Publications by authors named "Francesco Vladimiro Segala"

Background: . Breastfeeding improves infant survival, especially in low-resource settings. Although the risk of postnatal transmission is below 1% among virologically suppressed mothers living with HIV, exclusive breastfeeding (EBF) rates and retention in HIV care remain suboptimal.

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Background: Mozambique's minimal contribution to global gas emissions contrasts sharply with the significant impact climate change has on the region, particularly in terms of frequent droughts, cyclones, and floods. These climate-related disasters exacerbate vulnerabilities related to food security, human health, and economic growth. This study evaluates the impact of a Social Behavior Change (SBC)-based intervention on preparedness against water-borne diseases (WBDs) and vector-borne diseases (VBDs) among communities in Cabo Delgado, Mozambique.

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Objective: This study assesses the knowledge, practices, educational needs and hospital engagement in IPC among healthcare workers (HCWs) and students in Italy.

Methods: A national cross-sectional observational study was conducted from April to July 2024. Participants completed a validated questionnaire based on WHO and CDC guidelines.

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Antimicrobial resistance (AMR) is a critical health challenge in sub-Saharan Africa (SSA), driven by socioeconomic disparities, weak healthcare systems, and inadequate pharmaceutical regulation. This review examines AMR prevalence, drivers, and consequences in SSA, emphasizing the need for urgent interventions. A literature review was conducted using PubMed, Web of Science, Scopus, and Google Scholar, including studies published from January 2000 to June 2024.

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Antimicrobial resistance (AMR) and migration are two interlinked issues and both pose an escalating threat to global health. With an increasing trend, there are 281 million migrants globally, while AMR is contributing to over 5 million deaths annually, with a projected rise to 10 million by 2050 if left unaddressed. Both AMR and migration are multifaceted problems that extend beyond human health, involving animals, plants, and the environment-a fact highlighted by the One Health approach.

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Objectives: Migration status refers to socioeconomic factors that challenge access to the health care system and increase the risk of developing tuberculosis (TB) with worse outcomes. This systematic review and meta-analysis aimed to investigate the outcomes of TB among international migrants arriving in Europe compared with the nonmigrant population.

Methods: A systematic review and meta-analysis were conducted to identify studies investigating TB-related outcomes among migrants and nonmigrants in Europe.

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Background: Migration to Europe has intensified due to recent political conflicts, economic crises, and climate change, introducing an increased risk of neglected tropical diseases (NTDs) within this population. While NTDs typically impact tropical regions, their presence among migrants in Europe presents a growing challenge, compounded by limited research in this area. This study provides the first meta-analysis on the prevalence of NTDs in migrants across European nations.

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Progressive Multifocal Leukoencephalopathy (PML) is a rare opportunistic infection of the central nervous system (CNS) caused by human polyomavirus JC virus, with high mortality rate in people living with HIV (PLWH), without an effective specific treatment beside combined antiretroviral therapy (cART). The use of Pembrolizumab, an inhibitor of the Programmed cell death protein 1 (PD-1) receptor on T cells, has been associated with decreased viral clearance. Aim of this study is to evaluate clinical course of PLWH affected by PML treated with pembrolizumab.

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The Anthropocene era is marked by unprecedented human-induced alterations to the environment, resulting in a climate emergency and widespread ecological deterioration. A staggering number of up to one million species of plants and animals are in danger of becoming extinct, which includes over 10 % of insect species and 40 % of plant species. Unrestrained release of greenhouse gases, widespread deforestation, intense agricultural practices, excessive fishing, and alterations in land use have exceeded the ecological boundaries that were once responsible for humanity's wellbeing.

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Article Synopsis
  • Climate change is causing more frequent and intense tropical cyclones in Mozambique, leading to health crises like cholera outbreaks, particularly after Cyclones Idai and Kenneth in 2019.
  • A study in Cabo Delgado Province investigated factors contributing to acute watery diarrhea (AWD) and cholera, surveying 1,615 households to analyze the impact of climate disasters and armed conflict on health.
  • Key risk factors identified included overcrowding, poor access to safe water, and inadequate handwashing facilities, highlighting the need for targeted climate adaptation policies to improve community health.
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  • Long COVID is a significant public health issue affecting many individuals, with this study aiming to identify predictors of its development and specific symptoms over time.
  • The study involved over 1,000 hospitalized COVID-19 patients in Italy, using structured phone questionnaires to assess long COVID incidence and symptoms after a median follow-up of 19 months.
  • Results indicated that 91.7% experienced long COVID, particularly affecting respiratory and neurological systems, with vaccination reducing symptom odds and Delta variant infection greatly increasing the risk for neuropsychiatric symptoms.
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Background: Compared with the general population, international migrants arriving in Europe face severe socioeconomic challenges that result in higher HIV prevalence and limited access to health care, potentially leading to negative outcomes. In this systematic review and meta-analysis, we aimed to investigate the incidence of HIV-related outcomes among international migrants arriving in Europe compared with the incidence among the general population.

