Showing 137 results for Iran
F Norouzinezhad, H Erfani, A Norouzinejad, F Kaveh, F Ghaffari,
Volume 15, Issue 4 (1-2020)
Abstract
Background and Objectives: Kurdistan Province has always been one of the areas of interest in national disease control programs due to a high number of human brucellosis cases. This study was conducted to explore some of the epidemiological indexes and the trend of the incidence of human brucellosis in this area from 2009 to 2016.
Methods: The target population of this cross-sectional study included the human brucellosis patients living in Kurdistan Province whose disease was diagnosed between 2009 and 2016. The data of 6918 patients were analyzed. The incidence was calculated in 100,000 at-risk population.
Results: The highest incidence was 103.54 in 100,000 in 2014 and the lowest was 23.86 in 100000 in 2010. According to 8-year analysis, the highest incidence rate was seen in Bijar. Male gender, rural dwellers, farmers, ranchers, housewives, and those aged 24-25 years were at a higher risk of the disease based on the results. Most of the patients reported contact with livestock.
Conclusion: Comprehensive measures should be taken to control the infection transmission from domestic animals and their products to humans; moreover, preventing measures should be devised by health policy-makers, especially for villagers, housewives, and men.
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.
M Etemadi, A Olyaeemanseh, Mm Tadayon, E Rostami, M Shiri, Aa Fazaeli , Mj Kabir, A Mehrabi Bahar, A Vosough Moghadam ,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: The study aimed to analysis the psychometric properties of the health system resilience scale, assessing it and to introduce a conceptual model for qualitative analysis of Iran health system in the face of the civid-19 crisis.
Methods: In this Mixed-method study, the determination of face and content validity was performed using 8 experts. The structure validity was investigated in a cross-sectional study through an electronic survey of 178 actors in the Iran health system. Resilience has been assessed in five dimensions using 5point Likert scale.
Results: The percentage mean score of the Iranian health system resilience in the face of the Covid19 crisis was 41/08 and in the moderate level. The percentage mean score (standard deviation) for 5 dimension include awareness 39/2 (21), diversity 38/7 (21), self-regulation 36 (20/6), integration 39/9 (21/5) and adaptation 41/2 (21/8). Confirmatory factor analysis indicated the appropriate fit of the information with the five-component structure.
Conclusion: The maximum score of resilience dimension belongs to adaptation and the lowest to the self-regulation indicating that it requires interventions to involve the private sector, and to design a new delivery system for crisis situations. The questionnaire can be used as a standard instrument for assessing the health system resilience.
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.
S Aghamohamadi, A Khosravi, E Kazemi, A Atefi,
Volume 16, Issue 1 (6-2020)
Abstract
Background and Objectives: A large proportion of the data of cause of death is registered in hospitals in Iran. Assessment of the death data can help to identify the problems of cause of death registration system and improve it. Therefore, this study was conducted to review the quality of cause of death registration in Iranian hospitals in 2016.
Methods: All hospital deaths in 2016 were reviewed and classified by age group and sex using the Ministry of Health’s death registration system. Analysis of Causes of National Deaths for Action (ANACONDA) was used to evaluate the quality of the data of cause of death.
Results: About 24% of the recorded hospital deaths were assigned to garbage code categories. The highest percentage of this group was seen in the age group over 70 years old and the highest percentage of well-defined causes of death was seen in the age group below one year. Moreover, among the five groups of garbage code causes of death, the group with insufficient details of the cause of death based on ICD classification had the highest percentage in all age groups.
Conclusion: Since a substantial proportion of the causes of deaths registered in the Iranian hospitals are categorized in the garbage code categories and cannot be used for planning and health policy making, it is necessary to design a comprehensive plan to implement interventions such as implementation of process evaluation programs and training programs for physicians and coders.
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.
M Hadian, M Tajvar, Ms Yekani Nejad , M Arab,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: The main purpose of this study was to compare the predictive power of the Inequality-adjusted Human Development Index (IHDI) with the Human Development Index (HDI) with regard to the share of deaths caused by Non-Communicable Diseases (NCD) among all deaths in the world and Iran.
