Epidemiology and Health System Journal
Volume:9 Issue: 4, Autumn 2022

The aim of the current study was to assess the construct validity of the Persian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) among dentists and burnout rate and its related factors among general dentists in Shiraz during the coronavirus disease-19 (COVID-19) pandemic.  This cross-sectional study was performed among 385 general dentists in Shiraz. Multiple stage sampling was performed for sample selection. In addition to a questionnaire containing demographic and job-related characteristics, the burnout rate was assessed using the MBI-HSS. The MBI-HSS consists of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) dimensions. The Pearson correlation coefficient, independent t-test, and multiple regression analysis were applied for statistical analysis. Finally, confirmatory factor analysis (CFA) was used to test the model’s fitness.  A total of 385 dentists participated in the study, including 213 (55.3%) males and 172 (44.7%) females with a mean age of 32.89 ( ± 6.29) years. The mean years of activity, the number of patients per week, and working hours per week were 9.15 years, 31.55 patients, and 39.50 hours, respectively. Most dentists showed low to moderate burnout in terms of EE (86%) and moderate to high burnout with regard to DP (90.9%) and PA (96.6%). Regarding the association between demographic factors and burnout dimensions, EE had a significant association with gender (B = 0.26, P < 0.001), age (B = -0.04, P = 0.044), marital status (B = -0.42, P < 0.001), and years of practice (B = -0.26, P < 0.001). Further, DP was significantly associated with gender (B = 0.13, P = 0.043), marital status (B = -0.32, P < 0.001), working hours per week (B = 0.01, P = 0.047), and the number of working clinics (B = -0.17, P = 0.047). In addition, PA represented a significant association with marital status (B = -0.34, P < 0.001). The three-dimensional model showed appropriate fitness in the current study.  Most general dentists in Shiraz demonstrated low to moderate burnout regarding EE, most dentists had moderate to high burnout regarding DP and PA. Accordingly, gender, marital status, years of practice, the number of working clinics, and working hours should be considered burnout-associated factors by policymakers.

Guillain-Barré syndrome (GBS) has several types, some of which damage myelin and some others cause axonal damage. Detecting the type of GBS is important in determining the type of treatment and its prognosis. This study was conducted to investigate the epidemiological characteristics of GBS and its variants in patients referred to Sina hospital in Hamadan, Iran, in 2018.  In this cross-sectional study, 51 patients who were admitted to Sina hospital and diagnosed with GBS in 2018 were examined. Demographic data, GBS type, disease outcomes, and pre-clinical and clinical findings of patients were collected. Data were then analyzed using the Stata software version 12, and P value < 0.05 was considered statistically significant.  Of the 51 investigated patients, 34 (66.66%) were male. The most common variant type was acute inflammatory demyelinating polyneuropathy (AIDP) with 27.45% of cases followed by acute motor axonal neuropathy (AMAN) with 19.61% of cases. Further, the highest average hospitalization days (11.1 ± 11.7 days) were for chronic inflammatory demyelinating polyneuropathy (CIDP) patients, while the lowest (6.85 ± 1.91 days) was for AIDP patients (P < 0.001). All CIDP cases occurred in spring, and 71.43% of AIDP cases occurred in summer. Moreover, all 7 cases with acute motor and sensory axonal neuropathy (AMSAN) syndrome and the only case with the miller-fisher syndrome (MFS) occurred in fall (P < 0.001).   According to the results of this study, most variants of GBS in Hamadan province were AIDP in demyelinating form and AMAN variant in the axonal deterioration form. However, studies with a larger sample size are recommended in the west of Iran to better understand the epidemiology and to ensure common types of GBS.

