Iran's Program Research Articles

The study of acceptability HIV self-testing among Iranian injecting drug users: a qualitative study

BackgroundIn 2016, The World Health Organization introduced HIV self-testing (HIVST) as an alternative to traditional HIV testing (1), the present study aims to study the acceptability of HIV self-testing among Iranian women injecting drug users (WIDUs). The results of this study are expected to provide valuable evidence for the proper implementation of this program in Iran. Methods: This study employed a content analysis approach to gather qualitative data. The investigation was conducted from April to July 2023. We have chosen the following five provinces, namely Mashhad, Tehran, Kurdistan, Mazandaran, and Kerman, as the designated areas for our study. A sample of Iranians (17–62 years) was selected by purposeful and snowball sampling methods to participate in the study, and 31 semi-structured interviews were conducted. The data collection tool was an interview guide, which was designed based on a review of the literature. The data were analyzed using conventional content analysis. The interviews continued until data saturation was reached. Results: Based on our findings, we distilled 2 main themes and 9 categories including Inhibiting factors (Access and Affordability, Accuracy Concerns, Low knowledge, linkage to HIV treatment, the window period, Ignoring the danger) and Focalizing factors (Empowerment and autonomy, Stigma and privacy.ConclusionIran’s HIV stigma may discourage regular testing, but self-testing can help overcome challenges. Support for counseling, care links, and accurate information dissemination are crucial.

Sexual Function and Quality of Life in Iranian Women With Human Papillomavirus Infection.

Considering the prevalence of Human Papillomavirus (HPV) infection and the lack of HPV vaccination program in Iran among young women and the importance of quality of life and sexual performance in women, we decided to conduct a study to examine the relationship between HPV infection and sexual dysfunction and quality of life in Iranian women. In this cohort study, 250 married women who infected with HPV were recruited via convinence sampling from colposcopy clinic of Arash women hospital (Tehran, Iran) from April 2020 to May 2022.They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire (the total FSFI score is calculated by the sum of the nineteen items). Sexual quality of life-female (SQOL-F) items (Likert-type scale with a cut-off of 65 points) were organized into four sub-scales: psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression. All patients filled out the female sexual function index (FSFI) and sexual quality of life (SQOL) questionnaires. Variables were analysed via correlation coefficient and linear regression tests. Mean age and mean marriage duration were 38.5±4.5 and 12.2±7.2, respectively. There was a weak correlation between FSFI and SQOL (r=0.15, p=0.001).Time of marriage and genital warts were the predictors on the FSFI and SQOL. The findings suggest that HPV infection can impair sexual function and quality of life. This research contributes valuable insights, especially considering the prevalence of HPV.

The isolation and serotyping of foot-and-mouth disease virus in Iran during 2019-2022.

Foot-and-mouth disease (FMD) is a significant transboundary animal disease that has a considerable economic impact on livestock systems worldwide. In order to determine the presence and type of FMD virus in Iran, a total of 90 samples of vesicular fluid and epithelial tissue were collected from the tongues, tooth pads, and hooves of clinically suspect cattle on 40 vaccinatedfarms in 9 provinces of Iran. These samples were collected duringfour years, from January 2019 to December 2022, and the vaccine was a locally produced polyvalent inactivated vaccine. The collected samples were analyzed using ELISA and isolation methods to identify and characterize the FMD virus. The results of the ELISA tests revealed that 66.66% of the samples were positive for FMD, and the serotypes of the virus were determined. Considering ELISA reslut, 62% of the samples were assigned to serotype O, 33% to serotype A, and 5% to serotype Asia-1. Furthermore, 90% of the positive samples were inoculated onto monolayer cultures of pig kidneys (IB-RS2) for isolation and antigen detection by serotype-specific ELISA kit. The great majority of detected serotype Oviruses were from Esfahan province, while the most detectedserotype Aand serotype Asia-1 viruses were from Qom and Tehran provinces, respectively. These findings indicate that the ELISA and isolation methods are suitable for identifying and typing FMD viruses. The vaccination program in Iran, which includes three serotypes (O, A, and Asia-1), appears to be effective in controlling the spread of the disease. However, the continued circulation of these serotypes in most provinces suggests that ongoing surveillance and vaccination efforts are necessary.

