Amirhossein Erfani; Reza Shahriarirad; Keivan Ranjbar; Alireza Mirahmadizadeh; Mohsen Moghadami
Abstract
Background: Knowledge and awareness of disease transmission modes and basic hygiene principles during a public health crisis are crucial for developing effective control measures. The researchers aimed to evaluate Iranians’ knowledge, attitude, and practice (KAP) throughout the coronavirus disease ...
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Background: Knowledge and awareness of disease transmission modes and basic hygiene principles during a public health crisis are crucial for developing effective control measures. The researchers aimed to evaluate Iranians’ knowledge, attitude, and practice (KAP) throughout the coronavirus disease 2019 (COVID-19) pandemic to detect related sociodemographic variables.Methods: This cross-sectional, web-based survey was conducted from the 2nd - 8th March 2020 among the general population of Iran above 15 years of age. A 76-item self-designed questionnaire regarding KAP towards COVID-19 was used, and the participants’ demographic characteristics and sources of information were collected. The Snowball sampling method was applied for data collection, and responses were scored based on the Likert scale. Simple and multiple linear regression was performed using SPSS version 26. The statistical significance level was P<0.05.Results: Among 8591 participants, the overall achieved knowledge, attitude, and practice score regarding COVID- 19 characteristics were 90%, 90%, and 89%. Also, an overall score of 85% was achieved regarding the knowledge of the transmission mode and high-risk groups for COVID-19. There was a significant association between female gender, higher age, and higher education with knowledge, attitude, and practice. Male gender, being single, and lower education levels were associated with lower scores in knowledge and practice (P<0.001) and poorer attitudes towards COVID-19 (P<0.001, 0.002, and <0.001, respectively).Conclusion: During its outbreak, the Iranian population demonstrated decent knowledge, appropriate practice, and a positive attitude towards COVID-19. Furthermore, health education programs, mainly targeting lower-knowledge individuals regarding COVID-19, are essential for encouraging a positive attitude and maintaining safe practices. Hopefully, by increasing knowledge via public health policymakers and the cooperation of the Iranian authorities and the general population, optimistic control and elimination of the disease can be anticipated.
Alireza Mirahmadizadeh; Fatemeh Rezaei; Kimia Jokari; Sepideh Mohseni; Sima Afrashteh; Seyed Sina Dehghani; Alireza Jafari; Mohsen Moghadami; Mousa Ghelichi-Ghojogh
Abstract
Background: HIV, Tuberculosis, and Malariaare neglected due to the high pressure imposed on healthcare systems by COVID-19; however, since these diseases afflict a large number of patients globally, their effect on COVID-19, as a world pandemic, should be assessed. We aimed to assess the relationship ...
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Background: HIV, Tuberculosis, and Malariaare neglected due to the high pressure imposed on healthcare systems by COVID-19; however, since these diseases afflict a large number of patients globally, their effect on COVID-19, as a world pandemic, should be assessed. We aimed to assess the relationship between the prevalence of these diseases and COVID-19 indices.Methods: In this ecological study, a data set was provided, which included the epidemiologic indices of COVID-19 for each country. The scatter plots of the social capital for the studied countries based on the epidemiologic indices of COVID-19 and HIV (human immunodeficiency virus), and Malaria were drawn.Results: The prevalence of HIV, Tuberculosis, and Malaria were inversely correlated with the cumulative incidence rate of cases, the cumulative incidence rate of death, and COVID-19 tests performed per million, and was directly correlated with the recovery rate. No correlation was seen between case fatality rate and the prevalence of these infectious diseases.Conclusion: However, the results of this study were in favor of people afflicted with HIV, and Further studies should be conducted on the concurrence of infectious events and their adverse consequences with future analytical protocols.
Alireza Mirahmadizadeh; Mousa Ghelichi-Ghojogh; Fatemeh Rezaei; Mehdi Nejat; Haleh Ghaem; Jafar Hassanzadeh; Mohammadreza Karimi; Zohre Khodamoradi; Kimia Jokari; Leila Jahangiry
Abstract
Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can be transmitted through direct, indirect, or close contact with infected people by contaminated respiratory droplets or saliva. This study aimed to investigate the epidemiology of coronavirus disease 2019 (COVID-19) and the secondary ...
