Showing 25 results for Surveillance
B Lotfi, M Karami, A Soltanian, J Poorolajal, M Mirzaee,
Volume 11, Issue 2 (9-2015)
Abstract
Background & Objectives: This study was conducted to evaluate the completeness and geographical representativeness of the hepatitis B surveillance system between 2007 and 2013 in Hamadan Province.
Methods: In this descriptive study, all reported cases in Hamadan Province were extracted. The analytical literature review method was used to examine completeness. We used studies on the prevalence and incidence of hepatitis in Iran published between 2007 and 2013. Sensitivity analysis of the results was performed by simulation program using the R software. Geographical representativeness was assessed and plotted by the ArcGIS software, as well.
Results: Totally, 1378 cases were reported to the hepatitis B surveillance system in Hamadan Province. Most cases were from urban areas and were men, married, and housewives mostly in the age group 20 to 29 and 30 to 39 years. Completeness of the hepatitis B surveillance system was 77%. The hepatitis B surveillance system was not representative in terms of occupation but was representative in terms of age, sex, marital status, and place of living.
Conclusion: We concluded that the hepatitis B surveillance system had a relatively good performance. Moreover, findings of the analytical literature review method are affected by the included studies and interpretation of the results should be performed with caution.
K Jafari, M Karami, A Soltanian, N Esmailnasab,
Volume 12, Issue 2 (8-2016)
Abstract
Background and Objectives: Syndromic surveillance systems are used to early detection of outbreaks. The purpose of this study was to determine the feasibility of clinical and non-clinical data sources used in influenza syndromic surveillance in Zanjan.
Methods: In this time series study, clinical and non-clinical data related to influenza like illness (ILI) as a potential data source of syndromic surveillance systems, including the number of missed school days collected from 12 schools and the data of over the counter (OTC) drug sale obtained from 15 pharmacies selected randomly in Zanjan during 2014 were used. We used the line plot and moving average chart to explore trends and detect potential explainable patterns of data sources. The autocorrelation function and cross correlation function besides corresponding graphs were used to assess the feasibility of school absenteeism and OTC sale in timely detection of influenza outbreaks.
Results: Line plots indicated the presence of explainable patterns and the effect of the day of the week. The cross correlation value was 0.5 and cross correlogram revealed the similarity of both data sources in this study.
Conclusion: Our findings indicated the feasibility of influenza data sources, including school absenteeism and OTC, as potential data sources of syndromic surveillance systems.
M Hosseiny, Gh Moradi, Mm Gouya, A Janati, E Ghaderi,
Volume 13, Issue 1 (6-2017)
Abstract
Background and Objectives: Evaluation is one of the main components of communicable diseases surveillance. Despite the World Health Organization’s emphasis for preparation of evaluation tools, there is no suitable tool in Iran. This study aimed to prepare a tool for evaluation of communicable diseases surveillance in hospitals and to pilot it.
Methods: Items were prepared in the first step and the first version of questionnaire was developed. Face validity and content validity were checked. Piloting of the questionnaire was done in Tabriz hospitals. Data were entered into SPSS 18. For evaluation of reliability, internal consistency was measured using Cronbach's α and Kuder-Richardson.
Results: According to the results, we developed a questionnaire containing 29 questions in 5 domains with 20 indexes. Fifteen hospitals (78.9%) had a communicable diseases reporting system. The goals of reporting system were not described in these hospitals and only 2 (13.3%) hospitals had supporting laws. None of the hospitals had complete access to the surveillance system and reporting tools.
Conclusion: The developed questionnaire can be a useful tool to evaluate the communicable diseases surveillance system in hospitals. The reporting systems in the hospitals are not complete.
K Etemad, A Heidari, Mh Panahi, M Lotfi, F Fallah, S Sadeghi,
Volume 13, Issue 3 (12-2017)
Abstract
Background and Objectives: Data plays a major role in a health care system in development planning and health services support if they are correct, timely and accessible. The data of the Ministry of Health are not readily available and the limited access reduces their value. The aim of this study was to explore the challenges of access to the data of the Iranian Ministry of Health.