Strengths and Weaknesses of HIV Partner Notification Implementation in Iran.

HIV partner notification is a key intervention to facilitate access to HIV testing and treatment. This qualitative study investigated the strengths and weaknesses of the HIV partner notification program in Iran. Additionally, it provides comprehensive recommendations to mitigate potential harms and maximize the benefits of partner notification services. Using purposive sampling, 15 participants, including policymakers, service providers, and researchers in the field of HIV, were recruited from nine provinces between September and December 2023. The qualitative content analysis was conducted using the Graneheim and Lundman approach. Several strengths were reported for the HIV partner notification program, including alignment with international guidelines, use of trained counselors, integration with current HIV testing guidelines being used by HIV testing centers funded by the Ministry of Health, and a well-developed monitoring and evaluation plan at the facility, provincial, and national levels. Notable weaknesses of the program included a lack of a detailed implementation plan overall and for some key populations at high risk for HIV, such as female sex workers, lack of integration of the program with HIV testing services provided in hospitals and HIV centers funded by the Welfare Organization in Iran, lack of a simple quality checklist for monitoring and evaluation of the program. To increase the coverage and quality of the HIV partner notification program in Iran, a more detailed implementation plan, a simple quality checklist, and more targeted advocacy and training programs are needed.

Pistachio breeding programs in Iran

Pistachio breeding programs in Iran

Malaria elimination program in Iran: Challenges and opportunities.

Malaria elimination program in Iran: Challenges and opportunities.

Association of Beverage Consumption with Cardio-metabolic Risk Factors and Alanine Transaminase Levels in Children and Adolescents: The CASPIAN-V Study.

This study aims to evaluate the association of beverage consumption with cardiometabolic risk factors and alanine transaminase (ALT) levels in children and adolescents. This nationwide study is a part of the fifth survey of a national surveillance program in Iran. Overall, 4200 students, aged 7-18 years, were selected from 30 provinces by multi-stage cluster sampling. In addition to filling in questionnaires, blood sampling and biochemical tests were done. The weekly use of six different beverage types including milk, juice, tea, coffee, soda, and non-alcoholic beer, was documented by interview. The participation rate was 91.5% (n = 3843), and data of 3733 students were complete for the current study. Beverages containing high levels of sugar such as soda and non-alcoholic beer were significantly associated with higher levels of ALT. Model coefficient of regression (SD) was 0.66 (0.31) (P value: 0.034). Healthy beverages such as milk and fresh juice and also beverages containing high levels of caffeine did not have significant association with ALT levels (P value = 0.32, P value = 0.60). Healthy beverages had a significant and inverse relationship with triglycerides (TG) (P value = 0.029), total cholesterol (TC) (P value = 0.008) and low-density lipoprotein (LDL) (P value = 0.008) levels. This study showed that consuming sugar-sweetened beverages is significantly associated with higher levels of ALT, whereas healthy beverages are associated with a better cardiometabolic profile meaning that consuming healthy beverages leads to lower TG, TC, and LDL levels. The effects of beverages on children's health should be emphasized in health recommendations.

Pattern of Participation in Colorectal Cancer Screening from a Population-Based Screening Program in Iran.

In Isfahan, the fecal immunochemical test (FIT) has been used since January 2016 as part of the Iran's Package of Essential Non-communicable Diseases (IraPEN) program for colorectal cancer (CRC) screening. The test is recommended for people who are 50-70 years old. Then, those with positive results would be referred for colonoscopy. This study aims to describe the uptake of the program and its outcome. A retrospective observational study was performed by collecting data from Isfahan Vice-Chancellor for Health database for this study purpose. The number of participators, the number of positive FIT, and the number of detected polyps or cancers were determined. Between 2016 and 2019, the number of participants in the program reached 345 207 individuals (nearly 40% of the eligible population of 874 674). Totally, 21 264 participants (6.1%) had positive tests, of whom about 20% underwent the recommended colonoscopy with available reports, and 971 (24%) and 110 (3%) patients were diagnosed with polyps and CRC, respectively. Over four years of screening with FIT in Isfahan, 40% of the eligible population participated. Among those with positive FIT results, 20% underwent colonoscopy, and approximately 26% of these individuals were identified as having polyps or cancer. This study provides valuable insights into the uptake and outcomes of a population-based CRC screening program in Isfahan, Iran. The findings highlight the need for targeted interventions to increase participation rates and improve the detection of polyps and CRC cases.

