Metropolitan Area Of Milan Research Articles

Urban Water Management in Milan Metropolitan Area, a review

The increasing rate of urbanisation and extreme climatic events represent a constant threat for urban water resources management. In recent decades, Milan Metropolitan Area (Lombardy Region, Northern Italy) has been affected by a) frequent extreme rainfall events, responsible for the flooding of major surface water courses, and b) groundwater management problems, both from a quantitative (i.e. interaction with underground infrastructures) and qualitative point of view. Moreover, the increasing use of groundwater geothermal systems also requires further considerations. This work analyses the literature available in the area regarding surface floods, groundwater quantity, quality, and temperature. Finally, a discussion is provided to understand a) which approaches could promote an effective management of both surface water and groundwater resources b) which points of contact emerge between these two aspects of the urban water cycle, and c) which possible urban interventions could contribute to an integrated and functional management of water resources, also reducing some current issues.

Community‐based participatory research for urban regeneration: Bridging the dichotomies through the exp‐EIA method

AbstractUrban environment design profoundly influences citizens' health and well‐being. Despite the aim of urban regeneration initiatives to enhance community well‐being and social connections, they often struggle to ensure a balance of power among stakeholders, effectively involve citizens, and accurately assess subjective urban experiences. New methodological approaches in community‐based participatory research (CBPR) are advocated to facilitate interactions among social actors and overcome the digital versus real dichotomy. This article introduces the Experiential Environmental Impact Assessment (exp‐EIA) method as a novel research and intervention tool to address these challenges. Grounded in psychology, exp‐EIA aims to integrate emotional, cognitive, and community identity dimensions to capture the nuanced experiences of urban environments. Through digital data collection and visualization tools, exp‐EIA could facilitate participatory decision‐making processes across various stages of urban regeneration projects. Furthermore, its adaptability enables significant integration with existing participatory methods, fostering inclusive engagement and innovative design solutions. The theoretical framework of exp‐EIA, its application in CBPR, and its potential to bridge the gap between technological innovation and citizen engagement in urban regeneration processes are discussed. A blended case study conducted in the metropolitan area of Milan (Italy) is presented, highlighting a promising pathway towards more inclusive and effective approaches to community revitalization.

Sesto San Giovanni Public Space Strategy to Unforeseen Emergencies after Covid-19 Experience

Abstract This paper explores the multifaceted impact of Covid-19 on Sesto San Giovanni, in the Milan metropolitan area. It analyzes the challenges faced by local businesses and how the city responded with extraordinary measures for public spaces, revitalizing commercial sectors, and adopting new coping mechanisms. The pandemic underscored the strategic importance of public spaces and commercial activities as vital infrastructures for societal well-being and resilience. Integrating outdoor amenities like dehors and parklets into urban redevelopment plans has boosted economic vitality and social cohesion, creating a vibrant and interconnected urban environment.

Informal Urban Biodiversity in the Milan Metropolitan Area: The Role of Spontaneous Nature in the Leftover Regeneration Process

The present study reflects on spontaneous nature’s agency to reclaim abandoned urban areas in Italian urban brownfields, providing a focused analysis of the Metropolitan Area of Milan. These spaces are the products of phenomena, such as deindustrialization, demilitarization, and uncontrolled urban expansion, which have produced a compromised heritage and challenges to regeneration. Such abandonment sometimes produces new forms of urban nature, which suggests a possible path for ecological regeneration and coexistence, as affirmed by the multidisciplinary literature. The related informal urban biodiversity grows regardless of future planning provisions, triggering unexpected transformations of the urban environment and producing socio-ecological value, as demonstrated by citizens’ recognition of these places. The present study maps informal urban biodiversity in the Milan territory, identifying the presence of large contaminated sites, relevant urban voids, vacant lots, and former agricultural spaces. This study also reflects on possible paths for urban planning and policies to integrate informal urban biodiversity within the urban ecological structure by analyzing the main features and challenges of the corresponding regeneration processes.

