Journal of Health Sciences and Surveillance System
Volume:11 Issue: 1, Jan 2023

Depression and anxiety are the psychological problems that have intensified during Covid-19 and have affected the psychological well being of people. The purpose of this study was to systematically review the prevalence of anxiety and depression in Middle East countries.

In this review, we searched for studies aiming to estimate the prevalence of depression and anxiety during the Covid-19 pandemic among the general population in databases including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar from January 2020 to February 2021. We used the Comprehensive Meta-Analysis-2 software for data analyses and generated forest plots of the summary pooled prevalence.

In this systematic review, 55 articles with a total sample size of 28128 people were included. The pooled analysis of depression and anxiety amid the pandemic was estimated at 41% and 39%, respectively. Based on the study results, Iraq and Egypt had the highest prevalence rates of depression at 88% and 82%, respectively. Regarding anxiety, the highest and lowest prevalence rates were reported for Egypt with 91% and Qatar with 17%.

To effectively provide mental health services for people, particularly the ones who are suspected of higher risk of depression and anxiety, it is necessary to identify individuals who are more likely to be suffered from psychological problems.

Coronavirus disease 2019 (COVID-19) is a viral infection caused by SARS-CoV-2, first recognized in China and quickly became a global pandemic. The COVID-19 pandemic has been found to have positive and negative environmental impacts. Air, wastewater, and solid waste are some examples that show this pandemic’s consequences. The current review summarizes the interactions between the COVID-19 pandemic with air, water, wastewater, and solid waste. During the COVID-19 outbreak, air pollution, ambient noise, fuel, and energy consumption, have been reduced. On the other hand, air pollution has been shown to increase the risk of COVID-19; thus, there is a positive correlation between air pollution and the number of COVID- 19 cases. Moreover, the researchers have detected the SARSCOV- 2 in feces and wastewater. Therefore, exposure to SARSCoV- 2 is possible by utilizing untreated effluent and wastewater in irrigation or aerosol generation during specific wastewater treatment processes. Furthermore, monitoring SARS-CoV-2 in the wastewater allows us to detect the virus before it spreads in the community take the necessary measures, and implement effective policies. Changes in the composition and quantity of municipal solid waste (MSW) are typical results of the COVID-19 pandemic, as plastic waste generation has increased globally due to the higher use of disposable single-use plastic bags and packaging. Mixing infectious virus-infected waste with domestic waste has led to the terminus of waste recycling in many parts of the world due to its hazardous potential. Developing effective strategies based on the sustainable development approach may reduce the adverse effects of the COVID-19 pandemic and similar outbreaks in the future.

Faculty members are the main pillars of universities, and their performance has a vital role in the efficiency of universities. In the current era of the Covid-19 pandemic, students’ traditional evaluation method is not sufficient, and 360-degree evaluation is recommended, or multi-rater feedback is a means of providing evaluation from various stakeholders. The aim of this study was to compare the evaluation of faculty members’ teaching effectiveness in Larestan Medical School by 360 degrees and the evaluation done by the students in 2020 during the Covid-19 pandemic. This descriptive-analytic study compared the 360 degree evaluation and the students’ ratings on faculty members’ performance at Larestan University of Medical Sciences during 2020 -2021. The statistical population consisted of all full-time professors (N=28) selected by census method and students (N=280) chosen by random cluster sampling. The materials used were six valid and reliable questionnaires filled out by students, an expert in evaluation, heads of departments, deputies, peers, and self-assessment of faculty members. Data were analyzed through SPSS software (version 23) using the Friedman test (P<0.001). The results showed a significant difference between the 360-degree evaluation and students’ ratings (P=0.05). According to the students’ attitudes, there was a significant difference between the mean scores of the faculty members’ communication skills and instructional skills (P<0.001). In addition, according to the head of departments, peers, an expert in the evaluation and self-assessment of faculty members, there was a positive and significant correlation between these two evaluations. However, there was no correlation between the heads of departments’ views and those of the deputies for education (P<0.001). Given the views of different participants in this study and the dimensions of assessment of faculty members, it seems that 360-degree assessment is more realistic and fair to be done in universities. In general, it is suggested that professors, in order to better understand their strengths and weaknesses, should pay more attention to all stakeholders’ views in 360-degree evaluation to improve the quantity and quality of education.