Methods: The data required for this cross-sectional ecological study were extracted from the reports of the United Nations Human Development Program and the WHO in 2015. Pearson correlation test was used to investigate the correlation of HDI and IHDI with the share of deaths caused by NCDs and linear regressions models were used to determine the associations of IHDI and HDI with the dependent variable.
Results: At a significant level of P<0.01, the dependent variable showed a strong positive correlation with HDI (0.892) and IHDI (0.899). Simple linear regression showed that HDI alone predicted the dependent variable well (Adj.R2=0.794, P<0.001).However, according to the multivariate linear regression model, when IHDI and HDI were included in the model, IHDI was able to predict the dependent variable well (Adj.R2=0.809, P=0.001), while the relationship between HDI and the dependent variable was no longer significant.
Conclusion: Although HDI alone is an important predictor of NCD status, it loses its influence in the presence of IHDI. Therefore, in addition to HDI, IHDI that illustrates the impact of inequality on human development can provide more information on the status of deaths caused by NCDs.
A Mehri, M Yaseri, D Rahimi, S Nejat,
Volume 16, Issue 2 (8-2020)
Abstract
Background and Objectives: Self-confidence is an individual characteristic in students that enables them to have a positive or realistic view of themselves. The purpose of present study was to evaluate the validity and psychometric properties of the Self-confidence Questionnaire (PEI)
Methods: This cross-sectional study was conducted on 100 students of four medical universities. Validation of this questionnaire included the steps of translation, content validity, face validity, repeatability and internal consistency.
Results: The mean age of the participants in this study was 32.1 (SD = 5.5) years. The majority of the students were postgraduate students (47%) and the least (11%) were undergraduate students. The results of this study showed that the overall relevancy and clarity of the questions were 92% and 83%, respectively. The percentage of agreement on overall comprehensiveness was 100%. Cronbach's alpha coefficient and interclass correlation coefficient were higher than 0.7 in all domains. The ICC of each question was also between 0.72 and 0.98.
Conclusion: Based on the results of this study, the Persian version of the PEI questionnaire has an appropriate reliability for use in the student population of Iranian universities.
R Moradzadeh, M Jamalian, M Zamanian,
Volume 16, Issue 3 (11-2020)
Abstract
COVID-19 has now turned into a global crisis affecting all sections of economy and investment. Many interventions have been applied to control the COVID-19 epidemic. It seems that these measures and plans need to be assessed in the coming weeks and months to determine whether or not they have been effective. Each of these interventions started in their appropriate time during the epidemic; some of them are still in progress and some have been lifted. Nevertheless, improved public knowledge, attitude, and practice has played the most important role in controlling the COVID-19 epidemic. Future studies should take into account such interventions.
H Soori, T Yousefinezhadi,
Volume 16, Issue 3 (11-2020)
Abstract
Background and Objectives: The Eastern Mediterranean Region (EMR) has the third highest road traffic fatality rate in the world. This article evaluates the epidemiology of road injuries and some of its main control factors in Iran and compares them with other countries of the EMR.
Methods: This study was conducted to analyze and compare traffic injuries resulting in mortality using secondary data. Data from 175 countries and 19 members of the EMR were analyzed in this study. A review study was designed to provide policy options to improve the status of the measures.
Results: Mortality from traffic injuries in the region according to road users was 39% for four-wheelers, 34% for pedestrians, 15% for two-wheelers, 2% for cyclists and 10% for other users. The traffic-related mortality rate was higher for users of four-wheel motorcycles and pedestrians in the EMR compared to the global average. Moreover, deaths from traffic injuries in users of four-wheel vehicles and two-wheelers in Iran were higher than the regional average.
Conclusion: Although Iran and EMR member states have implemented some important preventive measures recommended by the World Health Organization, significant efforts are still needed to optimize the enforcement of existing road safety laws. Sufficient attention should be paid to the needs of pedestrians, cyclists, and motorcyclists that comprise about 50% of all road traffic fatality.
F Varse, Sh Rimaz, Y Moradi,
Volume 16, Issue 3 (11-2020)
Abstract
Background and Objectives: Randomized clinical trials are the gold standard for evaluating the effectiveness and safety of medical interventions. Some unpredictable challenges may affect the results of these studies. Therefore, the aim of this study was to identify the challenges of clinical trial studies in different stages including design, conduct, analysis, and reporting.
