Outbreak In Iran Research Articles

COVID-19 Telephone Consultation by Iranian Traditional Medicine as an Integrative medicine: Benefits and Challenges

The COVID-19 disease started in December 2019 in Wuhan, China, and spread across the world, including the Islamic Republic of Iran. Due to the high prevalence of this disease, it resulted in worry in many people and has led to several unnecessary visits to medical centers which may have increased the risk of infection. Preventive measures are necessary to control outbreaks and decrease disease burdens. Telemedicine such as telephone consultation is an efficient and safe platform to control disease in times of infectious epidemics by reducing the communication between people and the presence of non-infected people in medical centers. Iranian traditional medicine (ITM) as integrated medicine, is a collection of scientific principles and methods for the prevention and treatment of disease. The Nobaan’s telephone consultation system was set up by ITM specialists to provide consultations for COVID-19. A total of 43 ITM physicians have been consulting health seekers every day from 6:00 a.m. to 12:00 p.m. based on national guidelines for COVID-19 and a specialized guide from academic resources of ITM. From 18 March to 17 April 2020, the doctors received a total of 2778 calls and provided a total of 11221 minutes of consultation. In total, 50% of physicians answered more than 90% of the calls and the average length of each call was 4.5 minutes. Finally, it seems except few limitations compared with face to face patient visit, this newly consultation by ITM specialist may provide considerable help to prevent and manage COVID-19 outbreak in Iran.

Evaluating the Impact of COVID-19 Pandemic on Organ Donation and Transplantation Activities in Iran

Background: Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on reducing organ transplantation activities. Objectives: The aim of this study was to determine the donation and transplantation activities before and after COVID-19 outbreak in Iran. Methods: This retrospective study compared the donation and transplantation activities in two specific 9-month periods (average period of March - December 2019 Vs. March - December 2020). The questionnaire included the numbers of brain death confirmations, family consents, organ recoveries, and transplanted solid organs. The questionnaire was sent by email to the chief executive of the organ procurement unit. Results: A total of 15 organ procurement units responded to the survey. The largest reduction was seen in tissue transplantations (62.5%) during two time intervals. Brain death due to head trauma significantly decreased in two time intervals and suicide increased by 14.44% during the COVID-19 pandemic compared to 2018-2019 period. Significant reductions between the median of donation (P = 0.0187), median of potential donor (P = 0.005), median of family consent (P = 0.002), and median of eligible donor (P = 0.009) were observed during the two time periods. Conclusions: A significant reduction was observed in organ donation and transplantation during COVID-19 pandemic. Developing protocols and establishing new strategies for evaluation of organ donation to ensure the safety of organ recipients and medical staff is necessary.

Trend and prediction of COVID-19 outbreak in Iran: SEIR and ANFIS model

Abstract Background: Mathematical and predictive modeling approaches can be used in COVID-19 crisis to forecast the trend of new cases for healthcare management purposes. Given the COVID-19 disease pandemic, the prediction of the epidemic trend of this disease is so important. Methods: We constructed an SEIR (Susceptible-Exposed-Infected-Recovered) model on the COVID-19 outbreak in Iran. We estimated model parameters by the data on notified cases in Iran in the time window 1/22/2020 – 20/7/2021. Global sensitivity analysis is performed to determine the correlation between epidemiological variables and SEIR model parameters and to assess SEIR model robustness against perturbation to parameters. We Combined Adaptive Neuro-Fuzzy Inference System (ANFIS) as a rigorous time series prediction approach with the SEIR model to predict the trend of COVID-19 new cases under two different scenarios including social distance and non-social distance. Results: The SEIR and ANFIS model predicted new cases of COVID-19 for the period February 7, 2021, till August 7, 2021. Model predictions in the non-social distancing scenario indicate that the corona epidemic in Iran may recur as an immortal oscillation and Iran may undergo a recurrence of the third peak. Conclusion: Combining parametrized SEIR model and ANFIS is effective in predicting the trend of COVID-19 new cases in Iran.

