Using GIS in explaining spatial distribution of brucellosis in an endemic district in Iran

Background: To check the feasibility of using geographical information system (GIS) methods, we linked the brucellosis data of human and animals. Methods: In a village-based ecological study in Bardsir - a district in Kerman Province located nearly to the central part of Iran - data of human brucellosis, socio-economic level, and livestock characteristics (2001-3) were linked by using GIS methods. Results: Annual incidence of human brucellosis was 141.6 cases per 100,000 inhabitants. Most of the high risk villages were seen in the north and south of Bardsir (3.6% of villages). A positive association was observed between the frequency of brucellosis and density of cattle (OR = 1.81, P = 0.007). In addition, the size of human population was an independent determinant factor (OR = 1.94, P < 0.001). No association was found between frequency of the disease and socio-economic indicators and also the density of sheep. Conclusion: Our study showed that we could generate informative risk maps of brucellosis using health and veterinary data which might improve the quality of control programme in Iran

Care Seeking Patterns of STIs-Associated Symptoms in Iran: Findings of a Population-Based Survey

BACKGROUND: Understanding the prevalence of symptoms associated with sexually transmitted infections (STIs) and how care is sought for those symptoms are important components of STIs control and prevention. People's preference between public and private service providers is another important part of developing a well-functioning STIs surveillance system. METHODS: This cross-sectional survey was carried out in spring 2011, using a nonrandom quota sample of 1190 participants (52% female) in 4 densely-populated cities of Tehran, Kerman, Shiraz, and Babol. Two predictive logistic regression models were constructed to assess the association between the socio-demographic determinants (independent variables) and the dependent variables of history of STIs-associated symptom and seeking care. RESULTS: Around 57% (677 out of 1190; men: 29.70% and women: 81.80%) had experienced at least one STIs-associated symptom during the previous year. History of experiencing STIs-associated symptoms among men, was negatively significantly associated with older age (adjusted odds ratio [AOR] = 0.34, CI 95%: 0.17-0.67). Women who were married, in older ages, and had higher educations were more likely to report a recent (past year) STIs symptom, however all were statistically insignificant in both bivariate and multivariable models. Among those who have had STIs-associated symptoms in the last year, 31.15% did nothing to improve their symptoms, 8.03% attempted self-treatment by over-the-counter (OTC) medications or traditional remedies, and 60.93% sought care in health facilities. In both bivariate and multivariable analyses, care seeking among men was insignificantly associated with any of the collected demographic variables. Care seeking among women was positively significantly associated with being married (AOR = 2.48, 95% CI: 1.60-3.84). CONCLUSION: The reported prevalence of STIs-associated symptoms among our participants is concerning. A considerable number of participants had delayed seeking care and treatment or self-medicated. People should be informed about their sexual health and the consequences of delaying or avoiding seeking care for STIs. Participants preferred seeking care at private sectors which calls for engaging both public and private health sectors for reporting and following up STIs cases

The effects of alcohol on spontaneous clearance of acute hepatitis C virus infection in females versus males

Background Approximately one quarter of persons exposed to hepatitis C virus (HCV) will spontaneously clear infection. We undertook this study to investigate the impact of alcohol on likelihood of HCV spontaneous viral clearance stratified by sex groups. Methods Pooled data from an international collaboration of prospective observational studies of incident HIV and HCV infection in high-risk cohorts (the InC3 Study) was restricted to 411 persons (or 560.7 person-years of observation) with documented acute HCV infection and data regarding alcohol use. The predictor of interest was self-reported alcohol use at or after estimated date of incident HCV infection and the outcome was HCV spontaneous clearance. Sex stratified Cox proportional hazards models were used to evaluate the association between alcohol and spontaneous clearance, adjusting for age, race/ethnicity, and IFNL4 genotype. Results The median age was 28.5 years, 30.4% were women, 87.2% were white, and 71.8% reported alcohol use at or after incident infection. There were 89 (21.6%) cases of spontaneous clearance observed, 39 (31.2%) among women and 50 (17.5%) in men (p < 0.01). Overall, spontaneous clearance occurred less frequently among participants who drank alcohol compared to those who did not drink (18.9% v. 28.5%, p = 0.03). After adjustment for other covariates, alcohol was significantly and independently associated with lower relative hazards for spontaneous clearance of HCV in women (AHR = 0.35; 95% CI: 0.19–0.66; p = 0.001) but not in men (AHR = 0.63; 95% CI: 0.36–1.09; p = 0.10). Conclusion Results indicate that abstaining from drinking alcohol may increase the likelihood of spontaneous clearance among women

Sodium supply influences plasma sodium concentration and the risks of hyper- and hyponatremia in extremely preterm infants

Background: Hyper- and hyponatremia occur frequently in extremely preterm infants. Our purpose was to investigate plasma sodium (P-Na) concentrations, the incidence of hyper and hyponatremia, and the impact of possible predisposing factors in extremely preterm infants. Methods: In this observational study, we analyzed data from the EXtremely PREterm (&lt; 27 wk.) infants in Sweden Study (EXPRESS, n = 707). Detailed nutritional, laboratory, and weight data were collected retrospectively from patient records. Results: Mean ± SD P-Na increased from 135.5 ± 3.0 at birth to 144.3 ± 6.1 mmol/l at a postnatal age of 3 d and decreased thereafter. Fifty percent of infants had hypernatremia (P-Na &gt;145 mmol/l) during the first week of life while 79% displayed hyponatremia (P-Na &lt; 135 mmol/l) during week 2. Initially, the main sodium sources were blood products and saline injections/infusions, gradually shifting to parenteral and enteral nutrition towards the end of the first week. The major determinant of P-Na and the risks of hyper- and hyponatremia was sodium supply. Fluid volume provision was associated with postnatal weight change but not with P-Na. Conclusion: The supply of sodium, rather than fluid volume, is the major factor determining P-Na concentrations and the risks of hyper- and hyponatremia