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.

Environmental exposure to organophosphate pesticides and effects on cognitive functions in elementary school children in a Middle Eastern area.

Although the fundamental reasons for cognitive function disorders have been well documented, little is known about the impact of environmental exposures, such as pesticides, on children's cognitive function development. This study investigated the effect of exposure to organophosphate pesticides on children's cognitive function. In order to determine various factors of exposure, hair samples were collected from 114 elementary school children who lived in Boyer-Ahmad County in the province of Kohgiluyeh and Boyer-Ahmad, Iran. A detailed questionnaire was utilized to gather demographic information and exposure profile. Pesticides were detected in hair samples using a gas chromatography-mass spectrometer (GC-MS); also, cognitive function was assessed using the trail-making test (TMT), which was divided into two parts: TMT-part A and TMT-part B. Participants in the study were 10.12 ± 1.440 years old on average. Children in rural areas had higher mean total pesticide concentrations (13.612 ± 22.01 ng/g) than those who lived in the urban areas (1.801 ± 1.32). The results revealed that boys (46.44 s and 92.37 s) completed the TMT-part A and part B tests in less time than girls (54.95 s and 109.82 s), respectively, and showed better performance (2.14) on the cognitive function exam than girls (2.07). Diazinon and TMT-part B were positively correlated (p < 0.05). With the increase in pesticides, there was no discernible difference in cognitive function. Pesticide use throughout a child's development may affect certain cognitive function indicators. In order to assess causal relationships, group studies and case studies are required because the current research was cross-sectional in nature.

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.

The Relationship between Life Satisfaction and Quality of Life among People Living with HIV/AIDS in Kermanshah-West of Iran.

Since the late 20th century, identifying the multidimensional nature of HIV/AIDS and its negative effects on mental health and quality of life (QOL) in patients has prompted specialists to identify and control the psychological and behavioural variables resulting from this disorder. Thus, the current study aimed to assessing the relationship between life satisfaction (LS) and QOL among people living with HIV/AIDS in Kermanshah. This descriptive-correlation study was conducted on 364 HIV/AIDS patients referred to the Voluntary Counseling and Testing Center (VCT) in Kermanshah in 2016-2017, selected by convenience sampling method. Data gathering tools included Satisfaction with Life Scale (SWLS), World Health Organization Quality of Life-HIV Brief (WHOQOL-HIV BREF) questionnaire and demographic checklist. The Cronbach's alpha reliability coefficient varied from 0.70 to 0.83 for the five subscales of WHOQOL-HIV BREF questionnaire. The result showed that out of 364 patients, 38.19% were women. There was a positive correlation between LS and QOL in patients with HIV/AIDS in Kermanshah (p < .001), and LS was associated with the QOL. Furthermore, the results indicated that LS and QOL in patients with HIV/AIDS were at low levels.

Seroprevalence and Related Risk Behaviors of Hepatitis C, Hepatitis B and HIV Infections among Male Prisoners in Kermanshah, Iran.

Blood-borne infections are life-threatening challenges among prisoners. The aim of this study was to determine the prevalence of these infections and related risk behaviors among male prisoners. This cross-sectional study was performed on 1,034 voluntarily enrolled male prisoners in several prisons of Kermanshah province, Iran. All participants completed a questionnaire and were interviewed by an expert. To test the presence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections, 5-mL samples of blood were collected from all participants. Multivariable logistic regression was used to assess the association of HBV, HCV and HIV infections with the related risk factors. Totally, 1034 male prisoners participated in the current study. The mean age of subjects was 35.52 ± 8.12 years, with a range of 19-64 years. The prevalence rates of HBsAg+, HCVAb+, and HIVAb+ in male prisoners were 1.25% (95% CI: 0.67-2.14), 22.2% (95% CI: 19.7-24.2), and 3.09% (95% CI: 2.1- 4.3), respectively. Backward logistic regression analysis demonstrated a marked association between history of intravenous drug use and HBsAg+. There was also a positive association between HCVAb+ and age, region, age at the time of first substance use, and history of intravenous drug use and camp residency, as well as heterosexual relationships. HIV infection was also significantly associated with history of intravenous drug use and homosexual relationships. Although HBV infection was shown to be lower in Kermanshah than other parts of the country, a higher prevalence was found for HCV and HIV infections in this province.

