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Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran
Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi
Epidemiol Health. 2017;39:e2017002.   Published online December 30, 2016
DOI: https://doi.org/10.4178/epih.e2017002
  • 15,185 View
  • 358 Download
  • 10 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
The risk of transmission of Mycobacterium tuberculosis from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI.
METHODS
All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI.
RESULTS
The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17).
CONCLUSIONS
This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.
Summary
Korean summary
Key Message

Citations

Citations to this article as recorded by  
  • Prevalence and incidence of tuberculosis in health workers: A systematic review of the literature
    Eni Hilário da Silva, Ercilia Lima, Talita Raquel dos Santos, Maria Clara Padoveze
    American Journal of Infection Control.2022; 50(7): 820.     CrossRef
  • Mycobacterium tuberculosis infection and disease in healthcare workers in a tertiary referral hospital in Bandung, Indonesia
    Lika Apriani, Susan McAllister, Katrina Sharples, Isni Nurul Aini, Hanifah Nurhasanah, Rovina Ruslami, Dick Menzies, Philip C Hill, Bachti Alisjahbana
    Journal of Infection Prevention.2022; 23(4): 155.     CrossRef
  • Prevalence of modifiable risk factors of tuberculosis and their population attributable fraction in Iran: A cross-sectional study
    Kamal Sadeghi, Jalal Poorolajal, Amin Doosti-Irani, Mohammad Asghari Jafarabadi
    PLOS ONE.2022; 17(8): e0271511.     CrossRef
  • Prevalence of Latent Tuberculosis Infection in the Middle East and North Africa: A Systematic Review
    Mazin Barry, Stefano Centanni
    Pulmonary Medicine.2021; 2021: 1.     CrossRef
  • Meta-analysis of latent tuberculosis in healthcare workers in Iran: a retrospective review
    NazaninZahra Sepehri, Seyed Mohammad Saghanezhad, Farshad Khoddami, Amin Arasteh, Marziyeh Delirakbariazar, Azad Khaledi
    Transactions of The Royal Society of Tropical Medicine and Hygiene.2021; 115(9): 965.     CrossRef
  • Prevalence of latent tuberculosis infection among health workers in Afghanistan: A cross-sectional study
    Ghulam Qader Qader, Mohammad Khaled Seddiq, Khakerah Mohammad Rashidi, Lutfullah Manzoor, Azizullah Hamim, Mir Habibullah Akhgar, Laiqullrahman Rahman, Sean Dryer, Mariah Boyd-Boffa, Aleefia Somji, Muluken Melese, Pedro Guillermo Suarez, Ramesh Kumar
    PLOS ONE.2021; 16(6): e0252307.     CrossRef
  • Occupational Tuberculosis Among Laboratory Workers in South Africa: Applying a Surveillance System to Strengthen Prevention and Control
    Jennica Garnett, David Jones, Graham Chin, Jerry M. Spiegel, Annalee Yassi, Nisha Naicker
    International Journal of Environmental Research and Public Health.2020; 17(5): 1462.     CrossRef
  • Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review
    Lika Apriani, Susan McAllister, Katrina Sharples, Bachti Alisjahbana, Rovina Ruslami, Philip C. Hill, Dick Menzies
    European Respiratory Journal.2019; 53(4): 1801789.     CrossRef
  • A Study of The Prevalence of Latent Tuberculosis in Household Contacts of Patients with Active Tuberculosis in Kurdistan Region of Iraq: A Brief Report
    Nawfal Hussein, Amer A Balatay , Lokman A Almizori, Hilbeen H Saifullah
    International Journal of Infection.2019;[Epub]     CrossRef
  • Is latent tuberculosis infection challenging in Iranian health care workers? A systematic review and meta-analysis
    Mohammad Hossein YektaKooshali, Farahnaz Movahedzadeh, Ali Alavi Foumani, Hoda Sabati, Alireza Jafari, HASNAIN SEYED EHTESHAM
    PLOS ONE.2019; 14(10): e0223335.     CrossRef
Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries
Eunji Choi, Sangeun Lee, Bui Cam Nhung, Mina Suh, Boyoung Park, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2017;39:e2017006.   Published online February 5, 2017
DOI: https://doi.org/10.4178/epih.e2017006
  • 14,203 View
  • 424 Download
  • 56 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country.
METHODS
The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable.
RESULTS
The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening.
CONCLUSIONS
The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.
Summary
Korean summary
Key Message

