Journal of Preventive Medicine and Hygiene (JPMH)
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Implementing surveillance in territorial healthcare facilities: a proposal from ASST Nord Milano (Italy)
Full text linkNot applicable (Letter
Communication and Cholera Morbus: measures and fears in 19th Century Italy in the face of an unknown evil. Medical ignorance and ideological paradigms unchanged over time
Full text linkAbstract. The arrival of Cholera Morbus in Europe and Italy elicited a prompt institutional reaction. Starting in 1831, preventive measures characteristic of the plagues of the “Ancien Régime” were reactivated. The new disease triggered several instinctive and irrational reactions in the population, which resulted in the most diverse fears: fear of death, of doctors, of food, isolation, and abuse of food and alcohol. Ignorance of the origin of the disease, its etiology and modes of transmission meant that containment measures and treatment were often inefficacious. When patients recovered from the disease, this was due more to their living conditions and underlying state of health than to medical treatment, which was still limited to bloodletting, purgatives, and natural remedies (as emerges from the data from 1835 in the archives of the Genoese hospitals). As revealed by the pamphlets distributed around 1830, the disease was attributed to dietary disorders, personal and domestic hygiene, damp environments, menial occupations, and exposure to cold.
The medical theories of the time were still closely bound to the “miasmatic-humoral paradigm”, as the discoveries of Filippo Pacini, (1812-1883), John Snow (1813-1858) and Heinrich Hermann Robert Koch (1843-1910) had not yet been made. As for preventive measures at the institutional level, “contagionist” theories prevailed, which meant that sanitary cordons were reintroduced, safety measures (e.g. quarantine on people and goods) were implemented and great attention was placed on cleansing and disinfecting streets and public places.
Background. For centuries, Cholera Morbus was endemic to the territory of Bengal; only with the revolution in transport, starting from 1817, did the disease first spread beyond India [1], replacing the plague as the “scourge of urban populations” [2]. Cholera was localized in Asia until 1817, when a first pandemic spread from India to other regions of the world. Endemic in Asia, (in the delta of the Ganges-India), it remained enclosed to that geographical area until the beginning of the 1800s. It first emerged from the Sundarbans Forest where the bacterium Vibrio cholerae had perhaps been mutating for millennia.
It afterwards moved to the Mediterranean and Europe as new commerce routes were opened up between East and West and in the 1830s, Western Europe was faced with this totally new and unknown evil [3], which appeared in Italy in 1835
In memory of Ryan White, the boy with haemophilia who showed the world the other side of AIDS Lest We Forget…
Full text linkIn the 1980s, AIDS triggered a huge wave of fear, as always happens when unknown, deadly diseases emerge. The fact that gay men were among the first to be infected with HIV and to manifest the disease prompted public opinion to link the infection to behaviours that were, at least at that time, transgressive and therefore unacceptable and shameful. AIDS sufferers were therefore exposed to discrimination from the outset.
The case of young Ryan White prompted much-needed reflection in the mid-1980s. Born with a severe form of haemophilia, Ryan contracted AIDS through the therapeutic administration of an infected blood product. This demonstrated that AIDS was not a disease that affected only homosexuals and drug users; it could strike anyone.
Through the story of Ryan White, an “innocent victim” of AIDS, the authors highlight the changes that occurred between the 1980s and 1990s, and which led civil society – as well as researchers – to modify its perception of the disease.
This was no easy process, since discrimination and stigma have deep roots, exerting a cascading effect that is very difficult to counteract, and which sometimes proves even more harmful than the disease itself
Assessing Health System preparedness for dog mediated rabies in South-East Asia Region
Full text linkIntroduction. Rabies is one of the major public health challenges in the South-East Asia Region (SEAR), which is home to diverse populations where close human-animal interactions are common, creating a conducive environment for the transmission of dog mediated rabies. The scoping review intended to assess the health system preparedness of WHO South-East Asia Region countries, for dog mediated rabies, focusing on prevention, detection, and control efforts.
Methods. The published literature was searched using PubMed, Embase, and Scopus databases, focusing on studies published from January 2013 to November 2023. The inclusion criteria encompass primary studies published in English between January 2013 and November 2023 focusing on health system preparedness for prevention, control, and elimination of dog-mediated rabies in SEAR.
Results. A total of 178 studies were reviewed. Over the years, significant improvements were seen among most SEAR countries, but countries like Myanmar and the Democratic People’s Republic of Korea, have limited published evidence on health system preparedness for dog-mediated rabies. Most of the countries need to focus on various aspects like vaccine availability, inter-sectoral collaboration, robust rabies surveillance and reporting system for both humans and animals, strengthening of laboratory capacity and responsible dog ownership to be in alignment with the global goal of “Zero by 30” of ending dog mediated human rabies deaths by 2030.
