Journal of School of Public Health and

---

Management of solid wastes and improvement of its operational quality is dependent on the functional elements such as generation ,storage , collection,transportation ,processing ,and disposal. When these collections act on the basis of knowledge and sufficient information of present status and according to a set of coordinated guidelines and regulations , it proves useful in the promotion of the health quality of the community .Since it is necessary to know the present status in order to plan a better management of municipal solid wastes, a comprehensive study had been conducted in summer and fall of 1382 to aim at people’s knowledge ,attitude, and practice to the municipal solid wastes management of Kerman. The results of this study showed that the majority of the resident of Kerman enjoyed of sufficient and relatively good information and collectively had high degree of knowledge ,attitude ,and practice. The converge of knowledge ,and positive attitude people was 94.3% and 84.3% respectively ,and 72.4%of subjects was reached to good practice score. These systematic ,coordinated , and good results are indicative of the fact that the community is susceptible to accept amendments and to exercise comprehensive municipal solid wastes management. It is recommended to make advantage of this potential power in promoting the health quality of the community members along with applying functional elements of municipal solid wastes management in order to improve present operational status of the municipality.

---

Background and Aim: Rabies is one of the oldest and most serious zoonoses in the world. In Iran, the disease has been reported from most of the provinces and among domestic as well as wild animals. This study was conducted in the province of Kerman and aimed to assess the frequency and epidemiological features of suspected and confirmed animal rabies cases from 1993 to 2003.

Material and Methods: During the study period, all cases of suspected animals (brain specimens) had sent to Pasteur institute of Iran for pathological (Negri bodies) examinations. After collecting data on variables such as species of animal, city, season, annual rainfall and temperature, analysis was performed by calculation of Pearson correlation coefficient and Chi square, Fisher's exact, Students's t and Kolmogorov Smirnov tests using the SPSS package (ver.11.5).

Results: From 362 suspected brain samples, 301 (83.1%) had positive serologic and pathological results. We recorded an ascending trend over the study period (p=0.01). The effect of seasonal variations on the frequency of suspected and confirmed cases of animal rabies was significant (p<.001): most cases occurred in winter and fall. The relative frequencies of confirmed cases among the animals were as follows: As for domestic animals, the infection rate in cows was 81.45 % sheep and goats 10.63% dogs and cats, 4 % camels 1.33% and donkeys, 0.7%. Among wild animals (foxes, mongooses, wolves and jackals) the rate was 1.89%. Among wild animals, the total infection rate was 60 %. Concerning the role of predatory animals in the transmission of rabies to domestic animals, among the cases which had been confirmed (28 cases), the predator species were: foxes 50%, wolves 7%, mongooses and jackals 3%. Considering the relationship between frequency of animal rabies  and ecological variations in the province of Kerman, the results of this survey showed that there is some correlation between decreased rainfall (drought) and the resurgence of animal rabies (r=0.34, P=0.001).

Conclusion: The increasing number of stray dogs and the migration of these and wild animals to cities and villages could be an important factor in the spread of rabies in the region. Among various predatory species, the role of foxes in disease transmission merits further investigation.

---

Background and Aim: Considering the fact that injecting drug is the most common way of HIV transmission and having the point in mind that in spite of syringes availability, many of the IDUs still continue sharing needles, determining behaviors which lead them not to use HR packages seems invaluable. Determining the influential factors in sharing needles among IDUs who are Kermanshah's DIC clients and are provided with training program and HR Packages (syringes, needles, bleaching and condoms).

Materials and Methods: These subjects were studied in 2 steps. The first FGD (focus group discussions) and the second a cross sectional study. To gather data that we use a questionnaire based an FGG which includes: general characteristics, characteristics related to drug abuse and information about HIV.

Results: out 437 of cases that took part in the interview, 367 cases were IDUS. Among whom 28% individuals shared needles. The medium age was 33/4 and there was no significant difference between the two age groups. Only 27% were married. 61% of cases were unemployed. The unemployment rate among IDUs who share needles and syringes was a lat more significant (p=000) than those who don't share needles (P=000). The percentage of IDUs who share needles and don't living houses was higher than of those who live in houses (P=000). Most of cases started taking drugs before they were 20 years old.

