Journal of School of Public Health and Institute of Public Health Research

Climatic Survey of Malaria Incidence in Iran during 1971-2005

Mansour Halimi

Background and Aim: Environmental and ecological factors especially climatic conditions have a significant impact on the prevalence of parasitic diseases. These factors has is more importance in Malaria Incidence and Epidemiology. Malaria as the most important parasitic disease, considered as one of most important public health problem. The climatic factors not only affect the growth and proliferation of the Anopheles mosquito but also affect in Plasmodium activity . In present study we surveyed the malaria situation during 1972 to 2005. In order to the five climatic parameters including mean temperature, total precipitation, number of days with precipitation over 0mm, rainfall distribution index and relative humidity were used as annual average during 1971 to 2005.

Materials and Methods : we calculate average of annual of climatic parameters for the 31 synoptic stations of Iran Using GIS software. First, using the ordinary Kriging model with spherical a Semi variogram was traced maps of climatic parameters and these factors mean was calculated for each year . Finally, to investigate the relationship between climatic parameters with the prevalence index the Pearson correlation coefficient at 0.9 confidence level (p = 0.10) . was used. A multivariate linear regression model was applied to estimate the prevalence of disease based on the mentioned climatic factors .

Results : Study of malaria prevalence in 1971 to 2005 showed cases of disease with has a decreasing trend with slope 0.0142 in year that this trend has been accelerated from 1375 . Many cases of disease have been reported one year after increased precipitation . The result showed the weather humidity factors is important than temperature factors in the prevalence of malaria . I general, the developed model is explained 0.48 of changes prevalence time.

Conclusion: In order to be successful Anti-malaria campaign in Malaria-prone areas in addition different influencing factors climatic factors should be considered .

The contribution rate of health capital to economic growth:Empirical evidence from MENA countries (1996-2010)

Shokouh Masoumi

Background and Aim: In this paper, contribution rate of health capital in economic growth is computated.

Materials and Methods: In order to this, fuzzy neural network method is applied on statistical data from Middle East and North Africa countries in the period of fifteen years (1996-2010).

Results: The obtained results present that contribution rate of health capital in economic growth these countries has averagely been 44/79 percentages in this priod.

Conclusion: Investment in the field of health and education form the political suggestion of this research.

The concept and dimensions of Gender sensitive STIs/HIV/AIDS prevention services: a qualitative study

Masoumeh Simbar

Background: Sexually transmitted infections are one of the most prevalent infections all over the world that impose significant morbidity on people. There are an increasing number of sexually transmitted infections in Islamic Republic of Iran during recent years. So developing and implementing programs for STIs prevention and control is considered as a health priority. While the role of gender based power in sexual relationships has in recent years been acknowledged, the understanding has largely lacked practical considerations in the STIs/HIV/AIDS prevention fields. This study aims to explore gender sensitive STIs/HIV/AIDS prevention services concepts and dimensions.

Method : This study employed content analyzes research design. Semi-structured in-depth interviews were conducted with 37 expert reproductive health managers and providers that selected purposively and then continued by snow ball method. Data collected by using semi-structured interview guide. The interviews were transcribed and typed. Data was analyzed according to content analysis.

Results: 2 categories emerged as the result of data content analysis: 1) gender sensitive structure including employers, facilities and management dimensions 2) gender sensitive process including care and educational processes.

Conclusion: providing gender sensitive STIs/HIV/AIDS prevention services need gender sensitive management, facilities and providers and gender sensitive care and educational design.

Determining pattern of metastasis and prognostic factors in breast cancer using conditional regression model (PWP)

Mahmoud reza Gohari

Background and Aim : identifying the risk factors for metastasis is major concern for treatment processes of cancer patients. Metastasis makes patients frail and increase hazard of death. It also decreases physical and psychological quality of life of patients. Aim of this study is determining of prognostic factors for metastasis of breast cancer using conditional regression model.