Citations

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    Alzheimer's & Dementia.2022;[Epub]     CrossRef
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Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea
Ikhan Kim, Jinwook Bahk, Sung-Cheol Yun, Young-Ho Khang
Epidemiol Health. 2017;39:e2017011.   Published online March 15, 2017
DOI: https://doi.org/10.4178/epih.e2017011
  • 12,614 View
  • 220 Download
  • 10 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To examine the income gaps associated with self-rated poor health at the district level in Korea and to identify the geographical correlations between self-rated poor health, life expectancy, and the associated income gaps.
METHODS
We analyzed data for 1,578,189 participants from the Community Health Survey of Korea collected between 2008 and 2014. The age-standardized prevalence of self-rated poor health and the associated income gaps were calculated. Previously released data on life expectancy and the associated income gaps were also used. We performed correlation and regression analyses for self-rated poor health, life expectancy, and associated income gaps.
RESULTS
Across 245 districts, the median prevalence of self-rated poor health was 15.7% (95% confidence interval [CI], 14.6 to 16.8%), with interquartile range (IQR) of 3.1 percentage points (%p). The median interquintile gaps in the prevalence of self-rated poor health was 11.1%p (95% CI, 8.1 to 14.5%p), with IQR of 3.6%p. Pro-rich inequalities in self-rated health were observed across all 245 districts of Korea. The correlation coefficients for the association between self-rated poor health and the associated income gaps, self-rated poor health and life expectancy, and income gaps associated with self-rated poor health and life expectancy were 0.59, 0.78 and 0.55 respectively.
CONCLUSIONS
Income gaps associated with self-rated poor health were evident across all districts in Korea. The magnitude of income gaps associated with self-rated poor health was larger in the districts with greater prevalence of self-rated poor health. A strong correlation between self-rated poor health and life expectancy was also observed.
Summary
Korean summary
본 연구에서는 우리나라 245개 시군구의 자가평가 불건강 유병률의 소득수준 간 격차 크기를 규명하고, 시군구 단위 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 및 기대수명의 소득수준 간 격차의 상관성에 대하여 분석하였다. 연구 결과, 우리나라 245개 모든 시군구에서 자가평가 불건강 유병률에서의 저소득층에 불리한 불평등이 존재하였다. 또한, 자가평가 불건강 유병률과 그것의 소득수준 간 격차, 기대수명 그리고 자가평가 불건강 유병률의 소득수준 간 격차와 기대수명의 소득수준 간 격차는 높은 상관성이 나타났다. 이 연구는 지방정부 차원에서 건강 형평성 현황에 관한 유의미한 정보를 제공하여 지역별 보건정책 수립의 근거로 활용할 수 있다는데 의의를 찾을 수 있다.
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Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors
Teklehaymanot Huluf Abraha, Alemayehu Shimeka Teferra, Abebaw Addis Gelagay
Epidemiol Health. 2017;39:e2017012.   Published online March 20, 2017
DOI: https://doi.org/10.4178/epih.e2017012
  • 19,484 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, contraception during the extended postpartum period has been underemphasized in Ethiopia. Therefore, this study aimed to assess postpartum modern contraceptive use among women in northern Ethiopia and to identify factors associated with modern contraceptive use in the postpartum period.
METHODS
A community based cross-sectional study was conducted from March to April, 2015. Data were entered using Epi Info version 7 and then exported into Stata version 12 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and p-values <0.05 were considered to indicate statistical significance.
RESULTS
Nearly half (48.0%) of women used modern contraceptives during the extended postpartum period. Postpartum modern contraceptive use was significantly associated with secondary and tertiary education levels (aOR, 4.25; 95% CI, 1.29 to 14.00; aOR, 5.36 ; 95% CI, 1.14 to 25.45, respectively), family planning counseling during prenatal and postnatal care (aOR, 5.72 ; 95% CI, 2.67, 12.28), having postnatal care (aOR, 2.36; 95% CI, 1.15 to 4.87), resuming sexual activity (aOR, 9.53; 95% CI, 3.74 to 24.27), and menses returning after birth (aOR, 6.35; 95% CI, 3.14 to 13.39). In addition, experiencing problems with previous contraceptive use was negatively associated with modern contraceptive use (aOR, 0.34; 95% CI, 0.16 to 0.72).
CONCLUSIONS
Low rate of postpartum modern contraceptive use were found in the study area. Therefore, strengthening family planning counseling during antenatal and postnatal care visits, improving utilization of postnatal care services and improving women’s educational status are crucial steps for to enhance modern contraceptive use among postpartum women.
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Letter to the editor
Poor quality of life as a predictor of survival among thalassemia patients in Iran
Shahab Rezaeian
Epidemiol Health. 2017;39:e2017013.   Published online March 28, 2017
DOI: https://doi.org/10.4178/epih.e2017013