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Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can be transmitted through direct, indirect, or close contact with infected people by contaminated respiratory droplets or saliva. This study aimed to investigate the epidemiology of coronavirus disease 2019 (COVID-19) and the secondary attack rate (SAR) in the cases’ close contact.Methods: A total of 431 confirmed COVID-19 patients were randomly selected using systematic random sampling from 15 May to 13 June 2020. The required data were extracted from the CORONALAB database of the Center for Disease Control and Prevention (CDC) at Shiraz University of Medical Sciences. Detection of COVID-19 was performed using Real- Time Polymerase Chain Reaction (RT-PCR) and nasopharyngeal swabs. SAR was also calculated for different groups.Results: Among the index cases, 64.27% were male, 24.80% were public sector employees, and 4.87% were admitted to the intensive care unit. In addition, most of them aged 30-39 years. The SAR was 11.56% (95% CI: 9.86% to 13.25%) in the close contacts. Accordingly, the highest SAR was observed among the friends, 19.05% (95% CI: 7.17% to 30.92%), followed by the spouses of COVID-19 cases, 16.67% (95% CI: 10.81% to 22.51%). Furthermore, diabetes (6.03%) and cardiovascular disease (5.1%) were the most common comorbidities among the index cases.Conclusion: The findings suggested that the SAR was relatively lower among the close contacts. Considering the familial and non-familial relationships between the index cases and their close contacts were the major causes of disease transmission. Therefore, it is crucial to conduct tracing for COVID-19 contacts in all cases with whom patients have had close contact.
Zahra Hemati; Mehrab Sayadi; Mehrzad Lotfi; Abdulrasool Hemmati; Fatemeh Azadian; Alireza Mirahmadizadeh; Fatemeh Rezaei; Babak Shirazi Yeganeh
Abstract
Background: The coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide and becoming a pandemic. Since the diagnostic tests are relatively expensive, simple diagnostic tests are valuable for quarantining individuals suspicious of COVID- 19. This study is designed to predict the potential contributing ...
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Background: The coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide and becoming a pandemic. Since the diagnostic tests are relatively expensive, simple diagnostic tests are valuable for quarantining individuals suspicious of COVID- 19. This study is designed to predict the potential contributing factors of COVID-19 diagnosis.Methods: It was a referral-based historical cohort study. 363358 individuals referred to the health centers from February to November 2020 in Fars province were entered in the study. The collected data before the lab test were symptoms, underlying diseases, some conditions, risk factors, and demographic information. The Reverse transcriptase polymerase chain reaction test was performed to identify the COVID-19 virus. Chi-square and T-tests were used to compare the variables. A logistic regression test was used to identify predictor variables.Results: Positive COVID-19 test was reported for 119,324 (% 34.9) participations. The positive group result was compared with that of the negative group (n=244,034). The studied symptoms were significant in positive patients. According to the odds ratio (OR), smell disorder (OR=3.80, P<0.001), taste disorder (OR=3.17, P<0.001), and fever (OR=2.65, P<0.001) were common. However, diarrhea, chest pain and dyspnea showed the lowest odds ratio. According to the results, DM (OR=1.46, P<0.001), HTN (OR=1.42, P<0.001), and CVD (OR=1.27, P<0.001) were common in patients with positive COVID-19 tests. Cases whose Body Mass Index (BMI) was more than 40 (excessive obesity) showed a higher odd (OR=1.45, P<0.001) for being positive.Conclusion: According to the results, the symptoms and underlying diseases are effective factors in predicting COVID- 19 disease. Identifying these factors for Covid-19 disease helps health policymakers to make quick decisions and take timely action.
Habibollah Azarbakhsh; Aliasghar Valipour; Ali Hemmati; Alireza Mirahmadizadeh; Leila Moftakhar
Abstract
Background: COVID-19 emerged in China for the first time, and spread rapidly in the world and in Iran. It caused the death of many people. This study was performed to estimate the years of life lost due to COVID-19 in southwestern Iran.Methods: In this cross-sectional study, deaths due to COVID-19 were ...
