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Ali Akbari-Sari, Batoul Ahmadi, Mohammad Moradi-Joo, Alireza Arabi, Maryam Seyed-Nezhad,
Volume 19, Issue 4 (3-2022)
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: Referral system is one of the principles and foundations of primary health care services. One of the most important challenges and problems of the referral system is the lack of knowledge of people and patients of its nature, services and benefits. The purpose of this study was to identify the factors affecting the acceptance of the referral system by patients.
Materials and Methods: This was a qualitative study conducted in 2021 using the framework (structural) analysis method. The participants were 18 experts in the field of referral system and 14 patients referred to the outpatient and inpatient wards of Imam Khomeini Hospital Complex in Tehran selected by purposive sampling. Data were collected by Semi-structured interviews and analyzed using the MAXQDA.
Results: Based on the findings in this study, Factors influencing the acceptance of the referral system by patients were found to be the following: (1). Factors related to the stewardship and governance of the health system (responsibility and accountability, appropriate levels of health services, patient-centered care, and rules and regulations); (2). Factors related to the health services access (financial, physical and cultural); (3). Factors related to service providers (trusting healthcare staff, professional skills of service providers, and their behavioral and communication skills); (4). Factors related to the service delivery process (quality of service delivery, attention to patients' wants and needs, use of technology in service delivery, monitoring service delivery, and service coverage); (5). factors related to the recipients of the services (satisfaction, education, awareness and communication).
Conclusion: Considering the importance and key role of patients in the success of the referral system, health planners and policy makers should pay special attention to the factors identified in this study.
Ali Mohammad Mosadeghrad, Hosein Dargahi, Mahdi Abbasi, Mina Mirzaeianrad,
Volume 19, Issue 4 (3-2022)
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: Occupational injuries are an important human resource management challenge with negative effects on employees and organizations. A knowledge of the prevalence of occupational injuries is the first step in eliminating or reducing them. The aim of this study was to determine the prevalence of occupational injuries among financial employees of hospitals affiliated to Tehran University of Medical Sciences.
Materials and Methods: This was a cross-sectional questionnaire survey conducted in 2019 in 13 hospitals of Tehran University of Medical Sciences using a valid questionnaire to gather data. A total of 162 questionnaires were randomly distributed among the financial staff of the hospitals, but only 147 subjects completed the questionnaires. Data were analyzed using the SPSS statistical software.
Result: Analysis of the data showed that 52.6% and 50.2% of the financial staff of the hospitals were suffering from physical and mental occupational injuries, respectively. Most of the occupational physical injuries were related to headache, neck pain, back pain and visual impairment, and most of the occupational psychiatric injuries were stress and anxiety. Female and single employees experienced significantly more occupational injuries. Working in a sitting position for a long time, lack of proper equipment operation, lack of safety and health facilities, insufficient training and carelessness of staff were the causes of musculoskeletal injuries.
Conclusion: About half of the hospital financial staff were found to suffer from occupational injuries. Occupational injuries had had direct and indirect costs for the employees and the hospitals. Hospital managers should plan and implement measures to eliminate or reduce occupational injuries at an individual, group, and organizational level.
Arezu Amirali, Ameneh Elikaei, Roxana Mansour Ghanaie, Idesbald Boone, Abdollah Karimi, Tim Eckmanns, Andreas Lutz Jansen, Fatemeh Fallah, Noushin Marhamati, Niloofar Pashaei, Shahriar Janbazi, Ahmad Reza Shamshiri, Hamid Reza Baradaran, Mohammad Hossein Rostami, Masoud Alebouyeh,
Volume 19, Issue 4 (3-2022)
Volume 19, Issue 4 (3-2022)
Abstract
Background and Aim: The objective of this study was to determine the seroepidemiological history of SARS-CoV-2 infection among asymptomatic children in Tehran.
Materials and Methods: Blood samples of children younger than 14 years old were collected during the period autumn-winter 2020 and spring 2021 and tested for SARS-CoV-2 IgG antibody using the EUROIMMUN ELISA kit. In addition, questionnaires were used to collect demographic and infection status information in the participants. Data were analyzed using the SPSS software.
