Neville Calleja

Ministry for Health / University of Malta · Directorate for Health Information & Research / Faculty of Medicine & Surgery

Background: An infodemic is excess information, including false or misleading information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefits of medical and public health interventions, with s...

Healthcare professionals and resource planners can use healthcare delivery process mining to ensure the optimal utilisation of scarce healthcare resources when developing policies. Within hospitals, patients' Length of Stay (LOS) and volume of admitted patients, in terms of number and characteristics (age, gender, and social deter-minants), are sig...

Background: As part of the measures to contain the initial cases of Coronavirus Disease (COVID-19) in 2020, all educational facilities were closed in March 2020 and remained so for the remainder of that scholastic year. When they reopened in October 2020, most educational facilities on the Maltese islands did so with various mitigation measures in...

Evidence on what people eat globally is limited in scope and rigour, especially as it relates to children and adolescents. This impairs target setting and investment in evidence-based actions to support healthy sustainable diets. Here we quantified global, regional and national dietary patterns among children and adults, by age group, sex, educatio...

Unlabelled: Eastern Europe continues to have the highest rates of cancer of the uterine cervix (CUC) and human papillomavirus (HPV) infection in Europe. Aim: The aim of this study was to investigate CUC trends in Bulgaria in the context of a lack of a population-based screening program and a demographic crisis. Methodology: This was a retrospe...

Background: By December 2021, administration of the third dose of COVID-19 vaccinations coincided with the spread of the Omicron variant in Europe. Questions had been raised on protection against infection conferred by previous vaccination and/or infection. Method: Our study population included 252,433 participants from the COVID-19 vaccination...

Background Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. Methods We analyzed individual data for adults (15–99 years) diagnosed with a brain tumor (ICD-O-3 topography code...

BACKGROUND An infodemic is an excess of information of varying quality, including false or misleading information and/or ambiguous information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefi...

Background An infodemic is excess information, including false or misleading information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefits of medical and public health interventions, with su...

This is a retrospective study intended to determine the prevalence of severe hypoglycaemia requiring admission to Mater Dei Hospital from January to December 2018. We identified risk factors associated with hospital admission and conducted a survival analysis of the cohort. All patients admitted with diabetes and hypoglycaemia were identified by me...

Aims The primary aim of this study was to assess the reliability, intra- and inter-observer variation of the SPICE, Mucosal protrusion angle (MPA) and SHYUNG scores in differentiating a subepithelial mass (SEM) from a bulge. Methods This retrospective multicentre study analysed the 3 scores, radiological studies, enteroscopy and/or surgical findin...

Background: By December 2021, administration of the third dose of COVID-19 vaccinations coincided with the spread of the Omicron variant in Europe. Questions had been raised on protection against infection conferred by previous vaccination and/or infection. Method: Our study population (n = 252,433) included all those in the COVID-19 vaccination re...

Background Perinatal depression (PD) is linked with a multitude of poor outcomes and far-reaching complications that extend within the whole family unit. A growing body of evidence suggests that measuring PD literacy levels, attitudes and awareness is important as these may influence a perinatal woman's ability to seek support. Aim To explore preg...

Background Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in yo...

BACKGROUND Background: In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. Our objective is to describe how SARI surveillance was digitised in Malta and describe the characteristics of people included in the surve...

Background In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. Objective We sought to describe the process of digitizing and upgrading SARI surveillance in Malta, an island country with a centralized health syste...

Targeting and reducing health inequities is a requisite for public health. The Maltese Islands are divided into six geographical districts with a total area of 316 km ² . It is anticipated that the close geographical proximity and social integration would result in similar population health status. This study aims to identify whether geographical h...

The aim of this paper is to compare the impact of the COVID-19 pandemic on four small countries in the southern half of Europe with similar public health systems: San Marino, Montenegro, Malta and Cyprus, the latter two being island states. There are advantages and disadvantages in being a small nation amidst this crisis. The centralized public hea...

Purpose It is unclear whether Maltese cancer patients wish to know their diagnosis or to what extent they want to be informed. The aim was to assess patients’ preferences for receiving a cancer diagnosis and being involved in the decision-making process, and then compare this with results from similar international studies. Methods A total of 252...

BACKGROUND Vaccination against COVID-19 is crucial for controlling this scourge. COVID/vaccination deniers often rationalise their unfounded fears by citing rare vaccination side-effects. One of the most frequently cited side effects is myocarditis, especially in younger persons. Malta has very high vaccination rates. This study was carried out to...

Background The European Union has been criticized for responding to the COVID-19 pandemic in a reactive, rather than prosilient manner. For the EU bloc to be prosilient, it needs to have the right early warning indicators to allow short-term healthcare system preparedness and agile planning of the public health response. Method The association of...