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Background: COVID-19 emerged in China for the first time, and spread rapidly in the world and in Iran. It caused the death of many people. This study was performed to estimate the years of life lost due to COVID-19 in southwestern Iran.Methods: In this cross-sectional study, deaths due to COVID-19 were investigated from February 20, 2020 to November 20, 2020 in southwestern Iran. Descriptive analyses included: sex ratio of deaths, mean and standard deviation of quantitative variable of age at the time of death, and specific ages-sex mortality rates. Years of life lost due to COVID-19 were estimated using standard life expectancy and lifetime table of the World Health Organization in 2015.Results: The number of deaths due to COVID-19 was 938 cases. The sex ratio of mortality (male to female) was 1.2, and the people over the age of 80 years had the highest mortality rates in both sexes. The total number of years of life lost was 13205 years, and the 60-69 age group had the highest years of life lost.Conclusion: Based on the findings of our study, health policymakers need to implement timely strategies and plans to reduce deaths especially for the possibleadvent of the next wave of COVID-19.
Mohebat Vali; Alireza Mirahmadizadeh; Zahra Maleki; Sima Afrashteh; Arefe Abedinzade; Farzaneh Kasraei; Haleh Ghaem
Abstract
Background: Coronavirus is among the pathogens that primarily target the respiratory system. Given the importance of Health Care Workers (HCWs) in the fight against COVID-19, their infection with the virus and death can cause irreparable damage to public health. The present systematic review and meta-analysis ...
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Background: Coronavirus is among the pathogens that primarily target the respiratory system. Given the importance of Health Care Workers (HCWs) in the fight against COVID-19, their infection with the virus and death can cause irreparable damage to public health. The present systematic review and meta-analysis aimed to investigate the physical and psychological implications of COVID-19 among HCWs. Methods: In this systematic review and meta-analysis, some well-known databases were searched for the studies published before 26 June 2020 using the following search strategy: “Novel coronavirus pneumonia”, “Nurses”, “Physicians”, “Medical Staff, Hospital”, “Health Personnel”, and “Community Health Workers”. Finally, 101 out of the 2234 primary screened articles were assessed. Results: Of the total studies included, 54 were related to Physical problems, and 47 were related to Psychosocial Stress. Skin damage (54.48%), Nasal bridge (58.79%), and Dryness tightness (58.57%) were the most common Physical Problems, and Insomnia (32.03%) and Distress (29.34%) were the most common psychosocial problems among HCWs. Conclusion: Training and awareness of the treatment staff about the unwanted side effects of these diseases should be considered in educational programs in different countries because patient care depends on their availability.
Ali Mohammad Mokhtari; Rebecca Susan Dewey; Alireza Mirahmadizadeh
Abstract
Background: The COVID-19 pandemic is a challenging health problem around the world. At time of this study, the pandemic is still underway, so prevention and control are of great importance. This review provides a comprehensive examination and analysis of the literature related to the challenges of controlling ...
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Background: The COVID-19 pandemic is a challenging health problem around the world. At time of this study, the pandemic is still underway, so prevention and control are of great importance. This review provides a comprehensive examination and analysis of the literature related to the challenges of controlling COVID-19. Methods: In this narrative review study, the search was performed on international databases including PubMed, Scopus and Embase, using relevant keywords. The resulting articles and texts were reviewed and screened, and then the relevant information was extracted. Results: The number of patients who are thought to have contracted COVID-19 is much higher than that in the SARS and MERS epidemics. Despite a lower mortality rate, COVID-19 has caused more deaths. One of the challenges that have made the control of the disease more difficult include the emergence of multiple viral mutations. In this review, it was found that the best course of action comprises continuous monitoring of disease-related indicators as part of a series of measures taken together to ensure their effectiveness. Conclusion: It is recommended that governments should form international partnerships in their efforts to overcome the pandemic, and that preventive and control measures should be taken simultaneously. Introduction Coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan, the capital of Hubei Province, China, and one of China's main transportation hubs, and spread to other parts of the world (1, 2). One of the main reasons for the spread