According to evidence, a hydatid cyst is one of the most important health issues in most parts of the world. This study aimed to investigate the frequency of human hydatidosis in patients referred to health service centers in Hamadan province in 2019 using the enzyme-linked immunosorbent assay (ELISA) method.  In this cross-sectional study, blood samples were collected from 300 patients referred to medical diagnostic laboratories in Hamadan and evaluated for the presence of immunoglobulin G antibodies against hydatid cysts by ELISA. The data were analyzed using SPSS software.  Out of 300 samples, 16 (5.3%) cases were positive, including 10 (5.6%) cases of the residents of urban areas and 6 (4.9 %) cases from those residing in rural areas. Moreover, of all the positive cases, 8 (50%) cases were males and 8 (50%) cases were females. The highest percentage of infection (45.5%) was observed in the age group 20-30 years.  The findings indicated that human hydatidosis is a public health problem in this province. The implementation of control and prevention programs, as well as increasing the knowledge of people, can help in controlling and reducing infection in humans and livestock.

Urinary tract infections (UTIs) are intense public health problems and are precipitated by a variety of pathogens. This study was performed to determine the frequency of bacterial agents of UTIs and the antibiotic resistance pattern of Escherichia coli in urinary culture samples of patients at Shahid Ashrafi Esfahani hospital in Tehran, Iran.  A cross-sectional study was conducted on all urinary tract cultures from January 2021 to January 2022 at Shahid Ashrafi Esfahani hospital in Tehran, Iran. Urine culture and antimicrobial susceptibility tests were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analyses were performed by appropriate descriptive and inferential tests such as the chi-square test using Stata version 17, and the level of significance was set at 0.05.  The mean age of patients with E. coli was 50.2 ± 1.8 (confidence interval = 46.6-53.8) years, and their age range was between 6-87 years. The highest prevalence of infection occurred in men over 60 years of age and in women aged 40-60 years. Further, the highest resistance and the highest sensitivity were related to ceftazidime (CAZ) and cefotaxime (CTX), respectively.  In this study, the highest resistance and sensitivity belonged to CAZ and CTX, respectively. In addition, CTX is the primary antibiotic prescribed to deal with UTIs in medical practice.

Accurate and timely diagnosis is crucial for coronavirus disease 2019 (COVID-19) outbreaks. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are easily accessible and affordable, producing rapid results. They are an alternative to the limited gold-standard real-time reverse-transcription polymerase chain reaction (rRT-PCR) tests. This study assessed the performance of Ag-RDTs for COVID-19 outbreaks in institutional settings with high disease prevalence in Kelantan State, Malaysia.  This study analyzed a total of 303 individuals from five institutional outbreaks with paired nasopharyngeal specimens tested for COVID-19 by Ag-RDTs and rRT-PCR. The diagnostic performance of Ag-RDTs was evaluated through rRT-PCR as the gold standard based on cycle threshold (Ct) value, disease prevalence, and manufacturers.  There was a moderate agreement between Ag-RDTs and RT-PCR (κ = 0.603; 95% CI: 0.520- 0.686; P < 0.001). The overall specificity was 97.9% (95% CI: 94.1%-99.6%), sensitivity was 63.3% (95% CI: 55.3%-70.8%), accuracy Ag-RDTs was 81.2% (95% CI: 76.4%-85.5%), while positive and negative predictive value was 96.6% (95% CI: 90.2%-98.9%) and 74.1% (95% CI: 70.0%-77.9%), respectively. Further, lower median Ct was reported in 100 (33.0%) true-positive cases compared to 58 (19.1%) false-negative cases (20.3 vs 31.4, P < 0.001). The sensitivity was higher (P < 0.001) in those with high viral load (Ct value ≤ 25.0) with better performance and a prevalence > 10%. In addition, no significant difference was observed between the studied manufacturers.  The Ag-RDTs performed well in diagnosing COVID-19 among outbreaks with higher viral load and disease prevalence. High-risk cases tested negative by Ag-RDTs may have low viral load and require confirmation by rRT-PCR.