The COVID-19 pandemic has affected our lives in many ways, including the way we consume, produce and react to information. Underlining that the world is facing a rapid amplification and circulation of accurate but also low quality and false information, the UN Secretary-General and the Director-General of the World Health Organization both declared...

Background Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The aim was to estimate the DALYs due to Covid-19 in Malta (March 2020–21) and investigate its impact in relation to other causes of disease at a population level. Methods Mortality and weekly h...

Background: An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high...

Background: An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high...

(1) Objectives: The study aimed to examine data from Malta’s Health Interview Survey (HIS) to assess differences between persons in employment and those retired, across different time periods. (2) Methods: A repeat cross-sectional design was adopted. Data that were collected over a period of 12 years included three cross-sectional HIS waves (2002,...

Fitzpatrick skin phototype is one of the factors determining melanoma development, with fairer skin phototypes I and II known to be associated with a higher risk. This study aimed to identify any associations between skin phototype and the histologic subtype, Breslow's thickness, and the site of melanoma. Patients diagnosed with melanoma for over a...

Background An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high s...

BACKGROUND An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. The global scale and high stakes of t...

Background Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population health impact of diseases, injuries, and risk factors. The aim of this paper was to estimate the DALYs due to Covid-19 in Malta (March 2020-21) and investigate its impact in relation to other caus...

Mismatch repair protein expression defects in endometrioid endometrial adenocarcinoma Objectives: Endometrioid endometrial carcinoma (EEC) is the sentinel cancer in over half female patients with heritable mismatch repair (MMR) mutations as part of Lynch syndrome. Immunohistochemical testing for tumoural MMR-protein expression is the primary screen...

More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, o...

Abstract: More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on retrospective studies, expert...

The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality...

Objectives: This study comes at an opportune time due to recent introduction of the National Cervical Cancer Screening programme in Malta. It aims to assess the knowledge of 25-64 year-old females on cervical cancer and attitudes towards screening. Study design: A cross-sectional, telephone-based, quantitative survey conducted in 2017. Methods:...

The study presented in this article investigates the prevalence of tumoural mismatch repair protein expression defects in Maltese endometrial cancer cases and the role age at presentation plays in MMR IHC testing. With a mean 71 local patients per year diagnosed with endometrial carcinoma, data on the prevalence of MMR deficiency would improve the...

Introduction/Background Endometrial cancer has been shown to be the sentinel cancer in over half the female patients with heritable mismatch repair (MMR) mutations as part of Lynch syndrome. Immunohistochemical testing for MMR protein expression in endometrial cancer is the first screening test identifying cases that potentially harbour familial ca...

Introduction: Social factors might bring about health inequities. Vulnerable population groups, including those suffering from non-communicable diseases such as type 2 diabetes and depression, might be more prone to suffering the effects of such inequities. This study aimed to identify patients with type 2 diabetes with depression in a primary car...

COVID-19 continues pandemic and researchers and companies are racing to develop effective vaccines with currently (September 2020) over 320 vaccine candidates, 32 of which are in clinical trials that plan to enroll >280,000 volunteers from >470 sites in 34 different countries. Vaccines are given to healthy multitudes and for this reason, they must...

There is a significant relationship between ambient temperature and mortality. In healthy individuals with no underlying co-morbid conditions, there is an efficient heat regulation system which enables the body to effectively handle thermal stress. However, in vulnerable groups, especially in elderly over the age of 65 years, infants and individual...

Issue Early epidemiology established higher risk of morbidity & mortality amongst infected older individuals or those having specific chronic diseases, consuming most hospital care. Also where demand exceeding supply of healthcare, mortality was very high. As an island nation with one central main hospital, not overwhelming the healthcare system wh...

Background The prevalence of childhood overweight and obesity is increasing worldwide, with Malta having one of the highest rates among European countries. Childhood obesity is likely to track into adulthood, and can have multiple physical and psychological health outcomes. It also causes a substantial economic burden on society. A cross-sectional...

Background Low back pain (LBP) is a leading global cause of all-age years lived with disability (YLD). Studies conducted in Malta reported that musculoskeletal complaints were the commonest in primary care. The aim was to estimate for the first time the burden of LBP at population level in Malta in terms of disability-adjusted life years (DALYs) an...

Although brief smoking cessation interventions that follow the 5As algorithm (Ask, Advise, Assess, Assist, Arrange) can trigger smokers to quit, routine delivery remains low in Europe. This study aimed to identify the extent of smoking cessation practices of healthcare professionals interested in tobacco cessation, and their opinions and attitudes....

