JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH
Year:2003 | Volume:2 | Issue:3 (7)|Papers Count:10

This cross- sectional study was done to assess the prevalence of chronic cough by age and date of birth (age-period-cohort analysis). Using data from two National Health Surveys in 1991 and 1999 (involving cross-sectional general population samples), we studied all cases of chronic cough recorded during the period of 1991 to 1999 in people aged 2 to 70 years. A birth cohort analysis was performed on the data. Comparison with earlier surveys showed that the prevalence of chronic cough had fallen from 4.5% to 1.8%. Age-period-cohort analyses of the age effect revealed that prevalence rate of chronic cough increased with age but in every age group it actually decreased after the 8-year period. The fact that different trends are observed in cross-sectional and cohort data points to a strong cohort effect. The prevalence of chronic cough is strongly determined by a person's year of birth. Also for any given age group, prevalence rates were lower in younger compared to older cohorts.    

Carpet weaving is a high risk occupation for developing MSDs, as awkward working postures, repetitive movements, contact stress and long working time are common. The objectives of the present study, which was carried out at the Iranian hand-woven carpet industry, were determination of MSDs symptoms prevalence, workstation and working posture assessment, identification of major factors associated with MSDs symptoms in different body regions and developing guidelines for workstation design. In this study, 1439 randomly selected weavers from 9 Iranian provinces have participated. Data on personal details, workshop characteristics and MSDs symptoms was collected by questionnaire. Posture and workstation assessment were performed by observational technique. The results revealed that musculoskeletal symptoms prevalence rates in shoulders (47.8%), lower back (45.2%), wrists (38.2%), upper back (37.7%), neck (35.2%) and knees (34.6%) were high as compared to general Iranian population (for neck, back and large joints p<0.0001). Working postures were found to be deviated form neutral. Lack of proper seat, leg clearance, adjustment mechanisms, together with incorrect weaving height made weavers worked in constrained, harmful postures. The results were subjected to multivariate analyses in order to find the major factors associated with musculoskeletal symptoms. Several such factors were identified for symptoms of each body regions. Identified ergonomic factors were loom type, working posture, daily working time, seat type and type of knots. Based on the results, some general guidelines for weaving workstation design were developed. The prototype test showed that the new workstation was acceptable to subject tests and improved working posture.    

Liver flukes-induced pathological changes in liver parenchyma and biliary passages are so severe that, in some cases, may cause total physiologic dysfunction. The human disease is endemic to some parts of the country, and there were two vast epidemics of the human fascioliasis in Gilan province, northern most part of the country. According to WHO reports, the human disease is prevalent in Gilan, Mazandaran, and Isfahan. However, the aim of the present study was to collect more information about the naturally- infected animal hosts, and to extend the Knowledge to prognosticate the pathologic effects occurring in human cases of liver flukes in endemic parts of the human disease. The present study was carried out in slauther houses of Gilan and Khuzestan province, two most endemic areas of human and animal Distomatosis, respectively, from spring 2002 to summer 2003. A total of 30 infected livers were collected, and were examined both for visible gross and microscopic changes. The results of the present study showed that the pathologic changes varied from mild effects to total biliary obstruction. Most of the present knowledge on pathology of the human disease is based on studies in animal models. To have precise and comprehensive information about the tissue changes in naturally -infected animal may help to describe some unanswered concepts about the pathology of the human distomatosis.      

Across the world, violence against women is a major threat to their physical and mental well-being. This violation of the most fundamental human rights usually takes the form of family or domestic violence. According to global statistics, the rates of death and disability resulting from violence to women of reproductive is comparable to those from cancers and more than those due to car accidents and infectious diseases. Data for this cross-sectional study were collected from women referring to Tehran Forensic Center, with a view to obtaining a realistic picture of violence to women. The women in this study had presented with wounds and injuries inflicted by their husbands. These women had been referred to the Center by family courts to complete legal formalities concerning injury diagnosis and duration of treatment. Data were gathered on 120 subjects randomly selected women who completed questionnaires and interviews. The main factors underlying family violence were examined from five different aspects: behavioral and educational problems (79.2%), financial strain (54.2%), interference by the husband's family (39.2%), sexual problems (13.3%), and differences in culture and social class (10%). However, many women declared that several factors were contributing simultaneously to the problem of violence. Factors found to have an accelerating or interfering role included the woman's age and the couple's education level.      

Primary school students constitute an important demographic category: the fact that they are going through a phase of rapid physical, social and mental growth makes them especially vulnerable to the obnoxious effects of disease and malnutrition. In Iran, one of the major causes of malnutrition and growth deficiency is lack of food. The objective of this study was using anthropometric techniques to assess nutritional status in primary school students at Bandar Abbas. This is a cross-sectional study involving 1300 subjects selected by cluster sampling. Indices used in this study were weight for age (W/A), weight for height (W/H), and height for age (HIA). Malnutrition was defined as an index value more than 2 standard deviations below the standard level. We found wasting (W/H) in 15.7%, stunting (H/A) in 11.7% and underweight (W/A) 21.2% of the subjects, with no significant difference in nutritional status between boys and girls. Prevalence of all three types of malnutrition increased with age and school grade. Students who had received nutrition education showed better nutrition status compared to those without such background education. Measures to control malnutrition can include education, proper recording and follow-up of nutrition and growth data in the form of health files, and nutritional interventions. The latter is particularly relevant in higher age groups and school grades.      

