Exploring the Relation Between Health Literacy, Infodemic, and Acceptance of COVID-19 Vaccination in Iran: A Cross-Sectional Study.

BACKGROUND: Health literacy (HL) plays a crucial role in navigating the coronavirus disease 2019 (COVID-19) pandemic, especially with the abundance of conflicting information from unauthorized sources. OBJECTIVE: This study aims to measure COVID-19 vaccine acceptability, COVID-19 HL, and COVID-19 infodemic and their predictors in Iranians. METHODS: A cross-sectional study was conducted on the general population in Iran between August 20, 2021 to October 29, 2021. Data were collected using a valid questionnaire with four parts. Univariable and multivariable logistic regression models, generalized linear models, and ordinal regression with the Polytomous Universal Model were performed using SPSS version 26. KEY RESULTS: The study revealed that 68.6% of the participants were willing to accept the COVID-19 vaccine, 45% had sufficient knowledge about COVID-19, and 52.2% were confused by false information during the pandemic. The results showed that having sufficient COVID-19 HL was significantly associated with higher acceptance of the vaccine (adjusted odds ratio = 1.52, 95% confidence interval (CI): 1.02, 2.12). Additionally, higher COVID-19 HL scores were associated with a higher adjusted odds of confusion by false information with an odds ratio of 1.12 (95% CI: 1 .11, 1 .13). CONCLUSION: This study exhibits low levels of COVID-19 HL in Iran, and the fact that higher COVID-19 HL is associated with higher vaccine acceptance. Because vaccination is an essential preventive measure to stop the COVID-19 pandemic, factors associated with low vaccine acceptance need to be addressed by public health strategies. [HLRP: Health Literacy Research and Practice. 2024;8(4):e184-e193.].

Plain Language Summary We investigated the relationship between health literacy, infodemic and acceptance of COVID-19 vaccination on the general population in Iran. Of the participants, 68.6% were willing to accept the COVID-19 vaccine, 45% had sufficient knowledge about COVID-19, and 52.2% were confused by false information during the pandemic. The results of the study showed a positive association between COVID-19 HL and acceptance of the vaccine, also, a negative relationship with confusion by false information.

Association between birth weight and risk of nonneurological childhood cancers: a systematic review and meta-analysis.

OBJECTIVES: This systematic review aims to synthesize the available literature to determine the association between birthweight and the risk of nonneurological childhood cancers. METHODS: We conducted a systematic search of PubMed, Web of Science, and Scopus databases up to May 2023 to identify observational studies. Heterogeneity between studies was evaluated using the I2 statistics. Publication bias was assessed using Begg and Egger tests. We calculated the odds ratio (OR) or risk ratio (RR) with a 95% confidence interval (CI) using a random-effects model. RESULTS: Of 11 034 studies retrieved from the search, 56 studies (including 10 568 091 participants) were eligible. The ORs (95% CI) of low (<2500 g) versus normal birthweight (2500-4000 g) and childhood cancers were as follows: leukemia, 0.92 (0.77-1.11); acute lymphoblastic leukemia, 0.82 (0.72-0.94); acute myeloid leukemia, 0.98 (0.77-1.24); lymphoma, 0.99 (0.47-2.10); Hodgkin, 0.79 (0.61-1.03); non-Hodgkin, 0.85 (0.60-1.20); neuroblastoma, 1.34 (1.14-1.58); retinoblastoma, 0.95 (0.68-1.32); rhabdomyosarcoma, 0.86 (0.61-1.20); embryonal, 0.97 (0.66-1.43); alveolar, 1.92 (0.43-8.51); and Wilms tumor, 1.01 (0.83-1.24). The ORs (95% CI) of high (>4000 g) versus normal birthweight and childhood cancers were as follows: leukemia, 1.30 (1.18-1.42); acute lymphoblastic leukemia, 1.27 (1.16-1.39); acute myeloid leukemia, 1.13 (0.98-1.30); lymphoma, 1.69 (0.72-3.94); Hodgkin, 1.22 (1.02-1.46); non-Hodgkin, 1.22 (0.80-1.86); neuroblastoma, 1.20 (1.02-1.41); retinoblastoma, 1.17 (0.93-1.48); rhabdomyosarcoma, 1.07 (0.90-1.27); embryonal, 1.22 (1.00-1.49); alveolar, 1.02 (0.46-2.27); and Wilms tumor, 1.49 (1.34-1.67). CONCLUSION: This meta-analysis identified high birth weight as a potential risk factor for some childhood cancers, while low birth weight might be protective against a few.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

