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November 2017 -
Volume 15, Issue 9

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From the Editor

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Original contribution/Clinical Investigation
Diabetes Mellitus - Knowledge, Management and Complications: Survey report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah Haider, Muhammad Masood Ahmad

Alanine aminotransferase indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley Pocock

Comparative Analysis of Antimicrobial Peptides Gene Expression in Susceptible/Resistant Mice Macrophages to Leishmania major Infection

Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani, Amir Tavakoli Kareshk, Arash Asadi

Does socio-economic status of the patients have effect on clinical outcomes after coronary artery bypass grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed Kouhpyma

Comparison of the uterine artery Doppler indices during pregnancy between gestational diabetes and diabetes mellitus and healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud Jaafarnejhad,
Parisa Bahrami Kamangar

Survey single dose Gentamicin in treatment of UTI in children with range of 1 month to 13 years old in Jahrom during 2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab

Evaluation of control of bleeding by electro cauterization of bleeding points of amplatz sheath tract after percutaneous nephrolithotomy (PCNL) in Jahrom Peymanieh hospital during year 2015-2016
Ali Reza Yousefi , Reza Inaloo

Comparison of the three-finger tracheal palpation technique with triple ID formula to determine endotracheal tube depth in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori

Effect of Sevoflurane and Propofol on pulmonary arterial pressure during cardiac catheterization in children with congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza Mohseni, Azim Zaraki
Population and Community Studies

Prevalence and risk factors of obesity in children aged 2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal Darwish

Study and comparison of psychological disorders in normal students and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Comparative study of self-concept, physical self-concept, and time perspective between the students with multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Relationship between Coping Styles and Religious Orientation with Mental Health in the Students of the Nursing-Midwifery Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid Dastras, Shirzad Arianmehr

Tuberculosis in Abadan, Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi, Rahil Hojjati,
Parvin Gholizadeh

Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad ; Hassan Zareei Mahmoodabadi ; Hossein Tavangar ; Seyed Mojtaba Yassini Ardekani ; Ali Akbar Vaezi

A comparative study of the self-actualization in psychology and Islam
Simin Afrasibi, Zakieh Fattahi

The effectiveness of cognitive - behavioral therapy in reducing the post-traumatic stress symptoms in male students survivors of earthquake in the central district of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh

Reviews

Effects and mechanisms of medicinal plants on stress hormone (cortisol): A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley Pocock

Comparing Traditional and medical treatments for constipation : A Review Article
Mohammad Yaqub Rajput

A review of anti-measles and anti-rubella antibodies in 15- 25 year old women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab

Review of percutaneous nephrolithotomy in children below 12 years old in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo

Physical and mental health in Islam
Bahador Mehraki, Abdollah Gholami

International Health Affairs

The Challenges of Implementation of Professional Ethics Standards in Clinical Care from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi

Cognitive Determinants of Physical Activity Intention among Iranian Nurses: An Application of Integrative Model of Behavior Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki, Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi

Effect of resilience-based intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader Aghakhani, Vahid Alinejad, Yaser Moradi

Education and Training

Calculation of Salaries and Benefits of Faculty Members in the Ministry of Health and Medical Education of Iran
Abdolreza Gilavand

The effect of education on self-care behaviors of gastrointestinal side effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram Razie, Lila Nezam Abadi Farahani

Creating and Validating the Faith Inventory for Students at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Creating and Validating the Adjustment Inventory for the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Evaluating the Quality of Educational Services from the Viewpoints of Radiology Students of Ahvaz Jundishapur University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl

An Investigation of Psychosocial aspect of Iranian Nursing Students' Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari Anbohi, Amir Almasi-Hashiani, Fariba Borhani

Clinical Research and Methods

Comparison of the Antibacterial Effects of Chlorhexidine Mouth washes with Jaftex Mouth wash on Some Common Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi

Study of the effect of plasma jet on Fusarium isolates with ability to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss

The comparison of anti-inflammatory effect in two methods of topical dexamethasone injection and topical application of ginger alcoholic extract after removing mandibular wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran Mirzaie, Ramin Seyedian, Narges Aria, Saman Jokar

The effect of curcumin on growth and adherence of major microorganisms causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami, Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab


Middle East Quality Improvement Program
(MEQUIP QI&CPD)

