A Report on Statistics of an Online Self-screening Platform for COVID-19 and Its Effectiveness in Iran.

BACKGROUND: The most recent emerging infectious disease, coronavirus disease 2019 (COVID-19), is pandemic now. Iran is a country with community transmission of the disease. Telehealth tools have been proved to be useful in controlling public health disasters. We developed an online self-screening platform to offer a population-wide strategy to control the massive influx to medical centers. METHODS: We developed a platform operating based on given history by participants, including sex, age, weight, height, location, primary symptoms and signs, and high risk past medical histories. Based on a decision-making algorithm, participants were categorized into four levels of suspected cases, requiring diagnostic tests, supportive care, not suspected cases. We made comparisons with Iran STEPs (STEPwise approach to Surveillance) 2016 study and data from the Statistical Centre of Iran to assess population representativeness of data. Also, we made a comparison with officially confirmed cases to investigate the effectiveness of the platform. A multilevel mixed-effects Poisson regression was used to check the association of visiting platform and deaths caused by COVID-19. RESULTS: About 310 000 individuals participated in the online self-screening platform in 33 days. The majority of participants were in younger age groups, and males involved more. A significant number of participants were screened not to be suspected or needing supportive care, and only 10.4% of males and 12.0% of females had suspected results of COVID-19. The penetration of the platform was assessed to be acceptable. A correlation coefficient of 0.51 was calculated between suspected results and confirmed cases of the disease, expressing the platform's effectiveness. CONCLUSION: Implementation of a proper online self-screening tool can mitigate population panic during wide-spread epidemics and relieve massive influx to medical centers. Also, an evidence-based education platform can help fighting infodemic. Noticeable utilization and verified effectiveness of such platform validate the potency of telehealth tools in controlling epidemics and pandemics.

Epidemiological Characteristics and Trend in the Incidence of Human Brucellosis in Iran from 2009 to 2017.

BACKGROUND: The development of preventive measures and promotion of healthcare delivery systems for disease management is dependent on detecting the incidence rates of the diseases and important risk factors. The current study aimed to determine some epidemiological indices and trends of the human brucellosis incidence in Iran between 2009 and 2017. STUDY DESIGN: A descriptive cross-sectional study. METHODS: In the current study, online data were gathered from all cases of brucellosis who were potentially or definitely diagnosed and registered in medical centers, hospitals, laboratories, and private clinics in all districts of Iran. Epidemiologic questionnaires were used to collect data on demographic and background characteristics, risk factors, high-risk behaviors, and lab test results, respectively, based on the national brucellosis control plan. RESULTS: A total of 138,448 cases of brucellosis have been studied in Iran from 2009 to 2017. The highest (25.89) and the lowest (12.07) incidence rates were observed in 2014 and 2009, respectively. In this nine-year study, the highest incidences were reported in the Hamedan, Lorestan, Kordestan, and Kermanshah provinces. The cumulative percentages of the disease were estimated for different variables at the following rates: by gender: 57.9% for males; by age groups: 36.2% and 16.7% for the 25-44 and16-24 years age groups, respectively; by occupation: 33.2% for housewives; and by residential area: 75.7% for rural residents. CONCLUSIONS: Based on the obtained results, although the incidence of human brucellosis in Iran has declined since 2015, the number of cases has remained high.

First Cases of SARS-CoV-2 in Iran, 2020: Case Series Report.

In Jan 2020, the outbreak of the 2019 novel coronavirus (SARS-CoV-2) in Wuhan, Hubei Province of China spread increasingly to other countries worldwide which WHO declared it as a public health emergency of international concern. Iran was included in the affected countries. Throat swab specimens were collected and tested by using real-time reverse transcription PCR (RT-PCR) kit targeting the E region for screening and RNA dependent RNA polymerase for confirmation. Conventional RT-PCR was conducted for the N region and the PCR products were sequenced by Sanger sequencing. The first seven cases of SARS-CoV-2 infections were identified in Qom, Iran. This report describes the clinical and epidemiological features of the first cases of SARS-CoV-2 confirmed in Iran. Future research should focus on finding the routes of transmission for this virus, including the possibility of transmission from foreign tourists to identify the possible origin of SARS-CoV-2 outbreak in Iran.

How Much Emotional Intelligence Effect on Health Centers Performance? A Structural Equation Modeling Approach.

BACKGROUND: Emotional intelligence (EI) is very important factor to guide managers in a way that leads to access long and short-term organizational goals. The aim of this study was to detect how much emotional intelligence effect on health centers performance. STUDY DESIGN: This is a correlational/analytical study and due to providing some operational strategies for technical health managers and policy makers, it is an applied study. METHODS: This study was conducted in 2016 and the population was technical health managers of city health centers in Hamadan Province, western Iran selected by census method. To assess the performance, applied the score that managers have gained in health deputy monitoring. EI measured by Shiring Siberia questionnaire. Data analysis implemented by SPSS software using multiple linear regression, Spearman correlation and Structure Equation Model (SEM). RESULTS: Emotional intelligence of managers has a direct and significant impact on their performance (P=0.001), linear regression shows that an increment in the emotional intelligence score of managers, 0.718 units will be added to the performance score. Using multiple regression analysis, the severity of each dimension effect on performance were evaluated which awareness has greatest impact (P=0.001, B=0.017) and self-control has the weakest impact (P=0.014, B=-0.08) on performance. CONCLUSION: The level of Emotional intelligence and its aspects has a significant effect on the manager's performance. This fact demonstrates need to high attention of health top managers and decision-makers to enhance health managers EI skills.

