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Yousef Khonya, Mohammad Narimani, Seifollah Aghajani, Nader Hajloo,
Volume 19, Issue 4 (3-2022)
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: One of the emotions that plays an important role in the health of all people is the emotion of anger which is one of the main emotions. The aim of the present study was to compare the effectiveness of emotion regulation and resilience training mediated by locus of control on anger control in medical students.
Materials and Methods: This was an experimental study. The statistical population included all medical students randomly divided into three groups of 30 students each by simple and multi-stage cluster sampling. One of the experimental groups received 8 sessions of emotion regulation training and the other 8 sessions of resilience training. Data were collected on all the subjects using the Rotter locus of control and Spielberger's anger and trait questionnaires
and analyzed using repeated-measures and two-factors analysis of variance.
Results: Analysis of the data showed that there was a statistically significant difference between the emotion regulation and resilience training groups as regards anger control. In addition, the differences between the two groups as regards the locus of internal and external control in controlling anger and its subscales were also significant.
Conclusion: Teaching emotion regulation and resilience skills can, like other skills, help greatly students against the challenges of the present era.
Ali Mohammad Mosadeghrad, Tina Taherkhani, Shayan Shojaei, Matin Jafari, Sara Mohammadi, Alireza Emamzadeh, Shahrzad Akhavan,
Volume 20, Issue 1 (6-2022)
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: Primary health care is a holistic approach that aims to maximize people's health and well-being as quickly as possible in their immediate living environment. The primary health care system is the first point of contact of the people with the health system. Therefore, increasing its resilience will play a significant role in controlling and managing pandemics. This research aimed to identify strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic.
Materials and Methods: This study was conducted using the scoping review method. Using appropriate keywords search was done on the subject of the study in PubMed, Web of Science, Scopus, SID, Iranmedex and Magiran databases and Google and Google Scholar search engines. Finally, after screening and reviewing the titles, abstracts and texts of the retrieved documents, 36 articles were selected and strategies to strengthen the resilience of the primary health care system in the Covid-19 pandemic were extracted from them.
Results: A total of 48 strategies/solutions were extracted to strengthen the resilience of the primary health care system, categorized into 6 groups, namely, governance and leadership, financing, human resources, medicines and equipment, health information systems, and health service delivery. Among the most frequently solutions mentioned were the following: Dynamic and accountable leadership, using valid research evidence in policy-making, contingency planning, increasing inter-sectoral cooperation, advocacy for health policies, community involvement, sustainable financing, recruiting additional staff and training and supporting them, providing sufficient stocks of medicines and diagnostic kits, developing and modernizing public health information systems, facilitating people's access to health centers, continuing to provide health services, and increasing the community’s health literacy.
Conclusion: The structural and process components of the primary health care system including "governance and leadership", "financing", "staff", "equipment, vaccines and medicines", "information" and "health care delivery" should be strengthened in a coordinated manner in the primary health care system to be prepared for future epidemics.
Narges Salehnia, Hamed Mokhtari Torshizi, Hassan Ama Bandeh Gharaei, Seyed Mohammad Seyedi,
Volume 20, Issue 1 (6-2022)
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: In addition to health costs, institutions are a factor influencing directly and indirectly the promotion of health in a country. Air pollution, the main cause of which is the industry and in the control and reduction of which the governments have an important role, is another important factor affecting the health situation in a country. This paper reports the results of a study on the health impact of institutions, considering health costs and air pollution.
Materials and Methods: The impact of institutions on health in 38 developing countries during the period 2006-2018 was determined using the threshold panel method, health proxy life expectancy index and good governance index as the quality of institutions and explanatory variables of misery, per capita income, health costs and happiness. Based on the CO2 threshold variable, the sample was divided into two homogeneous regimes and the model was obtained with EVIEWS (10) and Stata (15) software packages.
Results: The findings indicate that the governance index and happiness in both regimes are significantly positive. Health costs in the upper group were found not to be significant and in the lower group to have little effect on health. In addition, income was significant in both regimes, though with little effect. Finally, the misery index was also found to be significant, but its coefficient in the lower group was not in line with the relevant theories.
Conclusion: Based on the findings of this study, institutions in developing countries play a major role and form a causal chain among other sectors which are very important in promoting health of the populations. Therefore, in order to promote health in these countries policies should be designed and implemented for institutional improvements.
Hossein Torkmani, Mehdi Ghasemi Motlagh, Behrang Ismaili Shad, Mohammad Mohammadipour,
Volume 20, Issue 1 (6-2022)
Volume 20, Issue 1 (6-2022)
Abstract
Background and Aim: Considering the harms and dangers of addiction and the fact that many people are trapped in it every day, it is important to identify the variables that affect it. The aim of this study was to predict the tendency to addiction among university students based on initial maladaptive schemas and cognitive emotion regulation.
Materials and Methods: This was a cross-sectional descriptive-analytical study. The statistical population consisted of all the 3548 students of Gonbad Kavous Payame-Noor University in the academic year 2019-20, from among whom a sample of 384 students was selected using the one-stage cluster random sampling method. The data collection tools were the following 3 questionnaires: early maladaptive schema (Young, 2005), cognitive emotion regulation (Garnefski & Kraaij, 2001) and addiction tendency (Wade and Butcher, 1992). Pearson correlation coefficient and multiple linear regression were used to analyze the data using the SPSS software version 22 at a statistical significance level of 0.05.
Results: Data analysis showed correlations between addiction and the following variables: excessive ringing in the ears (r = 0.491, p = 0.001), being guided by others (r = 0.523, p = 0.001), disturbed constraints (0.001 >, r = 0.426 p), impaired function (r = 0.389, p = 0.001), discontinuation (r = 0.406, p <0.001) and cognitive emotion regulation (p> 475, <0.001). 0r =). In addition, the results of multiple linear regression analysis showed the following: excessive ringing (β= 0.203, p = 0.001), being guided by others (β= 0.274, p = 0.001), disturbed constraints (β= 0.261, p = 0.001), impaired function (β= 0.229, p = 0.001), discontinuation (β= 0.193, p <0.001) and cognitive emotion regulation (β= 0.315, p = 0.001).
Conclusion: Based on the findings of this study, the average tendency to addiction among university students can be predicted by changing the initial maladaptive schemas and improving the cognitive emotional regulation.