Anxiety, anger, and mindfulness as predictors of general health in the general population during COVID‐19 outbreak: A survey in southeast Iran

Communities have been exposed to the complications and problems caused by COVID‐19 disease, which has had various and complex effects on general health. The aim of this study was to investigate the relationship between anxiety, anger, mindfulness, and general health in the general population during the COVID‐19 outbreak in Iran. This cross‐sectional study was performed on 456 participants from September 2020 to April 2021. For data collection, Demographic Characteristics Form, General Health Questionnaire, Freiburg Mindfulness Inventory‐Short Form, The trait anxiety section of the State‐Trait Anxiety Inventory, The State‐Trait Anger Expression Inventory‐2 were used. General health was positively correlated with anxiety and anger and negatively correlated with mindfulness. Anxiety was positively correlated with anger and negatively correlated with mindfulness. No significant correlation was found between anger and mindfulness. Based on the multiple regression model, anxiety, anger and a family member infected with COVID‐19 were the predictors of general health (p < 0.001). Given that anxiety, anger, and family members infected with COVID‐19 are all predictors of public health, it is suggested that psychological programs and interventions be designed to reduce anxiety and anger, as well as to support family members infected with COVID‐19, to promote general health.

Alcohol-related mortality during the COVID-19 outbreak in Iran: a commentary on happening a crisis amid another crisis

ABSTRACT Background: COVID-19 is the name of the disease caused by the SARS-CoV2 virus, which appeared in December 2019 in Wuhan, China, and spread quickly around the world. One of the prescribed ways to control and reduce the prevalence of COVID-19 was to use an alcohol-based hand sanitizer/antiseptic with at least 70% ethanol alcohol. Unfortunately, with the introduction of alcohol to control COVID-19 in Iran, a growth of nonstandard and counterfeit alcohol consumption was witnessed. Nonstandard alcohol consumption in Iran has led to a significant increase in alcohol-related deaths during the outbreak of COVID-19. Methods and materials: This commentary presents the statistics reported by official online media about alcohol poisoning in Iran.Results: This commentary briefly describes why the outbreak happened and presents some policy implications, such as implementing a real-time Alcohol Surveillance System (ASS) to monitor, control, and adopt tailored efforts to reduce alcohol use and minimize its side effects.Conclusion: Health policymakers and researchers need to design and communicate the overall structure of the alcohol surveillance system.

An Expert Opinion Regarding the Management of Lower Gastrointestinal Cancers During COVID-19 Outbreak in Iran: A Brief Report

Lower gastrointestinal cancer patients, like other immunosuppressed patients, are vulnerable to develop more severe infections. Iran is one of the countries with a high incidence of COVID-19, and some modifications are needed to adjust international protocols to deal with this pandemic. Therefore, our cancer institute has implemented some changes in the current treatment guidelines. In each specialty, all members agreed to choose the minimal intervention. The members know that some recommendations may interfere with the routine best-practice recommendations and decrease the quality measures in the patient's outcome. Therefore, these recommendations are valid just in the epidemic COVID-19 situation in the country. According to the consensus of colorectal and cancer surgery professors, if a patient is a new case of rectal cancer, he or she should be referred to undergo neoadjuvant chemoradiotherapy. But if the patient comes eight to twelve weeks after receiving chemoradiotherapy in accordance with the COVID-19 epidemic phase, it may be possible to delay surgery. A stent can be implanted in a patient with rectal cancer who presents with obstructive symptoms, and surgery can be postponed until resolving the crisis of the COVID-19 epidemic or its downward trend. For colon cancer, we will request a thoracic spiral CT scan. If there was no evidence of pulmonary involvement with COVID-19, the patient would undergo open surgery considering the patient's health and protection tips.

The Social Consequences of the Novel Coronavirus Disease (COVID-19) Outbreak in Iran: Is Social Capital at Risk? A Qualitative Study.

