Iranian Journal of Epidemiology

Assessment of the Care Status of Patients with Diabetes: A Descriptive Cross-Sectional Study in Yazd, Iran

Hossein Akhondi

Background and Objectives: Diabetes mellitus is one of the most common chronic metabolic diseases worldwide, and it requires comprehensive healthcare management. This cross-sectional descriptive study aims to evaluate the healthcare status of diabetic patients in Yazd, Iran, and identify gaps in provided care.
Methods: In this study, 702 diabetic patients registered in the Ministry of Integrated Health System were selected using cluster sampling. To identify care gaps, key indicators, including the frequency of HbA1c testing, referrals to specialists, number of visits to healthcare centers, receipt of diabetes education, and level of blood sugar control, were analyzed using descriptive statistics (frequency and percentage) using SPSS software and compared with international standards.
Results: The results of this study indicated that the quality of diabetes care in Yazd was below optimal standards. Only 63.7% of patients underwent hemoglobin A1c (HbA1c) testing, and 42.3% achieved optimal blood sugar control. Additionally, 31.2% of patients had elevated systolic blood pressure, and 12% had high diastolic blood pressure. Fewer than half of the patients were referred to specialists. A sedentary lifestyle was reported in 87.7% of cases, and 79.5% were found to be overweight or obese.
Conclusion: Based on the results, there are significant gaps in healthcare quality for diabetic patients in Yazd, including insufficient specialist referrals, lack of regular lab monitoring, and inadequate lifestyle interventions. Enhancing educational programs, regular specialist consultations, and comprehensive care approaches are essential to improving outcomes.

Association between Proteinuria and Sleep in the Azar Cohort Population: A Cross-Sectional Study

Mohammadreza Ardalan

Background and Objectives: Sleep disorders are common issues in people's health and can be related to metabolic and kidney diseases. Studies have shown that the relationship between proteinuria and sleep disorders can be modified. Since this relationship has not been investigated in Iranian populations, this study examined the relationship between proteinuria and sleep in the Azar cohort population.
Methods: This cross-sectional study used data from the Azar cohort study with a population of 15,000. Based on the study's inclusion and exclusion criteria, 105 patients with proteinuria were selected. After age and sex matching, 420 patients without proteinuria were included in the control group. The patients' sleep patterns were assessed based on a designed questionnaire, and the results were compared between the two groups.
Results: None of the sleep factors significantly differed between the two groups with and without proteinuria (P>0.05). Moreover, the mean weight, waist circumference, systolic blood pressure, diastolic blood pressure, and body mass index (BMI) were significantly different in the two groups (P<0.001).
Conclusion: There was no significant relationship between proteinuria and sleep in the Azar cohort population. However, the weight, BMI, waist circumference, and systolic and diastolic blood pressure significantly differed between people with and without proteinuria.

Trend Analysis of Economic Losses due to Anti-Rabies Serum and Vaccine Consumption in Iran (2015-2022)

Hesameddin Akbarein

Background and Objectives: Rabies is a public health threat worldwide. This study aimed to determine the amount and trend of the costs of anti-rabies serum and rabies vaccine in Iran between 2015 and 2022.
Methods: Using national data from March 2015 to March 2022, the cost of anti-rabies serum, human rabies vaccine, and the total cost of both were determined. The annual trend of the serum, vaccine, and total cost was determined using Joinpoint regression with a maximum of one.
Results: The highest rabies serum and vaccine costs were observed in 2021 and 2020 (58.3 and 6.874 US million dollars), respectively. Average Annual Percent Change was statistically significant (p<0.001) and indicated an increasing trend in the costs of anti-rabies serum. The trend in vaccine costs between 2015 and 2020 was increasing, and the annual percent change between 2015 and 2020 (p˂0.001) and 2021 (p˂0.001) were statistically significant. The average annual percentage change was statistically significant for the total costs of anti-rabies serum and rabies vaccine (p˂0.001) and indicated an increasing trend in Iran.
Conclusion: The lowest rabies vaccine costs were observed in 2021, which might be due to the COVID-19 pandemic. To reduce rabies losses, the domestic production of anti-rabies serum, implementing rabies control measures in unowned dogs, and increasing public awareness about animal bites, particularly dog bites, are recommended.

Safety Behaviors Against Earthquakes: A Study of Knowledge, Attitudes, and Behaviors of Earthquake Protection in Khoy, Iran

MoradAli Zareipour

Background and Objectives: Earthquakes are among the most dangerous natural disasters and can significantly harm human life. Accordingly, public awareness and preparedness for earthquakes are essential. Therefore, this study aimed to evaluate earthquake safety behaviors, focusing on knowledge, attitudes, and protective behaviors in Khoy, Iran.
Methods: The present study is a cross-sectional study conducted on 412 people in Khoy city using cluster sampling method. The data collection tool was a researcher-designed questionnaire comprising demographic characteristics and assessments of awareness, attitudes, and protective behaviors against earthquakes. The data were analyzed using the t-test, ANOVA, and backward logistic regression method with Stata 15 software.
Results: The results of the present study indicated that over 66% of individuals had poor knowledge, 42% had an average attitude, and 46% exhibited moderate protective behaviors against earthquakes. The regression model demonstrated that high knowledge increased the likelihood of exhibiting protective behaviors by 1.92 times (OR = 1.92, p = 0.006), while a positive attitude increased this likelihood by 6.12 times (OR = 6.12, p < 0.0001). Also, university education level 2.92 times (p=2.92, OR=0.055) and having previous experience of earthquake 1.89 times (p=0.057, OR=1.89) increase the likelihood of these behaviors.
Conclusion: Considering the low levels of awareness and protective behaviors against earthquakes among the residents of Khoy, educational workshops, and simulation exercises should be organized. Additionally, developing educational content could enhance individuals' preparedness for earthquakes.