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdieyh Heydari,
Volume 20, Issue 2 (9-2022)
Volume 20, Issue 2 (9-2022)
Abstract
Background and Aim: The health financing system is "the process of collecting, pooling and managing financial resources and purchasing healthcare services”. Iran's health financing system is facing challenges. The aim of this study was to evaluate the Iranian health financing system.
Materials and Methods: This descriptive study retrospectively evaluated the health financing system of Iran between 2000 and 2019 using archival data. Data were collected from the World Bank website and analyzed using the Excel software.
Results: Iran's health expenditure per capita increased by 3.7% annually between 2000 and 2019 and reached $868 (purchasing power parity) in 2019. Iran's total health expenditure increased from $32 billion in 2000 to $72 billion (purchasing power parity) in 2019 (5.9% annual increase). Iran accounted for about 0.6% of the world total health expenditure in 2019. In that year about 6.7% of the country's gross domestic product was spent on health, the global average being 9.8%, while the general government health expenditure (% of the then current health expenditure) in Iran and the world were 49.5% and 59.8%, respectively. Out-of-pocket expenditure (% of the then current health expenditure) decreased in the last decade in Iran, reaching 39.5% in 2019, compared to 18% worldwide.
Conclusion: Iran’s health system costs are increasing at a faster rate than the growth of its Gross Domestic Product (GDP). The country’s health expenditure (% of GDP) and, as a result, the general government health expenditure (% of general government expenditures) has decreased and out-of-pocket expenditure (% of current health expenditures) has increased. Therefore, reforms should be implemented to strengthen the country's health financing system.
Farhad Shekari, Hadi Jalilvand, Asghar Mohammadpoorasl,
Volume 20, Issue 2 (9-2022)
Volume 20, Issue 2 (9-2022)
Abstract
Background and Aim: The promotion of the health of the members of a society is based on the assessment of the situation of that society. This study was conducted in the Soufian district of Shabestar city with the aim of identifying and prioritizing its problems and needs with the direct participation of the people.
Materials and Methods: This was a cross-sectional study conducted in the Sufian District of Shabestar city in 2019, the methodology used being based the 8-phases model of North Carolina. The community health assessment was performed in 8 phases. The first seven phases included identifying and prioritizing the problems of the District, and the eighth was developing operational plans to solve its priority problems.
Results: A total of 23 different problems were identified. Prioritizing the problems according to the Hanlon method showed the ten main and priority problems to be, in a descending order, as follows: marriage of girls at an early age (21.01), excessive use of chemical fertilizers in farmlands (20.89), lack of social security clinics (20.51), unemployment (20.38), severe air pollution caused by incineration of industrial waste (20.01), accumulation of municipal waste in the city (19.89), high hardness of city water (19.76), lack of property deeds (19.63), lack of a specific unit in the industrial town to separate waste (19.38), and lack of a gas supply to Mehr Housing and lack of asphalted roads (19.28). Marriage of girls at an early age was identified as the main problem and with the first priority, and a general preliminary study was done on it; it was found that in about 43% of all marriages registered between 2014 and the first half of 2021 the ages of girls were under 18 years. Factors causing and increasing marriage of girls at an early age were identified to be as follows: low awareness of girls' families and girls themselves of the consequences of early marriage, social acceptance of early marriage in the area and low parental literacy.
Conclusion: In this study a wide range of social, cultural, economic and health problems were identified in the population studied. Marriage of girls at an early age is an important social problem with serious undesirable consequences. In an attempt to solve this problem it is essential to consider, in addition to legal and legislative strategies and actions, appropriate scientific, social, cultural and economic strategies and applied research.
Simzer Salehi, Mohammad Nourian, Leila Fathi,
Volume 20, Issue 2 (9-2022)
Volume 20, Issue 2 (9-2022)
Abstract
Background and Aim: Family female heads are one of the most vulnerable groups in the society and empowering them is essential. This research was a systematic study to design and develop a model of educational needs of female heads in the female-headed households.
Materials and Methods: This study was a qualitative applied research of a research synthetic type conducted using content-analysis and meta-analysis. The statistical population included all the relevant works published in Persian or English between 2012 and 2021 available in four reliable databases, namely, ERIC, Science Direct, PubMed and Google Scholar. Using the keywords "education of women-headed households, women's empowerment, women-headed households, and skills of women-headed households" and based on the inclusion criteria, initially 140 scientific articles were identified and finally, based on the exclusion criteria, 47 articles were selected for the final analysis. The Software MAXQDA 18 was used for the qualitative analysis of the articles.
Results: Analysis of the data obtained showed the educational needs of women-headed households as the main theme to consist of four subthemes including "knowledge and skills of desirable sexual orientation", "knowledge and skills of raising children", "knowledge and skills of occupation" and "individual and social development and empowerment”. Based on meta-analysis out of the four main themes 22 themes were extracted and a model was designed for educating female-headed households.
Conclusion: Considering that the educational needs of female-headed households have been identified, it is recommended that educational courses be designed in accordance with their educational needs.
Mohammad Moradi-Joo, Ali Akbari-Sari, Maryam Seyed-Nezhad, Seyed Mansoor Rayegani, Alireza Olyaeemanesh,
Volume 20, Issue 3 (12-2022)
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Clinical Practice Guidelines (CPGs), are "recommendations intended to optimize patient care based on systematic reviews of available evidence and assessment of the benefits and harms of alternative care options". CPGs play an important role in improving the quality of care, reducing the diversity of treatment methods, reducing medical errors, managing health costs and increasing patient safety. This study was conducted with the aim of analyzing the decisions, consequences and policy trends of using CPGs in Iran during the period 2001-2021.
Materials and Methods: This study was a type of health policy analysis, carried out using analysis of the policy process approach. Data were collected through reviewing policy documents (n=79) and qualitative interviews (n=27). Analysis of policy documents was done using the content analysis method, the software used being Excel software, while for analysis of the interviews the framework analysis method was used, the software being the MAXQDA10 software.
Results: The policy of using CPGs in Iran started in 2001 and has improved over the past two decades. During the period 2016-2021 a total of 836 CPGs (knowledge products) were published, but according to the participants, many of these CPGs or knowledge products did not have the necessary quality and were not used by physicians. The findings of this study also showed that in Iran there is a suitable atmosphere for implementing CPGs and the policies of using them are sound policies; however, there is a huge gap between the development and implementation of CPGs.