AIM: Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. DESIGN: This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. METHOD: By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. RESULTS: A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

COVID-19: Clinical features, case fatality, and the effect of symptoms on mortality in hospitalized cases in Iran.

Objective: Identifying the epidemiological characteristics of COVID-19 could help to control the pandemic. The aim of this study was to characterize the epidemiological features of hospitalized COVID-19 patients in Iran. Methods: Data were collected on patients admitted to a military referral hospital in Tehran, Iran, from February 8, 2020 to July 28, 2021. Sex, age, clinical symptoms, outcome, type of comorbidities, level of blood Spo2, time of admission, and time of discharge were investigated. Sex ratio, case fatality rate (CFR), and daily trends of hospital admissions and deaths were also determined. Descriptive statistics and multiple logistic regression with 95% confidence intervals were used for data analysis. The statistical significance level was set at 0.05. STATA16.0 and Excel 2010 were used for data analysis. Results: The median hospital length of stay (LOS) was 6 days. The following symptoms were most common: cough (63.5%), fever (50%), respiratory distress (46.1%), and muscular pain (40.8%). Hypertension (29.5%), diabetes (24.7%), and cardiovascular diseases (21.8%) were the most prevalent comorbidities. The CFR was calculated at 8.30%. Respiratory symptoms increased the odds of death by 45% (OR 1.45, 95% CI 1.03-2.06). Gastrointestinal symptoms were associated with a reduction in the mortality of COVID-19 cases, but this association was not statistically significant (OR 0.94, 95% CI 0.73-1.21). Conclusions: The results of this study emphasize higher mortality rates among older age groups, male patients, and patients with underlying diseases.

The prevalence of hepatitis C and hepatitis B in lesbian, gay, bisexual and transgender populations: a systematic review and meta-analysis.

OBJECTIVES: This study aimed to systematically review the literature on the prevalence of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in transgender and LGBT people and determine their pooled estimates worldwide. METHODS: Databases (PubMed, Scopus, Web of Science, Embase, Ovid, Cochrane, PsycInfo) were searched from April 2000 to July 2021. The analyses were executed using the random-effects model in Stata 16. RESULTS: Ten studies, including eight studies on four transgender people and two studies on 2150 LGBTs, were included. The pooled prevalence of HCV and HBV in all transgender populations globally were 9% (95% CI 3-15%) and 11% (95% CI 2-20%), respectively. The corresponding prevalence in male-to-female transgender people were estimated as 5% (95% CI 1-9%) and 6% (95% CI 3-10%), respectively. These estimates in American transgenders were 10% (95% CI 5-25%) and 16% (95% CI 8-23%), respectively. CONCLUSION: This study was identified the overall prevalence of HBV and HCV infections in transgender people, which were higher than those in the general population.

Psychometrics of the Persian version of the COVID-19-related health literacy in the Iranian population.