Breast cancer screening and early detection programs in Iran: A health policy analysis and recommendations

AbstractScreening and early detection programs for breast cancer (BC) have significantly reduced mortality rates and enhanced survival rates globally. Breast cancer screening programs in low‐ and middle‐income countries like Iran need improvement. This study examines Iran's breast cancer screening and early detection (BCSED) policies, employing the Policy Triangle Model in two phases: a review of 27 documents including various related sources related of policies and strategies, followed by 20 semi‐structured interviews across four distinct levels: policy, regional, clinical, and community levels. Content analysis for documents and MAXQDA2020 software for the second phase were used, and findings integrated. In our analysis of 27 national documents and 20 interviews, we found 10 themes, 19 sub‐themes, and 42 specific codes across four dimensions of the mentioned framework. Main themes in the context dimension covered deficient interactions, deficiency in knowledge management, cultural challenges, and socioeconomic challenges. From the analysis of 27 national documents, we recognized service excellence schemes, personal health encouragement, and service levels. Policy formulation and monitoring and evaluation emerged as central themes for the process dimension, while stakeholder challenges were prominent in the actors' dimension. BCSED programs are multifactorial issues. Proposed strategies to address these issues include the dedicated funds for BC prevention programs, strengthening the Ministry of Health's stewardship role, elevating public awareness, and conducting systematic screening trials in select cities to provide valuable national evidence for future policymaking.

COVID-19 Impact on Pathology Education Program in Iran

COVID-19 Impact on Pathology Education Program in Iran

Exposure to second-hand smoke and risk of lung cancer among Iranian population: A multicenter case-control study.

Despite the implementation of the WHO Framework Convention on Tobacco Control (FCTC) program in Iran, the regulation of second-hand smoke (SHS) exposure-an often-overlooked hazard-, still requires improvement. We employed a multi-center case-control study to investigate the association between exposure to secondhand smoke (SHS) from various tobacco products (cigarettes, water-pipes, pipes, and chopogh), opium use, and the risk of lung cancer. We included 627 lung cancer cases and 3477 controls. Exposure to SHS tobacco and SHS opium was collected through a questionnaire. We used mixed-model logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CI). Among the overall population exposed to second-hand tobacco smoke (SHTS), the odds ratio (OR) compared to those never exposed was 1.35 (95% CI: 1.08-1.71). Never smokers who were ever exposed to second-hand tobacco smoke (SHTS) had 1.69-fold risk of lung cancer compared to those who were never exposed (95% CI: 1.13-2.52). Exposure to SHTS between 2-3 per day (OR = 2.27, 95% CI: 1.13-4.53) and more than three hours per day (OR = 2.29, 95% CI: 1.20-4.37) can increase the risk of lung cancer compared with the no exposure group (P-trend <0.01). We did not observe any association between exposure to second-hand opium smoke (SHOS) and the risk of lung cancer, either in the overall population or among never-smokers. Our study estimates the impact of second-hand tobacco smoke (SHTS) on lung cancer risk in both the overall population and never-smokers. Additional studies are required to evaluate the association between exposure to second-hand smoke from opium and other type of tobacco, including water-pipe and the risk of lung cancer.

