Itamar Grotto

Itamar Grotto
  • MD, MPH, PhD
  • Professor (Full) at Ben-Gurion University of the Negev

About

287
Publications
44,505
Reads
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6,962
Citations
Current institution
Ben-Gurion University of the Negev
Current position
  • Professor (Full)
Additional affiliations
December 2007 - present
Ministry of Health (Israel)
Position
  • Director of Public Health Services
December 2007 - present
Ministry of Health (Israel)
Position
  • Firector of Public Health Services

Publications

Publications (287)
Article
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Politically stressful situations lead to emotional distress and reduce well-being. In Israel, a legislative plan has been advanced by the ruling coalition with the aim of altering the balance of power between the judicial system, government, and parliament. This plan, confronted by large-scale protests and nonviolent resistance on the part of a wid...
Article
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The recent vaccine-derived poliovirus type 2 (cVDPV2) outbreak in Gaza, linked to strains circulating in Egypt, highlights the challenges of maintaining vaccination efforts in conflict zones. Amid prolonged hostilities and a deteriorating healthcare system, vaccination coverage has significantly declined, leaving many children vulnerable to poliovi...
Article
Background and Methods: Based on an established ongoing prospective-longitudinal study examining anxiety in response to COVID-19, a representative sample of 1018 Jewish-Israeli adults were recruited online. A baseline assessment was employed two days prior to the first spread of COVID-19, followed by six weekly assessments. Three classes of general...
Article
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Objective To analyze an intervention that delivered tailored clinic staff training on postpartum depression (PPD) followed by awareness raising and social support aimed at lowering PPD among low-income Bedouin women in southern Israel. Methods We conducted a non-randomized controlled trial at two women’s health clinics. The study included 332 of t...
Article
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AimThe World Health Organization (WHO) 2006 growth standards were adopted in most countries, Israel included. We aimed to study the assumption that growth in early years is similar across populations by studying the validity of the WHO growth standards in a large population-based study of Israeli infants.Methods Computerized data on infants born in...
Article
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Brucellosis, a zoonosis mainly transmitted by consumption of unpasteurized dairy products, is endemic in Southern Israel, mainly among the Bedouin Arab population. However, the genomic epidemiology of B. melitensis in this region has not yet been elucidated. A cohort of brucellosis cases (n = 118) diagnosed between 2017–2019 was studied using whole...
Article
Background . A major, prolonged measles outbreak occurred in Israel during 2018-19, despite vaccination coverage rates of 97% and 96% for the first and second doses, respectively, of measles containing vaccine (MCV). Aim . To study the causes and patterns of the outbreak through analysis of the epidemiological data, review the control measures tak...
Article
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Background: Exposure to heat during pregnancy has been associated with reduced fetal growth. Less is known about associations with cold and the potential for critical time windows of exposure. Objectives: We aimed to evaluate, in a national retrospective cohort, critical windows of susceptibility during pregnancy to extreme temperatures (low and...
Article
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We compared three hypothetical trajectories of change in both general and COVID-19-specific anxiety during the 1st wave of the spread in the state of Israel: panic (very high anxiety, either from the outset or rapidly increasing), complacency (stable and low anxiety), and threat-sensitive (a moderate, linear increase compatible with the increase in...
Article
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Response to and monitoring of viral outbreaks can be efficiently focused when rapid, quantitative, kinetic information provides the location and the number of infected individuals. Environmental surveillance traditionally provides information on location of populations with contagious, infected individuals since infectious poliovirus is excreted wh...
Article
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Since current recommendations call for a substantial reduction in overall sodium consumption, we tested whether or not these recommendations are implemented in common large subpopulations such as those with abnormal weight or hypertension in the current high sodium, high-calorie nutritional environment. In a national representative cross-sectional...
Article
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Adequate thyroid hormone availability is required for normal brain development. Studies found associations between prenatal exposure to air pollutants and thyroid hormones in pregnant women and newborns. We aimed to examine associations of trimester-specific residential exposure to common air pollutants with congenital hypothyroidism (CHT). All ter...
Conference Paper
A National Immunization Registry as a Digital Assessment Tool during Outbreaks Background: Immunization registries assemble vaccinations data to one database, enabling monitoring and planning to sustain and increase vaccination coverage. Even in high coverage locations, “pockets” of unvaccinated children occur, limiting herd immunity against contag...
Article
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Background Asthma is a common chronic childhood illness and frequent cause of hospitalization. A decline in hospital admission rates was noted up to the 1990s, however, trends are not as clear since the turn of the century. This study aimed to assess the rates and regional differences of asthma admissions over more than two decades using the nation...