of the disease was the intense migration of Chinese people during New Year celebrations (1). With the rise of international trade, epidemics of new infectious diseases such as COVID-19 are able to spread more rapidly than ever before (3). On December 31, 2019, China announced the outbreak of the disease, at the time named 2019-nCoV, to the World Health Organization (WHO) (2, 4). On February 11, 2020, the WHO adopted a new name called coronavirus disease (COVID-19). In acknowledgement of the genetic structure of the virus, the International Committee on Virus Classification renamed 2019-nCoV as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (5). On January 30, 2020, the WHO announced that the outbreak was a public health emergency of international concern (5, 6) and in March 2020 classified it as a pandemic (7, 8). COVID-19 has been declared the sixth international public health emergency and, therefore, requires the public, health professionals and governments to work together to prevent its spread worldwide (5). Rapid production and sharing of knowledge at the international level is one of the useful measures for disease control that has been done (9). One of the greatest fallacies of the 21st century is that infectious diseases are disappearing, which is not the case (10). The COVID-19 epidemic has become a challenging health problem for many countries around the world (8), and as of 28 February 2021, it was estimated that there were 113,472,187 cases of the disease, 2,520,653 deaths, and about 91 million cases of recovery reported worldwide (11, 12). Although more than a year has passed since the beginning of this epidemic, the disease has not yet been controlled and no specific treatment has been found for it (13), so measures related to its prevention and control are very important. The aim of this study was to examine and characterize the global challenges of controlling COVID-19, and to provide comprehensive recommendations for action.
Sanaz Amiri; Forough Saki; Mozhgan Seif; Alireza Mirahmadizadeh
Abstract
Background: Insulin-dependent diabetes mellitus (IDDM) or type 1 diabetes mellitus (T1DM) is known as a chronic autoimmune disease with an increasing prevalence and incidence. This study was conducted to determine the incidence rate and prevalence of insulin-dependent diabetes in Iran in 2016 and 2017. ...
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Background: Insulin-dependent diabetes mellitus (IDDM) or type 1 diabetes mellitus (T1DM) is known as a chronic autoimmune disease with an increasing prevalence and incidence. This study was conducted to determine the incidence rate and prevalence of insulin-dependent diabetes in Iran in 2016 and 2017. Methods: In this cross-sectional study, the prevalence of IDDM in insured subjects under the age of 19 was measured through the prescribed insulin in two consecutive years. In this study, we assumed that IDDM patients are those who receive at least one prescription containing any insulin over 2 years in insurance databases. This study was carried out on 98% of patients under age 19, and the prevalence and incidence of IDDM were calculated. Finally, the result of this method was compared with Integrated Health System (IHS) databases. Results: In general, 1,135,105 insured persons under 19 years of age were enrolled in this study, and the prevalence rates of IDDM in subjects under 19 were 117.6 (111.5-124.2) and 136.8 (130.1-143.8) per 100,000 in 2016 and 2017, respectively. The incidence rate of this disease was 27.4 (24.6-30.8) per 100,000. The highest incidence and prevalence were significantly observed in the age group of 14-19 years. The prevalence of IDDM was not significantly different between boys and girls. Conclusion: The results of this study showed that the method of prescription follow up was appropriate, acceptable, convenient, and accurate. Our findings showed that the incidence and prevalence of IDDM in this method were in line with other worldwide reliable and accurate reports, even in the developed countries. The results of the present study showed that the prevalence and incidence rate of IDDM in Iran (Fars province) is at an intermediate level.
Mohebat Vali; Alireza Mirahmadizadeh; Zahra Maleki; Fatemeh Goudarzi; Arefe Abedinzade; Haleh Ghaem
Abstract
Backgrounds: Given the novelty of COVID-19, reviewing diagnostic methods can be of great help to community health policymakers. Considering the importance of diagnosing COVID-19 and the need for reducing the number of false positive and false negative cases that appear to be different in various ...
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Backgrounds: Given the novelty of COVID-19, reviewing diagnostic methods can be of great help to community health policymakers. Considering the importance of diagnosing COVID-19 and the need for reducing the number of false positive and false negative cases that appear to be different in various diagnostic methods, this systematic review aimed at comparison of PCR test accuracy with laboratory data and CT SCAN in COVID-19.
