Osong Public Health and Research Perspectives

Original Articles

The COVID-19 pandemic and healthcare utilization in Iran: evidence from an interrupted time series analysis: Monireh Mahmoodpour-Azari, Satar Rezaei, Nasim Badiee, Mohammad Hajizadeh, Ali Mohammadi, Ali Kazemi-Karyani, Shahin Soltani, Mehdi Khezeli; Osong Public Health Res Perspect. 2023;14(3):180-187. Published online June 22, 2023; DOI: https://doi.org/10.24171/j.phrp.2023.0041

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Graphical Abstract Abstract PDF: Objectives
This study aimed to examine the effect of the coronavirus disease 2019 (COVID-19) outbreak on the hospitalization rate, emergency department (ED) visits, and outpatient clinic visits in western Iran.
Methods
We collected data on the monthly hospitalization rate, rate of patients referred to the ED, and rate of patients referred to outpatient clinics for a period of 40 months (23 months before and 17 months after the COVID-19 outbreak in Iran) from all 7 public hospitals in the city of Kermanshah. An interrupted time series analysis was conducted to examine the impact of COVID-19 on the outcome variables in this study.
Results
A statistically significant decrease of 38.11 hospitalizations per 10,000 population (95% confidence interval [CI], 24.93–51.29) was observed in the first month of the COVID-19 outbreak. The corresponding reductions in ED visits and outpatient visits per 10,000 population were 191.65 (95% CI, 166.63–216.66) and 168.57 (95% CI, 126.41–210.73), respectively. After the initial reduction, significant monthly increases in the hospitalization rate (an increase of 1.81 per 10,000 population), ED visits (an increase of 2.16 per 10,000 population), and outpatient clinic visits (an increase of 5.77 per 10,000 population) were observed during the COVID-19 pandemic.
Conclusion
Our study showed that the utilization of outpatient and inpatient services in hospitals and clinics significantly declined after the COVID-19 outbreak, and use of these services did not return to pre-outbreak levels as of June 2021.

The Occurrence and Risk Assessment of Exposure to Aflatoxin M₁ in Ultra-High Temperature and Pasteurized Milk in Hamadan Province of Iran: Amir Sasan Mozaffari Nejad, Ali Heshmati, Tayebe Ghiasvand; Osong Public Health Res Perspect. 2019;10(4):228-233. Published online August 31, 2019; DOI: https://doi.org/10.24171/j.phrp.2019.10.4.05

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Objectives

Aflatoxins are a category of poisonous compounds found in most plants, milk and dairy products. The present research was carried out to detect the presence of aflatoxin M₁ (AFM₁) in samples of milk collected from Hamadan province, Iran.

Methods

Twenty five samples of ultra-high temperature (UHT) and 63 samples of pasteurized milk were collected and the amount of AFM₁ was measured by an Enzyme-Linked Immunosorbent Assay method. In addition, the estimated daily intake (EDI) and hazard index (HI) of AFM₁ was determined by the following equations:(EDI= mean concentration of AFM₁ × daily consumption of milk/body weight; HI= EDI/Tolerance Daily Intake).

Results

AFM₁ was detected in 21 (84%) UHT milk samples and in 55 (87.30%) pasteurized milk samples. Seven (28%) samples of UHT and 21 (33.33%) pasteurized milk samples had higher AFM₁ content than the limit allowed in the European Union and Iranian National Standard Limits (0.05 μg/kg). None of the samples exceeded the US Food and Drug Administration limit (0.5 μg/kg) for AFM₁. EDI and HI for AM₁ through milk were 0.107 ng/kg body weight/day, and 0.535, respectively.

Conclusion

A significant percentage of milk produced by different factories in Iran (84% of UHT and 87.3% of pasteurized milk) was contaminated with AFM₁. Therefore, more control and monitoring of livestock feeding in dairy companies may help reduce milk contamination with AFM₁. As the HI value was lower than 1, it can be assumed that there was no risk of developing liver cancer due to milk consumption.

