1
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Raoofi A, Amirkhani M, Monjazeb M, Peykari N. The Slums in the Mirror of Health: A Systematic Review Analysis from Iran. Int J Prev Med 2022; 13:137. [PMID: 36618537 PMCID: PMC9811963 DOI: 10.4103/ijpvm.ijpvm_71_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/14/2021] [Indexed: 01/10/2023] Open
Abstract
Background One billion worldwide population is living in slum areas that mostly accompanied with high rates of poverty, illiteracy, unemployment, unhealthy situation, and inappropriate health-care services. The prediction of enormous growth of slums by 2030 led to a raise to address the "plight of slums" in Sustainable Development Goals (SDGs). Methods To address evidence-based health-related priorities, we conducted a systematic review to summarizing evidences on health situations of slums population in Iran. Six electronic databases were systematically searched for published studies without any restriction on age, sex, and language to assess health situations of slums in Iran reported by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. All identified articles were screened, quality assessed, and data extracted by two authors independently. Results The finding of this systematic review in addition to overall view categorized in five categories: health system, reproductive health, infectious diseases, noncommunicable diseases and their risk factors, social issues besides overall situation of Slums. Conclusions Community-based participatory interventions with socioeconomic approach on modifiable risk factors; active response of health system; establishment new health care centers in slum areas; augmenting the quality of care; active case finding; and elevating health knowledge, attitude, and practice is crucial to achieve SDG's in Slum area.
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Affiliation(s)
- Azam Raoofi
- Ph.D. Student of Health Policy, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Manzar Amirkhani
- Ph.D., Ministry of Health and Medical Education, Shahid Beheshty University, Tehran, Iran
| | - Maryam Monjazeb
- MSc of Landscape Architecture, Shahid Beheshty University, Tehran, Iran
| | - Niloofar Peykari
- Ph.D. of Epidemiology, Associate Professor, Ministry of Health and Medical Education, Tehran, Iran,Address for correspondence: Dr. Niloofar Peykari, Associate Professor, Epidemiology, Ministry of Health and Medical Education, Tehran, Iran. Ministry of Health and Medical Education, Eyvanak St, Qods Town, Tehran, Iran. E-mail:
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2
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Poortaheri N, Alimohammadzadeh K, Hosseini SM, Maher A, Bahadori M. A health service package for residents of informal settlements: A developing country. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2105886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Naeimeh Poortaheri
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Khalil Alimohammadzadeh
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Seyed Mojtaba Hosseini
- Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Maher
- Department of Health Policy, School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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3
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Poortaheri N, Alimohammadzadeh K, Hosseini SM, Maher A, Bahadori M. Health needs assessment of the residents of the informal settlements in South-Eastern Iran: A case study of Bam city. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:239. [PMID: 34395676 PMCID: PMC8318141 DOI: 10.4103/jehp.jehp_1448_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/12/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Informal settlements are considered as one of the social problems in societies. As the residents do not have adequate access to basic services, including health services, their health is at risk. This study was conducted to evaluate the access to health services and determine the health needs of informal settlements in Bam city. MATERIALS AND METHODS This cross-sectional study was carried out in the spring of 2020 in Bam. The sample size was 400 residents of informal settlements in Bam, and the multi-stage random cluster sampling was used. A researcher-made questionnaire was used to collect the required data. The validity of the questionnaire was confirmed using the content validity, and its reliability was 85% by Cronbach's alpha. The data were analyzed using the SPSS version 23 software and descriptive statistics (frequency, mean, standard deviation, and percentage) as well as analytical statistics (Mann-Whitney and Kruskal-Wallis tests). RESULTS More than 50% of the individuals had good access to general practitioners and health centers. However, over 50% had poor access to dental, para-clinical, specialist, and hospital services. Furthermore, 49.3% of the people assessed their health status as poor in the previous year. A total of 46 items in the areas of communicable and non-communicable diseases, women's health, mental and social health and addiction, environmental health, etc., were identified as the most important health needs of the informal settlement residents. CONCLUSION Informal settlements are facing various health problems including environmental health, mental and social health, and addiction, meeting which requires collaboration of all stakeholders as well as provision of a comprehensive program and appropriate service packages.
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Affiliation(s)
- Naeimeh Poortaheri
- PhD Student in Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Khalil Alimohammadzadeh
- Associate Professor, Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran/Health Economics Policy Research Center, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Seyed Mojtaba Hosseini
- Assistant Professor, Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Maher
- Assistant Professor, Department of Health Policy, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadkarim Bahadori
- Full Professor, Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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4
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SeyedAlinaghi S, Taj L, Mazaheri-Tehrani E, Ahsani-Nasab S, Abedinzadeh N, McFarland W, Mohraz M, Mirzazadeh A. HIV in Iran: onset, responses, and future directions. AIDS 2021; 35:529-542. [PMID: 33252485 PMCID: PMC7924262 DOI: 10.1097/qad.0000000000002757] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Iran, a country in the Middle East and North Africa (MENA) region, has been actively involved in the fight against HIV/AIDS over the past three decades. The unique features of the HIV epidemic in Iran are reflected by the modes of transmission and its recent changes to improve management and prevention programs. In this review, we recount the initial onset and subsequent spread of HIV infection in Iran, beginning with the first case diagnosed to the ongoing responses and most recent achievements in controlling this epidemic. Although in the MENA region, Iran is one of the pioneers in implementing pertinent policies including harm reduction services to decrease HIV incidence, drug injection still continues to be the major risk of infection. In line with other nations, the programs in Iran aim at the UNAIDS 90-90-90 targets (UNAIDS 90-90-90 global targets to end the AIDS epidemic by 2020: by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression) and to eliminate mother-to-child HIV transmission. In this article, we discuss the strengths and shortcomings of the current HIV programs and offer suggestions to provide a better perspective to track and respond to the HIV epidemic. More generally, our account of the national religious and cultural circumstances as well as obstacles to the approaches chosen can provide insights for decision-makers in other countries and institutions with comparable settings and infrastructures.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mazaheri-Tehrani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ahsani-Nasab
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Abedinzadeh
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Willi McFarland
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, USA
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, USA
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
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5
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Najafi Z, Taj L, Dadras O, Ghadimi F, Moradmand B, SeyedAlinaghi S. Epidemiology of HIV in Iran. Curr HIV Res 2020; 18:228-236. [PMID: 32503409 DOI: 10.2174/1570162x18666200605152317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/27/2020] [Accepted: 05/06/2020] [Indexed: 02/08/2023]
Abstract
:
Iran has been one of the active countries fighting against HIV/AIDS in the Middle East
during the last decades. Moreover, there is a strong push to strengthen the national health management
system concerning HIV prevention and control. In Iran, HIV disease has its unique features,
from changes in modes of transmission to improvement in treatment and care programs, which can
make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from
the first case diagnosed until prevention among different groups at risk and co-infections. Not only
we addressed the key populations and community-based attempts to overcome HIV-related issues in
clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to
HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific
characteristics, and despite all the national efforts along with other countries in this region,
Iran still needs to take extra measures to reduce HIV transmission, especially in health education.
Although Iran is one of the pioneers in implementing applicable and appropriate policies in the
MENA region, including harm reduction services to reduce HIV incidence, people with substance
use disorder continue to be the majority of those living with HIV in the country. Similar to other
countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate
HIV infection and reduce the transmission, especially the mother-to-child transmission and
among other key populations.
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Affiliation(s)
- Zeinab Najafi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Dadras
- Department of Health Informatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fatemeh Ghadimi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
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6
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Nakhaeizadeh M, Abdolahinia Z, Sharifi H, Mirzazadeh A, Haghdoost AA, Shokoohi M, Baral S, Karamouzian M, Shahesmaeili A. Opioid agonist therapy uptake among people who inject drugs: the findings of two consecutive bio-behavioral surveillance surveys in Iran. Harm Reduct J 2020; 17:50. [PMID: 32698875 PMCID: PMC7373839 DOI: 10.1186/s12954-020-00392-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/26/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Opioid agonist therapy (OAT) uptake has been associated with multiple positive health outcomes among people who inject drugs (PWID). This study evaluated the pattern of OAT uptake among PWID in two consecutive national bio-behavioral surveillance surveys (2010 and 2014) in Iran. METHODS Data were obtained from two national bio-behavioral surveillance surveys (N2010 = 1783 and N2014 = 2166) implemented using convenience sampling at the harm reduction facilities and street venues in 10 geographically diverse urban centers across Iran. Multivariable logistic regression models were built to determine the correlates of OAT uptake for the 2014 survey, and adjusted odds ratios (AORs) along with 95% confidence intervals (CI) were reported. RESULTS The prevalence of OAT uptake decreased from 49.2% in 2010 to 45.8% in 2014 (P value = 0.033). OAT uptake varied across the studied cities ranging from 0.0 to 69.3% in the 2010 survey and 3.2 to 75.5% in the 2014 survey. Ever being married (AOR = 1.40; 95% CI 1.12, 1.75), having a history of incarceration (AOR = 1.56; 95% CI 1.16, 2.09), and human immunodeficiency virus (HIV) sero-positivity (AOR = 1.63; 95% CI 1.08, 2.50) were associated with OAT uptake. Conversely, PWID who reported using only non-opioid drugs (AOR = 0.43; 95% CI 0.26, 0.71) and those who reported concurrent use of opioid and non-opioid drugs (AOR = 0.66; 95% CI 0.51, 0.86) were less likely to uptake OAT. CONCLUSIONS Although OAT uptake among PWID in Iran is above the 40% threshold defined by the World Health Organization, there remain significant disparities across urban settings in Iran. Importantly, the OAT services appear to be serving high-risk PWID including those living with HIV and those with a history of incarceration. Evaluating service integration including mental health, HIV and hepatitis C virus care, and other harm reduction services may support the optimization of health outcomes associated with OAT across Iran.
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Affiliation(s)
- Mehran Nakhaeizadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, 7616913555, Iran
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616913555, Iran
| | - Zahra Abdolahinia
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, 7616913555, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616913555, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Haftbagh Highway, Kerman, 7616913555, Iran.
