Oral health status of patients infected with human immunodeficiency virus and related factors, Iran: a cross-sectional study.

BACKGROUND: Human immunodeficiency virus (HIV) continues to be a major global issue. HIV-infected patients commonly experience oral health problems. This study aimed to assess oral health status of the patients and its related factors in Shiraz, Iran. METHODS: In this cross-sectional study, by using simple random sampling, 250 HIV-infected patients were selected from Shiraz Voluntary Counseling and Testing Center in 2019. Patients' decayed, missing, and filled tooth (DMFT) index, plaque index (PI), and community periodontal index (CPI) were determined. Associations between patients' characteristics and the above-mentioned indices were examined by using Pearson correlation, one-way ANOVA, chi-square, and independent sample T test. The effect of possible confounding factors was controlled by using multiple linear regression and logistic models. RESULTS: Of the 222 participants, 111 (50%) had 15 or more missing teeth and 79 (35.6%) were edentulous. Their mean (SD) DMFT and PI were 20.71 (10.74) and 1.11 (0.79), respectively. About 40% of them had healthy gingiva. DMFT (p < 0.001), PI (p < 0.001), and CPI (p = 0.002) were significantly worse in men than women. The patients' DMFT and edentulous status were significantly associated with their age (both p < 0.001) and duration of disease (p = 0.001 and p = 0.008, respectively). Unemployed patients had the worst DMFT, PI, and CPI (all p < 0.001) and the highest percentage of edentulous individuals (p = 0.003). All examined indices were significantly worse in cigarette smokers, alcoholics, addicts, and patients with a previous history of imprisonment (all p < 0.001). The odds ratio of being edentulous was 5.74 times in addicted patients than in non-addicted ones (p < 0.001). The odds increased 0.11 with every year that the patients' age increased (p < 0.001). Multiple linear regression models also showed that the addicted patients had significantly more scores in DMFT index, PI, and CPI (all p < 0.001). CONCLUSIONS: Overall, oral health status of the HIV-infected patients was unsatisfactory. Therefore, effective interventional programs are needed for prevention and early treatment of dental problems among this population, especially for more vulnerable groups such as older men with low socioeconomic status, and those with high-risk behaviors.

Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology Statement in Observational Studies Published in Iranian Medical Journals.

BACKGROUND: Although much medical knowledge comes from observational research, such studies are more prone to confounding and bias than others. This study was conducted to evaluate the adherence of the observational studies published in Iranian medical journals to the STROBE (strengthening the reporting of observational studies in epidemiology) statement. METHODS: In this cross-sectional study, we selected 150 articles of Iranian medical journals, using multistage sampling from Aug 2016 to Jun 2017. The reported items of the STROBE statement in the articles was determined and considered as the adherence of the articles to the statement. The adherence of the articles with different characteristics was compared. RESULTS: The adherence of the articles to the statement varied from 24% to 68% with a mean score of 48%±9%. The lowest mean scores were found in the Result (36%) and Method (49%) sections. The adherence was significantly better in the articles published in the journals indexed in PubMed or Web of Knowledge (ISI) databases (P<0.001) and those written by cooperation of the authors from other countries (P=0.044). CONCLUSION: The evaluated articles in our study had not adequately reported the items recommended by the STROBE statement. This indicates deficiency in key elements for readers to assess the validity and applicability of a study.

Appropriateness of Congenital Hypothyroidism Screening Program in Fars Province, Iran: A Retrospective Study from 2005 to 2015.

