Disease In Iran Research Articles

Peritoneal dialysis vs. hemodialysis among patients with end-stage renal disease in Iran: which is more cost-effective?

BackgroundThere is little economic evidence on different modalities among patients with end-stage renal disease (ESRD) in Iran. This study aimed to assess the cost-utility of peritoneal dialysis (PD) and hemodialysis (HD) among ESRD patients in Iran.MethodsFrom the health system perspective and with a 10-year time horizon, we conducted a cost-utility analysis based on a Markov model to compare three strategies of PD and HD [the second scenario (30% PD, 70% HD), the third scenario (50% PD, 50% HD) and the fourth scenario (70% PD, 30% HD)] among ESRD patients with the current situation (PD, 3% vs. HD, 97%) as the basic scenario (the first scenario) in Iran. Cost data for PD, HD and kidney transplantation were extracted from the medical records of 720 patients in the Health Insurance Organization (HIO) database. The Iranian version of the EQ-5D-5 L questionnaire was filled out through direct interview with 518 patients with ESRD to obtain health utility values. Other variables such as transition probabilities and survival rates were extracted from the literature. To examine the uncertainty in all variables included in the study, a probabilistic sensitivity analysis (PSA) was performed. TreeAge Pro 2020 software was used for data analysis.Findings: Our analysis indicated that the average 10-year costs associated with the first scenario (S1), the second scenario (S2), the third scenario (S3) and the fourth scenario (S4) were 4750.5, 4846.8, 4918.2, and 4989.6 million Iranian Rial (IRR), respectively. The corresponding average quality-adjusted life years (QALYs) per patient were 2.68, 2.72, 2.75 and 2.78, respectively. The ICER for S2, S3 and S4 scenarios was estimated at 2268.2, 2266.7 and 2266.7 per a QALY gained, respectively. The analysis showed that at a willingness-to-pay (WTP) threshold of 3,000,000,000 IRR (2.5 times the GDP per capita), the fourth scenario had a 63% probability of being cost-effective compared to the other scenarios.ConclusionOur study demonstrated that the fourth scenario (70% PD vs. 30% HD) compared to the current situation (3% PD vs. 97% HD) among patients with ESKD is cost-effective at a threshold of 2.5 times the GDP per capita (US$4100 in 2022). Despite the high cost of PD, due to its greater effectiveness, it is recommended that policymakers pursue a strategy to increase the use of PD among ESRD patients.

Developing a model of public health system strengthening during pandemic of new emerging respiratory diseases for Iran: A protocol study.

The objective of this article is to propose a protocol for developing a model for strengthening the public health system in Iran. Currently, there is no clearly articulated model for strengthening public health systems during the pandemic of new emerging respiratory diseases in Iran. The protocol described here aims to: (1) identify components for strengthening public health systems, during the pandemic of new emerging respiratory diseases worldwide, (2) identify components for strengthening Iran's public health system, and (3) design a model for strengthening the public health system in Iran during the pandemic of new emerging respiratory diseases. The protocol proposes three phases. In the first phase, a realistic review will be conducted to identify components for strengthening public health systems worldwide based on six building block framework. In the second phase, a qualitative study will be used to identify components for strengthening public health systems in Iran during the pandemic of new emerging respiratory diseases. In the third phase, an initial model will be designed, and the Delphi technique will be used to finalize the model. Due to fragility and the significant strain that public health systems experienced during the pandemic, it is imperative to introduce a model that strengthens public health systems through some initiatives and strategies and explains the mechanisms by which they operate. A realist review and qualitative study will provide the evidence needed to support the effective implementation of public health interventions, taking into consideration the diverse contexts of these interventions in Iran.

Comparison of cystectomy and lobectomy of lung hydatid cyst in pediatrics: a retrospective study.

