RESUMO
We report the effect of a rodent control program on the incidence of zoonotic cutaneous leishmaniasis in an endemic region of Iran. A 1-year interruption in rodent control led to 2 years of increased incidence of zoonotic cutaneous leishmaniasis. Restarting rodent control led to a decline of zoonotic cutaneous leishmaniasis.
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Leishmaniose Cutânea , Zoonoses , Irã (Geográfico)/epidemiologia , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/prevenção & controle , Animais , Zoonoses/epidemiologia , Zoonoses/prevenção & controle , Humanos , Incidência , Controle de Roedores/métodos , Roedores/parasitologia , Reservatórios de Doenças/parasitologia , Reservatórios de Doenças/veterináriaRESUMO
Little is known about using noninvasive samples for diagnosing Crimean-Congo hemorrhagic fever (CCHF). We investigated detection of CCHF virus in serum, saliva, and urine samples. Our results indicate that serum is the best sample type for CCHF diagnosis; saliva can be used for noninvasive sampling.
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Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Saliva , Humanos , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/urina , Febre Hemorrágica da Crimeia/virologia , Febre Hemorrágica da Crimeia/diagnóstico , Febre Hemorrágica da Crimeia/epidemiologia , Saliva/virologia , Irã (Geográfico)/epidemiologia , Masculino , Feminino , Cinética , Adulto , RNA Viral/urina , Pessoa de Meia-IdadeRESUMO
Iran is located along the Central Asian corridor, a natural artery that has served as a cross-continental route since the first anatomically modern human populations migrated out of Africa. We compiled and reanalyzed the HVS-I (hypervariable segment-I) of 3840 mitochondrial DNA (mtDNA) sequences from 19 Iranian populations and from 26 groups from adjacent countries to give a comprehensive review of the maternal genetic variation and investigate the impact of historical events and cultural factors on the maternal genetic structure of modern Iranians. We conclude that Iranians have a high level of genetic diversity. Thirty-six haplogroups were observed in Iran's populations, and most of them belong to widespread West-Eurasian haplogroups, such as H, HV, J, N, T, and U. In contrast, the predominant haplogroups observed in most of the adjacent countries studied here are H, M, D, R, U, and C haplogroups. Using principal component analysis, clustering, and genetic distance-based calculations, we estimated moderate genetic relationships between Iranian and other Eurasian groups. Further, analyses of molecular variance and comparing geographic and genetic structures indicate that mtDNA HVS-I sequence diversity does not exhibit any sharp geographic structure in the country. Barring a few from some culturally distinct and naturally separated minorities, most Iranian populations have a homogenous maternal genetic structure.
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Variação Genética , Genética Populacional , População do Oriente Médio , Humanos , Irã (Geográfico) , DNA Mitocondrial/genética , Haplótipos , FilogeniaRESUMO
INTRODUCTION: Iran, a country in the Middle East, has several ethnic and ethno-religious groups and needs its own ethnic-specific databases for the forensic statistical parameters and allele frequency of STR markers. METHODS: We have investigated 600 unrelated Turk individuals from four northwestern provinces of Iran using the Identifiler™ system (TPOX, FGA, vWA, TH01, CSF1PO, D2S1338, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D19S433, and D21S11). Furthermore, STR allelic frequencies were compared to previously population-based data. RESULTS AND CONCLUSION: After Bonferroni correction, deviation from Hardy-Weinberg equilibrium (HWE) was observed in the FGA, TPOX, VWA, and D19S433 loci (P value < 0.05). The combined power of discrimination (CPD) and exclusion (CPE) values for all 15 STR loci were 0.9999999999999999999984 and 0.9999999, respectively. In comparison with Azerbaijani and Turkish populations, there were no significant differences on all STR markers. However, in the Chinese Han population, differences at 13 STR loci were detected. Additionally, comparisons of Fischer genetic distance indices (FST) P-values did not reveal any statistically significant difference between Northwestern Iran, Azerbaijan and Iran (Fars) populations. PCA and PCoA analyses showed that our population was grouped with different populations in different quarters, showing a positive and negative correlation, respectively. In the NJ and UPGMA phylogenetic trees, Iranian populations were grouped together. These results demonstrated that the given set of STR markers can be confidently used for all identification tests in Northwestern Iran.