Citations

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Seasonal variation and risk assessment of exposure to aflatoxin M1 in milk, yoghurt, and cheese samples from Ilam and Lorestan Provinces of Iran
Kousar Aghebatbinyeganeh, Mohammadhosein Movassaghghazani, Mohamed Fathi Abdallah
Journal of Food Composition and Analysis.2024; 128: 106083. CrossRef
Review, meta-analysis and carcinogenic risk assessment of aflatoxin M1 in different types of milks in Iran
Fatemeh Mortezazadeh, Fathollah Gholami-Borujeni
Reviews on Environmental Health.2023; 38(3): 511. CrossRef
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Fatma Ali Alsalabi, Zahoor Ul Hassan, Roda F. Al-Thani, Samir Jaoua
Heliyon.2023; 9(1): e12835. CrossRef
Risk assessments for the dietary intake aflatoxins in food: A systematic review (2016–2022)
Kiran Bhardwaj, Julie P. Meneely, Simon A. Haughey, Moira Dean, Patrick Wall, Guangtao Zhang, Bob Baker, Christopher T. Elliott
Food Control.2023; 149: 109687. CrossRef
A systematic literature review for aflatoxin M1 of various milk types in Iran: Human health risk assessment, uncertainty, and sensitivity analysis
Tooraj Massahi, Amir Kiani, Kiomars Sharafi, Behzad Karami Matin, Abdullah Khalid Omer, Gholamreza Ebrahimzadeh, Jalil Jaafari, Nazir Fattahi
Food Control.2023; 150: 109733. CrossRef
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Neda Mollakhalili-Meybodi, Amene Nematollahi
Environmental Monitoring and Assessment.2023;[Epub] CrossRef
Effect of basil seed and xanthan gum on physicochemical, textural, and sensory characteristics of low‐fat cream cheese
Jalal Portaghi, Ali Heshmati, Mehdi Taheri, Ebrahim Ahmadi, Amin Mousavi Khaneghah
Food Science & Nutrition.2023; 11(10): 6060. CrossRef
Evaluation of aflatoxin M1 content in milk and dairy products by high-performance liquid chromatography in Tehran, Iran
Nazanin SHABANSALMANİ, Mohammadhosein MOVASSAGHGHAZANİ
Harran Tarım ve Gıda Bilimleri Dergisi.2023; 27(3): 435. CrossRef
Seasonal Study of Aflatoxin M1 Contamination in Cow Milk on the Retail Dairy Market in Gorgan, Iran
Hadi Rahimzadeh Barzoki, Hossein Faraji, Somayeh Beirami, Fatemeh Zahra Keramati, Gulzar Ahmad Nayik, Zahra Izadi Yazdanaabadi, Amir Sasan Mozaffari Nejad
Dairy.2023; 4(4): 571. CrossRef
Aflatoxin M1 in milk and dairy products: global occurrence and potential decontamination strategies
Khurram Muaz, Muhammad Riaz, Carlos Augusto Fernandes de Oliveira, Saeed Akhtar, Shinawar Waseem Ali, Habibullah Nadeem, Sungkwon Park, Balamuralikrishnan Balasubramanian
Toxin Reviews.2022; 41(2): 588. CrossRef
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Rhea Sanjiv Chhaya, John O'Brien, Enda Cummins
Trends in Food Science & Technology.2022; 126: 126. CrossRef
The behavior of aflatoxin M1 during lactic cheese production and storage
Mahtab Einolghozati, Ali Heshmati, Freshteh Mehri
Toxin Reviews.2022; 41(4): 1163. CrossRef
Exposure assessment on aflatoxin M1 from milk and dairy products-relation to public health
Eleni Malissiova, Georgia Soultani, Konstantina Tsokana, Mary Alexandraki, Athanasios Manouras
Clinical Nutrition ESPEN.2022; 47: 189. CrossRef
Aflatoxin M1 in distributed milks in northwestern Iran: occurrence, seasonal variation, and risk assessment
Seyyed Ahmad Mokhtari, Ali Nemati, Mehdi Fazlzadeh, Eslam Moradi-Asl, Vahid Taefi Ardabili, Anoshirvan Seddigh
Environmental Science and Pollution Research.2022; 29(27): 41429. CrossRef
Brucellosis in Humans with the Approach of Brucella Species Contamination in Unpasteurized Milk and Dairy Products from Hamadan, Iran
Mohammad Mahdi Majzobi, Pejman Karami, Amir Khodavirdipour, Mohammad Yousef Alikhani
Iranian Journal of Medical Microbiology.2022; 16(4): 282. CrossRef
Probabilistic modeling and risk characterization of the chronic aflatoxin M1 exposure of Hungarian consumers
Zsuzsa Farkas, Kata Kerekes, Árpád Ambrus, Miklós Süth, Ferenc Peles, Tünde Pusztahelyi, István Pócsi, Attila Nagy, Péter Sipos, Gabriella Miklós, Anna Lőrincz, Szilveszter Csorba, Ákos Bernard Jóźwiak
Frontiers in Microbiology.2022;[Epub] CrossRef
The occurrence of aflatoxin M1 in doogh, kefir, and kashk in Hamadan, Iran
Mina KHORSHIDI, Ali HESHMATI, Zahra HADIAN, Slim SMAOUI, Amin MOUSAVI KHANEGHAH
Food Science and Technology.2022;[Epub] CrossRef
Characterization and mechanism of aflatoxin degradation by a novel strain of Trichoderma reesei CGMCC3.5218
Xiaofeng Yue, Xianfeng Ren, Jiayun Fu, Na Wei, Claudio Altomare, Miriam Haidukowski, Antonio F. Logrieco, Qi Zhang, Peiwu Li
Frontiers in Microbiology.2022;[Epub] CrossRef
Simultaneous multi-determination of pesticide residues in black tea leaves and infusion: a risk assessment study
Ali Heshmati, Fereshteh Mehri, Amin Mousavi Khaneghah
Environmental Science and Pollution Research.2021; 28(11): 13725. CrossRef
Development of a specific anti-idiotypic nanobody for monitoring aflatoxin M1 in milk and dairy products
Chong Cai, Qi Zhang, Seyni Nidiaye, Honglin Yan, Wen Zhang, Xiaoqian Tang, Peiwu Li
Microchemical Journal.2021; 167: 106326. CrossRef
Prevalence of aflatoxin M1 in pasteurized and ultra-high temperature (UHT) milk marketed in Dar es Salaam, Tanzania
F. Mwakosya Hilda, K. Mugula Jovin
African Journal of Microbiology Research.2021; 15(9): 461. CrossRef
Multi-mycotoxin occurrence in feed, metabolism and carry-over to animal-derived food products: A review
J. Tolosa, Y. Rodríguez-Carrasco, M.J. Ruiz, P. Vila-Donat
Food and Chemical Toxicology.2021; 158: 112661. CrossRef
Presence of Aflatoxin M1 in Commercial Milk in Paraguay
Andrea Alejandra Arrúa, Pablo David Arrúa, Juliana Moura-Mendes, Cinthia Cazal, Francisco Paulo Ferreira, Cristhian Javier Grabowski, Horacio Daniel Lopez-Nicora, Danilo Fernández Rios
Journal of Food Protection.2021; 84(12): 2128. CrossRef
The Occurrence and Risk Assessment of Aflatoxin M1 in Yoghurt Samples from Hamadan, Iran
Ali Heshmati, Amir Sasan Mozaffari Mozaffari Nejad, Tayebeh Ghyasvand
The Open Public Health Journal.2020; 13(1): 512. CrossRef