Conclusion: Low Education degree unemployed, no married. Live in street, start IDUs in low age the period of referring to DIC were the most important factors for share needles injection

---

Background and Aim: The time needed to achieve a wanted pregnancy is referred to as time to pregnancy (TTP). Due to differences in lifestyles and geographical locations in different countries, factors affecting TTP may be different in various countries. This study was conducted in 2011 to determine factors affecting time to TTP in Kermanshah, Iran.
Materials and methods: In this case-control study 174 women with TTP>12 months (cases) and 587 women with TTP<=12 months (controls) were selected. The tool for collecting data was a questionnaire. The SPSS-16 software was used for data analysis, a p-value <0.05 being considered as statistically significant.
]Results: Multivariate analysis showed that factors decreasing TPP statistically significantly were women's education level (≥high school diploma OR=0.854, CI 95%=0.741-0.984), frequency of intercourse in a week (OR=0.728, CI95%=0.631-0.839), blood group A compared to O (OR=0.639, CI95%=0.405-1.01), and non-exposure to smoking (OR=0.606, CI95%=0.380-0.965). On the other hand, factors increasing TPP were a woman's irregular menstrual cycle (OR=3.701, CI95%=2.127-6.441), lack of physical activity (OR=1.920, CI95%=1.263-2.918) and a body mass index (BMI) higher than 25 (OR=2.221, CI 95%=1.489-3.312).
Conclusion: According to the results of this study, a high BMI and lack of exercise increase, while factors such as frequency of intercourse decrease the length of TTP. Couples seeking medical intervention for pregnancy often disregard factors associated with TTP. It is recommended that care-providers support these couples, promote their awareness, and give them suitable advice.

---

  Anderson, H.R., 2009. Air pollution and mortality: A history. Atmospheric Environment, 43, pp. 142-152 .

  Box, GEP. and Jenkins, G.M., 1976. Time series analysis: forecasting and control, San Francisco, Holden Day Pulications .

  Duenas, C., Fernandez, M.C., Canete, S., Carretero,Liger E, 2005. Stocastic model to forecast ground level ozone concentration at urban and rural areas . Chemosphere, 61(10), pp. 1379-1389 .

  Ghorbani, M. and Younesian, M., 1389. Research Projects in Air pollution Epidemiology. Iranian Epidemiology Journal . 5, pp. 44-52 [In Persian].

  Goyal, P., Chan, A.T. and Jaiswal, N., 2006. Statistical models for the prediction of respirable suspended particulate matter in urban cities. Atmospheric Environment, 40, pp. 2068-2077 .

  Hamilton, JD., 1994. Time series analysis, Princeton Publications, USA .

  Hosseinpour, A.R., Forouzanfar, M.H., Yunesian, M., Asghari, F., Holakouie Naieni, K. and Farhood, D., 2005. Air pollution and hospitalization due to angina pectoris in Tehran, Iran: A time-series study. Environmental Research, 99, pp. 126-131 [In Persian].

  Ingrisch, M., Sourbron, S., Reiser, M.F. and Peller, M., 2009. Model selection in dynamic contrast enhanced MRI: The Akaike Information Criterion. In Dössel, O. and Schlegel, WC. (Eds.) IFMBE Proceedings 25/IV

  Khosravi Dehkordi, A. and Modarres, R., 1386. Time Series analysis of the daily air pollution in Isfahan from the Petrolium Industry. Mohit shenasi. 33, pp. 33-42 [In Persian].

  Kumar, U. and De Ridder, K., 2010. GARCH modelling in association with FFT-ARIMA to forecast ozone episodes. Atmospheric Environment, 44, pp. 4252-4265.

  Lau, J.C., Hung, W.T., Yuen, D.D. and Cheung, C.S., 2009. Long memory characteristics of urban roadside air quality. Transportation Research Part D, 14, pp. 353-359 .

  Liang, W., Wei, H. and Kuo, H., 2009. Association between daily mortality from respiratory and cardiovascular diseases and air pollution in Taiwan. Environmental Research, 109, pp. 51-58 .

  Liu, P.G., 2009. Simulation of the daily average PM10 concentrations at Ta-Liao with Box–Jenkins time series models and multivariate analysis. Atmospheric Environment, 43, pp. 2104 - 2113 .

