Publications by authors named "AliAkbar Haghdoost"

61 Publications

Temporal analysis of visceral leishmaniasis between 2000 and 2019 in Ardabil Province, Iran: A time-series study using ARIMA model.

J Family Med Prim Care 2020 Dec 31;9(12):6061-6067. Epub 2020 Dec 31.

Department of Health Economics, Research Center for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: Visceral leishmaniasis in human (VLH) also known as kala-azar is a neglected disease of humans that mainly occurs in more than 50 countries mostly located in the Eastern Mediterranean and the Northern America.

Objective: The purpose of this study was to determine the temporal patterns and predict of occurrence of VL in Ardabil Province, in northwestern Iran using autoregressive integrated moving average (ARIMA) models.

Methods: This descriptive study employed yearly and monthly data of 602 cases of VLH in the province between January 2000 to December 2019, which was provided by the leishmaniasis national surveillance system. The monthly occurrences case constructed the ARIMA model of time-series model. The insignificance of the correlation in the lags of 12, 24 and 36 months, and Chi-square test showed the occurrence of VLH does not have a seasonal pattern. Eleven potential ARIMA models were examined for VLH cases. Finally, the best model was selected with the lower Akaike Information Criteria (AIC) and Bayesian information criterion (BIC) value. Then, the selected model was used to forecast frequency of monthly occurrences case. The forecasting precision was estimated by mean absolute percentage error (MAPE). Data analysis was performed using Stata14 and its package time series analysis.

Results: ARIMA (5, 0, 1) model with AIC (25.7) and BIC (43.35) was selected. The MAPE value was 26.89% and the portmanteau test for white noise was (Q = 23.02, = 0.98) for the residuals of the selected model showed that the data were fully modelled. The total cumulative VLH cases in the next 24 months' in Ardabil province predicted 14 cases (95% CI: 4-54 case).

Conclusion: The ARIMA (5, 0, 1) model can be a useful tool to predict VLH cases as early warning system and the results are helpful for policy makers and primary care physicians in the readiness of public health problems before the outbreak of the disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jfmpc.jfmpc_1542_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928107PMC
December 2020

Estimating the Loss in Expectation of Life and Relative Survival Rate among Hemodialysis Patients in Iran.

J Res Health Sci 2020 Aug 3;20(3):e00487. Epub 2020 Aug 3.

Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: Information regarding the prognosis and burden of diseases can be used by policymakers to determine competing health priorities. We aimed to assess the Relative Survival Rate (RSR) and loss of expectation of life (LEL) to evaluate the prognosis and burden of diseases in Hemodialysis (HD) patients.

Study Design: A retrospective cohort study.

Methods: We recruited 648 HD patients referred to three referral centers in Kerman City, Iran, from 2008 to 2019. RSR, was defined as the ratio of the observed and the expected survival rates of general population for persons of the same age and sex as patients in the current study. LEL was determined as the difference between corresponding life expectancies (LE). The extended Cox proportional hazard model was used to identify variables associated with the outcome.

Results: Variables associated with outcome were diabetic status and age. In the 5th year of the follow-up study, the overall RSR was 0.57. In general, for HD patients, the estimation of LE and LEL was 22.6 and 12.36 year, respectively.

Conclusion: HD patients, especially older patients, showed a very poor prognosis, with a large amount of lost life expectancy. Therefore, they need more care and attention from health authorities. It is suggested to estimate the cost of eliminating the risk factors causing kidney diseases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34172/jrhs.2020.21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585771PMC
August 2020

Premature mortality of gastrointestinal cancer in Iran: trends and projections 2001-2030.

BMC Cancer 2020 Aug 12;20(1):752. Epub 2020 Aug 12.

HIV/STI Surveillance Research Center, Regional Knowledge Hub, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: The present study was conducted to determine the trend and projection of premature mortality from gastrointestinal cancers (GI cancers) at national and subnational levels in Iran.

Methods: Employing the data obtained from Iranian Death Registry System (DRS) and population data from census, the mortality rates of GI cancers was calculated among 30-70 age groups. The trends of esophageal, colon and rectum, gallbladder, pancreases, stomach, and liver cancer premature mortalities were estimated and projected at the national and subnational levels from 2001 to 2030. Then, Spatio-temporal model was used to project spatial and temporal correlations.

Results: The overall mortality rate of GI cancers was higher in males than in females, indicating 6.1, 3.9 and 3.9% per 100,000 individuals among males in 2001, 2015 and 2030 respectively and 3.8, 3.1 and 3.7 per 100,000 individuals among females in the same time-frame. The overall mortality rate of GI cancers in males was decreasing until 2015 and will remain stationary into 2030; however, the rate will be increasing among females in both time-frames. Also, there was a considerable variation in the mortality trends of different cancers. Pancreatic, gallbladder, and liver cancers were shown to have an increasing trend while a drop was observed in the mortality rates of stomach, colon and rectum, and esophageal cancers.