Methods: This study was a qualitative study using content analysis performed from 2017 to 2019. The study population included 13 clinical trial experts who were selected through purposeful sampling. Semi-structured interviews were conducted with all subjects. Data saturation was achieved after 13 interviews.
Results: Among the 4 steps of design, conduct, analysis, and reporting, the majority of the challenges were related to conducing randomized clinical trials. Lack of knowledge of researchers, subjects, sponsors and physicians and supervisory and ethical challenges were the main challenges related to performing these studies. Poor design and lack of clinical equipoise were considered as the main challenges in the design step. Inappropriate analytical methods due to the absence of statistician in these studies were considered as the most common challenge related to analysis. Finally, lack of familiarity with international guidelines was the most important challenge in reporting.
Conclusion: There are many challenges in different steps of clinical trial studies. Therefore, additional education sessions focusing on the related guidelines and standards as well as GCP workshops for researchers can be helpful.
P Khashayar, A Keshtkar, A Ostovar, B Larijani, H Johansson, N Harvey, M Lorentzon, U Mc Closkey , J A Kanis,
Volume 16, Issue 4 (3-2021)
Abstract
Background and Objectives: The purpose of this study was to adopt and calibrate the fracture risk assessment algorithm FRAX® for the Iranian population and to provide the required guidance on how to apply it in clinical practice.
Methods: The age-specific ten-year probability of major osteoporotic fractures was calculated in women with an average BMI to determine the fracture probability at two potential intervention thresholds. The first threshold was the age-specific fracture probability associated with a femoral neck T-score of -2.5 SD and the other was age-specific fracture probability in women with a history of fracture without BMD. Current Iranian guidelines were used to define these thresholds. The effect of adding BMD values to the assessment of these thresholds was also evaluated separately.
Results: Similar to women with a previous fracture, the 10-year probability of a major osteoporotic fracture increased from 4.9% at the age of 50 years to 17% at the age of 80 years. When using a BMD T-score of ≤−2.5 SD as the intervention threshold, the FRAX probability was twice as high in women aged 50 years as in women of the same age with an average BMD and no risk factor. The FRAX probability increased with age but a T-score of -2.5 SD was actually protective after 80 years or age.
Conclusion: Intervention thresholds based on BMD alone cannot effectively identify high-risk women for fracture, particularly in advanced ages. Using fracture probability based on ‘fracture threshold’ can help to improve the identification of these women.
ُsm Hosseini Shokouh, M Arab, S Emamgholipour, M Meskarpour Amiri ,
Volume 16, Issue 4 (3-2021)
Abstract
Background and Objectives: Understanding and analyzing the socio-economic factors affecting mental health is important for mental health policy-making in metropolitan areas. The aim of this study was to investigate the relationship between socio-economic factors and mental health of households living in Tehran.
Methods: This cross-sectional descriptive-analytical study was conducted on 650 households from 22 districts of Tehran using mixed sampling method. Mental health measures were collected using the standard SF-36 questionnaire and socioeconomic measures of the household were collected using a researcher-made questionnaire. The face validity of the questionnaire was measured by qualitative method and its content validity was confirmed by quantitative method. The test-retest method was used to test the questionnaire reliability. Regression models were estimated using ordinary least squares (OLS) and weighted least squares (WLS) methods. The Stata software was used for data analysis.
Results: Among the socioeconomic variables, four variables including years of education, health behaviors (regular physical activity, healthy eating habits), not-smoking, and social capital had a positive and significant relationship with all mental health measures (social role, emotional role, mental health and vitality ). The relationship between not-smoking and all mental health measures was more than other socioeconomic variables (P <0.05).
Conclusion: Mental health policymakers should place extra emphasis on the development of social capital in metropolitan cities, promotion of the citizens' health behaviors, and particularly on tobacco use and the related behavioral disorders.
A Hadianfar, S Rastaghi, A Saki,
Volume 16, Issue 5 (3-2021)
Abstract
Background and Objectives: The Covid-19 epidemic began in Wuhan, China in the late 2019 and became a global epidemic in March 2020. In this regard, one of the most important indicators of the healthcare systems is the in-hospital mortality rate, which occurs with a time lag of one to two weeks after hospitalization. The aim of this study was to investigate the relative risk of Covid-19 mortality considering this time lag according to the number of daily hospitalizations.
