Iranian Journal of Public Health
Year:2015 | Volume:44 | Issue:1|Papers Count:24

This systematic review intended to combine factors associated with tuberculosis treatment non-adherence and lost to follow up among TB patients with/without HIV in developing countries. Comprehensive remote electronic databases (MEDLINE, (PMC, Pub Med Central), Google scholar and Web of science) search was conducted using the following keywords: Tuberculosis, treatment, compliance, adherence, default, behavioural factors and socioeconomic factors. All types of studies intended to assess TB treatment non-adherence and lost to follow up in developing countries among adult TB patient from 2008 to data extraction date were included. Twenty-six original and one-reviewed articles, which meet inclusion criteria, were reviewed. TB treatment non-adherence and lost to follow up were continued across developing countries. The main factors associated with TB treatment non-adherence and lost to follow up were socioeconomic factors: lack of transportation cost, lack of social support, and patients-health care worker poor communication. Behavioural factors were Feeling better after few weeks of treatments, tobacco and alcohol use, knowledge deficit about duration of treatment and consequences of non-adherence and lost to follow up. TB treatment non-adherence and lost to follow up were continued across developing countries throughout the publication years of reviewed articles. Numerous, socioeconomic and behavioural factors were influencing TB treatment adherence and lost to follow up. Therefore, well understanding and minimizing of the effect of these associated factors is very important to enhance treatment adherence and follow up completion in developing countries.

Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985- 2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation.

Religion is one of the protective factors that facilities positive outcomes by preventing individuals from engaging in addictive substance. A recent study has confirmed that religion inhibits drug addiction. The concept of psycho-spiritual therapy was to introduce drug addiction. Therefore, of the various methods of psychotherapy, the usage of Taqwa (piety) emerged as an applicable method of Islamic spiritual therapy. This study was conducted in Malaysia as a Muslim country and focuses on Islamic recommendations and its relation to spiritual therapy.

Background: The aim of the study was to estimate the short-run and long-run effects of unemployment rate on health outcomes of Chinese population, which is under studied before.Methods: The Chinese aggregate data was analyzed (provincial data from 1990-2011). The fixed effect model and infinite distributed lag model (IDL) were applied to analyze the data. It aimed to estimate the short-run and long-run association between unemployment rate and health status of population in China. The mortality was applied as an indicator for health outcomes of entire population.Results: In the short run, when the unemployment rate was decreased by 1%, mortality will be reduced by approximately 4% (P<0.01). In the long-run, mortality will be increased by 6.8% with increased unemployment rate of 1% (P<0.05).|Conclusion: The result in China demonstrated that the unemployment rate was positively associated with mortality. The result also showed that the increased unemployment rate has been harmful to health outcomes of population. It will be significant to reduce the unemployment rate for improving potential public health benefits in developing countries like China.

Background: No studies have been reported on children obesity prevalence of Guangzhou, one of the most urbanized areas in China. This study tracks the secular trends of obesity prevalence of children.Methods: The data were derived from the surveys on students’ constitution and health carried out by government. Randomly, 3832 students in 2007, 13141 in 2008, 14052 in 2009, 13750 in 2010, and 15225 in 2011, aged 7-12 years, from urban primary school were examined. Anthropometric parameters were measured in all students.Results: The mean of body mass index increased significantly from 16.6 in 2008 to 16.8 in 2011 in the total group of children, and the total prevalence of overweight and obesity increased from 9.4 and 6.2 to 10.5 and 7.5 from 2007 to 2011, respectively. The minimum value of the mean body mass index and the overweight and obesity prevalence in the total age group all appeared in 2008. The prevalence of overweight and obesity in males was significantly higher than that in females in each year among the 5 years.Conclusion: Although the prevalence of children obesity in Guangzhou in 2011 is still lower than the average values of Chinese large coastal cities, a significant increase was found in their prevalence from 2007 to 2011 and the total obesity prevalence of children is even higher than that of adolescent. Furthermore, we found that the minimum value of overweight and obesity prevalence of the total group and almost all gender-specific age groups appeared in 2008.