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

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November 2017 - Volume 15, Issue 9

Tuberculosis in Abadan, Iran (2012-2016): An Epidemiological Study


Ali-Asghar ValiPour
Azimeh Karimyan
Mahmood Banarimehr
Marzieh Ghassemi
Maryam Robeyhavi
Rahil Hojjati
Parvin Gholizadeh

Student Research Committee, Abadan School of Medical Sciences, Abadan, Iran

Corresponding author:
Marzieh Ghassemi
Student Research Committee,
Abadan School of Medical Sciences,
Abadan, Iran

Abstract

Determining the course of the disease and its changes over time can be of great importance in assessing the rate and manner of access to the strategies used to control illnesses.

This retrospective descriptive-analytic study was carried out with a survey of patients with tuberculosis in the affiliated cities of the Abadan School of Medical Sciences during a period of 5 years. The required data were collected from the “TB Register” software as well as information registered by TB health experts. The Kolmogorov Smirnov, Independent-T, Mann Whitney U and Wilcoxon tests were used for analysis of data using SPSS 22- software.

In this study, 720 patients with tuberculosis were studied, of whom 62.9% were male. 73.6% of patients lived in urban areas. The prevalence of tuberculosis is 22.34 per 100,000 population, of which 15.36 per 100,000 is pulmonary tuberculosis. Mean age of patients was 41.39 (SD±17.69) years with a range of 4-92 years.

Considering the fact that tuberculosis is a life-limiting disease and is most prevalent in the young age group of society, who are considered as the main capital and workforce, educating people who are at risk can significantly contribute to the prevention of disease.

Key words: Epidemiology, Tuberculosis, Abadan


INTRODUCTION

Today, tuberculosis is one of the biggest health problems in the world. The disease burden of Tuberculosis (TB), the major cause of death from single-agent infectious diseases in the world (even more than AIDS, malaria and measles), ranks tenth in terms of the global burden of disease (1, 2) . One in three people in the world is suspected to have been infected with TB, and one person is added every second (1, 3). In 2015, 10.4 million people worldwide have been infected with TB, with an estimated 1.8 million deaths. Also, more than 95% of deaths from TB occur in low-to-middle-income countries where 75% of the cases are seen in the economically active age group (15-54 years) (3-5).

In the last few decades, TB prevalence has decreased sharply in Iran; that is to say the prevalence rate decreased from 142 cases per 100,000 populations in 1964 to 12.59 per 100,000 populations in 2015, which indicates a decrease of more than tenfold. Further, the highest TB incidence rate belonged to the population aged 65 and above (3, 6). Since Iran is a neighbor of Afghanistan and Pakistan, which are among the countries with the highest burden, as well as Iraq (due to its crisis in recent years) and the newly independent countries of northern Iran, which suffer from a high prevalence of multi-drug resistant TB, there is need to pay more attention to the disease (1, 3, 7).

Considering the emphasis of the national program of TB control of case finding and treatment of patients, it seems necessary to identify the distribution pattern of the disease and determine its associated factors; thus considering this necessity and considering that the city of Abadan is adjacent to Iraq, the need for this study is highlighted more than before.

MATERIAL AND METHODS

The present study is a retrospective descriptive-analytic study that was carried out with a survey of people with tuberculosis in the affiliated cities of the Abadan Faculty of Medical Sciences during a period of 5 years from 2012 to 2016. The study was conducted in the cities of Abadan (30° 20’21”N 48°18’15” E), Shadegan and Khorramshahr respectively with a population of 298,090, 138,480 and 170,976 that are located in Khuzestan province, southwest of Iran. In this study, patients’ information was collected by referring to the health department of Abadan Faculty of Medical Sciences and using special software for registering patients with TB (TB Register) as well as information registered by TB health experts. Individuals included in the study were all patients with TB who were identified and treated according to the Ministry of Health’s protocol. Data collected including age, gender, place of residence, type of TB, successful or unsuccessful treatment, death etc. were analyzed using SPSS ver. 22. Statistical analysis was performed using descriptive statistics (frequency, mean, minimum and maximum, number of data and standard deviation) to obtainpreliminary information. With regard to inferential statistics, Kolmogorov Smirnov test was used to determine the normality of variables and the Independent-T, Mann Whitney U and Wilcoxon tests were used for further analysis. To reject or accept the assumptions, P-value = 0.05 was used and the results were considered significant at (P <0.05).

