Quality of life of HIV-infected individuals: insights from a study of patients in Kermanshah, Iran.

BACKGROUND: Quality of life (QOL) is one of the major factors to assessing the health and wellbeing of People living with HIV (PLWH). Likewise, improved QOL is among the prominent goals of patient treatment. This study was conducted to investigate the QOL of PLWH in Kermanshah, Iran. METHODS: This cross-sectional study was conducted on 364 PLWH of Kermanshah between 2016 and 2017. Outpatients were selected as the sample through the convenience sampling method from HIV Positive Clients of Kermanshah Behavioral Diseases Counseling Center. The reasons for the selection of outpatients include: (a) some patients were substance users, homeless or did not have a fixed address to follow-up; (b) addresses and personal details that were registered on the first admission were incorrect or incomplete; (c) due to financial issues, some were forced to relocate frequently and were difficult to track; (d) some patients were convicts or prisoners, making it hard to find them after their release; (e) some of them were from other provinces, where managing access was not easy/possible. Data was collected using WHOQOL-HIV BREF questionnaire (Persian Version). Data also analyzed with STATA 14, and SPSS 23 using T-test and multiple regression. RESULTS: This study showed that mean (SD) age of PLWH was 40.21 (10.45) years. Females had better QOL than males except for spirituality, religion and personal beliefs. The gender differences disappeared in multivariate results. A significant association was observed between education and the independence, environment, and spirituality domains of QOL. In addition, being married was correlated with overall QOL, psychological and social relationships domains of QOL of PLWH. Drug use was a behavioral factor with negative influence on the QOL. CONCLUSION: This study found that marital status and drug use were the main predictors of various domains of QOL. Drug use was a behavioral factor with a negative influence on the QOL. Hence, it is recommended that health professionals, planners, and policymakers take effective measures to improve the status quo.

Evaluating the access of slum residents to healthcare centers in Kermanshah Metropolis, Iran (1996-2016): A spatial justice analysis.

Background: Proper access to health care centres and services is one of the key indicators of health justice, and it is more than ever important in slums. Objective: This aim of this research is to evaluate the accessibility of health care centres to slum residents in the Kermanshah metropolis, Iran during the period 1996-2016. Methods: In this cross-sectional study, data was obtained from the Census of Iran for the periods 1996, 2006 and 2016. Information on the number and location of health care centres was collected from the Kermanshah University of Medical Sciences. Network Analysis modelling method in Arc/GIS10.6 software was used to evaluate the accessibility of people to health centres. Results: The results show that the spatial pattern of health centres in Kermanshah was random during 1996, 2006 and 2016, but the spatial pattern of poverty in the metropolis was clustered. In addition, the distribution of health centres was not consistent with the population densities. However, the overall population with inappropriate access to health centres in the slums of Kermanshah metropolis decreased over the study period (1996-54.02%, 2006-51.09%, and 2016-34.71%). Conclusions: The findings of the study reveal that access to health care services by the slum population is not consistent with the increase of health care centres. This means that health policymakers were unsuccessful to provide the required health care services for the slums.

Investigation of spatial pattern of apnea disorder using geographic information system (GIS)-case study of Kermanshah metropolis.

Background: Apnea disorder is influenced by social and environmental factors. By assessing its hot spots and geography, the foci of this disorder and its at-risk groups can be identified for health interventions. This study was conducted to investigate the spatial pattern of apnea disorder using GIS in the Kermanshah metropolis. Methods: In cross-sectional study was conducted in kermanshah, the statistical population were 119 people (73.95% male and 26.05% female) of Kermanshah residents, which referred to the sleep center from 2012 to 2018 due to apnea disorder. Information was collected from the records of patients referred to the Sleep Disorder Center of Farabi Hospital, which is the only service center in the west part of Iran. The statistical tests were the mean center, standard distance, Getis-Ord Gi * index, nearest neighbor index, and kernel density estimation test in GIS software. Results: The spatial pattern of patients with apnea disorder has cluster formation in the Kermanshah metropolis. The age group of 50-54 had more apnea disorder than other age groups. In this age group, women were more prone to apnea than men. In terms of education, people with high education are more affected by this disorder; So that with the increase in education level, apnea disorder had also increased. Also, the findings showed that the disorder was more common in unemployed, married, overweight people with BMI (25-30), and obese people (30-40). Conclusion: The spatial pattern of patients with apnea disorder was clustered and does not correspond to the high population density centers located in the marginal and slum areas of the city. These can be used by stakeholders, including governmental organizations and health authorities at the national-regional level.

Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran.

Background: A suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006-14. Methods: This study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran's I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide. Results: The results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females. Conclusion: The results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention.

Lifestyle in People Living With HIV: A Study of Patients in Kermanshah, Iran.

There is limited research on the role of lifestyle in people living with HIV (PLWH). This study investigated the health-promoting lifestyle among PLWH in Kermanshah-Iran. This cross-sectional study was conducted in 321 PLWH patients referred to the Kermanshah Behavioral Diseases counseling Center between 2017 and 2018. Patients were selected using the convenience sampling method. Data was collected using a standard health promotion lifestyle profile (HPLP-II) questionnaire. Regression and T-tests were used in SPSS 21 and Stata software to analyze the data. The mean age of patients was 41.07 ± 9.14 years. The mean HPLP score of patients in stress management had the lowest mean score (19.44 ± 4.22), and health responsibility had the highest mean score (22.22 ± 4.57). Comparisons between women and men also showed that women had a lower mean score than men in stress management. In addition, significant differences in their HPLP were observed only in the area of physical activity. The final model had significant influence on the PLWH (P < .001), in which the main predictors were housing status, family members, and feelings of happiness. These variables had a negative effect on HPLP in PLWH's. An appropriate education and training has improved the PLWH health-oriented lifestyle. Given that the housing situation affected health responsibility, nutrition, spiritual growth, interpersonal relationships, and stress management, may have caused severe anxiety and confusion in PLWH. Addiction also had a negative effect on patients' spiritual growth. Relatively simple lifestyle changes such as nutrition and stress management can significantly improve PLWH.

Exploring the epidemiology of suicide attempts: Risk modeling in Kermanshah-Iran.

Background: Suicide attempt is a serious global public health issue. The patterns of suicide may vary depending on the individual characteristics, methods, causes, and the geographical area-also socio-cultural context that determine it. This study identifies the spatial patterns of suicide attempts in Kermanshah province, Iran. Method: The sample size of this cross-sectional study is 18,331 people (7234 males and 11097 females) who attempted suicide in Kermanshah province between 2006 and 2014. Data was collected from the records of patients referred to the emergency department of hospitals in Kermanshah and analyzed using tests of Mean Center, Standard Distance, and Average Nearest Neighbor. Results: The results of the mean center and standard distance tests show that drug overdose, poisoning with toxins and pesticides, and chemicals mostly were used in the central areas of Kermanshah province. The mean center of suicide attempts by self-immolation, hanging and firearms was in the western parts of the province, while the suicide attempts with narcotic drug were concentrated in the eastern regions of the province. Out of the 18,331 cases, 74% attempted suicide with drug overdose, 13% with toxins and pesticides, 0.59% with chemicals, 4% with fire, 1% by self-immolation, 1% by hanging, 0.16% with firearms and 0.7% with cold weapons. The spatial pattern of all suicide attempts in Kermanshah was clustered (Z-score < -2.58). Conclusion: The results of this study show that the methods of suicide attempt vary with geographical areas in the province. Therefore, it is suggested that planning tailored to the geographical location can reduce suicide attempts in Kermanshah.

Investigating Global Spatial Patterns of Diarrhea-Related Mortality in Children Under Five.