Background: This study examined the factors that affect loneliness of older people and their relationship with quality of life.Methods: Data in this cross-sectional study were collected through survey form, UCLA Loneliness Scale and Quality of Life (QOL) Short Form (SF-36) Scale. The total number of elderly people over the age of 65 yr from whom the study population was chosen was 4, 170.The study population was determined as 190 with G-power program by taking impact size 0.362, a=0.05, power (1-b) =0.80 at a confidence level of 95% and a substitute group composing of 10 individuals was added. In total, 83.2% (n=174) of the target population was reached via Multi-Stage Sampling Methods.Results: UCLA Loneliness median score of the participants was 33 (25thp=27, 75thp=40). It was found that the existence of chronic diseases and physical handicaps, regular use of medication, lack of hobbies and living with spouse increased loneliness (P<0.05). A negative relationship was identified between all sub-scales in the QOL scale and lone liness.Conclusion: Loneliness negatively affects QOL in old age and that the existence of chronic health problems and lack of hobbies are strong predictors for loneliness. Elderly people living alone must be evaluated as a high-risk group and thus policy makers and health personnel should be aware of the factors that can affect loneliness. In order to increase life quality of the aged population and psychological well-being of the elderly, social support systems must be taken into account and the elderly should be encouraged to participate in social activities.

Background: Visceral leishmaniasis (VL) remains an important public health problem in China. It is essential to elucidate the current epidemiological characteristics of VL for designing control policy.Methods: The data were obtained from China Disease Prevention and Control Information System from 2004 to 2012. Characteristics by major variables, such as age, gender, season and geography were analyzed using SPSS13.0.Results: The incidence of VL in China remained at a lower level in recent years. The outbreak appeared in xinjiang kashgar region in 2008. A total of 3337 VL cases were reported in China from 2004 to 2012, 97.03% of cases were concentrated in Xinjiang, Gansu and Sichuan provinces. The cases under 5 year-old accounted for 59.21%. concentrated in 3~5 months each year and annual December to January of next year The ratio of males to females was 1.67: 1 (2088: 1249). The lag time between symptom onset and diagnosis of VL appeared a marked decrease after 2008, and were shorter in endemic provinces of Xinjiang, Gansu and Sichuan than non-endemic provinces. The case fatality rate was 2.99% (10/3337) during the study period.Conclusion: The reported cases of VL were concentrated in Xinjiang, Gansu, Sichuan provinces in China, 2004-2012. The onset was given priority to children. The lag time between symptom onset and diagnosis of VL were difference among years and provinces. Therefore, prevention and control measures should be focused on improving awareness and capacities of diagnosis and treatment, targeting high-risk people in high-risk areas.

Background: In the case of the elderly who highly depend on family, serious health problems can be caused due to the reduction of family meals. Therefore, this study aims to suggest the fundamental data for management of cardio-vascular disease, one of the major causes of death in elderly Koreans, by investigating the effects of family meal frequency on the risk factors for cardiovascular disease in Korean elderly males and females.Methods: The raw data of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES III) were utilized. Data of 1, 236 respondents were extracted for analysis regarding anthropometry, blood, blood pressure, nutrients and total energy intake. For collected data, using SPSS 18.0 and Amos 18.0, the mean and standard deviation, and the path coefficient between groups through a multi-group analysis by structural equation model were checked Results: As family meal frequency increased, triglyceride and fasting blood glucose in Korean elderly males were likely to decrease, which led to conflicting results with those of Korean elderly females.Conclusion: Frequent family meal makes a positive effect on reducing several risk factors for cardiovascular disease in Korean elderly.

Background: In recent years, natural disasters and the accompanying health risks have become more frequent, and rehabilitation work has become an important part of government performance. On one hand, social networks play an important role in participants’ therapeutic community participation and physical & mental recovery. On the other hand, therapeutic communities with widespread participation can also contribute to community recovery after disaster.Methods: This paper described a field study in an earthquake-stricken area of Ya’an. A set of 3-stage follow-up data was obtained concerning with the villagers’ participation in therapeutic community, social network status, demographic background, and other factors. The Hierarchical linear Model (HLM) method was used to investigate the determinants of social network on therapeutic community participation.Results: First, social networks have significantly impacts on the annual changes of therapeutic community participation. Second, there were obvious differences in education between groups mobilized by the self-organization and local government. However, they all exerted the mobilization force through the acquaintance networks. Third, local cadre networks of villagers could negatively influence the activities of self-organized therapeutic community, while with positively influence in government-organized therapeutic activities.Conclusion: This paper suggests that relevant government departments need to focus more on the reconstruction and cultivation of villagers’ social network and social capital in the process of post-disaster recovery. These findings contribute to better understandings of how social networks influence therapeutic community participation, and what role local government can play in post-disaster recovery and public health improvement after natural disasters.

