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Mehmandoost S, Mirzazadeh A, Karamouzian M, Khezri M, Sharafi H, Shahesmaeili A, Maghsoudi SH, Ghalekhani N, Tavakoli F, Bazrafshani MS, Shokoohi M, Aghaali N, Haghdoost AA, Sharifi H. Injection cessation and relapse to injection and the associated factors among people who inject drugs in Iran: The Rostam study. Subst Abuse Treat Prev Policy 2023; 18:72. [PMID: 38031110 PMCID: PMC10687883 DOI: 10.1186/s13011-023-00583-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Drug injection is a major health-related problem worldwide. Injection cessation and relapse to injection could significantly alter the risk of HIV and hepatitis C virus (HCV) among people who inject drugs (PWID). This study aimed to estimate the rate of injection cessation and relapse to injection among PWID in Iran. METHODS This cohort study was conducted from 2018 to 2021 in the cities of Kerman and Tehran. Using a respondent-driven sampling (RDS) approach, 118 PWID with a history of injection in the last six months and negative HIV and HCV tests were recruited. Follow-up visits occurred every three months over a period of one year. Participants were interviewed and tested for HIV and HCV using rapid tests. Injection cessation was defined as the no injection of any type of drugs in the last three months. Relapse to injection was defined as re-initiating drug injection among those who had ceased injection. Two separate Cox regression models were applied, and an adjusted hazard ratio (aHR) with a 95% confidence interval (CI) were measured to assess the factors associated with each outcome. RESULTS The rate of injection cessation was 26.1 (95% CI: 21.3, 32.0) per 100 person-years, and the rate of relapse to injection was 32.7 (95% CI: 24.7, 43.2) per 100 person-years. At the baseline interview, 39.8% (n = 47) of participants reported injection cessation in the past three months before the interview. In the multivariable Cox regression analysis, the rate of relapse to injection was greater among women (aHR = 1.58; 95% CI: 1.01, 2.52), and those with higher monthly income (aHR = 1.63; 95% CI: 1.03, 2.59). However, there was no significant variable that predicted injection cessation. CONCLUSION Injection cessation was common among PWID in Iran, however, one-third relapsed to injection shortly after cessation. Harm reduction programs should include comprehensive strategies to reduce the probability of relapse among PWID who achieve injection cessation.
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Affiliation(s)
- Soheil Mehmandoost
- 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
| | - 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
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 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
- Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mehrdad Khezri
- 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
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Heidar Sharafi
- 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
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, 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
| | - Saiedeh Haji Maghsoudi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nima Ghalekhani
- 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
| | - Fatemeh Tavakoli
- 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
| | - Maliheh Sadat Bazrafshani
- 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
| | - 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
| | - Niloufar Aghaali
- 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
| | - 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
| | - 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.
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Ramezani A, Sorouri R, Haji Maghsoudi S, Dahmardeh S, Doroud D, Sadat Larijani M, Eybpoosh S, Mostafavi E, Olyaeemanesh A, Salehi-Vaziri M, Bavand A, Zarghani G, Moradi L, Ashrafian F, Bagheri Amiri F, Mashayekhi P, Tahmasebi Z, Biglari A. PastoCovac and PastoCovac Plus as protein subunit COVID-19 vaccines led to great humoral immune responses in BBIP-CorV immunized individuals. Sci Rep 2023; 13:8065. [PMID: 37202438 PMCID: PMC10195798 DOI: 10.1038/s41598-023-35147-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 05/20/2023] Open
Abstract
The optimal booster vaccine schedule against COVID-19 is still being explored. The present study aimed at assessment of the immunogenicity and antibody persistency of inactivated-virus based vaccine, BBIP-CorV and protein-subunit based vaccines, PastoCovac/Plus through heterologous and homologous prime-boost vaccination. Totally, 214 individuals who were previously primed with BBIBP-CorV vaccines were divided into three arms on their choice as heterologous regimens BBIBP-CorV/PastoCovac (n = 68), BBIBP-CorV/PastoCovac Plus (n = 72) and homologous BBIBP-CorV (n = 74). PastoCovac booster recipients achieved the highest rate of anti-Spike IgG titer rise with a fourfold rise in 50% of the group. Anti-RBD IgG and neutralizing antibody mean rise and fold rise were almost similar between the PastoCovac and PastoCovac Plus booster receivers. The antibody durability results indicated that the generated antibodies were persistent until day 180 in all three groups. Nevertheless, a higher rate of antibody titer was seen in the heterologous regimen compared to BBIP-CorV group. Furthermore, no serious adverse event was recorded. The protein subunit-based booster led to a stronger humoral immune response in comparison with the BBIP-CorV booster receivers. Both the protein subunit boosters neutralized SARS-CoV-2 significantly more than BBIP-CorV. Notably, PastoCovac protein subunit-based vaccine could be successfully applied as a booster with convenient immunogenicity and safety profile.
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Affiliation(s)
- Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, Iran
| | - Rahim Sorouri
- IPI Directorate, Pasteur Institute of Iran, Tehran, Iran
| | - Saiedeh Haji Maghsoudi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sarah Dahmardeh
- Department of Vaccination, Pasteur Institute of Iran, Tehran, Iran
| | - Delaram Doroud
- Quality Control Department, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Mona Sadat Larijani
- Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, Iran.