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7
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Mahmud S, Mumtaz GR, Chemaitelly H, Al Kanaani Z, Kouyoumjian SP, Hermez JG, Abu‐Raddad LJ. The status of hepatitis C virus infection among people who inject drugs in the Middle East and North Africa. Addiction 2020; 115:1244-1262. [PMID: 32009283 PMCID: PMC7318323 DOI: 10.1111/add.14944] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/14/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS People who inject drugs (PWID) are a key population at high risk of hepatitis C virus (HCV) infection. The aim of this study was to delineate the epidemiology of HCV in PWID in the Middle East and North Africa (MENA). METHODS Syntheses of data were conducted on the standardized and systematically assembled databases of the MENA HCV Epidemiology Synthesis Project, 1989-2018. Random-effects meta-analyses and meta-regressions were performed. Meta-regression variables included country, study site, year of data collection and year of publication [to assess trends in HCV antibody prevalence over time], sample size and sampling methodology. Numbers of chronically infected PWID across MENA were estimated. The Shannon Diversity Index was calculated to assess genotype diversity. RESULTS Based on 118 HCV antibody prevalence measures, the pooled mean prevalence in PWID for all MENA was 49.3% [95% confidence interval (CI) = 44.4-54.1%]. The country-specific pooled mean ranged from 21.7% (95% CI = 4.9-38.6%) in Tunisia to 94.2% (95% CI = 90.8-96.7%) in Libya. An estimated 221 704 PWID were chronically infected, with the largest numbers found in Iran at 68 526 and in Pakistan at 46 554. There was no statistically significant evidence for a decline in HCV antibody prevalence over time. Genotype diversity was moderate (Shannon Diversity Index of 1.01 out of 1.95; 52.1%). The pooled mean percentage for each HCV genotype was highest in genotype 3 (42.7%) and in genotype 1 (35.9%). CONCLUSION Half of people who inject drugs in the Middle East and North Africa appear to have ever been infected with hepatitis C virus, but there are large variations in antibody prevalence among countries. In addition to > 200 000 chronically infected current people who inject drugs, there is an unknown number of people who no longer inject drugs who may have acquired hepatitis C virus during past injecting drug use. Harm reduction services must be expanded, and innovative strategies need to be employed to ensure accessibility to hepatitis C virus testing and treatment.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Ghina R. Mumtaz
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Epidemiology and Population Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar
| | - Joumana G. Hermez
- Department of Communicable Diseases, HIV/Hepatitis/STIs Unit, World Health Organization,Regional Office for the Eastern MediterraneanCairoEgypt
| | - Laith J. Abu‐Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine‐QatarCornell University, Qatar Foundation, Education CityDohaQatar,Department of Healthcare Policy and Research, Weill Cornell MedicineCornell UniversityNew YorkNY, USA,College of Health and Life SciencesHamad bin Khalifa UniversityDohaQatar
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8
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Rezaei-Mojaz S, Nazmara Z, Najafi M, Movahedin M, Zandieh Z, Shirinbayan P, Roshanpajouh M, Asgari HR, Abbasi M, Koruji M. Evaluation of Enkephalin-Degrading Enzymes in Sperm from Heroin-Addicted Men. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:301-306. [PMID: 31710191 PMCID: PMC6875862 DOI: 10.22074/ijfs.2020.5817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 06/09/2019] [Indexed: 12/13/2022]
Abstract
Background The aim of this study was to investigate two enkephalin-degrading enzymes, aminopeptidase N (APN/
CD13) and endopeptidase (NEP/CD10), gene and protein expression levels in sperm samples of fertile and heroin-
addicted men, and the correlation between their expressions and semen quality. Materials and Methods In this case-controlled study, semen was collected from 24 normozoospermic healthy
(as a control group) and 24 heroin-addicted men donors (as case or addiction group). Sperm cells isolated by Cook
Medical gradient (40-80%) and followed up by swim-up techniques were used for real-time quantitative polymer-
ase chain reaction (qPCR) and flow cytometry techniques to assess APN/CD13 and NEP/CD10 genes and proteins
subsequently. Semen parameters were analyzed by computer-assisted sperm analysis. Results The findings revealed that there were significant differences in sperm total motility (41.07 ± 3.63 vs. 63.03
± 3.31 %, P=0.0001), progressive motility (35.21 ± 2.64 vs. 20.93 ± 3.22%, P=0.001) and viability (69.9 ± 4.69 vs.
86.81 ± 1.26 %, P=0.002) in the addicted group vs. control ones. APN and NEP gene expression levels in the addicted
group decreased compared with the control ones (1.00 ± 0.67 vs. 0.36 ± 0.13, P= 0.008 and 1.07 ± 0.11 vs. 0.52 ± 0.12
0.002, respectively). Flow cytometry analysis showed that the average percent of APN/CD13 in heroin consumers
significantly decreased compared with the healthy ones, while NEP/CD10 rate between two groups was similar. We
also observed that duration of drug dependence is correlated with sperm viability (r=-0.627, P=0.016) and motility
(r=-0.410, P=0.05), NEP (r=-0.434, P= 0.049), and APN (r=-0.641, P=0.002) gene expression levels. Conclusion We conclude that semen quality and enkephalin-degrading enzymes were altered in heroin-addicted men.
other confirming the internal validity of our estimates.
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Affiliation(s)
- Samira Rezaei-Mojaz
- Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Nazmara
- Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Najafi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Movahedin
- Anatomical Sciences Department, School of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Zahra Zandieh
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Peymaneh Shirinbayan
- Pediatric Neuro-Rehabilitation Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Roshanpajouh
- School of Behavioral Sciences and mental Health, Tehran Psychiatry Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Asgari
- Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Koruji
- Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic Address:
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9
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Asadollahi A, Najafi A. Do risk factors increase measurement of hepatitis B, C signs and HIV-AIDS among middle-aged and older IDUs in southwest Iran? DRUGS AND ALCOHOL TODAY 2019. [DOI: 10.1108/dat-05-2018-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Injecting drug use addiction is a main factor in hepatitis B, C infection and HIV–AIDS infection. The purpose of this paper is to measure seroprevalence of hepatitis B, C virus and HIV–AIDS amongst injecting drug users (IDUs) and its influencing factors.
Design/methodology/approach
The cross-sectional method was used in mid-2017 in Ahwaz city, southwest Iran. In total, 133 IDUs, aged 29–71 years (mean age=48.21 ± 10.4), were chosen from Aria addiction treatment centre. The data were collected on demographic and behavioural characteristics. In addition, serum samples were screened for those diseases.
Findings
In a total of 131 IDUs, 2 (1.5 per cent) were HIV+, 16 (11.7 per cent) HCV+ and 8 (6.1 per cent) HBV+. There was a significant correlation between diseases and IDU. Results of multiple regression stated that IDU was a more predicting variable as β=0.76 and the model was able to predict 74.1 per cent of the variance, F (3, 35)=12.42, ρ<0.001, R2=0.741, OR=3.01, 95% CI [1.44, 3.83]. The synchronised pairwise effect of age, imprisonment and IDU with GLM analysis was significant, F (2, 114)=20.433, ρ<0.000,
η
HCV
+
2
=
0.609
,
η
HBV
+
2
=
0.616
, and
η
HCV
+
2
=
0.612
, λWilks’=0.056. The infection rate among IDUs was significant and the most important risk factor for these infections has been intravenous drug use, together with age of misusing and imprisonment.
Research limitations/implications
The non-cooperation of two samples, lack of participation of three addiction rehabilitation centres in Ahwaz city, the end of cooperation in the first two months of the implementation of the plan, and the lack of consistency of the three serum samples in the cases (two cases) were limitations of the study.
Practical implications
Based on the results, the following suggestions could be presented: establishing “Intervention Clubs” for treatment in the peripheral urban areas for the participation of women drug users – the responsible organisation is Cultural and Social Deputy of Ahwaz Municipality Organisation. Integration of “Small Self-caring Groups” in Sepidar Women’s Penitentiary in the East Ahwaz region – the responsible organisation is Khuzistan Province Prisons Organisation (the southwestern Iranian prisons authority); constructing “Community-based Committees” to increase the level of social intervention – the responsible organisation is the Iran Drug Control Headquarters at Iranian Presidential Office; screening of injecting drug use in the populations at risk, especially girls and women in marginalised areas – the responsible organisation is Deputy Director of Prevention and Treatment of Addiction in the Iran Welfare and Rehabilitation Organisation; establishing an “Patient Treatment Center” in high-risk areas along with directing drug users and supervising the relevant authorities – the responsible organisation is Deputy Police Commander on Social Assistance; providing education to families involved with addiction in the “Neighborhood Parks” – the responsible organisation is Deputy for Health Affairs.
Social implications
They are mixed with practical implications as well.
Originality/value
The comprehensive harm reduction plan and prison-related issues of IDUs with shared syringe along with the pairwise age and imprisonment need to consider the above factors.
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Bastani P, Marshall BD, Rahimi-Movaghar A, Noroozi A. The risk environments of people who use drugs accessing two harm reduction centers in Tehran, Iran: A qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:90-96. [DOI: 10.1016/j.drugpo.2018.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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11
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Nematollahi S, Ayubi E, Almasi-Hashiani A, Mansori K, Moradi Y, Veisani Y, Jenabi E, Gholamaliei B, Khazaei S. Prevalence of hepatitis C virus infection among high-risk groups in Iran: a systematic review and meta-analysis. Public Health 2018; 161:90-98. [PMID: 29935474 DOI: 10.1016/j.puhe.2018.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/12/2017] [Accepted: 04/18/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Determination of the true burden of hepatitis C virus (HCV) infection among high-risk groups relies heavily on occurrence measures such as prevalence, which are vital for implementation of preventive action plans. Nevertheless, up-to-date data on the prevalence of HCV infection remain scarce in Iran. This study aimed to review the relevant literature systematically and determine the pooled prevalence of HCV infection among high-risk groups in Iran. STUDY DESIGN Systematic review & meta-analysis. METHODS In 2016, electronic scientific databases including PubMed, Scopus, Web of Science and local databases were searched using a detailed search strategy with language restricted to English and Farsi. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. RESULTS In total, 1817 records were identified in the initial search, and 46 records were included in the meta-analysis. The overall prevalence of HCV among high-risk groups was 32.3%. The prevalence was 41.3% in injection drug users (IDUs), 22.9% in prisoners, 16.2% in drug-dependent individuals and 24.6% in drug-dependent prisoners. Subgroup and meta-regression analyses revealed that geographical location and year of publication were the probable sources of heterogeneity. CONCLUSION This meta-analysis found a high prevalence of HCV among high-risk groups in Iran, particularly among IDUs. There is a need for prevention strategies to reduce the burden of HCV infection among high-risk groups, particularly IDUs.
