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Massah O, Moradi A, Farhoudian A, Amini-Lari M, Joulaei H, Daneshmand R. HIV Programs in Iran (Persia), Iraq and Saudi Arabia: A Brief Review of Current Evidence in West and Southwest Asia. Addict Health 2016; 8:136-144. [PMID: 28496952 PMCID: PMC5422010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
BACKGROUND In Western and Southwest Asia, literature is not documented on human immunodeficiency virus (HIV) programs in Iran, Iraq and Saudi Arabia. The present study is the first brief review that describes HIV programs in these three neighboring countries. METHODS Data regarding the evidence of HIV programs were gathered through a systematic literature searching. English publications were retrieved through searching online scientific databases. Grey literature was also searched online. The review was based on the studies related to the last decade. FINDINGS Systematic searching resulted in retrieving 21,948 studies but only 21 studies were relevant to the study aim. The review findings indicated that Iran has provided a nationwide sero-surveillance data system and has identified its key populations. Detecting HIV prevalence has been limited to case-finding in Iraq and Saudi Arabia. However, strategic plans for HIV have been provided in the three countries. HIV education, knowledge and support have been provided but still needs consideration in the three countries especially in Iraq. The low coverage of antiretroviral therapy (ART) has remained a critical gap in the provision of comprehensive HIV programs in these three countries. This issue has been followed by the lack of opiate substitution therapies for drug dependents and injecting drug users in Iraq and Saudi Arabia. Condom promotion and voluntary HIV counselling and testing have been provided for at-risk groups in the three countries but need more nationwide coverages. However, needle and syringe programs (NSPs) have been only provided in Iran. CONCLUSION The review concluded that the provision of effective HIV programs should address training human resources and infrastructural development. This issue should be facilitated by international collaborations and governmental supports.
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Affiliation(s)
- Omid Massah
- Senior Researcher, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Afsaneh Moradi
- Senior Researcher, Department of Psychology, School of Psychology and Educational Sciences, Alzahra University, Tehran, Iran
| | - Ali Farhoudian
- Pcychiatrist, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahmood Amini-Lari
- Senior Researcher, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- Senior Researcher, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Daneshmand
- Pcychiatrist, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Correspondence to: Reza Daneshmand MD,
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Akbari M, Akbari M, Naghibzadeh-Tahami A, Joulaei H, Nasiriyan M, Hesampour M, Bagheri-Lankarani K. Prevalence of HIV/AIDS among Iranian Prisoners: A Review Article. Addict Health 2016; 8:195-206. [PMID: 28496958 PMCID: PMC5422016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/21/2016] [Indexed: 10/31/2022]
Abstract
BACKGROUND Worldwide, prisoners are more at risk of being infected by human immunodeficiency virus (HIV) as well as hepatitis C and B in comparison with other risk groups. The combination of acquired immune deficiency syndrome (AIDS), addiction and prison are factors that threaten the health of our society. Influence of risky behaviors is so common on transmission of AIDS into prisoners' bodies. This study used available information and reports to investigate the prevalence of HIV in Iranian prisons. METHODS The following review of documents available in national and foreign databases, a total of 26 studies were investigated and required information was extracted from both the full papers and abstracts. FINDINGS The selected studies differed methodologically in their sampling method and data collection tools. Within the 26 studies analyzed, there was a combined study cohort of 39707 people in whom HIV prevalence varied between 0% and 24.40%. CONCLUSION In this study, HIV prevalence ranged widely among the prisoners, and in most of these studies, the rate in Iran was higher than that of other countries. The prevalence of disease was highest among intravenous drug users. Unless proper preventive and control plans among risk groups such as prisoners are not implemented in a timely and suitable manner, the risk of infection in the broader society will increase.