Conclusion. Each SEAR country demonstrates distinctive strengths and challenges in the elimination of rabies. However, incorporation of inter-sectoral coordination and strengthening the rabies surveillance system by linking both animal and human contribute to the control efforts in South-East Asia countrie
The role of specific nutrients in preventing immune system and blood cell disorders: an umbrella review
Full text linkIntroduction. Nutritional deficiencies affecting the immune and haematopoietic systems represent a well-known global public health challenge: only the iron deficiency anaemia affects 1.62 billion individuals, especially in vulnerable populations. However, the protective effect that nutrition might give on disorders of these systems is still poorly understood. This umbrella review aims to synthesise the available evidence on the effectiveness of nutritional interventions in the primary prevention of blood and immune disorders, with a focus on the role of essential micronutrients and bioactive compounds.
Materials and methods. The protocol for this review was registered on PROSPERO (registration number 535785). A systematic search was conducted on PubMed, Web of Science, Embase and Cochrane until April 2024, using MeSH terms and keywords related to nutritional interventions, preventive effects and immune and haematopoietic system disorders. The search strategy followed the PRISMA guidelines for umbrella reviews. Two independent review teams performed the screening and data extraction, while a third reviewer resolved any disputes. Methodological quality was assessed using the JBI Critical Appraisal Checklist, risk of bias was analysed using the tools ROBINS-E for non-experimental studies, ROBIS for systematic reviews and RoB 2 for RCTs. The quality of evidence was assessed according to the GRADE approach.
Results. Of the 1028 articles identified, 13 met the inclusion criteria after systematic screening. Considering specific infection rates, vitamin D supplementation showed a significant protective effect (OR 0.88, 95% CI 0.81-0.96), with particular efficacy in deficient subjects (< 25 nmol/L). Zinc showed significant preventive efficacy (RR 0.68, 95% CI 0.58- 0.80), especially in nasal formulations. Multiple micronutrient interventions demonstrated synergistic effects in reducing iron deficiency (RR 0.44, 95% CI 0.32-0.60) and vitamin A deficiency (RR 0.42, 95% CI 0.28-0.62). The methodological quality of the included studies was high, with JBI scores ranging from 9.5 to 11/11, indicating a solid evidence base.
Conclusion. The evidence supports the effectiveness of nutritional interventions in boosting the immune system, with particular relevance for vitamin D and zinc supplementation. The multiple micronutrient approach emerges as a promising strategy, especially in more-at-risk populations. Both individualised approaches and public health interventions are recommended. Future research should focus on optimising nutrient combinations and identifying predictive biomarkers of response for the primary prevention of blood and immune disorder
Digital Resources as a Tool for Physical Activity Promotion and Attendance among University Students: a Pilot Study
Full text linkBackground. Various digital resources (DR) to support people in staying physically active have recently been developed and diffused, especially among young people. Our study aimed to evaluate how the epidemiological scenario determined by the COVID-19 pandemic may have influenced the current methods of carrying out physical activity (PA) among university students.
Methods. An online survey was conducted to analyze DR usage habits as a tool useful for PA attendance before, during, and after the COVID-19 pandemic. Data from the World Health Organization (WHO)-5 questionnaire and the Body Mass Index were also collected.
Results. The survey, conducted on 656 university students (77.0 % female, 22.2 % male, 0.8 % not specified), revealed increased use of DRs during the confinement period, from 21.3% to 74.3%, as expected. Interestingly, DR usage remained 7% higher than before. Moreover, PA levels were related to higher perceived well-being (WHO-5), and DRs were associated with low/moderate PA intensity and lower BMI values. Specifically, DR use was revealed in 32% of those having a BMI under 24.9 and 17% of those with a BMI higher than 25.