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Abstract
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Cohort Profile
Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort: study protocol and results of the first 3 years of enrollment
Jee-Seon Shim, Bo Mi Song, Jung Hyun Lee, Seung Won Lee, Ji Hye Park, Dong Phil Choi, Myung Ha Lee, Kyoung Hwa Ha, Dae Jung Kim, Sungha Park, Won-Woo Lee, Hyeon Chang Kim
Epidemiol Health. 2017;39:e2017016.   Published online April 1, 2017
DOI: https://doi.org/10.4178/epih.e2017016
  • 14,226 View
  • 314 Download
  • 32 Citations
AbstractAbstract AbstractSummary PDF
Abstract
Although the etiologies of cardiovascular disease (CVD) are widely understood, the goal of finding a globally effective solution for preventing CVD is unrealistic. Therefore, we aimed to conduct a community-based prospective study on the prevention and management of CVD in Korean adults. This study was designed to recruit 8,000 healthy adults over the course of 5 years. The baseline assessment includes a wide range of established CVD risk factors, including demographic characteristics, medical history, health behaviors, psychological conditions, body size and composition, blood pressure, the augmentation index, carotid ultrasonography, an electrocardiogram, and biochemical indicators, as well as some novel factors, such as social network characteristics, exposure to environmental pollutants, inflammatory markers, hemostatic markers, and immunosenescence markers. Annual telephone interviews and follow-up health examinations at 5-year intervals after the baseline assessment are planned to collect information on changes in health status and its determinants. Additionally, indirect follow-up using secondary data sources will be conducted to obtain information on health services utilization and death. So far, more than 6,000 adults have been enrolled during the first three and a half years, and almost all participants have been tracked by annual telephone follow-up surveys. The data have been uploaded to iCReaT, the clinical research information management system of the Korea National Institute of Health.
Summary
Korean summary
심뇌혈관 및 대사질환 원인연구센터(Cardiovascular and Metabolic Diseases Etiology Research Center)에서는 심뇌혈관질환 및 대사질환의 새로운 발병 원인을 찾고 효율적인 예방 전략을 개발하고자 코호트(CMERC cohort와 CMERC-HI cohort)를 구축하였다. 지역사회에 거주하는 만 30-64세 건강한 성인을 대상으로 하는 CMERC cohort는 2013년부터 2018년 까지 총 5년 동안 8000명 등록을 목표로 기반조사를 진행 중이며(2016년 12월 현재 6000여명 등록), 이미 알려진 다양한 위험요인 이외에 사회연결망 정보와 면역노화 관련 바이오마커 등 새로운 위험 요인에 관한 광범위한 정보가 수집되고 있다. CMERC cohort는 심뇌혈관 및 대사질환 예방연구의 기초자료로 활용되어 과학적 데이터에 근거한 예방 전략 수립에 기여하게 될 것이다.
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Editorial
Current status of hepatitis C virus infection and countermeasures in South Korea
Sook-Hyang Jeong, Eun Sun Jang, Hwa Young Choi, Kyung-Ah Kim, Wankyo Chung, Moran Ki
Epidemiol Health. 2017;39:e2017017.   Published online April 13, 2017
DOI: https://doi.org/10.4178/epih.e2017017
  • 20,813 View
  • 339 Download
  • 24 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis, hepatocellular carcinoma, and liver-related mortality. The new antiviral drugs against HCV, direct acting antivirals, result in >90% cure rate. This review aimed to summarize the current prevalence, clinical characteristics, outcomes, and treatment response associated with HCV infection, and countermeasures for optimal HCV control in South Korea. Based on a literature review, the current anti-HCV prevalence in the Korean population is 0.6 to 0.8%, with increasing prevalence according to age. The major HCV genotypes in Korean patients were genotype 1b and genotype 2. Successful antiviral treatment leads to significantly reduced liver related complications and mortality. However, only about one third of the individuals with HCV infection seem to be managed under the current national health insurance system, suggesting a remarkable rate of underdiagnoses and subsequent loss of opportunity to cure. A recent study in South Korea showed that targeted population screening for HCV infection is cost-effective. To prevent recently developed clusters of HCV infection in some clinics, mandatory surveillance rather than sentinel surveillance for HCV infection is required and governmental countermeasures to prevent reuse of syringes or other medical devises, and public education should be maintained. Moreover, one-time screening for a targeted population should be considered and a cost-effectiveness study supporting an optimal screening strategy is warranted.
Summary
Korean summary
우리나라 C형간염 유병률은 1% 미만(0.6-0.8%)이며, 수혈에 의한 C형간염은 더 이상 발생하지 않을 것으로 보인다. 그러나 최근 의료기관에서 C형간염 집단감염이 발생하여 국가적 대응이 필요한 공중보건의 문제로 떠올랐다. 2016년 부터는 C형간염을 완치할 수 있는 효과적이고 안전한 약제가 건강보험급여로 인정되어 이미 진단된 환자들에서는 효과적인 치료가 시작되었다. 그러나 진단되지 않은 상태에서 간질환이 진행되고 있는 환자들을 발굴하기 위해 국가 검진체계와 연계하여 선별검사를 시행한다면, 단기적으로는 진단과 치료비용 부담이 커지겠지만 장기적으로 사망률을 감소시키고, 삶의 질을 높이는 비용효과적인 C형간염 퇴치 전략이 될 것이다.
Key Message