Conclusion: Variation of GI cancers patterns and trends around the country indicated that a more comprehensive control plan is needed to include the predicted variations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12885-020-07132-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425152PMC
August 2020

Validity and reliability of the Persian version of the Adverse Childhood Experiences Abuse Short Form.

J Educ Health Promot 2020 30;9:140. Epub 2020 Jun 30.

Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

Background And Aim: Measuring child abuse and adverse experiences is a critical task with regard to its long-term impact on the health of individuals and communities. The purpose of this study was to validate the Persian version of the International Adverse Childhood Experiences Abuse Short Form (ACE-ASF) in Iranian society.

Materials And Methods: This cross-sectional study was conducted in Kerman, southeast of Iran, in 2019, on 494 students from Kerman University of Medical Sciences, selected by convenience sampling method. Psychometric properties of the questionnaire were examined after the forward and backward translation processes. The factor structure of the questionnaire was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The concurrent validity of the questionnaire was assessed using the childhood trauma questionnaire (CTQ). Cronbach's alpha and corrected item-total correlation were used to measure reliability.

Results: The mean age of participants was 24.3 ± 5.3 years. Based on EFA, two physical-emotional abuse and sexual abuse factors were obtained. The CFA fit indices well supported two extracted factors. The CFA showed acceptable factor loadings. The internal consistency coefficient of Cronbach's alpha was 0.75 for the physical-emotional abuse factor and 0.77 for the sexual abuse factor. The correlation coefficient of ACE-ASF and CTQ was r = 0.56. The reliability index of intraclass correlation coefficient was 0.73 (95% confidence interval: 0.60-0.84).

Conclusion: The Persian version of the ACE-ASF questionnaire has acceptable psychometric properties.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jehp.jehp_15_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377151PMC
June 2020

Early sex work initiation and its association with condomless sex and sexually transmitted infections among female sex workers in Iran.

Int J STD AIDS 2020 06;31(7):671-679

Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Early sex work initiation among female sex workers (FSWs) increases their vulnerabilities to high-risk sexual practices and sexually transmitted infections (STIs). We examined the association of early sex work with condomless sex indicators, HIV, and other STIs, including human papillomavirus, chlamydia, trichomoniasis, syphilis, and gonorrhea, among FSWs in Iran. We recruited 1347 FSWs from 13 cities in 2015, with 1296 participants (94.2%) reporting information about their age of sex work initiation. Early sex work was defined as the initiation of selling sex before 18 years of age. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported using multivariable logistic regression. Overall, 10.1% of FSWs reported early sex work initiation. FSWs who initiated sex work earlier were more likely to report last-month inconsistent condom use (aOR = 3.31, 95% CI: 1.82, 6.02) and condomless sex with last client (aOR = 1.72, 95% CI: 1.15, 2.56). There was no statistically significant association between early sex work and HIV (aOR = 1.40, 95% CI: 0.43, 4.53) and any other STIs (aOR = 1.01, 95% CI: 0.69, 1.48), except for chlamydia (aOR = 2.09, 95% CI: 1.08, 4.04). These findings suggest that FSWs with early sexual debut would benefit from differentiated interventions including screening for STIs and enhanced counseling for condom use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0956462420913431DOI Listing
June 2020

Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran's health system?

Iran J Microbiol 2020 Apr;12(2):73-76

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244828PMC
April 2020

Is reporting many cases of COVID-19 in Iran due to strength or weakness of Iran's health system?

Iran J Microbiol 2020 Apr;12(2):73-76

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244828PMC
April 2020

Comprehensive conceptual framework for futures studies in health.

Med J Islam Repub Iran 2019 9;33:131. Epub 2019 Dec 9.

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34171/mjiri.33.131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137864PMC
December 2019

Future Trends of the Primary Healthcare System in Iran: A Qualitative Study.

Int J Prev Med 2019 9;10:158. Epub 2019 Oct 9.

Department of Health Services Management, Health School, Arak University of Medical Sciences, Arak, Iran.

Background: Primary healthcare system in Iran has played an extensive role in promoting people health in the past decades. However, regarding universal developments in the different global aspects effective on health, the performance of this system has been influenced significantly. The aim of the present research is to identify the future trends of the primary health care in Iran.

Methods: The participants of this qualitative case study were experts in primary healthcare, which were selected and interviewed through purposive sampling method. The interview process was saturated after 25 interviews, so we stopped the process at this point. Framework analysis based on STEEP model used to analysis the interviews.

Results: The most important social/value, technological, economic, environmental, and political future trends of primary healthcare in Iran included demographic transition, epidemiological transition, social and cultural changes, emergence of modern and advanced technologies, internet and cyberspace, budgeting limitations, resource management, changing paradigm from volume to value in providing health services, environmental pollutions, natural disasters, health governance, intellectual paradigm of senior officials, regional security, international development, and other internal factors of the health system.

Conclusions: The identified factors can be turned into opportunities for Iran primary healthcare system if health planners and policymakers have a deep and accurate look at these influential factors and manage them properly.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijpvm.IJPVM_334_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826581PMC
October 2019

Distinct genetic variation and heterogeneity of the Iranian population.