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Affiliation(s)
- S Nematollahi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - E Ayubi
- Department of Community Medicine, School of Medicine, Zahedan University of Medical sciences, Zahedan, Iran
| | - A Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - K Mansori
- School of Public Health, Dezful University of Medical Sciences, Dezful, Iran; Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Y Moradi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Y Veisani
- Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran
| | - E Jenabi
- Pediatric developmental disorders Research center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - B Gholamaliei
- Department of Health Education, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - S Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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Mahmud S, Akbarzadeh V, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses. Sci Rep 2018; 8:150. [PMID: 29317673 PMCID: PMC5760657 DOI: 10.1038/s41598-017-18296-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/07/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to characterize hepatitis C virus (HCV) epidemiology in Iran and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed and synthesized reports of HCV incidence and/or prevalence, as informed by the Cochrane Collaboration Handbook, and reported our findings following the PRISMA guidelines. DerSimonian-Laird random effects meta-analyses were implemented to estimate HCV prevalence in various risk populations. We identified five HCV incidence and 472 HCV prevalence measures. Our meta-analyses estimated HCV prevalence at 0.3% among the general population, 6.2% among intermediate risk populations, 32.1% among high risk populations, and 4.6% among special clinical populations. Our meta-analyses for subpopulations estimated HCV prevalence at 52.2% among people who inject drugs (PWID), 20.0% among populations at high risk of healthcare-related exposures, and 7.5% among populations with liver-related conditions. Genotype 1 was the most frequent circulating strain at 58.2%, followed by genotype 3 at 39.0%. HCV prevalence in the general population was lower than that found in other Middle East and North Africa countries and globally. However, HCV prevalence was high in PWID and populations at high risk of healthcare-related exposures. Ongoing transmission appears to be driven by drug injection and specific healthcare procedures.
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Affiliation(s)
- Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Vajiheh Akbarzadeh
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA.
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Koozegar M, Shahesmaeili A, Noroozi M. Transition from First Drug Use to Regular Injection among People Who Inject Drugs in Iran. ADDICTION & HEALTH 2018; 10:32-40. [PMID: 30627383 PMCID: PMC6312558 DOI: 10.22122/ahj.v10i1.458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/19/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The study aimed to evaluate the interval between first drug use and regular injection and factors associated with transition from first injection into premature regular injection among people who inject drugs (PWIDs). METHODS In a multicenter cross-sectional study, we recruited 400 PWIDs using snowball sampling. Age of first drug use, age of initiation of regular injection, and demographic and behavioral data were collected using face to face interview. Premature transition to regular injection was defined as initiation of regular injection within the five years of first injection. Data were analyzed using bivariate and multivariate logistic regression survey analysis. FINDINGS The mean age of first drug use and age of initiation of regular injection was 29.87 ± 6.54 years, respectively. Having history of sexual abuse in childhood [adjusted odds ratio (AOR) = 3.1], history of imprisonment (AOR = 3.4), use of heroin as the first drug (AOR = 4.3), and doing the first injection at friends' houses (AOR = 2.2) or in ruins (AOR = 2.2) significantly increased the chance of premature transition to regular injection, while being a female decreased the chance of premature transition to regular injection (AOR = 0.4). Compared to curiosity, being friend with a drug user (AOR = 0.4), having withdrawal symptoms (AOR = 0.2), and low cost of injection (AOR = 0.3) at the first occasion of drug injection reduced the chance of premature transition to regular injection. CONCLUSION New interventions to prevent injection initiation among drug users are needed and should be integrated in harm reduction programs.
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Affiliation(s)
- Masoomeh Koozegar
- MSc Student, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- Assistant Professor, HIV/STI Surveillance Research Center AND WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Noroozi
- Assistant Professor, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Sharbafchi MR, Heydari M. Management of Substance Use Disorder in Military Services: A Comprehensive Approach. Adv Biomed Res 2017; 6:122. [PMID: 28989915 PMCID: PMC5627564 DOI: 10.4103/abr.abr_283_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Historically, substance misuse has been a serious problem faced by worldwide military personnel. Some research showed that military personnel have higher rates of unhealthy substance use than their age peers in the general population. These problems have serious consequences and may lead to significant military difficulties in the field of readiness, discipline, and mental or physical health. In this review, we gathered various methods for prevention, diagnosis, and treatment of substance use disorders and suggested a comprehensive plan for Iran Armed Forces to improve existing services. MATERIALS AND METHODS This article is a narrative review study, which was carried out on 2016. A careful literature review was performed between January 1970 and April 2016 on several national and international databases. Articles were screened according to the following inclusion criteria: (1) review articles about prevention and treatment protocols, (2) executive guidance, (3) cohort articles about risk factors of addiction, and (4) randomized controlled trials about prevention or treatment of substance use disorders in army service members. After screening by title and abstract, 130 articles selected of 832 founded articles, and after quality assessment, finally, 63 articles included in the review. RESULTS There is a necessity to manage substance use disorder through prevention, screening, and then referral to proper services for diagnosis and treatment. Urinalysis programs for screening are cost-effective and should be considered as a main method. Effective treatment includes both behavioral and pharmacological methods. CONCLUSIONS The ideal prevention program will include multiple and mutually reinforcing evidence-based universal, selective, and indicated attempts at both the individual and environmental levels. The implementation of screening and treatment strategies needs strict rules and national guideline for the comprehensive management of substance use disorders in army.
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Affiliation(s)
- Mohammad Reza Sharbafchi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Heydari
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Baqiyatallah Hospital, Tehran, Iran
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Rezaei M, Hatami SE, Hojjat SK, Rahimi A, Ein Beigi E. Demographic background and dangerous behaviors of heroin-addicted patients under maintenance treatment in the North East of Iran (North Khorasan province). JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1378740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mahdi Rezaei
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Seyed Esmaeil Hatami
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Seyed Kaveh Hojjat
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Ahmad Rahimi
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Elahe Ein Beigi
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Mohammadzadeh E, Amjadi FS, Movahedin M, Zandieh Z, Nazmara Z, Eslahi N, Shirinbayan P, Asgari HR, Azad N, Salimi M, Koruji M. In vitro development of embryos from experimentally Kerack-addicted Mice. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.7.413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lindbom SJA, Larsson M, Agardh A. The naked truth about HIV and risk taking in Swedish prisons: A qualitative study. PLoS One 2017; 12:e0182237. [PMID: 28759572 PMCID: PMC5536296 DOI: 10.1371/journal.pone.0182237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 07/12/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This qualitative study explores former prison inmates' perceptions and attitudes towards HIV risk inside Swedish prisons. METHOD In 2014, eight semi-structured interviews were conducted with former male prisoners to gain a deeper understanding of situations perceived to be associated with risk of HIV transmission. The material gathered from the interviews was analyzed by manifest and latent qualitative content analysis. RESULTS The findings revealed that risky behavioral practices, such as sharing needles, unprotected sexual activity, and lack of openness about HIV status represented potential health threats with regard to the risk of HIV transmission. CONCLUSIONS Evidence from the study indicates that educational interventions regarding HIV and the transmission routes are required for HIV prevention in Swedish prisons.
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Affiliation(s)
- Sigrid J. A. Lindbom
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Markus Larsson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
- * E-mail:
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Farooq SA, Rasooly MH, Abidi SH, Modjarrad K, Ali S. Opium trade and the spread of HIV in the Golden Crescent. Harm Reduct J 2017; 14:47. [PMID: 28732503 PMCID: PMC5521118 DOI: 10.1186/s12954-017-0170-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/22/2017] [Indexed: 11/10/2022] Open
Abstract
The Golden Crescent region of South Asia-comprising Afghanistan, Iran, and Pakistan-is a principal global site for opium production and distribution. Over the past few decades, war, terrorism, and a shifting political landscape have facilitated an active heroin trade throughout the region. Protracted conflict has exacerbated already dire socio-economic conditions and political strife within the region and contributed to a consequent rise in opiate trafficking and addiction among the region's inhabitants. The worsening epidemic of injection drug use has paralleled the rising incidence of HIV and other blood-borne infections in the region and drawn attention to the broader implications of the growing opiate trade in the Golden Crescent. The first step in addressing drug use is to recognize that it is not a character flaw but a form of mental illness, hence warranting humane treatment of drug users. It is also recommended that the governments of the Golden Crescent countries encourage substitution of opium with licit crops and raise awareness among the general public about the perils of opium use.
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Affiliation(s)
| | | | - Syed Hani Abidi
- Aga Khan University, Karachi, Pakistan.,Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kayvon Modjarrad
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
| | - Syed Ali
- Department of Biomedical Sciences, Nazarbayev School of Medicine, Nazarbayev University, Astana, Kazakhstan. .,Dow University of Health Sciences, Karachi, Pakistan.
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In vitro development of embryos from experimentally Kerack-addicted Mice. Int J Reprod Biomed 2017; 15:413-422. [PMID: 29177242 PMCID: PMC5601932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Prenatal drug exposure, as a common public health concern, is associated with an increased risk of adverse effects on early embryo development. OBJECTIVE To investigate the in vitro development of - embryo from experimentally Kerack-addicted mice. MATERIALS AND METHODS Twenty-five female mice were studied in five groups: control, vehicle, and three experimental groups of Kerack-dependent mice (I, II, and III) which received different doses of Kerack for 14 days. After the establishment of addiction model (7 days), experimental groups I, II, and III were given Kerack intraperitoneally at the doses of 5, 35, and 70 mg/kg, twice a day for a period of 7 days, respectively. The vehicle group received normal saline and lemon juice whilst the control group just received water and food. Morulae were obtained through oviduct flashing. The survived embryos were cultured in T6+ 5mg/ml bovine serum albumin. The developmental rates up to hatched stage daily and embryo quality (differential staining and Tunnel staining) were also assessed. RESULTS The developmental potential of embryos obtained from the addicted mother was significantly decreased in comparison with control group. There was a significant reduction in the rate of blastocyst formation in the high dose Kerack dependent group. However, in addicted mice there was reduction in the total cell number (40.92% vs. 65.08% in control) and, inner cell mass percentage (17.17% vs. 26.15% in control) while apoptotic cells numbers were increased (7.17 vs. 1.46 in control) (p<0.05). CONCLUSION The Kerack addiction during pregnancy retards preimplantation development and induces apoptosis.
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Boroumandfar Z, Kianpour M, Zargham A, Abdoli S, Tayeri K, Salehi M, Momeni G, Khorvash F. Changing Beliefs and Behaviors Related to Sexually Transmitted Diseases in Vulnerable Women: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:303-307. [PMID: 28904544 PMCID: PMC5590361 DOI: 10.4103/ijnmr.ijnmr_117_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The first step in health education is awareness of the people and their acceptance to change their behavior. Therefore, the aim of this study was to investigate the effects of empowerment program towards the concept of self-care and prevention of sexually transmitted diseases (STDs) in women at risk of STDs. MATERIALS AND METHODS The present study was conducted as a qualitative approach (step of action and observation of an action) by using conventional content analysis method. An empowerment program regarding STDs (Action) was performed among 32 (with convenient sample) drug user women with addicted husbands referring to the counseling center for vulnerable women (drop in enter) in Isfahan in 2015. The knowledge of quiddity, transmission, and prevention of STDs, as well as some items of life skills such as self-awareness, interpersonal communication, and assertive behavior were taught in an educational program. Teaching methods were lectures, group, and individual training and role play. The impact of the program on modified belief and behavior change regarding STDs was evaluated with structured interviews. RESULTS Analysis of the obtained results yielded three categories. The categories were awareness of STD, believing in being at risk, and decision and change. CONCLUSIONS Promoting self-care and prevention through education programs based on action research can make a significant reduction in the incidence of problems and cause a behavior change in women with the disease or those at risk for STDs.