Methods: In this systematic review, EMBASE (Elsevier, 2018), MEDLINE (National Library of
Medicine, 2018), Scopus, ProQuest, Web of Science (Clarivate Analytics, 2018b), and Google Scholar
data bases were searched for the studies published prior to 3 April 2020. Based on the inclusion criteria, 20 out of 859 primarily screened studies were finally assessed.
Results: The results indicated that the laboratory diagnosis of viral nucleic acid could have false-negative results, and serological testing of virus-specific IgG and IgM antibodies should be used as an option for diagnosis. Moreover, chest Computerized Tomography (CT) was found to be more sensitive in comparison toReverse Transcription Polymerase Chain Reaction (RT-PCR) (98% vs. 71%). Hence, the articles offered the combined use of chest CT, SARS-CoV-2 RT-PCR, and multi-plex PCR.
Conclusions: Follow-up RT-PCR and chest CT are necessary in COVID-19. In addition, serological testing of virus-specific IgG and IgM antibodies along with laboratory diagnosis of viral nucleic acid can lead to the highly sensitive and accurate diagnosis. Moreover, Enzyme-Linked Immunosorbent Assay (ELISA) is one of the cost-effective methods in epidemic conditions in low- and middle-income countries.
Mohebat Vali; Alireza Mirahmadizadeh; Zahra Maleki; Fatemeh Goudarzi; Arefe Abedinzade; Haleh Ghaem
Abstract
Background: The new Corona virus disease (COVID-19) appeared in Wuhan, China in December 2019. Methods, such as quarantine, isolation, and social distancing, if implemented properly, can help prevent the transmission of the disease. This study aimed to examine the effects of quarantine, isolation, and ...
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Background: The new Corona virus disease (COVID-19) appeared in Wuhan, China in December 2019. Methods, such as quarantine, isolation, and social distancing, if implemented properly, can help prevent the transmission of the disease. This study aimed to examine the effects of quarantine, isolation, and social distancing on the prevention of COVID-19.
Methods: In this systematic review, EMBASE (Elsevier, 2018), MEDLINE (National Library of Medicine, 2018), Scopus, ProQuest, Web of Science (Clarivate Analytics, 2018b), and Google Scholar databases were searched for the studies published prior to 10 April 2020. The search and data extraction were conducted by two authors and to check and control the quality of the articles, we used the Newcastle-Ottawa checklist.
Results: Based on the inclusion criteria, 24 out of the 768 primarily screened studies were finally assessed.
Studies showed that the short-term negative psychological effects of quarantine included frustration, boredom, anger, and confusion. Nonetheless, extending the adult quarantine period to 18-21 days could be effective in preventing the spread of the virus and controlling the disease. Moreover, the decision to control the people’s travels through restrictions on freedom of movement must be balanced regarding the estimated epidemiological impact and the expected economic outcome.
Conclusions: Although isolation, quarantine, and social distancing all have challenges, they are very useful methods for controlling the disease, which can be best used by knowing their duration of implementation.
Alireza Mirahmadizadeh; Sadaf Sahraian; Hamed Delam; Mozhgan Seif
Abstract
Objective: Type 2 diabetes is the most prevalent chronic disease in the world. Timely and appropriate control can significantly reduce the burdens and costs of this disease. Although insulin injection is the most efficient method to control type 2 diabetes, patients avoid this method for unknown reasons. ...
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Objective: Type 2 diabetes is the most prevalent chronic disease in the world. Timely and appropriate control can significantly reduce the burdens and costs of this disease. Although insulin injection is the most efficient method to control type 2 diabetes, patients avoid this method for unknown reasons. The main aim of the present study is to determine the factors influential in non-adherence to insulin using tools and models that have not been applied in this field so far.
Methods: The tendency to insulin injection in 457 patients with type 2 diabetes was investigated in this cross-sectional study using the classic logistic regression and new learning algorithms, including conditional tree, conditional forest, and random forest. Different fits were compared so that the best model can be determined to identify the factors in non-adherence to insulin.
Results: Although random forest had the highest accuracy among the fitted models, all the methods had a relative consensus that having life insurance, academic education, and insulin injection experience in immediate family members increase the tendency to accept insulin therapy. Our results also showed that younger patients and those who were committed to a specific diet better approved insulin therapy.