PLoS Genet 2019 09 24;15(9):e1008385. Epub 2019 Sep 24.

Cologne Center for Genomics, University of Cologne, Cologne, Germany.

Iran, despite its size, geographic location and past cultural influence, has largely been a blind spot for human population genetic studies. With only sparse genetic information on the Iranian population available, we pursued its genome-wide and geographic characterization based on 1021 samples from eleven ethnic groups. We show that Iranians, while close to neighboring populations, present distinct genetic variation consistent with long-standing genetic continuity, harbor high heterogeneity and different levels of consanguinity, fall apart into a cluster of similar groups and several admixed ones and have experienced numerous language adoption events in the past. Our findings render Iran an important source for human genetic variation in Western and Central Asia, will guide adequate study sampling and assist the interpretation of putative disease-implicated genetic variation. Given Iran's internal genetic heterogeneity, future studies will have to consider ethnic affiliations and possible admixture.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pgen.1008385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759149PMC
September 2019

Iranome: A catalog of genomic variations in the Iranian population.

Hum Mutat 2019 11 17;40(11):1968-1984. Epub 2019 Aug 17.

Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Considering the application of human genome variation databases in precision medicine, population-specific genome projects are continuously being developed. However, the Middle Eastern population is underrepresented in current databases. Accordingly, we established Iranome database (www.iranome.com) by performing whole exome sequencing on 800 individuals from eight major Iranian ethnic groups representing the second largest population of Middle East. We identified 1,575,702 variants of which 308,311 were novel (19.6%). Also, by presenting higher frequency for 37,384 novel or known rare variants, Iranome database can improve the power of molecular diagnosis. Moreover, attainable clinical information makes this database a good resource for classifying pathogenicity of rare variants. Principal components analysis indicated that, apart from Iranian-Baluchs, Iranian-Turkmen, and Iranian-Persian Gulf Islanders, who form their own clusters, rest of the population were genetically linked, forming a super-population. Furthermore, only 0.6% of novel variants showed counterparts in "Greater Middle East Variome Project", emphasizing the value of Iranome at national level by releasing a comprehensive catalog of Iranian genomic variations and also filling another gap in the catalog of human genome variations at international level. We introduce Iranome as a resource which may also be applicable in other countries located in neighboring regions historically called Greater Iran (Persia).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/humu.23880DOI Listing
November 2019

Determinants of risky sexual practice, drug abuse and alcohol consumption in adolescents in Iran: a systematic literature review.

Reprod Health 2019 Jul 24;16(1):115. Epub 2019 Jul 24.

PhD Candidate in Health Policy, Faculty of Management and Medical Informatics, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, 7616913555, Iran.

Background: Evidence shows that the prevalence of risky sexual practice, drug abuse, and alcohol consumption behaviors in low and middle income countries such as Iran is not in a favorable condition. Preventive programs against these behaviors in Iran are very rare, and the results are unclear, which may be due to the lack of deeply and systematically understanding of the determinants of these behaviors. Evidence suggests that these behaviors are coincidence. So all of these behaviors were examined together. The present study was conducted aiming at determining the reasons for the occurrence of these behaviors among 15-19-year-old adolescents in Iran.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed to review published and unpublished studies in Iran. The databases used were Scopus, PubMed, Web of Science, and Cochrane Library. The query terms were "Synthetic Drug" OR "Designer Drug", AND Adolescents OR Teenagers OR Juvenile, AND Iran. The Joanna Briggs Institute Critical Appraisal Checklist was employed for critical appraisal. The quantitative studies using the regression model to analyze the factors affecting these behaviors were studied as the form of the theme. For analyzing the data, narrative synthesis and thematic analysis were used.

Results: Twelve studies were meticulously reviewed. The findings were classified into five main themes (including individual, family, friends, school, and community) and 26 sub-themes. The most frequent main theme and sub-themes were respectively Family, Higher age, Male gender, Weak religious beliefs, Low self-esteem, Anti-social behaviors in family, Mother's employment, Parenting style, Poor intimacy of parents, Absence of parents, Peer pressure, and Lack of appropriate recreation. No primary study has referred to the political, economic, or policy factors affecting such behaviors.

Conclusions: The most identified sub-themes belong to family factors. Iran is a country with ideology of Islam; however, being Muslim does not guarantee adherence to all Islamic guidelines. So being Muslim is not a good reason to prevent these behaviors. Iran needs precise policy making in this area through considering family structure. It is also suggested that primary studies referring to the political, economic, or policy factors affecting such behaviors should be carried out.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12978-019-0779-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657032PMC
July 2019

Educational ranking of medical universities in Iran (ERMU).

Med J Islam Repub Iran 2018 17;32:126. Epub 2018 Dec 17.

Mental Health Research Center, Tehran Institute of Psychiatry- School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.