Assuntos
Frequência do Gene , Genética Populacional , Repetições de Microssatélites , Humanos , Etnicidade/genética , Marcadores Genéticos , Irã (Geográfico) , População do Oriente Médio/genéticaRESUMO
Vibrio cholerae, as a natural inhabitant of the marine environment is among the world-leading causes of diarrheal diseases. The present study aimed to investigate the genetic relatedness of Iran 2012-2016 V. cholerae outbreaks with 7th pandemic cholera and to further characterize the non-ST69/non-ST75 sequence types strains by whole-genome sequencing (WGS).Twenty V. cholerae isolates related to 2012, 2013, 2015 and 2016 cholera outbreaks were studied by two genotyping methods - Pulsed-field Gel Electrophoresis (PFGE) and Multi-locus Sequence Typing (MLST)-and by antimicrobial susceptibility testing. Seven sequence types (STs) and sixteen pulsotypes were detected. Sequence type 69 was the most abundant ST confirming that most (65%, 13/20) of the studied isolates collected in Iran between 2012 and 2016 belonged to the 7th pandemic clone. All these ST69 isolates (except two) exhibited similar pulsotypes. ST75 was the second most abundant ST. It was identified in 2015 and 2016. ST438, ST178, ST579 and STs of 983 and 984 (as newfound STs) each were only detected in one isolate. All strains collected in 2016 appeared as distinct STs and pulsotypes indicative of probable different originations. All ST69 strains were resistant to nalidixic acid. Moreover, resistance to nalidixic acid, trimethoprim-sulfamethoxazole and tetracycline was only observed in strains of ST69. These properties propose the ST69 as a unique genotype derived from a separate lineage with distinct resistance properties. The circulation of V. cholerae ST69 and its traits in recent years in Iran proposes the 7th pandemic strains as the ongoing causes of cholera outbreaks in this country, although the role of ST75 as the probable upcoming dominant ST should not be ignored.Genomic analysis of non-ST69/non-ST75 strains in this study showed ST579 is the most similar ST type to 7th pandemic sequence types, due to the presence of wild type-El Tor sequences of tcpA and VC-1319, VC-1320, VC-1577, VC-1578 genes (responsible for polymyxin resistance in El Tor biotype), the traits of rstC of RS1 phage in one strain of this ST type and the presence of VPI-1 and VSP-I islands in ST579 and ST178 strains. In silico analysis showed no significant presence of resistance genes/cassettes/plasmids within non-ST69/non-ST75 strains genomes. Overall, these data indicate the higher susceptibility of V. cholerae non-ST69/non-ST75 strains in comparison with more ubiquitous and more circulating ST69 and ST75 strains.In conclusion, the occurrence of small outbreaks and sporadic cholera cases due to V. cholerae ST69 in recent years in Iran shows the 7th pandemic strains as the persistent causes of cholera outbreaks in this country, although the role of ST75 as the second most contributed ST should not be ignored. The occurrence of non-ST69/non-ST75 sequence types with some virulence factors characteristics in border provinces in recent years is noteworthy, and further studies together with surveillance efforts are expected to determine their likely route of transport.
Assuntos
Cólera , Vibrio cholerae , Humanos , Cólera/epidemiologia , Vibrio cholerae/genética , Tipagem de Sequências Multilocus , Irã (Geográfico)/epidemiologia , Ácido Nalidíxico , Pandemias , Surtos de DoençasRESUMO
The hepatitis C virus (HCV) continues to pose a significant public health challenge in Iran, mirroring a worldwide concern. This situation calls for a cohesive strategy that aligns with the World Health Organization's (WHO) goals for HCV elimination by 2030. Central to this strategy is targeting high-risk groups, notably people who inject drugs and prisoners, with prevention, screening and treatment. The deployment of point-of-care testing and treatments in prisons and harm reduction facilities is vital. The adoption of cost-effective generic direct-acting antivirals represents a major step forward. Furthermore, innovative educational initiatives for healthcare providers and awareness campaigns for the public are critical. Additionally, tackling stigma, ensuring treatment affordability and upholding strict surveillance and data management, coupled with ongoing policy reviews, are vital components. This comprehensive and integrated approach is designed to drive Iran towards eliminating HCV and can serve as a blueprint for other countries with similar challenges.