Consumption Feedback and Water Saving: A Field Intervention Evaluation in the Metropolitan Area of Milan

This paper investigates whether informative feedback on consumption can nudge water saving. We launched a five-month online information campaign which involved around 1,000 households located in the province of Milan (Italy) with a smart meter. A group of households received monthly reports via email on their per capita daily average water consumption, including a social comparison component. The Intention to Treat (ITT) analysis shows that, compared to a benchmark group, the units exposed to the intervention reduced their per capita water consumption by around 6% (25.8 liters per day or 6.8 gallons). Being able to observe the email opening rate, we find that the ITT effect is mainly driven by complying units. Through an Instrumental Variable approach, we estimated a Local Average Treatment Effect equal to 54.9 liters per day of water saving. A further Regression Discontinuity Design analysis shows that different feedback on consumption class size differentially affected water saving at the margin. We also found that the additional water saving increased with the number of monthly reports, though it did not persist two months after the campaign expired.

Analyzing Strawberry Preferences: Best-Worst Scaling Methodology and Purchase Styles.

This research has investigated Italian consumers' preferences for and purchasing behaviors of strawberries utilizing the Best-Worst Scaling methodology (BWS). This approach enables the key factors that influence strawberry purchasing decisions to be identified and different choice groups to be characterized. To achieve this goal, a survey was conducted on a sample of 496 respondents living in the metropolitan area of Milan (North Italy). The declared preferences of the individuals for 12 strawberry characteristics, divided into intrinsic, extrinsic, and credence attributes, were first measured. A Latent Class Analysis (LCA) was then performed to identify different clusters of consumers according to the individuals' preferences. Subsequently, the heterogeneity of the clusters was tested, using the Chi-square test, and sociodemographic characteristics and purchasing habits were considered. The results suggest that the most important attribute in the choice of strawberries was appearance, highlighting the importance of preserving it throughout the supply chain, followed by one of the increasingly important aspects of diets, which is health benefits. The attribute considered the least important was the brand. This study demonstrates, from a holistic point of view, that sociodemographic characteristics, food habits, and perceptions of different strawberry attributes influence consumers' preferences and behaviors. Practical implications suggest a new prospective for communication marketing strategies for producers, creating a better brand identity and highlighting in their marketing all of the aspects that consumers would like to know about the fruits they choose as quality certifications.

Short-term exposure to fine particulate matter exposure impairs innate immune and inflammatory responses to a pathogen stimulus: A functional study in the zebrafish model

Short-term exposure to fine particulate matter (PM2.5) is associated with the activation of adverse inflammatory responses, increasing the risk of developing acute respiratory diseases, such as those caused by pathogen infections. However, the functional mechanisms underlying this evidence remain unclear. In the present study, we generated a zebrafish model of short-term exposure to a specific PM2.5, collected in the northern metropolitan area of Milan, Italy. First, we assessed the immunomodulatory effects of short-term PM2.5 exposure and observed that it elicited pro-inflammatory effects by inducing the expression of cytokines and triggering hyper-activation of both neutrophil and macrophage cell populations. Moreover, we examined the impact of a secondary infectious pro-inflammatory stimulus induced through the injection of Pseudomonas aeruginosa lipopolysaccharide (Pa-LPS) molecules after exposure to short-term PM2.5. In this model, we demonstrated that the innate immune response was less responsive to a second pro-inflammatory infectious stimulus. Indeed, larvae exhibited dampened leukocyte activation and impaired production of reactive oxygen species. The obtained results indicate that short-term PM2.5 exposure alters the immune microenvironment and affects the inflammatory processes, thus potentially weakening the resistance to pathogen infections.

Urban Air Mobility (UAM): Airport shuttles or city-taxis?

In the last years, Urban Air Mobility (UAM) has been receiving increasing attention and even if the first services are expected to be launched shortly, there is still uncertainty about which type of commercial services (e.g., airport shuttles or city-taxis) will be implemented at an early stage, as well as which price point will be perceived as affordable by travelers. Based on data collected through a large-scale survey campaign in the Milan metropolitan area (Italy), in this paper passengers' value of travel time savings for different UAM services are estimated using advanced discrete choice modeling. Estimated mixed logit models allowed to comparatively analyze the differences between the two potential use cases, i.e., airport shuttle and city-taxi services. Results show a willingness to pay for UAM services from/to airports that is greater (in a range of 44%–57%) than for travelling within the metropolitan area, and greater (in a range of 31%–44%) for business travels than for other purposes, indicating that the most financially sustainable UAM services will potentially be available for airport-shuttle connections from/to central business districts.