Several international ranking systems are available for examining the performance of universities internationally. However, it seems that in these rankings the educational functions are relatively discounted. In this study, we presented the theoretical framework, methodology, and results of 2 rounds of ERMU (educational ranking of medical universities) in Iran. The indicators were designed through literature reviews, expert panels, and consensus among professionals using Delphi method. Six domains, including quantitative expansion, educational management scheme, educational management, qualitative development, and alignment with the National Master Plan for Science and Education were assessed. Nineteen educational processes and outcome-based indicators were defined at the end. Some of them, such as the number of educational disciplines, were normalized based on the number of academic staff. Using exploratory factorial analysis, the interval validity of the final instrument was assessed. Also, the internal consistency of the tool was evaluated by calculating Cronbach's alpha. Data were collected in 2 rounds in 2010 and 2014. The required data were collected and cross-validated from different sources in medical universities and in the Ministry of Health. The analysis yielded 2 factors, explaining a total of 61.6% of the variance for the entire set of variables. The calculated Cronbach's alpha was 0.94. The correlation coefficient for all items was 0.88. The comparison of the results of the 2 rounds showed a significant improvement in the scores of universities in all domains. The results showed a relatively fitted model with acceptable reliability. In addition, it seems that the ranking of medical universities has improved their performance in the study indictors. It seems that in the long-term, monitoring these indicators and the visibility of their scores may improve the educational performance of universities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14196/mjiri.32.126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387823PMC
December 2018

Dual Unsafe Injection and Sexual Behaviors for HIV Infection Among People Who Inject Drugs in Iran.

AIDS Behav 2019 Jun;23(6):1594-1603

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

We used two national surveys (2010: N = 1597; 2013: N = 1057) of people who inject drugs (PWID) in past-month to assess the prevalence and population size of PWID with either safe or unsafe injection and sex behaviors, overall and by HIV status. In 2013, only 27.0% (vs. 32.3% in 2010) had safe injection and sex, 24.6% (vs. 23.3% in 2010) had unsafe injection and sex, 26.4% (vs. 26.5% in 2010) had only unsafe injection, and 22.0% (vs. 18.0% in 2010) had unsafe sex only. Among HIV-positive PWID in 2013, only 22.1% (~ 2200 persons) had safe injection and sex, 14.2% (~ 1400 persons) had unsafe injection and sex, 53.1% (~ 5200 persons) had unsafe injection, and 10.6% had unsafe sex (~ 1100 persons). Among HIV-negative PWID in 2013, only 27.5% (~ 22,200 persons) had safe injection and sex, 25.9% (~ 20,900 PWID) had unsafe injection and sex, 23.2% (~ 18,700 persons) had unsafe injection, and 23.3% (~ 18,800 persons) had unsafe sex. HIV-positive and -negative PWID in Iran continue to be at risk of HIV acquisition or transmission which calls for targeted preventions services.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10461-018-2345-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527484PMC
June 2019

Setting research priorities to achieve long-term health targets in Iran.

J Glob Health 2018 Dec;8(2):020702

Engineering Seismology Department, International Institute of Earthquake Engineering and Seismology (IIEES), Tehran, Iran.

Background: In 2015, it was estimated that the burden of disease in Iran comprised of 19 million disability-adjusted life years (DALYs), 74% of which were due to non-communicable diseases (NCDs). The observed leading causes of death were cardiovascular diseases (41.9%), neoplasms (14.9%), and road traffic injuries (7.4%). Even so, the health research investment in Iran continues to remain limited. This study aims to identify national health research priorities in Iran for the next five years to assist the efficient use of resources towards achieving the long-term health targets.

Methods: Adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 48 prominent Iranian academic leaders in the areas related to Iran's long-term health targets, a group of research funders and policy makers, and 68 stakeholders from the wider society. 128 proposed research questions were scored independently using a set of five criteria: feasibility, impact on health, impact on economy, capacity building, and equity.

Findings: The top-10 priorities were focused on the research questions relating to: health insurance system reforms to improve equity; integration of NCDs prevention strategy into primary health care; cost-effective population-level interventions for NCDs and road traffic injury prevention; tailoring medical qualifications; epidemiological assessment of NCDs by geographic areas; equality in the distribution of health resources and services; current and future common health problems in Iran's elderly and strategies to reduce their economic burden; the status of antibiotic resistance in Iran and strategies to promote rational use of antibiotics; the health impacts of water crisis; and research to replace the physician-centered health system with a team-based one.

Conclusions: These findings highlight consensus amongst various prominent Iranian researchers and stakeholders over the research priorities that require investment to generate information and knowledge relevant to the national health targets and policies. The exercise should assist in addressing the knowledge gaps to support both the National General Health Policies by 2025 and the health targets of the United Nations' Sustainable Development Goals by 2030.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7189/jogh.08.020702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188089PMC
December 2018

A review of methods to estimate the visibility factor for bias correction in network scale-up studies.

Epidemiol Health 2018 16;40:e2018041. Epub 2018 Aug 16.

Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4178/epih.e2018041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280069PMC
November 2018

Underreporting in HIV-related high-risk behaviors: comparing the results of multiple data collection methods in a behavioral survey of prisoners in Iran.

Prison J 2018 Mar 24;98(2):213-228. Epub 2018 Jan 24.

Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

We explored the potentials of using three indirect methods including crosswise, proxy respondent method, and network scale-up (NSU) in comparison to direct questioning in collecting sensitive and socially stigmatized HIV-related risk behaviors information from prisoners (N=265). Participants reported more sexual contact in prison for their friends than they did for themselves (10.6% vs. 3.8% in men, 13.7% vs. 0% in women). In men, NSU provided lower estimates than direct questioning, while in women NSU estimates were higher. Different data collection methods provide different estimates, and collectively offer a more comprehensive picture of HIV-related risk behaviors in prisons.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0032885517753163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075723PMC
March 2018

Foresight in health sciences using CLA method.

Med J Islam Repub Iran 2017 14;31:84. Epub 2017 Dec 14.

Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Development in health is not possible without progress of science. Rapid changes in the various areas make the future health system more complex and risky. Therefore, foresight of health sciences is very important. This futures studies was conducted in 4 steps; also, literature and documents review, statistics and information review, focus group discussions, working group, and scenario planning were used. Cause level analysis was used for data analysis and syntactic as main frameworks. The findings in legal health sciences documents revealed that the value system was not defined clearly and coherently and that logical linkage among myths, discourse, and social structural layers was ambiguous. In trend analysis, 24 trends were recognized; however, political and economic streams were strong, independent, and uncertain factors which created 4 main scenarios although the social and environmental factors divided them into 16 subscenario tunnels. Postmodern discourse in probability scenarios will be dominant and science will be understood as tools for generation of wealth. University structure will be decentralized and transformed into similar R&D to join the health industry, and our quantitative growth (articles, disciplines, and students) in health sciences will decrease. If the current trends (probability scenarios) continue, we will move to an undesirable situation. The main challenge in this regard is the lack of a unique and dominant discourse in health sciences based on the Islamic Republic of Iran doctrine. Therefore, in this study, shifting the paradigm by a new approach and discipline in the health sciences is suggested.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14196/mjiri.31.84DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014787PMC
December 2017

The District Health Information System (DHIS2): A literature review and meta-synthesis of its strengths and operational challenges based on the experiences of 11 countries.

Health Inf Manag 2019 May 13;48(2):62-75. Epub 2018 Jun 13.

3 Deputy for Public Health, Iranian Ministry of Health and Medical Education, Tehran, Iran.

Background: Health information systems offer many potential benefits for healthcare, including financial benefits and for improving the quality of patient care. The purpose of District Health Information Systems (DHIS) is to document data that are routinely collected in all public health facilities in a country using the system.

Objective: The aim of this study was to examine the strengths and operational challenges of DHIS2, with a goal to enable decision makers in different counties to more accurately evaluate the outcomes of introducing DHIS2 into their particular country.

Method: A review of the literature combined with the method of meta-synthesis was used to source information and interpret results relating to the strengths and operational challenges of DHIS2. Databases (Embase, PubMed, Scopus and Google Scholar) were searched for documents related to strengths and operational challenges of DHIS2, with no time limit up to 8 April 2017. The review and evaluation of selected studies was conducted in three stages: title, abstract and full text. Each of the selected studies was reviewed carefully and key concepts extracted. These key concepts were divided into two categories of strengths and operational challenges of DHIS2. Then, each category was grouped based on conceptual similarity to achieve the main themes and sub-themes. Content analysis was used to analyse extracted data.

Results: Of 766 identified citations, 20 studies from 11 countries were included and analysed in this study. Identified strengths in the DHIS were represented in seven themes (with 21 categories): technical features of software, proper management of data, application flexibility, networking and increasing the satisfaction of stakeholders, development of data management, increasing access to information and economic benefits. Operational challenges were identified and captured in 11 themes (with 18 categories): funds; appropriate communication infrastructure; the need for the existence of appropriate data; political, cultural, social and structural infrastructure; manpower; senior managers; training; using academic potentials; definition and standardising the deployment processes; neglect to application of criteria and clinical guidelines in the use of system; data security; stakeholder communications challenges and the necessity to establish a pilot system.

Conclusion: This study highlighted specific strengths in the technical and functional aspects of DHIS2 and also drew attention to particular challenges and concerns. These results provide a sound evidence base for decision makers and policymakers to enable them to make more accurate decisions about whether or not to use the DHIS2 in the health system of their country.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1833358318777713DOI Listing
May 2019

Estimation and Projection of Prevalence of Colorectal Cancer in Iran, 2015-2020.

Adv Biomed Res 2018 30;7:20. Epub 2018 Jan 30.

Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.

Background: Population aging and more prevalent westernized lifestyle would be expected to result in a markedly rising burden of colorectal cancer (CRC) in the future years. The aim of this study is to estimate the limited-time prevalence of CRC in Iran between 2015 and 2020.

Materials And Methods: Aggregated CRC incidence data were extracted from the Iranian national cancer registry (IR.NCR) reports for 2003-2009 and from GLOBOCAN-2012 database for 2012. Incidence trends were analyzed by age groups, genders, histopathologic, and topographic subtypes to estimate annual percentage changes. Incidence was projected for 2020. The prevalence was estimated applying an adopted version of a previously introduced equation to estimate limited-time prevalence based on the incidence and survival data. Monte Carlo sensitivity analyses were applied to estimate 95% uncertainty levels (ULs). In each scenario, incidence, survival, annual percentage changes, and completeness of case ascertainment at IR.NCR were replaced under pre-assumed distributions.