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Affiliation(s)
- Morteza Akbari
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- PhD Student, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Naghibzadeh-Tahami
- PhD Student, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Nasiriyan
- Assistant Professor, Department of Biostatistic and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hesampour
- Department of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri-Lankarani
- Professor, Health Policy Research Center AND Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Lankarani KB, Joulaei H, Khankeh HR, Zarei N, Fararouei M, Saboori Z. Health Equity as a Challenging Goal for Policymakers: A Systematic Review. Glob J Health Sci 2016. [DOI: 10.5539/gjhs.v9n2p144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
<p>The ultimate goal of every health system is to maintain and promote community health by ensuring the equitable utilization of health services. In recent years, many countries have undergone health sector reform to improve health equity, but most continue to face challenges ahead. This study reviewed the effects of health system reform on reducing health inequity with a focus on the social determinants of health since 2000. This systematic review included an evidence search within the PubMed/Medline, Google Scholar, and Scopus medical research databases. Out of 1,559 published articles between 2000 and 2014, 29 who met the inclusion and exclusion criteria were chosen. Most countries studied considered financial intervention, such as increasing governmental health expenditure and insurance coverage, to establish universal health coverage. Primary care has been neglected in many reform plans as most countries focused on inpatient or outpatient care. None of the reforms have been entirely successful and health inequity remains among different socioeconomic groups. The articles highlighted the significance of socioeconomic and political determinants on the success rate of reforms within the study context. Moreover, strengthening primary health care, implementing stepwise reform, establishing a robust monitoring system and considering quality along with quantitative coverage is necessary to reduce health inequity.<strong></strong></p>
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Peymani P, Heydari ST, Hoseinzadeh A, Sarikhani Y, Hedjazi A, Zarenezhad M, Moafian G, Aghabeigi MR, Maharlouei N, Foroutan A, Ahmadi SM, Ghaffarpasand F, Joulaei H, Lankarani KB. Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey. Chin J Traumatol 2016; 15:279-83. [PMID: 23069098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran. METHODS This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medicine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS version 11.5. P value less than 0.05 was considered significant. RESULTS The mean age of decedents was (47.2+/-26.2) years, ranging from 6 months to 103 years old. Males accounted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality. CONCLUSION Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs coordination among trauma system organizations.
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Affiliation(s)
- Payam Peymani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Heydari ST, Maharlouei N, Foroutan A, Sarikhani Y, Ghaffarpasand F, Hedjazi A, Zarenezhad M, Moafian G, Aghabeigi MR, Peymani P, Ahmadi SM, Dehghankhalili M, Joulaei H, Lankarani KB. Fatal motorcycle accidents in Fars Province, Iran: a community-based survey. Chin J Traumatol 2016; 15:222-7. [PMID: 22863339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran. METHODS This cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level. RESULTS Of the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death. CONCLUSIONS Head injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.
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Affiliation(s)
- Seyed Taghi Heydari
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Joulaei H, Maharlouei N, Lankarani KB, Razzaghi A, Akbari M. Narrative review of women's health in Iran: challenges and successes. Int J Equity Health 2016; 15:25. [PMID: 26880036 PMCID: PMC4754925 DOI: 10.1186/s12939-016-0316-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 02/08/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In each society, the health of women in different periods may be endangered by an unequal distribution of resources, facilities, and gender prejudices. The present study evaluated the time trend of Iranian women's health between 1990 and 2013. METHODS This narrative review includes an integration and descriptive summary of the existing evidence on trends and criteria of different aspects of women's health from social determinant point of view. The evidence was drawn from peer-reviewed, cross-national or large-scale studies, official sources of the Ministry of Health, reviews, and online scientific databases published between 1990 and 2013. RESULTS The average life expectancy of Iranian women has increased from 44.15 years in 1960 to 75.75 years in 2012; in most deprived provinces of Iran, however, this criterion is about 67.3 years, and in the capital it is 75.8 years. In 2011, 43.37 % of DALYS, 36.21 % of YLL, and 1.92 % of YLD were dedicated to women; these figures were 3.63 % lower than they were in 2003. Although a significant reduction has occurred in maternal mortality rate, which dropped from 83 to 23 per 100,000 between 1990 and 2013, there is no equal distribution in maternal mortality across the country as manifested by the unfavorable conditions of border provinces (SD = 19.2). The prevalence of HIV/AIDS is an alarming health problem among Iranian females, increasing approximately 546 % between 2007 and 2015. As for mental health, depression in women was ranked first among diseases in 2011 compared to a second place ranking in 2003. As regards social health, the delinquency of women has increased in recent years compared to men with women committing more crimes related to drugs and actions against virtue. The annual report of the United Nations for the gender gap index in 2013 ranked Iran as 130 among 136 countries (from 0.622 in 2000 to 0.584 in 2013). CONCLUSION Generally, over the last three decades, the health indices of Iranian women have grown in aspects of physical, mental, and social health. Remarkable differences can be seen among female health indices based on geographic location and in comparison with men. To promote an improved health status for Iranian women, the root causes of the discrepancies must be identified and a comprehensive national plan must be established.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Najmeh Maharlouei
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR, Iran.
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR, Iran.
| | - Alireza Razzaghi
- Guilan Road Trauma Research Center, Guilan University of Medical Science, Guilan, Iran.
| | - Maryam Akbari
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR, Iran.