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Affiliation(s)
- Zahra Boroumandfar
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Kianpour
- Department of Social Sciences, Isfahan University, Isfahan, Iran
| | - Ali Zargham
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samereh Abdoli
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Katayoun Tayeri
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Salehi
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Godratollah Momeni
- Department of Islamic Studies, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Bokharaei-Salim F, Keyvani H, Esghaei M, Zare-Karizi S, Dermenaki-Farahani SS, Hesami-Zadeh K, Fakhim S. Prevalence of occult hepatitis C virus infection in the Iranian patients with human immunodeficiency virus infection. J Med Virol 2016; 88:1960-6. [PMID: 27463051 DOI: 10.1002/jmv.24474] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 12/23/2022]
Abstract
Occult hepatitis C virus (HCV) infection is a new form of chronic HCV infection described by the presence of the genomic HCV-RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) samples, and undetectable levels or absence of HCV-RNA and in the absence or presence of anti HCV antibodies in the plasma specimens. The aim of the present study was to evaluate the occurrence of occult HCV infection (OCI) among Iranian subjects infected with human immunodeficiency virus (HIV) using RT-nested PCR. From March 2014 until April 2015, 109 Iranian patients with established HIV infection were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV-RNA status was examined by RT-nested PCR using primers from the 5'-NTR. HCV genotyping was conducted using RFLP analysis. For the confirmation of HCV genotyping by RFLP method, the PCR products were sequenced. Of the 109 patients, 50 were positive for antibodies against HCV. The HCV-RNA was detected in PBMC specimens in 6 (10.2%) out of the total 59 patients negative for anti-HCV Abs and undetectable plasma HCV-RNA and also from 4 (8.0%) out of the total 50 patients positive for anti-HCV Abs and undetectable plasma HCV-RNA. HCV genotyping analysis showed that 6 (60.0%) patients were infected with HCV subtype 3a, 3 (30.0%) were infected with HCV subtype 1a and 1 (10.0%) patient was infected with HCV subtype 1b. This study revealed the incidence of OCI (9.2%) in HIV-infected Iranian patients. Hence, designing prospective studies focusing on the detection of OCI in these patients would provide more information. J. Med. Virol. 88:1960-1966, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Farah Bokharaei-Salim
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran.,HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Esghaei
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Shohreh Zare-Karizi
- Department of Genetic, Islamic Azad University, Varamin Pishva Branch, Tehran, Iran
| | | | | | - Shahin Fakhim
- Faculty of Engineering, Department of Civil Engineering, Payame Noor University, Karaj, Iran
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Willingness to Receive Treatment for Hepatitis C among Injecting Drug Users on Methadone Program: Implications for Education and Treatment. ADDICTION & HEALTH 2016; 8:90-97. [PMID: 27882206 PMCID: PMC5115642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is common among people who inject drugs (PWID) on methadoneprogram in Iran (Persia). However, a few PWID on methadone program report willingness to receive HCVtreatment. This study aimed to assess the factors which were associated with willingness to receive HCVtreatment in a group of PWID on methadone program in Iran. METHODS We surveyed 187 PWID at seven drops in centers in Tehran, Iran. Details of demographiccharacteristics, drug use, injection, HCV, and drug treatment history were collected using a 25-itemquestionnaire. Participants were serologically tested for the current status of HCV. FINDINGS The study found that 28.3% of the participants were HCV seropositive. In total, 49.1% of theparticipants reported unwillingness to receive HCV treatment. Awareness of current HCV status [odds ratio(OR) = 3.43; 95% confidence interval (CI): 1.33-7.26; P < 0.050]; adequate knowledge of HCV treatmentcenters in the community (OR = 3.9; 95% CI: 1.24-5.38; P < 0.050); participation in an educational programon HCV (OR = 2.9; 95% CI: 2.33-8.56; P < 0.001) and recent participation in the meetings of self-helpgroups (OR = 4.6; 95% CI: 3.43-9.33; P < 0.001) were significantly associated with current willingness toreceive HCV treatment. CONCLUSION The study results indicate that awareness of HCV status and the provision of adequate HCVeducation via different information centers can be associated with an increased willingness for HCVtreatment among PWID on methadone program. Conducting more research is suggested to assess theefficacy of educational programs and self-help groups in facilitating HCV treatment among PWID onmethadone program.
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Bagheri Amiri F, Mostafavi E, Mirzazadeh A. HIV, HBV and HCV Coinfection Prevalence in Iran--A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0151946. [PMID: 27031352 PMCID: PMC4816272 DOI: 10.1371/journal.pone.0151946] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/07/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND worldwide, hepatitis C and B virus infections (HCV and HCV), are the two most common coinfections with human immunodeficiency virus (HIV) and has become a major threat to the survival of HIV-infected persons. The review aimed to estimate the prevalence of HIV, HBV, HCV, HIV/HCV and HIV/HBV and triple coinfections in different subpopulations in Iran. METHOD Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports on prevalence of HIV, HBV, HCV and HIV coinfections in different subpopulations in Iran. We systematically reviewed the literature to identify eligible studies from January 1996 to March 2012 in English or Persian/Farsi databases. We extracted the prevalence of HIV antibodies (diagnosed by Elisa confirmed with Western Blot test), HCV antibodies and HBsAg (with confirmatory laboratory test) as the main primary outcome. We reported the prevalence of the three infections and coinfections as point and 95% confidence intervals. FINDINGS HIV prevalence varied from %0.00 (95% CI: 0.00-0.003) in the general population to %17.25 (95% CI: 2.94-31.57) in people who inject drugs (PWID). HBV prevalence ranged from % 0.00 (95% CI: 0.00-7.87) in health care workers to % 30.9 (95% CI: 27.88-33.92) in PWID. HCV prevalence ranged from %0.19 (95% CI: 0.00-0.66) in health care workers to %51.46 (95% CI: 34.30-68.62) in PWID. The coinfection of HIV/HBV and also HIV/HCV in the general population and in health care workers was zero, while the most common coinfections were HIV/HCV (10.95%), HIV/HBV (1.88%) and triple infections (1.25%) in PWID. CONCLUSIONS We found that PWID are severely and disproportionately affected by HIV and the other two infections, HCV and HBV. Screenings of such coinfections need to be reinforced to prevent new infections and also reduce further transmission in their community and to others.
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Affiliation(s)
- Fahimeh Bagheri Amiri
- Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran
- Department of Epidemiology, University of Tehran, Tehran, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran
- Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Sakha MA, Kazerooni PA, Zandian H, Ravaghi H, Mostafavi H, Delavari S, Ziloochi MH. CHALLENGES AND SUCCESSES OF HARM REDUCTION SERVICES IN WOMEN'S DROP-IN CENTRES: PERSPECTIVE OF VULNERABLE WOMEN. Mater Sociomed 2016; 27:434-7. [PMID: 26889106 PMCID: PMC4733544 DOI: 10.5455/msm.2015.27.434-437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The objective of this study was to shed light on the challenges and successes of HIV/AIDS services delivery as perceived by Sex workers. METHODS Face-to-face semi-structured interviews were conducted with 20 IDUs and Sex workers in drop-in centers in Shiraz. A thematic analysis of these qualitative data was conducted by the authors. RESULTS Participants identified major challenges and successes of HIV/AIDS services delivery. Access services, services delivery in terms of challenges and the successes concept were classified. CONCLUSIONS Our study demonstrates that while there is greater availability of HIV/AIDS services, this does not equate with greater accessibility because multiple, complex and interrelated barriers to HIV/AIDS service utilization at the service delivery level such as Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSW.
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Affiliation(s)
| | | | - Hamed Zandian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Ravaghi
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hakimeh Mostafavi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajjad Delavari
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Norouzian H, Gholami M, Shakib P, Goudarzi G, Ghobadian Diali H, Rezvani A. Prevalence of HCV Infections and Co-Infection With HBV and HIV and Associated Risk Factors Among Addicts in Drug Treatment Centers, Lorestan Province, Iran. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2016; 5:e25028. [PMID: 27162762 PMCID: PMC4859996 DOI: 10.5812/ijhrba.25028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 03/01/2015] [Accepted: 03/09/2015] [Indexed: 01/27/2023]
Abstract
Background: Hepatitis C is an infectious disease caused by blood-borne pathogen, hepatitis C virus (HCV). Objectives: The purpose of this study was to investigate the prevalence of HCV infection and associated risk factors among addicts in drug treatment centers in Lorestan Province, Iran. Patients and Methods: A cross-sectional sero-behavioral survey was given to drug addicts in the drug treatment centers of Khorramabad, Lorestan Province, Iran during June 2012 - March 2013. Drug addicts were interviewed using a standard questionnaire including demographic, imprisonment history, and HCV-related risk behavior items. Thereafter, the sera drawn from the participants were tested for anti-HCV antibody (Ab), anti-human immunodeficiency virus (HIV) Ab, and hepatitis B surface antigen (HBsAg). Results: The mean age of the cohorts was 31.7. Up to 60.2% of drug users had educational levels less than high school, 67.5% were self-employed, and 32.5% were office workers. The mean duration of drug injection was 6.8 years. Statistical analyses indicated that the prevalence of HCV among drug addicts was positively associated with age, past incarceration, drug injection history, the duration of drug use, and tattooing. In addition, 16.23% of volunteers were HCV-positive. Of those infected with HCV, 1.10% was co-infected with HBV, 2.95% were positive for HIV, and 0.36% of HCV-positive cases were infected with all three viruses. Conclusions: The high prevalence of HCV infection among this group implies a high rate of transmission and exposure to the risk of serious diseases. It is important that the high prevalence of HCV infection be taken into consideration to control further transmission of this infection.
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Affiliation(s)
- Hossein Norouzian
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Mohammadreza Gholami
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Pegah Shakib
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Gholamreza Goudarzi
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran
- Corresponding author: Gholamreza Goudarzi, Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran. Tel/Fax: +98-6633120133, E-mail:
| | | | - Azam Rezvani
- Deputy of Health Services, Lorestan University of Medical Sciences, Khorramabad, IR Iran
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Baghersad Z, Alimohammadi N, Boroumandfar Z, Golshiri P. Effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted disease in vulnerable women. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2016; 21:527-533. [PMID: 27904639 PMCID: PMC5114800 DOI: 10.4103/1735-9066.193418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Vulnerable women are prone to sexually transmitted diseases due to their high-risk behaviors. The present study aimed to investigate the effect of self-care training program based on Orem's model on the behaviors leading to sexually transmitted diseases in vulnerable women. Materials and Methods: This field trial was initially conducted on 100 women covered under health services and welfare organization in Isfahan city, who were selected by rationing ssampling. For needs assessment, they filled the self-care needs assessment questionnaire in three domains of knowledge, attitude, and practice. Then, at the stage of intervention (self-care training), 64 subjects were selected through convenient sampling and were assigned to experimental and control groups by random allocation. Data were analyzed by descriptive and analytical statistical tests through SPSS 18. Results: Results showed that mean scores of knowledge (P < 0.001), attitude (P < 0.001), practice (P = 0.04), and behavior change (P = 0.01) were significantly higher immediately after and 3 months after intervention, compared to before intervention, but there was no significant difference in mean scores between immediately after and 3 months after intervention. Conclusions: With regard to these results, it can be concluded that if the educational programs are planned based on clients’ real needs assessment, the learners follow the educational materials, related to their problems, more seriously and it results in a notable behavior change in them.
