the Italian NVC proposed that measles elimination should also be documented at the subnational level through regional ASUs and Synthetic Regional Reports (SRRs). The regional ASUs and the SRRs for 2014, 2015 and 2016 were produced and appraised by the NVC to evaluate the Regions’ performances in each individual year as well as over the whole period. A specific analysis of vaccination coverage, including official immunization data for 2017, was performed. Moreover, the measles epidemic of 2017 was examined. Firstly, in the period 2014–2016, low immunization rates were registered in most Regions. Sixty-three per cent of southern Regions reported rates below the national mean and an overall low-quality performance. The approval of Italy’s mandatory vaccination law in 2017 resulted in a marked increase in vaccination coverage; however, this increase was not homogeneous among Regions. Secondly, more than 50% of Regions did not report any supplemental immunization activity (SIA) for the period 2014–2016. Thirdly, from 2014 to 2016, fewer than one-third of Regions improved their reporting of outbreaks. Finally, over the study period, only two Regions reached the target required by the WHO for measles laboratory investigations. In countries with decentralized health policies, subnational monitoring can help identify local barriers to measles elimination. In Italy it has highlighted the need for further SIAs and a stronger surveillance system.
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spelling pubmed-62002082018-11-19 Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal Adamo, Giovanna Sturabotti, Giulia Baccolini, Valentina de Soccio, Pasquale Prencipe, Grazia Pia Bella, Antonino Magurano, Fabio Iannazzo, Stefania Villari, Paolo Marzuillo, Carolina PLoS One Research Article Although most countries in the WHO European Region were verified in 2017 as having interrupted endemic measles transmission, nine countries were still endemic. Among these, Italy accounted for the second highest number of measles cases reported in Europe in 2017. The elimination of measles is verified at national level by each country’s National Verification Committee (NVC) through the production of an Annual Status Update (ASU). Since in Italy decentralization has led to an inhomogeneous implementation of immunization strategies among the 21 administrative Regions, the Italian NVC proposed that measles elimination should also be documented at the subnational level through regional ASUs and Synthetic Regional Reports (SRRs). The regional ASUs and the SRRs for 2014, 2015 and 2016 were produced and appraised by the NVC to evaluate the Regions’ performances in each individual year as well as over the whole period. A specific analysis of vaccination coverage, including official immunization data for 2017, was performed. Moreover, the measles epidemic of 2017 was examined. Firstly, in the period 2014–2016, low immunization rates were registered in most Regions. Sixty-three per cent of southern Regions reported rates below the national mean and an overall low-quality performance. The approval of Italy’s mandatory vaccination law in 2017 resulted in a marked increase in vaccination coverage; however, this increase was not homogeneous among Regions. Secondly, more than 50% of Regions did not report any supplemental immunization activity (SIA) for the period 2014–2016. Thirdly, from 2014 to 2016, fewer than one-third of Regions improved their reporting of outbreaks. Finally, over the study period, only two Regions reached the target required by the WHO for measles laboratory investigations. In countries with decentralized health policies, subnational monitoring can help identify local barriers to measles elimination. In Italy it has highlighted the need for further SIAs and a stronger surveillance system. Public Library of Science 2018-10-24 /pmc/articles/PMC6200208/ /pubmed/30356247 http://dx.doi.org/10.1371/journal.pone.0205147 Text en © 2018 Adamo et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Adamo, Giovanna
Sturabotti, Giulia
Baccolini, Valentina
de Soccio, Pasquale
Prencipe, Grazia Pia
Bella, Antonino
Magurano, Fabio
Iannazzo, Stefania
Villari, Paolo
Marzuillo, Carolina
Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title_full Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title_fullStr Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title_full_unstemmed Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title_short Regional reports for the subnational monitoring of measles elimination in Italy and the identification of local barriers to the attainment of the elimination goal
title_sort regional reports for the subnational monitoring of measles elimination in italy and the identification of local barriers to the attainment of the elimination goal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200208/
https://www.ncbi.nlm.nih.gov/pubmed/30356247
http://dx.doi.org/10.1371/journal.pone.0205147
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