1
|
Abbasi M, Zaim M, Moosazadeh M, Alizadeh M, Dorosti A, Khayatzadeh S, Nikookar SH, Raeisi A, Nikpoor F, Mirolyaie A, Hokmabad BN, Bazmani A, Kaveh F, Azimi S, Enayati A. Uncovering the knowledge gap: A web-based survey of healthcare providers' understanding and management of dengue fever in East Azerbaijan, Iran. PLoS One 2024; 19:e0305528. [PMID: 38905180 PMCID: PMC11192336 DOI: 10.1371/journal.pone.0305528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Dengue fever (DF) is increasingly recognized as one of the world's major mosquito-borne diseases and causes significant morbidity and mortality in tropical and subtropical countries. Appropriate and timely diagnosis and risk stratification for severe disease are crucial in the appropriate management of this illness. Healthcare providers (HCPs) play a key role in dengue fever diagnosis, management and prevention. The present study was conducted to determine the knowledge, attitudes and practices (KAP) among HCPs in East Azerbaijan Province, Iran. METHODS A cross-sectional survey among 948 HCPs, using a structured questionnaire, was conducted in East Azerbaijan Province from May to July 2022. Data analysis was undertaken using descriptive methods, the Chi-square test or Fisher's exact test, and logistic regression. A P-value <0.05 was considered for statistical significance. RESULTS Out of the 948 (68.5% female) respondents, 227 were physicians and 721 were health professionals. The knowledge level of DF was found to be largely inadequate in the present study population (80.4%). The physician vs. health professional were a significant factor in differentiating attitude scores. The mean practice score regarding DF prevention and control measures among respondents was 8.40±1.97. CONCLUSION The findings call for urgent continuous education and training courses to increase KAP levels and increased capacity and capability for DF prevention and control. This is of outmost importance for the first point of care of DF patients.
Collapse
Affiliation(s)
- Madineh Abbasi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Zaim
- Department of Medical Entomology & Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Moosazadeh
- Faculty of Health, Department of Medical Entomology and Vector Control, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
- Non-Communicable Disease Institute, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahasti Alizadeh
- Health Management and Safety Promotion Research Institute, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbasali Dorosti
- Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Simin Khayatzadeh
- Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Hassan Nikookar
- Faculty of Health, Department of Medical Entomology and Vector Control, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran
| | - Ahmad Raeisi
- Department of Medical Entomology & Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Vector Borne Diseases, Communicable Diseases Control, Ministry of Health, Tehran, Iran
| | - Fatemeh Nikpoor
- Department of Vector Borne Diseases, Communicable Diseases Control, Ministry of Health, Tehran, Iran
- Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Mirolyaie
- Department of Vector Borne Diseases, Communicable Diseases Control, Ministry of Health, Tehran, Iran
| | - Behrooz Naghili Hokmabad
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahad Bazmani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Kaveh
- Department of Vector Borne Diseases, Communicable Diseases Control, Ministry of Health, Tehran, Iran
| | - Somayeh Azimi
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmadali Enayati
- Department of Medical Entomology and Vector Control, School of Public Health and Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
2
|
Enayati A, Valadan R, Bagherzadeh M, Cheraghpour M, Nikookar SH, Fazeli-Dinan M, Hosseini-Vasoukolaei N, Sahraei Rostami F, Shabani Kordshouli R, Raeisi A, Nikpour F, Mirolyaei A, Bagheri F, Sedaghat MM, Zaim M, Weetman D, Hemigway J. Kdr genotyping and the first report of V410L and V1016I kdr mutations in voltage-gated sodium channel gene in Aedes aegypti (Diptera: Culicidae) from Iran. Parasit Vectors 2024; 17:34. [PMID: 38273349 PMCID: PMC10811842 DOI: 10.1186/s13071-024-06123-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/08/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Aedes aegypti is the main vector of arboviral diseases worldwide. The species invaded and became established in southern Iran in 2020. Insecticide-based interventions are primarily used for its control. With insecticide resistance widespread, knowledge of resistance mechanisms is vital for informed deployment of insecticidal interventions, but information from Iranian Ae. aegypti is lacking. METHODS Fifty-six Ae. aegypti specimens were collected from the port city of Bandar Lengeh in Hormozgan Province in the South of Iran in 2020 and screened for kdr mutations. The most common kdr mutations in Latin America and Asia (V410L, S989P, V1016G/I and F1534C), especially when present in combinations, are highly predictive of DDT and pyrethroid resistance were detected. Phylogenetic analyses based on the diversity