Methods: We did a systematic review and meta-analysis to identify studies investigating HIV-related outcomes in migrants and the general population living with HIV in Europe.

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Introduction: The current Infectious Disease Society of America and American Thoracic Society (IDSA/ATS) guidelines recommend linezolid or vancomycin as an empiric treatment for methicillin-resistant (MRSA) pneumonia in hospitalized patients with specific risk factors,. A nasal PCR-assay for MRSA, with its high negative predictive value, can guide a rapid antibiotic de-escalation avoiding unnecessary anti-MRSA treatment. The indiscriminate use of these drugs has contributed to the emergence of resistant strains leading to adverse effects without any survival benefit, increasing hospital stays and associated costs.

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Introduction: Climate change is contributing to increase the frequency and severity of climate disasters in Mozambique, leading, since 2019, to extensive damage to infrastructure and displacement 1.3 million people. Aim of this study is to evaluate baseline preparedness to vector-borne and water-borne infections among households and internally displaced people exposed to climate disasters in Mozambique.

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Nurses play a pivotal role in combating antimicrobial resistance (AMR). However, the success of local and national AMR containment efforts hinges on the knowledge, attitude, and practice (KAP) of nursing staff and undergraduate students. This study aims to explore the determinants of nurses' KAP regarding AMR, offering insights to control the emergence and spread of drug-resistant pathogens.

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Background: The eco-climatic crisis has been defined by the World Health Organization as the "single biggest health threat facing humanity," influencing both the emergence of zoonoses and the spread of vector-borne and water-borne diseases. The aim of this survey was to explore knowledge, eco-anxiety and attitudes toward the ecological and climate crisis among young Italian doctors and medical students.

Methods: A cross-sectional, multicenter survey was conducted from November 2022 to June 2023, by administering an anonymous questionnaire to Italian doctors and students of medicine.

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Coronavirus disease 2019 (COVID-19) can lead to persistent and debilitating symptoms referred to as Post-Acute sequelae of SARS-CoV-2 infection (PASC) This broad symptomatology lasts for months after the acute infection and impacts physical and mental health and everyday functioning. In the present study, we aimed to evaluate the prevalence and predictors of long-term impairment of working ability in non-elderly people hospitalised for COVID-19. This cross-sectional study involved 322 subjects hospitalised for COVID-19 from 1 March 2020 to 31 December 2022 in the University Hospital of Bari, Apulia, Italy, enrolled at the time of their hospital discharge and followed-up at a median of 731 days since hospitalization (IQR 466-884).

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Remdesivir (RDV) was the first Food and Drug Administration (FDA)-approved medication for COVID-19, with discordant data on efficacy in reducing mortality risk and disease progression. In the context of a dynamic and rapidly changing pandemic landscape, the utilization of real-world evidence is of utmost importance. The objective of this study is to evaluate the impact of RDV on patients who have been admitted to two university referral hospitals in Italy due to COVID-19.

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Background: Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact - although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) - PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services.

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Article Synopsis
  • * The survey revealed a median knowledge, attitudes, and practices (KAP) score of 14 out of 29 among 1,702 participants, with higher scores linked to attending classical High Schools, being sexually active, and having received the HPV vaccine.
  • * Notably, students who sought information from TikTok had better KAP scores, while being heterosexual was associated with lower scores, indicating a need for urgent school-based interventions to enhance sexual health education among this demographic.
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Background: In Europe and Italy, marginalized communities have a higher risk for both contracting sexually transmitted infections (STI) and progressing towards adverse outcomes.

Objectives: This study focuses on the screening of HIV, HBV, HCV, and syphilis among homeless individuals and agricultural migrant workers living in Apulia, Italy. It aims to assess STI prevalence and investigate factors that might hinder return to collect test results.

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Extrapulmonary tuberculosis (TB) is estimated to account for up to 20% of active cases of TB disease, but its prevalence is difficult to ascertain because of the difficulty of diagnosis. Involvement of the heart is uncommon, with constrictive pericarditis being the most common cardiac manifestation. Diagnostic research for cardiac disease is frequently lacking, resulting in a high mortality rate.

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Introduction: Pulmonary tuberculosis (TB) is an infectious disease with high incidence in low-income countries (LICs); it remains one of the infectious diseases with the highest mortality in the world, especially in LICs. It is crucial to recognise and diagnose TB as soon as possible, but microbiological tests on sputum are not always sensitive enough. New methods for an early diagnosis of TB are needed.

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Long COVID, also known as "post-acute sequelae of COVID-19," affects at least 65 million individuals worldwide with a wide spectrum of symptoms that may last weeks, months, or permanently. Its epidemiology and burden in Africa are unclear. This meta-analysis examines long-term COVID-19 effects in the WHO African Region.

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