ABSTRACT
We conducted in-depth interviews with key tobacco control policy-makers to explore their views and opinions of trends in tobacco use and the effectiveness of tobacco control programmes over the past 3 decades. A qualitative interview study was conducted in 2014 using a grounded theory approach. In-depth interviews were conducted with 86 key tobacco control policy-makers and data collection was based on principles of saturation. The core code "tobacco consumption and its control programme" was extracted and its related themes were listed. After review and classification by an expert panel, 9 categorized codes emerged. The final 31 codes were ordered according to their conceptual differentiations. Overall, tobacco consumption was constant over the past 3 decades; however it was increasing in females and young people and decreasing in older people; hookah consumption was increasing. A positive outcome is that tobacco use is now viewed negatively in the Islamic Republic of Iran, largely due to tobacco control programmes but the current situation is still not ideal and a comprehensive tobacco control law is needed.
Subject(s)
Health Promotion/trends , Smoking Cessation , Tobacco Use/trends , Female , Humans , Interviews as Topic , Iran , Islam , Male , Qualitative ResearchABSTRACT
We conducted in-depth interviews with key tobacco control policy-makers to explore their views and opinions of trends in tobacco use and the effectiveness of tobacco control programmes over the past 3 decades. A qualitative interview study was conducted in 2014 using a grounded theory approach. In-depth interviews were conducted with 86 key tobacco control policy-makers and data collection was based on principles of saturation. The core code "tobacco consumption and its control programme" was extracted and its related themes were listed. After review and classification by an expert panel, 9 categorized codes emerged. The final 31 codes were ordered according to their conceptual differentiations. Overall, tobacco consumption was constant over the past 3 decades; however it was increasing in females and young people and decreasing in older people; hookah consumption was increasing. A positive outcome is that tobacco use is now viewed negatively in the Islamic Republic of Iran, largely due to tobacco control programmes but the current situation is still not ideal and a comprehensive tobacco control law is needed
Nous avons mené des entretiens approfondis auprès de responsables politiques clés de la lutte antitabac afin d'examiner leurs vues et opinions sur les tendances du tabagisme et sur l'efficacité des programmes de lutte antitabac au cours des trois dernières décennies. Une étude qualitative par entretiens a été conduite en 2014 suivant la méthodologie dite de la théorie à base empirique. Des entretiens approfondis ont été menés auprès de 86 responsables politiques clés de la lutte antitabac, et la collecte des données a reposé sur le principe de saturation. Le code source " consommation de tabac et programmes de lutte antitabac " a été extrait et les thèmes apparentés ont ensuite été listés. Après examen et classification par un groupe d'experts, neuf codes catégorisés ont émergé ultérieurement. Les 31 codes finaux ont été ordonnés en fonction de leurs différenciations conceptuelles. Dans l'ensemble, le tabagisme est resté constant au cours des 30 dernières années ; mais il a augmenté chez les femmes et les jeunes, a baissé chez les personnes âgées, et la consommation de houka a connu une augmentation. L'un des résultats positifs est que le tabagisme est à présent perçu négativement en République islamique d'Iran, en grande partie grâce aux programmes de lutte antitabac. Mais la situation actuelle est loin d'être idéale et l'adoption d'une législation antitabac complète est nécessaire
Subject(s)
Tobacco Use , Tobacco Use Disorder , Nicotiana , Drug and Narcotic Control , Surveys and Questionnaires , SmokingABSTRACT
While airways reactivity is among the characteristics of asthma, it is not considered a sufficient condition diagnostically and the methacholine challenge is a non-specific diagnostic aid in cases of chronic cough and reactive airways disease. The aim of this cross-sectional study was to determine the metacholine response positivity and diagnosis of asthma in patients with chronic cough presenting to a hospital in Tehran during 2007 and 2008. Of 101 patients with chronic cough (with no history of sinusitis, recent pulmonary infection, bronchitis, gasteroesophageal reflux or underlying pulmonary conditions), 51.5% showed reactive airways disease to the methacholine test, 40.6% were unreactive and 7.9% were indeterminate. A positive methacholine challenge test was positively correlated with new wheezing. Although the methacholine challenge test is not a primary test for evaluating chronic cough, if no other reason for chronic cough is found, it may be a guiding test for asthma.