Hydatid cyst is an endemic disease in Iran. The treatment of choice for paediatric lung hydatid cysts is surgical removal of the cyst. However, due to its high prevalence the risk of recurrence after the surgery, cystectomy with capitonnage, which preserves the lung tissue, is a favourable surgical approach compared to lobectomy. Herein, the authors compared the outcome of cystectomy and lobectomy of lung hydatid cysts. This is a retrospective study conducted in the paediatric surgery department. Paediatric patients who had undergone surgery due to pulmonary hydatid cysts were enroled. The patients were divided into two groups including cystectomy and non-anatomic lobectomy. Then, the length of surgery, length of hospitalization, postoperative complications, and the time required to remove the chest tube were calculated in each group. A total of 32 patients were enroled in this retrospective study. Age, sex, location, and size of cysts were not significantly different between the two groups. The duration of surgery in the lobectomy and cystectomy groups was 116.3±33.7 versus 116.1±28.2 min, respectively (P=0.53). Surgery complications including the need for blood transfusion, pneumothorax, need for bronchoscopy and atelectasis were not different between the study groups. The mean time for first chest tube removal was significantly different between the groups with the lobectomy group having a shorter time (P=0.02). The length of hospital and ICU stay were not different between the two surgical procedures. The time to remove the first chest tube was significantly higher in cystectomy compared to lobectomy (P=0.02). The complications and outcome of the cystectomy are comparable to the lobectomy technique. However, the cystectomy method has the advantage of preserving the lung tissue, therefore it's a favourable technique in endemic areas for hydatid cysts where reoperation may be indicated.

Prevalence of Human Adenovirus, Epstein-Barr Virus, and Cytomegalovirus in Pediatric Hematologic Diseases in Iran

Prevalence of Human Adenovirus, Epstein-Barr Virus, and Cytomegalovirus in Pediatric Hematologic Diseases in Iran

Analysis of the Epidemiological Trend of Tuberculosis in Sistan and Baluchestan Province during 2015-2019

Introduction: Tuberculosis is one of the oldest and best-known diseases that has been with mankind for many years. Despite the reduction of infectious diseases in Iran, tuberculosis still remains in some parts of the country, especially in the south of Iran. The aim of this study was the epidemiological investigation of tuberculosis in Sistan and Baluchistan Province.
 Methods: The current research was conducted cross-sectionally in 2022. The study population included all the patients with tuberculosis in Sistan and Baluchistan Province. Data were collected by census method and using standard checklist. Data analysis was done using SPSS v16 software and descriptive and analytical tests.
 Results: In this study, the files of 5382 patients with tuberculosis in Sistan and Baluchistan Province were examined. 2489 patients (42.6%) were men. The most affected group were 2309 elderly people (39.5%) and 20 patients (0.34%) with HIV. The number of 4309 patients (73.8%) were suffering from pulmonary tuberculosis. There was a significant relationship between the elderly age group (P=0.04), female gender (P=0.02), non-Iranian nationality (P=0.02), and urban residences (P=0.03) with tuberculosis. However, no significant relationship was observed between marital status (P=0.06) and prison history (P=0.07).
 Conclusion: The incidence of tuberculosis fluctuated during the five years, but the overall incidence has been decreasing. Considering that some factors such as age groups, gender and symptoms such as cough, weight loss and chest pain increase the chance of contracting the disease. Therefore, doctors of health centers can take an important step in reducing the incidence of tuberculosis with timely visits and regular monitoring of the treatment process of patients.

Prevalence and risk factors of gastroesophageal reflux disease in Iran: A cross-sectional analysis from the PERSIAN cohort.

This study assessed the prevalence of gastroesophageal reflux disease (GERD) in a general adult population in Iran. The association between GERD and various factors was also evaluated. We performed a cross-sectional study on 163,018 individuals aged over 35 who were enrolled in the PERSIAN cohort. GERD was defined as the occurrence of heartburn and/or regurgitation symptoms at least several days a month. Survey design analysis for pooled data was performed and multiple regression analysis was conducted to determine the independent risk factors for GERD. The prevalence of GERD in our study was estimated at 21.86% (95% confidence interval:17.4%-36.4%). The mean age of the participants was 49.84 years±9.25 (35-70) and 44.75% of the participants were male. Symptoms of heartburn and regurgitation were reported in 18.65% (n: 29,170) and 6.06% (n: 9,717) of participants, respectively. In the multivariate analysis, several factors were found to be associated with a higher prevalence of GERD: female sex, age >50, current smoking, opium use, weekly consumption of fried foods, frequent consumption of hot tea, less than 6 hours of sleep per night, psychiatric disorders, usage of NSAIDs, and poor oral hygiene, were associated with a higher prevalence of GERD. Conversely, higher education levels and average physical activity were found to be less commonly associated with GERD. We found a relatively high prevalence of GERD (21.86%) in this population-based study in Iran. By identifying modifiable risk factors, this research offers opportunities for targeted interventions and lifestyle modifications to reduce the burden of GERD.