Connected urban green spaces for pluvial flood risk reduction in the Metropolitan area of Milan

Rethinking cities in a more sustainable and integrated way is a key opportunity for successful climate change adaptation and disaster risk management. Nature-based solutions and green infrastructures can help to safeguard urban nature and biodiversity while providing multiple benefits to reduce climate risks and improve human well-being. Nature-based solutions help to mitigate flood risk by regulating storm-water runoff and peak-flow. This paper investigates the effects of nature-based solutions and green infrastructure networks on pluvial flood risk in the Milan metropolitan area in terms of direct economic damage to buildings and population exposed. Results show that extending the urban green networks by 25 % can potentially halve the pluvial flood damages and reduce the population exposed by 40 %. For all analysed rainfall intensities, damages to buildings and share of population exposed decrease (up to 60 % and 50 % respectively) as green area coverage increases, with slightly higher flood risk reduction for lower-intensity events. The applied methodological framework makes it possible to identify priority-action urban areas and hence inform decision-making processes as for where green solutions are most efficient.

Testing an algorithm to identify disabilities using current health and social healthcare database: the experience of the Agency for Health Protection of the Metropolitan Area of Milan

to describe prevalence of disability in the population of the Agency for Health Protection of Milan (ATS Milan), integrating current administrative healthcare, socio-healthcare, and social data; to classify disability with a diagnosis into a predominant structural and functional category according to the International Classification of Functioning, Disability and Health (ICF), supplementing it with additional levels of detail. retrospective observational study. subjects residing in the territory of ATS Milan in the years from 2018 to 2022. Main outcomes measures: prevalence of disability in the population of ATS Milan from 2018 to 2022; average annual costs since disability diagnosis of the entire population and stratified by the most common ICF classifications. the prevalence of disability ranges from 5.8% in 2018 to 8.4% in 2022. In general, women have a higher prevalence than men. However, there are significant differences in the gender distribution depending on the considered age group. The main disabilities (32.2%) affect the structures of the nervous system and mental functions, followed by disabilities identified solely by major prosthetic devices (9.4%) and sensory disabilities with alterations in sensory functions with the presence of a major device (5.2%). Analysis of average total annual per capita costs shows an upward trend with increasing years since the diagnosis. the definition of standardized tools, such as the selection from several available healthcare data provided by service suppliers, can be helpful in obtaining reliable data on the prevalence of disability in the population. This evidence can be useful in planning public health interventions to address the needs of this population. The work developed by ATS Milan has been carried out in alignment with the activities outlined in Mission 5 of the National Recovery and Resilience Plan (PNRR), in particular for the reform of disability legislation, which foresees the definition of standardized tools for the in-depth study of the epidemiological aspects of the phenomenon.

Heterogeneity in users’ intention-to-use Urban Air Mobility services

Urban Air Mobility (UAM) is receiving increasing attention by the industry and the scientific community. The first commercial services are expected to be launched in a short period. However, users’ acceptance and willingness-to-use UAM should not be taken for granted and need to be carefully assessed. This study presents the results of a large-scale RP-SI (Revealed Preference-Stated Intention) survey carried out in the metropolitan area of Milan (Italy): it was designed to collect data aiming at both profiling potential UAM passengers and developing models to assess the impact of different factors on users’ intention-to-use UAM services. The results obtained through hybrid ordered choice modeling analysis outlined the statistical importance of three identified latent constructs (i.e., flying concerns, propension towards technology and UAM safety concerns) in explaining the intention of using UAM services. Particularly, concerns regarding the flight or the UAM safety have been found to have a minor negative influence in the intention to use UAM compared to the user's propension towards technology which has instead a major positive influence. Moreover, a lower propensity towards embracing these new aerial services has been found in females and in those currently not traveling alone, while those traveling for business purposes or using taxis for daily travels exhibit a higher propensity towards their adoption.

Extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: 10-year experience in a metropolitan cardiac arrest centre in Milan, Italy

IntroductionGrowing evidence supports extracorporeal cardiopulmonary resuscitation (ECPR) for refractory out-of-hospital cardiac arrest (OHCA) patients, especially in experienced centres. We present characteristics, treatments, and outcomes of patients treated with ECPR in a high-volume cardiac arrest centre in the metropolitan area of Milan, Italy and determine prognostic factors. MethodsRefractory OHCA patients treated with ECPR between 2013 and 2022 at IRCCS San Raffaele Scientific Institute in Milan had survival and neurological outcome assessed at hospital discharge. ResultsOut of 307 consecutive OHCA patients treated with ECPR (95% witnessed, 66% shockable, low-flow 70 [IQR 58–81] minutes), 17% survived and 9.4% had favourable neurological outcome. Survival and favourable neurological outcome increased to 51% (OR = 8.7; 95% CI, 4.3–18) and 28% (OR = 6.3; 95% CI, 2.8–14) when initial rhythm was shockable and low-flow (time between CPR initiation and ROSC or ECMO flow) ≤60 minutes and decreased to 9.5% and 6.3% when low-flow exceeded 60 minutes (72% of patients). At multivariable analysis, shockable rhythm (aOR for survival = 2.39; 95% CI, 1.04–5.48), shorter low-flow (aOR = 0.95; 95% CI, 0.94–0.97), intermittent ROSC (aOR = 2.5; 95% CI, 1.2–5.6), and signs of life (aOR = 3.7; 95% CI, 1.5–8.7) were associated with better outcomes. Survival reached 10% after treating 104 patients (p for trend <0.001). ConclusionsPatients with initial shockable rhythm, intermittent ROSC, signs of life, and low-flow ≤60 minutes had higher success of ECPR for refractory OHCA. Favourable outcomes were possible beyond 60 minutes of low-flow, especially with concomitant favourable prognostic factors. Outcomes improved as the case-volume increased, supporting treatment in high-volume cardiac arrest centres.

P13 Carer Preferences and Willingness-to-Pay for Home Care Services for Older People With Dementia: A Discrete Choice Experiment in the Milan Metropolitan Area

P13 Carer Preferences and Willingness-to-Pay for Home Care Services for Older People With Dementia: A Discrete Choice Experiment in the Milan Metropolitan Area

Towards new geographies of cohesion in a context of growing inequalities: insights from two social innovation projects in Milan metropolitan area

ABSTRACT This contribution critically examines the possible interface between territorial cohesion and social innovation by investigating how two local social innovation initiatives in the Milan metropolitan area have tried to tackle existing territorial inequalities. The paper draws on the outcomes of the Horizon 2020 Project ‘COHSMO―Inequality, Urbanization and Territorial Cohesion: developing the European social model of economic growth and democratic capacity’ (2017–2021) and places emphasis on the ways in which social innovation can emerge in the public sector and be sustained by public action in connection with civil society to solve problems of socio-spatial inequalities in distressed urban neighborhoods. Findings show that social innovation in the two cases has been interpreted as a trigger for empowering socially vulnerable inhabitants and reconnecting them with existing welfare services. This has happened through a filter mechanism that allowed to create a soft space where institutional and third-sector actors could approach vulnerable individuals in informal settings, answer to their emerging social needs, and promote empowerment processes. The analysis highlighted a relationship of complementarity between social innovation and the welfare system due to the capacity of socially innovative actions to fill some gaps present in existing welfare spaces or in the market.

Contribution of chemical composition to oxidative potential of atmospheric particles at a rural and an urban site in the Po Valley: Influence of high ammonia agriculture emissions

The present study investigates the chemical composition and oxidative potential (OP) of PM10 particles at two sites in the Po Valley (Norther Italy), with the aim of evidence the impact of high level of atmosphere ammonia (NH3). Field measurements were conducted in a rural location (Bertonico) close to farms strongly impacted by high ammonia emissions from agriculture and livestock husbandry. The urban site was in the metropolitan area of Milan. The NH3 concentrations observed at the rural site were about 5 times higher than those at the urban location, generating higher levels of secondary inorganic aerosol (ΣSIA) at Bertonico (16.6 ± 6.33 μg m−3) than at Milan 12.6 ± 4.93 μg m−3. The oxidative potential measured with the ascorbic acid assay (OPAAV) was almost triple in Milan than at Bertonico, namely 1.48 ± 1.08 nmol min−1 m−3 and 0.44 ± 0.23 nmol min−1 m−3, respectively, while the measured OPDTTV responses were similar at both sites, close to ∼ 0.5 ± 0.3 nmol min−1 m−3. These results suggested that the SIA components don't significantly contribute to the PM10 oxidative reactivity, although they account for most of the PM10 mass. Despite such an OP-inactivity, the SIA components resulted significantly correlated with both OPAAV and OPDTTV responses. This may be likely due to their inter-correlation with other redox-active components, such as the secondary organic species, which are synergically produced along with the SIA formation. In addition, an increase in the metals reactivity towards the OP assays, may be associated with the PM10 acidic environment produced by enhanced HNO3 and H2SO4 levels. Therefore, the contribution of the SIA to PM oxidative toxicity cannot be ignored in assessing health risk associated with PM exposure.