Methods: This qualitative study was conducted in 2015. Twenty-three academic and administrative experts were selected purposefully. Semi-structured interviews were conducted to collect the data. The transcripts of the interviews were analyzed using content analysis.
Results: The results of this study provided 4 main themes (challenges of access to the data of the surveillance system, challenges of access to the data of national surveys and ordered projects, challenges of access to the data of electronic health records, and challenges of access to confidential data) and 15 sub-themes.
Conclusion: Given the multiple challenges of access to the data of the Iranian Ministry of Health, it is suggested to design access mechanisms in a systematic manner in the form of guidelines and organizational structures for data access management.
G Moradi, A Veysi, K Rahmani, H Erfani, A Doosti Irani , Mr Shirzadi, F Gharachorloo, M Nabav, Mm Gouya,
Volume 15, Issue 1 (5-2019)
Abstract
Background and Objectives: Leishmaniasis control in each country, especially in countries where the disease is endemic, requires designing and implementing an organized national surveillance system. Iran has long been considered as an endemic country for leishmaniasis. The purpose of this study was to review the leishmaniasis surveillance system in Iran.
Methods: In this review study, the data were obtained from the surveillance system, reports and documents, published guidelines, reviews of the existing structures, and the views of the managers and experts of the Center for Communicable Diseases control in Iran in 2018.
Results: The surveillance system for two types of leishmaniasis, cutaneous leishmaniasis and visceral leishmaniasis (Kala-azar), is currently operational in the country, and new cases are reported monthly. For each identified case, in addition to the epidemiologic attributes, treatment and follow-up as well as follow-up of possible contacts are done as per to the guidelines for each of these diseases.
Conclusion: The current surveillance system for leishmaniasis has improved the process of reporting cases in recent years. However, the low rate of reporting of cases, especially for cutaneous leishmaniasis, and epidemiological complexities in the transmission of the infection indicate the need for reviewing and improving the current surveillance system. Data from the surveillance system and the increasing number of leishmaniasis cases in Iran reveal the need for innovations to strengthen the control measures for this disease.
S Eybpoosh, B Eshrati,
Volume 15, Issue 1 (5-2019)
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.
Gh Moradi, S Vahedi, Kh Rahmani, M Zeinali, E Mostafavi, H Erfani, F Bonakdar, Mkh Ghanbari, B Amiri, E Ghaderi, Mm Gouya,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Iran has long been considered to be one of the countries in the world with endemic brucellosis. The aim of this study was to review the surveillance system of brucellosis in Iran.
Methods: Data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, the review of records, documents, books and published articles and also interviews with process owners and experts of brucellosis surveillance in 2017-2019.
Results: In the current surveillance system in Iran, all patients with brucellosis will undergo standard treatment for at least 2 months. The patient identified at each site, private or public sector, reports to the health center of the city. After reporting cases to higher levels, city health center carried out required epidemiologic investigation in the place of reported case in collaboration with its environmental levels. Finally, the individual assessment form, epidemiologic investigation form, for reported case is completed and registered in national surveillance database.
Conclusion: Although integration of the brucellosis surveillance program into the health system of the country and reporting and treatment of human cases in accordance with the country's protocol in recent years is well executed, brucellosis control in Iran requires the one health approach. Accordingly, it can be concluded that despite the decrease in the number of brucellosis cases in recent years, the weakness in livestock surveillance has led to many fluctuations in the health system's success in providing surveillance for human cases of brucellosis.
Gh Moradi, E Ghaderi, M Sargolzaei, H Fallahi, S Eybpoosh, K Tayeri, S Akbarpour , K Entezarmahdi, Kh Rahmani,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Iran is one of the Middle Eastern countries that implemented the HIV / AIDS control and surveillance program many years ago. The purpose of this study was to review the HIV / AIDS surveillance system in Iran.
Methods: This was a review research to assess the processes, structures and achievements of the HIV/AIDS surveillance system in Iran. The information sources of this study included data from the surveillance system, reports and documentation, and published guidelines, reviewing existing structures and views of managers and practitioners of the HIV/AIDS surveillance system in Iran.