Seroprevalence of Toxocara in Children from Urban and Rural Areas of Ilam Province, West Iran: Sahar Shokouhi, Jahangir Abdi; Osong Public Health Res Perspect. 2018;9(3):101-104. Published online June 30, 2018; DOI: https://doi.org/10.24171/j.phrp.2018.9.3.03

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Abstract PDF

Objectives

The present study was performed to determine the seroprevalence of Toxocara in children ≤ 10 years old, from rural and urban areas of Ilam.

Methods

Serum samples from 383 children ≤ 10 years old, were selected randomly from rural and urban areas of Ilam province and surveyed using enzyme-linked immunosorbent assays.

Results

The total rate of infection with Toxocara was 22% (31% with a history of contact with dogs and cats, and 14% without a history of contact). Of those infected, 23% were male and 18% were female, 36% lived a rural life and 20% had an urban life. A significant correlation was found between the incidence of disease, and urban and rural life, as well as exposure to dogs and cats. There was no correlation between prevalence and gender or age.

Conclusion

Given the high prevalence of infection with Toxocara amongst children in Ilam province, preventive work in the community such as education in risk management and periodic treatment with anti-parasitic drugs and elimination of stray dogs and cats is an appropriate measure.

Citations

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Seroprevalence and Potential Risk Factors of Toxocariasis among General Population in Southwest Iran: Implications on the One Health Approach
Masoud Foroutan, Aida Vafae Eslahi, Shahrzad Soltani, Naser Kamyari, Ehsan Moradi-Joo, Jean-Francois Magnaval, Milad Badri, Rahul Shivahare
Journal of Immunology Research.2024; 2024: 1. CrossRef
Maternal COVID-19 infection and the fetus: Immunological and neurological perspectives
Shahab Falahi, Amir Abdoli, Azra Kenarkoohi
New Microbes and New Infections.2023; 53: 101135. CrossRef
Seroprevalence of Toxocariasis and Its Associated Risk Factors among Adult Population in Kavar District, Fars Province, South of Iran: A Cross-Sectional Community-Based Seroepidemiological Survey
Fatemehsadat Pezeshkian, Ali Pouryousef, Mostafa Omidian, Fattaneh Mikaeili, Ali Reza Safarpour, Sara Shojaei-Zarghani, Bahador Sarkari, Payam Behzadi
Interdisciplinary Perspectives on Infectious Disea.2023; 2023: 1. CrossRef
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Morteza Shams, Ayoub Rashidi, Jasem Mohamadi, Mohamad Moradi, Reza Pakzad, Razi Naserifar, Jahangir Abdi, Fariba Ghelichi, Arezoo Bozorgomid, Nahid Maspi, Azra Kenarkoohi, Yasin Mohammadi, Amir Abdoli, Shahab Falahi
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Azra Kenarkoohi, Amir Abdoli, Arman Rostamzad, Mahmoud Rashnavadi, Razi Naserifar, Jahangir Abdi, Morteza Shams, Arezoo Bozorgomid, Sepideh Saeb, Dhurgham Al-Fahad, Kosar Khezri, Shahab Falahi, Shibiao Wan
BioMed Research International.2023; 2023: 1. CrossRef
Seroprevalence and risk factors of Toxocara canis infection in children aged 2–15 years from the southwest Iran
Masoud Foroutan, Shahrzad Soltani, Samaneh Bahadoram, Fatemeh Maghsoudi, Naser Kamyari, Shekoufe Haddadi
Comparative Immunology, Microbiology and Infectiou.2022; 85: 101801. CrossRef
Seroprevalence of Toxocara spp. in children (3–13 years old) in Zahedan, Southeast of Iran
Alireza Salimi Khorashad, Majid Shahraki, Mansour Rahmati Balaghaleh, Samaneh Abdolahi Khabisi, Sangeetha Rala, Reza Shafiei, Hadi Mirahmadi
Journal of Parasitic Diseases.2021; 45(2): 449. CrossRef
The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis
Behnam Abedi, Mehran Akbari, Sahar KhodaShenas, Alireza Tabibzadeh, Ali Abedi, Reza Ghasemikhah, Marzieh Soheili, Shnoo Bayazidi, Yousef Moradi
Clinical and Experimental Pediatrics.2021; 64(11): 575. CrossRef
Seroprevalence and associated risk factors of toxocariasis among nomads in Boyer-Ahmad County, southwest Iran
Nasir Arefkhah, Mohammad Reza Shadzi, Fattaneh Mikaeili, Bahador Sarkari, Farideh Esfandiari, Fatemeh Goudarzi
Transactions of The Royal Society of Tropical Medi.2020; 114(5): 372. CrossRef
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Nastaran Khalili, Neda Khalili, Ali Nickhah, Bahman Khalili
Journal of Parasitic Diseases.2020; 44(1): 145. CrossRef
Seroprevalence of toxocariasis and its related risk factors among municipal street sweepers in Shiraz District in Fars Province, southern Iran
Amirhossein Erfani, Ali Pouryousef, Nasir Arefkhah, Reza Shahriarirad, Mohammad Rastegarian, Ali Zeighami, Fattaneh Mikaeili, Seyed Younes Hosseini, Bahador Sarkari
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Factors Associated with Cesarean Section in Tehran, Iran using Multilevel Logistic Regression Model: Payam Amini, Maryam Mohammadi, Reza Omani-Samani, Amir Almasi-Hashiani, Saman Maroufizadeh; Osong Public Health Res Perspect. 2018;9(2):86-92. Published online April 30, 2018; DOI: https://doi.org/10.24171/j.phrp.2018.9.2.08