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Erradicação de Doenças , Hepatite C , Humanos , Irã (Geográfico)/epidemiologia , Erradicação de Doenças/métodos , Erradicação de Doenças/organização & administração , Hepatite C/prevenção & controle , Hepatite C/epidemiologia , Antivirais/uso terapêutico , Hepacivirus , Programas de RastreamentoRESUMO
Ticks play an important role in the transmission of parasitic diseases, especially pathogenic protozoa in canine hosts, and it is very important to determine the role and extent of their infection with these pathogens in order to determine important control strategies. This study assessed the molecular prevalence of three protozoan pathogens including Hepatozoon canis, Leishmania spp. and Babesia spp., in ticks using PCR. A total 300 stray dogs were investigated and 691 ticks (171 male, 377 female and 143 nymph) were detected directly from 45 infested dogs. Species, stage of growth, and gender were determined for each tick. DNA extracted from 224 ticks (26 male, 165 female and 33 nymph). The molecular presence of three protozoan pathogens including Hepatozoon spp. (18S rRNA gene), Leishmania infantum (kinetoplastid minicircle DNA) and Babesia spp. (ssrRNA gene) were investigated using PCR method. One species of ticks, Rhipicephalus sanguineus was identified. Two of the target pathogens, Hepatozoon spp. (7/83; 8.43 %) and Babesia spp. (1/83; 1.2 %), were detected by PCR method. Sequence analysis of the ssrRNA gene of detected Babesia spp. showed a close relationship to the deposited strains of Babesia vulpis in the gene bank. To the best of our knowledge, this is the first study to undertake a phylogenetic analysis of H. canis and Babesia spp. in stray dogs in Alborz province, Iran and the first report about molecular detection of Babesia vulpis from tick infesting dogs in Iran. According to the above results, it seems necessary to implement tick control programs in dogs.
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Babesia , Doenças do Cão , Filogenia , RNA Ribossômico 18S , Animais , Cães , Irã (Geográfico)/epidemiologia , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Babesia/genética , Babesia/isolamento & purificação , Babesia/classificação , Feminino , Masculino , RNA Ribossômico 18S/genética , DNA de Protozoário/genética , Reação em Cadeia da Polimerase , Rhipicephalus sanguineus/parasitologia , Carrapatos/parasitologia , Eucoccidiida/genética , Eucoccidiida/isolamento & purificação , Eucoccidiida/classificação , Leishmania infantum/genética , Leishmania infantum/isolamento & purificação , Leishmania infantum/classificação , Infestações por Carrapato/veterinária , Infestações por Carrapato/epidemiologia , Infestações por Carrapato/parasitologia , Leishmania/genética , Leishmania/classificação , Leishmania/isolamento & purificaçãoRESUMO
INTRODUCTION: Toxoplasma gondii (T. gondii) infection in dogs is distributed globally. Given the potential impact of T. gondii on human reproductive health and its zoonotic potential, focusing on infected dogs with breeding disorders may provide valuable new insights into the role of toxoplasmosis on reproductive disorders. This study aimed to elucidate the potential role of T. gondii on reproductive disorders by conducting a serosurvey on a kennel with breeding disorders in Kerman, Iran. MATERIALS AND METHODS: Purebred dogs with American Kennel Club-certified Pedigrees were randomly selected in both genders from a breeding kennel with a history of reproductive problems such as neonatal deaths, abortion stillbirths, and male infertility. Blood samples were collected from selected dogs, and serosurvey was done with a Toxo-Screen kit using the modified agglutination test (MAT). FINDINGS: From 46 selected breeding dogs, 20 (43.5 %) were positive in the Toxoplasma MAT test, consisting of 24 samples (52.17 %) with different reproductive disorders and 22 (47.83 %) healthy dogs. However, the presence of reproductive disorder had no significant relationship with seropositivity (p = 0.067). Seroprevalence of toxoplasmosis had no significant relationship with sex (p = 0.28) and age (p = 0.18) in the studied population. CONCLUSION: Screening with the standard MAT method reduces the risk of transmitting toxoplasmosis by preventing the entry of infected dogs into the kennel, identifying the infected cases to start specific treatments, optimizing the proper nutritional conditions, and ensuring the hygiene of the environment. Fresh/refrigerated raw meat, unpasteurized milk feeding, rodent infestation of grass-covered dog runs, and the main dry food storage facilities were the primary risk factors in kennels.
