Showing 8 results for Eshrati
B Eshrati, A Rezaei Ashtiani , F Khazaei, F Torkamani, M Azimi,
Volume 3, Issue 1 (21 2007)
Abstract
Background & Objectives: The summer of 2005 witnessed an outbreak of cholera in Iran due to V. cholera, Inaba serotype. During the outbreak, there were 16 registered cases in Markazi Province. The aim of this study was to determine the risk factors for cholera outbreak in this part of the country.
Methods: This was a case-control study in which cases were matched to controls on age and sex. All of the reported cases were compared with controls from the same neighborhood, with 2 controls selected for each case. We used paired odds ratios and conditional logistic regression to show the effect of each putative risk factor, and p values of < 0.05 were considered as statistically significant.
Results: Multivariate results from 16 cases and 32 controls showed significant associations between the cholera outbreak and the following set of factors: eating raw vegetable (OR=9, 95%CI: 2.25-35.98), proper warming of refrigerated food (OR=0.12, 95%CI: 0.015-1.022), inadequate washing of fruits and vegetables (OR=4.29, 95% CI: 0.88-21.06) , and eating non-pasteurized ice creams (OR=4.96, 95%CI: 0.99-24.83).
Conclusions: Although the number of reported cases was small in Markazi Province, the results show that education in personal hygiene is important in the prevention of a cholera outbreak.
Z Pouransary , Z Sheikh , B Eshrati , P Kamali ,
Volume 3, Issue 3 (18 2008)
Abstract
Background & Objectives: Men (husbands) play a very important role in family planning programs, especially in developing countries. The objective of this study was to determine the prevalence of different methods of contraception in women of reproductive age in Iranshahr in 2004-2005 and the extent of their husbands' participation in family planning.
Methods: This was a cross-sectional study focused on women who were married but not pregnant at the time of the research. We used multi-stage cluster sampling and a pre-tested questionnaire to record the method of contraception and to see if the husband was actually participating in family planning. We used the SPSS (13th version) software to calculated measures of location and dispersion.
Results: The total sample of 700 married women in the (10-49y) age group included 400 subjects in rural areas and 300 in cities. Of these, 696 agreed to take part in the research. Overall, 65.5% of these women were using at least one form of contraception the remaining 34.5% did not use any contraceptive methods. The percentage of unwanted pregnancies was estimated at 16%. The mean number of pregnancies was 7, with a median of 4.5. Sixty-three percent of the subjects reported good cooperation by their husbands. Logistic regression analysis showed that the probability of using contraception was significantly related to the husband's cooperation.
Conclusions: Our results underline the importance of men's support and cooperation in the success of family planning efforts.
M Naghavi, F Abolhassani, F Pourmalek, N Jafari, M Moradi Lakeh, B Eshrati, N Mahdavi Hezaveh, H Kazemeini, A Tehrani Banihashemi, Sh Shoaee,
Volume 4, Issue 1 (22 2008)
Abstract
Background & Objective: Disability-Adjusted Life Years (DALY) summarizes the fatal and nonfatal outcomes of diseases and injuries in one number and gives a quantitative assessment of the health of a population. Estimating the burden of diseases and injuries in Iran in terms of DALY both nationwide and in 6 provinces.
Methods: We used slightly modified versions of the methods developed by the World Health Organization for estimating the burden of premature mortality, disability, and the DALY.
Results: The DALY rate per 100,000 was 21572 and 62% of this was life lost due to premature mortality the remaining 38% was due to disability from diseases and injuries. Fifty-eight percent of the total DALYs had been lost due to non-communicable diseases, 28% due to external causes (injuries), and 14% due to communicable, maternal/ perinatal and nutritional illnesses. The group of diseases and injuries with the highest burden in males waz intentional and unintentional injuries (2.789 million DALYs), while in the female population this position was held by mental disorders with 1.191 million DALYs. The single most important cause of burden was traffic accidents in males and ischemic heart disease in females. Disease burden showed considerable variability between different provinces.
Conclusion: The profile of health and disease in Iran has generally shifted from the predominance of communicable, maternal/perinatal, and nutritional illnesses towards predominance of non-communicable diseases and injuries at the national level. These figures on disease burden at population level are the most objective evidence that can be used in policy making and management of health programs, health research, and resource development within the health sector.
A Mohammadbeigi, J Hassanzadeh, B Eshrati, N Mohammadsalehi,
Volume 9, Issue 2 (Vol 9, No 2, Summer 2013 2013)
Abstract
Background and Objectives: Inequity in health is a universal term which used for showing current differences, variations and inequalities of people in access to health. But inequality in health refers to some inequities which seems are unfair or caused by some errors and biases. The current study aimed to describe some of the common health related inequity measures to be useful for the inequity researchers and other interested health coworkers.
Methods: The calculation, advantage and disadvantage of most common health-inequity indexes including slope index of inequity, relative index of inequality, Theil’s Index, mean log deviation, index of disparity, Gini coefficient, weighted utilization social welfare function, absolute and relative concentration index were assessed. Inequity size of these measures was calculated by using the health care utilization survey data.
Results: Average of health care utilization in in-need subjects was 66.4%. This indicator was in the first to fifth quintiles equal to 57.6%, 63.4%, 71.6%, 69.5% and 75.3%, respectively. Relative concentration index and Gini coefficient was calculated as 0.053 and 0.0062, respectively.
Conclusion: Inequity in health care utilization in Markazi province differs based on the types of inequity measures. Selection of the inequity indexes dependent to the objective and the scale of under study variable. Among discussed indexes, concentration index determine the more accurate and also show the gradient of inequity. Therefore it can be used as the best index.