Molecular detection and phylogenetic analysis of Borrelia spp. from sheep and goats blood samples in West Azerbaijan province, Iran.

Borrelia species are spirochetes transmitted by ticks that are important in human and animals. In most countries, there is still no molecular epidemiology of borreliosis in ruminants. This study was aimed to evaluate the existence of Borrelia spp. DNA in the blood samples of small ruminants using polymerase chain reaction (PCR) method in West Azerbaijan Province, Iran. To detect Borrelia spp. DNA, about 1,018 ruminants (456 goats and 562 sheep) blood samples were examined from different bioclimatic regions in West Azerbaijan province, Iran. The DNA extracting and PCR were conducted. In sheep, the following prevalence rates were respectively obtained for the 16S rRNA, 5S - 23S rRNA and ospA genes: 3.55% (20/562), 2.13% (12/562) and 0.88% (5/562). And so, the prevalence rates of the genes in goats were 0.87% (4/456) for 5S - 23S rRNA gene, 1.75% (8/456) for 16S rRNA gene and 0.65% (3/456) for ospA gene. The prevalence of Borrelia spp. was significantly different in small ruminants based on the farms and localities. The sheep and goats in humid areas (north of West Azerbaijan) were infected statistically more than those in sub-humid areas (south of West Azerbaijan). It is demonstrated that host species like sheep and goats may have a key role in natural Lyme disease cycles and other borreliosis diseases in Iran.

First report of a ‘Candidatus Phytoplasma trifolii’‐related strain (16SrVI) associated with okra curled pod disease in Iran

First report of a ‘<i>Candidatus</i> Phytoplasma trifolii’‐related strain (16SrVI) associated with okra curled pod disease in Iran

Study of innovation capacity of fisheries companies in the covid-19 pandemic crisis.

Many countries have encountered coronavirus pandemic crisis around the world. Through the outbreak of this disease in Iran, preventive plans have been implemented to break the chain of the disease infection. These measures in the economic sector have affected supply, production and demand, and to some extent have led to the partial or complete closure of some businesses and occupations. In the context, it seems that innovative an "innovation capacity" infrastructure measures and turning to innovation in this crisis can be a strategy to moderate and optimize the situation. This study tries to design concepts of the fisheries firms' innovation capacity model in the context of the COVID-19 pandemic crisis. After collecting data, they were analyzed using SPSS and PLS SMART software, which were performed in two parts: descriptive statistics and analytical or inferential statistics. A novel research model is presented to examine the impact of factors such as innovation management, social, cultural, human and organizational capital, crisis strategies, government actions in crisis situations, and marketing strategies in crisis situations, as well as, recognition and application of marketing advantages in crisis situations, which offers a re-analysis of innovation capacity. According to the results, among the variables played a significant role on the level of innovation capacity in epidemic conditions, innovation management (p> 0.000; β = 0.593), and recognition and application of marketing advantages (p> 0.049; β = 0.209) were the most significant, independent variables affecting the innovation capacity, which explained its variations.

Medically Significant Vector-Borne Viral Diseases in Iran.

Vector-borne viral diseases (VBVDs) continue to pose a considerable public health risk to animals and humans globally. Vectors have integral roles in autochthonous circulation and dissemination of VBVDs worldwide. The interplay of agricultural activities, population expansion, urbanization, host/pathogen evolution, and climate change, all contribute to the continual flux in shaping the epidemiology of VBVDs. In recent decades, VBVDs, once endemic to particular countries, have expanded into new regions such as Iran and its neighbors, increasing the risk of outbreaks and other public health concerns. Both Iran and its neighboring countries are known to host a number of VBVDs that are endemic to these countries or newly circulating. The proximity of Iran to countries hosting regional diseases, along with increased global socioeconomic activities, e.g., international trade and travel, potentially increases the risk for introduction of new VBVDs into Iran. In this review, we examined the epidemiology of numerous VBVDs circulating in Iran, such as Chikungunya virus, Dengue virus, Sindbis virus, West Nile virus, Crimean-Congo hemorrhagic fever virus, Sandfly-borne phleboviruses, and Hantavirus, in relation to their vectors, specifically mosquitoes, ticks, sandflies, and rodents. In addition, we discussed the interplay of factors, e.g., urbanization and climate change on VBVD dissemination patterns and the consequent public health risks in Iran, highlighting the importance of a One Health approach to further surveil and to evolve mitigation strategies.