Conclusion: Although the process of applying CPGs has improved in Iran, their implementation faces challenges and, thus, they have not been fully implemented. Therefore, there is a need to adopt new standard methods and approaches to improve the quality and reliability of CPGs. Certainly, the support of the government, Ministry of Health and Medical Education, the medical community, insurance organizations and other stakeholders, along with proper collaboration and appropriate policy formulations, are essential to achieve success.
Siroos Ahmadi, Mohammad Norian Najafabadi,
Volume 20, Issue 3 (12-2022)
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Substance use disorder (SUD) is a disease in the treatment of which the biological and medical methods are emphasized, but social factors also play an effective role. This research has tried to investigate the relationship between problem-solving skill and successful quitting of SUD.
Materials and Methods: This was a causal-comparative research in which two groups, namely, drug addicts with successful quitting (n = 222) and those with unsuccessful quitting (n = 222) selected by multi-stage random sampling were compared. The research tool for measuring the problem solving skill was the Social Problem Solving Scale of D'Zurilla et al. (2002).
Results: The findings showed that the mean problem-solving skill score and its five components were significantly higher in the successful quitting group than in the unsuccessful group. Based on the logistic regression results, the problem-solving skill (B=0.271, Wald=110.490 Sig=0.000, EXP (B) =1.76, Cox & Snell=0.457) will increase the chance of successful quitting 1.76 times and can explain 0.457 of the changes in the dependent variable.
Conclusion: It can be concluded that psychosocial factors are also effective in the treatment of the substance use disorder. This means that paying more serious attention to these factors will help to alleviate one of the basic social and public health problems of the society.
Mohammad Khammarnia, Mostafa Peyvand, Nasim Mohammadiyane Razangi,
Volume 20, Issue 3 (12-2022)
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Diabetes is a disease in which blood sugar level is high due to hormonal disturbances. Monitoring and evaluation certainly helps to prevent, manage and control this widespread disease. The aim of this study was to study the epidemiology of diabetes in the Diabetes Clinic in Bu-Ali Hospital, Zahedan in South East Iran.
Materials and Methods: This was a cross-sectional descriptive-analytical study conducted in 2020 including all the 1164 patients referring to the Diabetes Clinic in Bu-Ali Hospital. Data were collected using a standard check list and analyzed using the Stata-v14 software.
Results: Information on 1164 patients with diabetes was recorded and analyzed. Most (97.7%) of the patients had type-2 diabetes. The average fasting blood sugar in patients with type-1 and type-2 diabetesd was 236 and 201 mg/dL respectively, the corresponding A1C levels being abnormally high ─ 9.6% and 8.4%. Fasting blood sugar was associated with diabetic foot complications and nephropathy (p<0.05).
Conclusion: Based on the findings of this study the level of care of diabetic patients in terms of quantity and quality is not quite acceptable, not conforming to the respective national standards. This issue indicates the unfavorable performance of the Diabetes Center, which can be attributed to the poor conditions of the geographic region, insufficient equipment and specialized manpower and low health literacy of the people. Therefore, increasing the awareness of overweight and obese people, especially those with a family history of diabetes, about prevention can help to reduce the incidence of the disease or minimize its complications.
Aboulghasem Pour-Reza, Ali Mohammad Mosadeghrad, Farinaz Moghadasi,
Volume 20, Issue 3 (12-2022)
Volume 20, Issue 3 (12-2022)
Abstract
Background and Aim: Surgical site infection (SSI) is an infection that occurs within 30 days after surgery and involves the skin and subcutaneous tissue of the surgical incision. It is one of the most common nosocomial infections which, in addition to endangering lives of the patients, increases the heath care expenditures in the health system. The objective of this study was to estimate the cost of surgical site infections in hospitals.
Materials and Methods: This was a case-control study conducted in a teaching hospital in Kashan, Iran in 2017 to find information about direct hospitalization costs of surgical site infections. Detailed information about the hospiutalization costs of case and control patients was extracted using patient records and the hospital information system software.
Results: Out of all the patients 115 (1.04%) experienced an SSI. The median additional direct medical cost was US$ 2577 and US$ 1034 for the case and control in-patients, respectively (p <0.001). The cost of treating SSI was US$ 1543 per patient. The direct hospitalization costs were 2.5 times greater for patients with an SSI than for those without an SSI. Further analysis of the data showed that the cost of SSI was related to the patient's age, duration of surgery and length of hospital stay before infection.
Conclusion: Surgical site infection treatment costs imposes high costs on the patients, health insurance companies and the hospitals. Therefore, hospitals managers should design and implement interventions to reduce surgical site infections.
Hamed Yeganeh, Hossein Parvaresh, Mohsen Dehghani Ghanataghestani, Mohammadreza Mohammadi Soleimani,
Volume 20, Issue 4 (3-2023)
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: The health, safety and environment (HSE) system is an integrated system that tries to create a healthy, pleasant and lively environment with no accidents, damages and injuries by converging and synergizing human resources, facilities and equipment. The purpose of the present study was to investigate the validation of the revised scale of HSE performance.
Materials and Methods: This was a descriptive and analytical research conducted using the psychometric method. The statistical population included all workers of the steel companies in Kerman Province, Iran in 1400. Using the cluster sampling method based on psychometric criteria a sample of 100 was selected for the convergent validity and a sample of 578 for the construct validity section. Data were collected through two scales of HSE performance and job stress (Cohen et al., 1983). Content validity, convergent validity and factor analysis methods were used to check the validity of the scale. The reliability of the scale was checked using the internal homogeneity and classification reliability (dividing in 2 haves). The SPSS version 22 software was used for data analysis.
Results: Confirmatory factor analysis confirmed the six-factor model. The questionnaire was used along with the 35-item occupational stress questionnaire of Cohen et al. (1983) which had good reliability and validity. The alpha coefficient obtained for the whole scale was 0.79, and for the subscales as follows: resilience 0.93, demand 0.90, role 0.93, control 0.85, support 0.72 and relationships 79.0. In addition, the reliability coefficient of the scale was also calculated using the classification method. The classification coefficient for the first and second halves of the data was 0.87 and 0.62, respectively, the correlation between the two halves being 0.248. These findings indicated a favorable internal consistency coefficient for the HSE performance scale (P<0.001).
Conclusion: According to the findings obtained based on the HSE validation, which showed that the fit of the model is high and also that the evaluation of HSE performance has a great role in the health of employees, more attention should be paid to the establishment and implementation of HSE management in Kerman steel companies.