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Anticorpos Antiprotozoários , Doenças do Cão , Toxoplasma , Toxoplasmose Animal , Animais , Cães , Toxoplasma/imunologia , Toxoplasmose Animal/epidemiologia , Toxoplasmose Animal/parasitologia , Estudos Soroepidemiológicos , Masculino , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Feminino , Anticorpos Antiprotozoários/sangue , Irã (Geográfico)/epidemiologia , Cruzamento , Testes de AglutinaçãoRESUMO
This study aimed to fill a crucial gap in our understanding of Babesia infection in dogs in Mashhad, northeast Iran. We not only investigated the prevalence of Babesia species among dogs but also undertook a comprehensive comparison of clinical, hematological, and clinicopathological findings between infected and non-infected cases, a unique aspect of our research. MATERIALS AND METHODS: Our research was conducted with meticulous attention to detail. We randomly collected blood specimens from a diverse population of 150 dogs, including owned pets (n = 47), stray dogs (n = 66), and shelter dogs (n = 37), to ensure the reliability and representativeness of our findings. We then used microscopy and PCR to investigate Babesia spp. infection and analyzed various biochemical and hematological variables. RESULTS: The overall prevalence of babesiosis was 15.3 % (23/150) by PCR and 2 % (3/150) by microscopy. Upon microscopic examination, two cases of large Babesia and one case of small-sized Babesia were identified. The sequencing results confirmed that the two dogs testing positive for large-sized Babesia species in this study were both infected with B. vogeli, exhibiting 100 % sequence identity. There was no association between infection and gender, while housing status (k = 37.294, p = 0.000) and age (k = 6.897, p = 0.021) significantly related to infection rate. Among laboratory variables, infection with Babesia spp. showed a remarkable association with Hct (k = 4.749, p = 0.025) and RBC count (k = 14.669, p = 0.000), which were significantly lower in infected dogs compared to non-infected dogs (p < 0.05). Aside from severe non-regenerative anemia observed in all three clinically infected cases, the most clinicopathological changes were observed in one B. vogeli-infected dog, including pancytopenia, azotemia, hyperphosphatemia, hyperkalemia, hypoglycemia, hypocholesterolemia, hyponatremia. CONCLUSION: This study reveals a higher-than-expected prevalence of canine babesiosis in Northeastern Iran, necessitating further investigation of tick vectors and Babesia spp. distribution. Notably, many infected dogs were asymptomatic, raising concerns about silent spread via carriers. Moreover, the high prevalence of infection in shelters highlights the need for more effective control strategies in these centers.
Assuntos
Babesia , Babesiose , Doenças do Cão , Animais , Cães , Irã (Geográfico)/epidemiologia , Babesia/genética , Babesia/isolamento & purificação , Babesia/classificação , Babesiose/epidemiologia , Babesiose/parasitologia , Doenças do Cão/parasitologia , Doenças do Cão/epidemiologia , Masculino , Feminino , Prevalência , Reação em Cadeia da Polimerase , DNA de Protozoário/genética , MicroscopiaRESUMO
We aimed to examine the relationship between body image and the meaning of life among women with breast cancer. The analytic sample included 142 women with breast cancer, and data were collected using a standardized questionnaire through face-to-face interviews. We used Kolmogorov-Smirnov test, Pearson test, Spearman and Mann-Whitney U test to determine the relationship between the research variables. We found an association between the mean score of body image and the mean score of the meaning of life. As the average score of body image increases, the score of the meaning of life increases (p < 0.05). Findings indicated that the body image score increases by increasing the score of the meaning of life and its dimensions, especially existential vacuum and acceptance of death. Future research and targeted treatments should consider the role of body image in shaping the meaning of life among women with breast cancer.
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Imagem Corporal , Neoplasias da Mama , Qualidade de Vida , Humanos , Feminino , Imagem Corporal/psicologia , Neoplasias da Mama/psicologia , Irã (Geográfico) , Pessoa de Meia-Idade , Adulto , Inquéritos e Questionários , IdosoRESUMO
BACKGROUND: Results from studies investigating the association between ultra-processed foods (UPFs) and breast cancer are scarce and, in some cases, contradictory. Therefore, we aimed to evaluate the association between the intake of processed foods (PFs) and UPFs with the risk of breast cancer in Iranian women. METHODS: The present case (n = 133) - control (n = 266) study was carried out at two general hospitals in Tehran, Iran. A 168-item semi-quantitative food frequency questionnaire was used to assess the participants' dietary intake. Also, the NOVA classification was used to identify PFs and UPFs. The association between PFs and UPFs with the odds of breast cancer was analyzed using logistic regression models. RESULTS: According to Model 1 of conditional logistic regression, the odds of breast cancer were higher in the last tertile of UPFs than in the first tertile (odds ratio (OR) = 1.930; 95% confidence interval (CI): 1.080-3.449). In Model 2, no significant association was observed between the second and last tertiles of PFs and UPFs with the odds of breast cancer compared to the reference tertile. Also based on menopause status, the odds of breast cancer increased in the last tertile only among premenopausal women in Model 2 (OR = 3.656; 95% CI: 1.326-10.079). CONCLUSIONS: This study demonstrated that higher consumption of UPFs is associated with higher odds of breast cancer in premenopausal women.