Urban green governance and mechanisms of generation of ecosystem services: Milan’s green governance models

ABSTRACTThis paper studies the governance of the green spaces in the metropolitan area of Milan, aiming to understand the political mechanisms that underpin the generation of ecosystem services in the urban context. Based on semi-structured interviews to relevant policymakers and stakeholders and on the study of planning documents and greening policies, the research identifies the main actors who are involved in green planning and management in the city and in the metropolitan area. By analysing their green management and planning roles, economic resources and greening visions and priorities, the study depicts five coexisting green governance models. In particular, the research highlights the decreasing influence of public institutions in green planning and management and the rising relevance of private-public collaborations. These dynamics of green governance may affect the generation and the distribution of ecosystem services. On the one hand, greening in private-led regeneration processes tend toward recreational and final ecosystem services, aiming to raise land values. On the other hand, the civic projects of afforestation have evolved in territorial initiatives that go beyond the mere objective of implementing new green spaces, looking at broader planning themes – i.e. soft mobility and social welfare – demanding a stronger metropolitan coordination.

Invasive and Non-Invasive Human Salmonellosis Cases Admitted between 2015 and 2021 in Four Suburban Hospitals in the Metropolitan Area of Milan (Italy): A Multi-Center Retrospective Study.

Non-Typhoidal Salmonellas (NTSs) are diffused worldwide. In Italy, more than 3500 cases are notified each year, but despite this, data about salmonellosis are scarce. Our multi-center, retrospective, descriptive study selected 252 patients with positive cultures for Salmonella spp. (feces 79.8%, blood 8.7%, feces and blood 7.5%), aiming to describe the epidemiological and clinical characteristics of this population. Bacteremic infections constituted 16.3% (41/252) of patients. Extreme ages (≤12 and ≥65 years old) accounted for 79.7%, but only elder ages were strongly associated with bacteremic infections (aOR 5.78). Invasive infections had a 7-fold higher mortality rate than non-invasive disease (9.8% vs. 1.4%, p = 0.013), with an overall rate of 2.8%. The two more represented serogroups were O:4 (52.8%) and O:9 (22.2%). The O:9 serogroup was strongly associated with a higher frequency of invasive infection (aOR 2.96, 95% CI 1.17-7.63). In particular, S. napoli, an emerging serovar in Europe, accounted for 31.7% of bacteremic infections and only 9.5% of non-bacteremic ones (p < 0.001). Antibiotic microbial resistance (AMR) observed a steep increasing trend and was detected in 60.4% of cases (122/202): amoxicillin/clavulanate, ampicillin, and gentamicin were most commonly involved (26.7%, 21.8%, 14.3%, respectively), while TMP/SMX, ciprofloxacin, and ceftriaxone were <10%. Resistance was, in general, less common in the O:9 serogroup, while amikacin resistance was significantly more common. Factors associated with an MDR Salmonella acquisition were time (OR 1.37 per year more), O:4 serogroup (OR 2.67), and being a woman (OR 2.11). The most frequent symptoms were diarrhea (90.5%) and fever (81.7%). In conclusion, our study highlights a high burden of NTS infections, leading to severe or fatal outcomes in frail patients. Furthermore, AMR shows an increasing trend with a concerning high prevalence of cephalosporine resistance compared to the rest of Europe.

Wastewater-based epidemiology revealed in advance the increase of enterovirus circulation during the Covid-19 pandemic