Materials and Methods: in this survival study, hospital records of 246 women with breast cancer who underwent surgery and treatment at hospital Fayyazbakhsh were used. Patients were followed until 2012 May and their final situations recorded. Metastasis free survival estimated with Kaplan-myier method. To determine the prognostic factors, a conditional regression model called PWP fitted. All statistical analysis was conducted with R software, version 2.10.

Results: 202 patients (82.1%) were alive until follow up and 44 patients (17.9%) died.54patients experience metastasis. 11 patients (4.7%) had two metastases. Most of metastases were shown in bone, liver, lung and brain. Median metastasis free survival (MFS) estimated 64 month. One, two and three year MFS were 88%, 80.1% and 76.6%, respectively. Lymph node involvement and HER2 were shown as prognostic factors for metastasis. Age, Esterogen Receptor, Prosterogen Receptor, Grade and tumor size were not significant ( P> 0.05).

Conclusion: number of lymph nodes involvement as a prognostic factor involve more nodes and increase risk of metastasis and death. Thus prognosis and treatment of cancer in early stages increase survival of patients.

Infestation of patients to demodicosis refered to the skin clinicis and it relation to some related factors in Tehra, Iran

Gholam reza Molavi

Backgrond and Aim: Demodicosis is a common skin disease. Great number of admissions to the clinics is occurring in the country. Regarding the high prevalence of this parasitic arthropod, investigating on pathogenesis, route of transmission and the complications they may produce, is considered of great importance. Generally, demodex parasites often exist in the skin tissue and tend to live in the face specifically in cheeks, forehead and nose, where sebum excretion is active and may provide a favorable habitat for living and breading the parasite. Diagnosis is carried out during an exploratory skin test for a cne, pityriasis rosacea and ophthalmic infectious diseases such as blepharitis. Determination of their biological role in chronicity of general skin disorders is an interesting topic in research.

Materials and Methods: Patients were admitted to the Razi hospital, Research Center for skin diseases and leprosy, and three other clinical laboratories considered for assays. The questionnaire was filled for each patient and the sample was taken from the affected area. Ecto parasites were transferred to the potassium chloride solution 10% and studied under a light microscope.

Results: A total of 100 patients were studied, from which 78 patients were diagnosed as infected with the Demodex folliculorum. Of these, (%92) were female and (%7.6) male (p <0.05). The highest frequency was observed in the age group 41 to 50 years (P <0.05).

Conclusion: In this study, the relative frequency of demodicosis was more common in women and in the middle-aged group. Generally this high level of frequency will intensify the necessity of the identification of parasites and its pathological effects in chronic infectious diseases.

Validation and Reliability Study of Farsi Version of Work Ability Index Questionnaire

Adel Mazloumi

Background and Aim: Work ability reflects the interactions among personal characteristics, working conditions, employees' functional capabilities, and also employees' health status. Hence, the aim of the present study was to provide the Farsi version of Work Ability Index and to validate it among Iranian workers.

Materials and Methods: In the first stage, Backward Translation method was used for linguistic validation of the questionnaire. Cross sectional survey of a sample of 645 workers from some Iranian companies were conducted. The study estimated the reliability of the questionnaire by means of test-retest, as well as the construct validity using factor analysis. In order to determine discriminant capacity, the mean scores of different dimensions of work ability index were compared between workers with and without sick leave.

Results: Accordingly, the questionnaire showed a good internal consistency. ICC coefficients for the questionnaire were acceptable. Moreover, factor analyses related to the questionnaire items indicated that only one question is sufficient for each item of "work ability in relation to the demands of the job" and "mental resources". Also, questions related to the item of "number of current diseases diagnosed by physician" can be integrated in six questions. A good level of discriminant validity was observed for all dimensions except for the item of "work ability regarding work demands".

Conclusion: According to the acceptable validity and reliability of Work Ability Index, obtained in the present study, using this questionnaire for evaluating workers' work ability in all Iranian work environments, especially in industrial settings, is recommended.