Congenital hypothyroidism (CH) may lead to irreversible mental retardation. To prevent the complication, screening was conducted routinely for all neonates in Iran. This study aimed to evaluate the appropriateness of CH screening programs in Fars province, southern Iran. This retrospective study (February-May, 2017) was conducted in the Health System Research Center of Shiraz University of Medical Sciences (SUMS). The data were obtained from the non-communicable diseases' unit of SUMS regarding congenital hypothyroidism screening of all neonates born in Fars province from 2005 to 2015. We evaluated the coverage of CH screening, the incidence rate of CH, the percentage of the neonates screened for CH in ideal time, and neonates with CH treated in appropriate time. Descriptive statistics were used to determine the indices. To compare the incidence rate of boys and girls, we used Chi-square test. The coverage of CH screening in Fars Province increased from 50.0% in 2005 to 99.7% in 2015. Furthermore, the percentage of the neonates screened in the ideal time and the neonates with CH treated in an appropriate time increased from 26.0% and 78.0% in 2005 to 86.6% and 99.7% in 2015, respectively. In the evaluated period, the coverage of CH screening in Fars province (98.1%) was higher than that of the other provinces of Iran (83.0%). The study showed good screening coverage in Fars Province from 2005 to 2015. The coverage was considerably better than other provinces of Iran and improved during the study period. Also, over the course of time, more neonates were screened in an ideal time and treated in the appropriate time.

Factors Affecting Dental Caries of Preschool Children in Shiraz, 2014.

STATEMENT OF THE PROBLEM: Dental caries, the most common infectious disease, can lead to several consequences, including inflammation and bleeding of the gum, abscess formation, tooth loss, and subsequently loss of available space in the arch. PURPOSE: This study was designed to determine dental caries status of Shiraz preschool children and its related factors. MATERIALS AND METHOD: This cross-sectional study was conducted on the children registered in Shiraz kindergartens in 2014. The study recruited 453 children by randomized cluster sampling. We evaluated the children's demographic and oral hygiene factors, and their dental caries status using decayed, missed, and filled tooth (dmft) index and prevalence of the children with untreated dental caries. Relationship between the children's characteristics and their dental caries status was evaluated. RESULTS: Only 119 children (30.1%) were caries-free. The children's mean dmft index was 3.88(±3.9). After controlling the effect of confounding factors, the children's dental caries status was significantly associated with variables indicating their socioeconomic status such as fathers' job, mothers' education, and number of children in the family. Furthermore, there was a significant association between the children's dental caries status and their oral hygiene habits such as frequency of tooth brushing. CONCLUSION: The dental caries status of the studied preschool children was not desirable which could be indicative of the inadequacy of the current preventive programs. To improve this issue, interventional preventive programs such as tooth brushing are recommended. The programs are more necessary for the children of low socioeconomic families and those with poor oral hygiene habits.

Occupational Exposure of Shiraz Dental Students to Patients' Blood and Body Fluid.

STATEMENT OF THE PROBLEM: Exposure to patients' blood and body fluids would prone the dental students to the risk of blood borne infections. Several studies have shown a high prevalence of these exposures in dental settings particularly in developing countries. However, few studies have evaluated the epidemiology of these exposures in dental students in Iran. PURPOSE: To assess the epidemiology of occupational exposures among dental students and consequently designing the appropriate interventions in order to prevent these exposures. MATERIALS AND METHOD: In this cross-sectional study performed during March to June 2011, all 191 Shiraz clinical dental students were asked to complete a self-administered questionnaire. This questionnaire included demographic information and experience of sharp injuries and mucocutaneous contaminations. Chi square and t-test were employed to evaluate the risk factors of exposure. RESULTS: 80%of the participants were exposed to the patients' blood or body fluids during their clinical course. No association was found between the exposure and demographic factors. Injection needle and recapping were the most common causes of these injuries. The most common sites that were injured and caused mucocutaneous contamination were finger and face, respectively. The most frequent activity causing contamination was using high-speed rotary instruments. Only 6.4% of the exposures had been reported to the related authorities and the remains were underreported. CONCLUSION: Blood and body fluid exposure in dental setting is common and a lot of them are not reported. To reduce the hazards of these exposures, infection control authorities should design interventions especially for mentioned high-risk conditions. They should change dental students' behavior especially regarding not recapping injection needles and using eyewear. Dental schools seem to need a management center and a standard protocol for following up the exposures.

