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 STIsassociated 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

Determining the Effective Factors on Gastric Cancer Using Frailty Model in South-East and North of Iran

Background and Purpose: Gastric cancer is the third leading cause of mortality in Iran after cardiovascular diseases and accidents. The aim of the present study was to assess survival and it’s affecting factors in gastric cancer patients through using Cox and parametric models along with frailty. Materials and Methods: In this study, the medical records of gastric cancer patients treated from 2008 to late 2010 were collected in Afzalipour and Bahonar Hospitals in Kerman and Imam Khomeini Hospital in Sari. 383 patients entered the study and were followed up for at least five years. The survival of patients was assessed by using Cox proportional hazard, log-normal and log-logistic models under gamma and inverse-Gaussian distributions, as two special models for frailty. Models efficiency comparison criteria were Akaike information criterion and Cox-Snell residuals. Results: Out of 196 patients in Kerman, 132(67.3%) were males and 64(32.7%) were females. The average age of the patient was 61yr and 59 yr for the males and females, respectively. Also, the survival rates after 1, 3, and 5 years of the diagnosis were 62%, 50%, and 45%, respectively. In the city of Sari, 69% (129 people) of the patients were male and 31% were female. The mean ages of male and female were 66 and 62 yr, respectively. At the same time, 1, 3, and 5 year survival rates of patients were 58%, 36%, and 30%, respectively. Based on Akaike information criterion, Cox-Snell residuals, and non-monotonic failure rate, log-logistic model along with gamma frailty was more fitted in comparison with other models. Using this model, radiotherapy, heartburn, and tumor grade were found as significant predictors. Conclusion: Radiotherapy, heartburn, and tumor grade could be considered as more affected factors. According to rejection of the proportional hazard assumption, assessments of residual figures, and according to non-significant frailty effect by log-normal model, log-logistic model along with gamma frailty was found to be the best fitted model

Seasonal Pattern Of Brucellosis In Iran: A Systematic Review And Meta-Analysis

Background and purpose: Investigation of the seasonal pattern of brucellosis occurrence may help us to determine the etiology of disease. Seasonal pattern of brucellosis in different parts of Iran has been reported by several studies. Combining the results of these studies provide a reliable estimation of a total seasonal pattern of this zoonosis disease. This study aims to determine the overall pattern of brucellosis in Iran using meta-analysis method. Materials and Methods: Relevant evidence was identified searching the national and international databanks. Eligible articles were entered into the final meta-analysis after comprehensive review of evidence as well as quality assessment. We also calculated the standard error of the incidence according to binomial distribution formula. Because of the significant heterogeneity observed between the results, random effects model was used to combine the results. All data analyses were conducted using Stata software. Results: In total, 26 studies were entered into this systematic review including 17,311 subjects. Incidences (95% confidence intervals) of brucellosis in Iran during spring, summer, autumn and winter were estimated as of 34.4% (30.3-38.6), 33.2% (30.7-35.7), 16.4% (13.3-19.5) and 14.9% (12.7-17.1), respectively. Conclusion: This meta-analysis showed that the highest incidences of brucellosis are occurred during spring and summer, while the lowest incidences are occurred during winter and autumn

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 STIsassociated 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

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