Conclusions: The reasons for non-adherence to insulin can be summarized in economic and psychological aspects. Therefore, the health system policies are recommended to address economic issues and also raise public awareness about this treatment method.
Alireza Mirahmadizadeh; Reza Majdzadeh; Kazem Mohammad
Abstract
Background: The goal of this study was to analyze the cost-effectiveness of harm reduction programs among Intravenous Drug Users (IDUs) who referred to Drop-In Centers (DICs) for prevention of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) infection. Methods: To calculate ...
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Background: The goal of this study was to analyze the cost-effectiveness of harm reduction programs among Intravenous Drug Users (IDUs) who referred to Drop-In Centers (DICs) for prevention of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) infection. Methods: To calculate the cost-effectiveness of HIV/AIDS prevention, we used data from a cross-sectional study carried out in 2009 in which we selected 13 DICs out of 45 active DICs using systematic random sampling. Through interview, data of all IDUs (1309) who had attended DICs were collected by means of a questionnaire approved by 3 experts. Averted cases of HIV infection were considered as the unit of effectiveness. The cost was also calculated from the perspective of governmental service provider and all costs were converted into US dollar (USD). Sensitivity analysis was used to measure the effect of some uncertain parameters in modeling the number of HIV cases that have been averted; also, Incremental Cost-Effectiveness Ratio (ICER) was estimated. Results: Results showed that the DICs averted around 120.2 HIV cases in one year (102.977 cases from drug injection, 11.45 cases from homosexual and 5.77 cases from heterosexual ways). ICER for each HIV infection averted was 13,248.5 USD. Sensitivity analysis showed that providing harm reduction services in the best and worst case scenarios could change the ICER from 13,055 to 13,954 USD for each HIV case averted, respectively. Conclusion: Since the most common cause of transmission and spread of HIV infection in Iran is drug injection via needle shared by IDUs, DICs programs in.
Shahla Heidari; Sareh Keshavarz; Alireza Mirahmadizadeh
Volume 5, Issue 4 , October 2017, , Pages 180-187
Abstract
AbstractBackground: In this cross-sectional study, 501 employees of petrochemical companies were selected by simple sampling method.Methods: Data were collected using Swedish Occupational Fatigue Inventory (SOFI-20), Occupational Fatigue/Exhaustion Recovery (OFER-15), and General Health Questionnaire ...
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AbstractBackground: In this cross-sectional study, 501 employees of petrochemical companies were selected by simple sampling method.Methods: Data were collected using Swedish Occupational Fatigue Inventory (SOFI-20), Occupational Fatigue/Exhaustion Recovery (OFER-15), and General Health Questionnaire (GHQ-28). To identify the factors associated with fatigue and general health, we used ordinary least squares regression (OLS) and SUR and the results were compared. The analysis showed that satisfaction, mental disorder and sleepiness were the important factors associated with fatigue among these workers. However, the SUR estimator provided higher precision of the estimates than the OLS estimator as the parameters obtained by SUR are characterized by lower standard errors. As the models are intended to predict the fatigue risk factors, we particularly focused on the SUR method because it assesses the precision of the model in predicting fatigue determination. SUR estimators performed consistently better than the OLS estimators since SUR takes the correlation between error terms into account. Results: The findings showed that the study population were young and almost had a low job tenure. The correlation test showed that there was a significant relationship between fatigue and general health with job satisfaction (p=0.05), sleep disorder (p=0.01) and mental disorder (p=0.001). Finally, the analysis showed that fatigue as the result of work was affected by some organizational and individual risk factors, among which "general health status" in general fatigue and "job satisfaction and mental disorders" in mental, physical, shift work, chronic and acute fatigue had the most effect.Conclusion: The prevalence of fatigue among the study population was assessed high. Thus, elimination and reduction of casual risk factors are necessary to reduce the prevalence of fatigue at work environmental.
Alireza Mirahmadizadeh; Maryam Marzban; Maryam Siadati; Karam Tavani; Abdolrasul Hemmatid
Volume 5, Issue 2 , April 2017, , Pages 72-78
Abstract
Background:Patient satisfaction is an integral component of service quality and obtaining feedback from patients about the quality of primary health care is the best way to extend more patient-centered goals to health care delivery. This study was conducted to measure the level of client satisfaction ...