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Affiliation(s)
- Zahra Baghersad
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Boroumandfar
- Research PhD Student, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parastoo Golshiri
- Department of Community Medicine and Family Physician, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Mehrazmay A, Karambakhsh A, Salesi M, Heydari M, Ahmadi K. Predictors of Change in Substance Abuse Status in Soldiers. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e16305. [PMID: 26473069 PMCID: PMC4601242 DOI: 10.5812/ircmj.16305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 10/18/2014] [Accepted: 03/01/2015] [Indexed: 11/16/2022]
Abstract
Background: Military service is a stressful task that influences the life style of army personnel. Several factors can make soldiers less capable of coping with stressful events; so they may try to start drug abuse or increase in the amount or diversity of substance abuse. Understanding factors responsible for this misbehavior among soldiers is crucial for their commanders to modify these factors. Objectives: This study aimed to determine the predictors of change in substance abuse status in soldiers. Patients and Methods: This cross-sectional research was conducted to evaluate the substance abuse status among Iranian soldiers in 2010. The target population was the soldiers who had spent at least 3 months of their military service. Cluster sampling was done from army service garrisons in 12 provinces in Iran. A total of 3960 soldiers were selected with different levels of education and age. Data gathering was done with demographic questionnaires, Texas Christian university (TCU) drug screen II and ASI questionnaire (fifth edition). Four types of dependent variables were defined: “improvement”, “without change”, “deterioration”, and “severe deterioration”. Backward ordinal regression analysis was done and P values, OR, and SE were calculated by SPSS19 software. Results: Totally, 6.7% of soldiers improved, 82% remained without change, 6.1% deteriorated, and 5.2% severely deteriorated with regard to their substance abuse. Modifiable predictors were distance from home lower than 200 km (OR =1.54), bad relationship with commanders (OR = 1.88), service place dissatisfaction (OR = 1.39), and always feeling lonely (OR = 1.83). Non-modifiable factors were alcohol use within family and friends (P = 0.000); psychiatric drug use history (OR = 1.72); suicidal attempt history (OR = 1.31); divorce, separation, and extramarital contact (P = 0.001); unemployment (P = 0.019); leisure time dissatisfaction (P = 0.004); living alone (OR = 2.43); and substance abuse onset before age 15 (OR = 1.71). Conclusions: Considering non-modifiable risk factors, leaders and commanders may recognize more vulnerable soldiers and try to resolve modifiable factors and decrease the risk of getting worse (with respect to substance abuse) about 7.3 times.
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Affiliation(s)
- Alireza Mehrazmay
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Karambakhsh
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mahmood Salesi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mostafa Heydari
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Khodabakhsh Ahmadi, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, P. O. Box: 19945-581, Tehran, IR Iran. Tel: +98-2182482475, E-mail:
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Rahimi-Movaghar A, Amin-Esmaeili M, Shadloo B, Malekinejad M. Transition to injecting drug use in Iran: A systematic review of qualitative and quantitative evidence. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:808-19. [PMID: 26210009 PMCID: PMC4625838 DOI: 10.1016/j.drugpo.2015.04.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 02/19/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Injection drug use, a behavior associated with significant adverse health effects, has been increasing over the past decade in Iran. This study aims to systematically review the epidemiological and qualitative evidence on factors that facilitate or protect the transition to injection drug use in Iran. METHODS We conducted electronic searches in five international (Medline, Web of Science, EMBASE, CINAHL, PsycINFO), one regional (IMEMR) and three Iranian (Iranmedex, Iranpsych, IranDoc) databases, as well as contacting experts in the field. Two trained researchers screened documents to identify relevant studies and independently dual-extracted data following pre-specified protocol. We applied principles of thematic analysis for qualitative data and applied a random effect meta-analysis model for age of first injection. RESULTS A total of 38 documents from 31 studies met eligibility criteria, from which more than 50% were implemented from 2006 to 2008. The weighted mean age of first injection was 25.8 (95% Confidence Interval: 25.3-26.2). Between 1998 and 2011, the age of first injection was relatively stable. Overall, drug users had used drugs for 6-7 years before they started injection use. Heroin was the first drug of injection in the majority of the cases. We identified factors influencing the initiation of or transition to injection use at various levels, including: (1) individual (pleasure-seeking behavior, curiosity and development of drug dependency commonly reported), (2) social and environmental (role of peer drug users in the first injection use, the economic efficiency associated with injections and the wide availability of injectable form of drugs in the market). CONCLUSION Harm reduction policies in Iran have almost exclusively focused on drug injectors in Iran. However, given the extent of the non-injection drug use epidemic, evidence from this study can provide insight on points of interventions for the prevention of the transition to injection use.
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Affiliation(s)
- Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Address: Address: No. 669, South Karegar Ave., Tehran, Iran, Postal Code: 1336616357
| | - Masoumeh Amin-Esmaeili
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Address: Imam Khomeini Hospital, Keshavarz Blvd., Tehran, Iran, Postal code: 14197-33141
| | - Behrang Shadloo
- Iranian Research Center for HIV/AIDS (IRCHA), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Address: Imam Khomeini Hospital, Keshavarz Blvd., Tehran, Iran, Postal code: 14197-33141
| | - Mohsen Malekinejad
- Depaertment of Epidemiology and Biostatistics, Global Health Sciences, University of California San Francisco, Address: 3333 California Street, Suite 265, San Francisco, CA 94118, USA
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Jafari S, Mathias R, Joe RS, Baharlou S, Nasr A. Effect of law enforcement on drug abuse: a comparison of substance use in Pakistan, Afghanistan, Iran and Turkey. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2014.900579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Malekinejad M, Mohraz M, Razani N, Akbari G, McFarland W, Khairandish P, Malekafzali H, Gouya MM, Zarghami A, Rutherford GW. High HIV prevalence in a respondent-driven sampling survey of injection drug users in Tehran, Iran. AIDS Behav 2015; 19:440-9. [PMID: 25280446 DOI: 10.1007/s10461-014-0904-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Iran is facing unprecedented dual drug use and HIV epidemics. We conducted a cross-sectional survey to obtain HIV prevalence and risk behavior data from injection drug users (IDU) in Tehran. We used respondent-driven sampling (RDS) to recruit IDU through successive waves starting with 24 "seeds," conducted anonymous face-to-face interviews and HIV testing and counseling, and used RDSAT to adjust data. During 44 weeks, 1,726 study referral coupons resulted in 645 (37 %) IDU referrals, of whom 548 (85 %) were enrolled. From those enrolled, 84 % were incarcerated, 47 % employed, 55 % single, 27 % under 30 years of age, and 26 % homeless. The adjusted HIV prevalence was 26.6 % (95 % confidence interval 21.3-32.1), and was higher among certain IDU subgroups (e.g., those who sharing injection paraphernalia). Our estimates of HIV prevalence were higher than some other estimates; however, repeated surveys using similar methodology are needed to monitor the trend of HIV epidemic over time.
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Affiliation(s)
- Mohsen Malekinejad
- Institute for Health Policy Studies, University of California, 3333 California Street, Suite 265, San Francisco, CA, 94118, USA,
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Vakili V, Baseri H, Abbasi Shaye Z, Bazzaz MM. Marital instability and its predictors in a representative sample of Mashhadi citizens, Iran, 2014. J Med Life 2015; 8:8-13. [PMID: 28255390 PMCID: PMC5327718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 07/27/2015] [Indexed: 11/01/2022] Open
Abstract
Background:High quality and supportive relationships is essential to develop healthy individuals in all aspects of life. This study deals with the marital instability frequency and its predisposing factors and predictors in a representative sample of Mashhad, Iran, in 2014. Methods:In a cross-sectional study, a total number of 583 couples participated. A checklist and the marital instability index (MII) were divided into 2 sections: the first section (part A) focused on the marital instability of couples and the second section (part B) focused on attractions and obstacles in each family, completed via a face-to-face interview. Results:247 (42.2%) participants were male and 338 (57.8%) were female. The median age of participants was 34 years with a maximum of 82. The mean score of the marital instability was 19.97 ± 7.29 and 13.96 ± 3.08 for attractions and obstacles. Age, education, suspicion regarding the partner, history of divorce, the way to get married (personal or by family), socioeconomic concordance with partner, expressing love to partner and partner expressing love, were identified as predictors of marital instability. Sex, addiction, history of divorce, socioeconomic fit, family interfering, violence behavior and love expression regarding the partner, were predictors of attractions and obstacles part. Conclusion:The overall score obtained from the marital instability questionnaire in this study was fair and showed lower levels of marital instability and divorce among our participants. However, it was necessary to inform young couple about the underlying factors of marital instability. Findings could be promising for the policy makers to design specific interventions suited to target population.
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Affiliation(s)
- V Vakili
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Baseri
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Z Abbasi Shaye
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M M Bazzaz
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Assari S, Moghani Lankarani M, Dejman M, Farnia M, Alasvand R, Sehat M, Roshanpazooh M, Tavakoli M, Jafari F, Ahmadi K. Drug Use among Iranian Drivers Involved in Fatal Car Accidents. Front Psychiatry 2014; 5:69. [PMID: 25221521 PMCID: PMC4148638 DOI: 10.3389/fpsyt.2014.00069] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 05/31/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the problem of substance use among drivers is not limited to certain parts of the world, most epidemiological reports on this topic have been published from industrial world. AIM To investigate pattern of drug use among Iranian drivers who were involved in fatal road accidents. METHODS This study enrolled 51 Iranian adults who were involved in fatal vehicle accidents and were imprisoned thereafter. Data came from a national survey of drug abuse that was done among Iranian prisoners. The survey collected data at the entry to seven prisons in different regions of the country during a 4-month period in 2008. Self-reported lifetime, last year, and last month drug use was measured. Commercial substance screening tests were applied to detect recent substance use (opioids, cannabinoids, methamphetamines, and benzodiazepines). RESULTS The commercial substance screening test showed three distinct patterns of recent illicit drug use: opioids (37.3%), cannabinoids (2.0%), opioids and cannabinoids (13.7%). 29.4% were also positive for benzodiazepines. The substance use screening test detected 23.5% of participants who had used drugs but did not disclose any substance use. CONCLUSION Opioids are the most common illicit drugs being used by Iranian drivers who are involved in fatal car accidents. The high rate of substance use prior to fatal car accidents in Iran advocates for the need for drug use control policies and programs as major strategies for injury prevention in Iran. There is also a need for substance screening among all drivers involved in fatal car accidents in Iran, as more than 20% of users may not disclose substance use.