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Perspective
An opposing view on including high school students in a latent tuberculosis infection control program in Korea
Jong-Myon Bae
Epidemiol Health. 2017;39:e2017015.   Published online March 31, 2017
DOI: https://doi.org/10.4178/epih.e2017015
  • 11,839 View
  • 194 Download
  • 5 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The Korea Centers for Diseases Control and Prevention (KCDC) has announced a control program against latent Mycobacterium tuberculosis infection (LTBI), for a “TB-safe country” this year with the goal of a “TB-free Korea” by 2025. The program includes high school students as one target group; however, some school health teachers and parents have expressed their opposition to this. The 2015 World Health Organization guidelines do not recommend inclusion of asymptomatic high school students in LTBI control programs. Based on this guideline, the KCDC should consider excluding this population from the program.
Summary
Korean summary
질병관리본부는 결핵안심국가를 만들기 위하여 고등학교 1학년생을 포함한 잠복결핵감염 검사사업을 2017년 추진하기로 공고하였다. 그러나 2015년에 발표된 WHO 지침에 따르면 해당 대상자들은 검사대상자로 제시되어 있지않다. 근거중심의 보건정책 추진을 위해서 사업 대상 선정을 재검토할 필요가 있다.
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Original Articles
Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting
Afshin Fathi, Mohammad Hajizadeh, Khalil Moradi, Hamed Zandian, Maryam Dezhkameh, Shima Kazemzadeh, Satar Rezaei
Epidemiol Health. 2017;39:e2017022.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017022
  • 17,610 View
  • 454 Download
  • 37 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.
METHODS
A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.
RESULTS
The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).
CONCLUSIONS
Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Summary
Korean summary
Key Message

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Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015
Mehdi Moradinazar, Farid Najafi, Mohammad Reza Baneshi, Ali Akbar Haghdoost
Epidemiol Health. 2017;39:e2017023.   Published online June 15, 2017
DOI: https://doi.org/10.4178/epih.e2017023
  • 9,771 View
  • 165 Download
  • 3 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.
METHODS
We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0 , was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.
RESULTS
The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.
CONCLUSIONS
Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
Summary
Korean summary
Key Message