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Abstract PDF

Objectives

Over the past few decades, the prevalence of cesarean sections (CS) have risen dramatically worldwide, particularly in Iran. The aim of this study was to determine the prevalence of CS in Tehran, and to examine the associated risk factors.

Methods

A cross-sectional study of 4,308 pregnant women with singleton live-births in Tehran, Iran, between July 6–21, 2015 was performed. Multilevel logistic regression analysis was performed using demographic and obstetrical variables at the first level, and hospitals as a variable at the second level.

Results

The incidence of CS was 72.0%. Multivariate analysis showed a significant relationship between CS and the mother’s age, socioeconomic status, body mass index, parity, type of pregnancy, preeclampsia, infant height, and baby’s head circumference. The intra-class correlation using the second level variable, the hospital was 0.292, indicating approximately 29.2% of the total variation in the response variable accounted for by the hospital.

Conclusion

The incidence of CS was substantially higher than other countries. Therefore, educational and psychological interventions are necessary to reduce CS rates amongst pregnant Iranian women.

Citations

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Determinants of cesarean mode of childbirth among Rwandan women of childbearing age: Evidence from the 2019–2020 Rwanda Demographic and Health Survey (RDHS)
Nsereko Etienne, Uwase Aline, Mpinganzima Ornella, Usanzineza Henriette, Niyitegeka Jean Pierre, Turabayo Jean Léonard, Mwiseneza Marie Josee, Mugeni Girimpundu Candide, Moreland Patricia
Public Health Challenges.2024;[Epub] CrossRef
Virtual Reality, Fear of Pain and Labor Pain Intensity: A Randomized Controlled Trial
Halimeh Mohammadi, Javad Rasti, Elham Ebrahimi
Anesthesiology and Pain Medicine.2023;[Epub] CrossRef
The double burden of maternal overweight and short stature and the likelihood of cesarean deliveries in South Asia: An analysis of national datasets from Bangladesh, India, Maldives, Nepal, and Pakistan
Mosiur Rahman, Syed Emdadul Haque, Md. Jahirul Islam, Nguyen Huu Chau, Izzeldin Fadl Adam, Md. Nuruzzaman Haque
Birth.2022; 49(4): 661. CrossRef
Geospatial analysis of cesarean section in Iran (2016–2020): exploring clustered patterns and measuring spatial interactions of available health services
Alireza Mohammadi, Elahe Pishgar, Zahra Salari, Behzad Kiani
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef
Factors associated with cesarean delivery in Bangladesh: A multilevel modeling
Md. Akhtarul Islam, Mst. Tanmin Nahar, Md. Ashfikur Rahman, Sutapa Dey Barna, S.M. Farhad Ibn Anik
Sexual & Reproductive Healthcare.2022; 34: 100792. CrossRef
The Birth Satisfaction Scale-Revised Indicator (BSS-RI): a validation study in Iranian mothers
Reza Omani-Samani, Caroline J. Hollins Martin, Colin R. Martin, Saman Maroufizadeh, Azadeh Ghaheri, Behnaz Navid
The Journal of Maternal-Fetal & Neonatal Medicine.2021; 34(11): 1827. CrossRef
The effect of familiarization with preoperative care on anxiety and vital signs in the patient’s cesarean section: A randomized controlled trial
Mehrnush Mostafayi, Behzad Imani, Shirdel Zandi, Faeze Jongi
European Journal of Midwifery.2021; 5(June): 1. CrossRef
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Ying Wang, Xiang-Yong Li, Li-Li Wu, Xiao-Yan Zheng, Yu Deng, Meng-Jie Li, Xu You, Yu-Tian Chong, Yuan-Tao Hao
European Journal of Gastroenterology & Hepatology.2020; 32(1): 120. CrossRef
Factors Contributing to Iranian Pregnant Women’s Tendency to Choice Cesarean Section
Soraya Nouraei Motlagh, Zahra Asadi-piri, Razyeh Bajoulvand, Fatemeh Seyed Mohseni, Katayoun Bakhtiar, Mehdi Birjandi, Maryam Mansouri
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Aliza K. C. Bhandari, Bibha Dhungel, Mahbubur Rahman
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Profiling of Virulence-associated Factors in Shigella Species Isolated from Acute Pediatric Diarrheal Samples in Tehran, Iran: Sajad Yaghoubi, Reza Ranjbar, Mohammad Mehdi Soltan Dallal, Somayeh Yasliani Fard, Mohammad Hasan Shirazi, Mahmood Mahmoudi; Osong Public Health Res Perspect. 2017;8(3):220-226. Published online June 30, 2017; DOI: https://doi.org/10.24171/j.phrp.2017.8.3.09

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Abstract PDF

Objectives

The genus Shigella comprises the most infectious and diarrheagenic bacteria causing severe diseases, mostly in children under five years of age. This study aimed to detect nine virulence genes (ipaBCD, VirA, sen, set1A, set1B, ial, ipaH, stx, and sat) in Shigella species (spp.) using multiplex polymerase chain reaction (MPCR) and to determine the relation of Shigella spp. from pediatric diarrheal samples with hospitalization and bloody diarrhea in Tehran, Iran.