Online information-seeking behavior of Iranian web users on Google about Henoch–Schönlein purpura (HSP): an infodemiology study

Backgrounds: Previous studies have indicated that users’ health information-seeking behavior can serve as a reflection of current health issues within a community. This study aimed to investigate the online information-seeking behavior of Iranian web users on Google about Henoch–Schönlein purpura (HSP).MethodsGoogle Trends (GTr) was utilized to collect big data from the internet searches conducted by Iranian web users. A focus group discussion was employed to identify users’ selected keywords when searching for HSP. Additionally, keywords related to the disease’s symptoms were selected based on recent clinical studies. All keywords were queried in GTr from January 1, 2012 to October 30, 2022. The outputs were saved in an Excel format and analyzed using SPSS.ResultsThe highest and lowest search rates of HSP were recorded in winter and summer, respectively. There was a significant positive correlation between HSP search rates and the terms “joint pain” (P = 0.007), “vomiting” (P = 0.032), “hands and feet swelling” (P = 0.041) and “seizure” (P < 0.001).ConclusionThe findings were in accordance with clinical facts about HSP, such as its seasonal pattern and accompanying symptoms. It appears that the information-seeking behavior of Iranian users regarding HSP can provide valuable insights into the outbreak of this disease in Iran.

Climate Change and the Looming Threat of Cardiovascular Diseases in Iran: A Narrative Review

In this narrative article, we delve into the intersection of climate change and the rising incidence of cardiovascular diseases (CVDs) in Iran, shedding light on the urgent need for comprehensive action to protect the nation's health and heritage. Against the backdrop of Iran's diverse landscapes and cultural heritage, the article sheds light on the profound impacts of climate change on public health. Rising temperatures, more frequent heatwaves, deteriorating air quality, and disruptions in food security are identified as key climate-related factors intensifying the prevalence of CVDs. Vulnerable populations, including low-income communities and marginalized groups, face a disproportionate burden. The narrative emphasizes the urgent need for compre-hensive action, encompassing healthcare infrastructure, public awareness campaigns, and climate adaptation measures. Climate justice emerges as a critical element, ensuring equitable access to resources and healthcare. The conclusion calls for collective efforts to protect cardiovascular health, uphold climate justice, and secure a sustainable future for Iran and the world

The Association between Levels of Physical Activity and Lifestyle, Life Expectancy, and Quality of Life in Patients with Alzheimer’s Disease

Background: Engaging in physical activity could help improve the quality of life in patients with Alzheimer’s disease. The objective of this study was to determine the association between the levels of physical activity and lifestyle, life expectancy, and quality of life in patients with Alzheimer’s disease in Iran and Italy. Methods: A total of 165 participants from Iran and Italy were enrolled in this cross-sectional study. In Iran, 85 patients participated in the study. In Italy, we enrolled 80 patients at the Sapienza University teaching hospital, Policlinico Umberto 1 in Rome. The inclusion criteria in this study include patients over 60 years old, non-smokers, and non-users of antidepressants and hypnotics. Results: The results of Tukey’s post hoc test of the study conducted in Iran showed that the lifestyle of patients with moderate (p = 0.001) and low (p = 0.009) physical activity levels was significantly better than inactive patients. Life expectancy in patients with moderate physical activity levels was significantly higher than inactive patients (p = 0.011). The quality of life was significantly better in patients with moderate (p = 0.001) and low (p = 0.002) physical activity levels than inactive patients. On the other hand, the findings of Tukey’s post hoc test of the study in Italy showed that the quality of life in patients with low (p = 0.001) and moderate physical activity levels (p = 0.01) was significantly higher than inactive patients. Conclusions: A low to moderate level of physical activity could be associated with an improved lifestyle, life expectancy, and quality of life in patients with Alzheimer’s disease compared to inactivity.