The Middle East Respiratory Syndrome coronavirus (MERS-Co V) was known as a human pathogen associated with respiratory symptoms. This study aimed to investigate attitudes, knowledge, and practice about MERS-CoV in paramedics. In this quasi-experimental study, 82 paramedics in Iran in April 2019 were selected in a stratified cluster sampling. Paramedics worked in Health Centers in Iran. We performed educational intervention in this study. A four-point Likert scale researcher-made questionnaire containing demographic (9 questions) and MERS-CoV (33 questions) items was administered to collect the data. The collected data were analyzed by SPSS 18 software. Out of 82 paramedics, who completed questionnaires, 42.7% (35 people) were male, 56.1% (46 people) had a diploma degree, and 19.5% (16 people) had less than 1 year of work experience. about the participants reported 2 laboratoryconfirmed infections at Kerman State. In addition, 67.1% (32 people) passed a course to become familiar with disease. Theparamedics’ mean age was 37.52±8.88. The knowledge mean score of paramedics was 12.82 (SD=10.04). The highly significant source of data collection in paramedics was the attendance in a course to become familiar with disease (43.9%, 36). The mean score of the practice of paramedics was 13.98 (SD=10.00). The most significant concern in neglecting travel to polluted areas in paramedics was public health defects (39%, 32). There was a significant relationship (P<0.05, t=9.06) between knowledge score and variables: gender (P=0.001), education level (P=0.001), and years in service (P=0.039). The paramedic had concerns and tend to increase the knowledge regarding prevention. The awareness of the transmission of diseases was the most important factor for modifying practice and preventing diseases. Health decisionmakers recognized preventive actions to hinder the transmission of this fatal virus.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can be transmitted through direct, indirect, or close contact with infected people by contaminated respiratory droplets or saliva. This study aimed to investigate the epidemiology of coronavirus disease 2019 (COVID-19) and the secondary attack rate (SAR) in the cases’ close contact. A total of 431 confirmed COVID-19 patients were randomly selected using systematic random sampling from 15 May to 13 June 2020. The required data were extracted from the CORONALAB database of the Center for Disease Control and Prevention (CDC) at Shiraz University of Medical Sciences. Detection of COVID-19 was performed using Real- Time Polymerase Chain Reaction (RT-PCR) and nasopharyngeal swabs. SAR was also calculated for different groups. Among the index cases, 64.27% were male, 24.80% were public sector employees, and 4.87% were admitted to the intensive care unit. In addition, most of them aged 30-39 years. The SAR was 11.56% (95% CI: 9.86% to 13.25%) in the close contacts. Accordingly, the highest SAR was observed among the friends, 19.05% (95% CI: 7.17% to 30.92%), followed by the spouses of COVID-19 cases, 16.67% (95% CI: 10.81% to 22.51%). Furthermore, diabetes (6.03%) and cardiovascular disease (5.1%) were the most common comorbidities among the index cases. The findings suggested that the SAR was relatively lower among the close contacts. Considering the familial and non-familial relationships between the index cases and their close contacts were the major causes of disease transmission. Therefore, it is crucial to conduct tracing for COVID-19 contacts in all cases with whom patients have had close contact.

Coronavirus disease 2019 (COVID-19) has posed an unusual threat to global health. Up to May 26, 2021, according to a report by the World Health Organization (WHO), 167.01 million cases, and 3.47 million deaths were reported. This study aimed to estimate and compare epidemiological indices of COVID-19 in high-incidence countries. We conducted a descriptive and comparative analysis intending to examine the epidemiological indices of COVID- 19 in high-incidence countries, using the data published by the WHO until May 17, 2021. We calculated the incidence and mortality rate per 1,000,000 inhabitant-day at risk daily, weekly, and overall, using person-day as the denominator. The fatality rate in 14 countries was about 1.94%. The highest fatality rate was acquired in Italy (2.99%), followed by the United Kingdom (2.86%) and Iran (2.79%). The lowest value on the fatality rate was in Turkey and India, at 0.88% and 1.1%. The highest incidence rate was reported in the USA (207 cases per 1,000,000 person-day), followed by France (190), Poland (171), and Argentina (167). The highest mortality rate for the whole period was extracted in Brazil (4.60 death per 1,000,000 population-day), and the lowest rate happened in India (0.42). Until May 17, 2021, COVID-19 has affected about 117.6 million patients and caused 2.3 million deaths in 14 highincidence countries. This study shows that a specific pattern of COVID-19 has been observed in every country.

COVID-19 epidemic in Iran has imposed a heavy social, economic, political, and psychosocial burden and caused devastating social problems. On the other hand, it has also led to promising social cohesion. This study aimed to explore the community-wide changes following the COVID-19 pandemic and to understand how these changes may affect the Iranian community.