  López-Villarrubia, E., Ballester, F., Iñiguez, C. and Peral, N., 2010. Air pollution and mortality in the Canary Islands:a time-series analysis. Environmental Health, 9 .

  Lumbreras, J., Garcia-Martos, C., Mira, J. and Borge, R., 2009. Computation of uncertainty for atmospheric emission projections from key pollutant sources in Spain. Atmospheric Environment, 43, pp. 1557-1564 .

  Masjedi, M.R., Jamaati, H.R., Dokoohki, P., Ahmadzadeh, Z., Alinejad Taheri, S., Bigdeli, M., Agin, K., Ghavam, S.M., Rostiman, A. and Izadi S., 2001. The correlation between air pollution and acute respiratory and cardiac attacks. Pazhoohesh dar pezeshki, 25, pp. 25-33 [In Persian].

  Nasrollhi, Z. and Ghaffari Goolak, M., 2010. Air pollution and its effective factors. Faslnameh Pazhoohesh Eghtesadi, 3, pp. 375-395 [In Persian].

  Quintela-del-Rio, A. and Francisco-Fernandez, M., 2011. Nonparametric functional data estimation applied to ozone data: Prediction and extreme value analysis. Chemosphere, 82, pp. 800-808 .

  Rajarathnam, U., Sehgal M., Nairy S., Patnayak R.C., Chhabra S.K., Kilnani, K.V., R and Committee., HHR, 2011. Time Series study on air pollution and mortality in Dehli. Res Rep Health Eff Inst, Mar, pp. 47-74 .

  Samet, J.M., Dominici, F., Zeger, S.L., Schwartz, J. and Dockery, D.W., 2000. The national morbidity, mortality and air pollution study. Part 1: Methods and Methodologic Issues. Research Report 94 Cambridge, MA, Health Effects institute .

  Sharma, P., Chandra, A. and Kaushik, S.C., 2009. Forecasts using Box–Jenkins models for the ambient air quality data of Delhi City. Environ Monit Assess, 157, pp. 105–112 .

  Wagemakers, E. and Farrell, S., 2004. AIC model selection using Akaike weights. Psychonomic Bulletin and Review, 11, pp. 192-196 .

  Zhang, F., Wang, W., Lv, J., Krafft, T. and Xu, J., 2011. Time-series studies on air pollution and daily outpatient visits for allergic rhinitis in Beijing, China. Science of the Total Environment, 409, pp. 2486–2492 .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  Scientific Journal of School of Public Health and Institute of Public Health Research /85

  Vol. 11, No. 2, Summer 2013

  

  Forecasting ambient air pollutants by time series models in Kerman, Iran

  

  Mansouri, F., MS.c. Student, Dept of Environmental Health Engineering, Faculty of Public Health, Kerman Medical University, Kerman, Iran

  Khanjani, N., Ph.D. Assistant Professor, Department of Epidemiology and Department of Environmental Health, Faculty of Public Health, Kerman Medical University, Kerman, Iran - Corresponding author: n_khanjani@kmu.ac.ir

  Rananadeh Kalankesh, L., MS.c. Student, Department of Environmental Health Engineering, Faculty of Public Health, Kerman Medical University, Kerman, Iran

  Pourmousa, R., MS.c. Lecturer, Department of Statistics, School of Mathematics and Statistics, Shahid Bahonar University, Kerman, Iran

 

  

  Received: Apr 3, 2012 Accepted: Feb 14, 2013

 

  ABSTRACT

 

  Background and Aim: Air pollution is one of the most important problems of big cities in developing countries and can have several negative health effects on humans. Therefore studying these pollutants can help in developing programs for air pollution control. The aim of this study was to estimate and predict the changes of air pollutants in Kerman, Iran.

  Materials and Methods: In this ecological study, data about seven important air pollutants in Kerman including NO, CO, NO₂, NO_x, PM₁₀, SO₂ and O₃ from March 2006 until September 2010 was inquired from the Kerman Province Environmental Protection Agency. Then the data was calculated as averages per month and by incorporating time series models, predictions were done for each pollutant.