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Affiliation(s)
- Bahram Heshmati
- HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bayati M, Mahboub Ahari A, Badakhshan A, Gholipour M, Joulaei H. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique. Iran J Radiol 2015; 12:e18372. [PMID: 26715979 PMCID: PMC4691520 DOI: 10.5812/iranjradiol.18372v2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 03/27/2014] [Accepted: 04/09/2014] [Indexed: 11/16/2022]
Abstract
Background: Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. Objectives: The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). Materials and Methods: We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results: Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion: As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system such as ABC technique, hospitals would be able to generate robust evidences for financial management of their overhead, intermediate and final ACs.
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Affiliation(s)
- Mohsen Bayati
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mahboub Ahari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Center of Excellence in Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Badakhshan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahin Gholipour
- Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Corresponding author: Mahin Gholipour, Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Tel: +98-2165324531, Fax: +98-2188989129, E-mail:
| | - Hassan Joulaei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Behbahani Rad A, Joulaei H, Vossoughi M, Golkari A. Assessing Oral Health Status and Behaviors in 6-Year-Old School Children in Rural and Urban Areas of Shiraz, Southern Iran. Int J School Health 2015. [DOI: 10.17795/intjsh-33036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zarei N, Joulaei H, Darabi E, Fararouei M. Stigmatized Attitude of Healthcare Providers: A Barrier for Delivering Health Services to HIV Positive Patients. Int J Community Based Nurs Midwifery 2015; 3:292-300. [PMID: 26448956 PMCID: PMC4591575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Despite the success of developed countries in preventing the spread of HIV/AIDS, the disease is expanding in developing countries where an unfavorable attitude exists among people, health professionals and employees. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLWHA). METHODS The study is a cross-sectional survey. The data were gathered using a structured questionnaire. The study sample included 575 health care providers of public and private hospitals in Shiraz. The data were gathered using a structured questionnaire in spring 2014. Data analysis was carried out using the Statistical Package for Social Sciences, version 21. RESULTS The most dominant attitude of the health care providers toward HIV/AIDS patients was related to fear (42.42%). According to the results of this study, there was a significant relationship between stigmatized attitude of the health care providers and their religious beliefs, society stigmatized attitude, and knowledge of transmission routes. The relationship between social stigmatized attitude of health care providers and their knowledge of transmission routes, with their willingness to provide services to patients is significant, as well (P<0.05). 39.6% and 46.2% of the respondents preferred not to provide services to the prostitutes and homosexual patients. CONCLUSION Fear of contamination and social stigmatized attitude are the main impediments to dealing with patients and providing services to them. Hence, it seems that creating an effective knowledge about transmission and correcting the socio-cultural beliefs of health providers are two key strategies to tackle this problem.
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Affiliation(s)
- Nooshin Zarei
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding author: Hassan Joulaei, Pharm, MPH; Shiraz HIV/AIDS Research Center, 2nd floor, Voluntary Counseling and TestingCenter, Lavan Ave, Delavaran-e Basij Blvd, Khatoun Sq, Shiraz, Fars, Iran Tel/Fax: +98 71 37386272;
| | - Elahe Darabi
- Department of Sociology and Social Planning, School of Economy, Management and Social Sciences, Shiraz University, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of public Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Bagheri Lankarani K, Mohammad Alinejad Z, Mooghali A, Joulaei H, Akbari M, Heshmati B. An Analytical Study of Health System Managers’ Decision-Making Models. Shiraz E-Med J 2015. [DOI: 10.17795/semj31330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Bagheri Lankarani K, Ghahramani S, Zakeri M, Joulaei H. Lessons Learned From National Health Accounts in Iran: Highlighted Evidence for Policymakers. ACTA ACUST UNITED AC 2015. [DOI: 10.17795/semj27868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Joulaei H, Rudgari O, Motazedian N, Gorji-Makhsous S. Hepatitis E virus seroprevalence in HIV positive individuals in Shiraz, Southern Iran. Iran J Microbiol 2015; 7:103-8. [PMID: 26622971 PMCID: PMC4662777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world. It is usually a self-limited disease but may leads to the deaths of about 20% of pregnant women in developing countries. This study was conducted to determine the prevalence of HEV infection among HIV individuals . MATERIALS AND METHODS This is a cross-sectional survey of HIV positive individuals in voluntary counselling and testing center of Shiraz in 2013 Using the systematic random sampling method, 158 patients enrolled for the research. They were asked about their age, gender, area of residence, marital status, number of children, education level, occupation, history of imprisonment, mode of HIV transmission, and viral hepatitis co-infection Three ml venous blood sample was drawn from each subject and transferred to the laboratory of voluntary counselling and testing center. RESULTS The overall seroprevalence of hepatitis E was 26 (16.4%), where it increased significantly with age ranging from zero in subjects less than 30 years of age to 47.4% in those aged 50 years or older. CONCLUSION Co-infection of HIV positive individuals with HEV is an issue that should be of concern to health care providers.