Background: Informal payments to health care providers have been reported in many African, Asian and European countries. This study aimed to investigate different aspects of these payments that are also known as under-the-table payments in Iran.Methods: This is an in-depth interview-based qualitative study conducted on 12 purposively chosen clinical specialists. The interviewees answered 9 questions including the ones about, definitions of informal payments, the special-ties and hospitals mostly involved with the problem, how they are paid, factors involved, motivation of patients for the payments, impact of the payments on the health care system and physician-patient relationship and the ways to face up with the problem. The findings of the study were analyzed using qualitative content analysis method.Results: Six topics were extracted from the interviews including definitions, commonness, varieties, motivations, outcomes and preventive measures. It was revealed that under-the-table payments are the money taken (either in private or public portions) from patients in addition to what formally is determined. This problem is mostly seen in surgical services and the most important reason for it is unrealistic tariffs.Conclusion: Regarding the soaring commonness of informal payments rooted in underpayments of health expenditures in some specialties, which deeply affect the poor, the government has to boost the capitation and to invest on health sectors through supporting the health insurance companies and actualizing the health care costs in accord with the real price of the health care delivered.

Background: Detection of Plasmodium vivax specific antibodies with serological tests could be a valuable tool for epidemiological researches. Whereas P. vivax cannot be simply obtained in vitro, serological tests using total or semi-purified antigens are infrequently used. Given this restriction, the present study investigated whether recombinant P. vivax merozoite surface protein 1 (PvMSP-1 42 kDa) could be useful in detection of antibodies from the serums of a P. vivax infected person using serological tests.Methods: Parasite DNA was extracted from blood sample of an Iranian P. vivax-infected patient. The region of PvMSP-142 kDa was amplified by PCR then cloned into pTZ57R/T vector and sequenced. The insert was sub cloned into pGEX 6P1 expression vector. Afterwards, it was transformed into E. coli BL21 and cultured massively. Sub cloning of gene was confirmed by PCR and enzyme digestion and sequencing finally. Production of recombinant protein was confirmed by SDS-PAGE. Western blot was performed by human sera to appraisal binding ability to the IgG antibodies of P. vivax infected patients. Recombinant protein was purified and estimated by Bradford assay.Results: The specialty values of the Western blot determined with 10 sera from naturally infected individuals, 10 sera from healthy individuals and 7 sera from individuals with other infectious diseases.Conclusion: For the Iranian population, using a Western blot assay for MSP-142 recombinant protein can be used as the foundation for promotion of serological assay for the detection of P. vivax malaria such as ELISA.

Background: Hookah smoking is growing in popularity especially among women but little is known about the determinants influencing on hookah smoking initiation. In order to address this emerging health risk, a qualitative study was conducted to explore the factors that contribute in the first hookah smoking trial by women.Methods: This qualitative study was conducted during 2012 to 2013 in Tehran, Iran. Participants were recruited to represent diversity in smoking status, ethnicity, age groups and residence. Data was collected through in-depth individual interviews and was analyzed through content analysis.Results: Four main themes were identified from the qualitative data including: Positive attitude toward hookah smoking; Social and family facilitators; Psychosocial needs and gaps and Sensory characteristic of hookah.Conclusion: From this study, a variety of factors which contribute to the initiation of hookah smoking among women have been identified. Since one of the major causes of increased hookah smoking may be its ordinary use, all factors causing the ordinary use should be eliminated, and efforts should be made in opposition to hookah smoking promotions.

Background: Health care management in disasters is one of the main parts of disaster management. Health in disasters is affected by performance of various sectors, and has an interactive impact on various aspects of disaster management. The aim of this study was to identify the most important themes affecting the healthcare management in disaster.Method: In this qualitative study with a content analysis approach, in-depth interviews in two steps with 30 disaster experts and managers were conducted to collect the data.Results: Eleven themes affecting healthcare management in disasters were identified. These themes were related to human resources management, resources management, victims' management transfer, environmental hygiene monitoring, nutrition management, mental health control, inter-agency coordination, training, technology management, information and communication management, and budget management.Conclusion: Providing effective health care service in disasters requires a comprehensive look at the various aspects of disaster management. Effective factors on the success of healthcare in disaster are not limited to the scope of healthcare. There should be a close relationship and interaction between different sectors of disaster management.