  Results: All of the pollutants were steady in Kerman, except CO which is significantly decreasing and PM₁₀ which is increasing. All of the pollutants had a seasonal pattern. Time series models with a 12, 3, 8, 12, 12, 12 and 6 month seasonal pattern were fit for O₃ , SO₂ , PM₁₀ , NO_x , NO₂ , CO and NO consecutively.

  Conclusion: The production of ambient CO is decreasing in Kerman and one reason is probably replacing and retiring old automobiles. However PM₁₀ is increasing in Kerman and in most seasons it is above standard and therefore control initiatives should be implemented.

---

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

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

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

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

---

Background and Aim: Malaria is still one of the major health problems in comparison with any other parasitic disease in Iran with considerable economic and mortality consequences. Sistan-and-Baluchestan, Hormozgan and Kerman are the most affected provinces in the country approximately 96% of the cases are reported from these three provinces. The aim of this study was to determine the frequency, distribution and rate of parasitaemia of human Plasmodium (P.) species in patients infected with malaria parasites in Kerman province.

Materials and Methods: A total of 92,798 peripheral blood smears were collected from suspected malaria patients during the period 2009-10. Thin and thick blood smears were prepared according to the World Health Organization (WHO) standard procedure. Percentage of parasitaemia was determined based on the number of parasites in the positive slides. The Chi-square test was used for data analysis.

Results: A total of 571 samples were found to contain human Plasmodium species, including 523, 44, and 4 cases of P. vivax, P. falciparum and mixed infection, respectively. The results also showed that, as compared with the previous year, the total number of P. vivax cases

decreased in 2010 by 33.96%. The highest level of parasitaemia was observed in one of the patients infected with P. falciparum, with 77240 parasites/µl of blood, and the lowest in a patient infected with P. vivax, with 48 parasites/µl of blood. There were no differences between the positive and negative cases as regards parameters such as nationality, habitat or gender (Chi-square, p<0.05).  Furthermore, based on the Mann-Whitney test, there was no significant difference between the mean counts of P. falciparum and P. vivax (p-value = 0.464).

Conclusion: Considering that Iran is in the elimination stage of malaria, patient finding and rapid, timely diagnosis of the disease are very important, particularly cases coming from Pakistan and Afghanistan, helping sustainability of the elimination program.

---

Background and Aim: Cardiovascular diseases (CVDs) are a major cause of death worldwide. The objective of this study was to determine the most important behavioral (inadequate nutrition, low physical activity, smoking and alcohol consumption) and non-behavioral (stress, high blood sugar, dyslipidemia, hypertension and obesity) risk factors for CVD among CVD patients hospitalized in Kermanshah Heart Hospital. This was a needs assessment study aiming at designing interventions for reducing CVD risk factors.
Materials and Methods: In this cross-sectional study 402 CAD patients (60.4% males and 39.6% females) were selected by consecutive sampling from among those hospitalized in Imam Ali Hospital for the first time. Data were collected using the Iranian version of WHO Stepwise questionnaire and the patients’ files and analyzed using the SPSS-16 software.
Results: The mean (±SD) age of the patients was 54.2 (±8.8) years. About 73% of them had a poor diet and 46.5% had low physical activity; in addition, 36% of the men had consumed alcohol in the previous year and 26.1% were smokers. Non-behavioral risk factors were quite common too. The proportions of the patients suffering from diabetes, hypertension and overweight-plus-obesity and abdominal obesity were 49.3%, 48.0%, 54.7% and 61.0%, respectively. Finally, 43.3% of the patients had high stress, 31.0% were hypertriglyceridemic and in another 21% hypercholesterolemia was seen.
Conclusion: Based on the findings it can be concluded that, as compared to other risk factors, imbalanced nutrition was more prevalent common among the patients. Another major risk factor was obesity, particularly abdominal obesity. In addition, blood glucose disorders were more common than dyslipidemia.
 