Results: In Iran, all cases with HIV / AIDS as well as people with high risk behaviors are referred to behavioral disease counseling centers in order to receive health care services. Harm reduction in people with risky behaviors in the form of counseling centers, drug addicts' centers, and women's counseling centers in collaboration with governmental and non-governmental organizations, and attention to the second generation of HIV/AIDS surveillance, particularly conducting behavioral studies, are other components of the HIV / AIDS surveillance system in Iran
Conclusion: Although the HIV / AIDS surveillance system in Iran has a large structure with many achievements in reducing new HIV cases, especially in some high-risk groups such as injecting drug users, as well as reducing HIV transmission from infected mothers to their children, strengthening this surveillance system, especially for sexual high-risk groups, is essential for controlling HIV/AIDS in the country.
Gh Moradi, Kh Rahmani, P Hemati, H Akbari, F Rezaei, M Dadras, B Amiri, H Erfani, M Soroush, S Darvishi, J Soltani, T Mokhtari Azad , Mm Gouya,
Volume 15, Issue 2 (9-2019)
Abstract
Background and Objectives: Iran, like most other countries in the world, is always threatened with global epidemics and pandemics of influenza. The purpose of this study was to review the influenza surveillance system in Iran.
Methods: Data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, the review of records, documents, books and published articles and also interviews with process owners and experts of influenza surveillance in 2017-2019.
Results: Influenza surveillance in Iran Currently, a combination of surveillance methods, including caring for patients, laboratory care, hospital care and surveillance of respiratory disease epidemics and also border surveillance. Reporting of human influenza outbreaks, as well as suspected avian flu as main notifiable diseases carried out through telephone. For each suspect case, in addition to taking and sending a sample to diagnose and also detect subtypes of the virus, medical treatment is immediately initiated and tracking of possible contacts is also done.
Conclusion: Although there is currently good coherence in the surveillance of influenza in Iran, but based on concerns about the emergence of influenza pandemics in the future, and considering the possible genetic variation of the flu viruses, the tracking of the flu virus circulation along with updating surveillance system especially emphasizing methods and formulas for rapid identification of disease outbreaks, as well as providing better health care and treatment is essential.
E Abdalmaleki, Zh Abdi, M Goharimehr, R Alvandi, S Riazi Esfahani , E Ahmadnezhad,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Iran has carried out a series of surveys based on the Global school-based student health survey (GSHS) referred to as the CASPIAN. The aim of this paper was to compare the methodology and tools of CASPIAN surveys and to propose recommendations and suggestions for future implementations.
Methods: The data of this systematic review study were gathered from the World Health Organization (WHO) documentations, international databases including Pubmed, EMBASE, Scopus, GoogleScholar, and ScienceDirect, and national databases including Magiran, SID, and Irandoc. The search was conducted in both English and Persian (for the time period from 2003 to 2018). The time and place of the study, target population, questionnaire(s), sample size, and sampling method were compared between the surveys.
Results: Five rounds of CASPIAN survey were conducted in Iran from 2003 to 2015. The surveys had two sets of questionnaires for students and parents. In all five rounds, sampling methods and questionnaires were similar in the core and differed in some details that were added selectively in each round. The questionnaires were designed based on the GSHS and the WHO stepwise approach to non-communicable disease risk factor surveillance (STEPS) programs.
Conclusion: Considering the small variation in each series and compliance with the global model, it is suggested that the next CASPIAN survey be conducted according to the previous series in accordance with the standards presented in the global model in recent years in a reasonable interval from the 2015 survey.
E Ghaderi, M Salehi Vaziri , E Mostafavi, Gh Moradi, Kh Rahmani, M Zeinali, Mr Shirzadi, H Erfani, Sh Afrasiabian, S Eybpoosh,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: To provide an overview of the national program of Crimean-Congo hemorrhagic fever surveillance in Iran, its current achievements, and challenges.
Methods: In this mixed method study, the relevant reports, documents, and guidelines, as well as published literature and surveillance data were gathered and critically reviewed. The opinions of the key informants at local and governmental levels were assessed through structured interviews.