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Neoplasias da Mama , Fast Foods , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Pessoa de Meia-Idade , Irã (Geográfico)/epidemiologia , Adulto , Fast Foods/efeitos adversos , Fatores de Risco , Razão de Chances , Manipulação de Alimentos , Idoso , Dieta/efeitos adversos , Inquéritos e Questionários , Alimento ProcessadoRESUMO
BACKGROUND: Despite the severe impact of COVID-19 on cancer patients, data on COVID-19 outcomes in cancer patients from low- and middle-income countries is limited. We conducted a large study about the mortality rate of COVID-19 in cancer patients in Iran. METHODS: We analyzed data from 1,079 cancer (average age: 58.2 years) and 5,514 non-cancer patients (average age: 57.2 years) who were admitted for COVID-19 in two referral hospitals between March 2019 and August 2021. Patients were followed up until death or 31st August 2021. Multiple logistic regression models estimated the odds ratio (OR) and 95% confidence intervals (CI) of factors associated with ICU admission and intubation. The Cox regression model estimated hazard ratios (HRs) and 95% CI of factors associated with hospital and post-discharge 60-day mortalities. RESULTS: The cancer patients had higher ICU admission (OR = 1.65, 95% CI: 1.42-1.91; P-value 0.03) and intubation (OR = 3.13, 95% CI = 2.63-3.73, P-value < 0.001) than non-cancer patients. Moreover, hospital mortality was significantly higher in cancer patients than in non-cancer patients (HR = 2.12, 95% CI: 1.89-2.41, P-value < 0.001). HR for the post-discharge mortality was higher in these patients (HR = 2.79, 95% CI: 2.49-3.11, < 0.001). The hospital, comorbidities, low oxygen saturation, being on active treatment, and non-solid tumor were significantly associated with ICU admission (P-value < 0.05) in cancer patients, while only low oxygen saturation was associated with intubation. In addition, we found that old age, females, low oxygen saturation level, active treatment, and having a metastatic tumor were associated with death due to COVID-19 (P-value < 0.05). Only lung cancer patients had a significantly higher risk of death compared to other cancer types (HR = 1.50, 95% CI: 1.06-2.10, P-value = 0.02). CONCLUSION: Cancer patients are at a higher risk of ICU admission, intubation, and death due to COVID-19 than non-cancer patients. Therefore, cancer patients who are infected with COVID-19 require intensive care in the hospital and active monitoring after their discharge from the hospital.
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COVID-19 , Mortalidade Hospitalar , Neoplasias , Alta do Paciente , Humanos , COVID-19/mortalidade , COVID-19/complicações , COVID-19/epidemiologia , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Masculino , Feminino , Neoplasias/mortalidade , Neoplasias/complicações , Neoplasias/diagnóstico , Idoso , Alta do Paciente/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Adulto , Hospitalização/estatística & dados numéricos , Fatores de RiscoRESUMO
BACKGROUND: Breast cancer (BC) is the most common cancer in women worldwide. Early diagnosis of BC could considerably improve outcomes. Since health literacy could influence preventive behaviors and women's ability to make decisions about breast care, therefore, this study aimed to explore breast cancer literacy in women. METHODS: This qualitative study was conducted in Iran using the directed content analysis. Data were collected through face-to-face interviews with a purposeful sample of women from April 2021 to June 2022 and continued until saturation was reached. Interviews were analyzed using the initial matrix developed based on the European health literacy framework. RESULTS: In all twelve women were interviewed. During data analysis, 612 primary codes grouped into four dimension of health literacy (access, understanding, appraise, and apply) of three health domain (health care, disease prevention, and health promotion). Many believed that it was difficult to access accurate information about BC. They used various sources to obtain information. The participants addressed some facilitators and barriers in understanding the information and for information appraisal they mentioned seeking help from health professionals. Through the acquired cognitive skills, the participants took some steps to apply BC information. Also, having information about BC and the involvement of relatives with cancer were indicated as triggers for decision-making on breast care, while poor financial conditions, not having enough information, fear, shame, and embarrassment, were pointed out as inhibiting factors. CONCLUSIONS: The findings suggest that barriers in access, and understanding of information on breast cancer exist among women. The findings also suggest that women's decision-making and preventive behaviors on breast care are much dependent on social and cultural factors.
