Search

Objective To investigate the incidence of coronavirus disease 2019 (COVID-19) cases, hospitalizations and deaths in Iranians vaccinated with either AZD1222 Vaxzevria, CovIran[R] vaccine, SARS-CoV-2 Vaccine (Vero Cell), Inactivated (lnCoV) or Sputnik V. Methods We enrolled individuals 18 years or older receiving their first COVID-19 vaccine dose between April 2021 and January 2022 in seven Iranian cities. Participants completed weekly follow-up surveys for 17 weeks (25 weeks for AZD1222) to report their COVID-19 status and hospitalization. We used Cox regression models to assess risk factors for contracting COVID-19, hospitalization and death. Findings Of 89 783 participants enrolled, incidence rates per 1 000 000 person-days were: 528.2 (95% confidence interval, CI: 514.0-542.7) for contracting COVID-19; 55.8 (95% CI: 51.4-60.5) for hospitalization; and 4.1 (95% CI: 3.0-5.5) for death. Compared with SARS-CoV-2 Vaccine (Vero Cell), hazard ratios (HR) for contracting COVID-19 were: 0.70 (95% CI: 0.61-0.80) with AZD1222; 0.73 (95% CI: 0.62-0.86) with Sputnik V; and 0.73 (95% CI: 0.63-0.86) with Covlran[R]. For hospitalization and death, all vaccines provided similar protection 14 days after the second dose. History of COVID-19 protected against contracting COVID-19 again (HR: 0.76; 95% CI: 0.69-0.84). Diabetes and respiratory, cardiac and renal disease were associated with higher risks of contracting COVID-19 after vaccination. Conclusion The rates of contracting COVID-19 after vaccination were relatively high. SARS-CoV-2 Vaccine (Vero Cell) provided lower protection against COVID-19 than other vaccines. People with comorbidities had higher risks of contracting COVID-19 and hospitalization and should be prioritized for preventive interventions. [phrase omitted] [phrase omitted] Objectif Analyser l'incidence des cas, hospitalisations et deces lies a la maladie a coronavirus 2019 (COVID-19) chez les Iraniens vaccines avec Vaxzevria AZD1222, CovIran[R], le vaccin contre le SARS-CoV-2 (cellule Vero), le vaccin inactive (lnCoV) ou Spoutnik V. Methodes Nous avons recrute des individus de minimum 18 ans ayant recu leur premiere dose de vaccin contre la COVID-19 entre avril 2021 et janvier 2022 dans sept villes iraniennes. Les participants ont rempli des enquetes de suivi hebdomadaires pendant 17 semaines (25 semaines pour AZD1222) afin de communiquer sur leur statut COVID-19 et leur hospitalisation. Nous avons utilise des modeles de regression de Cox pour evaluer les facteurs augmentant les risques de contracter la COVID-19, d'etre hospitalise et de mourir. Resultats Sur 89 783 participants recrutes, le taux d'incidence pour 1 000 000 jours-personnes etait de 528,2 (intervalle de confiance de 95%, IC: 514,0-542,7) en termes d'infection a la COVID-19; de 55,8 (IC de 95%: 51,4-60,5) en termes d'hospitalisation; et de 4,1 (IC de 95%: 3,0-5,5) en termes de deces. Compare au vaccin contre le SARS-CoV-2 (cellule Vero), le rapport de risque (RR) de contracter la COVID-19 s'elevait a 0,70 (IC de 95%: 0,61-0,80) avec AZD1222; a 0,73 (IC de 95%: 0,62-0,86) avec Spoutnik V; et a 0,73 (IC de 95%: 0,63-0,86) avec CovIran[R]. Concernant l'hospitalisation et le deces, tous les vaccins offraient un niveau de protection similaire 14 jours apres la seconde dose. Avoir contracte la COVID-19 par le passe premunissait contre une reinfection (RR: 0,76; IC de 95%: 0,69-0,84). Le diabete et les maladies respiratoires, cardiaques et renales entrainaient un risque accru de contracter la COVID-19 apres la vaccination. Conclusion Le taux d'infection a la COVID-19 apres la vaccination etait relativement eleve. D'autre part, le vaccin contre le SARS-CoV-2 (cellule Vero) s'est revele moins efficace que les autres vaccins. Enfin, les personnes souffrant de comorbidites avaient plus de risques de contracter la COVID-19 et d'etre hospitalisees; elles devraient donc etre prioritaires lors des interventions preventives. [phrase omitted] Objetivo Analizar la Incidencia de los casos, hospitalizaciones y muertes a causa de la enfermedad por coronavirus de 2019 (COVID-19) en los iranies vacunados con Vaxzevria AZD1222, la vacuna CovIran[R], la vacuna contra el SARS-CoV-2 (celula Vero), la vacuna inactivada (lnCoV) o la Sputnik V. Metodos Se inscribieron personas de 18 anos o mas que recibieron su primera dosis de la vacuna contra la COVID-19 entre abril de 2021 y enero de 2022 en siete ciudades iranies. Los participantes completaron encuestas de seguimiento semanales durante 17 semanas (25 semanas para AZD1222) para informar sobre su estado de la COVID-19 y la hospitalizacion. Se utilizaron modelos de regresion de Cox para valorar los factores de riesgo de contraer la COVID-19, de ser hospitalizado y de morir. Resultados De los 89 783 participantes inscritos, las tasas de incidencia por 1 000 000 de dias-persona fueron 528,2 (intervalo de confianza del 95 %, IC: 514,0-542,7) en el caso de contraer la COVID-19; 55,8 (IC del 95 %: 51,4-60,5) en el caso de hospitalizacion; y 4,1 (IC del 95 %: 3,0-5,5) en el caso de muerte. En comparacion con la vacuna contra el SARS-CoV-2 (celula Vero), los cocientes de riesgos instantaneos (CRI) de contraer la COVID-19 fueron 0,70 (IC 95 %: 0,61-0,80) con AZD1222; 0,73 (IC 95 %: 0,62-0,86) con Sputnik V; y 0,73 (IC 95 %: 0,63-0,86) con CovIran[R]. En cuanto a la hospitalizacion y la muerte, todas las vacunas proporcionaron una proteccion similar 14 dias despues de la segunda dosis. Los antecedentes de la COVID-19 protegieron contra la contraccion de la COVID-19 de nuevo (CRI: 0,76; IC 95 %: 0,69-0,84). La diabetes y las enfermedades respiratorias, cardiacas y renales se asociaron a un mayor riesgo de contraer la COVID-19 despues de la vacunacion. Conclusion Las tasas de contraer la COVID-19 despues de la vacunacion fueron relativamente altas. La vacuna contra el SARS-CoV-2 (celula Vero) proporciono una menor proteccion contra la COVID-19 que otras vacunas. Las personas con comorbilidades tenian un mayor riesgo de contraer la COVID-19 y de ser hospitalizadas, por lo que deberian ser prioritarias para las intervenciones preventivas., Introduction To end the ongoing global pandemic of coronavirus disease 2019 (COVID-19), it is imperative to have safe and effective vaccines that can provide immunity against severe acute respiratory syndrome [...]