Results: The program was integrated into Iran’s primary healthcare (PHC) network in 1999. The involved organizations include CDC, medical universities, Pasteur Institute of Iran (PII), and Veterinary Organization. Case finding is based on standard definitions of suspected, probable, and confirmed cases. Laboratory confirmation is necessary for diagnosis and is provided within 48 hours after receipt of the specimen by the National Reference Laboratory of PII. CCHF treatment is primarily supportive. Antiviral therapy with ribavirin is also considered. Both therapeutic services are free. Education mainly focuses on high-risk groups and healthcare workers. Major achievements of the program include rapid diagnosis and treatment of cases, prevention of nosocomial transmission, identification of high-risk provinces and major transmission routes, improved outbreak preparedness, development of laboratory tests for detection of other arboviruses, and reduction of CCHF case fatality rate.
Conclusion: Program implementation has had a positive impact on early detection and proper control of annual outbreaks. However, some aspects of the program still need improvement, including promotion of the general and high-risk populations’ awareness and regional collaborations (especially among neighboring countries) for infection control in humans, livestock, and vectors.
Kh Rahmani, Gh Moradi, Mb Khadem Erfan , L Faraji, Gh Zamini, B Mohammadian, M Karimi, F Bahrami, A Raeisi,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Iran started malaria elimination campaigns many years ago. The purpose of this study was to review the malaria surveillance system in Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, a review of records, documents, books and published articles, and also interviews with process owners and experts of malaria surveillance in 2017-2019.
Results: The surveillance system of malaria in Iran has a coherent structure, in which all identified cases are reported and monitored from the environmental levels to the center by telephone instantly. Considering that the main goals of the malaria program including disease elimination have been obtained, the surveillance system in Iran is currently aiming at strengthening the elimination phase. In this stage, all new cases are also epidemiologically investigated in addition to examination, treatment and follow-up for categorization of the cases in categories of relapse, indigenous, introduced, and induced.
Conclusion: The successful implementation of the surveillance system for malaria over time has caused indigenous cases of disease to be limited to three southeastern provinces of the country and there are fewer than 300 new cases a year. Despite success, since the goal of malaria surveillance in Iran is now disease elimination, continuous monitoring of correct implementation of all processes and evaluation of the applied strategies are necessary.
E Ghaderi, Gh Moradi, S Sharafi, Kh Rahmani, Sh Ahmadi, B Mohsenpour, M Nasehi,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Over the past decades, the Iran’s anti-tuberculosis campaign has become highly structured and many achievements have been made. The purpose of this study was to describe the characteristics of the TB surveillance system and its components in the Islamic Republic of Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control, a review of the records, documents, books and published articles, and also interviews with process owners and experts of TB surveillance during 2017-2019.
Results: Case finding and treatment and follow-up of TB patients and their household contacts are done In the TB surveillance system. The implementation of the DOTS, (DIRECTLY OBSERVED TREATMENT SHORT-Course) is a major component of the TB surveillance system. Patient registration is done in an online application, which allows extracting and reporting the important indicators of the program. In this surveillance system, there is a special sensitivity to the treatment of patients, so the incidence of multi drug-resistant TB in the country is lower than that of the neighbors. The presence of regional laboratories that cover the entire region of the country is one of the strengths of the TB surveillance program in Iran.
Conclusion: Despite budget problems, the anti-TB program in Iran has many achievements. However, new strategies need to be considered to reduce the incidence of TB.
E Mostafavi, Gh Moradi, Kh Rahmani, F Jahanbakhsh, S Eybpoosh, M Keypour, E Ghaderi, H Erfani, K Hajibagheri, M Zeinali, M Khodabandehloo, M Shirzadi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: The purpose of this study was to present a summary of the rabies surveillance program in humans in the country, its achievements and its strengths and weaknesses.
Methods: This study was a review of the country's plan for surveillance and control of rabies in humans. The sources of information included the data, reports, documents, and published guidelines. The viewpoints of stakeholders and experts were also reviewed in this study.