Article
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Exposure to Legionella spp. contaminated aerosols in hotel settings confers risk for travel-associated Legionnaire’s disease (TALD). In this study, we investigated the prevalence of Legionella contamination and its molecular diversity in hotels and resorts across Israel. The study was comprised of a convenience sample of water systems from 168 hote...
Article
Background: Hydraulic fracturing together with directional and horizontal well drilling (unconventional oil and gas (UOG) development) has increased substantially over the last decade. UOG development is a complex process presenting many potential environmental health hazards, raising serious public concern. Aim: To conduct a scoping review to a...
Article
Neural tube defects (NTDs) are common and disabling congenital malformations that remain a public health challenge despite prevention efforts. In 2000, The Israeli Ministry of Health published recommendations on daily folic acid (FA) supplementation for women of reproductive age and established a national NTD registry. This study aims to evaluate t...
Article
Parental hesitancy to vaccinate their children derails the success of mass vaccination campaigns. We examined the effect of parents’ personification of the vaccinating agency on vaccine hesitancy (i.e. negative or positive mind change) in 555 parents in a mass wild poliovirus vaccination campaign. Parents were assessed before and after the campaign...
Article
Pertussis incidence in developed countries, including Israel, has increased over the past two decades despite the addition of two booster doses in children. However, as pertussis is characterized by a multi-annual periodicity, and since clinical diagnosis can miss cases, determining disease trends at the population level is challenging. To bridge t...
Article
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Background: In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past....
Article
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Background: Undocumented migrants in Israel, mostly originating from HIV endemic countries, are not covered by Israel's universal healthcare coverage. We initiated a Public-Private Partnership (PPP) to handle this public health and humanitarian challenge. The PPP venture included the Ministry of Health (MoH), pharmaceutical companies, pharmacies,...
Article
Full-text available
Background In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. T...
Article
ABSTRACT Background: Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 livebirths in Tel Aviv, Israel. Methods: Longitudinal exposure to mean of greenne...
Article
Background: Immunization has a significant impact in protecting from severe diseases. Various factors that could influence child immunization coverage and parents’ decisions about vaccinating their children should be further explored in specific population groups. Objectives: The current study has two main objectives: to assess the main information...
Article
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Background and aim Universal smoking cessation strategies are not always successful for minorities, among whom smoking is highly prevalent despite high intention to quit. This study identifies facilitators for smoking cessation, as perceived by minority male smokers, that can inform a culturally appropriate national plan for smoking prevention and...
Data
Pattern match for smoking cessation clusters among Arab men by age groups. (TIFF)
Data
Level of agreement (%) on each of the statements about barriers and facilitators to smoking cessation. (PDF)
Data
Pattern match for smoking cessation clusters among Arab men by employment status. (TIFF)
Data
Pattern match for smoking cessation clusters among Arab men by physician advice received. (TIFF)
Data
Point map of smoking cessation facilitators, barriers and social determinants (the numbers in the map refer to the statement's number as it appears in Table 2). (TIFF)
Data
Pattern match for smoking cessation clusters among Arab men by marital status. (TIFF)
Data
Pattern match for smoking cessation clusters among Arab men by education level. (TIFF)
Article
Significance The 2013–2014 silent polio epidemic in Israel was a setback to global eradication efforts because Israel had previously been certified as polio-free by the World Health Organization. Fortunately, Israel has a robust environmental surveillance program that detected the epidemic and allowed rapid mobilization of a vaccine campaign before...
Article
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We report preliminary findings of a large outbreak of human leptospirosis with 36 confirmed/probable and 583 suspected cases from June-August 2018, linked to contaminated water bodies in Northern Israel. There was a travel-associated case in Germany; additional cases are being investigated in other countries. The presumed chain of transmission, imp...
Article
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Pertussis is the only vaccine-preventable disease that has re-emerged in Israel. In the last two decades, despite high primary immunization coverage, crude incidence increased over tenfold, with especially high morbidity among infants and adolescents and with 19 infant deaths. Two pertussis vaccine boosters were added, in 2005 for 7-year-olds and i...
Article
Introduction: The 2013 reemergence of wild poliovirus in Israel led to the reinstatement of a routine OPV vaccination. Fearing VAPP in immunocompromised, the MOH regulated contraindications for vaccination candidates and household contacts. In this study we estimate the size of the contraindicated population to OPV vaccination. Method: We studie...