As well as causing a global health crisis, the COVID-19 pandemic has also generated multilevel social changes by damaging psychosocial and economic resources across Iranian society. Therefore, this qualitative study was conducted to examine and explain these social consequences and their impact on the social capital of Iran during the COVID-19 outbreak. Using a content analysis approach, nine experts participated in semistructured, in-depth interviews. Interviews were recorded and transcribed verbatim and analyzed using Lundman and Graneheim's method. The social impacts of COVID-19 can be summarized into six categories and 32 subcategories. Three positive-negative categories emerged from the data analysis: “formation of new patterns of social communications; formation of new patterns of behavior; creation of economic changes.” Three entirely negative categories included “creating a climate of distrust; disruption of cultural, social, and religious values; psychosocial disorders.” Overall, most findings (27 out of 32 subcategories) indicated the destructive effects of the COVID-19 pandemic on social capital. Therefore, this raises concerns about social capital endangerment in Iran. However, positive social impacts can guide policies that strengthen social action and improve social capital.

Knowledge, attitude and practice of Sari birth cohort members during early weeks of COVID-19 outbreak in Iran

BackgroundIt has been determined that the coronavirus disease 2019 (COVID-19) pandemic needs social distancing and proper measures to prevent its spreading. This study aimed to determine COVID-19 knowledge, attitude, and practice among Sari Birth Cohort (SBC) members.MethodsIn this cross-sectional study linked to the SBC in north of Iran, mothers living in Sari and its suburbs from March 28 to April 8, 2020 were evaluated. The measurement tool was an online researcher-made, self-reported knowledge, attitude, and practice questionnaire related to COVID-19.ResultsIn total, 1449 mothers with a mean age of 31.51 ± 5.73 years participated. Of them, 82.4% had good knowledge (98.6% in healthcare workers and 79.2% in housewives, p = 0.000). Most of them were worried about spread of the disease in the country (97.4%) and agreed that COVID-19 will finally be successfully controlled around the world (72.2%). Sleep disturbance was reported in 42.7% of mothers. Eighty-eight percent of cases wore masks and gloves when leaving home, 99.4% washed their hands frequently while 12.9% went to any crowded places. People with better knowledge followed safer practices (p = 0.000) and were more worried about the spread of the disease in the country and infection (among themselves and their first-degree relatives) (p = 0.000).ConclusionsMost of the SBC members had a good level of knowledge about COVID-19 but were worried about a long-term pandemic period. They also had good practices regarding the prevention of the disease.

SARS-CoV-2 outbreak in Iran: The dynamics of the epidemic and evidence on two independent introductions.

The SARS‐CoV‐2 virus has been rapidly spreading globally since December 2019, triggering a pandemic, soon after its emergence. While Iran was among the first countries confronted with rapid spread of virus in February 2020, no real‐time SARS‐CoV‐2 whole‐genome tracking in early phase of outbreak was performed in the country. To address this issue, we provided 50 whole‐genome sequences of viral isolates ascertained from different geographical locations in Iran during March–July 2020. The corresponding analysis on origins, transmission dynamics and genetic diversity of SARS‐CoV‐2 virus, represented at least two introductions of the virus into the country, constructing two major clusters defined as B.4 and B.1*. The first entry of the virus might have occurred around very late 2019/early 2020, as suggested by the time to the most recent common ancestor, followed by a rapid community transmission that led to dominancy of B.4 lineage in early epidemic till the end of June. Gradually, reduction in dominancy of B.4 occurred possibly as a result of other entries of the virus, followed by surge of B.1* lineages, as of mid‐May. Remarkably, variation tracking of the virus indicated the increase in frequency of D614G mutation, along with B.1* lineages, which showed continuity till October 2020. The increase in frequency of D614G mutation and B.1* lineages from mid‐May onwards predicts a rapid viral transmission that may push the country into a critical health situation followed by a considerable change in composition of viral lineages circulating in the country.

Psychological Status of Opioid Treatment Service Staff in Tehran, the Epicenter of COVID-19 Outbreak in Iran: A Longitudinal Cohort Study

Background: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome that emerged in early December 2019. Global proliferation, abrupt increases in confirmed cases, and the risk of self-infection have caused significant stress and anxiety among staff working in opioid treatment services (OTS). The aim of our study was to determine the psychological status of staff working in OTS during the outbreak period of COVID-19 in Tehran.

Investigation of the urbanization contribution to the COVID-19 outbreak in Iran and the MECA countries.

