مجله اپیدمیولوژی ایران
سال هفدهم شماره 3 (پیاپی 63، پاییز 1400)

COVID-19 is a new disease and little information is available on its risk factors. The aim of this study was to determine the mortality risk factors in patients with COVID-19 in the northeast of Iran.  
 

A case-control study was conducted. Patients of both sexes with a confirmed diagnosis of Covid-19 infection who died during the study were studied as the case group and patients who were in good general health and ready for discharge were studied as the control group. Data analysis was performed with the STATA software version 14 using descriptive statistics and univariate and multiple logistic regression tests.
 

Six hundred and eleven patients were studied (27% cases and 73% controls). Multiple logistic regression analysis showed that the odds of death were 2.8 times higher in patients over 80 years compared to patients aged 50-60 years. In addition, age under 40 years reduced the odds of mortality by 85% and living in rural areas increased odds of death by 2.2 times. Cough, general fatigue, pain, nausea and vomiting increased the odds of COVID19 survival.
 

The odds of mortality were higher in elder patients with COVID-19. In addition, living in rural areas increased the odds of mortality in patients. Cough and fatigue reduced mortality; however, it is needed to address other hidden factors for sound judgment.

Using a random sample of women aged 15 to 50 years in Tehran, this study sought to estimate the lifetime prevalence of abortion (intentional and unintentional) and to identify its associated factors.
 

The control data of a population-based case-control study conducted in 2014 in Tehran was used in the present study. Data from 544 randomly selected women aged 15-50 living in municipality areas of Tehran were included in this study. A multiple logistic regression model was used to investigate factors associated with abortion and to estimate the adjusted odds ratios (ORs) and 95% confidence intervals.
 

Overall, 102 women (18.8%, 95% CI (22.4% -15.8%)) reported a lifetime history of abortion. In the logistics regression model, being single (OR =3.46, 95% CI: 1.42-8.47) older age (OR = 1.07, 95% CI: 1.04-1.11) increased the odds of a positive lifetime history of abortion. However, having a child (OR = 0.27, 95% CI: 0.11-0.65)), more education years (OR = 0.89, 95% CI: 0.82-0.96)) and higher religious beliefs (OR = 0.65, 95% CI: (0.45-0.93)) decreased the odds of a positive lifetime history of abortion..
 

High reported lifetime prevalence of abortion in the present study and its subsequent risks to maternal health highlight the need for educational interventional programs taking into account the level of education and knowledge of mothers along with their religious.

The aim of this study was to investigate the epidemiological characteristics of patients with Covid-19 in Hamadan Province. 

In this descriptive cross-sectional study, demographic and epidemiological data of all people who presented to hospitals in Hamadan Province from February 2019 to December 2020 were extracted using two checklists. Data were then analyzed using the Stata software. 

In this study, 9674 covid-19 positive patients were examined. According to results, 49.11% of the cases occurred in the elderly over 60 years. The rate of involvement was higher in females than males (51.57% vs. 48.43%). Moreover, 72.05% of the definitive patients lived in the city and 0.76% reported traveling to areas with a high prevalence of the disease two weeks before the onset of symptoms. The highest incidence of this disease per one hundred thousand population was in Malayer, Hamedan and Nahavand counties and the highest fetality was in Razan and Dargazin, Tuyserkan and Asadabad counties, respectively. The data of suspected, probable, and definite outpatients with Covid-19 presenting to medical centers were not evaluated in this study. 

Due to the high death rate in the elderly, males, those with underlying diseases, and people living in rural areas, it is necessary to design and apply precautionary measures in these groups. Attention should be paid to these high-risk groups in the shortest possible time to reduce the burden of this disease on individuals as well as the health care system.

This qualitative study was conducted to identify reasons for not using condoms by people who inject drugs (PWID) in Iran.
 

Purposeful sampling was applied to recruit four groups [male PWID (n = 14), female PWID (n=6), service providers (n=8), and HIV/Addiction experts (n = 9)] into a qualitative study. Data were collected through focus group discussions (FGDs) or individual in-depth interviews. Data were analyzed using conventional content analysis.
 

The mean age was 44.0 years for male and 38.2 for female PWID. Qualitative analysis showed 16 themes for not using a condom, which were grouped in three main categories, including knowledge (3 themes), accessibility (4 themes), and individual barriers to use condoms (9 themes). Poor knowledge included low perceived level of risk, insufficient training, and misconceptions. Lack of access to condoms resulted from the country's new policy for population growth control and decrease in the number of pharmacies and harm reduction centers and prisons where condoms were previously distributed free of charge. Common reported individual barriers to condom use were poverty, homelessness, depression, low self-care, and low self-esteem, less pleasure, having sex under the influence of drugs, and stigma.
 