Assuntos
Neoplasias da Mama , Letramento em Saúde , Pesquisa Qualitativa , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Irã (Geográfico)/epidemiologia , Adulto , Pessoa de Meia-Idade , Tocologia , Médicos/psicologia , Confiança , Conhecimentos, Atitudes e Prática em Saúde , Tomada de Decisões , Encaminhamento e ConsultaRESUMO
BACKGROUNDS: Dietary potassium can play an important role in decreasing inflammatory factors as a protective factor for cancers. In this case-control study, we aimed to assess the possible association between dietary potassium intake and the risk of breast cancer (BC) among Iranian adult women. METHODS: The present case-control study was conducted at Shohada and Imam Hossain hospitals, in Tehran. The study included 134 newly diagnosed cases of BC and 267 controls. A validated semi-quantitative 168-item food frequency questionnaire was used to compute the potassium intake. Logistic regression, adjusted for potential confounders, was used to estimate odds ratios(ORs) and 95% confidence intervals(CI) of BC according to tertiles of potassium intake. RESULTS: The mean(M) ± standard deviation(SD) of age and body mass index (BMI) were 47.9 ± 10.3 years and 29.4 ± 5.5 kg/m2, respectively. Also, the M ± SD of potassium intake for the control and case groups was 1616 ± 293 and 1542 ± 338 (mg/1000 Kcal), respectively. In the multivariable-adjusted model for potential confounders, the higher total potassium intake was associated with decreased odds of BC (OR: 0.35, 95%CI: 0.19-0.62, P for trend < 0.001). Moreover, an inverse relationship was observed between potassium from plant sources (OR: 0.39, 95%CI: 0.22-0.69, P for trend = 0.001) and fruit and vegetable sources (OR: 0.49, 95%CI: 0.28-0.87, P for trend = 0.016) and odds of BC. CONCLUSIONS: Our findings suggested that diet rich in potassium may have a predictive role to reduce the odds of BC.
Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Pessoa de Meia-Idade , Estudos de Casos e Controles , Adulto , Irã (Geográfico)/epidemiologia , Potássio na Dieta/administração & dosagem , Fatores de Risco , Razão de Chances , Índice de Massa Corporal , DietaRESUMO
BACKGROUND AND PURPOSE: Radiotherapy (RT) is an essential treatment modality against cancer and becoming even more in demand due to the anticipated increase in cancer incidence. Due to the rapid development of RT technologies amid financial challenges, we aimed to assess the available RT facilities and the issues with achieving health equity based on current equipment compared to the previous reports from Iran. MATERIALS AND METHODS: A survey arranged by the Iran Cancer Institute's Radiation Oncology Research Center (RORC) was sent to all of the country's radiotherapy centers in 2022. Four components were retrieved: the reimbursement type, equipment, human resources, and patient load. To calculate the radiotherapy utilization rate (RUR), the Lancet Commission was used. The findings were compared with the previous national data. RESULTS: Seventy-six active radiotherapy centers with 123 Linear accelerators (LINACs) were identified. The centers have been directed in three ways. 10 (20 LINACs), 36 (50 LINACs), and 30 centers (53 LINACs) were charity-, private-, and public-based, respectively. Four provinces had no centers. There was no active intraoperative radiotherapy machine despite its availability in 4 centers. One orthovoltage X-ray machine was active and 14 brachytherapy devices were treating patients. There were 344, 252, and 419 active radiation oncologists, medical physicists, and radiation therapy technologists, respectively. The ratio of LINAC and radiation oncologists to one million populations was 1.68 and 4.10, respectively. Since 2017, 35±5 radiation oncology residents have been trained each year. CONCLUSION: There has been a notable growth in RT facilities since the previous reports and Iran's situation is currently acceptable among LMICs. However, there is an urgent need to improve the distribution of the RT infrastructure and provide more facilities that can deliver advanced techniques.
