Hepatitis B vaccination coverage among Iranian children aged 15-26 months in 2006

This study in 2006 estimated the hepatitis B virus (HBV) vaccination coverage in the Islamic Republic of Iran at the national and district levels in urban, rural and remote populations of 41 university health service areas. Of 21 905 children recruited to the study, vaccination coverage based on vaccination card records was 100% in 14, 15 and 10 of the 41 university areas for the 1st, 2nd and 3rd doses of HBV respectively. National levels of HBV1, HBV2 and HBV3 coverage were 98.9%, 98.8% and 98.4% respectively. The lowest HBV vaccination coverage rate was 90.7% (in a remote district). HBV vaccination coverage was at an acceptable level in Iranian children

Sentinel hospital-based surveillance of Rotavirus diarrhea in Iran

Background. Rotavirus is the most common causes of severe, acute diarrhea during childhood and is an important cause of morbidity and mortality in developing countries. We established active hospital-based surveillance of childhood diarrhea to assess the scope of severe rotavirus disease in Iran. Methods. From May 2006 through April 2007, prospective surveillance of rotavirus diarrhea among children aged <5 years was conducted in 5 sentinel hospitals in Iran. Stool samples were tested for rotavirus using a commercially available enzyme immunoassay, and rotavirus-positive samples were genotyped using reverse-transcriptase polymerase chain reaction. Results. Of 2198 children admitted to the hospital for acute gastroenteritis, 1298 (59.1%) had stool samples test positive for rotavirus by enzyme immunoassay. Of the rotavirus episodes, 85% occurred during the first 2 years of life, with the peak prevalence of severe rotavirus disease occurring from September through January. Among the 110 rotavirus-positive samples that were genotyped, G4P[8] was the most commonly detected rotavirus genotype (30.9% of strains). Other commonly detected genotypes included P[8] with G nontypeable (21.8%), G4 with P nontypeable (13.6%), G1[P8] (10.9%), and G2[P4] (5.5%). Conclusions. Rotavirus is the most common cause of severe diarrhea in Iran, which indicates that safe and effective rotavirus vaccination in Iran is a public health priority. © 2009 by the Infectious Diseases Society of America. All rights reserved

Prevalence, risk factors, and epidemiology of food-borne botulism in Iran

Background: Botulism is a severe neuroparalytic disease caused by toxins produced by several Clostridium species. This work presents the surveillance results of botulism in Iran, with the distribution of the cases by regions and by vehicle of transmission. Methods: We describe the findings of the Centers for Disease Control and Prevention (CDC) surveillance on 2037 suspected cases of food-borne botulism during 2007�2017. Results: A total of 252 (12.3) cases were confirmed to food-borne botulism. The mean annual incidence per 100,000 Iranian Natives was 7.1 cases for male individuals and 3.3 cases for female individuals. All botulism events were confirmed to be foodborne. The most commonly implicated food was home-prepared traditional processed fish product, followed by the consumption of commercially canned products and non-pasteurized dairy products. Forty-eight (19) fatal botulism were reported which, the case-fatality rate declined from 4.5 to 0.7 during the study period. Conclusion: Laboratory-based diagnosis of botulism is an imperative procedure to elucidate cases, particularly food-borne botulism, to identify toxins in food and confirm clinical diagnosis, helping sanitary control measures. In addition, educational materials related to botulism prevention should be disseminated to different communities. © 2020 Atlantis Press

Psychiatric disorders among people living with HIV/AIDS in IRAN: Prevalence, severity, service utilization and unmet mental health needs

Background: HIV and psychiatric disorders are closely correlated and are accompanied by some similar risk factors. Objective: The aim of this study was to assess psychiatric comorbidity and health service utilization for mental problems among people living with HIV/AIDS in Iran. Methods: A total of 250 cases were randomly selected from a large referral center for HIV treatment and care in Tehran, Iran. Psychiatric disorders in the past 12 months including mood, anxiety, and substance use disorders were assessed through face-to-face interview, using a validated Persian translation of the Composite International Diagnostic Interview (CIDI v2.1). Severity of psychiatric disorders, social support, socio-economic status, service utilization and HIV-related indicators were assessed. Results: Participants consisted of 147 men and 103 women. Psychiatric disorders were found in 50.2 (95 confidence interval: 43.8�56.6) of the participants. Major depressive disorder was the most prevalent diagnosis (32.1), followed by substance use disorders (17.1). In bivariate analysis, psychiatric disorders were significantly higher among male gender, single and unemployed individuals and those with lower social support. In multivariate regression analysis, only social support was independently associated with psychiatric disorders. Among those with a psychiatric diagnosis, 41.1 had used a health service for mental problems and 53 had received minimally adequate treatment. Conclusion: The findings of the study highlight the importance of mental health services in the treatment of people living with HIV/AIDS. © 2018 Elsevier Inc

Prevalence of high blood pressure in Iranian adults based on the 2017 ACC/AHA guideline