Assessment of educational centers and satisfaction evaluation of instructors offering pre-marriage education program in Iran

Assessment of educational centers and satisfaction evaluation of instructors offering pre-marriage education program in Iran

An in-depth examination of geriatric nursing master's programs: A comparative analysis between Iran and Canada

This study was undertaken with the explicit objective of comparing the educational curriculum of the Master's program in Geriatrics in Iran with that of the Alberta Nursing School in Canada. This comparative descriptive study employed George F. Bradley's 4-step method, involving the stages of description and proximity analysis. Data were sourced from internal databases, including Magiran and Scientific Information Database, supplemented by external databases such as Google Scholar, PubMed, and Scopus. The geriatric nursing master's program in Alberta is characterized by a longer duration and a more established history. The delineation of roles for graduates in this context is more specific compared to the situation in Iran. The admission criteria in Alberta are more stringent, emphasizing the quality of candidates through a comprehensive evaluation of general and professional factors. Conversely, the admission process for nursing master's students in Iran considers a broader set of criteria. Furthermore, a substantial disparity exists between the course topics in Iran and the pressing societal and clinical needs. The inadequacy of clinical space and the scarcity of experienced professors emerge as significant challenges within the training program in Iran. The formulation of the curriculum for the geriatric nursing master's program should adhere to a systematic and comprehensive framework that aligns with societal needs. Graduates of the program should possess a well-defined professional position within the healthcare landscape. The educational process should involve the utilization of accomplished professors and a dynamic clinical environment to effectively train students.

Workforce and Employment Status of Sleep Medicine Graduates in Iran

&#x0D; &#x0D; &#x0D; &#x0D; Background and Objective: Sleep medicine is a multidisciplinary specialty that focuses on diagnosing and treating sleep disorders. Sleep medicine fellowship programs in Iran commenced in 2012 at Tehran University of Medical Sciences, Tehran, Iran. This study aimed to investigate the human resources and employment status of sleep medicine fellowship graduates in Iran.&#x0D; Materials and Methods: This study was a descriptive cross-sectional study conducted in Iran in 2022 using conven- ience sampling and included 41 sleep medicine fellows in Iran. Data collection tools included a demographic question- naire and a researcher-made survey. Data were analyzed using the SPSS software.&#x0D; Results: Out of 57 sleep medicine fellows, 41 individuals with an average age of 44.95 ± 7.57 years participated in the study. Only 12% of the fellows were satisfied with their income, and all participants expressed dissatisfaction with their insurance coverage. 92% considered the existence of a national guideline for sleep medicine to be crucial, while 66.7% felt the curriculum of medical sleep medicine had some deficiencies.&#x0D; Conclusion: Lack of a suitable national guideline for treating and preventing sleep disorders, lack of insurance coverage for tests and respiratory assist devices, and high costs of establishing and equipping specialized sleep clinics are major challenges recognized by sleep medicine fellows. Additionally, due to the low priority given to these diseases by authorities and the inappropriate distribution of sleep medicine specialists in the country, access to appropriate treatment for sleep disorders is only feasible in giant cities.&#x0D; &#x0D; &#x0D; &#x0D;

Picture analysis of billboards and infographic graphics advertising COVID-19 on promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic

Today, advertising science is a tool that helps advertisers to design their advertising to meet the needs of the audience. In this regard, knowing and understanding the audience is one of the most important points that advertisers should pay attention to before advertising in order to better attract the audience. This study has been done with the aim of billboards and infographics analysis related to promoting preventive behaviors and vaccination against the Coronavirus disease pandemic and investigating the opinion of the general adult population of Iran. The method used in this research is the qualitative method. In this research, according to the type of data and research goals, Kress and Van Leeuwen’s discourse theory method has been used. The sample size includes 36 advertising billboards and infographics. Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services. The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran). Then, an online survey about promoting preventive behaviors and taking vaccination against the Coronavirus disease pandemic was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms. The assessment of validity involved experts in infection control and linguistics. The reliability of the measurement, determined through the Cronbach’s alpha internal consistency coefficient, yielded a coefficient of 0.968. In this study, data analysis was conducted using IBM SPSS Statistics software, version 15.0 (IBM Corp., Armonk, NY, USA). Finally, users’ opinions about of billboards and infographics were analyzed using descriptive statistics. The results of component analysis and surveys show that visual components such as «The staring look at the spectator (Demand)», «Head-on Shot (inclusion)», «Down Shot (Creating a sense of participation for the represented person)», «Close-up (intimate/individual relationship)», «Level Shot (equality)» and «High-Angle Shot (Presenting power)» in medical advertising has had a great impact in arousing public opinion to create a positive attitude towards preventive measures and vaccination during the Coronavirus disease epidemic. The results of this research show that in visual communication, visual components play a significant role in creating and maintaining target ideologies. Also, advertising in the field of preventive measures in medical sciences requires certain rules that determine people’s culture and the main foundation of their attitude and thinking. Therefore, it is necessary to know such knowledge and learn it by the medical staff to deal with critical situations.