B Eshrati, R Emroozi, Es Mousavi, Ms Azimi, A Esmaeeli, H Bakhtiari, Ssh Hosseini, M Ramezani ,
Volume 9, Issue 3 (2-2014)
Abstract
Background & Objectives:: To assess inequity of childhood health care package provision according to the distance of health houses from the town and the provincial capital in Markazi province (Iran).
Methods: We used 4 measures of childhood health care provision by family medicine program in randomly selected health houses in Markazi province. The measures included were monitoring of the childhood health by the GP (General Practitioner), childhood disease management according to the Iranian MOHME guidelines, good knowledge of the GP about the content of the guidelines and good knowledge of the GP about the 1-59 month death registration system. These measures were estimated by a predefined, interviewer administered questionnaire. The distance of each selected health house was determined in each district health center. To assess the inequity of the measures we estimated concentration index and its 95% confidence interval using covariance method. P Values of greater than 0.05 were considered as statistically insignificant.
Results: About 46 health house were randomly selected. All of the estimated concentration indices about the childhood care measures were less than 0.1 and their differences with zero score were insignificant
( p value> 0.05 ).
Conclusion: according to the data of our study it seems there is no inequity between different health houses in accordance of their distance from district center and provincial capital. It seems necessary to measure other health indices to assess the inequity of the whole of the health care providing system.
M Nazarzadeh, D Khalili, B Eshrati, F Hadaegh, F Azizi,
Volume 9, Issue 4 (3-2014)
Abstract
Background & Objectives: The case-cohort study is one of the youngest designs in epidemiology and some methodological aspects of it are still in debate. This study aimed at comparing the estimated hazard ratio, standard error, and interaction hazard ratio between the case-cohort and cohort studies for assessing the relationship between diabetes and cardiovascular diseases.
Methods: A total of 1701 men and 2253 women aged between 40 and 75 years were considered as the main cohort. Subcohort sampling was performed using simple random sampling with a sampling fraction of 0.3%. The hazard ratio of the cohort study was calculated using Cox regression model and the 3 methods of Prentice, Self-Prentice, and Barlow were used for calculating the hazard ratio of the case-cohort study. The mentioned regression models were used to assess the interactions.
Results: The results of the two studies were similar in populations with higher incidence (cohort of men) and lower incidence (the cohort of women) when frequency percent of exposure variable was greater than 10%. When the sample size of the initial cohort was less than 1250 subjects, discrepancies were observed between the results of the two studies. In addition, the standard error of the case-cohort study was higher than the cohort study. The results of both studies were similar in assessing the considered interactions.
Conclusion: The results are similar when the initial cohort sample sizes are sufficient. Meanwhile, unlike the percentage of exposure frequency, the outcome incidence has a negligible impact on the discrepancy between the results while the effect of the relative frequency of the exposure levels on the results discrepancy is noticeable.
N Mohammadsalehi, K Holakouie Naieni , B Eshrati, A Mohammadbeigi, E Ahmadnezhad, Sh Arsangjang,
Volume 14, Issue 1 (Vol 14, No 1, 2018)
Abstract
Background and Objectives: Cholera is one of the public health ththat has received attention due to climate change and weather variables. In the current study, the trend of cholera and its epidemics was assessed in the last 50 years in Iran based on climatic variables.
Methods: In a retrospective cohort study, all cholera cases and epidemics of the disease in the country (Iran) were assessed using the registry system of the Center for Communicable Disease Control in the Ministry of Health and Medical education (MOH&ME) from 1964 to 2014. Furthermore, the incidence of cholera was evaluated in 2005-2014 by province. The temperature and rainfall data were obtained from the provincial Meteorological Organization. The correlation coefficient test and mixed-effects binomial regression model were used for data analysis.
Results: A significant positive correlation was found between cholera and rainfall (r = 0.168, P = 0.008). A one-millimeter increase in rainfall increased the incidence of cholera by 10.9% but temperature changes had no effect on cholera outbreaks. The incidence of cholera declined significantly by 14.7% each year from 2005 to 2014. The highest incidence of cholera was reported in Sistan-Baluchestan, Qom, Tehran, Kerman and Hormozgan provinces in a descending order.
Conclusion: In recent years, the the overall incidence of cholera has decreased. The occurrence of cholera is an outcome of rainfall in the previous year. Therefore, increased rainfall increases the number of cholera cases in the next year. However, temperature changes are not related to cholera outbreaks.
S Eybpoosh, B Eshrati,
Volume 15, Issue 1 (Vol.15, No.1 2019)
Abstract
Background and Objectives: This article provides an overview of the national nosocomial infection surveillance system in Iran and its current status, achievements, and challenges.
Methods: All relevant reports, documents, and program guidelines, as well as published literature and surveillance data related to the nosocomial infection surveillance system in Iran were critically reviewed. Opinions of the key informants at local and governmental levels were also reviewed.
Results: The program was launched in 2006 covering 100 volunteer hospitals. Since 2016, participation in the program is obligatory, leading to the participation of 555 hospitals with >100 beds (56%). Major data collected in the program include demographic characteristics, infections and related risk factors, pathogens and their antimicrobial susceptibility/resistance, and patient outcome. Recently, device-associated infection rates are also calculated in the program. Since its establishment in 2006, the program has improved in terms of case finding and coverage. Implementation of the program has also had positive impacts on the stakeholders’ knowledge, attitude, and practice.
Conclusion: Although the number of identified cases and program coverage have improved, a considerable proportion of the infected cases still remain undiagnosed. Implementation of the program has also improved the stakeholders’ awareness, attitude and practice. The program faces a number of challenges, including lack of appropriate scientific support from academics and executive issues. Integration of active and sentinel surveillance in selected hospitals, persuasion of physicians to actively participate in the program, and conducting incidence and prevalence surveys would help the program to better detect nosocomial infection cases.
