Journal of Health Sciences and Surveillance System
Volume:11 Issue: 3, Jul 2023

Scientific overwhelming evidence confirms that the prevalence and incidence of mosquito-borne viruses such as chikungunya (CHIK) are dramatically increasing in Middle- Eastern countries including Iran.

I n t his r eview a rticle, u sing r elevant k eywords (“Chikungunya” OR “CHIKV” OR “Aedes albopictus” OR “Aedes aegypti”), available literature was searched to collect data related to the reports of CHIK and its main vectors, Aedes albopictus and Ae. aegypti, in Iran and 15 neighboring countries: Pakistan, Afghanistan, Turkmenistan, Russia, Azerbaijan, Armenia, Turkey, Iraq, Kuwait, Bahrain, Qatar, United Arab Emirates (UAE), Oman, Saudi Arabia, and Yemen.

CHIK was reported in neighboring countries such as Pakistan, Turkey, Russia, Saudi Arabia, Yemen, Oman, Qatar, and Iraq. Furthermore, presumably introduced in 2019, CHIK was reported in 11 provinces in Iran with overall seropositivity of 17.23% in humans over the past three years. The mosquitoes, Ae. albopictus and Ae. aegypti, have recently been reported in the southeast and south of Iran.

Given the change in climate, even if the density of the vectors is still limited, there is no guarantee that their population will not spread much more in the coming years. This emphasizes the urgent need to strengthen the surveillance system for the vectors, and sustained surveillance of CHIK infections in mosquitoes and humans, preferably in a collaborative international project.

The prevalence of arboviruses is increasing worldwide. Their vectors are widely distributed in different continents of the world. Despite the importance of the phleboviruses, unfortunately data about the spread of the viruses in human and animal communities is very limited.

This study is a systematic review of phlebovirus and its vectors worldwide, with emphasis on Middle East countries including Iran. Accordingly, all English language articles which were conducted up to the end of 2020 were found by searching the databases, including Web of Science, PubMed, Google Scholar, Science Direct, and Scopus. Furthermore, the authors used the Strobe checklist to evaluate the quality of the articles.

Phlebotomus perniciosus was the main vector of the Tosca virus in the Mediterranean regions such as Italy, France, and Greece. In African counties, Aedes species were more important vectors of phleboviruses, especially Rift Valley fever. As these diseases can easily spread to even uninfected areas of Asia, permanent monitoring is needed to control phleboviruses.

Practical methods have been used to control the vectors and hosts of phleboviruses. Some important methods are listed as follows: impregnated bed nets/curtains, residual spraying, repellents, establishment of the robust surveillance of animal and their products, and limited movement of livestock during outbreak time. These methods can minimize the risk of transmission of phleboviral diseases, especially RVF infection.

Water pipe tobacco smoking is used as a traditional way of smoking, but its ascending trend and increasing consumption has become a global phenomenon, which has been associated with increased consumption of fruity or flavored tobaccos. Given the students’ increasing tendency in this regard, this study aimed to explore the medical students’ tendency toward using waterpipe tobacco smoking. This is a qualitative study using a semi-structured interview with 16 medical students in Southeastern Iran (Zabol) from January to May 2020. The data were analyzed using a thematic analysis approach. Data analysis led to the extraction of 4 themes of “cultural/ family roots”, “individual roots”, “attraction of tobacco flavor and water pipe”, and “misconception about health risks of water pipe tobacco smoking”. Waterpipe tobacco smoking has increased among students for leisure and entertainment. Given that waterpipe tobacco smoking is the basis for entering various opioid addictions and cigarettes, it needs more attention to students from the academic side of principals and families. It is recommended that national and academic authorities should consider the issues that attract the students toward water pipe tobacco smoking.

More satisfied patients in medical care accelerate the progress of treatments and achieve the foremost goal of treatment, which is to improve patients. The aim of this study was to assess the patients’ expectations and satisfaction with physicians working in public clinics in Kerman. This is a cross-sectional study conducted in four clinics under the auspices of Kerman University of Medical Sciences. 385 patients were enrolled in the study using simple random sampling. Britten questionnaire was used to collect the data. The collected data were analyzed through SPSS22 using appropriate tests. The validity of the questionnaire was confirmed using the content method. Cronbach’s alpha was calculated for reliability, which was 0.8 for the Reasons of visiting the Doctor Questionnaire and 0.9 for the questionnaire after the examination. The highest expectations of patients (73%) in the reasons for seeing a doctor were related to the diagnosis of the disease, and the lowest expectations were related to the tests and the desire to prescribe (28.6%). Overall satisfaction with the physician was 55.3% among the patients. There was no significant difference between the patients’ expectations of the physician with any of the demographic characteristics. Patients’ expectations before and after seeing a doctor were not significantly different. Understanding the relationship between the treatment team and the patient means that the decisions made for patients are not dependent on the treating physician and patients’ expectations.