Recently, positive psychology has received increasing importance, and research has shown that higher levels of happiness reduce the risk of mortality and morbidity. The aim of this study was to investigate the relationship between happiness and health behaviors in adolescents in Shahrekord.  In this cross-sectional-analytical study conducted in 2018-2019, 428 first and second cycle secondary school students were enrolled and filled out the Oxford Happiness Questionnaire and Health Behavior Questionnaire. Then, data were analyzed by SPSS.  The mean age of the participants was 15.42 ± 1.59 (range: 12-18) years, and 158 (36.9%) of them were boys. The mean score of happiness was 48.34 ± 18.98 out of 87 (range: 0-87), which is high. The mean score of health behaviors was calculated to be 12.21 ± 1.66 out of 16 (range: 8-16), which is moderate. In addition, the mean happiness score was significantly associated with gender (P = 0.001), education level (P = 0.01), family income (P = 0.001), living status with parents (P = 0.015), and personal estimate of happiness status (P = 0.001). Moreover, the mean score of health behaviors had a significant association with gender, educational district, education level, parents’ education level, birth order, income, and personal estimate of happiness (P < 0.05). Further, scores on happiness and health behaviors were positively correlated with each other (r = 0.391, P = 0.001) and negatively correlated with age (r = -0.139, P = 0.004).  The levels of happiness among adolescent students were relatively good, their levels of health behaviors were moderate, and both of them were associated with each other and with demographic and socioeconomic variables. Accordingly, happiness should be promoted in society, particularly in students, to achieve a higher level of health-promoting behaviors.

Tuberculosis (TB) is a major public health disease threat in the world, particularly in Nigeria. The burden of TB infection could have a far-reaching effect on the psychological, physical, and social well-being of patients and consequently deterioration in their health-related quality of life (HRQOL). Accordingly, this study examined the HRQOL of TB patients in directly observed therapy (DOT) centers in Lagos State, Nigeria.  The survey design was used for the study, and a total of twelve public DOT Centers were chosen as the study sites. A sample size of 310 was obtained using the Taro Yamane formula. A structured and validated questionnaire was applied to collect data. The World Health Organization Quality of Life Assessment-BREF tool was employed to assess HRQOL. Statistical analysis was conducted using SPSS software, version 23.  Based on the results, the overall status of the HRQOL of the studied TB patients was moderate (average weighted mean = 2.48) on a 4-point scale. The finding of the study also highlighted the significant effect of TB on several domains of HRQOL. The psychological domain had the highest HRQOL score (x̅ = 2.60 ± 0.64), while the environmental domain represented the lowest HRQOL score (x̅ = 2.31 ± 0.63).  Overall, the HRQOL of TB patients was at a moderate level. The disease had no negative impact on the HRQOL of TB patients across all domains. This finding calls upon strategies to ensure a healthy lifestyle and a conducive living physical environment.

Today, with the outbreak of the coronavirus disease 19 (COVID-19) pandemic, we have witnessed many efforts by different countries to produce a vaccine for this disease. Each vaccine has been marketed with different efficiencies, thus this research was designed to determine the efficacy of different types of these vaccines in 2022. 

The present research was a systematic review. Researchers surveyed six international databases, including Medline/PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and the ISI Web of Science, in January 2022. After reviewing the titles and abstracts of articles, 60 articles entered the final stage, and their full texts were reviewed based on the study purpose. All the vaccines included in the study were approved by the World Health Organization (WHO) or the Ministry of Health of the manufacturer country in the third phase of the clinical trial. 

All current vaccination platforms provide adequate protection against severe acute respiratory syndrome coronavirus 2 (SARC-CoV-2) infection and significantly reduce the risk of serious infection. In addition, people who receive two vaccine doses have higher efficacy than those who only receive one dose of each vaccine. The results of the studies demonstrated that the effectiveness of vaccines is different in various groups and countries. According to the results of the reviewed studies, the Pfizer vaccine had an overall effect of 100% on the age group of 12-15 years. The overall effect of the Moderna vaccine varied from 78.6% to 97% in different groups. In general, the available vaccines for COVID-19 are less effective in the Omicron variant. On the other hand, it seems that the COVID-19 vaccines had better efficacy on the alpha variant. 

Overall, the vaccines used in the COVID-19 pandemic have acceptable efficacy. Although serious side effects caused by the injection of the vaccine have been rarely reported in some studies, it seems that the safety of these vaccines is acceptable in general.