Investigation of Chronic Fatigue Syndrome Questionnaire Validity and Reliability CFS (DSQ Revised)

Abolfazl Zakerian

Background and Aim : Diagnostic tools for chronic fatigue syndrome, chronic fatigue syndrome questionnaire, created for research and clinical investigations in order to use it as a management tool for monitoring patients with this syndrome. The questionnaire is very comprehensive using a self-reporting system and all internal and external definitions according to the America's Center for Disease Control has been covered. It also assesses current and past activity levels and symptoms of fatigue and malaise after routine daily activities to ensure that these items are evaluated as well. The purpose of this study is to evaluate the reliability and validity of diagnostic questionnaire for Chronic Fatigue Syndrome (CFS).

Materials and Methods : In the discussion of content validity and reliability of survey studies, chronic fatigue syndrome questionnaire, prepared by the Department of Psychology, DePaul University, and was elected a full copy of the correspondence received from the questionnaire ratings. The questionnaire that was translated content validity was assessed by the 20 members of the faculty. However, re-translated from Persian into English for reference, was prepared with modifications, the validity of its validity was confirmed by the authors. Then, 30 nurses were selected to determine the reliability of the questionnaire chronic fatigue syndrome who was working in a Hospital. Inventory management under center and full justification of the researcher and the participants in the study by researchers at the distribution has been completed. The survey was carried out again after 15 days.

Results: The instrument showed good reliability and validity. In discussing the content validity of the Persian translation tool by 20 people associated professor of internal review, and its content validity was determined with respect to two of CVI and the results of CVR , and (CVR=0.7 and CVI=0.85) represents CREDIT the content is good . According to the results, the reliability of the questionnaire CFS, Cronbach's alpha to assess the results of the questionnaire showed very good reliability. Two step test reliability coefficients (ICC = Mixed & and Confidence Interval = 95%) also showed a significant relationship among questions as well. However, the internal correlation coefficient obtained for the 8 criteria CFS, showed high internal cohesion.

Conclusion: This study suggests the CFS questionnaire as a reliable instrument for all levels in research and clinical applications. Using this tool can help with background checks and even in advanced levels to be effective, it has enough power and accuracy in the diagnosis of CFS sufferers.

Using social marketing model to persuade the women to do mammography

Ali Vafaei najjar

Objectives: The role of mammography in early detection of b reast cancer is evident and persuasion to do that is very important in health sector. Majority of the interventions are based on education and informing and there has been less attention to making mammography cost beneficent. This study aimed at assessing the effect of a social marketing-based intervention to persuade to do mammography in Bojnord.

Methods: In this quasi-experimental study, two villages around Bojnurd with similar demographic characteristics, considered as intervention and comparison groups randomly. All 35- years and older women consist of 343 women (151 in intervention and 191 in comparison groups) were identified. To obtain the main idea for intervention, and exploring the viewpoints of target group about mammography, a formative research combined of a quantitative survey (through completing the questionnaire for assessing the women’s attitudes based on health belief model) and a qualitative study (through establishing four focus group discussions) was done. According to the gathered and analyzed data, an intervention focused on the main barriers designed and implemented through four weeks. One week after the intervention, the number of mammograms in two villages was determined and compared.

Results: Quantitative survey showed that the mean of the scores related to expending time and high economical costs (perceived barriers) not remember to do mammography and fear of exposure to x- ray is less than other constructs. In qualitative study, time expending and high economical cost considered as two main factors related to not doing mammography. After the intervention, 48.1 percent of the women in intervention group went to do mammography and there are no change similar results in comparison group.

Conclusions: Educational interventions are not enough to persuade women to do mammography and we have to consider their perceived barriers and concerns. One of the most effective approach to promote an idea, behavior or service, is identifying the viewpoints of target group and design them as consumer- oriented programs. So, acceptance of the idea and behavior will be cost-beneficent.