Results: Number of estimated within 1, 2-3 and 4-5-year CRC patients in 2015 were 13676 (95% UL: 10051-18807), 20964 (15835-28268), and 14485 (11188-19293), respectively. Estimated 5-year prevalence for 2020 (99463; 75150-134744) was 2.03 times of that for 2015. Highest 5-year prevalence was estimated in ages 55-59 for females and 75 + for males. Adenocarcinoma (41376; 31227 55898) was the most prevalent histologic subtype. The most prevalent tumor location was colon (30822, 23262-41638).

Conclusion: A substantial growth in the prevalence of CRC survivors is highly expected for future years in Iran. Establishment of specialized institutes is highly recommended to provide medical and especially social supports for Iranian CRC survivors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/abr.abr_178_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812060PMC
January 2018

Attributable risk fraction of four lifestyle risk factors of thyroid cancer: a meta-analysis.

J Public Health (Oxf) 2018 06;40(2):e91-e98

Member of Student Research Committee of Arak University of Medical Sciences, Arak, Iran.

Background: Lifestyle risk factors such as obesity, overweight, smoking and radiation exposure related to thyroid cancer. This study estimated the amount of excess risk that attributed to risk factors.

Methods: Major electronic databases were searched until February 2016. Epidemiological studies addressing the association between lifestyle risk factors and thyroid cancer were enrolled. The results were expressed as ARF with 95% confidence intervals (CIs) using a random-effects-model.

Results: We identified a total of 13 321 references and included 17 studies. The excess risk of thyroid cancer attributable to radiation exposure was 14% (95% CI: 5%, 23%; eight studies, I2 = 88.7%), to obesity was 13% (95% CI: 5%, 21%; four studies, I2 = 68.7%), to overweight was 10% (95% CI: 2%, 17%; four studies, I2 = 4.1%) and to smoking was -13% (95% CI: -33%, 6%; five studies, I2 = 30.6%). So obesity, overweight and radiation exposure are significantly associated with increased thyroid cancer risk and smoking has a protective effect on thyroid cancer but not significant.

Conclusion: A significant amount of the incidence of thyroid cancer is attributable to lifestyle risk factors. Since these factors are entirely preventable, so it is necessary to reduce factors that are associated with increased thyroid cancer risk and proper education to the community. Thus weight loss and protection against radiation can effectively reduce the incidence rate of thyroid cancer but smoking can have a protective effect.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/pubmed/fdx088DOI Listing
June 2018

Population size estimation of female sex workers in Iran: Synthesis of methods and results.

PLoS One 2017 10;12(8):e0182755. Epub 2017 Aug 10.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: Estimating the number of key populations at risk of HIV is essential for planning, monitoring, and evaluating prevention, care, and treatment programmes. We conducted this study to estimate the number of female sex workers (FSW) in major cities of Iran.

Methods: We used three population size estimation methods (i.e., wisdom of the crowds, multiplier method, and network scale-up) to calculate the number of FSW in 13 cities in Iran. The wisdom of the crowds and multiplier methods were integrated into a nationwide bio-behavioural surveillance survey in 2015, and the network scale-up method was included in a national survey of the general population in 2014. The median of the three methods was used to calculate the proportion of the adult female population who practice sex work in the 13 cities. These figures were then extrapolated to provide a national population size estimation of FSW across urban areas.

Results: The population size of FSW was 91,500 (95% Uncertainty Intervals [UIs] 61,400-117,700), corresponding to 1.43% (95% UIs 0.96-1.84) of the adult (i.e., 15-49 year-old) female population living in these 13 cities. The projected numbers of FSW for all 31 provincial capital cities were 130,800 (95% UIs 87,800-168,200) and 228,700 (95% UIs 153,500-294,300) for all urban settings in Iran.

Conclusions: Using methods of comparable rigor, our study provided a data-driven national estimate of the population size of FSW in urban areas of Iran. Our findings provide vital information for enhancing HIV programme planning and lay a foundation for assessing the impact of harm reduction efforts within this marginalized population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0182755PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552099PMC
October 2017

National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic.

J Diabetes Metab Disord 2017 23;16. Epub 2017 Jan 23.

INCDC, Ministry of Health and Medical Education, and EMRI, TUMS, Tehran, Iran.