Background: Low back pain (LBP) is a public health concern and a leading cause of ill health. A high prevalence of musculoskeletal complaints has been reported for Malta, a small European state. The aim was to estimate for the first time the burden of LBP at population level in Malta in terms of disability-adjusted life years (DALYs) and compare t...

The World Health Organisation (2016) recommends exclusive breastfeeding up to 6 months of age and the introduction of complementary foods at around 6 months. International literature suggests that although knowledge of the guidelines is high, only a minority of parents wait until 6 months to wean and sub-optimal weaning practices are common. The ai...

UNSTRUCTURED An infodemic is an overabundance of information– some accurate and some not – occurring during an epidemic. In a similar manner to an epidemic, it spreads between humans through digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. A WHO technical cons...

Background: An infodemic is an overabundance of information - some accurate and some not - that occurs during an epidemic. In a similar manner to an epidemic, it spreads between humans via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. Objective: A WHO te...

Background Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. Methods and findings In this multinational cross-sectional study, existing data...

PMID: 32572354 PMCID: PMC7302718 DOI: 10.7759/cureus.8195 Background and Objectives The incidence of glioblastoma multiforme (GBM) ranges from 0.59 to 5 per 100,000 persons, and it is on the rise in many countries. The reason for this rise is multifactorial, and possible contributing factors include an aging population, overdiagnosis, ionizing r...

https://maphm.org/symposium/

Background How does your Health Information System (HIS) measure up to others in the EU? How can you empower national HIS players with an objective peer-reviewed HIS assessment? Nine InfAct partners engaged in a capacity building exercise where experts in rotating groups of three countries performed peer assessments of each other’s national HIS. Us...

Issue and method Health information systems (HIS) in Europe are complex and involve multiple stakeholders. To strategically assess HIS, a support tool has been developed by the WHO Regional Office for Europe. It has been applied in nine countries by WHO Europe since October 2015. Additionally, nine countries are using the tool in a peer review form...

This study aimed to define the clinical features and prevalence of the finger-prick sign in a cohort of persons with diabetes mellitus (DM). One hundred and five consecutive persons with DM attending a hospital diabetes clinic (n = 44) or a dermatology out-patients clinic (n = 61) who performed self-monitoring of blood glucose (SMBG) at least once...

ntroduction:The trend towards delayed motherhood has accelerated in developed countries over the last few decades. Advanced maternal age (AMA) is defined as age 35 years and older at the estimated date of delivery.Objective:The aim of this large retrospective cohort study is to assess for the association between AMA and adverse maternal outcomes af...

Introduction: During the past three decades, significant increases in childbirth at advanced maternal age (AMA) have been noted in different high-income countries. Objective: The aim of this study is to assess for the association between AMA and different neonatal outcomes in Malta. Multivariate regression analysis was carried out. Materials and Me...

The Maltese health system is undergoing a period of change and transformation. This is partly in response to the changing socio-economic environment within the country. Planning and delivering adequate and appropriate health services necessitates that relevant local research on the health system takes place. In order to identify the top priorities...

Purpose: Individuals with dysglycaemic are prone to dyslipidaemia. Understanding the dyslipidaemic status of dysglycaemic individuals is essential for monitoring and early prevention. The aim was to assess the control of lipidaemia by glycaemic status in a representative adult population. Methods: A retrospective health examination survey was pe...

In the scholarly environment, research findings are disseminated as journal papers which support/dispute extant knowledge or add further to what is already known. The entire manuscript needs to be cited (in-text) and referenced (at the end of article), in order for readers to ascertain the validity of the research claim/s. This must be done in prop...

Highlights en • Former smokers exhibited a significantly higher metabolic risk compared with subjects with other smoking habits. • Current smokers with diabetes exhibited significantly higher fasting blood glucose and triglyceride levels. • Only former smoking was independently associated with increased dysglycemic risk after adjustment for potent...

Data may be normally distributed in which case standard and relatively familiar tests may be used for inferential testing. Or data may be non-normally distributed, such as ordinal data, in which case, non-parametric tests are usually advocated. This paper will review current thinking with regard to these tests, and the appropriateness of their appl...

This paper outlines Binomial and Poisson distributions which are both used to measure the occurrence of a number of random events within a certain period.

Linear regression is the equation which provides of straight line that best describes the association between two continuous variables, x and y. However, it is often the case that the dependent variable y is influenced by more than one variable and not just a single x variable. Multivariate analysis is a statistical modeling technique wherein multi...

In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. Methods CONCORD-3 includes individual records for 37·5 million patients diagn...

The management of patients with mesothelioma and thymic malignancy requires continuous multidisciplinary expertise at any step of the disease. A dramatic improvement in our knowledge has occurred in the last few years, through the development of databases, translational research programs, and clinical trials. Access to innovative strategies represe...