Application of Rodenticides for the Control of Zoonotic Cutaneous Leishmaniasis in Iran: A Systematic Review of the Literature

Introduction: Rodent control programs have a long history of controlling zoonotic cutaneous leishmaniasis (ZCL) in Iran. The present systematic review reports the effect of rodenticides in reducing ZCL in Iran. Materials and Methods: Various electronic databases were explored for reliable research using appropriate keywords between January 1970 and September 2023. Relevant studies were included based on the inclusion criteria. All articles identified from the systematic search were added into Endnote X9 (Clarivate Analytics) and duplicate articles were removed. This study followed standard procedures for systematic reviews and reported results according to systematic reviews guidelines. Results: Overall, 637 documents were identified after screening based on the PRISMA checklist, and finally, 13 papers were included in this systematic review. The findings indicated that most of studies used zinc phosphide (2.5%) and Klerat® mixed with wheat grains in rodents control programs in Iran. The results showed that rodent control programs were implemented in five provinces of Iran, including Esfahan, Yazd, Semana, Golestan, Kermanshah, and Fars, with the highest number of studies in Esfahan province. According to results, the incidence rate of ZCL significantly reduced after rodenticide implementation. Conclusion: This review study provides a better understanding of rodent control programs trends as a promising and practical approach to reducing ZCL incidence in Iran over the past 50 years and can serve as a reference for planning future control and research programs.

Text analysis of billboards and infographic graphics advertising COVID-19 on promoting preventive behaviors and taking vaccination against the coronavirus pandemic and investigating the opinions of the Iranian adult population

BackgroundAdvertising is one of the most important solutions that health centers and medical services around the world use to try to encourage public opinion to create a positive attitude towards preventive measures and vaccination. This study has been done with the aim of text analysis of billboards and infographics related to promoting preventive behaviors and vaccination against the coronavirus pandemic and providing solutions and models for preventive information and advertising in the field of health.MethodsThe study method in this research is a combination of qualitative and content analysis. Data collection was done in a targeted manner. The sample size includes 33 advertising billboards and infographics. Data collection has been done through searching the sites and websites of health networks and medical education centers in Iran, taking pictures of infographics and billboards in public places, and also receiving archive files of pictures from the public relations of health networks and medical services. The data was collected from February 19, 2020 to December 30, 2022 (the time frame of the pandemic and public vaccination program in Iran). The data was analyzed based on the three-dimensional discourse analysis theory of Fairclough. Then, an online survey about promoting preventive behaviors and vaccination against the coronavirus pandemic in the format of billboards and infographics was designed in SurveyMonkey and its link was provided to the audience through virtual networks and other platforms. The age group of people was selected from 18 to 70 years. Considering that the number of participants should be representative of the entire community under investigation, therefore, based on Cochran’s formula, the sample size was equal to 350 people. Finally, users’ opinions were analyzed using descriptive statistics. The assessment of validity involved experts in infection control and linguistics. The reliability of the measurement, determined through the Cronbach’s alpha internal consistency coefficient, yielded a coefficient of 0.968.ResultsThe results show that among the four linguistic components of words, syntax, coherence and text structure; “live metaphors”, “pronoun “we”, “collocation and reference”, and “attitude markers” have the most impact on the audience. The frequency percentage of the data shows that these language elements have tremendous power in attracting the audience to perform preventive behaviors. The results show that the language reflects the culture, opinions and needs of people in the society. Also, the results show that encouraging people to perform preventive behaviors should be through the integration of medical information with motivational linguistic factors in order to attract the audience more.ConclusionsIt can be concluded that the use of the appropriate pattern of medical advertising discourse and correct communication strategies, will help public participation in the field of epidemic control. The language of effective health education and health communication during an epidemic must be related to the ways of thinking and speaking of ordinary people. Also, words with metaphorical and ironic meanings have a high potential to influence the health performance of people in society and increase public awareness of health communication. Therefore, using them to create a new value system with the aim of controlling and overcoming the consequences of the epidemic is very effective.