of S989P and V1016G/I mutations were undertaken to assess the phylogeography of these kdr mutations. RESULTS Genotyping all four kdr positions of V410L, S989P, V1016G/I and F1534C revealed that only 16 out of the 56 (28.57%) specimens were homozygous wild type for all kdr mutation sites. Six haplotypes including VSVF (0.537), VSVC (0.107), LSVF (0.016), LSIF (0.071), VPGC (0.257) and LPGC (0.011) were detected in this study. For the first time, 11 specimens harbouring the V410L mutation, and 8 samples with V1016I mutation were found. V410L and V1016I were coincided in 8 specimens. Also, six specimens contained 1016G/I double mutation which was not reported before. CONCLUSIONS The relatively high frequency of these kdr mutations in Iranian Ae. aegypti indicates a population exhibiting substantial resistance to pyrethroid insecticides, which are used widely in control operations and household formulations. The detection of the 410L/1016I kdr mutant haplotype in Iranian Ae. aegypti suggests possible convergence of invasive populations from West Africa or Latin America. However, as Iran has very limited maritime/air connections with those African countries, a Latin American origin for the invasive Ae. aegypti in Iran is more plausible.
Collapse
Affiliation(s)
- Ahmadali Enayati
- Department of Medical Entomology and Vector Control, School of Public Health and Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Reza Valadan
- Department of Immunology and Molecular and Cellular Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahboobeh Bagherzadeh
- Department of Medical Entomology and Vector Control, School of Public Health, Student Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Cheraghpour
- Department of Medical Entomology and Vector Control, School of Public Health, Student Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hassan Nikookar
- Health Sciences Research Center, Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmoud Fazeli-Dinan
- Health Sciences Research Center, Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasibeh Hosseini-Vasoukolaei
- Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farzaneh Sahraei Rostami
- Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Razieh Shabani Kordshouli
- Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Raeisi
- Vector Borne Diseases Control Department, Iran CDC, Ministry of Health and Medical Education, Tehran, Iran
- Department of Medical Parasitology & Mycology, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nikpour
- Vector Borne Diseases Control Department, Iran CDC, Ministry of Health and Medical Education, Tehran, Iran
- Department of Environmental Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Mirolyaei
- Vector Borne Diseases Control Department, Iran CDC, Ministry of Health and Medical Education, Tehran, Iran
| | - Fatemeh Bagheri
- Hormozgan Provincial Health Center, Department of Communicable Diseases Control, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Mehdi Sedaghat
- Department of Medical Entomology and Vector Control, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Zaim
- Department of Medical Entomology and Vector Control, Tehran University of Medical Sciences, Tehran, Iran
| | - David Weetman
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Janet Hemigway
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|
3
|
Paquette SJ, Simon AY, XIII A, Kobinger GP, Shahhosseini N. Medically Significant Vector-Borne Viral Diseases in Iran. Microorganisms 2023; 11:3006. [PMID: 38138150 PMCID: PMC10745727 DOI: 10.3390/microorganisms11123006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Vector-borne viral diseases (VBVDs) continue to pose a considerable public health risk to animals and humans globally. Vectors have integral roles in autochthonous circulation and dissemination of VBVDs worldwide. The interplay of agricultural activities, population expansion, urbanization, host/pathogen evolution, and climate change, all contribute to the continual flux in shaping the epidemiology of VBVDs. In recent decades, VBVDs, once endemic to particular countries, have expanded into new regions such as Iran and its neighbors, increasing the risk of outbreaks and other public health concerns. Both Iran and its neighboring countries are known to host a number of VBVDs that are endemic to these countries or newly circulating. The proximity of Iran to countries hosting regional diseases, along with increased global socioeconomic activities, e.g., international trade and travel, potentially increases the risk for introduction of new VBVDs into Iran. In this review, we examined the epidemiology of numerous VBVDs circulating in Iran, such as Chikungunya virus, Dengue virus, Sindbis virus, West Nile virus, Crimean-Congo hemorrhagic fever virus, Sandfly-borne phleboviruses, and Hantavirus, in relation to their vectors, specifically mosquitoes, ticks, sandflies, and rodents. In addition, we discussed the interplay of factors, e.g., urbanization and climate change on VBVD dissemination patterns and the consequent public health risks in Iran, highlighting the importance of a One Health approach to further surveil and to evolve mitigation strategies.