Article
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Trends in birthweight and abnormal fetal growth, namely term low birthweight (LBW), macrosomia, small-for-gestational age (SGA) and large-for-gestational age (LGA), are important indicators of changes in the health of populations. We performed this epidemiological study to evaluate these trends among 2,039,415 singleton live births from Israel over...
Article
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Background There is on ongoing debate in the literature regarding the real burden of STIs (sexually transmitted infections) in Western countries and the proper strategies needed to estimate and to prevent them. Our purpose is to present an evidence-based national strategic plan for STI prevention in Israel through assessing the current burden of il...
Article
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The correct and rational use of medications can have a positive direct impact on disease outcomes, as well on the utilization of the health system resources. Unfortunately, 50% of the patients do not take their medications as prescribed, largely due to lack of patients’ understanding of their medical condition, as well as the lack of reliable medic...
Article
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Shiga toxin-producing Escherichia coli (STEC) is a significant cause of gastrointestinal infection and the haemolytic-uremic syndrome (HUS). STEC outbreaks are commonly associated with food but animal contact is increasingly being implicated in its transmission. We report an outbreak of STEC affecting young infants at a nursery in a rural community...
Article
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Between December 2016 and June 2017, 19 Hepatitis A virus (HAV)-positive cases, 17 of which were among men who have sex with men (MSM) were identified in the Tel Aviv area. Seven of the 15 sewage samples collected between January and June 2017 were also HAV-positive. All sequences clustered with two of the three strains identified in the current Eu...
Article
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Background Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs a...
Article
Objective: Parental compliance is crucial to the success of mass vaccination campaigns targeting children. Relying on psychological/neuroscientific research concerning the role of personification (i.e., viewing the inanimate as human) in behavior, the authors examined the effect of parents' personification of the Israeli Ministry of Health (MoH) o...
Article
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A major obstacle to eradicating polio is that poliovirus from endemic countries can be reintroduced to polio-free countries. Environmental surveillance (ES) can detect poliovirus from sewage or wastewaters samples, even in the absence of patients with paralysis. ES is underused, in part because its sensitivity is unknown. We used two unique data se...
Article
Introduction: Seasonal influenza is a significant disease affecting public health due to substantial morbidity and mortality and a high economic burden. in view of its high propensity for genetic mutations, the virus can easily evade preexisting immunity acquired from prior exposure to it, thereby causing severe seasonal epidemics. Influenza vacci...
Article
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Background Large amounts of expired and unused medications accumulate in households. This potentially exposes the public to hazards due to uncontrolled use of medications. Most of the expired or unused medications that accumulate in households (household medical waste) is thrown to the garbage or flushed down to the sewage, potentially contaminatin...
Article
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Background Worldwide, ambient air pollution accounts for around 3.7 million deaths annually. Measuring the burden of disease is important not just for advocacy but also is a first step towards carrying out a full cost-utility analysis in order to prioritise technological interventions that are available to reduce air pollution (and subsequent morbi...
Article
During 2013/14, Israel witnessed the silent reintroduction and sustained transmission of wild poliovirus type 1 (WPV1) detected through routine environmental surveillance performed on sewage samples. The public health response to silent poliovirus transmission in a population with high inactivated polio vaccine (IPV) coverage poses an emerging chal...
Article
Israel is a relatively rapidly growing country with a high fertility rate and a young population. These data emphasize the importance of an efficient and appropriate pediatric service for its population. Although the pediatric service in Israel has attained several achievements, such as a relatively low infant mortality, high vaccination rates, and...
Article
The use of human biomonitoring (HBM) as a tool for environmental health policy and research is developing rapidly in Israel. Despite challenges in securing political and financial support for HBM, the Ministry of Health has initiated national HBM studies and has utilized HBM data in environmental health policy decision making. Currently, the Minist...
Article
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Background Polio eradication is an extraordinary globally coordinated health program in terms of its magnitude and reach, leading to the elimination of wild poliovirus (WPV) in most parts of the world. In 2013, a silent outbreak of WPV was detected in Israel, a country using an inactivated polio vaccine (IPV) exclusively since 2005. The outbreak wa...
Article
In August 2013, a nationwide vaccination campaign with bivalent oral polio vaccine (bOPV) was initiated after isolation of wild-type poliovirus type 1 (WPV-1) in routine sewage surveillance in Israel. The campaign started in the Southern district and later extended to the entire country. This study examined the association between socioeconomic sta...
Article
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During the current outbreak of Ebola virus disease (EVD) in West Africa, preventing exportation of the disease posed many challenges for economically more developed countries. In Israel, although the risk of importing single cases was assumed to be low, the implications of local transmission were great. This article describes the EVD preparedness p...