Both structural and individual factors may play a role as barriers to condom use among PWID.

Given the importance of the early detection of any outbreak or change in the trend of meningitis, this study was conducted to estimate the fixed and dynamic alarm threshold levels of meningitis and its outbreak in Iran.
 

In this study, the data of all patients from 20 March 2016 to 20 March 2019 were extracted from the National Meningitis Disease Surveillance System. Alarm threshold levels were calculated separately for different seasons and provinces. To determine the alarm threshold levels, four methods of Upper Control Limit (UCL), relative increase, statistical cut off points, and recommendations provided by the World Health Organization were used.
 

The alarm threshold levels for confirmed cases were determined for Iran according to the upper limits of cumulative sum (CUSUM) algorithm and the statistical cut off points based on the 90th percentile, 2 cases per day for Iran. The fixed amount was 3 to 5 cases per week in populations under 30,000 and 5 to 7 per week in populations between 30,000 and 100,000. According to the relative increase method, a 30% increase in one week compared to previous weeks was considered as the threshold level.
 

The use of alarm threshold levels reported in this study can be a basis for detecting meningitis outbreaks.

Road accidents are a major public health problem and one of the leading causes of death in the world. Some survivors of traffic accidents experience acute stress disorder and post-traumatic stress disorder during weeks to months following the accident. These disorders can have disastrous effects on victims and their inability to return to normal living conditions.
 

This was a cross-sectional descriptive study. The Post-Traumatic Stress Disorder checklist (PCL5) was used to assess acute stress disorder and post-traumatic stress disorder. The sample size was 384 people and the data were collected one week and two months after the trauma in the orthopedic, emergency and inpatient wards of Taleghani, Shohadaye Tajrish and Haftom Tir hospitals. This study was conducted between October and January 2016.
 

This study was conducted on 350 participants. About 49% of the participants (n = 172) met the diagnostic criteria for acute stress disorder and 40.6% (n = 142) met the diagnostic criteria for post-traumatic stress disorder. There was a relationship between demographic variables of age and death of a close family or friend and the severity of post-traumatic stress disorder.
 

According to the results, about half of the participants had acute stress disorder and met the diagnostic criteria of post-traumatic stress disorder. This result highlights the high prevalence of this disorder in traffic accident victims and the importance of its follow-up and control.

Healthcare providers suffer from occupational burnout due to emotional and physical pressures dealing with patients, which affects all aspects of living behavior. This study aimed to identify the association between occupational burnout and driving behavior among the employees of Shahid Beheshti University of Medical Sciences.

A descriptive- analytical study was conducted on 1629 employees of Shahid Beheshti University of Medical Sciences that were selected using random sampling. The employees completed a demographic questionnaire, Maslach Burnout Inventory, and Manchester Driver Behavior Questionnaire. The data were assessed based on a Likert scale. 

The results of occupational burnout analysis showed that the mean scores of emotional exhaustion (72.2-22.2-5.6%), cynicism (0.6-42.8-51.6) and professional inefficacy (31.8-21.8-46.4%) were mild, moderate and severe, respectively. The results also showed a significant relationship between depersonalization disorder and unintentional driving violations (P=0.026), driving-related errors and self-adequacy (p=0.023), and occupational burnout and driving behavior and the variables of gender, shift work, working hours, and educational groups. In general, occupational burnout was higher in women than in men (P<0.05). 

Educational programs can improve low - risk driving ability among this group of employees. Psychological and counseling services should be reinforced in organizations so that the employees attain the ability to adapt to occupational psychological pressures to reduce occupational burnout in the long term.

Due to the importance of cutaneous leishmaniasis, the national leishmaniasis project began in 2007 in Iran. The aim of the present study was to evaluate community interventions in changes in the incidence of cutaneous leishmaniasis in Isfahan Province from 2002 to 2018: an Interrupted time series regression analysis.

The present study was a repeated cross-sectional study. The incidence and 95% confidence interval were used to describe the disease trend. Data were entered into the Excel and analyzed using STATA14 software at a significance level of 5%. Intermittent time series regression analysis was used to evaluate community interventions in changes of leishmaniasis incidence.

from 2002 to 2018, the data of 43,904 patients with leishmaniasis was registered in Isfahan Health Centers. The mean (standard deviation) age of the patients was 23.99 (19.03) years. The incidence had a decreasing trend after the interventions in all affiliated cities and the whole province.

The preventive intervention programs of the provincial health center have been rather successful and have reduced the incidence of the disease in the years after the intervention, so that despite the large number of confounding and influential factors regarding this disease, preventive intervention programs have led to disease control according to the reported annual incidence.