Depression is a worldwide disease affecting more than 300 million people and is associated with disability, burden of disease, and significant health care costs. Children’s nutritional status can definitely affect their growth. The burden of malnutrition remains high in developing countries and reduces the potential for individual, social, and economic development. The aim of this study was to investigate the relationship between breastfeeding depression and infant’s growth. This is a cross-sectional study on 90 breastfeeding mothers and their 2-4 month old infants in Yasuj. Data collection in mothers was done by measuring anthropometric variables and by interviews through questionnaires. For assessing maternal depression, Beck Depression Inventory questionnaire was applied, and neonatal physical growth was evaluated by head circumference, weight, and length Z-scores of 2-4 months old infants. The result showed that the relationship between maternal depression score and Z scores of infants’ weight, height, and head circumference was not significant (P>0.05 for all). There were no differences between depression scores of mothers and infants’ growth in different groups of education or occupation among mothers (P>0.05 for all). There was a significant relationship between maternal waist circumference with hip circumference, weight, and number of children (P<0.001 for all). This study showed that depressed mothers, despite having depression, were concerned with the optimal growth of their infants. However, tracking children’s developmental status and maternal depression over the time (especially in depressed mothers or underweight infants) in several stages can be helpful in increasing information in this regard.

Family and marital abnormalities are among the risk factors of psychological trauma in family members and threaten the family system, which is the basis of any healthy society. The aim of the present study was to compare the effects of cognitive-behavioral couple therapy (CBCT) and acceptance and commitment therapy (ACT) on intimacy and marital adjustment among couples applying for divorce. This is a quasi-experimental study based on a pretestposttest design with a control group. The study population consisted of all married people applying for divorce in Bushehr city, (Iran) in 2021, 45 of whom were selected as the sample through convenience sampling and randomly and equally assigned to three groups (n= 15 per group). The first and second experimental groups received CBCT and ACT (twelve 90-minute sessions for each), respectively. The research instruments included Walker and Thompson’s Intimacy Scale and Revised Dyadic Adjustment Scale. The data were statistically analyzed using univariate and multivariate analysis of covariance in SPSS-26. The results showed a significant difference between the experimental groups and the control group in the post test scores of intimacy and marital adjustment (P<0.001). There was a significant difference between CBCT and ACT in improving marital adjustment (P=0.012), whereas these two interventions did not exhibit such a difference in improving intimacy. The study findings suggested that both CBCT and ACT can be used for improving the intimacy between the couples applying for divorce. However, CBCT is more recommended for improving the marital adjustment of such couples because it exhibited more effectiveness than ACT in this regard.

Obesity has dramatically formed a public health problem across the world. The current survey explored the effects of motivational interviewing (MI) on paraclinical parameters and cardiorespiratory fitness among women with overweight and obesity who referred to the nutrition clinics. We conducted a single blind randomized clinical trial study on 136 women with overweight and obesity who were randomly assigned to MI (n=68) or control (n=68) groups during September 2014 to October 2015 year in Gorgan city of Golestan province. The Rockport Walk Test was used to evaluate the maximal oxygen consumption (VO2 max), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and total cholesterol which were also tested in participants trained to fast for 12 hours and avoid alcohol consumption in 24 hours before the blood test. The total cholesterol, LDL-C, HDL-C and cardio-respiratory fitness were investigated at baseline and at 12 months’ follow-up. Descriptive analysis was run to describe the mean and standard deviation of the demographic characteristics. Independent t-test, paired t-test, and chi-square test were applied. A P value<0.05 was considered as significant. The mean age of the MI and control group was 51.6±5.2 and 53.8±5.8 years, respectively. MI significantly reduced the total cholesterol (P=0.032), HDL-C (P=0.041) and LDL-C (P=0.011), while it increased VO2 max compared to the control group. MI may remarkably affect the participant’s paraclinical outcomes including lipid profiles and cardiorespiratory fitness levels. More surveys seem helpful to confirm the effectiveness of MI on long-time changes among people with overweight and obesity.