Background: Since the occurrence of the COVID-19 pandemic, information dissemination has increased rapidly. Promoting health literacy is currently crucial to prepare people to respond quickly to situations, such as the COVID-19 pandemic. Due to the importance of health literacy in this critical situation, we are looking for a questionnaire to measure COVID-19 health literacy. The COVID-19 Germany Health Literacy Questionnaire (HLS-COVID-Q22) is an excellent tool, so the study aimed to create a cultural validity of this questionnaire for the Iranian population. Methods: In this validation study, 880 samples were enrolled using a convenient sampling method. The questionnaire was translated through a backward forwarding procedure. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were employed for Persian version validity. McDonald's omega (Ω), Cronbach's alpha, and average inter-item correlation (AIC) coefficients were assessed for reliability. Results: Using EFA on the random half sample (n = 440), the EFA indicated that the scale had four factors: accessing, understanding, appraising, and applying health-related information in the COVID-19 pandemic context, which explained 59.3% of the total variance. CFA was used for the sample's second part (n = 440) to evaluate the goodness of fit of the four-factor solution. CFA showed the model fit. All indices RMSEA = 0.067, CFI = 0.934, IFI = 0.934, PCFI = 0.772, PNFI = 0.747, and CMIN/DF = 2.972 confirmed the model fit. The convergent validity of the HLS-COVID-Q22 was confirmed. McDonald's omega and Cronbach's alpha were very good (α and Ω >0.80). Conclusion: The Persian version of the HLS-COVID-Q22 had acceptable psychometric properties and is applicable to measure COVID-19 health literacy.

The association between Helicobacter pylori and obesity: a systematic review and meta-analysis of case-control studies.

INTRODUCTION: The relationship between H. pylori infection and obesity development has remained controversial among various studies. The aim of this study was to clarify the pooled effect of H. pylori infection on the development of obesity and vice versa. METHODS: We searched international databases including Medline (PubMed), Web of sciences, Scopus, EMBASE, Cochrane, Ovid, and CINHAL to retrieve all case-control studies reporting the effect of H. pylori on obesity and vice versa, which had been published in English between January 1990 and June 2019. The quality of included studies was assessed by the Modified Newcastle-Ottawa Scale for Case-Control studies. The logarithm of the odds ratio (OR) and its standard error was used for the meta-analysis. RESULTS: Eight case-control studies with 25,519 participants were included for qualitative and quantitative analyses. The pooled analysis showed that obese participants had a higher risk of H. pylori infection than lean participants with an odds ratio of 1.46 (95%CI: 1.26, 1.68). Also, the pooled analysis revealed that participants infected by H. pylori had a higher risk of obesity than non-infected participants with an odds ratio of 1.01 (95%CI: 1.01, 1.02). CONCLUSION: The results of this meta-analysis showed that there was a positive correlation between the risk of H. pylori infection and the prevalence of obesity development. Thus, H. pylori positive patients were more likely to be obese, and obese individuals had higher risks of H. pylori infection.

Global prevalence of HCV and/or HBV coinfections among people who inject drugs and female sex workers who live with HIV/AIDS: a systematic review and meta-analysis.

Coinfections of hepatitis C virus (HCV) and/or hepatitis B virus (HBV) with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are associated with high morbidity and mortality and poor prognosis. The main objective of this study was to evaluate the prevalence of HCV and/or HBV coinfections among people who inject drugs (PWID) and female sex workers (FSWs) who live with HIV/AIDS worldwide. Data sources were searched from January 2008 to October 2018 in different databases, including PubMed, Scopus, Web of Science, Embase, and Ovid. Data were analyzed in Stata 14 software using the Metaprop command. The results showed that the prevalence of HCV among PWID and FSWs with HIV/AIDS was 72% (95% CI: 59%-83%) and 40% (95% CI: 0%-94%), respectively. The prevalence of HBV among PWID and FSWs with HIV/AIDS was 8% (95% CI: 5%-13%) and 2% (95% CI: 0%-7%), respectively, and the prevalence of HCV/HBV in PWID with HIV/AIDS was 11% (95% CI: 7%-15%). The highest prevalence of HCV was observed in PWID in the Eastern Mediterranean and Europe regions, and the lowest was observed in the Africa region. The South-East Asia region had the highest prevalence of HBV among PWID, and the Africa region had the lowest prevalence. The high prevalence of HCV coinfection among PWID and FSWs with HIV/AIDS was an alarming health problem and requires appropriate interventions. Therefore, considering that these populations are key populations for HCV elimination, it is recommended to screen them regularly for HCV. In addition, harm reduction and HBV vaccination should be carefully considered.

Systematic Review and Meta-Analysis of Global Prevalence of HBsAg and HIV and HCV Antibodies among People Who Inject Drugs and Female Sex Workers.