Background: Prioritizing women’s health helps achievement of the 4th and 5th goals of Millennium Development Program. This study aimed to investigate association between social determinants of health and women's health of reproductive age.Methods: This population-based cross-sectional study, using multi-stage sampling procedure was conducted on 770, 15 to 49-year-old women residing in any one of the 22 municipality zones across Tehran, Iran. Eligible women were interviewed at home with SF-36 (Short Form Health Survey) and socio-demographic questionnaires. Social determinants of health contains; ethnicity, education, job, income, and crowding index. Data were analyzed by ANOVA and Multiple Linear Regression using SPSS-16.The threshold of P.V was considered 0.05.Results: Overall, 770 women with mean age 33.9±9.3 years were interviewed. Majority of them were married (72.27%), housewives (62.2%), of Persian ethnicity (64.3%), and educated to high school level (43.8%). Age with dimensions of health except role emotional, mental health, and social functioning had significant association with B from -0.65 to -0.16.educational level with dimensions of health except role emotional and social functioning had significant association with B from 3.61 to 6.43 (P<0.05). Income with dimensions of health except role physical had significant association with B from -9.97 to -4.42.Conclusion: Reflection of unfavorable economic conditions and low education level on negative women’ health experiences are alarming. Interaction between social determinants of health and health status must be considered in policymaking, and there is a need for policies that would enhance health of women in the low education and income brackets.

Echinococcus infection typically affects liver and lungs while rarely occur through heart. Cardiac hydatidosis can be fatal or lead to major complications if it is not treated. The majority of patients with cardiac hydatid cysts complain from cardiac problems as their first presentation. However, this article reports an unusual case suffers from an interventricular hydatid cyst presented by abdominal pain on 2013. After the patient transferred to Tehran Heart Center, surgical cyst excision with removing germinal layer and concurrent albendazole therapy was prescribed for the management of this Iranian 15 year old female.

Dear Editor-in-Chief: Age of puberty onset is considered to be of general public health relevance. A downward secular trend in age of puberty onset has now been repeatedly reported in both developed (1) and developing countries (2). Early puberty onset has been suggested to be a risk factor for a series of diseases in later life, including hormone-related cancer, type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease and all-cause mortality.

Dear Editor-in-Chief: Healthy infants have better chances of survival and prospects of appropriate physical and psycho-logical development. Birth weight is globally used as an indicator of neonate’s health status. According to World Health Organization, newborns with less than 2.5 kg are considered as having low birth weight (1). Empirical research reveals that maternal factors significantly determine the situation of infant’s health during and after gestation. Pakistan ranks second among the countries with high percentage of low birth weights (2). Nevertheless, determinants of low birth weight are rarely studied in Pakistan.

Dear Editor-in-Chief: Fruits along with vegetables are major contributors to our daily vitamin requirements. Both, fruits and vegetables are very important for health be-cause the nutrient contribution is dependent on the amount of vitamins present in these, as well as the amount consumed (1). Vitamin C or ascorbic acid (hereafter AA) is a water-soluble vitamin, which has an important role in all processes of oxidoreductions by neutralizing the free radicals that are harmful to the body (3). Rose hip fruits are known as medicines since prehistoric times and ascorbic acid is concentrated in the rose hip flesh. Rose hip fruit is used mainly in the support therapies in the cases of AA deficiency (1). More than, rose hip tea is responsible for the antioxidant activity because the high content of vitamin C and flavonoids (4).

Dear Editor in Chief: Community midwife is a character in the community who assists the mother during childbirth and primary maternity care (1). In public health, mid-wife is playing a positive role, promotes health care system for mother and child, and brings the good change in the maternal health conditions and newborn baby (2). Community midwife have a multipurpose role in maternal health, public health. In all these process, communication is very important. Empirical evidence shows that relationship between infant and primary health care taker has significant impact on maternal health and baby health (3). The role of a midwife also includes working independently to promote nor-mal birth, identifying deviations from the normal, carrying out emergency processes when compulsory, providing counselling and education for the woman and her family throughout pregnancy and childbirth, and promoting health in the wider community (4). Midwife and maternal health has a strong relationship, which is a positive sign. Community midwife needs in community respect because she is very responsive. With encouragement and support, she can perform health-relating services efficiently and smoothly.