Background: Desired health outcomes are more achievable through strong Primary Health Care (PHC). Using comprehensive and scientific tools, decision-makers are guided to formulate better PHC reforms and policies. This study introduces a sub-national framework based on the World Health Organization (WHO) proposed frameworks for the PHC performance measurement. Method: By a mixed-method and qualitative approach, the Iranian sub-national PHC Measurement Framework (PHCMF) was developed through a review of the WHO's PHC measurement conceptual framework (for selecting Key Performance Indicators (KPIs)), literature review (academic database), PHC-related national documents, consultations with an advisory committee of national experts (6-meetings), and the Delphi technique for finalizing the framework. Results: The Iranian sub-national PHCMF was finalized with 100 KPIs in three components including Health systems determinants, Service Delivery, and Health system objectives. Based on the result chain domain, most KPIs were related to the output (24 KPIs) and the least were related to the input and the process (9 KPIs). Conclusion: Regarding the comprehensiveness of the developed measurement framework due to its focus on all PHC operational levers and key aspects of PHC systems' performance, it can be used as a practical tool for assessing and improving the Iranian sub-national PHC system. [ABSTRACT FROM AUTHOR]

Background: Tobacco use is an established preventable risk factor for many noncommunicable diseases and is considered as an important indicator for monitoring progress towards Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). This study aimed to determine the situation of tobacco use among Iranian adults using 2016 household survey. Methods: This is a secondary analysis of the data from 2016 nationally representative STEPwise approach to Surveillance (STEPs) survey with a sample size of 31,050. The data on tobacco consumption was gathered using questions incorporated in the survey questionnaire. Results: The prevalence of current tobacco use in Iran was 25.2 % (24.4-25.9) in men versus 4% (3.7-4.3) in women. The prevalence was higher in rural areas and among second wealth group. The prevalence of current daily cigarette smoking was 20.1% (19.4-20.7) in men versus 0.9% (0.8-1.1) in women). Average number of cigarettes per day among current cigarette smokers was 14.5% (14.1-14.9), mean age at start smoking among daily cigarette smokers was 21.6% (21.1-22), and 95.2% (94.4-96) of daily current daily cigarette smokers attempted for cessation during past 12 months. Prevalences of exposure to secondhand cigarette smoke among nonsmokers at homes and workplaces were 23.21% (22.65-23.76) and 18.04% (17.2-18.87), respectively. Conclusions: There was a large difference between the prevalence of tobacco use between men and women (25.2% vs. 4%). Higher prevalences of tobacco use in rural areas and among lower wealth quintiles require more equity-based approaches in tobacco combatting actions. [ABSTRACT FROM AUTHOR]