Methods

Shigella spp. were isolated and identified using standard microbiological and serological methods. The virulence genes were detected using MPCR.

Results

Seventy-five Shigella spp. (40 S. sonnei, 33 S. flexneri, 1 S. dysenteriae, and 1 S. boydii) were isolated in this study. The prevalence of ial, sen, sat, set1A, and set1B was 74.7%, 45.4%, 28%, 24%, and 24%, respectively. All S. flexneri isolates, while no S. sonnei, S. dysenteriae, or S. boydii isolates, contained sat, set1A, and set1B. All isolates were positive for ipaH, ipaBCD, and virA, while one (1.4%) of the isolates contained stx. The highest prevalence of virulence determinants was found in S. flexneri serotype IIa. Nineteen (57.6%) of 33 S. flexneri isolates were positive for ipaBCD, ipaH, virA, ial, and sat. The sen determinants were found to be statistically significantly associated with hospitalization and bloody diarrhea (p = 0.001).

Conclusion

This study revealed a high prevalence of enterotoxin genes in S. flexneri, especially in serotype 2a, and has presented relations between a few clinical features of shigellosis and numerous virulence determinants of clinical isolates of Shigella spp.

Citations

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Factors Influencing Animal Bites in Iran: A Descriptive Study: Rouhullah Dehghani, Alireza Sharif, Mahla Madani, Hamed H. Kashani, Mohammad R. Sharif; Osong Public Health Res Perspect. 2016;7(4):273-277. Published online August 31, 2016; DOI: https://doi.org/10.1016/j.phrp.2016.06.004

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Abstract PDF

Objectives
Animal bite is a significant health economic challenge worldwide. In Iran, there has been an increase in the number of animal bites in recent years. This study was performed to investigate the epidemiology of animal bites and their influencing factors in Semirom, Iran, from 2008 to 2012.
Methods
This was a descriptive study conducted for 5 years. The data were based on the information sheets presented in health-care centers concerning how to combat against rabies caused by animal bites. The data obtained were classified and analyzed statistically.
Results
During the 5-year study period, 1,246 animal bite cases were reported; 60% of the victims belonged to rural areas and the remaining 40% to urban areas. Among various aggressive animals, dogs had the highest rate of attacks (63.4%). The highest rate of animal bite (23.19%) was reported in the age group of 10–19 years and the lowest one (2.32%) was reported in the age group of 0–4 years. The animal bite rates among men and women were 76% and 24%; respectively. The highest and lowest rates were found among students (23.5%) and employees (5.5%), respectively. Regarding the commonly injured organ, the highest (67%) and lowest rates (23%) were for lower extremities and head and face, respectively. Regarding the nationality of the victims, 98% were Iranians and the rest were Afghan.
Conclusion
Given the increasing number of animal bites reported, there is a need to implement strategies to prevent bite-related complications, which may have health and financial burden on the country. It is also necessary to increase awareness among target groups and to formulate preventive strategies with the help of various authorities to control animal bites.

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Epidemiological and Clinical Features of People with Malta Fever in Iran: A Systematic Review and Meta-Analysis: Mahmood Moosazadeh, Roja Nikaeen, Ghasem Abedi, Motahareh Kheradmand, Saeid Safiri; Osong Public Health Res Perspect. 2016;7(3):157-167. Published online June 30, 2016; DOI: https://doi.org/10.1016/j.phrp.2016.04.009

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Abstract PDF

Objectives
Numerous studies have reported the epidemiological and clinical features of Malta fever incidence in Iran. Review and synthesis of the related literature through meta-analysis can provide an appropriate measurement for aforementioned indices. Therefore, the present study aimed to determine the epidemiological and clinical features of people with Malta fever in Iran.
Methods
The required documents were obtained through searching national and international databases. In each study, standard deviation of the indices was calculated using binomial distribution formulas. Finally, the heterogeneity index was determined between studies using Cochran (Q) and I² tests.
Results
Combining the results of 47 articles in the meta-analysis indicated that 57.6% (55.02–60.1%) and 42.3% (49.8–44.9%) of the patients were male and female, respectively. Most of the patients lived in rural areas; 68.4% (63.6–73.2%) compared to 31.4% (26.7–36.3%). In addition, 20.8% (17.4–24.2%) of the patients were ranchers and farmers, 16.9% (14.5–19.4%) were students, and 31.6% (27–36.2%) were housewives. Of the patients studies, 50.5% (35.6–65.2%) experienced contact with animals and 57.1% (46.4–67.9%) used unpasteurized dairy products. Fever, joint pain, and sweating were detected among 65.7% (53.7–77.8%) and 55.3% (44.4–66.2%), respectively.
Conclusion
The present study revealed that the frequency of male patients with brucellosis was considerably more than that of female patients. The number of patients with Malta fever in rural areas was significantly more than in urban areas. High-risk behavior, unprotected contact with animals, and using unpasteurized dairy products were among the most significant factors affecting Malta fever incidence in Iran. Fever, joint pain, and sweating were detected among most of the patients with Malta fever.