Results: Since rabies is a zoonotic disease, its effective management requires a good collaboration between several organizations. Moreover, because Iran is located in an endemic region, there is a need for the development of regional and international cooperation for the success of disease prevention, control and management. Animal services for biting and rabies control are provided free of charge in more than 700 centers in the country. Major achievements of the program include timely preventive treatment for animal bite cases, knowledge of the geographical distribution of the disease, identification of high-risk provinces, and decreasing the percentage of human deaths.
Conclusion: The program has performed well for rabies secondary prevention. Some aspects of the program, however, still need to be improved, including improvement of educational programs targeting general population and high-risk groups, animal bite prevention, vaccination of domestic dogs, controlling the population of stray dogs, rabies control in wild animals, and proper waste collection and disposal.
M Karami, Kh Rahmani, Gh Moradi, Mm Gouya, A Sabouri , K Entezar Mahdi , Gh Kamali, Sm Zahraei,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: Elimination and eradication of measles requires designing and implementing an enhanced surveillance system. The purpose of this study was to review the measles surveillance system in Iran.
Methods: The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books, and published articles; and interviews with process owners and experts of measles surveillance in 2017-2019.
Results: Iran has a surveillance plan to eliminate the measles. The current design for suspected cases of measles in Iran is a case-based surveillance system, in which for each identified case with fever and maculopapular rashes, some activities such reporting, laboratory confirmation, clinical and epidemiological investigation and case registration in individual forms are done.
Conclusion: Complete surveillance of cases suspicious of measles and high coverage of vaccination in children less than 2 years in a cohesive surveillance system and rapid response to the outbreak have led to lack of occurrence of indigenous measles in Iran. Although the current status of the measles surveillance system in Iran seems to be favorable, since Iran is at the stage of measles elimination, it is essential to increase the sensitivity of the reporting system for suspected cases of measles and to maintain the status of vaccine coverage to save elimination status.
Mm Gouya, Sm Zahraei, Gh Moradi, M Karami, S Mahmodi, Sh Shah Mahmoodi , E Ghaderi, F Kaveh, A Norouzinejad , K Hajibagheri, Kh Rahmani,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: : According to the global strategy for polio eradication, targeted surveillance of the disease is one of the main tasks of the health system. The purpose of this study was to review the status and surveillance of poliomyelitis/acute flaccid paralysis (AFP) in Iran.
Methods: The present study was a review on the processes, structures and achievements of the poliomyelitis/AFP surveillance system in Iran during 2017-2019. The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books and published articles; and interviews with process owners and experts of poliomyelitis/AFP surveillance.
Results: The polio eradication program in Iran is based on the action plan of the World Health Organization that was introduced initially in 1988. Currently, the surveillance system of AFP is active at three levels: country, university, and city. The number of poliomyelitis cases in the country decreased from 50 cases per year in 1985 to zero in 2001, and Iran has been a polio-free country since 2001. The final report on polio eradication in Iran was approved by the regional commission on polio detection in April 2006.
Conclusion: The surveillance system of AFP has had a proper effectiveness throughout the country. Maintaining this situation in the country requires an increase in the sensitivity of the surveillance system of the disease, regular monitoring of vaccine coverage, strict implementation of international health regulations, especially on the eastern borders of the country, and providing technical assistance to neighboring countries.
K Sharifolkashani, P Yavari, , R Shekarriz, F Tajdini, N Aghili,
Volume 16, Issue 4 (3-2021)
Abstract
Background and Objectives: Correct and timely detection of the outbreaks of diseases with a short incubation period is of great importance in the health system. The aim of this study was to determine the detection of dysentery outbreaks using the cumulative sum method.
Methods: This time series study was conducted using the data of the National Surveillance System between 2014 and 2017. The outbreak alert threshold of each season and province was determined separately using the average of three years (1393 to 1395) in the same season and province. The dysentery outbreak in each season was exclusively predicted for Isfahan, Khuzestan, and Hamadan provinces in 2017 using the CUSUM method.
Results: In Isfahan Province, the outbreak alert was higher in the spring and summer and lower in the autumn and winter using the current method compared to the CUSUM method. For Khuzestan Province, the current outbreak alert was significantly higher in all seasons compared to the CUSUM method, while the current outbreak alert was lower than the alert predicted by the CUSUM method in Hamadan Province in all the seasons.