Emerging Non-communicable diseases burden move United Nation to call for 25% reduction by 2025 in premature mortality from non-communicable diseases (NCDs). The World Health Organization (WHO) developed global action plan for prevention and control NCDs, but the countries' contexts, priorities, and health care system might be different. Therefore, WHO expects from countries to meet national commitments to achieve the 25 by 25 goal through adapted targets and action plan. In this regards, sustainable high-level political statement plays a key role in rules and regulation support, and multi-sectoral collaborations to NCDs' prevention and control by considering the sustainable development goals and universal health coverage factors. Therefore, Iran established the national authority's structure as Iranian Non Communicable Diseases Committee (INCDC) and developed NCDs' national action plan through multi-sectoral approach and collaboration researchers and policy makers. Translation Iran's expertise could be benefit to mobilizing leadership in other countries for practical action to save the millions of peoples.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40200-017-0288-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5260033PMC
January 2017

Estimating the visibility rate of abortion: a case study of Kerman, Iran.

BMJ Open 2016 10 13;6(10):e012761. Epub 2016 Oct 13.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Objectives: Abortion is a sensitive issue; many cultures disapprove of it, which leads to under-reporting. This study sought to estimate the rate of abortion visibility in the city of Kerman, Iran-that is, the percentage of acquaintances who knew about a particular abortion. For estimating the visibility rate, it is crucial to use the network scale-up method, which is a new, indirect method of estimating sensitive behaviours more accurately.

Materials And Methods: This cross-sectional study was conducted in Kerman, Iran using various methods to ensure the cooperation of clinicians and women. A total of 222 women who had had an abortion within the previous year (74 elective, 74 medical and 74 spontaneous abortions) were recruited. Participants were asked how many of their acquaintances were aware of their abortion. Abortion visibility was estimated by abortion type. 95% CIs were calculated by a bootstrap procedure. A zero-inflated negative binomial regression analysis was conducted to assess the variables related to visibility.

Results: The visibility (95% CI) of elective, medical and spontaneous abortion was 8% (6% to 10%), 60% (54% to 66%) and 50% (43% to 57%), respectively. Women and consanguineal family were more likely to be aware of the abortion than men and affinal family. Non-family members had a low probability of knowing about the abortion, except in elective cases. Abortion type, marital status, sex of the acquaintance and closeness of the relationship were the most important determinants of abortion visibility in the final multifactorial model.

Conclusions: This study shows the visibility rate to be low, but it does differ among social network members and by the type of abortion in question. This difference might be explained through social and cultural norms as well as stigma surrounding abortion. The low visibility rate might explain the low estimates of abortion rates found in other studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2016-012761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073643PMC
October 2016

HIV Knowledge, Attitudes, and Practices of Young People in Iran: Findings of a National Population-Based Survey in 2013.

PLoS One 2016 14;11(9):e0161849. Epub 2016 Sep 14.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: The evidence is mixed on the HIV knowledge, attitude, and practices of youth in Iran. The aim of the current study was to assess knowledge, attitudes, and practices of Iranian youth towards HIV through a national survey.

Materials And Methods: Through a cross-sectional study with multistage cluster sampling, we administered a pilot-tested standard questionnaire to assess the levels of HIV knowledge, attitudes and practices of individuals aged 15-29 years old. Participants were recruited from 13 provinces in Iran and consisted of 2456 men and 2412 women.

Results: Only 37.3% of the participants had a high knowledge score. Most participants knew the main routes of HIV transmission; however, misconceptions existed about the transmission of HIV through mosquito bites across all age groups (31.7% correct response). Positive levels of attitude wereobserved among 20.7% of the participants. Most participants believed that people living with HIV (PLHIV) should be supported (88.3%) while only 46.3% were ready to share a table with them. Among those aged 19-29 years old, the main source of HIV information was mass media (69.1%), only 13.1% had ever tested for HIV, around 20.8% had ever had extramarital sex (31.7% male vs. 9.6% female),1.8% ever injected drugs (2.9% male vs. and 0.7% female). Among sexually active subjects in this age group, only 21.8% (26.1% male vs. 7.1% female) were consistent condom users.

Conclusions: The findings showed that Iranian youth and young adults have relatively insufficient overall knowledge and negative attitudes about HIV and PLHIV. Novel strategies involving schools and youth's networks could be employed to deliver a culturally sensitive sexual health program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161849PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023173PMC
August 2017

Health technology assessment: Off-site sterilization.

Med J Islam Repub Iran 2016 16;30:345. Epub 2016 Mar 16.

PhD, Assistant Professor, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Background: Every year millions of dollars are expended to equip and maintain the hospital sterilization centers, and our country is not an exception of this matter. According to this, it is important to use more effective technologies and methods in health system in order to reach more effectiveness and saving in costs. This study was conducted with the aim of evaluating the technology of regional sterilization centers.

Methods: This study was done in four steps. At the first step, safety and effectiveness of technology was studied via systematic study of evidence. The next step was done to evaluate the economical aspect of off-site sterilization technology using gathered data from systematic review of the texts which were related to the technology and costs of off-site and in-site hospital sterilization. Third step was conducted to collect experiences of using technology in some selected hospitals around the world. And in the last step different aspects of acceptance and use of this technology in Iran were evaluated.

Results: Review of the selected articles indicated that efficacy and effectiveness of this technology is Confirmed. The results also showed that using this method is not economical in Iran.