Assuntos
Neoplasias , Radioterapia (Especialidade) , Humanos , Irã (Geográfico)/epidemiologia , Neoplasias/epidemiologia , Neoplasias/radioterapia , Aceleradores de Partículas , Inquéritos e Questionários , Radioterapia/métodosRESUMO
BACKGROUND: Cancer is a significant public health concern and the second leading cause of death. This study aims to visualize spatial patterns of top common cancer types and identify high-risk and low-risk counties for these cancers in Iran from 2014 to 2017. METHODS: In this study, we analyzed 482,229 newly diagnosed cancer cases recorded by the Iranian National Population-Based Cancer Registry from 2014 to 2017. We employed a purely spatial scanning model and local Moran I analysis to explore spatial patterns across Iran. RESULTS: Approximately 53% of all cases were male. The average age of cancer diagnosis was 62.58 ± 17.42 years for males and 56.11 ± 17.33years for females. Stomach cancer was the most common cancer in men. The northern and northwestern regions of Iran were identified as high-risk areas for stomach cancer in both genders, with a relative risk (RR) ranging from 1.26 to 2.64 in males and 1.19 to 3.32 in females. These areas recognized as high-risk areas for trachea, bronchus, and lung (TBL) cancer specifically in males (RR:1.15-2.02). Central regions of Iran were identified as high-risk areas for non-melanoma skin cancers in both genders, ranking as the second most common cancer (RR:1.18-5.93 in males and 1.24-5.38 in females). Furthermore, bladder cancer in males (RR:1.32-2.77) and thyroid cancer in females (RR:1.88-3.10) showed concentration in the central part of Iran. Breast cancer, being the most common cancer among women (RR:1.23-5.54), exhibited concentration in the northern regions of the country. Also, northern regions of Iran were identified as high-risk clusters for colon cancer (RR:1.31-3.31 in males and 1.33-4.13 in females), and prostate cancer in males (RR:1.22-2.31). Brain, nervous system cancer, ranked sixth among women (RR:1.26-5.25) in central areas. CONCLUSIONS: The study's revelations on the spatial patterns of common cancer incidence in Iran provide crucial insights into the distribution and trends of these diseases. The identification of high-risk areas equips policymakers with valuable information to tailor targeted screening programs, facilitating early diagnosis and effective disease control strategies.
Assuntos
Neoplasias Pulmonares , Neoplasias da Próstata , Neoplasias Gástricas , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Irã (Geográfico)/epidemiologia , Incidência , Risco , Sistema de RegistrosRESUMO
BACKGROUND: Anopheles stephensi, a malaria-transmitting mosquito species, has developed resistance to various insecticides such as DDT, Dieldrin, Malathion, and synthetic pyrethroids. To combat this issue, the World Health Organization (WHO) suggests using Actellic®300CS and Icon®10CS for Indoor Residual Spraying to tackle pyrethroid-resistant mosquitoes. The aim of this research project was to evaluate the susceptibility of An. stephensi to certain insecticides at the diagnostic concentration + intensity 5x diagnostic concentration (5XDC) assays in Iran and to study the lasting effectiveness of Actellic®300CS and Icon®10CS against this particular malaria vector. METHODS: This study assessed the susceptibility of An. stephensi populations in southern Iran to various insecticides, including deltamethrin 0.05%, DDT 4%, malathion 5%, bendiocarb 0.1%, a synergist assay with PBO 4% combined with deltamethrin 0.05%, and an intensity assay using 5x the diagnostic concentration of deltamethrin (0.25%) and bendiocarb 0.5%. Laboratory cone bioassay tests were conducted to determine the residual effectiveness of Actellic®300 and Icon®10CS insecticides on different surfaces commonly found in households, such as cement, mud, plaster, and wood. The tests were carried out following the WHO test kits and standard testing protocols. RESULTS: The An. stephensi populations in Bandar Abbas were found to be susceptible to malathion 5% and deltamethrin 0.25% (5XDC), but exhibited resistance to DDT, standard concentration of deltamethrin, and both standard and intensity concentrations of bendiocarb. In laboratory cone bioassay tests, An. stephensi mortality rates when exposed to Actellic®300CS and Icon®10CS on different surfaces remained consistently more than 80%. Actellic®300CS achieved more than 80% mortality on all substrates for the entire 300-day post-spraying period. Conversely, Icon®10CS maintained mortality rates more than 80% on plaster and wood surfaces for 165 days and on mud and cement surfaces for 270 days post-spraying. Both Actellic®300CS and Icon®10CS demonstrated 100% mortality within 72 h of each test on all surfaces throughout the entire 300-day post-spraying period. CONCLUSION: The study shows the varying levels of resistance of An. stephensi Bandar Abbas population to different insecticides and demonstrates the consistent performance of Actellic®300CS in controlling these mosquitoes on various surfaces. The findings suggest that long-lasting CS formulations may be more effective for malaria vector control compared to the current options. Further research is needed to validate these findings in field settings and assess the impact of these insecticides on malaria transmission.