Medical students are exposed to high risk mental health disorders. Owing to the higher probability of exposure to the mentioned risk factors among dorm-resident students and senior students, the present study was conducted to explore mental health disorder and its relationship with higher academic year and dorm residence, amongthe medical students of Shiraz University of Medical Sciences. This cross-sectional study was conducted among 270 medical students in 2019. A multi-stage random sampling was applied. A standardized self-administered questionnaire, which comprised of demographic variables and General Health Questionnaire-28, was used. The mean age of the participants was 22.52±2.26 years. About 166 individuals (61.5%, CI 95%: 55.69, 67.30) showed symptoms of mental health disorders, and anxiety was the most common mental disorder with a prevalence of 16.7% in medical students. There were significant relationships between mental health and higher age (P=0.001), clinical phase students (P<0.001), single students (P=0.044), dorm residence (P<0.001), and those in poor economic condition (P=0.047). The chance of developing mental health disorders in dormitory students and in clinical phase students was 2.48 (CI 95%: 1.36, 4.53) and 2.97 (CI 95%: 2.12, 4.15) times higher than in non-dormitory and basic phase students, respectively. Due to the higher prevalence of mental health disorders among medical students compared to the general population, interventions should be done at the university level to promote the students’ mental health, especially clinical and dormitory students. In addition, policymakers should design and implement a comprehensive student mental health care program nationally.

Malaria is the most important mosquito-borne disease in Iran in recent decades. This disease is endemic in the south to the southeastern Iran. Knowledge about larval habitats, species diversity, and distribution pattern of malaria vectors will help authorities in the appropriate management of this disease. Qaleh Ganj county is one of the main endemic areas for malaria in the south of Iran. Little information is available about the fauna of mosquitoes and their characteristics in this area. This study aims to assess the fauna, larval habitats, species diversity, and distribution pattern of Anophelinae mosquitoes using the Geographic Information System (GIS) in Qaleh Ganj County, the southeast of Iran. The potential aquatic habitats for Anopheles larvae were selected based on the variety of topography and history of the malaria epidemic. The mosquito larvae were collected using dipping method from April to December 2018. Finally, the diversity, richness, and evenness indices were calculated. A total of 1042 larvae were found. The dominant species was Anopheles culicifacies s.l. Giles, 1901. The Shannon diversity index ranged from 0.76–1.54 between different collection sites, while the other indices showed the highest and lowest diversity, evenness, and richness of species in each area. Due to the fact that some of the species in this region are species complexes, molecular studies are needed to find better information about the genetic diversity of these species which can be helpful for the malaria elimination program in Iran.

The overall prevalence of metabolically unhealthy (MU) phenotype in Iranian adults is a matter of debate. This study aimed to estimate the prevalence and determinants of metabolically unhealthystate in people over 30 years old in the general population in Southern Iran. In this cross-sectional population-based study, 891 participants aged ≥30 were selected using a multi-stage cluster sampling method. The study examined age, sex, education, marital status, smoking behavior, weight, height, blood pressure, fasting blood sugar, and lipid profiles. MU was defined as the existence of at least two of four constituents of metabolic abnormalities based on ATP III criteria. Data analysis was carried out in Stata version 14. Finally, a logistic regression was performed to identify the risk factors for MU prevalence. The overall prevalence of MU was 49.4%, corresponding to 37.5%, 55.6%, and 60.2% of normal weight, overweight, and obese participants, respectively. MU prevalence significantly increased from 30.6% in participants aged 30-39 years to 69.7% in participants aged 60 years or older. The results of multivariate logistic regression showed that dyslipidemia (OR=2.98, CI95%:2.13-4.16), high LDL (OR=2.73, CI95%:1.77-4.20), obesity (OR=2.83, CI95%:1.84-4.36), overweight (OR=2.13, CI95%:1.53- 2.98), and higher age (OR=1.04, CI95%:1.03-1.05) was positively associated with the MU state. Metabolically unhealthy state is a public health problem in the study area. In terms of public health, screening for obesity and other metabolic disorders should be regularly performed in clinical practice to take appropriate preventive measures.