Results: Out of the 1142 children collected from the children with no COVID-19 symptoms, 33.3% (381/1142) were found to have had a history of SARS-CoV-2. The positive samples in girls and boys were 34.1% and 33.03%, respectively. Analysis of the data showed no statistically significant differences between the infection rate on the one hand and age, family size, underlying diseases, gender or occupations of the family members on the other hand. In addition, the infection rate was significantly lower in autumn 2020 than in winter 2020 and spring 2021.
Conclusion: SARS-CoV-2 infection can occur in children with no clinical symptoms. In addition, the infection rate is in direct correlation with an increase in age of the children.
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.
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.
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.
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.
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.
Atefeh Modabernejhad, Seyed Samad Beheshty, Vahid Ghasemi, Ramin Moradi,
Volume 20, Issue 4 (3-2023)
Volume 20, Issue 4 (3-2023)
Abstract
Background and Aim: Considering the destructive consequences of corruption in Iran’s healthcare system, the present study aimed to explain the roots and causes of corruption prevalence in this system.
Materials and Methods: This was a qualitative study with quantitative content analysis conducted in Iran’s Ministry of Health and Medical Education (MHME). Data were collected based on in-depth interviews with 13 experts in the MHME headquarters selected by theoretical and snowball sampling. The unit of analysis of the interviews was the sentence and the conducted interviews were analyzed through thematic analysis using the Shannon Entropy index.
Results: Data analysis showed that legislative fields with an importance coefficients (IC) of 0.293 ranked first, followed by social and cultural fields (IC 0.26), economic fields (IC 0.175), decision-making fields and organizational factors (IC 0.174), and, finally, individual factors and micro-level fields (IC 0.102).
Conclusion: Considering the importance coefficient of individual factors and micro-level fields,
it can be concluded that the personality and individual characteristics of the experts/relevant persons are less important in the corruption occurrence, while the legal, social and cultural variables paly crucial roles in explaining corruption in the Iran’s healthcare system.
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
1. Franco MA, Angel J, Greenberg HB. Immunity and correlates of protection for rotavirus vaccines. Vaccine. 2006; 24(15):2718-31.
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.
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.
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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.
Hosein Izadi Rad, Fereshteh Narouei, Parisa Mohammadi,
Volume 21, Issue 4 (3-2024)
Volume 21, Issue 4 (3-2024)
Abstract
Background and Aim: Women referring to health centers are one of the most important groups at risk of disease. Thus, in order to enjoy a high level of health, it is necessary for them to have health literacy. The purpose of this research was to find the demographic predictors of health literacy in women referring to comprehensive health service centers in Zahedan, Iran.
Materials and Methods: This was a descriptive-analytical study including 400 women selected by random cluster sampling from health centers under coverage of Zahedan University of Medical Sciences in 2022. The short form of the HELIA standard questionnaire was used to measure health literacy of the women. Data were analyzed using SPSS-22 software, the statistical tests being ANOVA, Kendall's correlation, and multiple regression.
Results: The subjects were between 18 and 60 years old. They were found to have obtained most of the information related to health and disease by asking doctors and healthcare workers (about 52.25%). The scores of the components of the subjects’ health literacy were as follows: average health literacy 69.91±23.34, reading 72.17±29.80, access 34.73±27.91, understanding 71.41±29.43, assessment 62.10±25.51, and the scope of decision-making and behavior 71.49±20.27. The strongest predictor of health literacy was found to be education, such that with an increase in the level of education, the health literacy of a woman would increase by 0.53 units. In addition, education variables, income level, age and ethnicity would predict 55% of the health literacy of the women.
Conclusion: This study shows that the health literacy score is related to age, education level, marital status, occupation, economic status and ethnicity, the strongest predictor of health literacy being the a high level of education. Therefore, considering the available evidence on the importance of health literacy and factors related to it and the low level of health literacy of women in this study, it is clear that women need to acquire, process and understand the basic information on health and therapeutic services in order to be able to make appropriate decisions. Briefly, women need to receive simple and understandable information and have more time to communicate with the health service personnel to understand health information.
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