Genotyping and phylogenetic analysis of Coxiella burnetii in domestic ruminant and clinical samples in Iran: insights into Q fever epidemiology

Coxiella burnetii, a zoonotic pathogen, is the causative agent of Q fever, an endemic disease in Iran. However, there is currently a lack of available data on the genotypes of C. burnetii in the country. Here, we typed 26 C. burnetii isolates detected in milk, abortion, cotylodon, and cardiac valve samples from various geographical areas and hosts (7 cattle, 8 goats, 10 sheep, and 1 human) using Multilocus Variable Number Tandem Repeat Analysis (MLVA/VNTR) with five loci:ms24, ms27, ms28, ms33, and ms34. As IS1111 was observed to be spontaneously inserted in locus ms23 across all of our examined C. burnetii samples, five loci were employed for MLVA/VNTR genotyping. Among the 26 C. burnetii strains, 22 distinct genotypes (A–V) were identified in the discriminative loci. In silico analysis categorized Iranian C. burnetii strains into five genomic groups along with seven singletons, representing 11 exiting clonal complexes worldwide. Clusters 10 and 11 exclusively consisted of Iranian samples. These findings revealed high genotyping diversity among C. burnetii isolates in Iran. The genotypes circulating in Iran differed significantly from those found in other regions worldwide. To gain a comprehensive understanding of Q fever epidemiology in Iran, it is crucial to conduct large-scale studies that assess the distribution of C. burnetii genotypes across different geographical areas, hosts, and sources.

Do Serological Tests Eliminate the Need for Endoscopic Biopsy for the Diagnosis of Symptomatic Patients with Celiac Disease? A Retrospective Study with Review of Literature.

Background: Celiac disease is one of the most common genetic allergies worldwide. The prevalence of celiac disease in Iran is similar to or even higher than the global prevalence. Celiac disease is a chronic inflammatory disease that affects the small intestine. Affected patients are allergic to gluten protein that exists in some grains, such as wheat and barley. Methods: Serological endomysial IgA antibody (EMA-AB) and tissue transglutaminase IgA antibody (TTG-IgA) tests were performed on 114 patients aged the ages of 0-18 years with histopathological findings of celiac disease. The results of these tests were compared to the results of the histopathological study of the duodenal biopsy. Results: Based on the receiver operating characteristic (ROC) curve and a calculation of the TTG-IgA test's sensitivity and specificity, the best diagnostic limit for the TTG-IgA test is 144, which has the best sensitivity and specificity. At this value (cut-off), the test's sensitivity was 62%, and the specificity was 93.7%. For the endomysial test, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 80%, 93%, 90%, and 75%, respectively. Conclusion: The diagnostic accuracy of the endomysial test is better than that of the TTG-IgA test in general for diagnosing patients with celiac disease. In the TTG-IgA test, false-positive cases are high due to a cut-off of 20, reducing the test's specificity. In these false-positive cases, the endomysial test helps in better diagnosis.

Midterm prognosis following total correction of tetralogy of fallot in adult patients.

Tetralogy of Fallot is a common congenital heart disease characterized by cyanosis. The primary treatment approach involves corrective surgery typically performed within the first year of life to achieve complete resolution. However, certain patients may undergo surgery at an older age. This study seeks to assess the efficacy of surgery by examining the midterm outcomes of total correction of Tetralogy of Fallot when performed in older individuals. This interventional-longitudinal study focused on patients who underwent complete surgery to correct tetralogy of Fallot at an advanced age of over 15 years. All of the participants were referred to the Shahid Rajaei Heart and Vascular Center, which is a referral center for congenital heart diseases in Iran, between 2010 and 2020. The surgical procedures for these patients involved primary total correction of tetralogy of Fallot or surgery following by shunt implantation. Prior to the surgery, the necessary information was gathered from the patients' medical records. The patients were then monitored over a 5-year period, during which they received regular check-ups from cardiologist with fellowship in adult congenital heart disease. A total of 94 participants were enrolled in the study, with an average age of 26.7 ± 9.6 years. Notably, the majority of the participants were male. The study reported a late mortality rate of 3.2%. Furthermore, 17 patients, constituting 18% of the cohort, underwent a secondary surgical procedure. This secondary surgery encompassed 14 cases of Pulmonary Valve Replacement (14.8%) and 3 cases of Ventricular Septal Defect repair (3.1%). While the optimal age for total correction of Tetralogy of Fallot is conventionally considered to be within the first year of life, this study demonstrated that surgical intervention performed at a later stage of life can yield favorable midterm prognoses. It is imperative to emphasize that individuals unable to undergo surgery at the ideal age due to a multitude of factors should not be deprived of the potential benefits associated with surgical intervention.