It is estimated that in 2025, the cost of diabetes will account for 40% of total health spending. In Iran, 4.5 to 5 million people are afflicted with diabetes, and its prevalence has doubled during the past three decades. The aim of this study was to determine the function and preparedness of diabetes surveillance system in Iran. In this cross-sectional study, all managers, health policymakers and experts of diabetes(N:125) entered the study and completed a questionnaire on the existence and implementation of the surveillance system domains (from data collection to evaluation) and the relationship between domains of this system and their function. The descriptive statistical method, path analysis, was employed using Amos. A ccording t o m anager’s v iewpoint, t he r ange o f existence and implementation of all domains of surveillance system were 12% to 68.7% in average. They believed that 10-69% of domains of surveillance system were working properly. Most of respondents (59-87%) declared that investing in diabetes at different levels of prevention was less than expected. Satisfaction with both diabetes surveillance system function and diabetic patients was low and they don’t have a good and bright future for diabetes and its various aspects. By modeling analytical structural equations, some components of surveillance system were moderately worked together. we conclude that we must first formulate and prepare a standard surveillance system as well as train the relevant personnel and make clear changes in the existing care system. With the current surveillance system, we have a long way to go to prevent and control diabetes to an acceptable the average level of performance of the care system is lower than expected

Irregular working times or atypical working schedules, accompanied by the risk of unhealthy dietary habits, physical inactivity, and partial sleep deprivation, potentially lead to increased metabolic risk factors. This study aimed to evaluate the nutritional status, physical activity level, and the knowledge, attitude and practice (KAP) of South Zagros Oil and Gas Production Company (SZOGPC) employees (predominantly irregular-shift workers) toward diet and nutrition. This cross-sectional study was conducted from January to October 2017 on 997 SZOGPC workers. Demographic characteristics, anthropometric measures, biochemical markers, physical activity status, KAP, and dietary intake of the employees were assessed and analyzed. The offered menus were also analyzed. The participants’ mean age was 37.0±6.7 years; the majority of them were married (88.2%) and had irregular-shift work (85.6%). Approximately four-fifths of the participants were either pre-obese or obese, and two-thirds had central obesity. Over half of the participants had high serum triglyceride concentrations and inadequate high-density lipoprotein cholesterol levels. Alkaline phosphatase and alanine transaminase levels were higher than the normal range in 79.0% and 36.2% of the subjects, respectively. The KAP survey showed that only 28-31% of the interviewed participants had acceptable KAP subscale or total scores on the principles related to weight gain and obesity. The mean energy intake was almost 50% more than the average recommendations. Irregular-shift workers appear to be at increased health risk, particularly in terms of acquiring non communicable diseases. Effective lifestyle interventions such as nutrition education and basic menu changes must be considered as a major priority to promote health in such populations.

Musculoskeletal disorders in the upper extremities are common among computer users. This study aimed to assess the effect of mouse pad angle on the forearm muscles activity and upper limb discomfort. This is an experimental research design. The mouse pad was set at 0, 10, 20, and 30 degrees of forearm supination. Ten subjects performed an identical text editing task with mouse in each pad position. Electrical activity of the selected forearm muscles was recorded with surface electrodes. 10-point rating scales were used for assessing perceived discomfort. Extensor Carpi Radialis had the lowest mean of Electromyography (EMG) values in the 0° slanted pad (5.94), and the highest values were associated with Pronator Quadratus in 0-degree slanted pad (22.29). The highest and the lowest mean (SD) of the users’ upper limb discomfort were 3.70 (1.63) and 1.90 (1.28) in 30° and 10° slanted pads, respectively. Using slanted mouse pads could be a helpful and practical tool for office workers to keep more neutral wrist/hand positions.

Identifying ethical challenges and then developing ethical codes and making ethical decisions are one of the solutions to promote professional ethics in any field. Given that ethical challenges in Iranian dentistry education have not been identified so far, the aim of the present study was to explain the ethical challenges in dentistry education. The present qualitative research was performed using qualitative content analysis approach. Participants included faculty members and students of general dentistry from dental schools of metropolitan area 5 of Iran (Shiraz, Yasuj, Bushehr, and Bandar Abbas); they were selected using purposeful sampling. The researcher collected data using semi-structured interviews and focus group. Participants’ conversations were recorded, implemented immediately, and analyzed using MAXQDATA software version 10. Confirmability, credibility, dependability, and transferability were used as the criteria used to ensure scientific accuracy. A total of 16 faculty members attended focus group sessions and individual interviews. A total of 114 codes were extracted, which were classified into three main categories: ethical challenge in the educational system (three subcategories), educational ethical challenge related to faculty members (four subcategories), and educational ethical challenge related to students (two sub-categories). There are many ethical challenges in the field of dental education from the faculty members and students’ perspective that must be addressed by faculty authorities, faculty members, and students. It is suggested that solutions to address these challenges should be considered in future researches; if necessary, appropriate ethical codes should be codified in this regard.

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