Objective: Investigating the trends of child diarrhea-related mortality (DRM) is crucial to tracking and monitoring the progress of its prevention and control efforts worldwide. This study explores the spatial patterns of diarrhea-related mortality in children under five for monitoring and designing effective intervention programs. Methods: The data used in this study was obtained from the World Health Organization (WHO) public dataset that contained data from 195 countries from the year 2000 to 2017. This dataset contained 13,541,989 DRM cases. The worldwide spatial pattern of DRM was analyzed at the country level utilizing geographic information system (GIS) software. Moran's I, Getis-Ord Gi, Mean center, and Standard Deviational Ellipse (SDE) techniques were used to conduct the spatial analysis. Results: The spatial pattern of DRM was clustered all across the world during the study period from 2000 to 2017. The results revealed that Asian and African countries had the highest incidence of DRM worldwide. The findings from the spatial modeling also revealed that the focal point of death from diarrhea was mainly in Asian countries until 2010, and this focus shifted to Africa in 2011. Conclusion: DRM is common among children who live in Asia and Africa. These concentrations may also be due to differences in knowledge, attitude, and practices regarding diarrhea. Through GIS analysis, the study was able to map the distribution of DRM in temporal and spatial dimensions and identify the hotspots of DRM across the globe.

Spatial modeling of mortality from acute lower respiratory infections in children under 5 years of age in 2000-2017: a global study.

BACKGROUND: Over the past few decades, various goals have been defined to reduce the mortality of children caused by acute lower respiratory infections (ALRIs) worldwide. However, few spatial studies to date have reported on ALRI deaths. PURPOSE: We aimed to assess the spatial modeling of mortality from ALRI in children under 5 years of age during 2000-2017 using a global data. METHODS: The data on the mortality of children under 5 years old caused by ALRI were initially obtained from the official website of the World Health Organization. The income status of their home countries was also gathered from the Country Income Groups (World Bank Classification) website and divided into 5 categories. After that, in the ArcGIS 10.6 environment, a database was created and the statistical tests and related maps were extracted. The Global Moran's I statistic, Getis-Ord Gi statistic, and geographically weighted regression were used for the analyses. In this study, higher z scores indicated the hot spots, while lower z scores indicated the cold spots. RESULTS: In 2000-2017, child mortality showed a downward trend from 17.6 per 100,000 children to 8.1 and had a clustered pattern. Hot spots were concentrated in Asia in 2000 but shifted toward African countries by 2017. A cold spot that formed in Europe in 2007 showed an ascending trend by 2017. Based on the results of geographically weighted regression test, the regions identified as the hot spots of mortality from ALRI in children under 5 years old were among the middle-income countries (R2=0.01, adjusted R2=8.77). CONCLUSION: While the total number of child deaths in 2000-2017 has decreased, the number of hot spots has increased among countries. This study also concluded that, during the study period, Central and Western Africa countries became the main new hot spots of deaths from ALRI.

Survey on the indexes of health equity in the physical environment and infrastructures of Kermanshah province, Iran.

BACKGROUND: Health equity is directly associated with the proper distribution of resources, the existence of infrastructures, and the balanced physical environment. The present study aimed to survey the indexes of health equity in the physical environment and infrastructures of Kermanshah province based on the national indexes. RESULTS: The results revealed that access to transportation, health centers, solid waste management, and green and sports per capita had the least distance from the negative ideal whereas the noise pollution index had the greatest distance. However, house hygiene and air pollution indexes were within the negative and positive ideal ranges. CONCLUSIONS: The health equity indexes were not distributed equitably across counties and geographical regions of Kermanshah province.

A study of 0-14-year-old children's access to health centers in rural areas using a buffer model (a case study of villages based in Kermanshah province, Iran).

INTRODUCTION: Children are among the most vulnerable groups in society, whose health is of prominent significance. Moreover, as a group of clients with special needs in the health care system, they require special attention. Therefore, the present study aimed to investigate the 0-14-year-old children's access to health centers in rural areas of Kermanshah Province, Iran. MATERIALS AND METHODS: In the present cross-sectional study, both the latest published demographic statistics related to the Population and Housing Census, announced by the Statistical Center of Iran in 2011, and the information about the public and private hospitals in the province, collected by Kermanshah University of Medical Sciences, were used as the basis for the analyses. In addition, given the importance of the spatial nature of the research, geographic information system was used for data analysis, and a buffer model was also applied. RESULTS: The results revealed that out of the total population of 0-14-year-old children residing in rural areas within 15,000 and 30,000-km radii of Kermanshah Province, 87.94% and 75.11% of girls versus 88.15% and 75.38% of boys lacked access to health centers, respectively. CONCLUSION: It was found out that the 0-14-year-old children's access to health centers was in poor condition in rural areas of Kermanshah Province, which would endanger the health of this age group.