Spatio-Temporal Study of Gastric Cancer Incidence in Kermanshah Province, Iran During the Years 2009-2014

Background and objective: Stomach cancer is the second common and the most deadly type of cancer in Iranian populations. The pattern of this cancer varies in different populations; demonstrating association with environmental, racial, and geographical factors. The focus of this study was to identify the clustering and the high-risk and low-risk regions for stomach cancer by using spatio-temporal analysis in Kermanshah province during 2009-2014. Method: All new cases of stomach cancer were studied by census method in 2009 to end 2014 in Kermanshah province. The required information and statistics (address, age, and sex) of patients were extracted from the cancer registry system of Vice-Chancellor in health affairs, Kermanshah University of Medical Sciences. Also, with having the location, diagnosis time, and counting information of all age groups of stomach cancer patients, the spatially and temporally abnormal places of clustering were identified with the use of saTScan and GIS. Results: the total number of stomach cancer subjects during the period of study was 1040, with a mean age of 66.5± 1. in addition, 11 regions (located in 1st, 2nd, and 3rd municipal districts) demonstrated abnormal Spatio-temporal pattern of stomach cancer incidence (hot spots) and clustered disease, with 5 regions (in 4th and 5th districts) representing lower chance of clustering (cold spots, p value˂0.05). Conclusion: Given the growing rate of stomach cancer incidence in specific geographical areas and, its high potential of mortality, and the possible relationship with environmental variables (e.g. climate variables); the efforts need to be focused on the identification of hot/cold spots, the predisposing factors, and the possible clusters in the affected areas.

Cutaneous leishmaniasis in Qasr-e Shirin, a border area in the west of Iran.

AIM: The prevalence of cutaneous leishmaniasis (CL) is growing in Iran, and new sources of the disease have been found in the country. The purpose of this study was to describe the epidemiology of CL in Qasr-e Shirin County, Kermanshah Province, West of Iran. Qasr-e Shirin is located near the Iran-Iraq border, and several million pilgrims pass through this area to Iraq every year. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out for active case detection from April 1, 2014, to March 31, 2015. All individuals with suspicious lesions were identified through house-to-house visits in the aforementioned area. A questionnaire was filled out for everyone with clinical suspicion of CL. A diagnosis was made based on parasitological examination of the lesion exudate. The annual incidence and prevalence of CL were estimated. RESULTS: In total, 5277 individuals were randomly screened for the presence of active lesions or scars suspected of CL. The overall prevalence of CL in the County was 4.8% (60 cases had active lesions and 194 cases had scars). All age groups were affected, but the highest incidence of CL was seen in the age group 20-29 years (1.9%). The incidence and prevalence were higher in women than men (5.5% vs. 4%). Most cases (45.6%) had a single lesion or scar and 44 (17.4%) patients had five or more lesions or scars. CONCLUSION: The incidence of CL in Qasr-e Shirin County is high. There is a need for further studies on reservoirs and vectors of leishmaniasis in this area. The results of such studies help to perform more efficient and timely spraying against phlebotomine sandfly or detect and decrease the animal reservoir population.

The Association of Age and Gender with Risk Factors of Noncommunicable Diseases among Employees in West of Iran.

BACKGROUND: The relationships that age and gender share with risk factors (RFs) of noncommunicable diseases (NCDs) were assessed among a large-scale employ in Western Iran. METHODS: In this epidemiologic cross-sectional study, 7129 employees from Kermanshah Province were assessed using a census method in 2012. Data on RFs of NCD were collected using a standard questionnaire. Demographic information, diet, physical activity, tobacco use, and history of hypertension, history of diabetes, cardiovascular diseases, osteoporosis, and cancer were studied. RESULTS: The proportion of ≥5 servings of fruits and vegetables consumption per day was lower in higher ages (P = 0.001), and this proportion was greater in females than males (72.1% vs. 47.8%; P < 0.0001). Tobacco use was more in higher ages and was higher among males than females (13.3% vs. 0.6%; P < 0.0001). Overweight and obesity prevalence increased in higher ages and was more prominent among males than females (67.8% vs. 55.3%; P < 0.0001). Overall, the prevalence of having 3-5 RFs was greater among those with ≥55 years and among males than females (20.4% vs. 6.6%; P < 0.0001). CONCLUSIONS: The prevalence of major RFs of NCDs was greater among older persons and male participants. More preventive programs such as health education on employees of Kermanshah are recommended.

