Iranian Journal of Epidemiology

Development and Validation of a Specific Questionnaire for Measuring the Attitude and Behavior of Mask Use in Pandemics with the Dominant Airborne Pattern: the Experience of COVID-19

Homayoun Sadeghi-Bazargani

Background and Objectives: Masks play a crucial role in preventing and controlling viral epidemics transmitted predominantly through the air. This study aimed to develop and validate a tool to measure people’s attitudes and behaviors related to mask usage during highly contagious viral epidemics.
Methods: In this psychometric study, the initial questionnaire was developed and face validity and content validity were assessed by 17 experts and three lay experts. Reliability was evaluated through internal consistency using Cronbach’s alpha and test-retest reliability using the Intraclass Correlation Coefficient (ICC). Construct validity was measured using exploratory factor analysis (EFA) with the principal component extraction method and Varimax rotation.
Results: Based on a review of previous studies, an initial 27-item questionnaire was crafted. During the face validity stage, two items were excluded. Through calculating the Content Validity Ratio (CVR) and the Content Validity Index (CVI), three and one items respectively removed. The average scale level content validity index (S-CVI/Ave) was 0.95. Cronbach's alpha coefficient was found to be 0.76 for attitude and 0.66 for practice sections; the ICC was equal to 0.873. EFA revealed two factors explaining 63.98% of the total variance.
Conclusion: This questionnaire demonstrated sound reliability and validity in Persian, providing an effective means to assess attitude and behavior related to mask usage during highly contagious viral epidemics. It stands as a valuable tool for use in Iran and other countries.

Investigating Knowledge Level, Attitude and Practices of Farmers within the Health Center Coverage Area in Urmia County Regarding the Use of Paraquat in 2022

Mina Maheri

Background and Objectives: Assessing farmers’ knowledge, attitude, and practices regarding paraquat usage, provides insights into the safe application of paraquat, and emphasizes the necessity of implementing educational programs for farmers if their level of knowledge, attitude, and practice are low. Therefore, the present study aimed to determine the status of knowledge, attitude and practice of farmers toward the use of paraquat.
Methods: A cross-sectional study was conducted on 288 farmers using multi-stage cluster sampling. Data were collected through a researcher-made questionnaire comprising demographic information and questions assessing knowledge, attitude, and practice toward paraquat. Descriptive and analytical statistics were employed for data analysis.
Results: Among the surveyed farmers, 71.9% had poor knowledge, 22.4% had medium knowledge, and 5.7% had good knowledge. Regarding attitude, 11.0% were classified as poor/negative, 44.5% as medium/neutral, and 44.5% as good/positive. In terms of practice, 10.3% exhibited poor, 27.0% medium, and 62.7% good practices in the safe use of paraquat. Significant relationship were observed between education levels with knowledge, attitude and practice, history of participating in educational programs related to pesticides and knowledge and attitude, as well residence and knowledge.
Conclusion: Given the poor knowledge of the surveyed farmers, which can lead to poor attitude and practice, it seems necessary to design and implement educational interventions aimed at improving their knowledge, attitude, and practice in the field of safe and correct use of paraquat. Designing and implementing programs to enhance farmers' knowledge, attitudes, and practices in the safe and correct use of paraquat is imperative.

Prophylactic Measures Implemented for Cases of Animal Bite in West Azerbaijan Province from 2012 to 2019

Sima Masudi

Background and Objectives: Animal bites are one of the most important public health problems that cause rabies. This study aimed to investigate the preventive measures taken for animal bite cases that occurred in West Azerbaijan province during 2012 to 2019.
Methods: This cross-sectional study involved the review data from all animal bite cases referred to rabies care centers in West Azerbaijan province. Information regarding prophylactic measures to prevent rabies, including post-bite procedures (washing, disinfection, dressing, stitches and receiving antibiotics), anti-rabies vaccine status (referral delay, vaccine dose received, vaccination history, anti-rabies serum, tetanus vaccination history) was analyzed using descriptive statistics. The relationship between delay in referral and the measures taken was investigated using the Chi-square test.
Results: Over the studied years, there were 47131 cases of animal bites. Among these, 63.9% were referred without delay, while 36.1% experienced a delay in referral. Notably, 99.6% of wounds were washed with soap and water, 94.5% were disinfected, and 31.3% received antibiotics. The proportion of individuals receiving antibiotics was significantly higher among those with delayed referrals. Regarding rabies vaccination, 77.3% had received all three initial doses, 15.4% had completed five doses, and 1.1% had not received any vaccine.
Conclusion: While prophylaxis measures for animal bite cases are commendable, there is a critical need for timely administration of rabies vaccine in rabies care centers. Implementing educational programs for general population to encourage prompt treatment-seeking in the event of animal bites is essential.