Investigating the Effectiveness of Cognitive Behavioral Hypnotherapy on the Sexual Function of Married Women of Reproductive Age in Sabzervar County in 2021-2022

Mahbobeh Pourheidari

Background and Objectives: Healthy sexual relations, as one of the basic components of human life, are one of the signs of physical and mental health that have a significant impact on the quality of individual and marital life.
The present study aimed to investigate the effectiveness of cognitive behavioral sleep therapy on the sexual function of married women of reproductive age in Sabzevar city in 2021-2022.
Methods: This study was conducted as a simple randomized clinical trial before and after intervention and one-month follow-up with intervention and control groups. The sample included 70 eligible women. The intervention group (N = 35) received four individual counseling sessions of cognitive-behavioral hypnotherapy, while the control group (N = 35) received no intervention. The research tool included a demographic questionnaire, Hypnotic Induced Profile (HIP), and Female Sexual Function Index (FSFI). Data were analyzed using SPSS version 22 software.
Results: Based on the results of sexual function, there was a significant difference between the intervention and control groups after cognitive behavioral hypnotherapy intervention (p<0.001) and one month after the intervention (p<0.001). The analysis of the components of sexual function (sexual desire, arousal, lubrication, orgasm, satisfaction, and pain) indicated that all components except for pain and satisfaction had significant differences between the intervention and control groups after the intervention and follow-up. The satisfaction component had a significant difference just one month after the intervention (p=0.010).
Conclusion: Cognitive behavioral sleep therapy counseling is efficacious in improving women's sexual function and most of its components. This approach is recommended to be used to enhance women's sexual function. Additionally, conducting more comprehensive studies can be beneficial.

Strategies for Managing Aedes Mosquito Control and Diseases Transmitted by It Based on International Guidelines: A Review Study

Hamid Sharifi

Background and Objectives: Dengue fever is a viral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes, seriously threatening public health. Therefore, prevention and control strategies are critical, given the lack of effective treatment. This study aimed to combine international guidelines for controlling Aedes mosquitoes and managing dengue fever.
Methods: This narrative review focused on international guidelines for preventing and controlling dengue fever and Aedes mosquitoes. Reputable international sources were reviewed, and the selection criteria included the credibility of the issuing organization, focus on vector-borne diseases, and adaptability to different environmental conditions. Key data from each guideline, including objectives, main messages, and recommendations, were extracted. The search timeframe was extended to 2024 and conducted on international websites.
Results: International guidelines emphasized an integrated approach to vector control. Environmental strategies include sustainable water system management, stagnant water elimination, and safe waste disposal. Chemical controls stress the cautious use of larvicides and insecticides while strictly adhering to resistance management protocols. Biological interventions, such as introducing predator species into water bodies, were recommended in specific conditions. The guidelines also highlighted community engagement and education and advocate for intersectoral collaboration. Innovative tools such as insecticide-treated materials, lethal traps, and disease trend prediction technologies were also endorsed. Social mobilization and intersectoral cooperation were key elements for long-term success.
Conclusion: International dengue control strategies combine a multifaceted approach, integrating environmental management, chemical and biological control, and community engagement. Implementing these guidelines as well as technological advancements, and international collaboration can significantly reduce the global burden of dengue fever.

Health Impact Assessment of Household Waste Management: A Scoping Review

Aliakbar Haghdoost

ackground and Objectives: Waste refers to solid, liquid, and gaseous materials (excluding sewage) generated from human activities and considered discardable by the producer. The production of household waste also rises with the increase in population. Therefore, evaluating the effects of household waste management on health is a critical issue. Effective interventions can be implemented to mitigate its impacts by identifying the problems and risks associated with this type of waste.
Methods: This study is a scoping review aimed at health impact assessment of household waste management. In this study, PubMed, Scopus, and Web of Science electronic databases were searched in English between 2014 and 2024, and the results were entered into Endnote software and screened.
Results: From the initial search of 3,504 studies, 109 full-text articles were ultimately included in the review. The results indicated that most of the research was conducted in developing countries. The primary data collection tools were laboratory samples, and most of the studies were quantitative. Most of these studies have focused on the effects of household waste management on physical health, while the least explored dimension was spiritual health.
Conclusion: This study shows that household waste management, in addition to its effects on physical health and environmental pollution, can affect mental, social, and spiritual health. Therefore, by identifying these effects, we should seek solutions for better household waste management to minimize negative health effects.

Electronic Health Record: A New Tool in Monitoring and Preventing the Spread of Epidemic Diseases in Schools

Zahra Saboohi

Electronic health records, as a new tool in monitoring and controlling epidemic diseases in Iranian schools, can help reduce the spread of diseases. This article examines the role of this system in preventing epidemics and increasing coordination between educational and health institutions.