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Affiliation(s)
- Hassan Joulaei
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Rudgari
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Motazedian
- Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding author: Nasrin Motazedian, MD. Address: Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, 2nd floor, Voluntary Counseling and Testing Center, Lavan Ave, Delavaran-e Basij Blvd, KhatounSq, Shiraz, Fars, Iran. Post Code: 71659-83885, Tel: +98-711-7386272, Fax: +98-711-7386272,
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Maharlouei N, Hoseinzadeh A, Ghaedsharaf E, Zolfi H, Arab P, Farahmand Z, Hallaj M, Fazilat S, Heidari ST, Joulaei H, Karbalaie F, Lankarani KB. The mental health status and associated factors affecting underprivileged Iranian women. Asian J Psychiatr 2014; 12:108-12. [PMID: 25193508 DOI: 10.1016/j.ajp.2014.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/19/2014] [Accepted: 07/28/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE The prevalence of mental disorders in Iran approximates to that of other countries. This study evaluates mental health status and its related factors among underprivileged women in Shiraz, Iran. METHODS This research was conducted between June, 2010 and November, 2012, and comprised 2108 women who participated in the Shiraz Women's Health Cohort Study. The questionnaire used in the study was completed by trained general practitioner and included demographic information and the 28-item version of the General Health. The t-test, chi-square test and multivariate logistic regression model were used for statistical analysis. A P-value <0.05 was considered significant. RESULTS The mean age of the participants was 49.7±10.6 years. According to the General Health Questionnaire, the most prevalent mental disorder was social dysfunction observed in 1643 (77.9%) participants followed by somatic symptoms found in 1308 (62%) subjects. Mental disorders were most prevalent among married women (63.8%, P=0.004). Participants holding high school diploma or university degree (141; 52.4%) comprised the smallest proportion of subjects with mental disorders (P=0.01). Of a total 265 participants whose husband were in prison, 171 (64.5%) exhibited mental disorders, presenting the greatest proportion of women with mental disorders. Logistic regression analysis showed an association between mental health status and participants' level of education, number of children and marital status, based on the General Health Questionnaire total score. CONCLUSIONS The results of this study showed a considerably higher prevalence of mental disorders among Iranian women in comparison with the general population. Therefore policymakers should pay greater attention to the mental health status of underprivileged Iranian women.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amin Hoseinzadeh
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Esmaeil Ghaedsharaf
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hosein Zolfi
- College of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran.
| | - Parisa Arab
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Farahmand
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mahbanoo Hallaj
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shiva Fazilat
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sayed Taghi Heidari
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hassan Joulaei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Karbalaie
- College of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran.
| | - Kamran B Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bagheri Lankarani K, Joulaei H. School Health, an Important Issue in the New Millennium. Int J School Health 2014. [DOI: 10.17795/intjsh-19857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Joulaei H, Bhuiyan AR, Sayadi M, Morady F, Afsar Kazerooni P. Slums' access to and coverage of primary health care services: a cross-sectional study in shiraz, a metropolis in southern iran. Iran J Med Sci 2014; 39:184-90. [PMID: 24753641 PMCID: PMC3993042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 05/07/2013] [Accepted: 05/22/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND The United Nations has predicted that the population of slum dwellers will have grown from one billion people worldwide to 2 billion by 2030. This trend is also predictable in Iran. In the Iranian metropolis of Shiraz, more than 10% of the residents live in slum areas. There are several problems regarding the delivery of social services in these areas. The aim of this study was to evaluate slums dwellers' access to and coverage of health care. METHODS This cross-sectional face-to-face study included 380 household of slum dwellers via stratified random sampling. Demographics, accessibility of health services, coverage of health care, and route of receiving health services were recorded through interviews. RESULTS Approximately, 21.6% of the households had no physical access to health centers. The coverage rate of family planning programs for safe methods was 51.4% (95% CI: 48.86-53.9%). Vaccination coverage among children under 5 years old was 98% (95% CI: 97-99%). Furthermore, 34% of pregnant women had not received standard health care due to a lack of access to health centers. CONCLUSION Limited access to health services along with inadequate knowledge of slum residents about health care facilities was the main barrier to the utilization of the health care in the slums.