The main objective of this research was to disclose the correlative contribution of urban-associated factors affecting the COVID-19 outbreak in the macro-scale of MECA countries and the downscaled micro-scale of the provincial divisions in Iran. For this purpose, the correlation coefficients between the variables and clustering analysis were used to expose the possible effects. Results revealed the comparatively strong relationships between some independent variables (e.g., total greenhouse gas emissions, CO2 emissions, nitrous oxide emissions, and urban population) and confirmed cases (R from 0.619 to 0.695), demonstrating the possible effective role of urbanization and its induced GHG emissions on the COVID-19 outbreak in the country level of the MECA region. Therefore, the results significantly confirmed the strong relationships between some independent variables (e.g., total population, urban population, fuel consumption, NO2–CO2 emissions, energy use, and total intra-changed travels) and confirmed cases (R from 0.724 to 0.945), explaining an explicit relationship between urbanization processes and the COVID-19 outbreak in Iran. Besides, the HCA results revealed the substantial role of the urban population and urban-induced energy use and gas emission in clustering locations regarding the COVID-19 outbreak in both the MECA region and Iran. The main implication of this research is to give a practical correlation between Coronavirus infection and urban constitution, aiming to increase the health of urban societies by creating effective planning in the future.

COVID-19 related callback in blood donors; Outcomes in blood donors and patients

Call back as a procedure to report post donation symptoms or illness by donors has been established since 2009 in Iranian Blood Transfusion Organization (IBTO). During the first phase of COVID-19 outbreak, all blood donors were requested to report any respiratory infection symptoms after donation. The study investigated the callback data of COVID-19 in Tehran Blood Center during the first 3 months of the outbreak in Iran. The purpose of this study was to estimate the frequency of post donation COVID-19 related call back reports and determine its implications for blood donors and patients.A telephone interview was conducted with donors who had reported COVID-19 symptoms. Some questions were asked to evaluate donor′s health at the time of blood donation. The donors categorized into three groups: laboratory-confirmed, suspected, and COVID-19 irrelevant based on their answers. In cases that the blood component obtained from a laboratory-confirmed donor had been released, the hospital was notified and asked to follow up the recipient for COVID-19.The results showed 30 donors (0.08 %) had callback related to COVID-19 and 76.63 % of the obtained component was disposed. The results also showed that only one donor had a laboratory-confirmed result with the RBC unit processed from her whole blood released for transfusion. The RBC unit recipient did not show any signs or symptoms of infection during a 46-day follow-up.Concluded that callback system was effective to remove most of the components obtained from the donors who reported to be COVID-19 suspected or confirmed. Moreover, the result did not support virus transmission through blood transfusion.

Clinical Predictive Values in Botulism: A 10-year Survey

BackgroundBotulism occurs periodically or in outbreaks in Iran. Botulism is lethal and accordingly a considerable issue in environmental health, although it is uncommon. This study was performed to evaluate the potential predictive factors in foodborne botulism in a 10-year span.Materials and methodsAll medical records from patients with foodborne botulism admitted to Imam Reza Hospital in 10 years (2005–2015) were analyzed retrospectively.Results61 cases were included (38 men, mean age ± SD 28.93 ± 19.14 years). All cases were treated with antitoxin. 6.6% of cases died. Canned beans were correlated with the admission to intensive care unit (ICU), and also, it increased the length of ICU stay significantly (P = 0.007 and 0.023, respectively). The incidence of dizziness and diplopia significantly induced excess demands for higher doses of antitoxin (P = 0.038 and 0.023, respectively). Risk of dysphagia was remarkably higher in cases with ptosis (P = 0.039, odds ratio: 3). While in this study, time elapsed between the onset of clinical manifestations and antitoxin administration was correlated with the occurrence of dysphagia, constipation, and blurred vision, and early treatment did not improve the outcomes. Multiple analysis of potential variables by a logistic regression model disclosed that the independent significant factors affecting mortality were the need for mechanical ventilation (P = 0.000), dyspnea (P = 0.044), general weakness (P = 0.044), and lack of consciousness (P = 0.008) at the time of admission.ConclusionsTaking clinical signs and symptoms into account upon patient arrival is important and, of course, is a key to further management in the emergency setting.How to cite this articleSaeidi S, Dadpour B, Jarahi L, Ghamsari AA, Nooghabi MN. Clinical Predictive Values in Botulism: A 10-year Survey. Indian J Crit Care Med 2021;25(4):411–415.