Methods: The data included the number of daily hospitalizations and deaths from Covid-19 from 15 May 2020 to 10 February 2021 in Iran, which was obtained from the Github database. A log-linear distributed lag model was used to evaluate the relationship and lag effect between daily hospitalization and relative risk of death.
Results: The mean number of daily hospitalizations and deaths were 1342.2 ± 7 731.5 and 190.6 11±118.6 in the study period, respectively. It was found that an increase in the number of daily hospitalizations had a significant relationship with an increase in the relative risk of death on the same day and in the following days. As the number of hospitalizations exceeded 2000 patients per day, the cumulative relative risk of death increased to more than one.
Conclusion: The results showed that the number of hospitalizations exceeding 2000 people per day was an alert for the country's healthcare system. Overall, prevention and observance of health protocols in the first level followed by early diagnosis of the disease, improving the hospitals facilities and preparedness of healthcare staff can reduce the relative risk of death in the possible future peaks.
Mh Rabiee, H Akbarin, S Bokaie, Mh Fallah Mehrabadi , A Sadrzadeh, F Tehrani,
Volume 17, Issue 1 (5-2021)
Abstract
Background and Objectives: The commercial layer chicken farming is one of the most important sectors of the poultry industry. This study was conducted to evaluate the status of biosecurity of commercial layer chicken farms in 9 Iranian provinces with the highest layer chicken population.
Methods: In this cross-sectional study, 202 commercial layer chicken farms were selected from nine Iranian provinces in 2019 using stratified random sampling. Then, the required data were collected using a questionnaire by presenting to the farms in person. The results are expressed as mean, standard variation, sum and adoption rate index.
Results: The results showed that the adoption level of total biosecurity measures was 68.18% in the commercial layer chicken farms in Iran. This figure was 72.11%, 75% and 60.82% for conceptual, structural and operational biosecurity measures, respectively. Among conceptual biosecurity measures, the lowest adoption level (29.20%) was for distance to the nearest garden and agriculture land. Among structural biosecurity measures, the lowest adoption level (28.96%) was for a hand disinfection spot before shed. Among the operational biosecurity measures, the lowest adoption level was for water filtrations (31.18%) and microbial testing of water (33.91%).
Conclusion: This study investigated the biosecurity status of commercial layer chicken farms in nine Iranian provinces with the highest layer chicken population and revealed some weaknesses in the implementation of these measures at conceptual, structural and operational levels.
Zahra Hosseinkhani, Mozhgan Abbasi, Amaneh Khaleghi, Elham Kakavand, Nahid Yazdi, Hassan Reza Mohammadi Moein,
Volume 17, Issue 2 (9-2021)
Abstract
Background and Objectives: The spread of COVID-19 in the world has had adverse effects on all aspects of people´ life and social and economic development of the communities. The current study was conducted to determine the knowledge, attitudes, and practices toward COVID-19 in the general population of Qazvin province.
Methods: This cross-sectional study conducted on 1223 people above 15 years in Qazvin province between December and January 2020. We used multistage stratified random sampling to select the participants from urban and rural health centers. The questionnaires were completed by the patients as well as through phone interviews. The questions included demographic information and knowledge, attitude, and practice toward COVID-19.
Results: In total, 1223 subjects with a mean (standard deviation) age of 35.6 ± 12.2 years participated in this study. The scores of knowledge, attitudes, and practice were 68%, 72% and 91%, respectively. The lowest score of knowledge was related to awareness of common symptoms of the disease (6%). Forty-two subjects believed they observed the principles of disease prevention. A distance of 2 meters was observed by 50.3%. The scores of knowledge (P=0.007) and practice (P=0.028) increased with age, and the scores of knowledge (P<0.001) and attitude (P=0.001) increased and decreased with an increase in the education level, respectively. Males had significantly lower knowledge (P=0.002) and practice (P<0.001) scores. Moreover, rural residents had higher attitude scores compared to urban residents (P=0.002).
Conclusion: The results suggest that the general population of Qazvin province had desirable knowledge, attitude and practice towards COVID-19 at the time of the epidemic.