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Diagnostic significance of hematological parameters in brucellosis
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Presence of Brucella spp. in Milk and Dairy Products: A Comprehensive Review and Its Perspectives
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Predicting of Bacteremia in Patients with Brucellosis Using Machine Learning Methods
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Hadi Bagheri, Leili Tapak, Manoochehr Karami, Zahra Hosseinkhani, Hamidreza Najari, Safdar Karimi, Zahra Cheraghi, Esteban Tlelo-Cuautle
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Hai-Tao Yuan, Cheng-Ling Wang, Li-Na Liu, Dan Wang, Dan Li, Zhen-Jun Li, Zhi-Guo Liu
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Antibiotic Resistance of Acinetobacter baumannii in Iran: A Systemic Review of the Published Literature: Jale Moradi, Farhad B. Hashemi, Abbas Bahador; Osong Public Health Res Perspect. 2015;6(2):79-86. Published online April 30, 2015; DOI: https://doi.org/10.1016/j.phrp.2014.12.006

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Abstract PDF

Objectives
Acinetobacter baumannii is a bacterium responsible for health care-associated infections, and it frequently develops multiple drug resistance (MDR). The prevalence of antibiotic-resistant A. baumannii in Iran has increased, and this may cause significant clinical problems. Therefore, in order to elucidate the development of antibiotic resistance, we performed a systematic review of the literature published on antibiotic-resistant A. baumannii reported in Iran.
Methods
Thirty-six publications that met the criteria for inclusion were reviewed from an initial 87 papers. Selected papers published between 2008 and September 2014, were categorized on the basis of the sample collecting year been between 2001 and 2013.
Results
Analysis of data revealed that, in general, there was an increase in antimicrobial resistance. During the initial time point of these studies (2001–2007) there was a high rate of resistance to all antibiotics, with the exception of carbapenems, lipopeptides, and aminoglycosides that had a low resistance rate in comparison with the others. Also, the resistance rate was increased in one group of these three antimicrobial groups from 2010 to 2013. In particular, there was an increase in resistance to carbapenems (imipenem and meropenem) from 2010–2011 and 2012–2013, whereas no significant change in the resistance rate of the other two antimicrobial groups (lipopeptides and aminoglycosides) during the study time was observed, although we did observe certain trends in amikacin (aminoglycoside group antibiotic) between 2011–2012 and 2012–2013.
Conclusion
These findings indicate that antimicrobial resistance of A. baumannii in Iran has increased, which may very well affect the antimicrobial resistance of this organism worldwide. Based on these results, novel prevention and treatment strategies against A. baumannii infections are warranted. Furthermore, these data may assist in revising treatment guidelines and regional policies in care units to slow the emergence of antimicrobial resistance.

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Brief Report

Acute Human Cytomegalovirus Infection with Bleeding in Iran: Behzad Pourhossein, Farhad Yaghmaei, Saber Esmaeili, Omid Banafshi, Shahla Afrasiabian, Mohammad Reza Shirzadi, Mark Schleiss, Ehsan Mostafavi; Osong Public Health Res Perspect. 2014;5(6):383-386. Published online December 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.10.003

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Abstract PDF: In December 2011, a 42-year-old male farmer was admitted to a hospital in Sanandaj (Western Iran) with fever and anemia in order to check whether he suffered from some infectious diseases. During the first 3 days after admission, the patient gradually developed progressive oliguria, fever, abdominal pain in the right upper quadrant, leukocytosis with toxic granulation, petechiae and ecchymosis, oral bleeding, and vomiting. The sonographic findings revealed splenomegaly and an increase in the thickness of the gall bladder wall. In order to manage the patient and taking into consideration the most probable differential diagnoses, diagnostic tests were performed on two blood samples collected from him, and real-time polymerase chain reaction for human cytomegalovirus was positive.

Original Articles

Characterization of Plasmid-Mediated AmpC and Carbapenemases among Iranain Nosocomial Isolates of Klebsiella pneumoniae Using Phenotyping and Genotyping Methods: Alireza Japoni-Nejad, Ehsanollah Ghaznavi-Rad, Alex van Belkum; Osong Public Health Res Perspect. 2014;5(6):333-338. Published online December 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.09.003

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27 Download
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Abstract PDF

Objectives
Plasmid-mediated AmpC β-lactamases (PMABLs) and carbapenemases are emerging groups of antimicrobial-resistance determinants. The aims of the study were to evaluate the occurrence of PMABLs and carbapenemases in clinical isolates of Klebsiella pneumoniae and compare the test performance of various phenotypic methods for detection of these enzymes in Iran.
Methods
A total of 100 K. pneumoniae isolates were collected from clinical specimens obtained in Valiasr Hospital. AmpC production in all isolates was determined using the AmpC disk test, the cephamycin Hodge test, the AmpC Etest, and the boronic acid combined-disk test. In addition, carbapenemase production was determined using the modified Hodge test, the EDTA disk synergy test, and the boronic acid combined-disk test. The performances of various phenotypic methods were evaluated by the comparison of their results with polymerase chain reaction (PCR) method as the gold standard.
Results
Of the 100 isolates, 19 (19%) were demonstrated to harbor the PMABL-resistance gene by the multiplex PCR method. The PCR result indicated the presence of carbapenemase genes in 12 isolates. The performance of various phenotypic tests carried out for detection of carbapenemase-producing isolates varied widely, ranging in sensitivity from 30% to 100% and in specificity from 90.8% to 100%.
Conclusion
This is the first report of MOX-type AmpC β-lactamase and bla_GES in K. pneumoniae in Iran. A comparison of the phenotypic methods showed that a combination of cefoxitin plus boronic acid is optimal for detecting plasmid-mediated AmpC enzymes in K. pneumoniae, whereas the implementation of molecular methods is often complex, requires specially trained personnel, and is associated with higher costs.

