Michele Sorrentino

Introduction: Since the COVID-19 pandemic onset, preventive measures (e.g., social distancing, hand hygiene, mask usage) and vaccines have been pivotal in mitigating transmission and reducing public health burdens. Although adherence to these measures, influenced by factors such as ventilation and exposure duration, has been extensively validated, their long-term sustainability faces socio-economic challenges. Objectives: To investigate the association between risk perception and adherence to preventive behaviors and conduct a meta-analysis comparing these behaviors in vaccinated versus unvaccinated subgroups. Methods: A systematic review following PRISMA guidelines identified studies (2021–2024) analyzing risk perception and preventive behaviors. Potential biases were assessed using the MMAT tool. A meta-analysis calculated pooled effect sizes across subgroups. Results: Of 1,594 screened studies, 10 met inclusion criteria (six for meta-analysis, n = 9,115). Populations included adults, students, and healthcare professionals across 24 countries. Most vaccinated individuals maintained preventive behaviors despite stable or declining risk perception, though social distancing and hand hygiene adherence decreased over time. Booster-vaccinated individuals exhibited higher compliance than partially vaccinated or unvaccinated counterparts. Unvaccinated individuals intending to vaccinate reported higher risk perception than those refusing vaccination. Meta-analysis revealed no significant difference in risk perception between vaccinated (70.3, 95% CI 60.8–79.8) and unvaccinated subgroups (70.8, 95% CI 61.9–79.6; I ² = 17.5%), suggesting limited influence on behavior maintenance. Conclusion: While vaccination and preventive measures curbed COVID-19 transmission, risk perception alone does not robustly predict sustained adherence, potentially due to risk compensation. Future research should prioritize determinants of long-term behavioral retention in public health strategies.

Background: Human papillomavirus (HPV) is a leading cause of cervical, anal, and oropharyngeal cancers. Despite the proven effectiveness of HPV vaccination, uptake remains low, particularly among males and specific demographic groups. In Italy, national HPV vaccination coverage stagnated at 38.8% in 2022, with significant regional disparities. While previous studies have explored individual and cultural barriers, organizational challenges within academic institutions remain underexamined. The aim of this cross-sectional study was assessing the uptake of HPV vaccination among Health Sciences students at the University of Naples Federico II. Methods: An anonymous online survey collected data on demographics, vaccination status, and institutional barriers. Logistic regression models were used to identify predictors of vaccination, adjusting for demographic factors, institutional communication, and knowledge-attitude scores. Results: Among 354 participants, 55.1% reported receiving at least one HPV vaccine dose. Female students had significantly higher vaccination rates (aOR: 7.95; 95% CI: 4.24–14.90), while older age was associated with lower uptake (aOR: 0.81; 95% CI: 0.73–0.91). Institutional vaccination invitations increased the likelihood of vaccination nearly threefold (aOR: 2.81; 95% CI: 1.48–5.33). Attitudes toward vaccination strongly predicted uptake, whereas knowledge scores showed no significant association. Conclusions: These findings highlight the need for structured institutional interventions, including targeted education, proactive vaccination invitations, and improved access to on-campus vaccination services. Strengthening university-led initiatives could significantly enhance HPV vaccine uptake among future healthcare professionals, contributing to broader public health efforts in HPV-related cancer prevention.

The International Health Regulations (IHR) provide a global framework for health security, requiring annual reporting on 35 indicators across 15 core capacities via the State Parties Annual Reporting (SPAR) tool. The COVID-19 pandemic exposed gaps in the IHR framework and monitoring systems, prompting calls for reform. This systematic review analyzed the correlations between IHR-SPAR scores and pandemic outcomes across nine studies (2020–2024), selected using the PRISMA guidelines. The study quality was assessed using the Joanna Briggs Institute’s tool for cross-sectional studies. Of 1019 screened studies, nine met the inclusion criteria. Higher SPAR scores generally correlated with lower COVID-19 incidence and mortality, although some high-scoring countries experienced severe outbreaks. Middle-income countries showed the greatest improvement, particularly in risk communication and emergency response, while zoonotic disease capacities saw little progress. While the SPAR tool aids monitoring, it requires revisions to better reflect real-world pandemic responses. High SPAR scores do not always indicate effective crisis management. This study recommends integrating more dynamic, operational, and context-sensitive indicators to enhance the global preparedness for future health emergencies.