Article
Recent years have seen a global trend of declining immunization rates of recommended vaccines that is more pronounced among school-age children. Ethnic disparities in child immunization rates have been reported in several countries. We investigated an effect of ethnicity on the vaccination rates of immunizations routinely administered within school...
Article
Background: Pneumococcal acute otitis media (AOM) has been previously considered as a more severe disease than that caused by other otopathogens, based on clinical and/or otologic scores. We sought to test this hypothesis in the pneumococcal conjugated vaccine (PCV) era. Methods: Children <6 years who presented with "severe" AOM episodes with midd...
Article
Since population-based data on epilepsy prevalence in Israel is not available, the aim of this study was to assess the prevalence of epilepsy in Bedouin children between the ages of 0-16 years living in Southern Israel. A cross-sectional study was conducted which included the collection of clinical and demographic data as well as the diagnosis of e...
Article
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Sequence-based typing (SBT) for Legionella pneumophila (Lp) has dramatically improved Legionnaires’ disease (LD) cluster investigation. Microbial whole genome sequencing (WGS) is a promising modality for investigation but sequence analysis methods are neither standardised, nor agreed. We sought to develop a WGS-based typing scheme for Lp using de n...
Article
This study aimed to assess HIV/AIDS point-prevalence among inmates and evaluate costs related to universal screening as currently practiced and appraise its necessity. All inmates newly incarcerated in Israel (2003-2010) underwent HIV tests and their medical files were cross-matched the with the national HIV/AIDS registry to who had been newly infe...
Article
In 2013, a silent wild poliovirus type 1 importation and sustained transmission event occurred in southern Israel. With the aim of preventing clinical poliomyelitis and ensuring virus re-elimination, the public health response to the importation event included intensification of clinical and environmental surveillance activities, enhancement of vac...
Article
Nitrogen Dioxide (NO2) is a product of fuel combustion originating mainly from industry and transportation. Studies suggest an association between NO2 and congenital malformations (CM). We investigated an independent effect of NO2 on CM by adjusting to individual factors and household environment in 1024 Bedouin-Arab pregnant women in southern Isra...
Article
The Israeli population genetic screening program for reproductive purposes, launched in January 2013, includes all known, nationally frequent severe diseases (carrier frequency 1:60 and/or disease frequency 1 in 15,000 live births). The carrier screening program is free of charge and offers testing for cystic fibrosis, fragile X syndrome, and spina...
Article
Since 2006 more than 60,000 migrants arrived in Israel from the Horn of Africa (HoA: Sudan, Eritrea, Ethiopia). They were detained in prison and screened for tuberculosis (TB) by means of an interview and chest X-ray (CXR). To evaluate the yield of this screening process. This cross-sectional study evaluated the validity of CXR in a random sample o...
Article
Israel has used an inactivated polio vaccine (IPV)-only schedule since 2005 (95% coverage). Silent reintroduction of wild type poliovirus 1 (WPV1) into Israel in early 2013 was detected in Southern Israel via routine environmental surveillance without clinical cases. To estimate the rate of WPV1 excretion by age and residence and inform decision-ma...
Article
The Bedouin-Arab population in Israel comprises a low socio-economic society in transition. Smoking among males and consanguineous marriages are frequent. A previous study showed elevated rates of major malformations within groups from this population residing near an industrial park, where high ambient values of arsenic (As) and nickel (Ni) were d...
Article
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Background: Israel has >95% polio vaccine coverage with the last 9 birth cohorts immunized exclusively with inactivated polio vaccine (IPV). Using acute flaccid paralysis and routine, monthly countrywide environmental surveillance, no wild poliovirus circulation was detected between 1989 and February 2013, after which wild type 1 polioviruses Sout...
Article
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Background: After 25 years without poliomyelitis cases caused by circulating wild poliovirus (WPV) in Israel, sewage sampling detected WPV type 1 (WPV1) in April 2013, despite high vaccination coverage with only inactivated poliovirus vaccine (IPV) since 2005. Methods: We used a differential equation-based model to simulate the dynamics of polio...
Article
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental pollutants associated with adverse health outcomes, including cancer, asthma, and reduced fertility. Because data on exposure to these contaminants in Israel and the Middle East are very limited this study was conducted to measure urinary levels of PAHs in the general adult popula...
Article
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During 2002 to 2011, 275 of 6828 children with giardiasis in Israel were reported with recurrent, over 6 months apart, episodes. The only significant multivariable-adjusted risk predictor of a recurrent episode was non-Jewish ethnicity (hazard ratio, 4.61 [95% confidence interval, 3.32–6.40]; P < .001), also accompanied by significant interaction w...
