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M Karami Jooshin , H Izanloo, A Saghafipour, F Rezaei, M Asadi Ghalhari ,
Volume 14, Issue 4 (3-2019)
Abstract

Background and Objectives: Cholera is one of the communicable diseases that should be reported immediately as a public health threat. This study was conducted to study the probable risk factors of cholera outbreak in Qom, central Iran, during 2017.
 
Methods: In a case-control study, 37 cholera patients diagnosed based on para - clinical tests and 37 control samples were evaluated. Charts, frequency tables, regression logistic, Chi-square and t-test in SPSS software ver.25 were used for data analysis.
 
Results: The causative agent in the Qom cholera outbreak was Vibrio cholerae serotype Inaba. Most of the patients (54%) were in the age range 21-40 years. Most of the cholera cases were males (87%), Iranians (81%), and school or college students (30%). The peak of the epidemic occurred in the third week of November 2017, coinciding with a religious event. Nearly half of the patients were identified at the cross-border surveillance centers. The most important risk factors for the outbreak were a history of travel to Iraq in order to attend the Arbaeen religious event (95%), (OR=75, P-value<0.001), and a history of consuming unreliable foods and water (94% and 50%, (OR=66, CI=8-410, P-value=0.00 and OR=11, CI=2.7-46)), respectively. 
 
Conclusion: Cross-border surveillance of cholera in common borders with Iraq, especially in the Arbaeen religious event, played a vital role in identifying patients suspected of cholera. The surveillance of communicable diseases should be strengthened when entering and leaving the Arbaeen event.
 
L Khazaei, S Khodakarim, A Mohammadbeigi , A Alipour,
Volume 15, Issue 2 (9-2019)
Abstract

Background and Objectives: an important problem challenging cesarean section is its extensive use as a common method of delivery. Due to the growing trend of cesarean section in Iran in recent years, the natural delivery promotion program was implemented as one the programs incorporated in the Health System Reform Plan in 2014. In this study, the trend of changes in the percentage of CS delivery in Qom Province following the implementation of this program was evaluated.
 
Methods: This trend analysis that was performed in all cesarean deliveries in Qom Province from 2005 to 2018 using a joinpoint regression method.
 
Results: These results showed an annual increase of0.4% in the CS percentage 95% CI: -0.5 to  1.2), which was not statistically significant. A significant decrease was observed in the rate of CS in governmental hospitals. Conversely, in non-governmental hospitals, the percentage of CS increased significantly.
 
Conclusion: According to the findings of this study, after more than 3 years of implementation of health sector evolution plan, overall implementation of this plan failed to significantly reduce the overall process of cesarean delivery during this period in Qom province and achieve the predetermined goals.

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