Publications by authors named "Mehrzad Tashakoriyan"

4 Publications

  • Page 1 of 1

Comparison of HIV Indicators after the Implementation of a New Model for TB and HIV Management in an Iranian Prison.

Infect Disord Drug Targets 2020 ;20(6):778-783

Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: A new national clinical guideline for the management of tuberculosis and HIV in Iranian prisons was released in 2011. The aim of this study was to compare HIV indicators in the case and control prisons after implementation of the new guideline.

Methods: This report examines outcomes observed during the pilot phase of its implementation at a case prison from October 2013 to June 2014 compared to a control prison that had not yet implemented the guideline. The case prison included incarcerated individuals in the Great Tehran Prison. A prison in Alborz province was considered as a control group. Pearson's Chi-squared, two-sample t-test, paired t-test and Kruskal-Wallis were used for the analysis.

Results: The intervention significantly increased the total number of inmates tested for HIV and of diagnoses of HIV-positive inmates in the case prison compared to the control prison (P<0.001). Moreover, coverage of antiretroviral therapy was higher in the case prison compared to the control prison (P=0.015).

Conclusion: We recommend the implementation of this guideline in all Iranian prisons.
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January 2020

Prevalence and Associated Factors of HIV Infection among Male Prisoners in Tehran, Iran.

Arch Iran Med 2017 Jun;20(6):356-360

Health and Treatment Office of Iranian Prisons Organization, Tehran, Iran.

Background: This is a cross-sectional survey conducted on 6900 male prisoners in Great Tehran Prison from October 2013 to May 2014.

Methods: In order to find HIV positive prisoners in the prison's quarantine and two housing units, we used HIV active case finding (ACF) strategy by rapid screening test. In ACF, healthcare staff and trained prisoners asked inmates to answer relevant questions about history of risky behaviors related to HIV as well as to be tested voluntarily by HIV rapid test. A positive result was confirmed by ELISA screening and Western blot tests. Furthermore, to find the prevalence of specific HIV risk factors among prisoners were assessed using a questionnaire, and the results were analyzed by STATA software, providing univariate and multivariate modeling.

Results: There were 85 HIV positive patients. The prevalence of HIV was 1.23%. The risk factors independently associated with HIV infection were age (adjusted odds ratio of 3.46 for 35-44 yrs., 95% CI:1.01-11.92), duration of imprisonment (adjusted odds ratio of 4.22 for ≥10 yr., 95% CI: 1.92-9.24 ), history of  injection drug use (adjusted odds ratio of 5.01, 95% CI: 2.24-11.18), history of needle sharing (adjusted odds ratio of 2.28, 95% CI: 1.25-4.16) and tattooing (adjusted odds ratio of 1.84, 95% CI: 1.05-3.24).

Conclusions: The prevalence and risk factors of HIV infection should be recognized by policy makers for intensifying harm reduction programs and reforming the HIV guidelines in prisons.
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June 2017

Revision and Implementation of "Clinical Guideline for Tuberculosis and HIV in Prisons", Great Tehran Prison, Iran.

Infect Disord Drug Targets 2018 ;18(1):72-80

Health and Treatment Office of Iranian Prisons Organization, Tehran, Iran.

Aim: To evaluate the feasibility of the revised "Clinical Guideline for HIV and TB" in the Great Tehran Prison during October 2013 to June 2014.

Methods: The guideline includes all aspects of HIV/TB diagnosis based on active case finding (ACF), treatment and care services. Before the implementation, a focus group discussion was conducted, and attended by experts on prison health. The objective was to identify defects and limitations of the guideline. After the discussion, the guideline was revised. The Great Tehran Prison contains three separate units; all prisoners are taken first to "reception and identification unit (quarantine)" and then send to two housing units according to their legal status. An HIV ACF strategy was employed in the quarantine, and two units through a voluntary provider-initiated HIV testing. Three staff of the triangular clinic trained the prisoners about common routes of HIV transmission and the symptoms of TB in the units. In the quarantine, all prisoners were examined for all HIV-risk factors, HIV testing and symptoms of TB. In unit one, healthcare staff continued the ACF process, while in unit two, the peers of prisoners were assigned as the healthcare communicators to proceed with the strategy. At this caring process, when the test result was positive, then the process of care, treatment and follow ups was initiated. Moreover, the use of directly observed therapy (DOT) for antiretroviral therapy (ART) and TB was applied to the sick prisoners. There was also a follow-up caring for released prisoner to refer them to care and treatment services outside the prison.

Results: The guideline was implemented in the prison successfully.

Conclusion: Regarding feasibility of the guideline, the investigators of this study suggest that the guideline should be implemented in other prisons across the country.
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November 2018

Quickness of HIV and Tuberculosis Diagnostic Procedures in Prison of Tehran, Iran.

Infect Disord Drug Targets 2016 ;16(2):109-12

Islamic Azad University, Tehran Medical Sciences Branch, Shariati Street, Zargandeh, Tehran, Iran.

Background: Quickness of diagnosis and getting results in prisons is lower than other settings. The present study aimed to assess the quickness of HIV and Tuberculosis diagnostic process in the Great Tehran Prison.

Materials And Methods: The present study evaluated the quickness of HIV diagnostic testing (ELISA, Western Blot and CD4 count) in the Great Tehran Prison over the period of October 2013 to May 2014. Also, all suspected tuberculosis (TB) patients in the prison were examined for the occurrence of active TB through collecting 35 chest X-rays and 215 sputum specimens for acid-fast bacillus (AFB) testing at the health center laboratory.

Results: The average interval between when test requests were made by a physician and when HIV ELIZA/ Western Blot was obtained was relatively long time. On average, the interval between a physician`s requests for CD4 count to assess the results was eight days. The average time interval between test requests by a physician to deliver sputum samples to the laboratory was four days. However, the average time interval between a physician`s requests for sputum samples to assess the results was 16 days.

Conclusion: Due to the significance of positive and negative results for making decision on diagnosis, initiation and follow up of treatment procedure, the time intervals should become shorter.
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March 2017