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Background and aims: Incidence of leprosy in Italy has declined steadily over the last century, but available evidence remains fragmentary. Our review aims to summarize available data on the epidemiology of leprosy cases in Italy. Methods: The following keywords were used to explore PubMed and Embase: leprosy, Hansen’s disease, (Mycobacterium) leprae, Italy, without any chronological restriction. Results: We identified a total of 39 reports, including 7 national reports, 11 international reports, 20 case reports. Notified leprosy cases were: 839 between 1925 and 1948; 434 between 1955 and 1979; 76 cases for the decade 1980-1989; 112 between 1990 and 1999; 62 between 2000 and 2009, and a total of 25 cases since 2009. Since 2003, 53% of all cases occurred in illegal residents. Focusing on individual cases, latency between early signs/symptoms and a proper diagnosis ranged between 2 and 20 years in 52.1% of individual cases. Conclusion: Imported cases of leprosy are responsible for most leprosy incidence in Italy, and social stigma, the unfamiliarity of healthcare professionals with such disorders, and difficulties of some high-risk groups to be appropriately assessed hint to a possible under-diagnosis. Professionals should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic. (www.actabiomedica.it)

IntroductionInternationally, the Triple Aim agenda (improved health of populations, improved patient experience, and reduced per capita health care expenditures) is gaining momentum in reforming healthcare systems. Towards implementing accountable care, policymakers, insurances, and managers need information about population health status to allocate resources, set priorities, plan interventions, and measure outcomes. To this extent, consolidated tools from public health research are attracting renewed interest. This paper aims to analyze the Burden of Diseases (BoD) tool and how it could be deployed to pursue the Triple Aim agenda, nationally or regionally. The Global BoD (GBoD) was introduced in the 1990s and then developed by the World Health Organization (WHO) and the Institute for Health Metrics and Evaluation (IHME), relying on aggregated data, population samples, and surveys. Nevertheless, to achieve more accurate and calibrated estimates, several countries have started to develop the BoD with different methodologies, which could influence the results and the tool's deployment within accountable care.MethodsAn Arksey and O'Malley approach was used in this scoping review. Electronic database MEDLINE and search engine Google were searched from January 2010 to February 2021. National BoD reports were included, and data and methodologies were extracted. The scoping review addressed three main goals: 1) benchmarking international and national or local development of the BoD; 2) analyzing and comparing the methods and data sources; 3) comparing the deployment strategies and the tool's scope. ResultsThe IHME and WHO approaches are the most consolidated hitherto. National experiences are increasing, while local applications are still limited to pilot research. Calculation methods vary based on age-weighting, discount rates, the number of included diseases and risk factors, reported advantages and disadvantages, data sources, and data computations. The deployment strategies are very fragmented and still at an embryonic stage compared to the debate on accountable care. DiscussionWhereas the utilization of a nation-based BoD is promising, experiences are still limited. The national implementation could be more reliable and calibrated on targeted populations to guide health interventions and measure population health outcomes. Multiple factors hamper the tool's development, such as costs, human and time resources, less meticulous methodology, and health analytics availability and robustness at the country level. Also, population health strategies and outcomes measurement are not yet institutionalized within accountable care. The tool deployment is fragmented across multiple entities and governance patterns. National and private insurance players are the most active, pioneering new strategies.ConclusionsThe BoD is an efficient way to assess the impact of diseases and risk factors in populations' life and quality of life. GBoD remains an essential benchmark for researchers and public health institutions worldwide. Lessons Learned National tools development is increasing and could be deployed for evaluating and planning healthcare interventions at the national or sub-national level. Limitations This study does not use systematic review criteria, and access to tools methodologies and deployment strategies is limited through published sources. Suggestions for future researchAssessment of the development, methods, and deployment of a national-based BoD compared to the accountable care aims and agenda.

Background Advances in the field of Information and Communication Technology (ICT) are revolutionizing healthcare, while massive migration flows and cross-border populations’ transit impose the planning, implementation, and evaluation of new integrated healthcare services and programmes. Nevertheless, no conclusive evidence exists on the vast potential offered by ICT to promote healthcare in migrant populations. Methods We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to retrieve, pool and critically appraise all the available evidence on the effectiveness of ICT-based interventions to support the healthcare provision to migrant and in-transit populations in Europe. We searched the electronic databases Medline and Embase, relevant grey literature and consulted with experts in the field. We restricted the area of interest to EU/EEA countries and included studies providing original quantitative data. Results Out of 127 retrieved records, 53 (42%) met the inclusion criteria. Included studies were classified in the following four interventions: implementation of healthcare services (47%), patients’ education (26%), healthcare services’ monitoring (17%), and interventions on providers (10%). The most relevant data refer to telemedicine, prevention interventions, and healthcare data sharing and the most represented specific health-topic is that of mental health (26%). We present available data qualitatively and quantitatively pooled by country, type of ICT, target population and health topic. Conclusions Selected ICT-based interventions have been implemented in Europe to promote healthcare in migrant populations; however, in most cases, no monitoring and evaluation exist on their impact, effectiveness, and cost-effectiveness. Strengthened efforts are needed to identify, plan, implement and evaluate effective interventions and share best practices to protect in-transit populations’ health. Key messages Information and Communication Technology (ICT) offer great potential to promote health-care in migrant populations. Effective ICT interventions and best practices should be shared across Europe.

Background: Describing knowledge, attitudes and beliefs about leprosy amongst Medical Professionals in a nonendemic area (Parma Province, North-Western Italy). Methods: A cross-sectional study was carried among a sample of Medical Professionals (MP; No. 242) during June and July 2019 as an on-line self-administered questionnaire including 21 true/false items about epidemiology, diagnosis, and clinical characteristics of leprosy. Effectors of better knowledge status (KS) and higher risk perception (RP) were assessed through calculation of respective multivariate odds ratios (OR) and 95% confidence intervals (95%CI) in two logistic regression analysis models. Results: A total of 102 questionnaires were retrieved (participation rate 42.1%; 67.6% of respondents