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Background:Patient satisfaction is an integral component of service quality and obtaining feedback from patients about the quality of primary health care is the best way to extend more patient-centered goals to health care delivery. This study was conducted to measure the level of client satisfaction with Urban Family Physician and Referral System (UFPARS) programMethods: This repeated cross-sectional study was done in Fars province, South of Iran, at two sections. Totally, 5901 patients in two sections (6 and 24 months after the UFPARS startup) were selected using multi-stage random sampling. The participants answered a self-administrated questionnaire. We measured the client satisfaction using 5-point Likert-scaled score and combined the questions; for each component of UFPARS, 6 satisfaction dimensions were made. We compared the participants’ level of satisfaction in two parts, using t-test.Results: Reliability was acceptable, and equal to 85% or more in all domains .In all components of UFPARS, the mean client satisfaction score was higher than 3 out of 5. The lowest client satisfaction scores were seen in the outpatient services. In three components of UFPARS including enrolment, family medicine and para-clinics, the mean satisfaction scores significantly decreased (P<0.001) between the two sections. But other components showed no significant change. Conclusions:The level of satisfaction with UFPARS in Fars province was shown to be relatively medium to high. Low client satisfaction between the two sections could be a bad sign and we recommend that the problems should be tackled gradually. Although family physician program in Iran has some limitations, implementing this plan step by step can lead to a medical reform in Iran. We can develop better programs based on the comments from service recipients, and prompt the project and some program processes.
Alireza Mirahmadizadeh; Ali Soleimani; Fariba Moradi; Elham Hesami; Maryam Kasraeian; Hamed Delam
Volume 5, Issue 1 , January 2017, , Pages 2-6
Abstract
Background/Objective: This study was conducted to assess the prevalence of low birth weight and its risk factors in Fars province, south of Iran, 2014.Methods: In this cross-sectional study, we collected data of 3,600 neonates through multi-stage random sampling. At first, we divided the hospitals into ...
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Background/Objective: This study was conducted to assess the prevalence of low birth weight and its risk factors in Fars province, south of Iran, 2014.Methods: In this cross-sectional study, we collected data of 3,600 neonates through multi-stage random sampling. At first, we divided the hospitals into two strata, private and public. Then by stratified random sampling, we selected the neonates from delivery list in each hospital. In univariate analysis, the variables in which the p-value was less than 0.2 were entered into multivariate logistic regression analysis model for adjusting. Two-sided p values <0.05 were statistically considered significant.Result: The prevalence of low birth weight in Fars province was 8.7% (95% CI: 7.8% - 9.7%). In term birth, factors such as mother’s age > 35 years, multiple birth and duration < 24 months with previous pregnancy were risk factors of low birth weight (P <0 .05) and just the father’s literacy was a protective factor for low birth weight.Conclusion: The prevalence of low birth weight in Fars province was low in comparison to that of the world and other districts of Iran. But we should plan for reduction of low birth weight to achieve world health organization’s goal. Variables of pregnancy interval of less than 2 years, multiple births, mother’s age over 35 years and father’s level of education could predict low birth weight of the neonates.
Mojtaba Naghshvarian; Mohammad Hossien Kaveh; Maryam hesampour; fariba Rezaee; Ali Reza Mirahmadizadeh
Volume 4, Issue 1 , January 2016, , Pages 32-39
Abstract
AbstractBackground: The reduction of suicidal attempts as one of the most important goals is improvement of societies’ health status. The present study aimed to assess the epidemiologic aspects of suicide cases in Fars province in 2010-2011.Methods: A total of 9714 suicide cases in Fars province, south ...