Subject(s)
Asthma/epidemiology , Bronchial Hyperreactivity/epidemiology , Cough/epidemiology , Adolescent , Adult , Aged , Asthma/diagnosis , Bronchial Hyperreactivity/diagnosis , Bronchial Hyperreactivity/metabolism , Bronchial Provocation Tests , Chronic Disease , Cough/metabolism , Cross-Sectional Studies , Female , Humans , Iran/epidemiology , Male , Methacholine Chloride/metabolism , Middle Aged , Respiratory Function Tests , Respiratory Sounds , Young AdultABSTRACT
While airways reactivity is among the characteristics of asthma, is not considered a sufficient condition diagnostically and the methacholine challenge is a non-specific diagnostic aid in cases of chronic cough and reactive airways disease. The aim of this cross-sectional study was to determine the metacholine response positivity and diagnosis of asthma in patients with chronic cough presenting to a hospital in Tehran during 2007 and 2008. Of 101 patients with chronic cough [with no history of sinusitis, recent pulmonary infection, bronchitis, gasteroesophageal reflux or underlying pulmonary conditions], 51.5% showed reactive airways disease to the methacholine test, 40.6% were unreactive and 7.9% were indeterminate. A positive methacholine challenge test was positively correlated with new wheezing. Although the methacholine challenge test is not a primary test for evaluating chronic cough, if no other reason for chronic cough is found, it may be a guiding test for asthma
Subject(s)
Cough , Chronic Disease , Cross-Sectional Studies , Asthma , Respiratory Sounds , Methacholine ChlorideABSTRACT
To study the participation of the private sector in detection and diagnosis of tuberculosis, all suspected cases referring to 4 private laboratories in Tehran for acid-fast bacillus examination during 2002-03 were documented. Of 9037 cases enrolled in the study, 637 had positive examination results (7.1%). Of these 531 (5.9%) cases were direct smear-positive and 489 (5.4%) were culture-positive. Data from the Iranian Ministry of Health showed 9479 cases referred to government laboratories in Tehran urban area during the study period, 208 (2.2%) of which were positive. This larger than expected proportion of TB patients who are detected and managed by the private sector indicates that much closer cooperation is needed between the public and private sectors.
Subject(s)
Disease Notification , Laboratories/organization & administration , Private Sector/organization & administration , Tuberculosis/diagnosis , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Bacteriological Techniques/methods , Chi-Square Distribution , Child , Cross-Sectional Studies , Disease Notification/statistics & numerical data , Female , Health Services Needs and Demand , Health Services Research , Humans , Infant , Interinstitutional Relations , Iran/epidemiology , Male , Middle Aged , Public Sector/organization & administration , Referral and Consultation/organization & administration , Sex Distribution , Surveys and Questionnaires , Tuberculosis/epidemiology , Tuberculosis/microbiology , Urban HealthABSTRACT
To study the participation of the private sector in detection and diagnosis of tuberculosis, all suspected cases referring to 4 private laboratories in Tehran for acid-fast bacillus examination during 2002-03 were documented. Of 9037 cases enrolled in the study, 637 had positive examination results [7.1%]. Of these 531 [5.9%] cases were direct smear-positive and 489 [5.4%] were culture-positive. Data from the Iranian Ministry of Health showed 9479 cases referred to government laboratories in Tehran urban area during the study period, 208 [2.2%] of which were positive. This larger than expected proportion of TB patients who are detected and managed by the private sector indicates that much closer cooperation is needed between the public and private sectors
Subject(s)
Laboratories , Cross-Sectional Studies , Age Distribution , Private Sector , TuberculosisABSTRACT
OBJECTIVE: To determine the case notification rate of patients with tuberculosis (TB) detected by private laboratories, in Tehran, Iran. STUDY DESIGN: Cross-sectional study. METHOD: All confirmed TB cases among suspected cases referred to private laboratories for acid-fast bacilli (AFB) examination in 2002-2003 were enrolled in the study. All AFB-positive cases were followed up for notification to the Iranian Ministry of Health (MOH) National Tuberculosis Programme (NTP). RESULTS: Of the total number of cases referred to private laboratories, 646 AFB-positive cases were followed up. Of these, 317 (49.1%) cases were female and 328 (50.8%) were male; the mean age was 52.2 years (SD +/- 21.7). Patients were contacted either at their residence or by telephone: 82 were found to be registered with the MOH while 564 (87.3%) could not be traced. A positive correlation was detected between physician advice for patient referral to health centres and case registration by the MOH (Fisher's Exact test 0.000). CONCLUSION: The private sector in Tehran plays a significant role in TB detection, but there are major gaps in the collaboration between the private and public health systems.