Assuntos
Anopheles , Resistência a Inseticidas , Inseticidas , Malária , Controle de Mosquitos , Mosquitos Vetores , Piretrinas , Anopheles/efeitos dos fármacos , Animais , Inseticidas/farmacologia , Controle de Mosquitos/métodos , Mosquitos Vetores/efeitos dos fármacos , Malária/prevenção & controle , Irã (Geográfico) , Piretrinas/farmacologia , Nitrilas/farmacologia , DDT/farmacologia , Malation/farmacologia , Fenilcarbamatos/farmacologiaRESUMO
BACKGROUND: Human papillomavirus (HPV) is responsible for the most common sexually transmitted infection, particularly among sexually active individuals. Understanding the geographical distribution and epidemiology of the most prevalent HPV genotypes is essential for developing effective prevention strategies. Consequently, this study aimed to examine the distribution of HPV genotypes among HPV-positive women and men in Sari, the capital city of Mazandaran province in northern Iran. MATERIALS AND METHODS: HPV DNA was extracted (PZP Company, Molecular IVD, Iran) from genital and cervical samples of the study participants. Genotyping was conducted for 90 cases utilizing the High + Low Papilloma Strip test (Operon Company, Spain). Demographic data were statistically analyzed in correlation with the virological data (STATA version 17). RESULTS: Overall, 67.7% (61 out of 90) of the cases tested positive for HPV, with 75% of those being classified as high-risk. The participant group consisted of 92% females (83) and 8% males (7). The highest HPV prevalence, 75% (36), was observed in females and males aged under 31, with the majority of positive cases belonging to high-risk genotypes. The most frequently identified genotypes were HPV-11 (23%), HPV-6 (21%), HPV-56 (18%), HPV-39 (16%), HPV-16, HPV-91, and HPV-66 each comprising (14%). HPV-56 was the most common high-risk genotype, accounting for 11 cases (18%), followed by HPV-39, which was present in 10 cases (16%). CONCLUSION: The prevalence of HPV infection was particularly high among individuals under the age of 31 for both genders, with men exhibiting a 100% infection rate. These findings emphasize the urgent need for targeted education aimed at the younger population and the implementation of infection control measures. Specifically, widespread HPV vaccination targeting HPV-6, HPV-11, HPV-39, and HPV-56 should be prioritized for the general population.
Assuntos
Genótipo , Papillomaviridae , Infecções por Papillomavirus , Humanos , Irã (Geográfico)/epidemiologia , Feminino , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Masculino , Adulto , Prevalência , Pessoa de Meia-Idade , Adulto Jovem , Papillomaviridae/genética , Papillomaviridae/classificação , Papillomaviridae/isolamento & purificação , Adolescente , DNA Viral/genética , Idoso , Colo do Útero/virologia , Papillomavirus Humano , AlphapapillomavirusRESUMO
PURPOSE: Systemic Lupus Erythematosus (SLE) significantly affects both the quality of life related to health and non-health aspects. This study aims to evaluate the psychometric properties of the Persian version of the Lupus_PRO questionnaire, version 1.7. The questionnaire serves as a specific self-report outcome scale for assessing the treatment outcomes of Lupus disease. METHODS: The Lupus_PRO questionnaire, version 1.7, was translated into Persian using the standard forward-backward method. After being completed by 218 patients with Lupus, the psychometric properties of the instrument were examined. The Convergent and Discriminant Validity of the scale were assessed using Average Variance Extracted and Cross Loadings, respectively. The construct validity of the questionnaire was also evaluated through Confirmatory Factor Analysis (CFA). Cronbach's alpha was calculated to assess the reliability of the questionnaire dimensions. FINDINGS: Out of the 218 patients with lupus who participated in the current study, 13 (6%) were male, and 205 (94%) were female. The mean (SD) age of participants was 40.29 (10.94) years. The Average Variance Extracted (AVE) for HRQOL and Non-HRQOL constructs, except for the Coping and Cognition dimension, was greater than 0.50, indicating satisfactory convergent validity. The interdimensional correlation coefficient (Discriminant Validity) for each dimension with other questionnaire dimensions was less than 0.10, indicating that the questionnaire has good convergent and discriminant validity. Additionally, the results of the Confirmatory Factor Analysis (CFA) indicated that the questionnaire was a suitable fit. In terms of reliability, Cronbach's alpha for the various questionnaire dimensions ranged from 0.51 to 0.91, indicating good internal consistency. CONCLUSION: The Persian version of the Lupus_PRO questionnaire, version 1.7, demonstrates acceptable validity and reliability in the Iranian population. This instrument can effectively measure various aspects of the quality of life in patients with lupus.
Assuntos
Lúpus Eritematoso Sistêmico , Psicometria , Qualidade de Vida , Autorrelato , Humanos , Feminino , Lúpus Eritematoso Sistêmico/psicologia , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Adulto , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Irã (Geográfico) , Inquéritos e Questionários/normas , Análise Fatorial , TraduçõesRESUMO
BACKGROUND: Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships. AIM: This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD. METHODS: A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3. OUTCOMES: Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction. RESULTS: After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01). CLINICAL IMPLICATIONS: This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support. STRENGTHS AND LIMITATIONS: The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners. CONCLUSION: The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.