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  • Age Changes and Suicidal Activity in Iran Over the Past Decade: A Systematic Review and Meta-Analysis
    Hamid Sharif Nia, Mohammad Heidari, Navaz Naghavi, Rebecca H. Lehto, Ali Akbar Haghdoost, Azar Jafari-Koulaee, Yasaman Hatef Matbue, Ameneh Yaghoobzadeh, Amir Hossein Goudarzian, Saeed Pahlevan Sharif
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    Mehdi Moradinazar, Mehdi Shaygani, Mary Ataei, Rosita Naseri
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The association between smoking or passive smoking and cardiovascular diseases using a Bayesian hierarchical model: based on the 2008-2013 Korea Community Health Survey
Whanhee Lee, Sung-Hee Hwang, Hayoung Choi, Ho Kim
Epidemiol Health. 2017;39:e2017026.   Published online June 22, 2017
DOI: https://doi.org/10.4178/epih.e2017026
  • 13,627 View
  • 372 Download
  • 35 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels.
METHODS
This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers.
RESULTS
At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas.
CONCLUSIONS
The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.
Summary
Korean summary
베이지안 계층화 방법을 이용하여 흡연 및 간접 흡연과 심혈관계 질환 유병의 전국 및 시/군/구별 연관성을 추정한 결과, 흡연은 뇌졸중 (RR=1.060) 과 고혈압 (RR=1.016) 유병에 유의하게 연관되었다.
Key Message

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Effect of antiretroviral therapy on changes in the fertility intentions of human immunodeficiency virus-positive women in Addis Ababa, Ethiopia: a prospective follow-up study
Hussen Mekonnen, Fikre Enquselassie
Epidemiol Health. 2017;39:e2017028.   Published online July 16, 2017
DOI: https://doi.org/10.4178/epih.e2017028
  • 9,700 View
  • 172 Download
  • 10 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia.
METHODS
An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women.
RESULTS
Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women.
CONCLUSIONS
ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.
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    Abdul Razak Doat, Roberta Mensima Amoah, Kennedy Diema Konlan, Kennedy Dodam Konlan, Juliana Asibi Abdulai, Margaret W. Kukeba, Iddrisu Mohammed, Joel Afram Saah
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  • Health workers’ knowledge of safer conception and attitudes toward reproductive rights of HIV-infected couples in Kano, Nigeria
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Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level
Enayatollah Homaie Rad, Vahid Yazdi-Feyzabad, Shahrokh Yousefzadeh-Chabok, Abolhasan Afkar, Ahmad Naghibzadeh
Epidemiol Health. 2017;39:e2017029.   Published online July 18, 2017
DOI: https://doi.org/10.4178/epih.e2017029
  • 13,854 View
  • 194 Download
  • 17 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.
METHODS
Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.
RESULTS
Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).
CONCLUSIONS
The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.
Summary
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  • Inpatient Out-of-Pocket in Iran After Health Transformation Plan
    Sulmaz Ghahramani, Kamran Bagheri Lankarani
    International Journal of Health Policy and Management.2018; 7(9): 877.     CrossRef
Prevalence and comorbidity of common mental disorders and associations with suicidal ideation in the adult population
Yousef Veisani, Fathola Mohamadian, Ali Delpisheh
Epidemiol Health. 2017;39:e2017031.   Published online July 22, 2017
DOI: https://doi.org/10.4178/epih.e2017031
  • 10,162 View
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  • 11 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Little information exists on the association between comorbidities of mental disorders and suicidal ideation in developing countries. The current study examined the relationship between the presence of comorbid mental disorders and suicidal ideation in the adult population.
METHODS
This cross-sectional study was conducted using the cluster random sampling method in 3 steps. Data were collected from a household assets survey and the self-administered 28-item General Health Questionnaire as first step in screening, and the Persian version of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition - Text Revision was used in the second stage to determine the prevalence of mental disorders. Bivariate and multivariate analysis were used to investigate the associations between mental disorders and suicidal ideation.
RESULTS
Of the 763 participants, 199 (26.1%) had 1 or more mental disorder. Forty-two (71.4%) subjects with comorbidities had a history of suicidal ideation, whereas 59 (7.7%) of all participants had a history of suicidal ideation. We found that major depressive disorder and obsessive-compulsive disorder were the most predictive of suicidal ideation in both sexes. The odds ratio for suicidal ideation associated with having 3 comorbid disorders was 2.70 (95% confidence interval [CI], 1.40 to 14.12) in males and 3.06 (95% CI, 1.25 to 15.22) in females.
CONCLUSIONS
Consistent with pervious data, our results confirmed that mental disorders and comorbidities of mental disorders were important predictors of suicidal ideation. Our findings are very useful for applied intervention programs to reduce the suicide rate in regions in which it is high.
Summary
Korean summary
Key Message