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Affiliation(s)
- Hassan Joulaei
- HIV/AIDS Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azad R Bhuiyan
- Department of Epidemiology and Biostatistics, Jackson State University, Mississippi, USA
| | - Mehrab Sayadi
- Statistics and Information Technology Unit, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Morady
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvin Afsar Kazerooni
- Control and Surveillance of Diseases Unit, Shiraz University of Medical Sciences, Shiraz, Iran
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69
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Joulaei H, Shahbazi M, Nazemzadegan B, Rastgar M, Hadibarhaghtalab M, Heydari M, Ghaffarpasand F, Rahimi N. The diminishing trend of β-thalassemia in Southern Iran from 1997 to 2011: the impact of preventive strategies. Hemoglobin 2013; 38:19-23. [PMID: 24274135 DOI: 10.3109/03630269.2013.858638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The marginal zones of the Caspian Sea and the Persian Gulf have a higher prevalence of thalassemia compared to other regions of Iran. This disease has disabled many people and resulted in increasing health care costs. The aim of this study was to assess the incidence of β-thalassemia (β-thal) and to evaluate the outcome of applied preventive strategies over a 14-year period in Fars Province, Southern Iran. This cross-sectional study comprised all new cases of β-thal recorded during 1997-2011. The data were obtained from the Non-Communicable Diseases Surveillance Department of Shiraz University of Medical Sciences, Shiraz, Iran, and are presented as mean ± standard deviation (SD). The Fars Health Network System screened 840 686 males and females applying for marriage certificates. Among the carriers, 50.5% cancelled their marriages, 42.5% married, and 7.0% did not show up at the clinics. The rate of cancelled marriages has reduced since 2000, when marriage candidates were given the option of prenatal diagnosis. From 2000 to 2011, a total of 3539 married couples were referred for prenatal diagnosis. Of these, 806 fetuses were found to carry thalassemia and 800 aborted. It is impressive to note that while 101 cases of thalassemia were recorded in 1997, this figure was reduced to two cases by 2011. This study has established that an integrated primary health care approach, with good infrastructure for implementing successful strategies, can significantly reduce the incidence of β-thal.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Centre, Shiraz University of Medical Sciences , Shiraz , Iran
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70
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Maharlouei N, Rezaianzadeh A, Hesami E, Moradi F, Mazloomi E, Joulaei H, Khodayari M, Lankarani KB. The preference of Iranian women to have normal vaginal or cesarean deliveries. J Res Med Sci 2013; 18:943-50. [PMID: 24523780 PMCID: PMC3906784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 07/11/2013] [Accepted: 09/01/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND The cesarean section (C-section) has higher risk compared to normal vaginal delivery (NVD). The aim of this population-based study was to evaluate the frequency of mothers' tendency toward the mode of delivery and the factors that can affect this inclination. MATERIALS AND METHODS This cross-sectional study was conducted from August 2011 to June 2012 in Fars Province, Iran, and comprised mothers in their 20(th) to 30(th) weeks of pregnancy. A questionnaire was designed to include, sociodemographic information, maternal knowledge, main sources of knowledge, attitude of the mother, husband, parents, close friends, and gynecologist, regarding the route of delivery, convenience factors, and barriers to choosing NVD, and mother's preference for the route of delivery. RESULTS Of 6921 participants, 2197 (31.7%) preferred C-section and 4308 (62.2%) favored NVD while 416 (6%) had no idea regarding the preferred route of delivery. Score of knowledge in 904 (13.1%) participants was zero, and 1261 women (18.2%) achieved an acceptable level of knowledge. Using binary logistic regression, positive history of previous abortion and/or infertility, higher education level of mother and husband, mother's unacceptable level of knowledge regarding complications of C-section, and mother's and husband's positive attitude toward C-section were determinant factors in choosing C-section as a preferred route of delivery. CONCLUSION Appropriate measures should be taken to raise awareness and knowledge of mothers and all families about complications of the C-section. Establishment of clinics for painless NVD and assuring mothers of benefits and lower complications of NVD can reduce the tendency for C-sections.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Department of Epidemiology, School of Hygiene and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Hesami
- Family Health Unit, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Moradi
- Family Health Unit, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ezat Mazloomi
- Family Health Unit, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Khodayari
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B. Lankarani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Address for correspondence: Prof. Kamran B. Lankarani, Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail:
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71
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Joulaei H, Nwagwu E, Nasihatkon A, Azadbahkt L, Shenavar R, Keshtkar V, Ahmadi SM. To assess the effects of nutritional intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz. J Res Med Sci 2013; 18:739-45. [PMID: 24381614 PMCID: PMC3872579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 07/21/2013] [Accepted: 08/29/2013] [Indexed: 12/02/2022]
Abstract
BACKGROUND The present study was carried out to assess the effects of community nutrition intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz, Iran. MATERIALS AND METHODS This case-control nutritional intervention has been done between 2008 and 2009 on 2897 primary and secondary school boys and girls (7-13 years old) based on advocacy approach in Shiraz, Iran. The project provided nutritious snacks in public schools over a 2-year period along with advocacy oriented actions in order to implement and promote nutritional intervention. For evaluation of effectiveness of the intervention growth monitoring indices of pre- and post-intervention were statistically compared. RESULTS The frequency of subjects with body mass index lower than 5% decreased significantly after intervention among girls (P = 0.02). However, there were no significant changes among boys or total population. The mean of all anthropometric indices changed significantly after intervention both among girls and boys as well as in total population. The pre- and post-test education assessment in both groups showed that the student's average knowledge score has been significantly increased from 12.5 ± 3.2 to 16.8 ± 4.3 (P < 0.0001). CONCLUSION This study demonstrates the potential success and scalability of school feeding programs in Iran. Community nutrition intervention based on the advocacy process model is effective on reducing the prevalence of underweight specifically among female school aged children.