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Affiliation(s)
- Shervin Assari
- Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Maryam Moghani Lankarani
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
- Medicine and Health Promotion Institute, Tehran, Iran
| | - Masoumeh Dejman
- Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Farnia
- Health and Treatment Bureau of Iran Prisons Organization, Tehran, Iran
| | - Ramin Alasvand
- Health and Treatment Bureau of Iran Prisons Organization, Tehran, Iran
| | - Mahmood Sehat
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
- Medicine and Health Promotion Institute, Tehran, Iran
| | - Mohsen Roshanpazooh
- Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran
| | - Mahmood Tavakoli
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Access to harm reduction programs among persons who inject drugs: findings from a respondent-driven sampling survey in Tehran, Iran. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 25:717-23. [PMID: 24974367 DOI: 10.1016/j.drugpo.2014.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 05/25/2014] [Accepted: 05/26/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Over the past two decades, drug injection-related risk behaviors have been the major drivers of the HIV epidemic in Iran. This study assesses the access of people who injected drugs (PWID) to harm reduction services (needle-exchange programs [NEP] and methadone maintenance treatment [MMT]) in Tehran, Iran in 2007, almost five years after the large-scale implementation of these programs. METHODS 572 consenting PWID (>18 years old, ever injected in the past month, lived in Tehran or its suburbs) were recruited (24 seeds) into a sero-behavioral survey using respondent-driven sampling method. Participants completed a face-to-face interview about HIV-related risk behaviors and access to harm reduction services. We calculated adjusted population estimates using RDSAT. RESULTS Overall, 99.2% of the participants were male, 41.6% aged between 30 and 39 years old, 55.4% lived alone in the past year, 83.2% were ever incarcerated, and 88.8% lived in the southern areas of Tehran. In terms of "awareness" and "use" of services among PWID, 62.8% and 54.8% reported for NEP (respectively) and 19.7% and 9.1% for drug treatment services (respectively). PWID who lived in Northwest and South-central Tehran were more likely to be aware (85.0% and 82.8%, respectively) of one or more services than PWID who lived elsewhere. Similarly, PWID who lived with friends were more likely to be aware of (88.6%) and use (85.9%) services (vs. other living partners). Overall, 11% of the participants were aware of but had not used any harm reduction services. CONCLUSIONS Despite a relatively high level of access to NEP among PWID in Tehran, a sizable fraction of the population remains without access to other services five years after their implementation. The use of harm reduction may be affected by certain PWID characteristics (e.g., living partners and geographical location). Ongoing surveillance activities are necessary to track change in access over time.
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Mumtaz GR, Weiss HA, Thomas SL, Riome S, Setayesh H, Riedner G, Semini I, Tawil O, Akala FA, Wilson D, Abu-Raddad LJ. HIV among people who inject drugs in the Middle East and North Africa: systematic review and data synthesis. PLoS Med 2014; 11:e1001663. [PMID: 24937136 PMCID: PMC4061009 DOI: 10.1371/journal.pmed.1001663] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 05/08/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is perceived that little is known about the epidemiology of HIV infection among people who inject drugs (PWID) in the Middle East and North Africa (MENA). The primary objective of this study was to assess the status of the HIV epidemic among PWID in MENA by describing HIV prevalence and incidence. Secondary objectives were to describe the risk behavior environment and the HIV epidemic potential among PWID, and to estimate the prevalence of injecting drug use in MENA. METHODS AND FINDINGS This was a systematic review following the PRISMA guidelines and covering 23 MENA countries. PubMed, Embase, regional and international databases, as well as country-level reports were searched up to December 16, 2013. Primary studies reporting (1) the prevalence/incidence of HIV, other sexually transmitted infections, or hepatitis C virus (HCV) among PWIDs; or (2) the prevalence of injecting or sexual risk behaviors, or HIV knowledge among PWID; or (3) the number/proportion of PWID in MENA countries, were eligible for inclusion. The quality, quantity, and geographic coverage of the data were assessed at country level. Risk of bias in predefined quality domains was described to assess the quality of available HIV prevalence measures. After multiple level screening, 192 eligible reports were included in the review. There were 197 HIV prevalence measures on a total of 58,241 PWID extracted from reports, and an additional 226 HIV prevalence measures extracted from the databases. We estimated that there are 626,000 PWID in MENA (range: 335,000-1,635,000, prevalence of 0.24 per 100 adults). We found evidence of HIV epidemics among PWID in at least one-third of MENA countries, most of which are emerging concentrated epidemics and with HIV prevalence overall in the range of 10%-15%. Some of the epidemics have however already reached considerable levels including some of the highest HIV prevalence among PWID globally (87.1% in Tripoli, Libya). The relatively high prevalence of sharing needles/syringes (18%-28% in the last injection), the low levels of condom use (20%-54% ever condom use), the high levels of having sex with sex workers and of men having sex with men (15%-30% and 2%-10% in the last year, respectively), and of selling sex (5%-29% in the last year), indicate a high injecting and sexual risk environment. The prevalence of HCV (31%-64%) and of sexually transmitted infections suggest high levels of risk behavior indicative of the potential for more and larger HIV epidemics. CONCLUSIONS Our study identified a large volume of HIV-related biological and behavioral data among PWID in the MENA region. The coverage and quality of the data varied between countries. There is robust evidence for HIV epidemics among PWID in multiple countries, most of which have emerged within the last decade and continue to grow. The lack of sufficient evidence in some MENA countries does not preclude the possibility of hidden epidemics among PWID in these settings. With the HIV epidemic among PWID in overall a relatively early phase, there is a window of opportunity for prevention that should not be missed through the provision of comprehensive programs, including scale-up of harm reduction services and expansion of surveillance systems.
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Affiliation(s)
- Ghina R. Mumtaz
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Helen A. Weiss
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sara L. Thomas
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Suzanne Riome
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Hamidreza Setayesh
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Gabriele Riedner
- Regional Office of the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Iris Semini
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Oussama Tawil
- Joint United Nations Programme on HIV/AIDS Regional Support Team, Middle East and North Africa, Cairo, Egypt
| | - Francisca Ayodeji Akala
- Human Development Sector, Middle East and North Africa Region, World Bank, Washington (D.C.), United States of America
| | - David Wilson
- Global HIV/AIDS Program, World Bank, Washington (D.C.), United States of America
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
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Pulmonary and latent tuberculosis screening in opiate drug users: an essential and neglected approach for harm-reduction facilities. J Addict Med 2014; 7:230-5. [PMID: 23666320 DOI: 10.1097/adm.0b013e31828d05ab] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Opiates drug users are at much higher risk of developing tuberculosis (TB) infection than general population. We conducted this study to determine the susceptibility for pulmonary and latent TB infection in opiates drug users. METHODS In this cross-sectional study, all opiates drug users referred to drop-in centers, methadone maintenance clinics, and harm-reduction facilities affiliated with Shiraz University of Medical Sciences in southern Iran were screened for pulmonary and latent TB infection. RESULTS The participation rate of opiate drug users was 87.66% (263 of 300). Mean age was 37.37 ± 8.33 (range, 20-65) years. Two hundred twenty-six (85.93%) were male and 197 (74.90%) were injection drug users (IDUs). One hundred sixty-three (61.97%) had TB-related symptoms. Culture for TB was positive in 3 patients (1.14%) (2 non-IDUs and 1 IDU). Two patients (0.76%) showed acid-fast bacilli in the direct sputum smear. Eighty-five of 244 patients (34.83%) had a 5- to 10-mm induration in the skin TB test. Twenty-nine of 223 patients (13%) had abnormal findings from chest x-ray films. CONCLUSIONS The prevalence of smear-positive pulmonary TB in opiate drug users is more than 100 times in the general population in Iran. Therefore, active and appropriate screening to detect pulmonary TB infection should be integrated into routine activities at all harm-reduction facilities for drug users, irrespective of their route of drug use or human immunodeficiency virus status, in this country.
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Amini M, Shirinbayan P, Behnam B, Roghani M, Farhoudian A, Joghataei MT, Koruji M. Correlation between expression ofCatSperfamily and sperm profiles in the adult mouse testis following Iranian Kerack abuse. Andrology 2014; 2:386-93. [DOI: 10.1111/j.2047-2927.2014.00195.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 12/27/2013] [Accepted: 01/23/2014] [Indexed: 02/06/2023]
Affiliation(s)
- M. Amini
- Cellular and Molecular Research Center; Iran University of Medical Sciences; Tehran Iran
| | - P. Shirinbayan
- Pediatric Neuro-Rehabilitation Research Center; University of Social Welfare and Rehabilitation Sciences; Tehran Iran
- Research Center for Substance Use and Dependence (DARIUS Institute); University of Social Welfare and Rehabilitation Sciences; Tehran Iran
| | - B. Behnam
- Cellular and Molecular Research Center; Iran University of Medical Sciences; Tehran Iran
- Department of Medical Genetics and Molecular Biology; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - M. Roghani
- Department of Physiology; School of Medicine; Shahed University; Tehran Iran
| | - A. Farhoudian
- Research Center for Substance Use and Dependence (DARIUS Institute); University of Social Welfare and Rehabilitation Sciences; Tehran Iran
| | - M. T. Joghataei
- Cellular and Molecular Research Center; Iran University of Medical Sciences; Tehran Iran
- Department of Anatomical Sciences; School of Medicine; Iran University of Medical Sciences; Tehran Iran
| | - M. Koruji
- Cellular and Molecular Research Center; Iran University of Medical Sciences; Tehran Iran
- Department of Anatomical Sciences; School of Medicine; Iran University of Medical Sciences; Tehran Iran
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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. IRANIAN JOURNAL OF MEDICAL SCIENCES 2014; 39:184-90. [PMID: 24753641 PMCID: PMC3993042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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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Javadi A, Ataei B, Kassaian N, Nokhodian Z, Yaran M. Co-infection of human immunodeficiency virus, hepatitis C and hepatitis B virus among injection drug users in Drop in centers. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:S17-21. [PMID: 25002888 PMCID: PMC4078381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 01/20/2014] [Accepted: 03/02/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are the three prevalent viral and bloodborne infections worldwide. Considering the similar route of transmission in these infections, their co-infections would be more challenging for health care professionals. Therefore, we investigated the rate of HIV/HBV/HCV co-infection among injection drug users (IDUs) referred to Drop in centers (DICs). MATERIALS AND METHODS In this cross-sectional study (2008-2009), IDUs referred to DICs in Isfahan province were evaluated. Venous blood samples were obtained and HBsAg, HBcAb, HCVAb, and HIVAb measured by using enzyme linked immunosorbent assay method. Demographic data and risk factors in patients with HBV/HCV, HIV/HCV, and HIV/HBV co-infections were obtained by a trained social worker using a structured checklist. Data were analyzed using Chi-square test, t-test, and multiple logistic regressions. RESULTS Totally, 539 IDUs with mean (standard deviation [SD]) age of 35.3 (7.9) were studied. HBV/HCV, HCV/HIV, and HBV/HIV co-infections were presented in 65 (12.1%), 6 (1.1%), and 0 (0%) of IDUs, respectively. All HIV infected IDUs were infected with HCV as well. There was a significant association between HBV/HCV co-infection and behaviors related to sharing needle (odds ratio [OR] = 2.06, 95% confidence interval [CI]; 1.23-3.45) and imprisonment (OR = 1.01, 95% CI; 1.04-1.06). CONCLUSION According to the results of this study, history of imprisonment and needle sharing were the only adjusted risk factors for HCV/HBV co-infection in IDUs. This might be a warning for national health system and needs to urgent paying attention. It seems that expanded harm reduction strategies can be useful to reduce this co-infection and its mortality and morbidity rate among IDUs.