Citations

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    A.D. Domínguez-González, G. Guzmán-Valdivia, F.S. Ángeles-Téllez, M.A. Manjarrez-Ángeles, R. Secín-Diep
    Heliyon.2022; 8(2): e08851.     CrossRef
  • Prevalence of Mental Disorders in the WHO Eastern Mediterranean Region: A Systematic Review and Meta-Analysis
    Alina Zuberi, Ahmed Waqas, Sadiq Naveed, Md Mahbub Hossain, Atif Rahman, Khalid Saeed, Daniela C. Fuhr
    Frontiers in Psychiatry.2021;[Epub]     CrossRef
  • Association between common stressful life events and coping strategies in adults
    Yousef Veisani, Zahra Jalilian, YasamanZahra Sadeghifard, Fathola Mohamadian
    Journal of Education and Health Promotion.2021; 10(1): 307.     CrossRef
  • Alcohol Intoxication and Suicide by Hanging in Poland
    Dorota Lasota, Witold Pawłowski, Paweł Krajewski, Anna Staniszewska, Krzysztof Goniewicz, Robert Czerski, Mariusz Goniewicz
    Alcohol and Alcoholism.2020; 55(3): 278.     CrossRef
  • Inequalities in common mental disorders between advantaged and disadvantaged groups: an Oaxaca – Blinder decomposition analysis on socio-economic factors
    Yousef Veisani, Shahab Rezaeian, Fathola Mohamadian, Ali Delpisheh
    International Journal of Human Rights in Healthcare.2020; 13(4): 325.     CrossRef
  • The Epigenetic Overlap between Obesity and Mood Disorders: A Systematic Review
    Mojgan Gharipour, Majid Barekatain, Johoon Sung, Naghmeh Emami, Ladan Sadeghian, Minoo Dianatkhah, Nizal Sarrafzadegan, Shayesteh Jahanfar
    International Journal of Molecular Sciences.2020; 21(18): 6758.     CrossRef
  • The relationship between multimorbidity and suicidal ideation: A meta-analysis
    Feiyang Xiong, Li Wang, Lianlian Shen, Wenhui Guo, Shixue Li, Qiangdong Guan
    Journal of Psychosomatic Research.2020; 138: 110257.     CrossRef
  • Suicide Risk in Obsessive-Compulsive Disorder and Exploration of Risk Factors: A Systematic Review
    Umberto Albert, Diana De Ronchi, Giuseppe Maina, Maurizio Pompili
    Current Neuropharmacology.2019; 17(8): 681.     CrossRef
  • The prevalence of suicidal ideation and suicide attempt in patients with rheumatic diseases: a systematic review and meta-analysis
    Zhenyu Li, Ying Yang, Chen Dong, Lin Li, Yafei Cui, Qian Zhao, Zhifeng Gu
    Psychology, Health & Medicine.2018; 23(9): 1025.     CrossRef
  • Suicide in early China and the current West
    Saxby Pridmore, William Pridmore
    Australasian Psychiatry.2018; 26(6): 651.     CrossRef
  • The Association between Parents’ Lifestyles and Common Psychiatry Disorders in Children and Adolescents: A Population-Based Study
    Saba Shakarami, Yousef Veisani, Koorosh Kamali, Seyed-Ali Mostafavi, Mohammad Reza Mohammadi, Fathola Mohamadian, Nastaran Ahmadi, Mohammad Fararouei, Ali Delpisheh
    Shiraz E-Medical Journal.2018;[Epub]     CrossRef
Perspective
The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea
Moo Sik Lee, Kwan Lee, Jee-Hyuk Park, Jee-Young Hong, Min-Young Jang, Byoung-Hak Jeon, Sang-Yun Cho, Sun-Ja Choi, JeongIk Hong
Epidemiol Health. 2017;39:e2017032.   Published online July 24, 2017
DOI: https://doi.org/10.4178/epih.e2017032
  • 9,824 View
  • 169 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.
Summary
Korean summary
2015년 한국의 메르스 유행후 한국의 감염병 대응인력을 대상으로 한 조사분석을 통하여 역학조사관 교육 개편의 필요성을 확인하고, 세부 교육과정, 방법 및 내용 등 포괄적인 교육강화 및 개선방안을 모색하여 향후 역학조사관 신규 교육프로그램의 개발과 역량강화 방안을 제시하였다.
Key Message

Citations

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    Bee-Ah Kang, Sijoung Kwon, Myoungsoon You, Heeyoung Lee
    Occupational and Environmental Medicine.2022; 79(4): 245.     CrossRef

Epidemiol Health : Epidemiology and Health