Ali Mohammad Mosadeghrad, Mahya Abbasi, Mahdi Abbasi, Mahdieh Heidari,
Volume 20, Issue 4 (3-2023)
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: Health system financing is the process of collecting, pooling, and allocating financial resources to maintain, restore or promote the health of the people. Developing countries face many challenges in mobilizing, managing and allocating health financial resources. The aim of this study was to identify sustainable financing methods in developing countries.
Materials and Methods: This study was conducted using the scoping review. All the studies related to health system financing methods in developing countries were searched in the English electronic databases (i.e., Pubmed, Scopus, Science Direct, and Web of science), Persian electronic databases (i.e., Magiran, Iranmedex, and SID) and Google Scholar and Google search engines using appropriate keywords. Finally, 94 suitable documents were selected and analyzed using the framework analysis method and MAXQDA software.
Results: Forty-two methods were identified to strengthen the sustainability and resilience of the health financing system in developing countries; these methods were grouped into three categories: collection and management of financial resources, pooling of financial resources and purchasing of health services. The most frequently used solutions to strengthen the sustainability of the health financing system in developing countries were as follows: expanding social health insurance plans, integrating multiple health insurance plans, strengthening public-private partnerships, establishing a robust referral system, imposing taxes on harmful commodities, using perspective fixed payment methods, defining needs-based health service packages, promoting donors’ contributions, and reforming health service tariffs.
Conclusion: The health financing system in developing countries should be strengthened. The financial reforms of the health system should be accompanied by reforms in providing health services to make possible efficient and effective results. Health policymakers and senior managers should strengthen the governance of the health financing system at the macro level. In addition, healthcare managers should increase the efficiency and reduce resource wastage by strengthening budget capacity and financial management at the micro level.
Shayesteh Vahdani, Mehdi Rezaei, Mansoor Alimahdi, Mohammad Mahdi Shariat Bagheri,
Volume 20, Issue 4 (3-2023)
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: Public vaccination programs are a way to control the Covid-19 disease. The success of a vaccination program requires the acceptance of the Corona vaccine by the society. The aim of the present study was to predict the acceptance of the Corona vaccine by medical students based on their anxiety, optimism and rumination.
Methods and Materials: This was a descriptive and correlational research. The study population consisted of all the medical students of Azad University, Tehran, Iran during the academic year 2021-2022, from among whom a sample of 509 was selected by the available sampling method. Data were collected using the Acceptance of the Corona Vaccine (KAPC), Anxiety of the Corona Virus (CDAS), Life Orientation (LOT) and Ruminative Responses Scale (RRS) questionnaires. The data were analyzed using the Pearson correlation, partial correlation and standard regression tests.
Results: Data analysis showed that several variables including corona anxiety (with components of mental and physical anxiety), optimism (with components of expectation of a positive outcome and hope for the future) and confidence in the safety of vaccine could positively predict the acceptance of the Corona vaccine. Rumination (with two components of depression symptoms and brooding) negatively predicted the acceptance of corona vaccine. Finally, the reflecting component, age and gender could not significantly predict the acceptance of the Corona vaccine.
Conclusion: To increase the acceptance rate of corona vaccine, paying attention to the roles of psychological factors such as corona anxiety, optimism, trust, and rumination can be helpful.
Mohammad Zia Hoseini, Fatemeh Setoodehzadeh, Mehdi Zanganeh Baygi,
Volume 20, Issue 4 (3-2023)
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: As a pandemic disease, Covid 19 has taken the lives of many people all over the world and has put a lot of pressure on the health care system and health care personnel. The experiences of managers and employees can help increase the efficiency of the health systems in future crises. This study was carried out in order to use the experiences of the personnel of the Crisis Section of Zahedan Medical University Public Health Deputy (ZMUPHD) in controlling the Covid-19 epidemic.
Materials and Methods: This was a qualitative research conducted in 2021-22 using the content analysis method including 30 employees of the Crisis Staff of the ZMUPHD selected by purposeful sampling. Data were collected based on semi-structured, in-depth interviews and analyzed in eight stages including typing the text of the interviews, determining semantic units, coding the text, revising the codes, classifying and developing the classes, revising the classes, identifying the themes and reporting the data.
Resulte: The experiences of the managers and employees of the ZMUPHD to deal withا the Corona pandemic were identified and extracted in 5 main areas including "Legislative", "Operational", "Manpower", "Supervisory" and "Financial", and 13 sub-areas.
Conclusion: Based on the results of the present study, one of the problems in the administration and management of the Covid crisis was the lack of sufficient supervision and political requirements in order to control and prevent the spread of the disease, as well as the lack of a single decision-making organization. Also, financial problems and problems related to human resources were found to be among the most important issues. On the other hand, from the point of view of the interviewees, the use of the 4030 system was one of the turning points in crisis management.
Elham Fatholahi, Mohammad Jafari,
Volume 21, Issue 1 (10-2023)
Volume 21, Issue 1 (10-2023)
Abstract
Background and Aim: Products such as tobacco are considered harmful to human life due to the fact that they contribute greatly to mortality around the world. Tobacco use kills more than eight million people worldwide annually. This has necessitated the imposition of taxes on such harmful products with the aim of reducing their demand and, thus, guaranteeing the increase in the health of the population in Iran.
Materials and Methods: Using the tobacco tax as a proxy for the tax on harmful products and the death rate as an indicator of the general health of the population, this study investigated the effect of the tax on harmful products on the health of the population in 30 provinces of Iran between 2007 and 2018. For this purpose, the dynamic panel generalized moment method (GMM) using Eviews 10 and stata17 software was used as an experimental estimation technique.
Results: Analysis of the data collected revealed that the tax on harmful products can help promote the health of the population, since the government can use the additional income thus generated to improve the health of the population. These findings support the World Health Organization's justification that taxes on harmful products, especially on tobacco, not only can reduce their consumption, but also can help to promote health outcomes. In addition, increasing the tax on cigarettes, which is considered the most important and key strategy by the World Health Organization, will lead to spending the resulting income on improving health and educational infrastructure, health centers, emergency services, etc.
Conclusion: In general, the more a government spends on health care, the more the health of the population and, consequently, the higher the life expectancy of the population. Regarding the effects of prices/and taxes on smoking or tobacco consumption on the mortality reduction in Iran, if the taxes imposed on harmful products are increased and the resulting additional funds are used and effectively administered to meet the recommendations of the World Health Organization, better desirable outcomes will result in the health of the population as compared to those observed in this study. In addition, the policymakers should start actions that will help promote economic growth, because this will increase the health of the population. Moreover, actions and efforts aiming to increase the population growth rate should be accompanied by significant investments in the health sector.