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Alireza Olyaeemanesh
- Health Equity Research Centre and National Institute of Health Research, Tehran University of Medical Science, Tehran, Iran
| | | | - Anahita Bavand
- Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, Iran
| | | | - Ladan Moradi
- Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, Iran
| | - Fatemeh Ashrafian
- Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, Iran
| | - Fahimeh Bagheri Amiri
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Parisa Mashayekhi
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Zahra Tahmasebi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Alireza Biglari
- School of Medicine, Tehran University of Medical Sciences, Enghelab Street, P.O. BOX 14155-6559, Tehran, Iran.
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Rastegari A, Baneshi MR, Hajebi A, Noroozi A, Karamouzian M, Shokoohi M, Mirzazadeh A, Khojasteh Bojnourdi T, Nasiri N, Haji Maghsoudi S, Haghdoost AA, Sharifi H. Population Size Estimation of People Who Use Illicit Drugs and Alcohol in Iran (2015-2016). Int J Health Policy Manag 2022; 12:6578. [PMID: 36243944 PMCID: PMC10125066 DOI: 10.34172/ijhpm.2022.6578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/09/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Estimating the number of people using illicit drugs and alcohol is necessary for informing health policy and programming. However, it is often challenging to reliably estimate the size of these marginalized populations through direct methods. In this study, we estimated the population size of these groups using the indirect Network Scale-Up (NSU) method in Iran from 2015 to 2016. METHODS Using a self-administered questionnaire, we asked 15 124 individuals (54% men) about the number of people they know who used different types of drugs at least once in the past 12 months. Prevalence estimates were reported per 100 000 population. The uncertainty level (UL) was calculated using the bootstrap method. RESULTS The average age of the respondents was 33 years old, and 35.1% of them were unmarried. The most common drugs and their prevalence were as follows: opium (2534 [95% UL: 2467-2598]), hashish (849 [95% UL: 811-886]), stimulants (methamphetamine, ecstasy pills, cocaine, and Ritalin) (842 [95% UL: 802-879]), heroin/crack (578 [95% UL: 550-607]), and drug injection (459 [95% UL: 438-484]). Additionally, we estimated the prevalence of alcohol use as 2797 (95% UL: 2731-2861). On average, substance use was 5.23 times more prevalent among men than women. Opium use was more prevalent among individuals aged >50 years old. Moreover, alcohol use was more prevalent among participants between 18 and 30 years old (5164 per 100 000 population). CONCLUSION Although opium continues to be the most prevalent illicit drug in Iran, the patterns of illicit drug use are heterogeneous among different age groups, genders, and provinces. Age-gender specific and culturally appropriate interventions are warranted to meet the needs of people in different subgroups.
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Affiliation(s)
- Azam Rastegari
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Center for Longitudinal and Life Course Research, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Ahmad Hajebi
- Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Psychiatry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Karamouzian
- Centre On Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | | | - Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
| | - Saiedeh Haji Maghsoudi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
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Rahi E, Baneshi MR, Mirkamandar E, Haji Maghsoudi S, Rastegari A. A Comparison between APGAR Scores and Birth Weight in Infants of Addicted and Non-Addicted Mothers. Addict Health 2011; 3:61-7. [PMID: 24494118 PMCID: PMC3905520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 04/03/2011] [Indexed: 11/14/2022]
Abstract
BACKGROUND Addiction in pregnant women causes complications such as abortion, asphyxia and cerebral and physical problems. APGAR score assesses vital signs and birth weight and represents the physical and brain growth of newborns. In this study, the effects of opium addiction in mothers on birth weight and APGAR scores of neonates were discussed. METHODS This study analytic, descriptive study was conducted on 49 pregnant women addicted to oral consumption of opium (0.5-0.8 grams daily) and 49 non-addicted women who referred to Afzalipour Hospital associated with Kerman University of Medical Sciences. Information including various personal characteristics, history of addiction and drug consumption, and the possibility of taking other drugs was collected by a researcher and recorded confidentially in a checklist. Birth weight and APGAR score t first, fifth and tenth minutes were also recorded. Statistical analysis was performed using Pearson correlation test, independent t-test, and repeated measure to evaluate the APGAR scores and other characteristics of the two groups of infants. FINDINGS Average birth weight of infants with addicted mothers was 2255 grams which had a significant difference with infants born by non-addicted mothers (P < 0.0001). Average APGAR scores at the first minute were 7.6 ± 1.1 and 8.6 ± 1.1 among infants from addicted and non-addicted mothers, respectively. Average APGAR scores over time (at minutes 1, 5 and 10) had a significant difference (P < 0.0001) where an ascending trend was seen. This difference was significant in both groups (P = 0.003). CONCLUSION Drug addiction in mothers decreases the APGAR score and birth weight of infants.
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Affiliation(s)
- Esmat Rahi
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Assistant Professor, Department of Biostatistics and Epidemiology, Research Center for Modeling in Health, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ehsan Mirkamandar
- Medical Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Saiedeh Haji Maghsoudi
- Regional Knowledge Hub for HIV/AIDS Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Azam Rastegari
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
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