Conclusion: According to the revealed evidences and also cost analysis, due to shortage of necessary substructures and economical aspect, installing the off-site sterilization health technology in hospitals is not possible currently. But this method can be used to provide sterilization services for clinics and outpatients centers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898854PMC
July 2016

Author's Reply.

Arch Iran Med 2016 Mar;19(3):235

View Article and Find Full Text PDF

Download full-text PDF

Source
March 2016

Perception of Alzheimer Disease in Iranian Traditional Medicine.

Iran Red Crescent Med J 2016 Mar 1;18(3):e22054. Epub 2016 Mar 1.

Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.

Context: Alzheimer disease (AD) is the most common cause of dementia. In regards to the world's aging population, control and treatment of AD will be one of the major concerns of global public health in the next century. Alzheimer disease was not mentioned with the same phrase or its equivalent in traditional medical texts. The main of present paper was to investigate symptoms and causes of alzheimer disease from the view point of Iranian traditional medicine.

Evidence Acquisition: In this qualitative study, we searched reliable sources of Iranian traditional medicine such as Canon of Medicide by Avicenna (Al-Quanon fi- tibb), Aghili cure by Aghili's (Molajat-E-aghili), Tib-E-Akbari, Exire -E-Aazam and Sharh-E-Asbab and some reliable resources of neurology were probed base on keywords to find a disease that had the most overlap in terms of symptoms with alzheimer disease. By taking from the relevant materials, the extracted texts were compared and analyzed.

Results: Findings showed that alzheimer disease has the most overlap with Nesyan (fisad-e-zekr, fisad-e-fekr and fisad-e-takhayol) symptoms in Iranian traditional medicine. Although this is not a perfect overlap and there are causes, including coldness and dryness of the brain or coldness and wetness that could also lead to alzheimer disease according to Iranian traditional medicine.

Conclusions: According to Iranian traditional medicine, The brain dystemperement is considered the main causes of alzheimer disease. By correcting the brain dystemperement, alzheimer can be well managed. This study helps to suggest a better strategy for preventing and treating alzheimer in the future.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5812/ircmj.22054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884442PMC
March 2016

Low HIV testing rate and its correlates among men who inject drugs in Iran.

Int J Drug Policy 2016 06 31;32:64-9. Epub 2016 Mar 31.

Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:

Background: Iran has a concentrated HIV epidemic among people who inject drugs (PWID). Low HIV testing uptake could contribute to the significant number HIV-infected PWID, who go undiagnosed. This study aims to assess HIV testing uptake and its correlates among PWID in Iran.

Methods: Data were collected through a national cross-sectional bio-behavioral study in 2010. Adult male HIV-negative PWID were included in the current analysis. All estimates were adjusted for the clustering effect of the sampling sites. Multivariable logistic regression was used to examine the correlates of recent HIV testing and adjusted odds ratios (AOR) were reported.

Results: Out of the 2146 eligible PWID for this study, 49.8% reported having ever tested for HIV. However, only 24.9% had tested in the previous year and received their test results. Around 65.2% of PWID knew an HIV testing site. In the multivariable analysis, knowing an HIV testing site (AOR=13.9; P-value<0.001), ≥24 years of age (AOR=3.30; P-value=0.027), and multiple incarcerations (AOR=1.71; P-value<0.001) were positively, and a monthly income of ≥65 US dollar (AOR=0.23; P-value=0.009) was negatively associated with having been tested and received the results.

Conclusion: Despite the availability of free HIV counselling and testing for PWID in Iran, only one-fourth of adult male PWID had been tested for HIV and received their results. Implementing policies and strategies to normalize routine HIV testing among PWID are crucial steps to help curb the epidemic among Iranian PWID.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.drugpo.2016.03.009DOI Listing
June 2016

DSM-IV-defined anxiety disorder symptoms in a middle-childhood-aged group of Malaysian children using the Spence Children's Anxiety Scale.

Trends Psychiatry Psychother 2016 Jan-Mar;38(1):14-22. Epub 2016 Mar 18.

Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Introduction: Pediatric anxiety disorders are the most common mental health disorders in the middle-childhood age group. The purpose of this study is to assess anxiety disorder symptoms, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), in a large community sample of low socioeconomic level rural children and to investigate some of the psychometric properties (internal consistency, construct and convergent validity and items rated as often or always experienced) of the Malay version of the Spence Children's Anxiety Scale - Child version (SCAS-C).

Method: Six hundred children aged 9-11 and 424 of their parents completely answered the child or parent versions of the SCAS.

Results: Results indicated that the internal reliability of subscales were moderate to adequate. Significant correlations between child and parent reports supported the measure's concurrent validity. Additionally, anxiety levels in this Malaysian sample were lower than among South-African children and higher than among their Western peers. There were both similarities and differences between symptom items reported as often or always experienced by Malaysian students and by children from other cultures. Confirmatory factor analysis provided evidence of the existence of five inter-correlated factors for anxiety disorders based on SCAS-C.

Conclusion: Although some of the instrument's psychometric properties deviated from those observed in some other countries, it nevertheless appears to be useful for assessing childhood anxiety symptoms in this country.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/2237-6089-2015-0027DOI Listing
January 2017