Maryam Tajvar, Mohammad Sarkout Ghosi, Elham Ehsani-Chimeh,
Volume 21, Issue 2 (9-2023)
Volume 21, Issue 2 (9-2023)
Abstract
Background and Aim: Assessment of disease risk with the ultimatevaim of implementing preventive strategies in the workplace is a necessity. This study was conducted to assess the risk of COVID-19 in hospital occupational groups in Saghez city, Iran.
Materials and Methods: This cross-sectional study was conducted in 2021 among three hospital occupational groups (total sample size = 300) in Saghez city, Iran, including physicians and nurses, as well as laboratory, administrative, financial, radiology and general service personnel, using the COVID-19 rapid risk analysis technique. Data were collected using a valid questionnaire based on the Likert scale and analysed (to determine acceptable, tolerable and intolerable risks) using the descriptive and inferential methods, the software used being SPSS-26.
Results: As regards the probability variable, the highest probability of occurrence of COVID-19 was related to the general service and administrative-financial occupational groups with an average of 1.6 and 1.5, respectively. The level of attitude was generally good and excellent. The analysis of the severity of the outcome variable was at a critical level in the physicians group (42.5) and at a catastrophic level in the other groups. In total, all occupations were rated at an unacceptable risk level (H), the general service and administrative-financial occupational groups being at a higher risk than other groups. There were statistically significant differences between the types of occupation on the one hand and the variables studied, as well as the individual characteristics and COVID-19 morbidity on the other hand.
Conclusion: Considering the high risk of occurrence of COVID-19 among the hospital professionals it is essential to develop and implement plans aiming at preventing and reducing the disease risk in them.
Somayeh Jalilvand, Atefeh Kachooei, Tayebeh Latifi, Mahdieh Motamedi‐rad, Mohammad Farahmand, Nasir Mohajel, Zabihollah Shoja,
Volume 21, Issue 2 (9-2023)
Volume 21, Issue 2 (9-2023)
Abstract
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12. Doro R, Laszlo B, Martella V, Leshem E, Gentsch J, Parashar U, et al. Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: is there evidence of strain selection from vaccine pressure? Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2014;28:446-61.
13. Mwanga MJ, Owor BE, Ochieng JB, Ngama MH, Ogwel B, Onyango C, et al. Rotavirus group A genotype circulation patterns across Kenya before and after nationwide vaccine introduction, 2010-2018. BMC infectious diseases. 2020;20(1):1-12.
14. Matthijnssens J, Mino S, Papp H, Potgieter C, Novo L, Heylen E, et al. Complete molecular genome analyses of equine rotavirus A strains from different continents reveal several novel genotypes and a largely conserved genotype constellation. The Journal of general virology. 2012;93(Pt 4):866-75.
15. Matthijnssens J, Ciarlet M, Rahman M, Attoui H, Banyai K, Estes MK, et al. Recommendations for the classification of group A rotaviruses using all 11 genomic RNA segments. Archives of virology. 2008;153(8):1621-9.
16. Hutson AM, Atmar RL, Graham DY, Estes MK. Norwalk Virus Infection and Disease Is Associated with ABO Histo-Blood Group Type. The Journal of Infectious Diseases. 2002;185(9):1335-7.
17. Carlsson B, Kindberg E, Buesa J, Rydell GE, Lidón MF, Montava R, et al. The G428A nonsense mutation in FUT2 provides strong but not absolute protection against symptomatic GII.4 Norovirus infection. PLoS One. 2009;4(5):e5593.
18. Tan M, Jiang X. Histo-blood group antigens: a common niche for norovirus and rotavirus. Expert reviews in molecular medicine. 2014;16.
19. Liu Y, Ramelot TA, Huang P, Liu Y, Li Z, Feizi T, et al. Glycan Specificity of P[19] Rotavirus and Comparison with Those of Related P Genotypes. J Virol. 2016;90(21):9983-96.
20. Hu L, Sankaran B, Laucirica DR, Patil K, Salmen W, Ferreon ACM, et al. Glycan recognition in globally dominant human rotaviruses. Nat Commun. 2018;9(1):2631.
21. Yen C, Steiner CA, Barrett M, Curns AT, Hunter K, Wilson E, et al. Racial disparities in diarrhea-associated hospitalizations among children in five US States, before and after introduction of rotavirus vaccine. Vaccine. 2010;28(46):7423-6.
22. Payne DC, Currier RL, Staat MA, Sahni LC, Selvarangan R, Halasa NB, et al. Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States. JAMA pediatrics. 2015;169(11):1040-5.
23. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. The Pediatric infectious disease journal. 2013;32(4):e178-81.
24. Shoja Z, Jalilvand S, Mollaei-Kandelous Y, Validi M. Epidemiology of viral gastroenteritis in Iran. The Pediatric infectious disease journal. 2014;33(2):218-20.
25. Kachooei A, Tava Koli A, Minaeian S, Hosseini M, Jalilvand S, Latifi T, et al. Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021–2022: Emergence of uncommon G9P [4] and G9P [8] rotavirus strains. Journal of medical virology. 2023;95(2):e2852.
26. Motamedi-Rad M, Farahmand M, Arashkia A, Jalilvand S, Shoja Z. VP7 and VP4 genotypes of rotaviruses cocirculating in Iran, 2015 to 2017: Comparison with cogent sequences of Rotarix and RotaTeq vaccine strains before their use for universal mass vaccination. Journal of medical virology. 2020;92(8):1110-23.
27. Jalilvand S, Afchangi A, Mohajel N, Roohvand F, Shoja Z. Diversity of VP7 genes of G1 rotaviruses isolated in Iran, 2009-2013. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2016;37:275-9.
28. Morozova OV, Sashina TA, Fomina SG, Novikova NA. Comparative characteristics of the VP7 and VP4 antigenic epitopes of the rotaviruses circulating in Russia (Nizhny Novgorod) and the Rotarix and RotaTeq vaccines. Archives of virology. 2015;160(7):1693-703.
29. Mouna BH, Hamida-Rebai MB, Heylen E, Zeller M, Moussa A, Kacem S, et al. Sequence and phylogenetic analyses of human rotavirus strains: comparison of VP7 and VP8( *) antigenic epitopes between Tunisian and vaccine strains before national rotavirus vaccine introduction. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2013;18:132-44.
30. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in Belgium and rotaviruses in Rotarix and RotaTeq. Journal of clinical microbiology. 2011; 50(3):966-976.
31. Hoshino Y, Jones RW, Ross J, Honma S, Santos N, Gentsch JR, et al. Rotavirus serotype G9 strains belonging to VP7 gene phylogenetic sequence lineage 1 may be more suitable for serotype G9 vaccine candidates than those belonging to lineage 2 or 3. Journal of virology. 2004;78(14):7795-802.
32. Jin Q, Ward RL, Knowlton DR, Gabbay YB, Linhares AC, Rappaport R, et al. Divergence of VP7 genes of G1 rotaviruses isolated from infants vaccinated with reassortant rhesus rotaviruses. Archives of virology. 1996;141(11):2057-76.
33. Bányai K, Gentsch JR, Martella V, Bogdán Á, Havasi V, Kisfali P, et al. Trends in the epidemiology of human G1P [8] rotaviruses: a Hungarian study. The Journal of infectious diseases. 2009; 200 (1):S222-S7.
34. Magagula NB, Esona MD, Nyaga MM, Stucker KM, Halpin RA, Stockwell TB, et al. Whole genome analyses of G1P [8] rotavirus strains from vaccinated and non‐vaccinated South African children presenting with diarrhea. Journal of medical virology. 2015;87(1):79-101.
35. Kulkarni R, Arora R, Arora R, Chitambar SD. Sequence analysis of VP7 and VP4 genes of G1P [8] rotaviruses circulating among diarrhoeic children in Pune, India: A comparison with Rotarix and RotaTeq vaccine strains. Vaccine. 2014;32:A75-A83.
36. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in belgium and rotaviruses in rotarix™ and RotaTeq™. Journal of clinical microbiology. 2011:JCM. 05590-11.
37. Farahmand M, Jalilvand S, Arashkia A, Shahmahmoodi S, Afchangi A, Mollaei-Kandelous Y, et al. Association between circulating rotavirus genotypes and histo-blood group antigens (HBGAs) in the children hospitalized with acute gastroenteritis in Iran. Journal of medical virology. 2021;93(8):7.
38. Ayouni S, Sdiri-Loulizi K, de Rougemont A, Estienney M, Ambert-Balay K, Aho S, et al. Rotavirus P[8] Infections in Persons with Secretor and Nonsecretor Phenotypes, Tunisia. Emerging infectious diseases. 2015;21(11):2055-8.
39. Nordgren J, Sharma S, Bucardo F, Nasir W, Gunaydin G, Ouermi D, et al. Both Lewis and secretor status mediate susceptibility to rotavirus infections in a rotavirus genotype-dependent manner. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014;59(11):1567-73.
40. Yu Y, Lasanajak Y, Song X, Hu L, Ramani S, Mickum ML, et al. Human milk contains novel glycans that are potential decoy receptors for neonatal rotaviruses. Molecular & cellular proteomics: MCP. 2014;13(11):2944-60.
41. Huang P, Xia M, Tan M, Zhong W, Wei C, Wang L, et al. Spike protein VP8* of human rotavirus recognizes histo-blood group antigens in a type-specific manner. Journal of virology. 2012;86(9):4833-43.
42. Parker EP, Ramani S, Lopman BA, Church JA, Iturriza-Gomara M, Prendergast AJ, et al. Causes of impaired oral vaccine efficacy in developing countries. Future microbiology. 2018;13:97-118.
2. Glass RI, Parashar UD, Bresee JS, Turcios R, Fischer TK, Widdowson M-A, et al. Rotavirus vaccines: current prospects and future challenges. The Lancet. 2006;368(9532):323-32.
3. Parashar UD, Gibson CJ, Bresee JS, Glass RI. Rotavirus and severe childhood diarrhea. Emerging infectious diseases. 2006;12(2):304.
4. Kargar M, Zare M, Najafi A. Molecular epidemiology of rotavirus strains circulating among children with gastroenteritis in Iran. Iranian journal of pediatrics. 2012;22(1):63.
5. Modares S, Rahbarimanesh AA, Karimi M, Modares S, Motamedirad M, Sohrabi A, et al. Electrophoretic RNA genomic profiles of rotavirus strains prevailing among hospitalized children with acute gastroenteritis in Tehran, Iran. 2008.
6. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. The pediatric infectious disease journal. 2013;32(4):e178-e81.
7. Jalilvand S, Roohvand F, Arashkia A, Shoja Z. Update on Epidemiology and Circulating Genotypes of Rotavirus in Iranian Children With Severe Diarrhea: 1986-2015. Int J Travel Med Glob Health. 2018;6(1):7-10.
8. Desselberger U. Rotaviruses. Virus research. 2014;190:75-96.
9. http://rega.kuleuven.be/cev/ viralmetagenomics/virus-classification/ rcwg. updated 25 Mar, 2021 [.
10. Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Reviews in medical virology. 2005;15(1):29-56.
11. Banyai K, Laszlo B, Duque J, Steele AD, Nelson EA, Gentsch JR, et al. Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre rotavirus vaccine era: insights for understanding the impact of rotavirus vaccination programs. Vaccine. 2012;30(1):A122-30.
12. Doro R, Laszlo B, Martella V, Leshem E, Gentsch J, Parashar U, et al. Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: is there evidence of strain selection from vaccine pressure? Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2014;28:446-61.
13. Mwanga MJ, Owor BE, Ochieng JB, Ngama MH, Ogwel B, Onyango C, et al. Rotavirus group A genotype circulation patterns across Kenya before and after nationwide vaccine introduction, 2010-2018. BMC infectious diseases. 2020;20(1):1-12.
14. Matthijnssens J, Mino S, Papp H, Potgieter C, Novo L, Heylen E, et al. Complete molecular genome analyses of equine rotavirus A strains from different continents reveal several novel genotypes and a largely conserved genotype constellation. The Journal of general virology. 2012;93(Pt 4):866-75.
15. Matthijnssens J, Ciarlet M, Rahman M, Attoui H, Banyai K, Estes MK, et al. Recommendations for the classification of group A rotaviruses using all 11 genomic RNA segments. Archives of virology. 2008;153(8):1621-9.
16. Hutson AM, Atmar RL, Graham DY, Estes MK. Norwalk Virus Infection and Disease Is Associated with ABO Histo-Blood Group Type. The Journal of Infectious Diseases. 2002;185(9):1335-7.