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Affiliation(s)
- Hassan Joulaei
- HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Emeka Nwagwu
- Department of Health Policy and Management, School of Health Sciences, Jackson State University, USA
| | - Aliasghar Nasihatkon
- Fars NIOC, Health Organization, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Azadbahkt
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Shenavar
- Department of community Nutrition, Deputy for Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Keshtkar
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mehdi Ahmadi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Address for correspondence: Mr. Seyed Mehdi Ahmadi, Health Policy Research Center, Shiraz University of Medical Sciences, Building No. 2, Eighth Floor, School of Medicine, Zand Avenue, Shiraz, Iran. E-mail:
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Heydari S, Hoseinzadeh A, Ghaffarpasand F, Hedjazi A, Zarenezhad M, Moafian G, Aghabeigi M, Foroutan A, Sarikhani Y, Peymani P, Ahmadi S, Joulaei H, Dehghankhalili M, Lankarani K. Epidemiological characteristics of fatal traffic accidents in Fars province, Iran: a community-based survey. Public Health 2013; 127:704-9. [PMID: 23871394 DOI: 10.1016/j.puhe.2013.05.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 12/26/2012] [Accepted: 05/09/2013] [Indexed: 02/08/2023]
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73
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Lankarani KB, Mahmoodi M, Heydari ST, Joulaei H, Ghaffarpasand F, Maharlouei N, Aghabeigi MR, Moafian G, Yamini N, Najafi A. The second international conference on reducing burden of traffic accidents, Shiraz, Iran. J Inj Violence Res 2013; 5:75-6. [PMID: 23275241 PMCID: PMC3591734 DOI: 10.5249/jivr.v5i1.322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 10/21/2012] [Indexed: 02/08/2023] Open
Affiliation(s)
- Kamran B Lankarani
- Health Policy Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
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74
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Ahmadi SM, Mohammadi MR, Mostafavi SA, Keshavarzi S, Kooshesh SMA, Joulaei H, Sarikhani Y, Peimani P, Heydari ST, Lankarani KB. Dependence of the geriatric depression on nutritional status and anthropometric indices in elderly population. Iran J Psychiatry 2013; 8:92-6. [PMID: 24130608 PMCID: PMC3796300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Malnutrition and depression are highly prevalent in the elderly and can lead to unfavorable outcomes. The aims of the current study were to determine the association between malnutrition and depression and also to find any correlation of depression with some anthropometric indices in free living elderly. METHOD In this cross-sectional study, 337 elderly subjects (193 females) were selected using cluster sampling. Depressive symptoms and nutritional status were determined by the Geriatric Depression Scale (GDS) and the Mini-Nutritional Assessment (MNA) scores questionnaires, respectively. Anthropometric indices were measured all in standard situations. Chi squared test and t-test were used when necessary. Pearson correlation coefficients were calculated for linear relations between variables. RESULTS Of all the total subjects, 43.62% were depressed; and of whom, 48.01% were malnourished or at risk of malnutrition. GDS had a significant negative dependence with the MNA for the entire sample (r=-0.58, p <0.0001). However, there was no significant correlation between age and GDS or MNA scores. Moreover, the mean GDS scores differed significantly between men and women (p <0.05), and women were more depressed than men (27.9% vs. 15%, respectively). The elderly subjects living in urban areas were more depressed than those living in rural areas (39.46% vs. 3.85% respectively). CONCLUSION The results of the present study revealed a high prevalence of depression and malnutrition among old subjects. Moreover, depression was associated with worsening of nutritional status. The mechanism of this association needs further study.