Tobacco Use and its Relationship with Health Complaints Among Employees of Kermanshah Province, Iran.

BACKGROUND: Identifying the pattern of tobacco use and its related factors in employees is crucial. This study aimed to investigate the pattern of tobacco use and its related factors in employees of Kermanshah Province, Iran. METHODS: In 2012, 7129 employees were investigated in a cross-sectional study using the census method. Data on tobacco use and on several chronic diseases obtained using a standardized questionnaire on noncommunicable diseases risk factors of the World Health Organization through face-to-face interviews. Statistical analysis was performed based on the Chi-square test and multivariate logistic regression. RESULTS: In general, the prevalence of tobacco use, smoking cigarettes, and smoking waterpipe was 9.9%, 8.9%, and 1.2% among the employees, respectively. Tobacco use was significantly higher in the age group over 40 (14.0%), in male gender (13.3%), in married individuals (10.8%) and in those with diploma and lower degree (16.4%), (P < 0.001). At the individual level, the odds ratio of tobacco use was 1.5 (95% confidence interval [CI]: 1.2-1.8) in hypertensive, 1.8 (95% CI: 1.2-2.6) in diabetic employees and 1.7 (95% CI: 1.3-2.3) in those with heart diseases, compared to healthy individuals. After adjusting for age, gender, marital status and educational level, there was not any significant relationship between tobacco use and health complaints and only the demographic variables remained significant. CONCLUSIONS: Preventive public health policies are mandatory especially in younger ages and male employees to promote their knowledge on disadvantages of tobacco use.

Trend of cutaneous leishmaniasis in kermanshah province, west of iran from 1990 to 2012.

BACKGROUND: This study was conducted to explain the trend of Cutaneous Leishmaniasis (CL) in Kermanshah Province, western Iran from 1991-2012. METHODS: In this analytical-descriptive study, all of the patients suspected to CL in Kermanshah Province were studied. Smears were prepared from most of them, stained with Giemsa, and examined microscopically for Leishman bodies. A few of the patients were diagnosed according to physician diagnosis and response to glucantime. Questionnaires were completed for all of them. Collected data were analyzed using SPSS-21 and Spearman and Kendall tests. RESULTS: From 1991 to 2012, 1684 cases of CL were recorded. In the years 2011-12 the frequency of CL in the province reached to 7.4/100,000, which showed a remarkable increase in the frequency of new cases CL in the province. In the years 2011-12 about 47% of total cases of CL in the province, was seen in Ghasr-e-Shirin district,which the frequency of CL in this district reached to 264.5/100,000. Frequency of CL in males and females was 57% and 43% respectively. The most cases of CL were seen in housewives (32.1%) and age groups of 20 to 29 years old (19.9%). In addition, the most cases of disease were seen in winter (41.8%) and fall (28.9%). CONCLUSION: CL is increasing remarkably in warm climates of the province, and Ghasr-e-Shirin must be of particular interest, as the most infected district in the province.

Spatiotemporal Distribution of Gastrointestinal Tract Cancer through GIS over 2007-2012 in Kermanshah-Iran.

BACKGROUND: Cancer is one of the common causes of disability and mortality in the world. The present study aimed to define the spatiotemporal distribution of gastrointestinal tract cancers using a geographic information system (GIS) over the time period of 2007-2012 in Kermanshah-Iran. MATERIALS AND METHODS: The method of studying was descriptive-analytical as well as comparative with gastrointestinal tract cancer patients based in the City of Kermanshah over the time period covered. For data analysis, the GIS and SPSS 16.0 were applied. RESULTS: According to the pathological reports within the space of 5 years, 283 cases of gastrointestinal tract cancer (157 in males, 156 in females) were reported. The performed tests in terms of spatial distribution in the environment of GIS indicated that the disease demonstrated a clustered pattern in the City of Kermanshah. More to the point, some loci of this disease have emerged in the City of Kermanshah that in the first level, 6 neighborhoods with 29-59 cases of this disease per square kilometer and in the second level, 15-29 cases. CONCLUSIONS: Gastrointestinal tract cancer demonstrated an ascending trend within the space of 5 years of research and the spatiotemporal distribution of cancer featured a concentrated and clustered pattern in the City of Kermanshah.