Dear Editor in Chief: Plantago L. genus (Plantaginaceae) includes a large number of species differing in salt tolerance; many of them are adapted to live in saline environments, thus making the genus Plantago a good model for comparative studies about responses to salinity stress (1). Plantago genus includes species well-known as medicinal plants and others can be used for food and animal feeding (P. coronopus, P. lanceolata, P. serraria). A large amount of data about the Plantago species usage refers to the leaves both in traditional and modern medicine. Extensive use of many Plantago species based on a remarkable variety of curative properties: astringent, antioxidant, anti-fungal, anti-cancer, antibacterial, spasmolytic, antiviral, antihyperlipidemic, immunostimulant, antitoxic, epithelising, pro-coagulant, anthelmintic etc (2). The seeds of several Plantago species are used as laxative, due to their emollient and diuretic properties. On the other hands, the seeds mucilage is an excellent thickening agent used in cosmetics but also as a stabilizer in the ice-cream industry or chocolate products (3). In addition, some Plantago species are also included in the diet being used as fresh salads, soups or side dish as well as herbal tea (4).

Dear Editor- in-Chief: The conflict in North Darfur State, western Sudan, started in 2003. With the country’s limited re-sources, the conflict led to difficulties in the delivery of curative health services. This conflict affected 1.6 million people, 81% of the population of North Darfur State, with 37% classified as Internally Displaced Persons (IDPs) (1). Eighty per-cent of the people in rural areas and 47% in urban areas have to live on less than US$1 per day. The number of outbreaks of disease among the people is very high (2). Because the capacity of government in North Darfur State is limited, the NGOs provide 52.9% of the health budget and nearly 60% of health personnel. In this study, a total 60 interviewees participated; 15 of the participants were expatriates working for international NGOs and 45 were health professionals and administrations working in the health sector. The result shows that the government has become increasingly dependent on the services of NGOs, which provide 70% of curative health services, yet the government is suspicious of NGO’s motives (3). More recently, the independence of South Sudan in July 2011 has led to continuing border issues and disputes over oil revenue. This has resulted in the further weakening of the public health system; thus making the communities even more reliant on services provided by NGOs.

Dear Editor-in-Chief: The extrapolation of stress concept in the field of medicine is of great interest nowadays. In correlation with stress, anxiety often lies at the basis of the decisions to avoid an orthodontic treatment, delay the beginning of it or the scheduled visit to a consultation. The perception of the severity of a malocclusion varies according to the degree of physiognomic damage and according to the personal variables. Social anxiety, fear of being rejected by peers, conflicts with adults - parents, teachers - may occur both before and after applying the orthodontic appliance. The presence of a physical anomaly, especially when it affects patients’ facial appearance, has psychological and social consequences, being in most cases a major source of stress for patients and their family.

crucial to those involved in healthcare education, practice and of course, to patients. Yet, responses to these questions are elusive (1-3). While we could say that the bad practitioner is one who practices badly, for example, one who fails in relation to specific competencies, the opposite does not seem to be entirely true (4-6). To achieve this objective, we interviewed Iranian patients through open-ended questions and examined their depictions of a ’good physician’. Whether physicians agree with the criteria defined by people or not is another issue that has also been addressed in this study. A comparison of physicians and patients’ views of a good physician can prove beneficial in training physicians and defining continuous education pro-grams.

Dear Editor-in-Chief: Despite the widespread use of chemical agents in the field of cardiovascular diseases, today, universal approach is towards natural remedies. Old medical schools are important sources of natural medicines and one of the most impressive ancient scientists is Avicenna (980-1037 AD). Avicenna not only devoted a chapter of Canon to heart dis-eases and their treatment but also wrote a treatise on cardiac drugs. The name of this essay is "Al-Resaleh fi Al-Adviyah Al-ghalbyah" which includes multiple simple cardiotonics such as Rose (Rosa damascena L.) and amla (Emblica officinalis Gaertn.) (1).