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Affiliation(s)
- Abbasali Javadi
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Behrooz Ataei, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Science, Isfahan, Iran. E-mail:
| | - Nazila Kassaian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zary Nokhodian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Arab M, Kohan M, Ranjbar H, Arab N, Rayani M, Mirrashidi SS, Rafiei H, Amiri M. Quality of life, social desirability and their relationship in opium addicted persons in southeast of Iran. Glob J Health Sci 2014; 6:97-103. [PMID: 24762351 PMCID: PMC4825398 DOI: 10.5539/gjhs.v6n3p97] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 02/22/2014] [Indexed: 11/28/2022] Open
Abstract
Background and Aim: Addiction leads to many problems which may adversely affect addicted people, their families and impose health care agencies with many challenges. This study aimed to examined quality of life (QoL), social desirability and their relationship among opium addicted persons in southeast of Iran. Material and Methods: In a cross-sectional study conducted from September 2012 to January 2013, 123 addicted people were studied. Date collection tools were; checklist of demographic data, Iranian version of the 36-item short form QoL (SF-36) and Marlowe-Crowne Social Desirability Scale (MC-SDS). Results: While mean score of QoL was 60.4±29.5, mean score of social desirability were 14.2±3.7. Low, moderate and high levels of social desirability were observed in 4.9%, 90.2% and 4.9% of participants, respectively. Pearson’s correlation were not significant between mean score of social desirability and mean score of QoL (p=0.969, r=0.004). Conclusion: Addicted participants of present study showed a moderate level of QoL and social desirability, without any significant relationship between QoL and social desirability. Further research is suggested in addicts with social and cultural differences.
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Affiliation(s)
| | - Mehri Kohan
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Esmaeili HR, Ziaddinni H, Nikravesh MR, Baneshi MR, Nakhaee N. Outcome evaluation of the opioid agonist maintenance treatment in Iran. Drug Alcohol Rev 2014; 33:186-93. [PMID: 24428135 DOI: 10.1111/dar.12112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 12/05/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Methadone maintenance treatment and buprenorphine maintenance treatment are the two main therapeutic options considered for opioid replacement therapy. This study was conducted to examine the effectiveness of methadone maintenance treatment and buprenorphine maintenance treatment in Iran under usual clinical conditions. DESIGN AND METHODS In this outcome research, 311 patients consented to participate in the study (77.8% response rate). The Opioid Treatment Index, General Health Questionnaire and WHOQOL-BREF questionnaire were used to assess the effectiveness of the therapeutic programs. Drop-out rate was calculated after two and six months of treatment. RESULTS Mean dose of methadone was in an acceptable range; however, doses for buprenorphine maintenance treatment patients seemed low. The rates of attrition after two and six months of treatment were 24.2% and 44.0% in the methadone maintenance treatment group and 41.3% and 65.4% in the buprenorphine maintenance treatment group, respectively (P < 0.001). Drug use, HIV risk-taking behaviour, and mental and physical health improved in both groups at six months of treatment, while quality of life improved only in the methadone maintenance treatment group. DISCUSSION AND CONCLUSIONS The retention seen in the buprenorphine group may in part be related to the low buprenorphine doses used. As a whole, the positive results provide support to continuation of maintenance programs.
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Affiliation(s)
- Hamid-Reza Esmaeili
- Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Assari S, Yarmohamadivasel M, Moghani Lankarani M, Sehat M, Narenjiha H, Rafiey H, Noori R, Shirinbayan P, Ahmadi K. Having Multiple Sexual Partners among Iranian Intra-Venous Drug Users. Front Psychiatry 2014; 5:125. [PMID: 25346698 PMCID: PMC4193211 DOI: 10.3389/fpsyt.2014.00125] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 08/25/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Transmission of HIV from intra-venous drug users (IDUs) to the community occurs predominantly through high-risk sexual behaviors. Limited information exists regarding the high-risk sexual behaviors of IDUs in Iran. AIM The aim of this study was to determine the prevalence and factors associated with having multiple sexual partners among Iranian IDUs. METHODS This is a national survey on drug-dependent adults. Participants were sampled from medical centers, prisons, and streets of capitals of 29 provinces in Iran between May 2007 and February 2008. We analyzed data of 1416 current IDUs. Socio-demographics and drug use characteristics were entered into a binary logistic regression model to determine predictors of having multiple sexual partners. RESULTS Having multiple sexual partners in the past or at the time of survey was reported by 56.4% of Iranian IDUs. Multivariate analysis showed that the likelihood of having multiple sexual partners in IDUs decreased by being married [odds ratio (OR), 0.38; P < 0.001] and increased by female gender (OR, 13.44; P = 0.02), having illegal income (OR, 1.72; P = 0.003), higher monthly family income (OR, 1.01; P = 0.003), pleasure, curiosity, and recreation as cause of first drug use (OR, 1.37; P = 0.04), ruins as usual place for injection (OR, 1.89; P = 0.001) and history of syringe sharing (OR, 1.50; P = 0.02). CONCLUSION Having multiple sexual partners was reported by majority of Iranian IDUs, and this was linked to socio-demographics, initiation data, and other risk behaviors. This information should be considered in prevention efforts to reduce sexual transmission of HIV infection in Iran.
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Affiliation(s)
- Shervin Assari
- Department of Health Behavior and Health Education, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health , Ann Arbor, MI , USA ; Department of Psychiatry, University of Michigan School of Medicine , Ann Arbor, MI , USA ; Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | | | - Maryam Moghani Lankarani
- Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran
| | - Mahmood Sehat
- Universal Network for Health Information Dissemination and Exchange , Tehran , Iran ; Medicine and Health Promotion Institute , Tehran , Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Hassan Rafiey
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran ; Center for Behavioral and Social Research, Darius Institute , Tehran , Iran
| | - Roya Noori
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Peymaneh Shirinbayan
- Pediatric NeuroRehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah Medical Sciences University , Tehran , Iran
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Assari S, Ahmadi K, Rezazade M. Socio-Economic Status Determines Risk of Receptive Syringe Sharing Behaviors among Iranian Drug Injectors; A National Study. Front Psychiatry 2014; 5:194. [PMID: 25852577 PMCID: PMC4369970 DOI: 10.3389/fpsyt.2014.00194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/16/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although needle and syringe sharing is one of the main routs of transmission of HIV in several countries in the middle east, very little is known about how socio-economic status of injecting drug users (IDUs) is linked to the receptive syringe sharing behaviors in these countries. AIM To study socio-economic correlates of receptive needle and syringe sharing among IDUs in Iran. METHODS The study used data from the Unhide Risk Study, a national survey of IDUs. This study sampled 636 IDUs (91% male) via snowball sampling from eight provinces in Iran in 2009. Socio-demographic and drug use characteristics were collected. We used a logistic regression to determine factors associated with receptive needle and syringe sharing during the past 6 months. RESULTS From 636 IDUs enrolled in this study, 68% (n = 434) reported receptive needle and syringe sharing behaviors in the past 6 months. Odds of receptive needle and syringe sharing in the past 6 months was lower among IDUs who were male [odds ratios (OR) = 0.29, 95% confidence interval (CI) = 0.12-0.70], had higher education (OR = 0.74, 95% CI = 0.64-0.86) but higher among those who were unemployed (OR = 4.05, 95% CI = 1.50-10.94), and were single (OR = 1.47, 95% CI = 1.02-2.11). CONCLUSION This study presented factors associated with risk of receptive needle and syringe sharing among Iranian IDUs. This information may be used for HIV prevention and harm reduction purposes. Socio-economic status of Iranian IDUs may be closely linked to high-risk injecting behaviors among them.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan , Ann Arbor, MI , USA ; Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan , Ann Arbor, MI , USA ; Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation , Tehran , Iran
| | - Khodabakhsh Ahmadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Majid Rezazade
- AIDS Prevention and Control Committee of Welfare Organization State , Tehran , Iran
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Gousheh A, Ziaaddini H, Baneshi MR, Nakhaee N. Drug Use among Residents of Juvenile Correctional Center in Kerman, Iran, and its Relationship with Personality Dimensions and Self-concept. ADDICTION & HEALTH 2014; 6:22-9. [PMID: 25140214 PMCID: PMC4137436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/11/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Identifying the status of substance misuse and its psychosocial correlates among residents of juvenile correctional centers, as a high risk group, could potentially illuminate the roadmap to prevention of drug use in this group. METHODS In this cross-sectional study, 93 individuals aged 13 to 18 were enrolled. A self-administered questionnaire was completed and dropped in a sealed box. It consisted of 4 parts of Piers-Harris Children's Self-Concept Scale, NEO Personality Inventory, drug use questions, and demographic variables. All questionnaires were well adapted in the Persian language. MANOVA was used to compare the subscale scores between the drug users and nonusers. FINDINGS All respondents were male and 40% were illiterate. More than 40% had drug dependent fathers. Use of cigarette, opium, and alcohol in the previous 30 days was reported by 31.9, 52.2, and 15.9% of respondents, respectively. In this population, the score of 3 of the 5 personality factors (i.e., neuroticism, extraversion, and openness) were higher than in the general population (P < 0.001). More than 88% of subjects had negative self-concept. Both the scores of personality and self-concept showed no significant difference based on the status of drug use. CONCLUSION Prevalence of lifetime and last-month drug use was found to be high. Regarding the profiles of personality and self-concept, more comprehensive evidence-based interventions are needed for improvement of their mental health.