Citations

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The Global and Regional Prevalence of Hospital-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection: A Systematic Review and Meta-analysis
Xing-chen Lin, Chang-li Li, Shao-yang Zhang, Xiao-feng Yang, Meng Jiang
Open Forum Infectious Diseases.2024;[Epub] CrossRef
High frequency of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae isolates in central Iran
Elnaz Abbasi, Ehsanollah Ghaznavi-Rad
BMC Microbiology.2023;[Epub] CrossRef
Detection of ESBL and AmpC producing Klebsiella pneumoniae ST11 and ST147 from urinary tract infections in Iran
Shaghayegh Shahkolahi, Pegah Shakibnia, Shahla Shahbazi, Samira Sabzi, Farzad Badmasti, Mohammad Reza Asadi Karam, Mehri Habibi
Acta Microbiologica et Immunologica Hungarica.2022;[Epub] CrossRef
Plasmid-mediated AmpC β-Lactamase gene analysis in Klebsiella Pneumoniae clinical isolates
Nabi Jomehzadeh, Khadijeh Ahmadi, Hasti Shaabaninejad, Gholamali Eslami
Biomedical and Biotechnology Research Journal (BBR.2022; 6(4): 582. CrossRef
Characterization of Antimicrobial Resistance Patterns of Klebsiella pneumoniae Isolates Obtained from Wound Infections
Roya Ghanavati, Hossein Kazemian, Parisa Asadollahi , Hamid Heidari, Gholamreza Irajian, Fatemeh Navab-Moghadam, Shabnam Razavi
Infectious Disorders - Drug Targets .2021; 21(1): 119. CrossRef
An investigation of extended-spectrum β-lactamases (ESBLs) in Klebsiella isolated from foodborne outbreaks in Iran
Farnaz Hajikarim, Mohammad Mehdi Soltan Dallal, Mohammad Reza Pourmand, Milad Abdi
Gene Reports.2020; 19: 100632. CrossRef
Prevalence and Mechanisms of Carbapenem Resistance in Klebsiella pneumoniae and Escherichia coli: A Systematic Review and Meta-Analysis of Cross-Sectional Studies from Iran
Mohammad Javad Nasiri, Mehdi Mirsaeidi, Seyyed Mohammad Javad Mousavi, Mania Arshadi, Fatemeh Fardsanei, Behnaz Deihim, Sara Davoudabadi, Samin Zamani, Bahareh Hajikhani, Hossein Goudarzi, Mehdi Goudarzi, Zahra Sadat Seghatoleslami, Hossein Dabiri, Payam
Microbial Drug Resistance.2020; 26(12): 1491. CrossRef
Characterization of β-lactam resistance in K. pneumoniae associated with ready-to-eat processed meat in Egypt
Shaymaa H. Abdel-Rhman, Grzegorz Woźniakowski
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Multiplex PCR to detect pAmpC β-lactamases among enterobacteriaceae at a tertiary care laboratory in Mumbai, India
Mubin Kazi, Kanchan Ajbani, Jeffrey A. Tornheim, Anjali Shetty, Camilla Rodrigues
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AmpC β lactamases in Urinary Klebsiella pneumoniae Isolates: First Report of ACC Type AmpC β-lactamase Resistance in Iran
Maryam Ghane, Laleh Babaeekhou, Mahdi Jafar Shanjani
Journal of Advances in Medical and Biomedical Rese.2019; 27(123): 23. CrossRef
The Molecular and Clinical Epidemiology of Extended-Spectrum Cephalosporin– and Carbapenem-Resistant Enterobacteriaceae at 4 US Pediatric Hospitals
Danielle M Zerr, Scott J Weissman, Chuan Zhou, Matthew P Kronman, Amanda L Adler, Jessica E Berry, Jaipreet Rayar, Jeff Myers, Wren L Haaland, Carey-Ann D Burnham, Alexis Elward, Jason Newland, Rangaraj Selvarangan, Kaede V Sullivan, Theoklis Zaoutis, Xua
Journal of the Pediatric Infectious Diseases Socie.2017; 6(4): 366. CrossRef
Previous Antibiotic Exposure Increases Risk of Infection with Extended-Spectrum-β-Lactamase- and AmpC-Producing Escherichia coli and Klebsiella pneumoniae in Pediatric Patients
Danielle M. Zerr, Arianna Miles-Jay, Matthew P. Kronman, Chuan Zhou, Amanda L. Adler, Wren Haaland, Scott J. Weissman, Alexis Elward, Jason G. Newland, Theoklis Zaoutis, Xuan Qin
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Molecular characterization of extended-spectrum β-lactamase, plasmid-mediated AmpC cephalosporinase and carbapenemase genes among Enterobacteriaceae isolates in five medical centres of East and West Azerbaijan, Iran
Mohammad Reza Sadeghi, Reza Ghotaslou, Mohammad Taghi Akhi, Mohammad Asgharzadeh, Alka Hasani
Journal of Medical Microbiology .2016; 65(11): 1322. CrossRef
High Prevalence of AmpC β-Lactamases in Clinical Isolates of Escherichia coli in Ilam, Iran
Abbas Maleki, Afra Khosravi, Sobhan Ghafourian, Iraj Pakzad, Shiva Hosseini, Rashid Ramazanzadeh, Nourkhoda Sadeghifard
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Evidence Gap on the Prevalence of Non-conventional Risk Factors for Type 2 Diabetes in Iran: Abdolreza Shaghaghi, Ali Ahmadi; Osong Public Health Res Perspect. 2014;5(5):292-297. Published online October 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.08.002