RESULTS AND DISCUSSION

Over a 5-year period of research, a total of 720 TB patients were identified in 3 of the surveyed cities, of which 18.9%, 25.3%, 17.5%, 18.1% and 20.3% of TB cases related to 2012, 2013, 2014, 2015 and 2016 (Figure 1). Figure 2 shows the number of TB cases in the selected cities. Of these, 89.7%, 4.2%, 4.3%, 1.3% and 0.4% included, respectively, new TB cases, relapsed TB cases, other cases, transmitted cases and treatment after absenteeism cases, and there was a significant difference between them.

Figure 1: Frequency of TB Patients Referred to Abadan Health Center (2012-2016)


Figure 2: Frequency of TB Patients according to Cities


The mean age of patients with TB was 41.39±17.69 with an age range of 4 to 92 years, of which 453 (62.9%) and 267 (37.1%) were male and female respectively, which shows a statistically significant difference. The mean age of men and women is 40.31 ± 16.29 and 43.21±19.73 respectively, which is not statistically significant. The results are calculated separately for urban and rural areas that show 530 (73.6%) and 190 (26.4%) of them lived in the urban and rural areas respectively, which shows a statistically significant difference. Table 1 provides a summary of the demographic data of TB patients based on information obtained from the Department of Health of Abadan Faculty of Medical Sciences.

Table 1: The details of demographic characteristics of TB patients referred to Abadan Health Centres

The results of data analysis show that 33.9%, 17.6%, 3.9% and 0.7% of the patients were married, single, divorced and patients with deceased spouses, and there was a significant difference among them pairwise from this point of view; i.e. the number of married people is more than single, more than divorced and more than a patient with a dead spouse. The data show that the literacy level of TB patients is significantly different, with 16.3% of illiterate patients, 17.4% of elementary education, 14.3% of secondary education, 6.1% of secondary education and diploma and 2.1% university degree. The following results were obtained with regard to the total number of individuals identified: completed the treatment period: 39.4%, recovery rate: 34.2%, death rate: 7.5%, wrong diagnosis: 3.2%, absence from the treatment period: 4.2%, were treatment failure: 2.8%, transmitted cases: 0.8% and ongoing treatment process: 7.9%. The results of TB treatment shows a significant difference. Of the total population, 54 deaths were reported from TB patients, of which 70.4%, 20.4%, 9.3% and 9.3% died due to other cases, unknown reasons and tuberculosis. There death causes differ significantly (Figure 3). In this study, a total of 720 TB cases were investigated in Abadan city over the past 5 years. The prevalence of TB and pulmonary TB was 22.34 and 36.15 per 100,000 people, respectively. The same prevalence rate was 22.34 and 17.52 per 100,000 inhabitants in the urban and rural areas, respectively.

Figure 3: Percentage of Treatment results in TB Patients Referred to Abadan Health Centers (2012-2016)


Figure 4 shows that the prevalence of tuberculosis in men and women living in the urban and rural areas was 27.11, 17.28 and 22.23 12.69 per 100,000 people, respectively. The prevalence of pulmonary tuberculosis was 15.36 per 100,000 people during the last 5 years. The same prevalence rate was 22.34 and 17.52 per 100,000 people, respectively. Figure 5 shows the frequency of TB patients per 100,000 people based on their place of residence for different age groups.

Figure 4: Tuberculosis incidence rate in Abadan Health Centers (2012-2016)


Figure 5: Tuberculosis incidence rate in Abadan Health Centers (2012-2016) according to living place