Collapse
Affiliation(s)
- Sarah-Jo Paquette
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada;
| | - Ayo Yila Simon
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Ara XIII
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX 77555, USA; (A.X.); (G.P.K.)
| | - Gary P. Kobinger
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX 77555, USA; (A.X.); (G.P.K.)
| | - Nariman Shahhosseini
- Department of Biological Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada;
| |
Collapse
|
4
|
Nikookar SH, Moosazadeh M, Fazeli-Dinan M, Zaim M, Sedaghat MM, Enayati A. Knowledge, attitude, and practice of healthcare workers regarding dengue fever in Mazandaran Province, northern Iran. Front Public Health 2023; 11:1129056. [PMID: 37469697 PMCID: PMC10352843 DOI: 10.3389/fpubh.2023.1129056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
Background Dengue fever is a rapidly emerging infection worldwide with a high public health burden. Adequate training of healthcare workers is essential to warrant the timely provision of health services to improve the outcome of dengue management. Methods This is an analytical cross-sectional study, conducted to assess the knowledge, attitudes and practice (KAP) of healthcare workers regarding dengue from April 2021 to March 2022 in Mazandaran Province, northern Iran. Data was collected using a researcher-made structured questionnaire, prepared as Google Forms, and sent to target groups through social media and email. Data analysis was performed by SPSS 22 software using descriptive and inferential statistics (Chi-square) at a significant level of 5%. Results Most of the respondents had heard about dengue (83.8%); media (32.7%) and academic education (25%) were the main sources of information. Respondents had less knowledge associated with dengue symptoms (52%) than prevention and control (69%), transmission (72.2%) and clinical management (81%). Based on the 70% cut-off point, the majority of the participants had a good attitude (81%) and practice (73%). However, only 49.6% of the respondents showed good practice regarding dengue local transmission. A significant difference was observed between participants knowledge on clinical management with occupation; attitude with gender and occupation; and practice with gender (p < 0.05). Conclusion The results of this study revealed gaps in some dimensions of KAP in healthcare workers, therefore, a greater focus should be placed on future training programs to raise knowledge and attitude leading to sound practice and behavior for adequate management of dengue.
Collapse
Affiliation(s)
- Seyed Hassan Nikookar
- Health Sciences Research Center, Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmoud Fazeli-Dinan
- Health Sciences Research Center, Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Morteza Zaim
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Sedaghat
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadali Enayati
- Department of Medical Entomology and Vector Control, School of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
5
|
Hanafi-Bojd A, Sedaghat M, Omid F, Karimi M, Haghi S. Modelling the probability of presence of Aedes aegypti and Aedes albopictus in Iran until 2070. ASIAN PAC J TROP MED 2023. [DOI: 10.4103/1995-7645.368017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
|