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Introduction: In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19. Methods: This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters. Result: The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah and Hamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces. Conclusion: In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectively mitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.

Abstract Background Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran. Methods The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura’s self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed. Results The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant. Conclusion Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.

Objective(s): Organizing the rapid response team is one of the strategic mechanisms that have been used to control the COVID-19 epidemic. This study aimed to compare the COVID-19 epidemic control before and after the implementation of rapid response program in southeast Iran. Methods: This cross-sectional study was carried out in Sistan and Baluchestan province in summer of 2021. The rapid response team has been settled in the region for 3 weeks since 3 July, and rapid response program including mass vaccination with a community-based approach has been implemented in catchment populations of three universities of medical sciences including Zaheadn, Iranshahr and Zabon. Data were collected from June 5, until September 23, 2021 and analyzed using descriptive statistics in Excel software. Results: During the study period, a total of 2,514,911 people were admitted and 2,125,389 people (84.5%) were discharged. 58,441 (2.3%) of the cases were hospitalized. The total number of tests taken during the study period was 310,741 (111,978 tests per million population). This rate decreased about 15% after the implementation (36% versus 21.7%). The total number of positive death cases was estimated at 0.9 per 1000 population. After the implementation, the mean number of hospitalized cases (59 patients per day), the mean difference of positive laboratory cases (400 cases per day), and the mean difference in the number of deaths (confirmed cases) decreased to eight cases per day. Conclusion: The findings showed that the implementation of rapid response program with community-based approach in was successful in controlling the COVID-19 epidemic.

Background: COVID-19 has become a global problem. In this case study, the experiences gained from disease control in rural areas are reported. Methods: An observational study was done in 2020 in Sistan and Balochestan, the largest province with most rural areas in the southeast of Iran. Results: After identification of the first patient of Covid-19 in a rural area, three measures were taken including: 1. Diagnosis, screening and treatment of the disease (Incident command post was established and the village was completely quarantined, etc.; 2. Intersectoral coordination for epidemiological management (limiting traffic for people and any gathering); and 3. Identification of any Covid-19 positive cases. The results of these measures showed that after quarantining the village and performing the mentioned actions, the number of patients decreased, and the disease was controlled. Conclusion: Quarantine of the contaminated rural area and people’s traffic routes is one of the most important measures in controlling Covid-19.

Introduction and purpose: The epidemiological identification of coronavirus disease 2019 (COVID-19) helps health policymakers to make appropriate decisions, which in return, contributes to controlling the epidemic. This study was conducted to determine the prevalence of this disease in areas of high population density in Zahedan, southeastern Iran. Methods: This retrospective cross-sectional study (descriptive-analytical) was performed on 230 people working and living in densely populated areas of Zahedan from May to June 2020. Data were collected based on a researcher-made questionnaire and the results of the RT-PCR test using throat and nasal swabs from the upper respiratory tract. The collected data were analyzed in SPSS-v16 software. Results: Based on the results, out of 230 participants in the study, 186 (80.9%) were male and 44 (19.1%) were female. The mean age of the subjects was obtained at 36.36 12±12.36 years. Less than 50% of people used personal protective equipment (e.g., masks, gloves, disinfectant solution). The prevalence of COVID-19 was 4.3% in this study and had a statistically significant relationship with such symptoms as fever and chills, headache, nausea, exhaustion, and loss of sense of smell (P

Abstract Background Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors related to the severity of COVID-19 in one of the less privileged areas in Iran. Methods In a multi-center study, all patients admitted to Zahedan University of Medical Sciences hospitals in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological, and clinical data of patients were extracted from medical records. Bivariate and multivariate logistic regression models were used to explore the risk factors associated with the severity of COVID-19. Results Among the 413 patients, 55.5% were male, and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 2.27; 95% CI 1.41–3.65), substance abuse (OR 2.49; 95% CI 1.14–5.43), having one underlying disease (OR 1.52; 95% CI 0.90–2.55), having two underlying disease (OR 2.31; 95% CI 1.19–4.50), and having three or more underlying disease (OR 2.60; 95% CI 1.19–5.66). Conclusions COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with the underlying disease. Understanding the factors affecting the disease severity can help the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.

The aim of this study is evaluation of breast cancer risk factors distribution in two groups of healthy people referral to cancer registry and Shahid Mottahari center in Iran. This study is cross-sectional study which is part of the study to estimate Gene-Environment Interaction in women with breast cancer with case-control studies in Shiraz. In this study, two control groups have been used. The sample size of 300 was specified for each group. Selection sources of groups include Cancer Registry Center and referred people to surgical and internal ward of Shahid Mottahari Clinic. Information collect tools have included Form No. 1 in Cancer Registry Center which includes information of age, use of oral contraceptives history, breastfeeding history, number of live births, age at menarche, age at first childbirth, etc. Considering the results obtained, it was showed that the highest frequency (144) in the group of Cancer Registry Center belongs to high school education, but the highest frequency of Shahid Mottahari Clinic is related to primary education (176).There is statistically significant difference between the two groups in terms of education, history of breast cancer in first-degree relatives and age at first birth, (P

OBJECTIVES The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran. METHODS This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran. RESULTS The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06). CONCLUSIONS This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.

Background: Due to their specific nature, such as high incidence, high intensity and direct involvement of all members of society, traffic injuries are of particular importance. Through a mega data, this study investigated the epidemiological aspects and depict current situation of road traffic injuries in Iran. Methods: Using legal medicine and traffic police data, deaths from road traffic injuries in men were predicted through determining the most appropriate model for death using time series statistical models; and then most important human factors associated with it in a period of 6 yr in Iran was analyzed using multi-nominal regression model. Results: The frequency of deaths from traffic injuries in the last seven years was 172,834 cases and the number of deaths at the accident scene was 42798 cases, of which 24.24% (41,971 cases) were recorded by the Traffic Police experts. Death rate from traffic injuries has been declined from 38 cases per 100,000 people in 2004 to 31 cases per 100,000 people between 2009 and 2010. Fatigue and sleepiness (AOR=10.36, 95% CI: 8.41-13.3) was the most significant human risk factors for death outcome in the urban and suburban traffic injuries. According to the predictions, the death rate is about 16488 (CI 95%, 8531-24364) for the year 2012. Conclusion: Despite all measures to prevent such injuries, even fatal injuries have still a high incidence. Intervention in the human risk factors field would be more effective due to their important roles in traffic injuries in Iran.