Sa Hashemi, K Holakoui-Naeini, Ma Mansournia, R Akrami, M Nomali, T Valadbeigi, V Mennati, Ha Adineh, Mr Taghavi, M Ghafouri, S Poorbarat, A Hoseinzadeh, M Farahdel, Mr Armat, M Haresabadi,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: COVID-19 is a new disease and little information is available on its risk factors. The aim of this study was to determine the mortality risk factors in patients with COVID-19 in the northeast of Iran.
Materials and Methods: A case-control study was conducted. Patients of both sexes with a confirmed diagnosis of Covid-19 infection who died during the study were studied as the case group and patients who were in good general health and ready for discharge were studied as the control group. Data analysis was performed with the STATA software version 14 using descriptive statistics and univariate and multiple logistic regression tests.
Results: Six hundred and eleven patients were studied (27% cases and 73% controls). Multiple logistic regression analysis showed that the odds of death were 2.8 times higher in patients over 80 years compared to patients aged 50-60 years. In addition, age under 40 years reduced the odds of mortality by 85% and living in rural areas increased odds of death by 2.2 times. Cough, general fatigue, pain, nausea and vomiting increased the odds of COVID19 survival.
Conclusion: The odds of mortality were higher in elder patients with COVID-19. In addition, living in rural areas increased the odds of mortality in patients. Cough and fatigue reduced mortality; however, it is needed to address other hidden factors for sound judgment.
M Karami, S Khazaei, F Shahbazi, M Mirzaei, A Biglarkhani, A Ataei, Seyed Jalalodin Bathaei, A Zahiri, M Shojaeyan, R Zamani, Ae Karshenas, F Heeders-Moghis, K Hamelmann, R Heidari Moghadam, I Khodadadi-Kahlan, S Bashirian, F Keramat, Sh Hashemi, E Jalili, F Azizi-Jalilian,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: The aim of this study was to investigate the epidemiological characteristics of patients with Covid-19 in Hamadan Province.
Materials and Methods: In this descriptive cross-sectional study, demographic and epidemiological data of all people who presented to hospitals in Hamadan Province from February 2019 to December 2020 were extracted using two checklists. Data were then analyzed using the Stata software.
Results: In this study, 9674 covid-19 positive patients were examined. According to results, 49.11% of the cases occurred in the elderly over 60 years. The rate of involvement was higher in females than males (51.57% vs. 48.43%). Moreover, 72.05% of the definitive patients lived in the city and 0.76% reported traveling to areas with a high prevalence of the disease two weeks before the onset of symptoms. The highest incidence of this disease per one hundred thousand population was in Malayer, Hamedan and Nahavand counties and the highest fetality was in Razan and Dargazin, Tuyserkan and Asadabad counties, respectively. The data of suspected, probable, and definite outpatients with Covid-19 presenting to medical centers were not evaluated in this study.
Conclusion: Due to the high death rate in the elderly, males, those with underlying diseases, and people living in rural areas, it is necessary to design and apply precautionary measures in these groups. Attention should be paid to these high-risk groups in the shortest possible time to reduce the burden of this disease on individuals as well as the health care system.
S Heidari, M Karami, Sm Zahraei, I Sedighi, F Azimian Zavareh,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: Given the importance of the early detection of any outbreak or change in the trend of meningitis, this study was conducted to estimate the fixed and dynamic alarm threshold levels of meningitis and its outbreak in Iran.
Materials and Methods: In this study, the data of all patients from 20¬ March 2016 to 20 March 2019 were extracted from the National Meningitis Disease Surveillance System. Alarm threshold levels were calculated separately for different seasons and provinces. To determine the alarm threshold levels, four methods of Upper Control Limit (UCL), relative increase, statistical cut off points, and recommendations provided by the World Health Organization were used.
Results: The alarm threshold levels for confirmed cases were determined for Iran according to the upper limits of cumulative sum (CUSUM) algorithm and the statistical cut off points based on the 90th percentile, 2 cases per day for Iran. The fixed amount was 3 to 5 cases per week in populations under 30,000 and 5 to 7 per week in populations between 30,000 and 100,000. According to the relative increase method, a 30% increase in one week compared to previous weeks was considered as the threshold level.
Conclusion: The use of alarm threshold levels reported in this study can be a basis for detecting meningitis outbreaks.