Background: The Herpes Zoster virus represents a significant public health threat for unvaccinated frail individuals and older adults, aged 50 or older. Globally, 95% of elderly and frail individuals are susceptible to develop Herpes Zoster as already being exposed to Varicella Zoster Virus. Organizational and logistical barriers, such as cost management, vaccine storage requirements, supply limitation, logistic difficulties, absence of a streamlined collection system, and healthcare system deficiencies might reduce vaccination uptake. Methods: A systematic review was conducted to identify studies published in the last 10 years, and focused on logistic and organizational barriers for Herpes Zoster vaccination uptake among frail and participants aged 50+ in Europe. Prisma guidelines were followed, and AXIS tool was used to evaluate the risk of bias. Results: After a thorough analysis, 4 studies were selected from a total of 863 for detailed review. The analysis revealed several barriers to vaccination uptake, including challenges involving healthcare professionals, participant-related obstacles concerning perceptions and knowledge, accessibility issues, structural deficiencies, and social dynamics. A significant barrier identified is the perception among participants that general practitioners either do not support the vaccination or that participants themselves underestimate the risk of developing Herpes Zoster. Additionally, current communication strategies have proven inadequate, indicating a need for more effective and updated approaches to increase public awareness. These factors contribute to hesitancy regarding vaccination. Conclusions: This study provides a comprehensive examination of the organizational and logistical barriers to the Herpes Zoster vaccination uptake. Tailored interventions are essential to overcome these barriers. Successfully addressing these challenges might enhance vaccination rate and reduce the public health burden associated with Herpes Zoster. Key messages: • Several logistic and organizational barriers reduce the Herpes Zoster vaccination uptake. • Further literature is required to understand how to overcome those barriers, and increase vaccination uptake.

Despite the existing body of evidence, there is still limited knowledge about the impact of SARS-CoV-2 positivity on delivery outcomes. We aimed to assess the impact of SARS-CoV-2 infection in women who gave birth at the University Hospital “Federico II” of Naples, Italy, between 2020 and 2021. We conducted a retrospective single-center population-based observational study to assess the differences in the caesarean section and preterm labor rates and the length of stay between women who tested positive for SARS-CoV-2 and those who tested negative at the time of labor. We further stratified the analyses considering the time period, dividing them into three-month intervals, and changes in SARS-CoV-2 as the most prevalent variant. The study included 5236 women with 353 positive cases. After vaccination availability, only 4% had undergone a complete vaccination cycle. The Obstetric Comorbidity Index was higher than 0 in 41% of the sample. When compared with negative women, positive ones had 80% increased odds of caesarean section, and it was confirmed by adjusting for the SARS-CoV-2 variant. No significant differences were found in preterm birth risks. The length of stay was 11% higher in positive cases but was not significant after adjusting for the SARS-CoV-2 variant. When considering only positive women in the seventh study period (July–September 2021), they had a 61% decrease in the odds of receiving a caesarean section compared to the fourth (October–December 2020). Guidelines should be implemented to improve the safety and efficiency of the delivery process, considering the transition of SARS-CoV-2 from pandemic to endemic. Furthermore, these guidelines should aim to improve the management of airborne infections in pregnant women.

The rise in international travel has led to an increase in travel-related infectious diseases. It is predicted that by 2030, the number of international travelers will reach 1.8 billion, with over 250 million people affected globally. This issue also has an economic impact, as the eradication of travel-related infectious diseases leads to a loss of USD 12 billion in tourism. To understand the association between demographic variables and knowledge, attitude, and behaviors related to travel-related infectious diseases, a cross-sectional survey-based study was conducted among 1191 individuals in the metropolitan city of Naples, Italy. Multiple linear regression was performed over three models. The results revealed that knowledge about travel-related infectious diseases was positively associated with age, female gender, non-smoking habits, being single, and higher education attainment. The attitude towards travel-related infectious diseases was positively associated with being female, non-smoking habits, being single, higher education attainment, and a higher level of knowledge. A statistically significant association was observed between behaviors and non-smoking habits and between higher levels of knowledge and attitudes. To address this issue, public health programs could be implemented to improve behaviors in the general population. Overall, this study provides valuable information about the determinants of knowledge, attitude, and behaviors related to travel-related infectious diseases in the general population.

Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population.

The overuse and inappropriate use of antibiotics pose a grave threat to public health, contributing significantly to the accelerated development of antimicrobial resistance (AMR) and increased rates of morbidity and mortality, making it a leading cause of death globally. To examine the relationship between demographic variables and knowledge, attitudes, and behaviors concerning antibiotic use, a survey-based cross-sectional study was conducted involving 1158 individuals. The questionnaire included two sections: in the first section, participants’ socio-demographic characteristics were analyzed; the second investigated knowledge, attitudes, and behaviors concerning antibiotics utilization using a total of 36 questions. Descriptive statistics were used, and then a multiple linear regression analysis (MLRA) using three models was carried out. In Model I, knowledge about antibiotics exhibited correlations with smoking habits and educational attainment. In Model II, attitudes were significantly associated with gender, smoking habits, age, education, relationship status, and knowledge. In Model III, behaviors related to antibiotics were correlated with educational attainment, having children, knowledge, and attitudes. Implementing tailored public health programs could be a cost-effective intervention to enhance behaviors associated with antibiotic use in the general population. This study offers valuable insights into the determinants of knowledge, attitudes, and behaviors regarding antibiotics in the general population.

The article explores a fascinating topic, but there are certain flaws in its current form that should be addressed for overall improvement. First and foremost, a more robust methodology for search and analysis would enhance the credibility of the st...