This qualitative study used the grounded theory approach and conducted from May 2020 to March 2021 at Shiraz University of Medical Sciences, Shiraz, Iran. Adopting a purposive sampling approach, 15 faculty members in different fields participated in this study, and 17 interviews were performed.

This study indicated that the core phenomenon in the social change process was “struggling for survival and livelihood”. Therefore, people tried to identify and choose strategies to deal with or repel COVID-19 disease as a life-threatening situation. A set of contextual factors influenced their choice. The media and the performance of organizations as intervening conditions also played an important role in this process. Finally, this complex process led to constructive and destructive outcomes in society.

The COVID-19 epidemic caused various multifaceted social changes in the Iranian community. Some social consequences were constructive and contributed to community development, while others jeopardized community development goals. Therefore, the paradigm model developed in this study can help policymakers and social planners develop programs to promote community health.

The most important way to prevent COVID-19 is to observe health behaviors such as keeping social distance from one another. After getting COVID-19, care-seeking behaviors can affect the severity of the disease. The current study aimed to investigate and compare the communication styles, care-seeking, and health behaviors in patients with COVID-19. A cross-sectional study was performed using a selfadministered questionnaire on patients with COVID-19 in Maragheh in 2020. The study population included 450 people selected using simple random sampling. Chi-square, one-way ANOVA, and Pearson Product Moment Correlation tests were used to compare communication styles, care-seeking, and health behaviors among outpatients and inpatients with COVID-19. Data were analyzed using SPSS 23 software. The first place to seek t reatment for outpatients and inpatients with COVID-19 was health centers (28.2%) and hospitals (44.5%), respectively. In terms of communication behaviors, close contact of family members with others at work, getting the disease from close friends or colleagues (45.8%), and having a history of contact with an infected COVID-19 person (43.5%) were the most reported items by outpatients. On the other hand, hospitalized cases reported close contact of family members with others at work (62.4%), attending physicians’ offices (43.8%), and attending gatherings (41.2%) more than other communication behaviors (P<0.0001). Care-seeking behavior is more appropriate among outpatients than inpatients, and preventive behaviors are more stable in outpatients than inpatients. Therefore, health education interventions in the community should focus on correcting careseeking behaviors and promoting good social communications.

The current study was carried out to analyze the clinical, laboratory, and computed tomography (CT) findings obtained from both groups of patients, i.e., those who died or recovered from coronavirus disease 2019 (COVID-19). This cross-sectional multicenter study was conducted on 71 adult patients with COVID-19 who had been discharged or died. Demographic, clinical, laboratory, and CT features were obtained from electronic medical records and compared between deceased and survived patients. Seventy-one patients (40 men, 31 women, 23–98 years) were included in the study. The mean age of deceased patients (70.77±17.36 years) was significantly higher than recovered ones (49.68±16.25 years) (P<0.001). Cough and neurological signs (a lateralizing sign of focal neurological insult) were shown to be significantly different between survived and non-survived groups (P=0.008 and P<0.001, respectively). Leukocytosis was present in 15 (41.7%) patients who died and 5 (14.3%) patients who were discharged (P=0.01). Hemoglobin and O2 saturation were significantly lower in patients who died than in recovered ones (P<0.001 and P=0.001, respectively). A significantly higher level of CRP was found in deceased infected patients compared to recovered ones (P=0.001). Crazy-paving pattern and consolidation were significantly higher in patients who died than in recovered subjects (P<0.001). Patients’ manifestations on admission, such as older age, cough, leukocytosis, low levels of hemoglobin and O2 saturation, as well as the occurrence of crazy-paving patterns and consolidation, were predictive of poor outcomes.

The coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide and becoming a pandemic. Since the diagnostic tests are relatively expensive, simple diagnostic tests are valuable for quarantining individuals suspicious of COVID- 19. This study is designed to predict the potential contributing factors of COVID-19 diagnosis. It was a referral-based historical cohort study. 363358 individuals referred to the health centers from February to November 2020 in Fars province were entered in the study. The collected data before the lab test were symptoms, underlying diseases, some conditions, risk factors, and demographic information. The Reverse transcriptase polymerase chain reaction test was performed to identify the COVID-19 virus. Chi-square and T-tests were used to compare the variables. A logistic regression test was used to identify predictor variables. Positive COVID-19 test was reported for 119,324 (% 34.9) participations. The positive group result was compared with that of the negative group (n=244,034). The studied symptoms were significant in positive patients. According to the odds ratio (OR), smell disorder (OR=3.80, P<0.001), taste disorder (OR=3.17, P<0.001), and fever (OR=2.65, P<0.001) were common. However, diarrhea, chest pain and dyspnea showed the lowest odds ratio. According to the results, DM (OR=1.46, P<0.001), HTN (OR=1.42, P<0.001), and CVD (OR=1.27, P<0.001) were common in patients with positive COVID-19 tests. Cases whose Body Mass Index (BMI) was more than 40 (excessive obesity) showed a higher odd (OR=1.45, P<0.001) for being positive. According to the results, the symptoms and underlying diseases are effective factors in predicting COVID- 19 disease. Identifying these factors for Covid-19 disease helps health policymakers to make quick decisions and take timely action.