The main objective of this study was to evaluate the prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis C virus (HCV) and hepatitis B virus (HBV) and their co-infections among people who inject drugs (PWID) and female sex workers (FSWs). Data sources were searched from January 2008 to October 2018 in different databases. Data were analyzed in Stata 16 software using the Metaprop command. The results showed that the prevalence of HIV, HCV and HBV among PWID was 15%, 60% and 6%, respectively. The prevalence of HIV, HCV and HBV among FSWs was 5%, 1% and 3%, respectively. The prevalence of HIV/HCV, HIV/HBV, HCV/HBV and HIV/HCV/HBV co-infections among PWID was 13%, 2%, 3% and 2%, respectively. The prevalence of HIV/HCV and HIV/HBV co-infections among FSWs was 3% and 1%, respectively. The results show that the prevalence of HCV and HIV infections in PWID and the prevalence of HIV in FSWs is higher than their prevalence in the general population. Interventions for the prevention of HIV and HCV in PWID appear to be poor, and may not be sufficient to effectively prevent HIV and HCV transmission.

A systematic review and meta-analysis of the prevalence of Helicobacter pylori in patients with diabetes.

BACKGROUND AND AIMS: Prior studies have shown that Helicobacter pylori (H. Pylori) has the important role in the development of gastrointestinal diseases and diabetes in patients with diabetes. Due to the contradictory results on the prevalence of H. pylori in patients, we carried out a systematic review and meta-analysis to discover the pooled prevalence of H. Pylori in patients with diabetes. METHODS: A systematic literature search was performed utilizing international databases including Medline (PubMed), Web of sciences, Scopus, EMBASE, Cochrane, Ovid and CINHAL to retrieve all cross-sectional studies which had reported H. pylori prevalence in patients with diabetes between January 1990 and March 2019. The random effects models were applied to calculate the pooled prevalence with 95% confidence interval. RESULTS: A total of 13 articles were selected for meta-analysis according to PRISMA guideline. The pooled prevalence of H. Pylori was obtained 54% (95% CI: 44%-64%) in patients with diabetes. The highest and least prevalence of H. pylori were associated to Africa (66%; 95%CI: 49%-73%) and USA (15%; 95%CI: 8%-26%). In addition, the rapid urease test and biopsy/histology had the most strength in detecting of the H. pylori infection. The meta-regression analysis demonstrated that H. pylori prevalence is not affected by patients' age, publication year, study duration, and HbA1C. CONCLUSION: Given that the high prevalence of H. pylori in patients with diabetes and its important role in the development of gastrointestinal diseases and diabetes, treatment and eradication of this bacterium should be considered in patients with diabetes.

Helicobacter pylori infection as a risk factor for diabetes: a meta-analysis of case-control studies.

BACKGROUND: There are several studies with varied and mixed results about the possible relationship between H. pylori and diabetes. Therefore, this current meta-analysis performed to determine the association between H. pylori infection and the risk of diabetes mellitus. METHODS: A systematic literature searches of international databases, including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL (January 1990-March 2019) was conducted to identify studies investigating the relationship between H. pylori infection and diabetes mellitus. Only case-control studies were analyzed using odds ratio (OR) with 95% confidence intervals (CIs). Stratified and subgroup analyses were performed to explore heterogeneity between studies and assess effects of study quality. Logarithm and standard error logarithm odds ratio (OR) were also used for meta-analysis. RESULTS: A total of 41 studies involving 9559 individuals (case; 4327 and control; 5232) were analyzed. The pooled estimate of the association between H. pylori infection with diabetes was OR = 1.27 (95% CI 1.11 to 1.45, P = 0.0001, I2 = 86.6%). The effect of H. pylori infection on diabetes mellitus (both types), type 1 and type 2 diabetes was 1.17 (95% CI 0.94 to 1.45), 1.19 (95% CI 0.98 to 1.45), and 1.43 (95% CI 1.11 to 1.85) respectively. Subgroup analysis by the geographical regions showed in Asian population risk of the effect of H. pylori infection on diabetes was slightly higher than other population, CONCLUSION: In overall a positive association between H. pylori infection and diabetes mellitus was found.