Depression Symptoms and Sleep Quality During COVID-19 Outbreak in Iran: A National Cross-sectional Study

Background: Coronavirus 2019 is a new infectious disease that has been declared by the World Health Organization as a global pandemic. This pandemic may have psychological effects on populations. Objectives: This study aimed to investigate the quality of sleep and depression in the Iranian community during COVID-19 pandemic. Methods: This nationwide cross-sectional web-based study was conducted from April 19 to May 12, 2020 in Iran. The data collection tools were the Pittsburgh Sleep Quality Index and Depression Center for Epidemiologic Studies’ Depression Scale questionnaires. Each province in Iran was assumed as a cluster, and generalized estimating equations models were used to determine the demographic variables that were related to depression symptoms and sleep quality during COVID-19 outbreak. Results: In this study, 73.5% and 41.4% of the participants had poor sleep quality and had depression symptoms, respectively. Perceived income, hours spent outdoors, the number of people with COVID-19 that were acquainted with, and a history of depression significantly were related to sleep quality. Also, gender, age, having a child, education level, economic status, and a history of depression were significantly associated with having depression symptoms. Conclusions: Most participants had poor sleep quality, and less than half had depression symptoms during the COVID-19 pandemic. These problems can disturb daily routines, cut social ties, and increase worries and fears of the future. Interventions are necessary to reduce psychological problems in Iran.

Outbreak Investigation of Officially Reported and Highly Pathogenic Avian Influenza (H5N8 Subtype) in Iran During 2016.

On 14 November 2016, an outbreak of highly pathogenic avian influenza (HPA) was reported from a commercial layer farm located in Malard, Tehran Province, Iran. This study aimed to investigate the HPAI H5N8 outbreaks in Iran. The questionnaire was prepared and completed through interviews with farm owners or field observations at the time of disease onset from November 2016 to February 2017. The HPAI H5N8 infection was confirmed in 30 different locations including 10 villages (33.3%), nine-layer farms (33%), two broiler breeder farms (6.67%), one layer breeder farm (3.3%), one turkey farm (3.3%), one partridge farm (3.3%), five national parks (16.7%), and one wetland (3.3%) in 12 provinces of Iran. The cumulative incidence rates of disease in villages, layer farms, broiler breeder farms, layer breeder farms, partridge farms, and turkey farms were 0.02%, 0.87%, 0.55%, 6.25%, 7.14%, and 0.69%, respectively. The findings reflect that among the investigated variables at infected locations, new birds entering the home in villages, live bird markets, inappropriate biosecurity conditions, transporting manure during the breeding period, close proximity of a common road to infected farms, and poultry movement inside (pullet) and outside were the most frequently observed possible risk factors for these outbreaks. In conclusion, attention should be focused on the study of the dynamics and movements of domestic poultry, investigation and modification of the structure of industrial poultry farms, training for all related people, enhancement of passive surveillance, an increase in biosecurity, raising the awareness of the authorities on the importance of the infection, and provision of the required credits and facilities.

Detection and Phylogenetic Study of Peste des Petits Ruminants in Iran, 2019: Updated Data.

Peste des Petits Ruminants (PPR) is caused by a morbillivirus from the Paramyxoviridae family and the infected animals, especially goats, that show clinical signs of necrotic stomatitis, enteritis, and pneumonia. The PPR virus has four lineages closely related to the geographical regions. Sufficient awareness of the lineage of the virus helps monitor the disease in different regions of a country. Phylogenetic studies have led to implementing strategies against new lineages that may enter a given country from the neighboring countries. The present research aimed to study the PPR virus (PPRV) detected phylogenetically by PCR in a small ruminant flock with PPR clinical signs. The goats in a flock in Alborz province showed clinical signs of PPR, and 10% died. Oral swabs and blood samples were taken from two affected goat flocks. The RT-PCR was conducted to detect PPRV RNA, and the sequence of the obtained RNA was analyzed phylogenetically. Moreover, all the samples were positive for the presence of PPRV and belonged to lineage IV. The isolates had high homology with each other and with the isolates from different countries. To inhibit the entrance of new isolates to Iran and reduce the incidence of outbreaks in Iran, it is essential to control the animals&amp;rsquo; movement across the borders and increase the vaccination coverage throughout the country. To eradicate PPR, an extensive vaccination program should cover small ruminant populations throughout the country.