Currently, COVID-19 is a global public health problem. This study aimed to estimate the seroprevalence of antibodies related to Covid-19 in the general population in southern Iran. This cross-sectional population-based study of the seroepidemiological type investigated the serological prevalence of COVID-19 from October to December 2020 in Jahrom, Fars province, Iran. A total of 612 participants were selected using multistage cluster random sampling regardless of age or gender. The dataset in the study included the participants’ demographic information, the history of exposure to COVID-19 patients, the history of PCR tests, and the history of COVID-19 symptoms in previous months. In addition, this study examined the raw and survey weight adjusted estimates with Stata version 14. Finally, logistic regression was performed to identify risk factors for serum prevalence. The participants’ mean age was 38.88±13.91 and the majority were 30 to 49 years (51.4%), with a female preponderance (58.7%). The estimated adjusted seroprevalence was 32.66 (95%CI: 28.93-36.63), with 207 positive cases for either IgG or IgM. The results of multivariable logistic regression showed that seropositivity in the participants was 4.95 times more likely associated with a history of positive PCR test (OR: 4.95, 95%CI: 2.46-10.90) and 2.14 times in patients with a history of muscle pain in previous months (OR: 2.14, 95%CI: 1.03-4.47). The actual number of patients with COVID-19 is significantly higher than the number of cases confirmed by the disease monitoring system based on PCR tests. Therefore, tracking individuals’ contact with confirmed patients using extensive testing and segregation of asymptomatic patients can help control the epidemic.

Mental disorders have become especially important in the current stressful world. Among these disorders, anxiety, and depression are highly prevalent. Stress is also a very common phenomenon. Given the teachers’ prominent roles in the education department and the importance of their mental health, the present study aimed to determine stress, anxiety, and depression among teachers during the COVID-19 Pandemic in 2020. This cross-sectional study examined 210 primary school teachers in district 3 of Isfahan province in Iran, using multi-stage random sampling. Data were collected by the Depression, Anxiety, and Stress Scale- 42 Items (DASS-42). Also, the obtained data were analyzed using SPSS Statistics 20 and conducting pearson test, t-test, ANOVA, and linear regression. The results indicated a high level of stress, anxiety, and depression among the teachers. Findings also showed that teachers’ depression was significantly associated with their age, work experience, type of housing, and student behavior (P<0.05). Further, teachers’ anxiety was significantly associated with their work experience and student behavior (P<0.05). Moreover, teachers’ stress was significantly associated with their history of mental diseases (P<0.05). Teachers’ depression, anxiety, and stress were not significantly correlated with their marital status, spouse’s job, education level, and Relationship with other colleagues (P>0.05). Given that stress, anxiety, and depression affect teachers’ mental health, and consequently the quantity and quality of their work, holding training courses and sessions to discuss teachers’ problems, provides practical and effective solutions, and offers them administrative and organizational support, can be an effective step towards improving their mental health.

In the early days of the pandemic, the rise in COVID-19 cases prompted many governments to lockdown the waterpipe-serving venues, which may affect the patterns of use among this centuries-old tobacco product. Here, we studied the pattern of WP smoking among Iranian adults during the COVID-19 epidemic. In this cross-sectional study, we conducted an online survey among sample of 213 waterpipe(WP) smokers who were selected by convenience sampling method from the Golestan province, in Northern Iran using WP smoking patterns, Lebanese Waterpipe Dependence Scale, 11 (LWDS11), and selected demographic variables. Collected data comprises demographic and WP smoking patterns during COVID-19. About 70% of participants reduced their WP use compared to the time before COVID-19, modestly due to pandemic effects. Around 38.5% of the subjects believed WP bars were covertly operating during the lockdown and continued serving their customers. Singles and less educated adults had lower mean attitude scores regarding the decrease in WP smoking during the COVID-19 pandemic (P<0.05). Structural equation analysis revealed that the immune system improvement with WP smoking had the strongest effect. (0.74). A strong inverse correlation exists between the WP dependence level and the negative belief toward WP smoking during the COVID-19 epidemic (r=-0.66, P<0.001). There is a clear need for appropriate interventions to change the belief of WP smokers regarding the dangers of this practice during the COVID-19 outbreak, particularly among single people and those with lower levels of education. Furthermore, regulatory authorities should exercise stricter controls to ensure the complete closure of WP bars.