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Affiliation(s)
- Amin Gousheh
- General Practitioner, Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hassan Ziaaddini
- Associate Professor, Department of Psychiatry, Research Center for Social Determinants of Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Associate Professor, Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nouzar Nakhaee
- Professor, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Nouzar Nakhaee MD,
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Haji-Maghsoudi S, Haghdoost AA, Baneshi MR. Selection of Variables that Influence Drug Injection in Prison: Comparison of Methods with Multiple Imputed Data Sets. ADDICTION & HEALTH 2014; 6:36-44. [PMID: 25140216 PMCID: PMC4137438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/09/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Prisoners, compared to the general population, are at greater risk of infection. Drug injection is the main route of human immunodeficiency virus ý(HIV) transmission, in particular in Iran. What would be of interest is to determine variables that govern drug injection among prisoners. However, one of the issues that challenge model building is incomplete national data sets. In this paper, we addressed the process of model development when missing data exist. METHODS Complete data on 2720 prisoners was available. A logistic regression model was fitted and served as gold standard. We then randomly omitted 20%, and 50% of data. Missing date were imputed 10 times, applying multiple imputation by chained equations (MICE). Rubin's rule (RR) was applied to select candidate variables and to combine the results across imputed data sets. In S1, S2, and S3 methods, variables retained significant in one, five, and ten imputed data sets and were candidate for the multifactorial model. Two weighting approaches were also applied. FINDINGS Age of onset of drug use, recent use of drug before imprisonment, being single, and length of imprisonment were significantly associated with drug injection among prisoners. All variable selection schemes were able to detect significance of these variables. CONCLUSION We have seen that the performances of easier variable selection methods were comparable with RR. This indicates that the screening step can be used to select candidate variables for the multifactorial model.
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Affiliation(s)
- Saiedeh Haji-Maghsoudi
- PhD Student, Regional Knowledge Hub and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Professor, Regional Knowledge Hub and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Associate Professor, Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Khodadoostan M, Ataei B, Shavakhi A, Tavakoli T, Nokhodian Z, Yaran M. The assessment of hepatitis B seroprevalence in persons with intravenous drug use history in the Isfahan province: Community-based study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:65-8. [PMID: 24672567 PMCID: PMC3963325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 10/11/2013] [Accepted: 10/31/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hepatitis B with its complications has become one of the universal problems. Injection drug use is one of the most important risk factors in the transmission of hepatitis B. Therefore, we assessed hepatitis B virus prevalence among cases with a history of intravenous drug use (IVDU) as the first announcement-based study in this regard. MATERIALS AND METHODS The announcement-based detection of hepatitis B seroprevalence in volunteers with a history of intravenous drug use was conducted in the Isfahan province. A comprehensive community announcement was made in all the public places and to all physicians, in all the regions. One thousand five hundred and eighty-eight volunteers were invited to the Isfahan reference laboratories and serum samples were tested for HBs-Ag, HBc Ab, and HBs-Ab, using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS In this study, 1588 individuals volunteered, who were estimated to be 50% of all the expected intravenous drug users in the community. HBs Ag was detected in 4.2% of them. HBc Ab and HBs Ab were detected in order in 11.4 and 17.3%, respectively. CONCLUSION We estimated that the seroprevalence of hepatitis B positivity in intravenous drug users was moderate to high. Therefore, it was suggested that this group be encouraged to prevent acquiring infection by vaccination, education, counseling for risk reduction, and treatment of substance abuse, and finally hepatitis B virus (HBV) screening.
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Affiliation(s)
- Mahsa Khodadoostan
- Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine, Research Center, Isfahan Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Shavakhi
- Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahmine Tavakoli
- Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zary Nokhodian
- Infectious Diseases and Tropical Medicine, Research Center, Isfahan Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Infectious Diseases and Tropical Medicine, Research Center, Isfahan Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Majid Yaran, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Number 21, Fribourg Street, Alley 8, Isfahan, Iran. E-mail:
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Haghdoost AA, Mirzazadeh A, Shokoohi M, Sedaghat A, Gouya MM. HIV trend among Iranian prisoners in 1990s and 2000s; analysis of aggregated data from HIV sentinel sero-surveys. Harm Reduct J 2013; 10:32. [PMID: 24257447 PMCID: PMC3842738 DOI: 10.1186/1477-7517-10-32] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 11/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Using the aggregated data of all sentinel sero-surveys (1991 to 2007), this study aimed to report the HIV trend among Iranian prisoners. METHOD Overall, we analysed the aggregated data from 397 HIV sero-surveys conducted in 72 prisons (included 155,771 prisoners) from 1991 through 2007. RESULTS The overall HIV prevalence was 2.8% (95% CI: 1.8%-4.3%). In 1998, HIV prevalence dramatically increased to 4.5% (95% CI: 1.1%-16.8%), which later became stable at level of 2.8%. Prisons were so heterogeneous regarding HIV prevalence (0% to 13.2%). CONCLUSION Since the outbreak, the ministry of health has acknowledged prisoners as one of the high-risk groups for HIV, increased the number of sentinel surveys and on-site harm reduction services to better monitor and response to the HIV epidemic. The downward trend of HIV prevalence after 2005 suggests the effectiveness of such interventions which need to be continued.
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Affiliation(s)
- Ali-Akbar Haghdoost
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Mostafa Shokoohi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sedaghat
- Ministry of Health & Medical Education, CDC, Tehran, Iran
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Des Jarlais DC, Boltaev A, Feelemyer J, Bramson H, Arasteh K, Phillips BW, Hagan H. Gender disparities in HIV infection among persons who inject drugs in Central Asia: a systematic review and meta-analysis. Drug Alcohol Depend 2013; 132 Suppl 1:S7-12. [PMID: 23891035 PMCID: PMC3825744 DOI: 10.1016/j.drugalcdep.2013.06.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Disparities in HIV infection, with females having higher rates of HIV infection than males, have been noted among persons who inject drugs (PWID) in many countries. We examined male/female HIV disparities among PWID in Central Asia and compared these disparities with patterns worldwide. METHODS A systematic review and meta-analyses were conducted for studies reporting HIV prevalence by gender among PWID. To be included in the analyses, reports had to contain (1) samples of PWID from Central Asia, (2) HIV data based on laboratory testing, (3) HIV prevalence reported for males and females, and (4) samples that were not recruited on the basis of HIV status. RESULTS Data were abstracted from 11 studies in 5 countries in Central Asia: China, Kazakhstan, Russia, Tajikistan, and Uzbekistan; the total sample size was 12,225. The mean weighted OR for HIV prevalence among females to males was 0.913 (95% CI 0.07, 1.26), with high heterogeneity among studies (I(2)=70.0%) and a possible publication bias among studies with small sample sizes (Eggers test=-1.81, 95% CI -5.18, 0.54). CONCLUSIONS The non-significant higher HIV prevalence among male PWID in Central Asia contrasts with the worldwide findings which show slightly higher HIV prevalence among female PWID. This may reflect the relative recency of the HIV epidemics in Central Asia. The findings also suggest there may be factors that protect female PWID from HIV in some settings. Further examination of transmission dynamics in Central Asia is necessary to better understand the HIV epidemic among PWID.
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Affiliation(s)
- Don C Des Jarlais
- The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York City, USA.
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Khajehkazemi R, Osooli M, Sajadi L, Karamouzian M, Sedaghat A, Fahimfar N, Safaie A, Mostafavi E, Haghdoost AA. HIV prevalence and risk behaviours among people who inject drugs in Iran: the 2010 National Surveillance Survey. Sex Transm Infect 2013; 89 Suppl 3:iii29-32. [PMID: 24037249 PMCID: PMC3841768 DOI: 10.1136/sextrans-2013-051204] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To assess the prevalence of HIV and related risk behaviours among people who inject drugs (PWID) in Iran. METHODS We conducted a national cross-sectional bio-behavioural surveillance survey between March and July 2010, interviewing male PWID from a geographically dispersed sample through a facility-based sampling method. RESULTS We recruited 2480, and tested 2290 PWID. The overall prevalence of HIV was 15.2% (95% CI 9.7% to 23.1%). Among those who had injected drugs over the last month, 36.9% had used a non-sterile needle, and 12.6% had practiced shared injection. Over the past 12 months preceding the interview, 30.4% had sold sex for money, drugs, goods or a favour. In the multivariate analysis, the prevalence of HIV had a positive association with age, while having above high school education, and permanent job were protective. CONCLUSIONS Unsafe injection, and sexual risk behaviours are still frequent and the prevalence of HIV among PWID remains high. Intensified efforts are needed to prevent the further spread of HIV among Iranian PWID and their sexual partners.
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Affiliation(s)
- Razieh Khajehkazemi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Osooli
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Centre for Haemostasis and Thrombosis, Skane University Hospital, Lund University, Lund, Sweden
| | - Leily Sajadi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sedaghat
- HIV/AIDS Control Office, Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran
| | - Noushin Fahimfar
- HIV/AIDS Control Office, Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ehsan Mostafavi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran
| | - Ali-Akbar Haghdoost
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Mamani M, Majzoobi MM, Torabian S, Mihan R, Alizadeh K. Latent and active tuberculosis: evaluation of injecting drug users. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:775-9. [PMID: 24616784 PMCID: PMC3929809 DOI: 10.5812/ircmj.6283] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 01/15/2013] [Accepted: 06/24/2013] [Indexed: 12/17/2022]
Abstract
Background There is a high risk of tuberculosis (TB) infection among injecting drug users (IDUs). Objectives This study aimed to determine the frequency of latent and active TB infection among IDUs. Materials and Methods In a cross-sectional study between 2008 and 2009, IDUs referred to the methadone maintenance treatment (MMT) centers in Hamedan-Iran, undergone tuberculin skin test (PPD; purified protein derivative) were recruited. The participants with positive results for PPD test (> 5 mm and > 10 mm in HIV positive and negative cases), undergone other complementary procedures such as chest-X-ray and sputum smear test. Results Overall, 268 IDUs between 18 and 70 (mean: 34.5 [8.2]) years were included in the study. PPD test had positive findings in 49 cases (18.3%). There was no significant difference of PPD positivity between HIV positive and negative participants (17.7% vs. 18.5%). An active TB was found among IDUs. Conclusions The high prevalence of latent and active TB among IDUs indicates the need for TB screening tests among this population.
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Affiliation(s)
- Mojgan Mamani
- Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, IR Iran
| | - Mohammad Mahdi Majzoobi
- Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, IR Iran
- Corresponding author: Mohammad Mahdi Majzoobi, Division of Infectious Diseases, Farshchian Hospital, Hamedan, IR Iran. Tel.: +98-9183148151, Fax: +98-8118269808, E-mail:
| | - Saadat Torabian
- Department of Social Medicine, Hamedan University of Medical Sciences, Hamedan, IR Iran
| | - Ronak Mihan
- Hamedan University of Medical Sciences, Hamedan, IR Iran
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Prevalence and Risk Factors of Hepatitis B Virus Genotype D Amongst Inmates in Alborz Province, Iran: A Cross-Sectional Survey. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.10221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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