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Abstract PDF

Objectives
Robust scientific evidence exists about the role of non-conventional risk factors in type 2 diabetes worldwide. The current epidemiological pattern of the disease in Iran suggests a precipitating role for these non-conventional risk factors. This review was performed to examine the research evidence suggesting a higher prevalence of non-conventional type 2 diabetes risk factors in Iran.
Methods
MeSH keywords were applied to search several databases, including PUBMED, MEDLINE, AMED, EMBASE, Iran DOC, and the Scientific Information Database without a time limit from inception to September 2011. The quality of the non-interventional and population-based studies on Iranians included in these databases was assessed by the authors and any disagreement was resolved with consensus.
Results
The literature search yielded 1847 publications, of which 62 were included in this study after eliminating non-relevant and overlapping papers. No study was found that verified a higher prevalence of the non-conventional type 2 diabetes risk factors in the Iranian population.
Conclusion
The identified evidence gap about the role of prominent non-conventional risk factors of type 2 diabetes in the Iranian population could be a major caveat in the application of an evidence-based approach to endorse or reject existing hypothesis about these risk factors. Studies on the prevalence of non-conventional biomarkers of type 2 diabetes among Iranians could be a promising area of research.

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Application of Pender’s health promotion model for type 2 diabetes treatment adherence: protocol for a mixed methods study in southern Iran
Nahid Shahabi, Zahra Hosseini, Teamur Aghamolaei, Amin Ghanbarnejad, Ahmad Behzad
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Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS)
Sanam Hariri, Zahra Rahimi, Nahid Hashemi-Madani, Seyyed Ali Mard, Farnaz Hashemi, Zahra Mohammadi, Leila Danehchin, Farhad Abolnezhadian, Aliasghar Valipour, Yousef Paridar, Mohammad Mahdi Mir-Nasseri, Alireza Khajavi, Sahar Masoudi, Saba Alvand, Bahman
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Association of modified Nordic diet with cardiovascular risk factors among type 2 diabetes patients: a cross-sectional study
Elnaz Daneshzad, Shaghayegh Emami, Manije Darooghegi Mofrad, Sahar Saraf-Bank, Pamela J. Surkan, Leila Azadbakht
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High Prevalence of Class 1 to 3 Integrons Among Multidrug-Resistant Diarrheagenic Escherichia coli in Southwest of Iran: Mohammad Kargar, Zahra Mohammadalipour, Abbas Doosti, Shahrokh Lorzadeh, Alireza Japoni-Nejad; Osong Public Health Res Perspect. 2014;5(4):193-198. Published online August 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.06.003

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Abstract PDF

Objectives
Horizontal transfer of integrons is one of the important factors that can contribute to the occurrence of multidrug-resistant (MDR) bacteria. This study aimed to determine the prevalence of integrons among MDR Escherichia coli strains isolated from stool specimens and investigate the associations between the existence of integrons and MDR properties in the southwest of Iran.
Methods
There were 164 E. coli strains isolated from January 2012 to June 2012. Fecal specimens identified as E. coli by the conventional methods. Subsequently the antibiotic resistance was assessed using Clinical and Laboratory Standard Institute criteria. The presence of class 1–3 integrons and embedded gene cassettes was verified using specific primers by multiplex polymerase chain reaction assay.
Results
Among a total of 164 studied samples, 69 (42.07%) isolates were multidrug resistant. Class 1 and class 2 integrons were present in 78.26% and 76.81% MDR isolates, respectively. For the first time in Iran, class 3 integron was observed in 26.09% MDR isolates. Significant correlations were identified between: class 1 integron and resistance to amikacin, gentamicin, chloramphenicol, ampicillin, tetracycline, nalidixic acid, and co-trimoxazole; class 2 integron and resistance to aminoglycosides, co-trimoxazole, cefalexin, ampicillin, and chloramphenicol; and class 3 integron and resistance to gentamicin, kanamycin, and streptomycin.
Conclusion
Our results indicate that integrons are common among MDR isolates and they can be used as a marker for the identification of MDR isolates. Therefore, due to the possibility of a widespread outbreak of MDR isolates, molecular surveillance and sequencing of the integrons in other parts of the country is recommended.

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Frequency of antimicrobial resistance and integron gene cassettes in Escherichia coli isolated from giant pandas (Ailuropoda melanoleuca) in China
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Colistin-Resistant Klebsiella pneumoniae: Prevalence of Integrons and Synergistic Out Turn for Colistin-Meropenem
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Detection of Class I and II integrons for the assessment of antibiotic and multidrug resistance amongEscherichia coliisolates from agricultural irrigation waters in Bulacan, Philippines
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