Department of Life, Health and Environmental Sciences, University of L'Aquila.
Ann Glob Health. 2019 Mar 19;85(1):40. doi: 10.5334/aogh.2455.
Measles is a highly contagious human infectious disease. It can lead to serious complications and often requires hospitalization. In Italy, as in other European countries, the goal of measles elimination in 2015 failed. To reach this target, identifying susceptible individuals, closing any immunity gaps and reaching adequate vaccination coverage is necessary.
To contribute to these purposes, a retrospective observational study on measles-related hospitalization between 2004 and 2016 in Italy was conducted, using the national hospital discharge database as informational flow.
Admission frequencies and hospitalization rates were compared between regions with low (<90%) and high (≥90%) vaccination coverage for measles at age 24 months. Categorical variables were analyzed using the χ2 test or the χ2 test for trend for ordinal variables; t test was performed to verify the significance when annual average hospitalization rates were compared. Trends of vaccination coverage and hospitalization rates were analyzed using the slope of the regression line.
During the study period, 9,546 measles-related hospitalizations were collected in Italy, with an average annual number equal to 734. The overall measles hospitalization rates increased from 0.21 × 100,000 persons in 2004 to 0.82 × 100,000 in 2016 (β = 0.04; p = 0.689). A shift of mean age (from 1-17 years to 18-44 years) of measles-related hospitalizations was shown. A number of admissions for the low vaccination coverage group about twice as much as recorded for the other regional group was shown (6,344 vs 3,202). The involvement of 18-44 age class in the high vaccination coverage group was 14% higher compared with the low vaccination coverage group, in which, however, the 1-17 age class presented a 16% higher frequency.
These findings confirmed that large measles epidemics continue to occur in Italy, although with regional differences related to different rates of measles immunization. Vaccination coverage >90% led to a halving of measles hospitalizations, but it is insufficient for the elimination: ≥95% coverage continues to be the target to be reached.
麻疹是一种高度传染性的人类传染病。它可导致严重的并发症，且通常需要住院治疗。在意大利，与其他欧洲国家一样，2015 年消除麻疹的目标未能实现。为了实现这一目标，有必要确定易感染人群、消除免疫空白并实现足够的疫苗接种覆盖率。
为了实现这些目标，本研究通过使用国家住院数据库作为信息源，对意大利 2004 年至 2016 年期间与麻疹相关的住院情况进行了回顾性观察研究。
对 24 月龄时麻疹疫苗接种率低（<90%）和高（≥90%）的地区进行住院频率和住院率的比较。使用卡方检验或有序变量的卡方检验趋势检验分析分类变量；当比较年平均住院率时，进行 t 检验以验证差异的显著性。使用回归线的斜率分析疫苗接种覆盖率和住院率的趋势。
研究期间，意大利共收集了 9546 例与麻疹相关的住院病例，年平均数量为 734 例。总体麻疹住院率从 2004 年的 0.21×100,000 人增加到 2016 年的 0.82×100,000 人（β=0.04；p=0.689）。麻疹相关住院病例的平均年龄（从 1-17 岁到 18-44 岁）出现了转移。低疫苗接种覆盖率组的住院人数约为高疫苗接种覆盖率组的两倍（6344 例比 3202 例）。高疫苗接种覆盖率组的 18-44 岁年龄组的参与率比低疫苗接种覆盖率组高 14%，而低疫苗接种覆盖率组的 1-17 岁年龄组的频率则高 16%。
这些发现证实，尽管意大利各地的麻疹免疫率不同，但仍会继续发生大规模的麻疹疫情。疫苗接种覆盖率>90%可使麻疹住院人数减半，但这还不足以消除麻疹：仍需将覆盖率≥95%作为目标。