The findings of this study revealed that the highest number of TB patients is seen in the age group of 30-39 years, which is true in both the urban and rural groups, and then the age group of 20-29 years is placed in the next ranking. Nikbakht et al. in their study in Babol city reported the age group of 18-38 years as the group with highest number of tuberculosis patients (7). Gholami et al. in a study in Urmia found that the highest number of people with tuberculosis was seen in the age group of 40 -31 years (8). Noeske et al. also reported that most of the TB patients belonged to the age group of 25-34 years in Cameroon(5). In a study in Hamedan province, Khazaei et al. (6) reported that the largest TB cases occur in the age group over 60 years old, which is more consistent with the TB pattern of the whole country (7). It seems that the high number of affected people in the age group of 20-39 years old is due to the high population of this age group and the high prevalence of addiction among them. In the present study, the mean age of the patients studied was 41.39 ± 17.79 years with an age range of 4 to 92 years. Also, men accounted for the largest number of patients. In a study in northern Iran (9), Babamahmoodi et al. reported that the mean age for women and men was 50.57 and 51.14 respectively, and the majority of patients were male. Fronti and Hoa have also reported a higher incidence of the disease among men in their studies (10, 11). In a study in France, Cavalli reported a mean age of 40 years for patients (12). According to World Health Statistics, men were affected by the disease more than women(4). In a study, the most patients were affected by new cases of disease (89.8%). Hoa et al. (11) also reported the highest incidence of new cases. In general, the prevalence of the disease and pulmonary tuberculosis in this study was 22.34 and 15.36 per 100,000 people respectively, which was higher than the average prevalence of tuberculosis in the whole of Iran(3), which is 12.6 per 100,000 people for all TB cases and 8.57 per 100,000 for pulmonary tuberculosis. The prevalence rate reported in Cavalli et al.’s study (France) (12) and Fronti’s study (Italy) is 8.7 and 7.42 per 100,000 people, respectively.

CONCLUSIONS

Considering the fact that tuberculosis is a life-limiting disease and is most prevalent in the younger age group of society that is considered as the main capital and workforce, educating people who at risk can significantly contribute to the prevention and spread of disease.

REFERENCES

1. World Health Organization. factsheet no. 104- Tuberculosis. Available at: http://www.who.int/mediacentre/factsheets/fs104/en/ (Accessed august 2017)
2. Arsang SH , Kazemnejad A , Amani F Epidemiology of Tuberculosis in Iran (2001-08). Journal of Gorgan University of Medical Sciences. 2011;13(3):78-86.
3. Tuberculosis status, Center of Disease Control and Prevention (Division of TB and Leprosy Elimination), ministry of health and medical education, Iran, available at: http://tb-lep.behdasht.gov.ir/ (Accessed august 2017).
4. World Health Organization. Global Tuberculosis report, 2015. Available at: http://www.who.int/tb/publications/factsheet_global.pdf?ua=1.
5. Noeske J, Nana Yakam A, Abena Foe JL. Epidemiology of tuberculosis in Cameroon as mirrored in notification data, 2006-2014. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 2016;20(11):1489-94.
6. Khazaei S, Roshanaei G, Saatchi M, Zahiri A, Bathaei S, Salehynia H, et al. Epidemiology of pulmonary tuberculosis in the Hamadan province during 2005-11. 2. 2015;3(6):12-9.
7. Nikbakht HA, Hosseini SR, Sharifi-fathabad H, Habibzade R, Daemi A, Ghaffari-fam S. Clinical epidemiology and treatment findings of acute tuberculosis patients in Babol City (2009–2013). Journal of Acute Disease. 2016;5(3):216-21.
8. Gholami A, Gharehaghaji R, Moosavi-Jahromi L, Ali Sadaghiyanifar A. Epidemiologic Survey of Pulmonary Tuberculosis in Urmia city during 2004-2007. Knowledge & Health 2009;4(3):19-23.
9. Babamahmoodi F, Alikhani A, Yazdani Charati J, Ghovvati A, Ahangarkani F, Delavarian L, et al. Clinical epidemiology and paraclinical findings in tuberculosis patients in north of Iran. BioMed research international. 2015;2015:381572.
10. Fronti E, Vecchia M, Scudeller L, Pratico L, Marone P, Muzzi A, et al. Epidemiology of Mycobacterium tuberculosis infection in Pavia province, Lombardy, Northern Italy, 1998-2013. New Microbiol. 2016;39(4):264-8.
11. Hoa NB, Wei C, Sokun C, Lauritsen JM, Rieder HL. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Vietnam. BMC public health. 2011;11:367.
12. Cavalli Z, Ader F, Valour F, Saison J, Boussel L, Dumitrescu O, et al. Clinical Presentation, Diagnosis, and Bacterial Epidemiology of Peritoneal Tuberculosis in Two University Hospitals in France. Infect Dis Ther. 2016;5(2):193-9.


 


 


 

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