Prevalence of nasopharyngeal carriage of Streptococcus pneumoniae in children 7 to 14 years in 2016: A survey before pneumococcal conjugate vaccine introduction in Iran.

Streptococcus pneumoniae is a common cause of community-acquired pneumonia, meningitis, and otitis media in children. The aim of this study was to determine the prevalence of nasopharyngeal carriage of Streptococcus pneumoniae among children in the city of Hamadan, west of Iran. In this cross-sectional study, 532 students aged 7 to 14 years old from Hamadan were enrolled during the period from February to April 2016. Children were recruited using multi-stage sampling method. Informed consent form was obtained from parents of children. A researcher developed checklist was completed for every child by interviewer and samples of the throat of children were taken by swap method from the nasopharyngeal area. Descriptive statistics and chi square test were used to describe the study population. This study was approved by the Committee on Ethics of Hamadan University of Medical Sciences (IR.UMSHA.REC.1394.66). Prevalence of nasopharyngeal carriage of S. pneumoniae in children was 12.03% (95%CI: 9.38-15.10). About 37% (196 persons) of study population were male and 63% were female. Sixty four percent (345 people) of the studied population were from district two in Hamadan and others from District one. Prevalence of nasopharyngeal carriage of S. pneumoniae by sex was 13.77% (95% CI: 9.27-19.40) in males and 11.02 % (95% CI: 7.87-14.85) in females (P = 0.345). Considering the high prevalence of nasopharyngeal carriage of Streptococcus pneumoniae in children studied in Hamadan, pneumococcal conjugate vaccine (PCV) is recommended to be integrated into the Iran's National Immunization Program.

The critical role of injecting drug users on the spatial distribution of hepatitis C virus; a study in the West of Iran.

AIM: This study was conducted to provide a clear epidemiological picture of HCV spatial pattern. BACKGROUND: Hepatitis C virus (HCV) is one of the major problems of public health, that its spatial and spatiotemporal pattern remain unclear in Hamadan province. METHODS: We used the scan statistic to identify the spatial and spatiotemporal clusters of HCV in Hamadan province with an emphasis on considering the role of carrier's and injecting drug users (IDUs) cases. We repeated the same analysis to estimate the effect of some influencing factors on the formation of clusters. All HCV cases that had been recorded by deputy health of Hamadan University of Medical Sciences during 2008-2016 were included in this study. RESULTS: The location of the purely spatial cluster for carriers, IDUs and total of cases were similar to each other, a cluster consisting of Toyserkan, Nahavand, Asadabad, Malayer and Bahar cities. However, after adjustment, the location of the identified cluster for both carries and IDUs cases changed to a cluster consisting of Asadabad, Bahar, Toyserkan and Nahavand cities. This cluster also observed for spatiotemporal clusters carriers, IDUs and total of cases even after adjustment. CONCLUSION: Although further studies in individual level are needed, our results revealed that spatial distribution of HCV in Hamadan province (especially in clusters areas) can strongly dependent on the distribution of IDUs cases. Consequently, the effectiveness of HCV combating programs is subjected to properly controlling these case through various counseling, behavioral and therapeutic programs.

Influenza A (H1N1) in Hamedan Province, Western Iran in 2009: A Case-Control Study.

BACKGROUND: The novel influenza A (H1N1) virus was first detected in March 2009 in Mexico and then disseminated to many other countries worldwide. In this study, we assessed the potential risk factors of swine flu as well as the most important clinical manifestations of this infectious disease among confirmed cases during early phase of pandemic H1N1. METHODS: Subjects (cases and controls) were selected from those patients with signs and symptoms of respiratory tract infection who referred to health centers of eight cities throughout Hamedan Province, western Iran form July to December 2009. Characteristics of the participants were obtained by interviewers using pre-determined questionnaire. Cases were distinguished by pharyngeal soap speci-mens positive for influenza A virus using polymerase chain reaction (PCR). Logistic regression model was conducted at 0.05 significance level using Stata 9.1 statistical software to assess the effects of various risk factors on H1N1 influenza infection. RESULTS: Totally, 245 confirmed cases of H1N1 influenza were compared with 388 controls. Case fatality rate of influenza infection was about 2.86%. In comparison with age group of 1-19 yr old, adjusted odds ratio estimates was 1.91 [95% CI: 1.06, 3.46] for age group of 20-39 yr old, 0.94 [0.37, 2.38] for age group of 40-59 yr old, and 0.34 [0.09, 1.37] for age group of 60-79 yr old. Adjusted odds ratio estimates of influenza A infection was 8.12 [95% CI: 3.11, 21.6] for pregnant women compared to non-pregnant women; 1.84 [95% CI: 1.32, 2.86] for high educated individuals in comparison with low educated individuals; 2.11 [95% CI: 1.25, 3.57] for whose who had close contact with suspected influenza patients; and 2.15 [95% CI: 1.16, 3.98] for individuals with normal body mass index (BMI= 25-30) compared with underweight individuals (BMI< 20). There were no significant differences in clinical manifestations between cases and controls. CONCLUSION: The risk of influenza A infection is highest among children and adolescents, pregnant women, high educated individuals, and those who had close contact with suspected influenza patients during pandemic phase. In addition, there is no pathogonomonic sign or symptom to distinguish influenza infection clinically from other kinds of respiratory track infections.