Qualitative Analysis of Newborn Hearing Screening Program in Iran.

Early diagnosis of hearing loss and timely interventions are important to minimize the consequences of this condition, especially for children. This research was conducted to analyze the newborn hearing loss screening program in Iran. This qualitative study was conducted using the content analysis method and based on the CIPP model in 2023. The snowball method was used to recruit a sample with maximum diversity. The criteria for selecting people for interviews included having at least three years of experience in the newborn hearing loss screening program and sufficient knowledge in the field. To ensure the reliability of the results, four criteria proposed by Lincoln and Guba were used. Data analysis was conducted by MAXQDA2022 software. In the current research, using content analysis in the form of the CIPP model, based on the viewpoints of the interviewees (40 people), the management requirements of the newborn hearing loss screening program were categorized into the four main categories of context (texture), input, process, and output. Eight subcategories were identified in the context dimension, four subcategories in the input dimension, seven subcategories in the process dimension, and four subcategories in the output dimension. According to the findings of this research, in order to properly implement the newborn hearing loss screening program, there is a need to conduct pilot studies, need assessments, evidence-based programs, and epidemiological studies and to prioritize services and resources. Also, communication between service delivery levels needs to be improved, and attention should be paid to personnel motivation and screening programs.

Factors associated with late initiation of antiretroviral therapy in Iran’s HIV/AIDS surveillance data

Early initiation of Antiretroviral Treatment (ART) in HIV patients is essential for effectively suppressing the viral load and prognosis. This study utilized National HIV/AIDS Surveillance Data in Iran to identify factors associated factors with the duration to initiate ART. This hybrid cross-sectional historical cohort study was conducted on Iran’s National HIV/AIDS Surveillance Data from 2001 to 2019. Sociodemographic characteristics, route of transmission, HIV diagnosis date, and ART initiation date were collected. Multivariable linear and quantile regression models were employed to analyze the duration to initiate ART by considering predictor variables. This study included 17,062 patients (mean age 34.14 ± 10.77 years, 69.49% males). Multivariate quantile regression coefficients varied across different distributions of the dependent variable (i.e., duration to initiate ART) for several independent variables. Generally, male gender, injecting drug use (IDU), and having an HIV-positive spouse were significantly associated with an increased duration to initiate ART (p < 0.05). However, a significant decrease was observed in older patients, those with a university level education, men who had sex with men (MSM), and patients diagnosed after 2016 (p < 0.05). Despite improvements in the duration to initiate ART after implementing the WHO’s 2016 program in Iran, various sociodemographic groups were still vulnerable to delayed ART initiation in the region. Therefore, programs including early testing, early ART initiation, active care, educational and cultural interventions, and appropriate incentives are required for these groups.

Strategies for improving the financing of family medicine program: Evidence from Iran.

The impact of health financing on the performance of the entire health system, including access, quality, and efficiency of healthcare, has been emphasized in the Astana Declaration, and the need to strengthen primary healthcare (PHC) and policy integration has been emphasized. After about two decades, the family medicine (FM) program in Iran is still facing great challenges. The aim of this study is to explore strategies for strengthening financing of the FM program in Iran, a vital component of PHC. A qualitative study was conducted in 2021. Purposeful sampling was used to select 34 policymakers, managers, and experts from various levels of the Ministry of Health, Iran universities of medical sciences, plan and budget organization of Iran, and health insurance organization in Iran. Thirty-four semistructured interviews were conducted to collect data, which were analyzed by content analysis. Through the analysis of interviews, our study has identified five strategies (identification and management of sustainable resources, pooling of sustainable resources, modeling of service provision, payment system model and its implementation process, and FM management structure), and 13 actions for strengthening financing of the FM program in Iran. Our study has identified five strategies and 13 actions for strengthening the financing of the FM program in Iran. These strategies and actions should be considered by policymakers during the review of the FM program in Iran. Without implementation of the suggested strategies and action, allocated resources may be wasted.