The outbreak of COVID-19 has become the current crisis in most countries. Therefore, paying attention to the consequences and determinants of COVID-19. Mortality can lead to better control of the condition. This study aimed to investigate the COVID-19 mortality rate and its demographic and health determinants in Fars province. This research was conducted using a quantitative method. For this purpose, available data for selected counties in Fars province were analyzed. The COVID-19 mortality rate was considered a dependent variable. In addition, the variables of literacy rate, urbanization rate, elderly population ratio, unemployment rate, the ratio of the active hospital, ratio of prehospital emergency stations, the ratio of centers for primary health care, and the ratio of active hospital beds were considered independent variables. Findings showed that the variables of the elderly population ratio, urbanization rate, and unemployment rate had a direct relationship with the COVID-19 mortality rate. The findings also indicated that the COVID-19 mortality rate in the 45-49 age range begins to accelerate and peaks between 95 and 99 years old. In addition, the literacy rate was inversely related to the COVID-19 mortality rate. The results also showed an inverse relationship between all the selected health variables and the dependent variable. Improving the economic situation, specifically reducing the unemployment rate, emphasizing public education of the people, as well as improving the medical and health facilities, can facilitate the response to pandemics.

With the onset of the coronavirus crisis, the medical treatment staffs were at the forefront of dealing with the disease. The lived experiences in the face of this disease can help better manage the epidemic and identify organizational and individual barriers and challenges. This study aimed to investigate the experiences of medical staff working in COVID- 19 wards in Shiraz teaching hospitals.

The present study is a qualitative study conducted in 2021-2022. A semi-structured interview was used to collect data. Eighteen nurses, physicians, and health workers of Shiraz University of Medical Sciences were employed for the interview. The snowball sampling technique based on the target group was used. Data were analyzed by The Colaizzi seven-step analysis method.

Three themes, including “tensions”, “material and spiritual support”, and “pleasant feeling” and eight sub-themes were extracted. The sub themes were “resilience”, “insufficient knowledge”, “depression”, “expressing gratitude by friends”, “public attention”, “organizational support”, “feeling proud”, and “altruism”.

The present study shows that COVID- 19 caused a lot of pressure on the medical staff during the pandemic, which led to psychological and emotional damage. On the other hand, material and spiritual support played an important role in reducing distress in times of crisis.

Coronavirus disease (COVID-19) is an immensely transmissible viral infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This study aimed to assess the presence of SARS-CoV-2 in the indoor air, on the surfaces, and on the fomites of a COVID-19 referral hospital in Shiraz, Iran. In this cross-sectional study, indoor air sampling was conducted utilizing a standard midget impinger containing 15 ml of viral transfer medium (VTM) equipped with a sampling pump with a flow rate of 10 L min-1 for 60 minutes. Surfaces and fomites were sampled using sterile polyester swabs. The realtime reverse transcription-polymerase chain reaction (rRT-PCR) was utilized to detect SARS-CoV-2. The RNA of SARS-CoV-2 was detected in about 41.2% indoor air and 32% swab samples. Four out of the six (66.7%) indoor air samples up to a distance of 2 meters from the patient’s bed in intensive care units (ICU-1, ICU-3), accident and emergency (A&E-2), and negative pressure rooms were positive for SARS-CoV-2 RNA. All air samples within 2 to 5 meters of the patient’s bed were negative. This study’s results did not support the airborne SARS-CoV-2 transmission; However, it showed contamination of surfaces and fomites in the studied hospital’s wards.

The COVID-19 pandemic has induced some negative environmental issues, especially in the waste management sector. In developing countries, handling waste is carried out by two groups: waste workers and waste pickers who are exposed to possible hazards of infected waste. In the present narrative review, we searched for high-quality English publications in PubMed, Scopus, and Embase databases. The COVID-19 pandemic led to several problems in waste management systems, especially in developing countries. Due to poor management systems, waste workers and pickers are likely exposed to health risks related to unhealthy waste handling. The support of governments is urgently required to properly inform ordinary people about the correct ways of disposing of PPE and also train sanitation workers and waste pickers to reduce the hazardous possibilities. Additionally, financial support can also act as a suppressive agent to reduce the number of waste pickers.