17. Carlsson B, Kindberg E, Buesa J, Rydell GE, Lidón MF, Montava R, et al. The G428A nonsense mutation in FUT2 provides strong but not absolute protection against symptomatic GII.4 Norovirus infection. PLoS One. 2009;4(5):e5593.
18. Tan M, Jiang X. Histo-blood group antigens: a common niche for norovirus and rotavirus. Expert reviews in molecular medicine. 2014;16.
19. Liu Y, Ramelot TA, Huang P, Liu Y, Li Z, Feizi T, et al. Glycan Specificity of P[19] Rotavirus and Comparison with Those of Related P Genotypes. J Virol. 2016;90(21):9983-96.
20. Hu L, Sankaran B, Laucirica DR, Patil K, Salmen W, Ferreon ACM, et al. Glycan recognition in globally dominant human rotaviruses. Nat Commun. 2018;9(1):2631.
21. Yen C, Steiner CA, Barrett M, Curns AT, Hunter K, Wilson E, et al. Racial disparities in diarrhea-associated hospitalizations among children in five US States, before and after introduction of rotavirus vaccine. Vaccine. 2010;28(46):7423-6.
22. Payne DC, Currier RL, Staat MA, Sahni LC, Selvarangan R, Halasa NB, et al. Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States. JAMA pediatrics. 2015;169(11):1040-5.
23. Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. The Pediatric infectious disease journal. 2013;32(4):e178-81.
24. Shoja Z, Jalilvand S, Mollaei-Kandelous Y, Validi M. Epidemiology of viral gastroenteritis in Iran. The Pediatric infectious disease journal. 2014;33(2):218-20.
25. Kachooei A, Tava Koli A, Minaeian S, Hosseini M, Jalilvand S, Latifi T, et al. Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021–2022: Emergence of uncommon G9P [4] and G9P [8] rotavirus strains. Journal of medical virology. 2023;95(2):e2852.
26. Motamedi-Rad M, Farahmand M, Arashkia A, Jalilvand S, Shoja Z. VP7 and VP4 genotypes of rotaviruses cocirculating in Iran, 2015 to 2017: Comparison with cogent sequences of Rotarix and RotaTeq vaccine strains before their use for universal mass vaccination. Journal of medical virology. 2020;92(8):1110-23.
27. Jalilvand S, Afchangi A, Mohajel N, Roohvand F, Shoja Z. Diversity of VP7 genes of G1 rotaviruses isolated in Iran, 2009-2013. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2016;37:275-9.
28. Morozova OV, Sashina TA, Fomina SG, Novikova NA. Comparative characteristics of the VP7 and VP4 antigenic epitopes of the rotaviruses circulating in Russia (Nizhny Novgorod) and the Rotarix and RotaTeq vaccines. Archives of virology. 2015;160(7):1693-703.
29. Mouna BH, Hamida-Rebai MB, Heylen E, Zeller M, Moussa A, Kacem S, et al. Sequence and phylogenetic analyses of human rotavirus strains: comparison of VP7 and VP8( *) antigenic epitopes between Tunisian and vaccine strains before national rotavirus vaccine introduction. Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2013;18:132-44.
30. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in Belgium and rotaviruses in Rotarix and RotaTeq. Journal of clinical microbiology. 2011; 50(3):966-976.
31. Hoshino Y, Jones RW, Ross J, Honma S, Santos N, Gentsch JR, et al. Rotavirus serotype G9 strains belonging to VP7 gene phylogenetic sequence lineage 1 may be more suitable for serotype G9 vaccine candidates than those belonging to lineage 2 or 3. Journal of virology. 2004;78(14):7795-802.
32. Jin Q, Ward RL, Knowlton DR, Gabbay YB, Linhares AC, Rappaport R, et al. Divergence of VP7 genes of G1 rotaviruses isolated from infants vaccinated with reassortant rhesus rotaviruses. Archives of virology. 1996;141(11):2057-76.
33. Bányai K, Gentsch JR, Martella V, Bogdán Á, Havasi V, Kisfali P, et al. Trends in the epidemiology of human G1P [8] rotaviruses: a Hungarian study. The Journal of infectious diseases. 2009; 200 (1):S222-S7.
34. Magagula NB, Esona MD, Nyaga MM, Stucker KM, Halpin RA, Stockwell TB, et al. Whole genome analyses of G1P [8] rotavirus strains from vaccinated and non‐vaccinated South African children presenting with diarrhea. Journal of medical virology. 2015;87(1):79-101.
35. Kulkarni R, Arora R, Arora R, Chitambar SD. Sequence analysis of VP7 and VP4 genes of G1P [8] rotaviruses circulating among diarrhoeic children in Pune, India: A comparison with Rotarix and RotaTeq vaccine strains. Vaccine. 2014;32:A75-A83.
36. Zeller M, Patton JT, Heylen E, De Coster S, Ciarlet M, Van Ranst M, et al. Genetic analyses reveal differences in the VP7 and VP4 antigenic epitopes between human rotaviruses circulating in belgium and rotaviruses in rotarix™ and RotaTeq™. Journal of clinical microbiology. 2011:JCM. 05590-11.
37. Farahmand M, Jalilvand S, Arashkia A, Shahmahmoodi S, Afchangi A, Mollaei-Kandelous Y, et al. Association between circulating rotavirus genotypes and histo-blood group antigens (HBGAs) in the children hospitalized with acute gastroenteritis in Iran. Journal of medical virology. 2021;93(8):7.
38. Ayouni S, Sdiri-Loulizi K, de Rougemont A, Estienney M, Ambert-Balay K, Aho S, et al. Rotavirus P[8] Infections in Persons with Secretor and Nonsecretor Phenotypes, Tunisia. Emerging infectious diseases. 2015;21(11):2055-8.
39. Nordgren J, Sharma S, Bucardo F, Nasir W, Gunaydin G, Ouermi D, et al. Both Lewis and secretor status mediate susceptibility to rotavirus infections in a rotavirus genotype-dependent manner. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2014;59(11):1567-73.
40. Yu Y, Lasanajak Y, Song X, Hu L, Ramani S, Mickum ML, et al. Human milk contains novel glycans that are potential decoy receptors for neonatal rotaviruses. Molecular & cellular proteomics: MCP. 2014;13(11):2944-60.