Economic Burden of Vision Loss and Eye Disorders in Iran.

Globally, population growth and ageing are expected to increase the risk of vision impairment for more people. Eye disorders impose heavy social and economic burdens on communities through increased poverty, reduced quality of life, and decreased employment. We aimed to calculate the economic burden of eye diseases in Iran. Prevalence-based and top-down cost estimation methods were used with a sociological approach. Data were collected from the Northeastern Ophthalmology Center Institute for Health Assessment, and Evaluation, besides the 2017 census. Eye diseases were classified according to the ICD10. Data were analyzed using Excel 2016 software. Survey data were collected from 19,113 patients with vision loss and eye disorders. The average cost of vision loss/eye disorders was estimated to be $250.3. The findings indicated that the economic burden of visual diseases was $2,844 million a year, with direct medical costs comprising 87% (66% of inpatient and 21% of outpatient) and direct non-medical and indirect costs estimated at 6% and 7%, respectively. Furthermore, 72.8% of direct medical costs was paid by insurance companies, 20.6% by patients, and 6.6% by the government. Eye diseases and vision loss in Iran, as in other countries, are costly for the health system and society. Instituting effective policies and measures to address this rising burden should be a national priority. Another suggestion in this area would be to focus on preventive care and policies such as health education, highlighting the role of reorientation of health services and advocacy (for policies that promote eye health), where relevant.

Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study

ObjectivesChronic obstructive pulmonary disease is a chronic disease with numerous complications. Therefore, its effective management depends on home-based pulmonary rehabilitation. The effectiveness of home-based pulmonary rehabilitation programmes in turn depends...

Job Burnout among Employees and Therapists in Counseling Centers for Behavioral Diseases in Iran

Job Burnout among Employees and Therapists in Counseling Centers for Behavioral Diseases in Iran

Epidemilogic Study of Death Caused by Endocrine, Nutritional, and Metabolic Diseases in Iran During 2006-2018

Objective: The epidemiological transition and the increase of chronic diseases resulted in the rise of endocrine, nutritional and metabolic (ENM) diseases as causes of death. This study aimed to explore the death rate caused by ENM in Iran 2006-18.&#x0D; Materials and Methods: Secondary data analysis was done. The demographic data on death were extracted (age, sex and cause of death) at the provincial level from the death records registered by civil registration. The conditions and trends of ENM death were analyzed from 2006 to 2018. The differences were analyzed in terms of age, sex, place of residence, and over time through indicators of death rate, sex ratio, and years of life lost (YLL).&#x0D; Results: Out of 1708 pregnant women, 244 (14.3%) had GDM, and 1464 (85.7%) did not. There was a statistically significant difference between these two groups in terms of age (P: &lt;0.001), weight (P: &lt;0.001), number of pregnancies (P: &lt;0.001), delivery (P: &lt;0.001), previous diseases (P: &lt;0.001), and Rh (P: 0.01). While in terms of the ABO blood group system (P= 0.3) and abortion rate (P= 0.067), no statistically significant difference was observed.&#x0D; Conclusion: 6,906 people were died in Iran between 2006- 2018 due to ENM diseases. The death rate from this disease increased from 3.5 per 100,000 people in 2006 to 8.4 in 2018. More women died, especially in old age, with the peak of death being at the age of 50 and older. ENM death resulted in the loss of 67,041 years of life.&#x0D;