Conclusion: Compared to constant threshold-based methods, using the CUSUM method seems to be a better way for reporting outbreaks, especially in areas with a high incidence.
Fatemeh Ershadinia, Elham Rahimi, Bushra Zareie, Hadi Pashapoor, Manoochehr Karami,
Volume 19, Issue 2 (9-2023)
Abstract
Background and Objectives: The disease surveillance system provides essential information about the population at risk and the disease pattern. This review aimed to describe the experiences of countries in establishing COVID-19 school-based surveillance systems.
Methods: We conducted a systematic review. Four databases were searched between January 2019 and December 2022 using relevant keywords. The studies were screened by two people according to the inclusion and exclusion criteria. The findings were extracted using a standard form and aligned to the objectives of the review.
Results: The data from 12 studies were extracted using the standard form. All studies related to the school-based surveillance system of COVID-19. Most of studies were conducted in the United States of America and England. The reports did not conform to the standard. The number of schools covered in surveillance systems ranged from 2 to more than 6000 schools. The age group in these studies was 0 to 19 years. Schools submitted data daily or weekly.
Conclusion: The results of the COVID-19 surveillance systems in schools should be reported according to standard Instructions. This is considered a necessity to monitor and evaluate the surveillance system. It also allows other countries and researchers to share and use the results. In addition, sensitivity, timeliness, and positive predictive value were not reported in implemented surveillance systems.
Manoochehr Karami,
Volume 20, Issue 3 (12-2024)
Abstract
Artificial intelligence (AI) refers to the process in which computers, rather than human intelligence, perform tasks, such as early warning of an epidemic. This editorial aimed to describe the potential applications of digital health and the challenges faced by the health system of Iran concerning the application of artificial intelligence and innovative technology in public health surveillance and early warning of epidemics. The use of new technologies at national and subnational levels for early warning of public health threats requires a suitable platform within the context of disease surveillance systems. The Iran health system currently utilizes a syndromic approach and event-based surveillance to monitor acute respiratory infections. However, the structure of Iran's national communicable disease surveillance system has faced challenges due to the inability to share and exchange data at the level of primary health care data sources. Accordingly, application and integration of AI should be considered as Iran’s health priority to promote infrastructure and technology requirements, including compatibility, interoperability, and strategies for ethical and responsible use by public health authorities. Since pandemics and epidemics have not been limited to the previous ones, such as COVID-19, influenza, SARS, dengue fever, and similar threats, operations planning is required for the integration of artificial intelligence tools to prepare and respond to biological threats promptly by the Iranian Ministry of Health, stakeholders, and other parties.
Bahar Haghdoost, Zhaleh Abdi, Iraj Harirchi, Elham Ahmadnezhad,
Volume 21, Issue 2 (9-2025)
Abstract
The COVID-19 pandemic has highly impacted health systems, and the limitations of the national reporting system have reduced the accuracy of estimating the burden of this disease. This study examined the underreporting of COVID-19 cases and hospitalizations using data from the National Survey on Risk Factors for Non-communicable Diseases (STEPS) in Iran in 2021. In this study, 25,425 individuals from the population aged 18 and above were randomly enrolled. In addition to information on non-communicable disease risk factors, participants were questioned about a history of COVID-19 infection, hospitalization, and intensive care unit admission. The frequency of these events was then compared with registry data at the time of data collection. According to the results, 9.3% (95% CI: 8.56 to 9.44) reported a history of COVID-19 infection. Furthermore, among those infected, 12.71% (11.25 to 14.20) reported a history of hospitalization due to COVID-19. Among those hospitalized, 13.74% (8.25 to 18.9) had been hospitalized in intensive care units. Based on this, it is estimated that the sensitivity of recording symptomatic cases was 61.7% (59% to 65%) and for hospitalized cases was 86% (77% to 97.1%).
As a conclusion, it can be stated that the registered incidence of symptomatic COVID-19 cases in Iran was underreported by nearly 40%, and hospitalizations due to COVID-19 were underreported by about 15%. Compared to data from many other countries, including developed nations, this situation can be considered as acceptable.