41. Huang P, Xia M, Tan M, Zhong W, Wei C, Wang L, et al. Spike protein VP8* of human rotavirus recognizes histo-blood group antigens in a type-specific manner. Journal of virology. 2012;86(9):4833-43.
42. Parker EP, Ramani S, Lopman BA, Church JA, Iturriza-Gomara M, Prendergast AJ, et al. Causes of impaired oral vaccine efficacy in developing countries. Future microbiology. 2018;13:97-118.
Prevalence and Distribution of Common Rotavirus Genotypes in Iran and Comparing them with Vaccine Strains Before the Start of the National Vaccination Program
Somayeh Jalilvan1, Atefeh Kachooei2, Tayebeh Latifi3, Mahdieh Motamedi‐Rad4, Mohammad Farahmand3, Nasir Mohajel5, Zabihollah Shoja6*
1- Ph.D. Associate Professor, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2- Ph.D. Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3- Ph.D. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4- MSc. Department of Virology, Pasteur Institute of Iran, Tehran, Iran
5- Ph.D. Assistant Professor, Department of Virology, Pasteur Institute of Iran, Tehran, Iran
6- Ph.D. Associate Professor, Department of Virology, Pasteur Institute of Iran, Tehran, Iran
* Corresponding author: zabihollahshoja@gmail.com, zshoja@alumnus.tums.ac.ir
Received: May 25, 2023 Accepted: Oct 11, 2023
ABSTRACT
Background and Aim: Since the discovery of rotaviruses in 1973, these viruses have been identified as one of the most important and common causes of diarrhea in infants and children all over the world. Before the introduction of rotavirus vaccination, this virus led to the death of more than 500,000 children in the world annually, which mainly occurs in developing countries. With the introduction of Rotarix and RotaTeq vaccines as well as ROTAVAC and ROTASIIL in the world, the death rate has decreased by 50%. Iran, like many countries, is in the period before rotavirus vaccination, and considering putting the rotavirus vaccine in the vaccination program is one of the priorities of the country's health system. Therefore, knowing the genotypes circulating in Iran in the past and recent years and their comparison with vaccine strains is very important. Our aim in the current study is to review the prevalence of rotavirus and its genotypes circulating in Iran and whether the existing vaccines based on the circulating strains in Iran can be effective.
Materials and Methods: Studies regard to the prevalence and genotypes of rotavirus in Iran were reviewed.
Results: G1P[8] genotype includes more than 50% of circulating genotypes. Non-G1P[8] genotypes, including G4P[8], G3P[8] and G9P[8], have also had a high frequency in some studies. In addition, in a recent study, it has been shown that the rare and uncommon genotype G9P[4] has been introduced as a common genotype.
Conclusion: Studies in Iran have shown that the country may face a change in the rotavirus genotype pattern in the future. This study can provide useful information to recommend appropriate policies for rotavirus vaccination before the start of the national vaccination program and may even change policies for the use of existing vaccines.
Ahmad Nejati, Alireza Asgari Golzardi, Farshad Khodakhah, Katayoun Samimi-Rad, Seyedeh Maryam Yousefi, Yaghoub Mollaei-Kandelousi, Maryam Keyvanlou, Mohammad Razaghi, Parastoo Soheili, Delaram Yaghoubzadeh, Nastaran Ghavami, Susan Mahmoudi, Seyed Mohsen Zahraei, Shohreh Shahmahmoodi,
Volume 21, Issue 3 (12-2023)
Volume 21, Issue 3 (12-2023)
Abstract
Background and Aim: During the COVID-19 pandemic public health measures and protocols such as regular hand washing and wearing a face mask were recommended at the national level. The implementation of these health protocols reduced the prevalence of respiratory diseases, but no study has been conducted to investigate the impact of the implementation of these protocols on the spread of viruses that are transmitted through fecal-oral route. Considering that non-polio enteroviruses (NPEVs) are mainly transmitted through fecal-oral route, this study was conducted to determine the prevalence of non-polio enteroviruses in patients with acute flaccid paralysis (AFP) in Iran before and during the COVID-19 pandemic.
Materials and Methods: To detect non-polio enteroviruses stool samples of AFP cases received by Iran National Polio Laboratory in 2019 (before the COVID-19 pandemic) and 2021 (during the COVID-19 pandemic) were tested. To isolate NPEVs by cell culture, the WHO standard protocol was used, and the TaqMan One-Step Real Time PCR was used for molecular testing.
Results: In 2019, a sample of 21 out of 1070 patients and a sample of 12 out of 100 patients were found to be positive for non-polio enterovirus by cell culture and the molecular method, respectively; these ratios decreased to10 out of 678 and 3 out of 100 in 2021.
Conclusion: Based on the findings of this study, it can be concluded that the observance of personal hygiene and public health protocols during the COVID-19 epidemic have, in addition to the general reduction of respiratory transmission of viruses, also affected the faecal-oral transmission of viruses.
Fatemeh Setoodehzadeh, Hossein Ansari, , Fatemeh Nazari, Fatemeh Khabiri, Mohammad Hassan Amiri Moghaddam,
Volume 21, Issue 3 (12-2023)
Volume 21, Issue 3 (12-2023)
Abstract
Background and Aim: The health system is trying to prevent unnecessary referrals to higher levels by providing tiered services and thus reduce the cost of health care. Therefore, this study was conducted in Zahedan City, Iran with the aim of finding the causes of referrals from level 1 to higher tiers in rural areas.
Materials and methods: This cross-sectional study was conducted on 458 rural patients referred to the second level in the rural areas of Zahedan City, Iran. Data were collected from the family health files available in the Sib system and analyzed using the SPSS-16 statistical software, the statistical tests being descriptive statistics (percentage, frequency) and Chi-square test.
Results: The highest (57.6%) and lowest (4.1%) proportions of referrals to the second level of service provision were found to have been in 2018 and 2016, respectively. From among the referred patients nearly 50% had been referred due to the need for a higher expertise, thus most referrals (67.2%) were to specialists. Further analysis of the data showed that only in 23.6% of the cases there was a feedback from the higher level to the first level.
Conclusion: The findings show that referrals from family physicians to higher levels in the health system requires higher medical expertise and patient insistence. In addition, feedback to the first level of service provision has not received proper attention. Establishing interactions between physicians and other health service levels, refresher training of physicians, emphasizing the importance of providing feedback and promoting the awareness of patients can reduce to a large extent inappropriate referrals.
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