Generalized Anxiety Disorder During the COVID-19 Outbreak in Iran: The Role of Social Dysfunction.

The COVID-19 epidemic has both physical and psychosocial consequences for the general population. The present study aimed to investigate the relationship between the prevalence of generalized anxiety disorder (GAD) and social dysfunction during the COVID-19 epidemic in Iran. This cross-sectional web-based study was conducted on 1000 Rafsanjani citizens in southeastern Iran. Data were collected by using the Generalized Anxiety Disorder-7 and the General Health Questionnaire from March 15 to March 30, 2020. The prevalence of GAD was 27.8%. The mean score of social functioning was 9.71 ± 2.66, and all participants had social dysfunction. Multivariate logistic regression test showed a significant correlation between anxiety and social functioning (confidence interval [CI], 1.16-1.30; p < 0.001), sex (CI, 1.49-3.04; p < 0.001), and concern about COVID-19 (CI, 1.38-2.73; p < 0.001). The COVID-19 epidemic had negative psychosocial consequences in the general population in Iran.

COVID-19 Outbreak in Iran: Lessons to Learn, Measures to Take.

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Mental health outcomes among health-care workers during the COVID-19 outbreak in Iran

PurposeThe increasing prevalence of coronavirus disease (COVID-19) is a global crisis that leads to physical and psychological outcomes for health-care workers, so this study aims to investigate the mental health outcomes (including general health, generalized anxiety disorder and posttraumatic stress disorder) in health-care workers in Rafsanjan, Iran.Design/methodology/approachBy using convenience sampling, this cross-sectional study was conducted on 332 health-care workers working in public hospitals in southern Iran. Data collection lasted from March to April 2020. General Health Questionnaire (GHQ-28), Generalized Anxiety Disorder 7-item (GAD-7) and Impact of Event Scale were used to collect data. The data were then analyzed by using SPSS 25 and descriptive and inferential statistics (chi-square and multivariate logistic regression).FindingsIn total 45.5% of the participants had psychological disorder according to GHQ. In addition, 25.3% of the participants had GAD and 31.6% had posttraumatic stress disorder (PTSD). The results using multivariate logistic regression showed that only income was significantly associated with psychological disorders (95% confidence interval for odds ratio: 1.32–6.45, P = 0.008).Practical implicationsAccording to the results, the incidence of GAD and PTSD was high among health-care workers. Therefore, it is recommended that the psychological skills of health-care workers be strengthened through counseling and training programs.Originality/valueThis paper provides a novel analysis of mental health in health-care workers in Iran.

Corona Virus Outbreak in Iran: A Comparison with China, Italy and South Korea in One Month afterInfection

Introduction: The coronavirus outbreak has become a serious issue of the entire world. In some ways, the ability to provide outbreak rate prediction is helpful. Therefore the main purpose of this study was to investigate the incidence pattern of Confirmed COVID-19 Cases in Iran, and comparison between countries with high infected person such as China, Italy and South Korea. Method: In this cross sectional study 126789 infected cases with COVID 19 related countries with highest infection, China, Italy, Iran and South Korea in 30 day timespan was extracted from the cumulative frequency chart at https://www.worldmeters. Info/coronavirus/. The incidence rate pattern was presented. Results: The findings show the frequency pattern of the infected person’s frequency within 30 days since the first case has observed in Iran are similar. Although incidence rate coronavirus is similar to other countries in during 14 days, but after the 14th day, there is a noticeable difference between the obtained pattern of confirmed cases in Iran and other countries. There is a spectacular difference in the number of patients in Iran and South Korea after the seventh day and between Iran and Italy after the fourteenth day. Conclusion: The Covid-19 quickly spread across the world and caused varying challenges. Thus the prevention strategies aimed at reducing transmission in the community are a necessity.