Toxoplasmosis is a zoonosis of broad geographic distribution. This disease is caused by infection with the protozoan parasite Toxoplasma gondii. The most important ways to diagnose the disease are the serological techniques such as IFA and ELISA. The aim of this consideration, was comparison between the two methods, IFA and ELISA, in order to determine the incidence of antibody against Toxoplasma in pregnant women. In this descriptive-cross sectional study, from 600 pregnant woman whom have referred to Alzzahra and Izadi maternity hospitals of Qom, during four months (from Sep.2001 to Jan.2002), the specimen of blood has been prepared. After bloodletting and parting of serum, IFA and ELISA have tested its specimens. From 600 specimens of serum, from the tested mothers by IgG-ELISA method, 257 individuals (%42.8) and by IgG-IFA method, 246 individuals (%41) had Specific IgG antibody. Also, The comparison between the two methods, IFA and ELISA, demonstrates that 246 cases (%41) were positive in both methods, and 343 cases (%57.2) were negative in both methods, and only 11 cases (%1.8) were positive in ELISA and negative in IFA technique. In this study, the effect of different factors has been studied, in which deal with the prevalence rate of Toxoplasma infection. Although, these results shows that transmission of Toxoplasma infection in this city, like other parts of world and Iran has been done, but considerable percent of pregnant women (%57.2 by ELISA method and %59 by IFA method) lacking any type of acquired immunity against of this infection. Therefore, considering secure status and accomplishing exclusive experiments before marriage and also training and informing the people of region especially pregnant women with educational programs and supervision in pregnant period is necessary. On the other hand, with regard to the rate of concordance of the two tests (%98.2), The ELISA because of its high sensitivity and specificity, easier technique and lower expense it is preferred in order to screening Toxoplasma infection.    

To determine the level of knowledge and to assess attitudes and lifestyles in patients with unstable angina. A descriptive study was conducted among CCU patients in Mashad hospitals. 180 subjects were chosen by sequential admission. They filled an 82-item questionnaire covering demographic variables (4 items) -Knowledge (5 items) -attitude (56 items) -lifestyle (17 items). Findings indicate that the global level of knowledge is sufficient on issues such as cardiac risk factors, current treatments, and treatment compliance. The same patients showed very low knowledge of pain-inducing behaviors. Meanwhile, attitude scores turned out to be relatively low  in some areas including perceived threat of disease (severity and susceptibility) and internal health Locus of Control. Health care professionals (physicians, nurses,..) tended to ignore the need for proper education of cardiac patients. There is a strong need to promote patient education in order to enhance knowledge and bring about a change in attitudes.      

One of the main problems in malaria control is the resistance of Plasmodium falciparum to chloroquine and some other antimalarial drugs. This resistance is now quite common in most regions where falciparum malaria is endemic. Between 1968 and 1976, two in-vivo studies were carried out in endemic areas in the south of Iran and they showed P.falciparum to be chloroquine-sensitive. In 1983, the Department of Protozoology in the School of Public Health undertook in vivo and in vitro studies on the response of P.falciparum to chloroquine and other antimalarials. In the Iran-Shahr region a few cases of in vivo resistance to chloroquine were found in 1983, and the rate of resistance was 5.7% at RI level. Between 1994 and 1996, resistance in this region gradually increased to 51.2% at RI, RII and RIII. In Bandar-Abbas and Kahnoudj areas, prevalence of chloroquine-resistant P. Falciparum infection was 32.5% at RI and RII from 1986 to 1987; it increased to 64.8% at RI, RII and RIII levels from1994 to1996 and then altered between 68% and 84% at RI and RII levels in the 1997-2001 period. 88 chloroquine-resistant patients were treated with standard doses of sulfadoxinepyrimethmine (Fansidar) alone or in combination with amodiaquine and then examined with 28-day in-vivo tests. In 13.6% of them resistance was observed at RI and RH levels. In micro in-vitro tests, using WHO standard kits, the rates of resistance of P. falciparum to chloroquine, amodiaquine, sulfadoxine-pyrimethamine, mefloquine and quinine were 33.4%, 15.2%, 17.9%, 2.2% and 0.0% in 281, 72, 39,44 and 72 cases respectively. As mefloquine has never been used in the studied areas, the sporadic cases of in-vitro mefloquine resistance may be considered as cases of innate and/or imported resistance. Primary resistant cases were seen mostly among Afghan and Pakistani immigrants/passengers. Hence these individuals are likely to have introduced chloroquineresistant malaria into this country. The in vivo response of Plasmodium vivax to chloroquine was also studied in 827 patients was also studied in the endemic areas of the South-East between 1995 and 2001. The mean parasite clearance time (MPCT) was 2.78 and no resistant cases were found. Most cases in these studies had been referred by the local Malaria Control Laboratories to the research facilities at Health Training and Research Centers in Bandar-Abbas and Iran- Shahr. Some had received chloroquine, and those with a good response had not been referred. Therefore, the high rates of chloroquine resistance found in these studies probably do not reflect overall resistance rates at population level. To determine true resistance levels in these areas, all eligible patients must undergo WHO's simplified in-vivo tests performed by trained malaria microscopists or laboratory technicians.