Conference Paper
Israel was certified as polio-free country in June 2002. The last case of polio was reported in 1988. Vaccination with Oral Polio Vaccine (OPV) was stopped in 2005, when Israel moved to an Inactivated Polio Vaccine (IPV) only schedule, with national vaccination coverage of 95%. Environmental surveillance, by systematic samples from sewage treatment...
Article
Full-text available
Lifestyle may be associated with risk behaviours. This study compares gym exercise and sexual risk behaviour between men who have sex with men (MSM) and heterosexual men. The research was based on the assumption that men who become muscular and physically attractive increase their number of sex partners and consequently their risk of HIV or other s...
Article
Full-text available
Wild poliovirus type 1 (WPV1) introduction into southern Israel in early 2013 was detected by routine environmental surveillance. The virus was identified genetically as related to the South Asian (SOAS) R3A lineage endemic to Pakistan in 2012. Intensified, high-throughput environmental surveillance using advanced molecular methods played a critica...
Article
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Tuberculosis (TB) patients who are co-infected with HIV are at greater risk of mortality. Nevertheless, not all countries achieved sustainable and TB and HIV collaboration to describe the burden of both diseases at a national scale. This study aims to describe HIV prevalence among TB-patients in Israel and identify variable associated with TB/HIV c...
Article
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Cutaneous leishmaniasis has long been endemic in Israel. After a 15-year period of moderate illness rates, reported incidence increased from 0.4 cases per 100,000 population in 2001 to 4.4 cases per 100,000 population in 2012, and the disease emerged in areas where its presence had previously been minimal. We analyzed all cases reported to the nati...
Article
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Background Minority men have higher smoking rates and smoking cessation interventions are less effective among them. In Israel, the prevalence of smoking among Arab men is nearly double that of Jewish men. However, there is a lack of knowledge regarding the various methods that could aid in smoking cessation. We have used the Concept Mapping (CM)...
Article
An association between prenatal exposure to (semi-)metals and of neonatal morbidity was assessed by introducing an oxidative stress as a possible intermediate step. An oxidative stress was measured by cell proliferation (CP) ratio in umbilical cord blood cells. Urine samples of 18 out of 58 enrolled women (31%) were positive for (semi-)metals; 25.9...
Article
In 2013, samples from routine environmental surveillance at a sewage-treatment plant in Israel tested positive for wild-type poliovirus. In response, Israeli health policymakers ramped up environmental surveillance and launched supplementary immunization activities.
Article
Background: The widespread use of 7-valent pneumococcal conjugate vaccine (PCV7) has changed acute otitis media (AOM) bacteriology. Only scattered data with regards to this effect of PCV13 have been published so far. Methods: We retrospectively identified children younger than 6 years of age who presented to our hospital with AOM, and had middle e...
Article
Introduction Israel hosts documented labor migrants (DLM), and recently also undocumented migrants (UDM), mostly from Horn of Africa. This study aims to compare treatment outcomes and other clinical aspects between a sample of 154 DLM and 113 UDM who were treated in two tuberculosis clinics between 2005 and 2010. Results and Discussion Compared...
Article
Full-text available
Influenza vaccine is the most effective method of preventing influenza and its complications, but coverage rates are not satisfactory. Therefore, an effective intervention is required to increase vaccination coverage. In a recent study published in IJHPR, Yamin et al. identified the need to target risk perception in the public, as a major intervent...
Article
An emergency response was triggered by recovery of wild poliovirus type 1 (WPV1) of the South Asia (SOAS) lineage from sewage in southern Israel in April 2013 during routine environmental surveillance. Public health risk assessment necessitated intensification of environmental surveillance in order to facilitate countrywide monitoring of WPV1-SOAS...
Article
Israel has been certified as polio-free by the World Health Organization and its routine immunisation schedule consists of inactivated poliovirus vaccine (IPV) only. At the end of May 2013, the Israeli Ministry of Health (MOH) has confirmed the reintroduction of wild-type poliovirus 1 into the country. Documented ongoing human-to-human transmission...
Article
Full-text available
Poliovirus vaccine coverage in Israel is over 90%. The last nine birth cohorts have been vaccinated exclusively with inactivated polio vaccine (IPV). However, between February and July 2013 type 1 wild poliovirus (WPV1) was detected persistently in 10 and intermittently in 8 of 47 environmental surveillance sites in southern and central Israel and...

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