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

Drug abuse among street children in Tehran: A rapid assessment

Maroe Vameghi

Background and Aim: Children who work or live in the streets are one of the high-risk groups for HIV. The high population of street children and lack of comprehensive intervention programs for them increase their risk for HIV in Iran. This study intended to explore the situation of drug abuse in street children in Tehran, the capital city.

Materials and Methods: This paper reports part of a comprehensive rapid assessment and response (RAR) research project on street children in Tehran during 2012-13. Data were collected by interviewing subjects using questionnaires. The sample size was 289 street children selected by time-location sampling in Tehran.

Results : Data showed that about 25.6% of the street children had had some history of cigarette smoking, alcohol abuse, and/or drug abuse. Most of them were boys aged 15-18 years. The prevalence rate of cigarette and/or hubble-bubble smoking, alcohol consumption and drug abuse during the preceding 6 months 12.1%, 11% and 6.9%, respectively. Significant associations were found between alcohol consumption and drug abuse on the one hand and the children’s age, type of occupation and home-leaving experience on the other. Further analysis of the data showed that the main reason for drug abuse was curiosity (56.6%), followed by mere enjoyment (39.6%) and leisure (35.8%) .

Conclusion : It can be concluded that drug abuse among street children is highly associated with gender, age, alcohol consumption, cigarette smoking and leaving home experience. Therefore, it is recommended to start drug abuse prevention programs at lower ages, with particular emphasis on boys. In addition, family intervention and improvement of children’s lifestyle aiming at preventing home-leaving could be a main strategic plan for reducing drug abuse among street children.

The review of community assessment papers to determine priority problems in selected populations of Iran

Koroush Holakoie naieni

Background and Aim: The community assessment is the basis of strategic policies for health professionals and managers. The aim of community assessment is collection of the data that relating to public health problems, data analysis and concludes about necessary capacities for providing the necessary resources to resolve problems.

Materials and Methods: In this study the databases of Scientific Information Database, MagIran, MEDLINE, Google Scholar, and IranMedex were searched up to April 2014 (farvardin1393). All papers of community assessment in the country according to our standard community assessment model were included in this study.

Results: Overall 11 studies were evaluated and the common feature of all research is to identify problems of society and local problems. The drug addiction was classified in 3 of the studies as a main problem and in 7 of studies was classified in the ten major problems. Poverty and unemployment are allocated to the next priority, the second priority in 2 studies, the third priority in 3 studies and the fourth priority in 3 studies. Environmental health problems and socio-cultural problems were the next priorities.

Conclusion: The proposed model can be used to suggest new health services with due consideration of community problems, as well as develop suitable, effective intervention strategies. This type of community study should not be conducted only once. Rather, it should be repeated periodically in any community, results compared and used for policy-making.

Seasonality pattern of suicide in Iran: A systematic review

Mahmood Moosazadeh

Background and Aim: Investigation of seasonal suicide might help in learning about the etiology of suicide committers’ behavior. Literature search indicates that a large number of preliminary studies have been carried out on this subject, in many of which seasonal and climatological aspects of suicide have been investigated. In the present study, the seasonal and time pattern of suicide incidence in Iran was determined based a systematic review.

Materials and Methods : Search was performed in the national databases, namely, SID, Iranmedex, Magiran and Medlib, as well as international databases such as PubMed, Scopus and Google scholar, using such keywords as Iran/Iranian, seasonality and suicide. The technical quality of papers was assessed using checklists. Data of each of the preliminary studies were extracted in terms of general variables and such specific variables as season, month, hour, weekdays and climatic conditions.

Results: Of a total number of 49,522 documents obtained from a primary electronic search, eventually 32 papers were included in this study. The highest numbers of suicides committed were 7 and 8 in summer and spring, respectively. Similarly, among the primary studies that had reported only the monthly occurrence of suicide, the highest rate in 7 cases was spring and 7 in summer. In most of the studies (8 cases) the highest number of suicides had taken place between 1:00 and 6:00 PM.

Conclusion: These findings indicate that suicide occurrence in Iran has a seasonal pattern, most cases committed being in spring and summer.

Self-immolation causes and preventive strategies from the viewpoint of healthcare providers: A qualitative study

Narges Khanjani

Background and Aim: Suicide by burning is one of the main health problems very common among women living in the west part of Iran. The objective of this study was to explore its causes and preventive strategies from the viewpoint of healthcare providers .

Materials and Methods: This was a qualitative study, using semi-structured interviews, carried out in Kermanshah. The participants were the health care personnel working in Imam Khomeini Hospital, a teaching hospital and referral center in the west part of Iran. Sampling was purposeful and continued until data saturation. Data analysis was conducted through thematic analysis.

Results: Four themes were extracted for the causes of self-immolation including cultural context, mental health problems, self-immolation as a way to highlight the outcry, and economic problems. As regards prevention strategies, two main themes, namely, cultural changes and mental education and services, emerged.

Conclusion: Self-immolation is a multi-dimensional phenomenon. Different factors interact, resulting in self-immolation by women in stressful situations. Comprehensive preventive strategies such as education, as well as cultural changes, can help to reduce the burden of self-immolation.

Association between index of nutritional quality and multiple sclerosis

Azita Hekmatdoost

Background and Aim: The role of nutritional quality of the diet in the development and progression of multiple sclerosis (MS) is not yet well understood. The aim of the present study was to determine the association between index of nutritional quality (INQ) and MS.