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Affiliation(s)
- Seyed Mehdi Ahmadi
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran,School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Keshavarzi
- Department of Epidemiology, Faculty of Health & Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hassan Joulaei
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yaser Sarikhani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Payam Peimani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Taghi Heydari
- Department of Biostatistics, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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75
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Dashti AS, Karimi A, Arjmand R, Moghadami M, Kheirkhah T, Shiva F, Gholinejad Z, Joulaei H. Serologic evidence of pertussis infection in vaccinated Iranian children. Iran J Med Sci 2012; 37:260-5. [PMID: 23390332 PMCID: PMC3565199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 04/14/2012] [Accepted: 05/20/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND It seems that the incidence of pertussis-like illnesses is considerably increasing despite the wide coverage of immunization with the whole cell pertussis vaccine. We aimed to investigate the occurrence of pertussis in vaccinated children by measuring anti-pertussis antibodies. METHODS In this cross-sectional study, blood samples were taken from vaccinated children aged 2, 4, 6, 12, 18, and 72 months. Anti-pertussis IgG and IgA were measured by ELISA. P<0.05 was considered significant. RESULTS 725 children were enrolled in the study. Geometric mean titers for IgG that showed a slight decease after 2 months of age and increased distinctly in children aged 72 months. The frequency of the individuals whose IgG was above the determined cut-off (derived from mean+2SD) was observed in 1% of the 2, 4, and 6-month-old infants, 6% of the 12 and 18-month-olds and 12% of the 6-year -old children. Positive IgA titers were detected in 5, 9, 6, 23, 11, and 8% of children aged 2, 4, 6, 12, 18, and 72 months, respectively. CONCLUSION Since a considerable percentage of children had high levels of anti-pertussis IgG antibodies (≥2 SD), positive anti-pertussis IgA, and most importantly an increased level of anti-pertussis IgG geometric mean titer at 6 years of age, further investigations regarding the protection provided by the presently used pertussis vaccine seems necessary.
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Affiliation(s)
- Anahita Sanaei Dashti
- Department of Pediatric Infectious Diseases, Pediatric Ward, Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Department of Pediatric Infectious Diseases, Pediatric Ward, Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Arjmand
- Department of Pediatrics, Pediatric Ward, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohsen Moghadami
- Vice-Chancellor for Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taherh Kheirkhah
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farideh Shiva
- Department of Pediatric Infectious Diseases, Pediatric Ward, Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zari Gholinejad
- Department of Pediatric Infectious Diseases, Pediatric Ward, Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Joulaei
- Vice-Chancellor for Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hatam N, Joulaei H, Kazemifar Y, Askarian M. Cost efficiency of the family physician plan in fars province, southern iran. Iran J Med Sci 2012; 37:253-9. [PMID: 23390331 PMCID: PMC3565198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 04/22/2012] [Accepted: 04/28/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND In recent years use of family physicians has been determined as a start point of health system reform to achieve more productive health services. In this study we aimed to assess the cost-efficiency of the implementation of this plan in Fars province, southern Iran. METHODS This cross-sectional descriptive study was done in 2007 in 18 provincial health centers as well as 224 rural health centers in Fars province. Data were collected using forms, statistics, and available evidence and analyzed by expert opinion and ratio techniques, control of process statistics, and multi indicator decision model. RESULTS Although in the family physician plan more attention is paid to patients and the level of health training, availability, and equity has improved and the best services are presented, it has not only decreased the costs, but also increased the referrals to pharmacies, laboratories, and radiology clinics and the costs of healthcare. CONCLUSION Although the family physician plan has led to more regular service delivery, it has increased the patients' referral to pharmacies, laboratories, and radiology centers and more referrals to family physicians. It seems that the possibility of setting regularity in health system can be gained in the following years of the family physician program mainly via planning, appropriate management and organizing correct health plans according to need assessments, and continual supervision on activities, which would happen according to current experiences in this plan.
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Affiliation(s)
- Nahid Hatam
- Department of Health Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Joulaei
- Department of Health Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yalda Kazemifar
- Office of Health System Research, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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77
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Joulaei H, Lankarani KB, Shahbazi M. Iranian and American health professionals working together to address health disparities in Mississippi Delta based on Iran's Health House model. Arch Iran Med 2012; 15:378-80. [PMID: 22642250 DOI: 012156/aim.0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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78
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Peymani P, Heydari ST, Hoseinzadeh A, Sarikhani Y, Hedjazi A, Zarenezhad M, Moafian G, Aghabeigi MR, Maharlouei N, Foroutan A, Ahmadi SM, Ghaffarpasand F, Joulaei H, Lankarani KB. Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey. Chin J Traumatol 2012. [PMID: 23069098 DOI: 10.3760/cma.j.issn.1008-1275.2012.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran. METHODS This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011. The data were from the Fars Forensic Medicine Registry. In 4 923 recorded road traffic accident fatalities, 971 deaths were due to pedestrian accidents. The demographic and accident-related information were analyzed by SPSS version 11.5. P value less than 0.05 was considered significant. RESULTS The mean age of decedents was (47.2+/-26.2) years, ranging from 6 months to 103 years old. Males accounted for 69.8% of all deaths. Fatal accidents were most common in September; 56.1% of the fatal injuries occurred on intracity roads and 33.1% on extracity roads. Fatal head injuries were present in 60.54% of cases. Evaluation of the injury site and the cause of death found that they were significantly associated with age, interval between injury and death. Besides, the type of roads played an important role in mortality. CONCLUSION Although the clinical management of trauma patients has been improved in our country in the recent decade, decreasing the burden of injuries needs coordination among trauma system organizations.