Background:: In 2017, American College of Cardiology (ACC) and the American Heart Association (AHA) presented a new guideline for assessing blood pressure in adults. This study aimed to assess the prevalence of hypertension in Iranian adults based on ACC/AHA 2017 guideline. Methods: Data from 9801 Iranian adults (59.2 women) aged between 20-69 years were obtained from the sixth round of National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD) performed in 2011. Blood pressure was classified as normal, elevated blood pressure, and stage 1 and 2 hypertension using a weighted analysis and 2017 ACC/AHA guidelines. Data were presented as prevalence and 95 confidence interval (95 CI). All analyses were performed in Stata/SE 14.0. Results: Overall prevalence of hypertension in Iranian men was 52.0. Also, 32.9 (95 CI: 29.9-36.0) and 19.1 (95 CI: 16.921.6) of men had stage 1 and 2 hypertension, respectively. In addition, 44.3 of women had hypertension, of whom 26.3 (95 CI: 24.5 - 28.2) had stage 1 and 18.0 (95 CI: 16.1-20.1) stage 2 hypertension. Furthermore, 16.5 (95 CI: 14.4-18.9) and 9.6 (95 CI: 7.86-11.7) of men and women had elevated blood pressure, respectively. Conclusion: The findings of this study indicated that adopting the 2017 ACC/AHA guidelines showed a higher prevalence of adult hypertension (48.2) in Iran. In this study, the prevalence of hypertension in men was higher than in women, which was steadily increased by age in older adults in both sexes. © Iran University of Medical Sciences

Erythropoietic protoporphyria without skin symptoms-you do not always see what they feel

Erythropoietic protoporphyria (EPP) is an inherited disorder of the porphyrin metabolism that often remains undiagnosed in children. We report on a 4-year-old girl who had been suffering for 1 year from recurrent painful crises affecting her hands, feet, and nose following sun exposure. Objective skin lesions were absent until the age of 6. Porphyrin analysis revealed elevated free erythrocyte protoporphyrin (FEP) levels confirming the diagnosis of EPP. This illustrates that skin lesions might be completely absent in children affected with EPP, a fact that has only been reported once previously. Because EPP can manifest with few and unspecific cutaneous symptoms or no skin lesions at all, like in this patient, the diagnosis of EPP might be delayed or missed. EPP should be excluded in all photosensitive children, especially when discomfort is disproportionate to the extent of the cutaneous lesions. The clinic, pathophysiology, diagnosis, complications, and therapy of EPP are discussed

Incidence, mortality, and burden of crimean congo hemorrhagic fever and its geographical distribution in Iran during 2009-2015

Background: This study aimed at estimating the incidence, mortality, burden, and geographical distribution of Crimean Congo Hemorrhagic Fever (CCHF) using Disability Adjusted Life Years (DALYs) in Iran 2009-2015. Methods: CCHF-related DALYs was calculated using a method developed by WHO for the investigation of Global Burden of Diseases (GBD). DALYs was calculated through adding years of life lost due to premature death (YLLs) to years lived with disability (YLDs). To calculate YLD, the average duration of the disease and its disability weight were set at 25 d and 0.613, respectively. The data on the incidence and mortality were collected from the CCHF surveillance system from the governmental section. Results: The highest and the lowest incidence rates of CCHF were observed in 2009 (122 cases) and 2010 (254 cases), respectively. Moreover, the lowest and highest mortality rates were reported in 2009 (20 cases) and 2012 (52 cases), respectively. The mean rate of fatality from CCHF observed between 2009 and 2015 was about 21.1. In addition, the lowest and highest DALYs were observed in 2009 (483 cases) and 2010 (1156 cases), respectively. CCHF incidence, DALYs, and mortality rate over the studied period were higher among males than females. CCHF-related DALYs did not have an equal distribution in all provinces of Iran; some provinces were suffering from a higher burden of the disease. Conclusion: It is recommended to improve the CCHF surveillance system, identify high-risk areas, practice early diagnosis and intervention, develop vaccines, control, and fight tick, and screen livestock to control and prevent the spread of this disease. © 2019, Iranian Journal of Public Health. All rights reserved

Incidence, mortality, and burden of hepatitis B and C and geographical distribution in Iran during 2008-2015

Background: This study aimed at estimating the incidence, mortality, and burden of Hepatitis B (HBV) and Hepatitis C (HCV) viruses and their trends from 2008 to 2015. Methods: The Disability Adjusted Life Year (DALYs) index was applied to calculate the burden of the diseases by age, sex, time, and locations. The incidence and demographic data were obtained from HBV and HCV surveillance system, and the data on natural history was extracted from the cohort studies; moreover, the data on the standard life expectancy was obtained from the Iranian life table 2016. The two values of 0.03 and 21.5 yr were set as the discount rate and mean standard duration of the disease for both types of hepatitis. Results: The burden of HBV decreased from 13735 to 78277.6 yr, but there was an increase in the burden of HCV from 5174 to 14395 yr over the studied period. The burden of both types of hepatitis was higher among males than females. The incidence of HBV increased from 46611 to 22996 cases, and the incidence of HCV increased from 1210 to 3939 cases. The HBV decreased from 1925 to 1394 cases; however, the number of deaths caused by HCV increased from 197 to 583 cases over the studied period. The share of YLLs raised from 5 to 10 for HBV whereas it changed from 23 to 62 for HCV over the studied years. Tehran, Khorasan Razavi, and Golestan had the highest and Chaharmahal and Bakhtiari, Kurdistan, and Kermanshah had the lowest adjusted burden of HBV per 1000 population. Conclusion: Although the incidence, mortality, and burden of HBV declined over the eight studied years, these values increased dramatically for HCV. © 2019, Iranian Journal of Public Health. All rights reserved