Materials and Methods: In this case-control study, 70 patients with a definitive diagnosis of MS in the preceding year and 140 frequency-matched hospital controls were selected from among 20-50 year-old patients referred to Sina and Lolagar hospitals in Tehran. The subjects’ dietary intakes were assessed using a valid and reliable semi-quantitative food frequency questionnaire. INQs for all the nutrients were then calculated for every participant, and logistic regression analysis was used to calculate the odds ratios for having MS in relation to every nutrient’s INQ.

Results: After adjusting for potential confounders, it was seen that subjects who had higher INQs for alpha-linolenic acid, vitamins A, D, K, B₁, B₂, B₅, B₆, folate, B₁₂, and C, and minerals calcium, phosphorus, zinc, and potassium were less likely (p<0.05) to have MS as compared to subjects with lower INQs for these nutrients.

Conclusion: The findings of the present study show inverse associations between the INQ of many nutrients and risk of having MS. Therefore, it seems that overall improvement of the nutritional quality of the diet might be an appropriate approach for prevention of this disease.

Psychometric properties of a protection motivation theory questionnaire used for cancer early detection

Fazllolah Ghofranipour

Background and Aim: Cancer is the third cause of mortality in Iran, killing more than 30000 persons annually. The Motivation Theory is a useful approach for predicting and planning intervention programs to change behaviors related to cancer prevention and early detection. Considering the absence of a valid and reliable protection motivation theory questionnaire for cancer early detection in Iran, this study was conducted to design such a questionnaire and assess its psychometric properties in Yazd

Materials and Methods: This was a cross-sectional study. A questionnaire was designed based on similar questionnaires currently in use and its validity and reliability were determined. The reliability coefficients were calculated by Cronbach α and intraclass correlation coefficients. To determine the validity of the scale, two methods were used, namely, face validity and content validity. Confirmation factor analysis was used to determine factorial validity using Amous 21 software .

Results: The CVR for all items of the questionnaire, CVI, ICC and internal consistency of the questionnaire were found to be 1, 0.97-1.0, 0.71-0.98, and 0.65-0.93, respectively. The confirmation factor analysis revealed that the questionnaire fitted the Iranian population. The Cronbach alpha coefficient for the questionnaire constructs varied between 0.71-0.98 and 0.65-0.93

Conclusion: The validity and reliability of the Persian version of PMT scale for cancer early detection are acceptable and suitable, so it can be used in similar research.

Knowledge, attitude and practice of women living in Yazd, Iran regarding food poisoning

Sepideh Khalatbari

Background and Aim: Food poisoning occurs under circumstances where proper action for protecting foods from microbial contamination and chemical toxins is not taken. In the Iranian society women have an important role in preparing food in the home. The objective of this study was to assess the knowledge, attitude and practice (KAP) of women living in Yazd, Iran regarding food poisoning.

Materials and Methods: This was a cross-sectional descriptive study. Data were collected through interviewing 266 women living in Yazd, selected randomly by calling at their homes. Data analysis was performed using SPSS version 18. The minimum and maximum accessible scores for knowledge, attitude and practice were 0 and 15, 15 and 45 and 0 and 20, respectively.

Results: The mean (± SD) score of knowledge, attitude and practice was 11.13 ± 2.54, 39.98 ± 4.52 and 17.73 ± 1.96, respectively. Further analysis of the data showed that 63.2% of the women had no knowledge about safety of refrigerated cooked foods and 41.4% had an erroneous attitude about fruit and vegetable cleaning, believing that merely cleaning them would make them safe to eat. As regards practice, 68.8 % of the women prepared and ate semi-cooked eggs.

Conclusion: Yazdi women lack a sound knowledge about (a). some agents of food poisoning such as, for example, Salmonella and (2). food cooking and preserving temperatures. It is recommended to plan and execute educational programs aiming at promoting knowledge and improving practice of women in these areas.

Fauna and monthly activity of sand flies at endemic focus of visceral leishmaniasis in the west territory compared to the east of Meshkinshahr district, Ardebil Province

Mohammad reza Abai

Background and Aim: Sand flies are responsible for transmission of leishmaniasis, papatasi fever and carrion disease. Warning of sand fly population is the first step for the establishment of baseline data for the vector control operations of visceral leishmaniasis (VL). In order to attempt to the difference between species composition and bieocology of sand flies, the comparative research was carried out in west and east of Meshkinshahr district where having high and low prevalence of VL as well as mild semiarid and semiarid steppe climates respectively.

Materials and Methods : Sand flies were biweekly collected using sticky paper traps from indoor and outdoor shelters from four villages at west and east of Meshkinshahr district. The specimens was removed from sticky paper traps and washed in acetone and preserved in 70% alcohol. The preserved sand flies were mounted using Puri’s media and identified using valid keys. The labeled specimens were deposited in Medical Entomology Museum, School of Public Health under code GC22ST6-93 .

Results: During this study, totally 783 and 400 sand flies were respectively caught from indoor (19-27%) and outdoor (73-81%) of both at west and east. The sex ratios of collected sand flies were estimated 2.3 and 1.9. in latter areas. The genera percentage of sand flies were 66.3-64.5% for Phlebotomus and 33.7-35.5% for Sergentomyia compromising of 7 subgenera which included in 20 and 17 species respectively in west and east areas. For the first time, Se.sintoni and Se.mervynae was reported in Meshkinshahr district.

Conclusion: The Ph.kandelakii and Ph.perfiliewi were introduced as prevalent species in the west area compared to the east. In the west area, activity duration and number of generation was higher than east. The prevalent species in the east area was Ph.papatasi. The high density of Ph.anderjevi was seen in both studied areas. The most proven vectors of visceral leishmaniasis were revealed in the west of Meshkinshahr district.