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AbstractBackground: The reduction of suicidal attempts as one of the most important goals is improvement of societies’ health status. The present study aimed to assess the epidemiologic aspects of suicide cases in Fars province in 2010-2011.Methods: A total of 9714 suicide cases in Fars province, south of Iran, in 2010-2011 were enrolled in this cross-sectional study through census. The study data were collected using suicide registry forms in the health centers affiliated to Fars province department of health services and analyzed using SPSS, version 17.Results: The rate of suicide attempts was 116.5 per 100,000 population in Fars province (93per 100,000 among men and 141.5 per 100,000 among women). The results showed significant differences between the suicide rates based on sex, age group, place of living, and season of the year (P<0.001). Most of these cases were female (59.4%), single (52.9%), 15-24 years old (56.4%), had high school education (25.8%), lived in urban areas (69.6%) and were female homemakers (30.3%). Based on the data, however, the largest number of suicide deaths resulted from self-immolation (56.7%).Conclusion: The present study findings revealed different rates of suicidal attempts based on sex and age group. Also, the importance of education and mental support, especially among women and singles, and also preventive measures in the context of uncontrolled immigration from the countryside to the large cities seems to essential more than ever. Yet, defects in some findings, particularly information about etiology, suggest that more researches should be conducted and suicide data registry and reporting systems should be improved.
Alireza Mirahmadizadeh; Mitra Rahimi Haghighi; Pegah Shoa Hagighi; Abdolrasool Hemmati; Mohsen Moghadami
Volume 3, Issue 3 , July 2015, , Pages 107-112
Abstract
Background: The dependency ratio (DR) is defined as the ratio of the non-working population to the economically active population. Dependency ratio is calculated by the sum of population under fifteen years and over 65 years divided by 15-64 year old population. The interpretation of DR variation gives ...
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Background: The dependency ratio (DR) is defined as the ratio of the non-working population to the economically active population. Dependency ratio is calculated by the sum of population under fifteen years and over 65 years divided by 15-64 year old population. The interpretation of DR variation gives us the impact of health care services and some reproductive interventions. This study analyzed a 23-year DR trend in rural population of Fars province and the effect of some fertility variables on it. Methods: In this study, using data from vital horoscope and regression analysis, we analyzed a 23-year period of DR and some fertility indicators. Results: The total DR significantly declined from 102.5% in 1990 to 41.4% in 2012 (P<0.001). Most of this reduction is attributed to reduction in young DR. Old dependency ratio (population of 65 years and more) was significantly growing (P<0.035). Number of rural health house, family planning coverage, total fertility rate and general fertility rate was significantly associated with total dependency ratio (P<0.009). Conclusion: We passed the first stage of demographic transition, i.e. young dependency ratio declining. But the old dependency ratio slowly increased; it is recommended that the health care services should be promoted in future, especially services for old age people.
Alireza Mirahmadizadeh; Elham Kavoosi; Marzieh Vakili; Razieh Shenavar; Mohsen Moghadami
Volume 1, Issue 2 , October 2013, , Pages 57-66
Abstract
Background: Iodine deficiency disorders (IDD) have been recognized as a major public health problem worldwide. Consequences of IDD include goiter, hypothyroidism, and intellectual disability followed by retarded growth and development of the brain. This report aimed to determine the state of IDD in Fars ...
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Background: Iodine deficiency disorders (IDD) have been recognized as a major public health problem worldwide. Consequences of IDD include goiter, hypothyroidism, and intellectual disability followed by retarded growth and development of the brain. This report aimed to determine the state of IDD in Fars province, south of Iran.Methods: In this study, we gathered data from all scientific papers, published and unpublished reports of IDD surveillance system, results of IDD-related surveys and all data from the center for disease control (CDC) at provincial and national levels during 1989-2012. Five main IDD indices are summarized, interpreted, and then organized in graphs and tables.Resuits: After formation of national committee of IDD followed by launching of extensive iodine delivery, most of IDD indices have improved. The percentage of iodized salt intake has increased from 0 to near 100%, and that of salt with adequate amount of iodine has increased to 94.5%. Median of urinary iodine concentration (UIC) has always been higher than the acceptable value (≥100 μg/L) and 68% of people had a mean of UIC ≥100 μg/L. The percentage of TSH (Thyroid-Stimulating Hormone) >5 mU/L in the screened newborns has persistently been less than 1% during 2005-11. Prevalence of goiter has declined from 68% in 1989 to 1.3% in 2007.Conclusion: Present findings address those efforts to combat iodine deficiency which were effective. According to the small sample size and also the fact that some data have been derived at the national level, we recommend that a comprehensive populationbased survey should be carried out with sufficient sample size to achieve information with high accuracy and precision.