---

Background and Aim: Paying attention to the hygiene and safety of food will have a great success for people around the world. In recent decades, due to mass production and food processing, the globalization of food trade, industrialization, etc., the prevalence of diseases associated with contaminated water and food is increasing. Therefore, the study of knowledge and attitude of people in this field have been a necessity and this research was conducted to investigate the knowledge and practice of people of Kermanshah city, Iran in relation to food hygiene and safety.
Materials and Methods: This was a cross-sectional study. Data were collected through questionnaires. 252 inhabitants of Kermanshah were randomly allocated by cluster sampling. Data analysis was performed using SPSS version 17 by Spearman and X² test.
Results: Most of Kermanshah people were lack of proper knowledge and practice about food poisoning. Of these, 54% of people mistakenly thought that fully cooked foods also have microbes. In addition, 68.3% of the subjects did not have a proper health function regarding the consumption of fresh fruits and vegetables, so that they only cleaned it before consumption. Finally, the mean score of knowledge and practice was 11.62 ± 2.27 and 17.69 ± 1.59, respectively.
Conclusion: Considering the significant correlation between the level of knowledge and practice of the people living in Kermanshah about food safety, the necessity of conducting appropriate educational programs to increase the awareness and subsequently improve the performance of the related organs can upgrade status.
 

---

Background and Aim: Performance evaluation is a useful way to obtain information for decision-making and management of healthcare organizations. The purpose of this study was to assess the performance of health houses in rural areas in Kerman City, Iran during the outbreak of Covid-19.
Materials and Methods: This cross-sectional study was conducted in 2021-22 using descriptive and analytical methods. The research population included all the health houses in Kerman City (n=57), Iran. The tool for data collection was the Health House Performance Evaluation Checklist of the Ministry of Health and Medical Education developed to supervise the performance of health houses during the outbreak of Covid-19. Data analysis was done using SPSS 26 software, the statistical tests being descriptive statistics (mean and standard deviation) and analytical statistics including independent t-test, one-way analysis of variance and Pearson and Spearman correlations.
Results: The average performance score of the health houses (n =55) in managing Covid-19 was 96.37 out of 136. Installation of the village map on the wall of the health house  (92.3%), screening and following up the positive-test individuals and informing the health care team to track and isolate individuals in close contact (84.6%) were found to have the highest, and injecting the third dose (78.8%) and the second dose (75%) of the Covid vaccine the lowest,  scores. From among the characteristics investigated the variable of native Behvarzes (the personnel of health houses) had a statistically significant positive relationship with the performance score (p=0.01). In addition, the health houses with more than one Behvarz were found to perform better than those with only one Behvarz (p=0.05).
Conclusion: Assessing the performance of health care units at times of crisis, including communicable diseases epidemics, will make it possible to identify the bottlenecks that need improvement for better preparedness in the future. Based on the findings of this  research, the expansion of the coverage of the covid-19 vaccination, updating the disease incidence, the performance of health care teams at home visits, and the progress of the operational plan were the variables that needed improvement most.
 

---

Background and Aim: Performance evaluation is a useful way to obtain information for decision-making and management of healthcare organizations. The purpose of this study was to assess the performance of health houses in rural areas in Kerman City, Iran during the outbreak of Covid-19.
Materials and Methods: This cross-sectional study was conducted in 2021-22 using descriptive and analytical methods. The research population included all the health houses in Kerman City (n=57), Iran. The tool for data collection was the Health House Performance Evaluation Checklist of the Ministry of Health and Medical Education developed to supervise the performance of health houses during the outbreak of Covid-19. Data analysis was done using SPSS 26 software, the statistical tests being descriptive statistics (mean and standard deviation) and analytical statistics including independent t-test, one-way analysis of variance and Pearson and Spearman correlations.
Results: The average performance score of the health houses (n =55) in managing Covid-19 was 96.37 out of 136. Installation of the village map on the wall of the health house  (92.3%), screening and following up the positive-test individuals and informing the health care team to track and isolate individuals in close contact (84.6%) were found to have the highest, and injecting the third dose (78.8%) and the second dose (75%) of the Covid vaccine the lowest,  scores. From among the characteristics investigated the variable of native Behvarzes (the personnel of health houses) had a statistically significant positive relationship with the performance score (p=0.01). In addition, the health houses with more than one Behvarz were found to perform better than those with only one Behvarz (p=0.05).
Conclusion: Assessing the performance of health care units at times of crisis, including communicable diseases epidemics, will make it possible to identify the bottlenecks that need improvement for better preparedness in the future. Based on the findings of this  research, the expansion of the coverage of the covid-19 vaccination, updating the disease incidence, the performance of health care teams at home visits, and the progress of the operational plan were the variables that needed improvement most.