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Affiliation(s)
- Payam Peymani
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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79
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Heydari ST, Maharlouei N, Foroutan A, Sarikhani Y, Ghaffarpasand F, Hedjazi A, Zarenezhad M, Moafian G, Aghabeigi MR, Peymani P, Ahmadi SM, Dehghankhalili M, Joulaei H, Lankarani KB. Fatal motorcycle accidents in Fars Province, Iran: a community-based survey. Chin J Traumatol 2012. [PMID: 22863339 DOI: 10.3760/cma.j.issn.1008-1275.2012.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To identify the main characteristics of victims of motorcycle accidents in Fars Province, Iran. METHODS This cross-sectional study was conducted in Fars Province which has the fourth largest population of all 31 provinces in Iran from March 2009 to June 2010. We included data from all 542 recorded cases of fatalities due to motor vehicle accidents. Data were recorded from the forensic medicine registry consisting of demographic and accident-related information. Demographic information consisted of name, age, sex, status of fatal victim (motorcycle driver vs passenger) and educational level. RESULTS Of the 2 345 autopsy records from the forensic medicine archives, 542 (23.1%) gave the cause of death as motor vehicle accidents. Mean age of these victims was (31.4+/-6.5) years, and the male to female ratio was 28. Head injury was the most common cause of death in these victims, and overall they tended to have a low level of education. Motorcycle accidents frequently involved younger age groups (15-35 years), and head trauma related with non-use of a helmet was the most common cause of death. CONCLUSIONS Head injury is frequent among victims in the province we studied. This situation may be related to the victims' low socioeconomic status and little education regarding traffic laws leading to speeding and disregard of these laws along with their weak enforcement.
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Affiliation(s)
- Seyed Taghi Heydari
- Health Policy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Lankarani KB, Joulaei H. First international conference on school health: October 19-20, 2011, Shiraz, Iran. Arch Iran Med 2012; 15:526-7. [PMID: 22827794 DOI: 012158/aim.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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81
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Honarvar B, Moghadami M, Moattari A, Emami A, Tabatabaee HR, Jahromi BN, Asadi N, Mousavizadeh A, Lankarani KB, Joulaei H, Ghaffarpasand F. Titering of 2009 pandemic H1N1 influenza virus hemagglutinin inhibition antibody in nonvaccinated pregnant women in Shiraz, Southern Iran. Hum Vaccin Immunother 2012; 8:604-11. [PMID: 22634450 DOI: 10.4161/hv.19189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Influenza may cause severe complications for pregnant women. In this study antibody response against 2009 H1N1 influenza virus in pregnant women was investigated. This seroprevalance cross sectional and questionnaire based study was conducted using a convenient sampling method. Blood samples of pregnant women were checked for antibodies against 2009 H1N1 influenza virus using hemagglutination inhibition assay. An antibody titer level of ≥ 1:40 dilution was considered as the protective level. 167 (43.60%) of 383 pregnant women who participated in this study had protective antibody levels against this virus. 62 (35.63%) of 3rd trimester, 79 (46.74%) of 2nd trimester, and 21(52.50%) of 1st trimester pregnant women were immune respectively (χ2(for trend) = 8.20, p < 0.004). Lack of protective antibody level was significantly seen more in pregnant women of 3rd trimester of pregnancy (OR = 2.37, CI = 1.09-5.18). Pregnant women with higher education (OR = 1.67, CI = 1.02-2.73) and those with history of anemia (OR = 2.09, CI = 1.18-3.68) had more immunity. Older women (OR = 0.95, CI = 0.91-0.99) and those with history of psychological diseases (OR = 0.19, CI = 0.05-0.70) had less immunity. Vaccination of pregnant women, especially those who are in the higher trimesters of pregnancy, older, or less educated, against the 2009 H1N1 influenza virus should be continued.
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Affiliation(s)
- Behnam Honarvar
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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