Investigating the Correlation between the Excessive use of Mobile Phones and Depression among Students at Shahroud University of Medical Sciences

Mahbobeh Poorheidari

Background and Objectives: The mobile phone has become an indispensable tool for communication and interactions. This study aimed to investigate the relationship between excessive mobile phone use, depression, and social loneliness among students at Shahroud University of Medical Sciences.
Methods: This descriptive-analytical study, conducted in 2019, employed stratified random sampling to survey 313 students from Shahroud University of Medical Sciences. Data collection involved demographic questions, a harmful mobile phone use scale, and depression scale (Kavaja and Bryden). Collected data were entered into SPSS 18 and analyzed using descriptive and analytical statistics.
Results: The study included 313 participants with an average age of 22.16 ± 3.41 years. Pearson's correlation coefficient revealed a positive correlation between depression scores and various variables, including education level, interest in the field, native status, place of residence, history of taking antidepressants, employment status, financial problems, family life status, father's age, and excessive use of mobile phones. The results of linear regression analysis, as indicated by the coefficient of determination (0.603) demonstrated a high intensity of correlation between factors influencing depression and the actual depression scores.
Conclusion: According to the results of the study, there is a significant relationship between excessive use of mobile phones and depression and social loneliness in students, which requires proper planning for intervention.

Exploring Prospective Job Opportunities for Epidemiologists in Public and Non-Governmental Sectors and Projecting the Required Workforce in Iran Until 2027

Ali Akbar Haghdoost

Background and Objectives: The influential role of epidemiologists in improving health outcomes and conducting pertinent research becomes apparent when they are strategically positioned and available in sufficient numbers within a nation. This study aims to identify potential job positions in epidemiology within both governmental and non-governmental sectors while estimating the necessary workforce of epidemiologists in the country until 2027.
Materials and Methods: The present study was conducted as a combination in two quantitative and qualitative parts. In the qualitative part, interviews were conducted with experts, policy makers, graduates and students of this field in the field of job opportunities. In the quantitative part, the number of epidemiologists needed was estimated using modeling and parameters obtained from the review of the literature and the opinions of experts in this field. In this study, the current and near future needs up to 1406 have been considered.
Results: Based on the interviewes, job opportunities for epidemiologists in the country encompass diverse domains, including problem management and analysis, conducting applied research, data analysis, dashboard development, teaching, training, and future-oriented work (forecasting). Acounting for lost job opportunities, the estimated number of epidemiologists required in the country until 2027 is 1122 individuals, that most of them contribute to the country's health system if job opportunities are created. The highest demand for epidemiologists was identidied in units of the Ministry of Health, medical universities, research centers, and hospitals.
Conclusion: Estimating the number of epidemiologists needed using modeling in the country and paying attention to the current number of graduates, reveals that the growth of this field and the increase in graduates can only occur if job opportunities are clearly defined, created, and implemented across proposed job levels.

Prediction of Mental Health Among Iranian Adolescents Based on Nutrition, Physical Activity and Leisure Time Using Data Mining Techniques

Maryam Jahanbakhsh

Background and Objectives: The present research was conducted to predict mental health based on three factors: nutrition, activity, and leisure time, among students in the adolescent age group, using data mining techniques.
Methods: The present analytical study was conducted on 14274 data available in the Caspian 5 database. According to the CRISP-DM method, data mining was done in 6 steps using decision trees, k nearest neighbors, simple Bayesian and random forest techniques in Rapidminer software.
Results: Among the four data mining techniques used to predict the mental health of adolescents based on nutrition, physical activity and leisure time, the random forest technique has the highest accuracy (91.72) and specificity (82.73) and the k-nearest neighbors technique has the highest sensitivity (96.30). In addition, based on random forest techniques, the rule with the highest level of support showed that an adolescent who is in high school, eats breakfast, lunch, and dinner every day, drinks tea and coffee weekly, exercises 2 hours a week at school,also, he has 4 days of physical activity for 30 minutes in the last week, and he goes to school with the service, with 100% confidence has good mental health.
Conclusion: Based on the random forest technique, which has showen the best performance, nutrition has the greatest impact on the mental health of Iranian adolescents. So, it is necessary to think about providing a suitable platform for training parents and adolescents regarding proper nutrition and increasing awareness in the field of adolescent mental health.

Investigating the Impact of Climatic and Environmental Factors on the Epidemiology of Cutaneous Leishmaniasis in Iran: A Review Study

Sareh Shakerian

Background and Objectives: Cutaneous Leishmaniasis is a significant endemic diseases in Iran, leading to skin lesions, lifelong scars, and social stigma. This study aims to investigate the influence of climatic and ecological factors on the prevalence of cutaneous Leishmaniasis in Iran.
Methods: This study employed a narrative review approach. A comprehensive search was conducted using key terms such as 'skin Leishmaniasis', 'cutaneous Leishmaniasis', 'climatic factors,' and 'environmental factors' in both national and international databases. All relevant research was included without limitations on location, time, or research methodology.
Results: The initial search yielded 823625 articles. After refining the search keywords and conducting initial screening, 184 studies remained following the removal of duplicate articles. Subsequent screening for eligibility further narrowed down the selection to 30. The inclusion of 6 master theses brought the final number of studies for review to 36. A review of the studies showed a significant association between certain climatic factors, including temperature, humidity, hours of sunshine, and rainfall, and the incidence of cutaneous Leishmaniasis, across various geographical regions in the country. The relationship between factors such as vegetation, wind, and the number of disease cases had different results in different parts of the country.
Conclusion: The results of the present study show the effect of climatic and environmental factors on the rate of cutaneous Leishmaniasis in the country. Considering that the effect of these factors is not the same in all parts of the country, it is necessary to implement effective preventive measures to reduce the disease burden according to the needs of each geographical area.