Journal of Research in Health Sciences
Volume:11 Issue: 1, Winter-Spring 2011

Malaria is a major cause of morbidity and mortality in Nepal. The magnitude of malaria across the country is alarming and varies with location. Therefore, the present study aimed to model malaria incidence rates during 1998 to 2009 in Nepal. Data for the study were obtained from Health Management Information System (HMIS), Ministry of Public Health. A negative binomial model was used to fit malaria incidence rates as a function of year and location and provided a good fit, as indicated by residual plots. In total, 83,345 cases of malaria were reported from 1998 to 2009. The mean incidence rate was 0.30 per 1000 population. The models show trends and spatial variations in disease incidence. There was decreasing trend in the incidence rates of malaria (1998-2004), followed by a more moderate upward trend until 2008, when the rate decreases again. Zero malaria incidences occurred in six districts including Humla, Jajarkot, Manang, Kathmandu, Bhakthapur and Solukhumbu districts for over twelve years. Higher incidence occurred in Kanchanpur, Kailali, Bardiya, Kavre, and Jhapa districts for the study period. Malaria is still a public health problem in Nepal. This study showed a steady decreasing trend in malaria incidence but the numbers of cases are still very high. Higher rates were observed in Terai Region and border areas. These findings highlight the need for more systematic and effective malaria control measures on malaria burden areas of Nepal.

Noise is one of the most important harmful agents in work environment. Noise pollution in oil refinery industries is related to worker's health. This study aimed to determine the overall noise pollution of an oil refinery operation and its frequency analysis to determine the control plan for a vent noise in these industries. This experimental study performed in control unit of Tehran Oil Refinery in 2008. To determine the noise distributions, environmental noise measurements were carried out by lattice method according to basic information and technical process. The sound pressure level and frequency distribution was measured for each study sources subject separately was performed individually. According to the vent's specification, the measured steam noise characteristics reviewed and compared to the theoretical results of steam noise estimation. Eventually, a double expansion muffler was designed. Data analysis and graphical design were carried out using Excel software. The results of environmental noise measurements indicated that the level of sound pressure was above the national permitted level (85 dB (A)). The Mean level of sound pressure of the studied steam jet was 90.3 dB (L). The results of noise frequency analysis for the steam vents showed that the dominant frequency was 4000 Hz. To obtain 17 dB noise reductions, a double chamber aluminum muffler with 500 mm length and 200 mm diameter consisting pipe drilled was designed. The characteristics of steam vent noise were separated from other sources, a double expansion muffler was designed using a new method based on the level of steam noise, and principle sound frequency, a double expansion muffler was designed.

The systematic application of Pap test helps early diagnosis and effective treatment of cervical cancer. This study was conducted to assess the effect of education on health beliefs and practice of women eligible for Pap test using Health Belief Model (HBM). This quasi-experimental study was conducted in Hamadan City, the west of Iran, in 2010 using before-after design. In this study, 70 women aged 16 to 54 years participated voluntarily who had never done Pap test until the date of the study. The volunteers were divided into several small groups. For each group, 2-hour training session was held twice. The data collection tool was a self-administered multi-choice questionnaire that was developed based on HBM constructs. Health beliefs and practice of the target group were evaluated pre-intervention and four months later. Our findings indicated that education based on HBM was effective and could enhance the participant's knowledge significantly and improve the HBM constructs including perceived susceptibility, severity, benefits, and barriers. The training program enhanced the practice from zero before intervention to 81.4% after that. The results of the present study revealed that increase in knowledge had effect on the HBM constructs. Furthermore, there was a significant relationship between knowledge and both age and educational level. Health education based on HBM can enhance women's knowledge of cervical cancer, change their health beliefs and improve their behaviors regarding screening programs like Pap test.

During the last decades, to assess the risk factors of work-related musculoskeletal disorders (WMSDs), enormous observational methods have been developed. Rapid Entire Body Assessment (REBA) and Quick Exposure Check (QEC) are two general methods in this field.This study aimed to compare ergonomic risk assessment outputs fromQEC and REBA in terms of agreement in distribution of postural loading scores based on analysis of working postures. This cross-sectional study was conducted in an engine oil company in which 40 jobs were studied. All jobs were observed by a trained occupational health practitioner. Job information was collected to ensure the completion of ergonomic risk assessment tools, including QEC, and REBA. The result revealed that there was a significant correlation between final score (r=0.731) and the action levels (r =0.893) of two applied methods. Comparison between the action levels and final scores of two methods showed that there was no significant difference among working departments. Most of studied postures acquired low and moderate risk level in QEC assessment (low risk=20%, moderate risk=50% and High risk=30%) and in REBA assessment (low risk=15%, moderate risk=60% and high risk=25%). There is a significant correlation between two methods. They have a strong correlation in identifying risky jobs, and determining thepotential risk for incidence of WMSDs. Therefore, there is possibility for researchers to apply interchangeably both methods, for postural risk assessment in appropriate working environments.