Conclusion. This research highlights how DRs can represent a simple and economical way to stay active. Considering the importance of an active lifestyle for general well-being and health status maintenance, DR could be considered a good tool and included in policies to promote PA attendance in university student
Black Death of 1348 in Florence and SARS-CoV-2 (COVID-19) in the 650th anniversary of the death of the writer Giovanni Boccaccio (1313-1375)
Full text linkThe 650th anniversary of the death of the Tuscan writer Giovanni Boccaccio (1313-1375) provides an opportunity to reread some pages of his masterpiece, the Decameron, from a historical-medical perspective. In this work, Boccaccio gives an account of the “Black Death”, a devastating pandemic of bubonic plague, which reached Europe, Messina (Sicily), from Asia Minor in September of 1347. The plague travelled along the commercial route taken by Genoese sailors returning from their strategic trading posts at Kaffa on the Crimean Peninsula, which was under siege by the Mongols. The framework, the cage that encloses the 100 short stories that comprise Boccaccio’s work, is the starting point for a novelistic reinterpretation. On an unspecified summer day in 1348, the plague broke out in Florence, Italy. In a few years, the terrible “Black Death” decimated the population of Europe. The city of Florence was shocked by the aggressiveness of the disease and by the collapse of the most basic norms of respect and civil coexistence. On the 650th anniversary of Boccaccio’s death, the authors of this short article commemorate this great writer, his work and, in particular, the historical, social and public health responses to this massive pandemic. The Black Death shared some similar features with the recent COVID-19 pandemic: from the initial difficulties and misunderstandings to the adoption of public safety and prevention measures, such as quarantine, and the lasting impact on society after the event had passed. The similarities between Boccaccio’s description and what we experienced during the COVID-19 era regard also other aspects of public health aspects
Atti 58° Congresso Nazionale Società Italiana Igiene, Medicina Preventiva e Sanità Pubblica (SItI): Bologna, 22-25 ottobre 2025
No full textHealth-related quality of life of patients with chronic kidney disease: Does it improve after initiation of haemodialysis? A single-centre study from South India
Full text linkBackground. In recent years, research on quality of life has emerged as a valuable tool in assessing the effectiveness of therapeutic interventions in chronic kidney disease. This study aims to assess the health-related quality of life among patients with chronic kidney disease, and draw comparisons between haemodialysis and non-dialysis patients.
Methods. This is a prospective questionnaire-based observational study involving 148 patients (81 haemodialysis and 67 non-dialysis patients) with chronic kidney disease (Stage 3-5D) conducted in a tertiary care hospital in South India over six months (July 2023-December 2023). The instrument used was the Kidney Disease Quality of Life Short Form-36.
Results. The overall mean health-related quality of life score was better among non-dialysis patients compared to haemodialysis patients. A reduction in various domains, including physical functioning (p < 0.014), role limitations due to physical health (p < 0.001), role limitations due to emotional problems (p < 0.001) and social functioning (p < 0.007) were observed in the haemodialysis group. In our population, age, gender, employment status and socioeconomic classes were found to be independent predictors of health-related quality of life.
Conclusion. This study highlights the deleterious impact of chronic kidney disease on health-related quality of life, with more significant deterioration among patients undergoing haemodialysis compared to non-dialysis patients. Further, this study advocates potential areas of target for therapeutic intervention
The Role of SGLT2 Inhibitors in Preventing the Progression of Chronic Kidney Disease in Patients with Type 2 DM: A Systematic Review
Full text linkBackground. Type 2 diabetes mellitus is the most common type of diabetes and is the leading cause of chronic kidney disease globally. Currently, the medications recommended for treatment are not fully effective for treating CKD. Recent findings from the DAPA-CKD and EMPA-KIDNEY clinical trials have revealed that SGLT-2 inhibitors offer significant benefits in improving kidney function and preventing the progression of kidney disease.
Objective. This review aims to evaluate the efficacy and safety of SGLT2 inhibitors in delaying CKD progression and reducing dialysis dependency in patients with type 2 diabetes.
Methods. This research is a systematic literature study using PRISMA 2020 Protocols. Article searches were carried out in PubMed, Cochrane Library, Sage Journals, and Europe PMC, covering the period from January 2019 to March 2024. The search strategy used the keywords “SGLT2 Inhibitor” AND “Prevention” AND “Chronic Kidney Disease” AND “Type 2 Diabetes”. Articles that met the criteria were assessed for risk of bias using RoB2.
Results. From 7 articles with a total of 15,927 participants included in this systematic review, the overall risk of bias was low. Patients with type 2 diabetes and CKD who received SGLT2 inhibitors had a significantly lower risk of renal composite outcomes compared to placebo (e.g. HR 0.70, 95% CI 0.59-0.82). A modest initial decrease in eGFR was observed in the SGLT2i group compared to placebo, followed by stabilization over time.
Conclusion. SGLT2 inhibitors can be proposed as an effective treatment option for renal protection in patients with type 2 diabetes mellitus and chronic kidney disease, with moderate certainty of evidence from consistent RCT finding