Wastewater-based epidemiology (WBE) was conducted to track Enteroviruses (EVs) circulation in the Milan metropolitan area (Northern Italy) during Covid-19 pandemic (March 2020–December 2022).202 composite 24-hour wastewater samples (WWSs) were collected weekly from March 24, 2020, to December 29, 2022 at the inlet of two wastewater treatment plants (WWTP) in Milan (1.5 million inhabitants). EV-RNA was quantified and molecular characterization of non-polio EVs (NPEV) was performed by Sanger sequence analysis. Data from WWS were matched with virological data collected in the framework of Influenza-Like Illness (ILI) surveillance in the same place and time.EV-RNA was identified in 88.2 % of WWSs. The peak in EVs circulation was observed in late August 2020 (upon conclusion of the first national lockdown), in late August 2021, and in mid-April 2022.EV-RNA concentration in WWS (normalized as copies/d/1000 people) at peak of circulation presented a yearly increase (2020: 2.47 × 1010; 2021: 6.81 × 1010; 2022: 2.14 × 1011). This trend overlapped with trend in EV-positivity rate in ILI cases, expanded from 21.7 % in 2021 to 55.6 % in 2022. EV trends in WWS preceded clinical sample detections in 2021 and 2022 by eight and five weeks, respectively, acting as an early warning of outbreak.Although sequencing of EV-positive WWSs revealed the presence of multiple EV strains, typing remained inconclusive. Molecular characterization of EVs in clinical samples revealed the co-circulation of several genotypes: EV-A accounted for 60 % of EVs, EV-B for 16.7 %, EV-D68 for 23.3 %.EVs were circulating in Milan metropolitan area between March 2020 and December 2022. The epidemiological trends unfolded the progressive accumulation of EV transmission in the population after removal of Covid-19 restrictions. The increased circulation of EVs in 2021–2022 was identified at least 35 days in advance compared to the analysis of clinical data. The inconclusive results of Sanger sequencing lookout for improvement and innovative molecular approaches to deepen track EVs.

Designing Urban Spaces to Enhance Active and Sustainable Mobility: An Analysis of Physical and Symbolic Affordances in School Squares in the Metropolitan Area of Milan, Italy

As thresholds to cities, public spaces adjacent to schools play an important role in children’s everyday mobilities, potentially shaping their future mobility habits and affective experiences. The purpose of this paper is to investigate the urban design conditions of such spaces, defined as “school squares”, and, with the aid of affordance theory, to analyze spatial features and characteristics that might encourage or hinder active and sustainable mobility practices. In the first part of the paper, we define sustainable mobility, conduct a literature review on affective responses to the urban environment, and discuss active school travel (AST) in relation to the design of school squares. By focusing on 416 primary and lower secondary schools in the metropolitan area of Milan, we present an assessment method that is composed of on-desk and on-site surveys. In particular, Phase 1 defines the type of school squares, Phase 2 investigates physical affordances (spatial features and characteristics that directly influence active mobility practices, such as bicycle racks, protective barriers, benches, and parked cars), and Phase 3 discusses symbolic affordances (elements and characteristics that might induce different affective responses to a school square with regard to active mobility, such as bicycle racks, parked cars, greenery, and dustbins). The results indicate that in most cases school squares are characterized by typological confusion that has nothing to do with the school environment: narrow sidewalks, disorder, and low levels of safety. In order to promote active and sustainable mobility choices and enhance children’s mobile experiences, it is necessary to address the aforementioned features. The ultimate goal of this paper is to provide insights for developing an urban regeneration framework that considers school squares a safe context and a starting point from which to perform sustainable mobility practices.

Chagas disease prevalence among migrants from El Salvador in Milan: a cross- sectional study of an often-overlooked population

Background Chagas disease (CD) is considered to be highly endemic in El Salvador, where its prevalence is estimated to be 1.3–3.7%. Although more than 40,000 migrants from El Salvador are currently living in Europe (particularly in Spain and Italy), there are few data regarding the prevalence of CD in this population. The aim of this study was to evaluate the prevalence of CD among Salvadorans living in Italy. Methods A cross-sectional serological survey of CD among Salvadorans living in the metropolitan area of Milan was carried out between October 2017 and December 2019. The participants’ blood samples were tested for Trypanosoma cruzi antibodies using two different serological assays. The collected demographic data included their biological sex, province of origin, the type of housing in their country of origin, and family history of CD. Results Of the 384 subjects who voluntarily participated in the study, five (1.3%, most coming from La Paz) were positive to both serological assays and therefore conclusively diagnosed as having CD. Five other subjects had discrepant serological results but were not positive to a third assay. Three of the five subjects with a diagnosis of CD completed medical staging, one of whom had chronic disease (digestive and cardiac involvement). Conclusions The prevalence of CD among Salvadorans living in Milan is similar to that estimated by the WHO in 2010. Although they are often overlooked in CD surveys, Salvadoran migrants should be included in CD control programs in countries in which the disease is not endemic.