Following his inauguration in late 2013, President Rouhani aimed to boost quality and equity in the health care delivery system. To fulfill this aim, a set of interventions, called Health Transformation Plan (HTP), were implemented. So far, it has been a heated debate whether HTP breathes a spirit of a new reform. HTP has targeted long-standing historical deficits of the Iranian health system as well as urgent problems, both of which have been, to some extent, resolved. To decrease Out-Of-Pocket (OOP) health expenditures, HTP has presented new financing mechanisms to expand a safety net to Iranian citizens fundamentally. HTP also encompassed interventions to overcome problems in the provision of health care by recruitment of health workforces, establishing new health facilities, and expanding primary health care to urban and peri-urban areas. Furthermore, performance indicators including access, quality, and patient satisfaction have been affected. Given these changes, HTP is entitled to be a health system reform. However, a new agenda within HTP is required so that the Iranian health system can obtain better value for money that is to be spending on it. [ABSTRACT FROM AUTHOR]

Objective. This Study was conducted after a diarrhea outbreak that occurred in Yazd Province, Iran. The aim of the study was to compare knowledge, attitude, practice, and other risk factors of the affected communities regarding diarrhea outbreak (the cities of Zarch, Meybod, and Ardakan) to nonaffected communities (the cities of Yazd and Taft). Methods. A knowledge, attitude, and practice (KAP) survey study was conducted from August to September 2013 enrolling 505 subjects who were referred to health centers anonymously during the epidemic. The questionnaire included the following four parts: (a) general characteristics such as gender, education level, source of health information obtaining; (b) 12 questions on knowledge (Min = 0, Max = 36); (c) 10 questions on attitude (Min = 0, Max = 50); and (d) nine questions on practice (Min = 0, Max = 27). Results. The overall mean score of knowledge, attitude, and practice was 28.17 (SD = 4.58), 37.07 (SD = 4.39), and 21.31 (SD = 3.81), respectively. Practice on food- and waterborne outbreaks was significantly higher in females (P = 0.001) and in nonaffected communities (P = 0.031). Conclusions. Nonaffected communities had a considerably better practice score. With the increase in the score of knowledge about food- and waterborne outbreaks, the score of practice increased slightly. [ABSTRACT FROM AUTHOR]

Objective: To find out the prevalence and relationship of anemia in reproductive age women in rural area of Tabas, center of Iran. Iron deficiency anemia is the most common nutritional problem, affecting about 41.8% of pregnant and 30.2% of non-pregnant women worldwide. Materials and methods: A cross-sectional study was conducted on the random sample of 382 reproductive age women in rural areas of Tabas in March 2010. Independent sample t-test, one way analysis of variance (ANOVA) and logistic regression were applied for the data analysis. Results: The obtained data revealed a total response rate of 13.8% for prevalence of anemia, while 14.5% and 5.9% belonged to non-pregnant and pregnant participants, respectively. Low socioeconomic status (odds ratio 3.35) and high parity index (odds ratio 2.31) were associated with higher prevalence of anemia. Conclusion: Although this study was conducted in a rural area of Tabas, where their average incomes were lower than average income of major cities in Iran, the prevalence of anemia was lower than the rate reported in previous studies carried out in other locations of Iran, even in high risk (pregnant women) groups. [ABSTRACT FROM AUTHOR]

Background: HIV/AIDS continues to be a major global health problem. The aim of this study was to evaluate common opinions and beliefs about HIV/AIDS among Iranian teenager girls. Methods: This Qualitative study (face to face interviews with tape recording) was conducted among fifty female teenager school students in Urmia Iran. Results: The thematic analysis indicated the main information sources for HIV/AIDS among teenage girls to be their mother and teachers. The participants had little concern about the dissemination of HIV/ AIDS in Iran. Using a common syringe is mentioned as the main risk factor for HIV transmission. There were some misconceptions about the at risk group among teenage girls. Conclusions: Considering the misconceptions among the teenage girls, their beliefs should be reformed and reorganized in order to reduce the risk of exposure to HIV. The best practice is training life skills in the school level. [ABSTRACT FROM AUTHOR]

Background: Thalassaemia is one of the most common Mendelian disorders in Mediterranean area. Iran has about 26,000 Thalassaemic patients, so it is one of the most affected countries. The aim of this study was to evaluate the screening program and cost analysis of Thalassaemia prevention program in West-Azerbaijan province of Iran. Methods: This study evaluated the efficacy of Health system's Thalassaemia prevention program with a sensitivity analysis for its costs. The second five years of the program was evaluated. The economic burden of Thalassaemia is determined by the birth prevalence of the affected infants and the cost that is accrued to treat the infected individuals and was compared with the total cost of screening the couples for thalassemia trait. Results: The average incidence rate of major Thalassaemia was 19.8 per 100,000 live births and mean coverage rate of program was 74%. The rate of canceling the marriage among carrier couples was 53%. Cost analysis showed that the cost of screening and prenatal diagnosis program was much lower than the cost of treatment in potential thalassaemic patients. Conclusions: The prevention program of Thalassaemia including a premarital and pre-natal screening in west Azerbaijan province is demonstrated to be cost-effective. Taking some actions in order to increase the coverage of pre-marital screening, providing prenatal diagnosis in private and public sector, complete insurance coverage for the high-risk couples to perform the investigations more easily, were recommended. [ABSTRACT FROM AUTHOR]