Self care of diabetes is essential for control of disease and improvement of quality of patient's life. The aim of this study was to assess factors influencing self-care practice of patients in urban area of Urmia, Northwest of Iran. In this cross-sectional study, 400 diabetic patients were randomly selected from eight healthcare centers in Urmia City in 2010. Data collection tools was a questionnaire included data on demographic characteristics, diabetes statues, and self-care practice. Patient's self-care practice was classified to good, moderate, and poor levels. ANOVA and Chi–square tests were used to exam the association between self-care practice and clinical and behavioral factors. Spearman’s rho correlation was used to examine the relation between self-care practice and control of glycemia. The patient's self-care practice was good in 15.1%, moderate in 58.7%, and poor in 26.2%. There was a significant association between education (P= 0.030), duration of disease (P = 0.04), and treatment intensity (P = 0.001) and self-care practice of patients. Despite the important role of self-care practice in management of diabetes and preventing its serious complications, most patients who have medical record in health care centers had inappropriate self-care practice especially in SMBG, which has critical role in controlling diabetes.

The aim of this study was to assess the effects of road deicing salt on the quality of the ground water resources in Hamadan Province during winter season. Water samples were taken monthly from thirty wells located around the Hamadan-Asadabad highway. The quality of well water was examined by measuring amount of sodium, chloride, total hardness, total dissolved solid, electrical conductivity, total fecal coliform, and total coliform in well water sample. The correlation between mineral deposits in the water samples and the distance of wells from the highway was investigated using Pearson Correlation Coefficient. It was estimated that nearly 11,000 tons salt were applied annually in this province for deicing roads and streets. There was a statistically significant negative correlation between the quality variables of well water taken from a distance less than 400 meters from highway axis in the southern side except for fecal coliform and total coliform. No statistically significant correlation was seen between the distance from the highway axis and the quality variables of well water taken from the northern side. There was a significant difference between water quality variables of the wells located in a distance less than 200 meters in the northern side of the highway, with that of the wells located in southern side of the highway (p<0.05). A positive correlation between road dicing salt and mineral deposits in the ground water resources was indicated. Therefore, regarding the limited water resources in Hamadan Province, constraining application of road deicing salt is recommended.

Intestinal parasitic infection is one of the major public health problems in developing countries. Children are more vulnerable to these infections. In addition, the prevalence of infection is different among various communities; hence, there is a need for the periodical prevalence evaluation. This study was performed to define the prevalence of intestinal parasitic infection among the students of South Khorasan Province, eastern Iran in 2007. A cross-sectional study was performed on 2169 students aged 6-11 years in six cities of South Khorasan Province in 2007. Three stool specimens were collected from each student. Specimens were examined with direct wet and formalin ethyl acetate method. Data were analyzed with SPSS version 15 software. From a total 2169 students, 47.7% were infected with one or more intestinal parasites. Almost 33.4% were pathogen parasites. The most common parasite was Giardia (28.7%). The prevalence rate of infection was significantly higher in rural area than that of urban area (P=0.001). The prevalence of infection was also much more common in those students whose parents were less educated. Prevalence of intestinal parasitic infection in this region is remarkable. Public health education and using healthy water are recommended

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major global public health problems. This study was conducted to investigate the incidence rate of these infections over six successive years in Hamadan Province, the west of Iran. This retrospective cohort study was conducted on the database of hepatitis registry. In this study, 1257 subjects infected by HBV and 705 subjects infected by HCV were detected and enrolled. HBV infection was detected by presence of HBsAg and HCV infection by presence of Anti-HCV. In order to estimate province-based age-specific incidence rates of HBV and HCV infections, we used the same age-specific population as the denominator. The incidence rate pre 100,000 population from 2004 to 2009 for HBV infection was 19.60, 12.29, 12.31, 11.13, 9.46, 7.70 (P<0.001) and for HCV infection was 6.73, 7.42, 7.57, 8.45, 5.30, 5.17 respectively (P<0.001). The incidence rate of HBV infection decreased continuously over time, while the incidence rate of HCV infection fluctuated and even increased from 2004 to 2007 then decreased. The rate ratio of trend for HBV infection across successive years was 0.85 [95% CI: 0.82, 0.88] and that of HCV infection was 0.94 [95% CI: 0.90, 0.99]. The decreasing trend in the incidence rate of HBV infection in current years may be the result of vast national immunization of newborn and adolescents against hepatitis B infection. On the other hand, fluctuating incidence rate of HCV infection with a temporarily increasing growth is critical and should be the focus of the health policymaker's special attention.