Body fluid exposure in nurses of Fars province, Southern Iran.

BACKGROUND: Blood and body fluid exposures place healthcare workers at risk for blood-borne infections. To determine the extent of the problem in Iran, we assessed blood and body fluid exposure in healthcare workers in Fars Province hospitals. METHODS: We distributed 2,118 questionnaires using a stratified random sampling method among nurses of these hospitals. We used Chi-square test, Student's t-test, and multiple logistic regression analysis for determining risk factors for exposure. RESULTS: The overall prevalence of blood and body fluid exposures was 79% with a rate of exposure to sharps devices of 50%. Hypodermic needles were involved in most exposures (73%) with the most common source of injury being needle recapping (35%). Blood was the most frequent contaminant (87%) in mucocutaneous exposures, most commonly associated with inserting and removing intravenous lines (50%). Sharps injuries were independently associated with gender, professional level, and hospital location; mucocutaneous exposures were related to professional level and hospital location. Only 28% of nurses reported their exposures. CONCLUSION: The high level of risk found among nurses in Fars Province highlights the urgent need for interventions to enhance their occupational safety and to prevent unnecessary transmission of blood-borne viruses.

Needlestick injuries among nurses of Fars province, Iran.

PURPOSE: A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals. METHODS: Questionnaires were distributed in 52 hospitals to a stratified random sample of 2,118 (46.3%) nurses between April and September 2005 to collect self-reported NSI in the past 12- months. RESULTS: Of the 1,555 nurses who returned a completed questionnaire, 49.6% (95% confidence interval [95 CI] 47.1%-52.1%) recalled at least one sharps injury, of which 52.6% were classified as NSI. Just over one fourth (26.3%; 95 CI 24.1%-28.6%, 409/1,555) of respondents sustained at least one NSI, 75.6% (95 CI 71.1%-79.6%) recalled having sustained between 1 and 4 injuries in the past 12-months, of which 72.2% involved a hollow-bore needle and 95.1% of injuries involved fingers. Predictors of NSI included being a registered nurse (odds ratio [OR] 1.6, 95% CI 1.1-2.3) or midwife (OR 2.4, 95% CI 1.4-3.9) compared with nurse managers, being employed in a hospital located in other cities smaller than Shiraz (OR 1.4, 95% CI 1.1-1.8). Nurses who reported a previous contaminated NSI were less likely to sustain a further injury (OR 0.3, 95% CI 0.2-0.4). CONCLUSION: The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic.

Prevalence of vancomycin-resistant enterococci colonization and its risk factors in chronic hemodialysis patients in Shiraz, Iran.

BACKGROUND: Vancomycin-resistant entrococci (VRE) are increasing in prevalence at many institutions, and are often reported in dialysis patients. The aim of this cross-sectional prevalence study was to determine the prevalence and risk factors of VRE colonization in chronic hemodialysis patients in two hemodialysis centers in Shiraz, Iran. METHODS: Rectal swabs were obtained from all consenting patients and were streaked on the surface of Cephalexin-aztreonam-arabinose agar (CAA) and incubated at 37 degrees C in air for 24 h. The vancomycin susceptibility of each isolate was confirmed by disk susceptibility testing. The MICs of vancomycin and teicoplanin were confirmed by the E test. To identify risk factors, a questionnaire was completed for all the studied patients and the data of VRE positive and negative groups were compared using Man-Withney U test for continues data and the Fisher exact test for categorical data. RESULTS: Of 146 patients investigated, 9 (6.2%) were positive for VRE. All VRE strains were genotypically distinguishable. Risk factors for a VRE-positive culture were "antimicrobial receipt within 2 months before culture" (P = 0.003) and "hospitalization during previous year" (P = 0.016). CONCLUSION: VRE colonization is an under-recognized problem among chronic dialysis patients in Iran. VRE colonization is associated with antibiotic consumption and hospitalization.