faezeh ebadi

The COVID‑19 pandemic has created several challenges for countries all over the world. Different countries have taken different measures to fight this pandemic and reduce its challenges depending on their cultural, economic, and social structures. This study aims to understand and explain the Iranian health system’s response to fighting the COVID‑19 pandemic from the managers’ and authorities’ perspective.

This study is a basic applied research performed under a qualitative approach. In the survey, 30 experts including the managers of health centers and deputies and heads of the Ministry of Health and Medical Education and Medical Universities were selected by purposive snowball sampling and participated in semi‑structured interviews from March to May 2020. The researchers explained the actions of the Iranian health system in fighting the COVID‑19 pandemic in 2020 by content analysis.

As a result, 14 subthemes were found and classified into four major themes, including the informative and regulative actions (two subthemes), administrative and supportive actions (six subthemes), preventive and curative actions (three subthemes), and resource‑related actions (three subthemes).

Due to its strong health structures, such as urban and rural health networks, various general and specialized hospitals, experienced doctors, and committed health staff, Iran has taken practical actions in fighting the COVID‑19 pandemic. However, the findings of this study and its relevant measures can help combat this pandemic in countries with similar social and cultural structures or counter future similar crises.

Nosocomial infections represent a serious public health concern worldwide, and, especially, in developing countries where, due to financial constraints, it is difficult to control infections. This study aimed to review and assess the prevalence of nosocomial infections in Iran.

Different databases were searched between January 2000 and December 2017. To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95% confidence interval. To examine the heterogeneity among studies, the I2 test were conducted. The reporting of observational studies in epidemiology (STROBE) checklist was used to assess the methodological quality of observational studies. To further investigate the source of heterogeneity, meta-regression analyses stratified by publication year, sample size and duration of hospitalization in the hospital were carried out.

52 studies were included. Based on the random-effects model, the overall prevalence of nosocomial infection in Iran was 4.5% [95% CI: 3.5 to 5.7] with a high, statistically significant heterogeneity (I2=99.82%). A sensitivity analysis was performed to ensure the stability results. After removing each study, results did not change. A cumulative meta-analysis of the included studies was performed based on year of publication and the results did not change. In the present study, a high rate of infections caused by Klebsiella pneumoniae (urinary tract, respiratory tract, and bloodstream infections) was found.

Preventing and reducing hospital infections can significantly impact on reducing mortality and health-related costs. Implementing ad hoc programs, such as training healthcare staff on admission to the hospital, may play an important role in reducing infections spreading.

Low birth weight (LBW), a crucial determinant of neonatal complications, represents a major public health concern worldwide. Epidemiological research is of crucial importance for designing and implementing ad hoc interventions for this issue, helping and guiding decision- and policy-makers in each country to prevent the increased prevalence of LBW in infants through estimating the prevalence rate, identifying and controlling major risk factors. The present investigation aimed to systematically assess LBW prevalence rate in Iran and its determinants.

PubMed/Medline via Ovid, Embase, Web of Science and Scopus as well as Magiran, SID and Irandoc were searched from inception until November 2016. Also, the grey literature (via Google Scholar) was mined. The DerSimonian-Laird model was exploited. The I2 and Q-test tests were used to investigate heterogeneity between the studies. Sensitivity and subgroup analyses were performed to ensure the robustness and validity of our findings. Different cumulative meta-analyses were conducted stratifying according to the year of publication and sample size. Any potential bias in publication was assessed carrying out the Egger’s test.

LBW prevalence rate was estimated to be 8% (95%CI: 7-9) in Iran. Sensitivity analysis confirmed the stability of finding. Studies were cumulated by the year of publication, and the results did not change pre- and post-cumulative meta-analysis. No publication bias could be observed.

LBW prevalence rate in Iran is well comparable with the prevalence figures of both developed and developing countries. This could be due to the health reforms implemented in Iran throughout the years.

Depression is one of the most commonly diagnosed mental disorders. Nurses and other hospital service providers are a group at high risk for developing depression. Thus, knowing the prevalence of depression among nurses can help the health care decision- makers to plan ad hoc prevention programs to control depression in this group. This study was conducted to quantitatively assess the prevalence of depression in nurses by performing a systematic review and meta-analysis.

ISI/Web of Science (WoS), PubMed/MEDLINE via Ovid, PsychInfo, and Embase, as well as Iranian databases such as Irandoc, SID, and Magiran were searched from January 2000 to March 2017. To calculate the pooled prevalence rate, the random effects model based on the DerSimonian-Laird approach was used. I2 and the Q tests were used to examine heterogeneity among studies. To investigate the causes and sources of heterogeneity, the impact of such variables as quality, sample size, geographic region, and criteria used to diagnose depression was analyzed performing subgroup analyses. The quality of reviewed studies was assessed according to the 22-item STROBE checklist. Sensitivity analysis was performed to investigate the stability and robustness of the obtained results. All data were analyzed using the “meta” package included in the R Software Version 3.4.0.

A total of 30 studies were retained in the current investigation. The overall prevalence of depression was 22% [95%CI 19-27] among nurses, with a high statistically significant heterogeneity (I2= 94% and Q-test= 479.87).

This rate was higher than the prevalence of depression among the general population in Iran. Presence of happy nurses with good mental state at hospitals is essential for promoting the care provided to patients.