فهرست مطالب marjan meshkati

Job burnout is more frequent in stressful and high-risk jobs. Healthcare workers, especially Voluntary Counseling and Testing (VCT) workers and therapists, are more exposed to job burnout. This study aimed to compare the burnout rate among the staff and therapists working in behavioral disease counseling centers and health centers in 9 provinces of Iran.

This cross-sectional study was conducted in 9 provinces of Iran from January 2020 to March 2020. For this research, 94 VCT workers as the experimental group, and 103 public clinic workers participated as the available sampling group. To collect the data, the Meslesh questionnaire was used and descriptive statistics (frequency, percentage, mean, etc.) and inferential methods were applied for statistical analysis (t-test, one-way analysis of variance and Tukey post hoc test, chi - square test and Spearman correlation test). (P< 0.05)

Our finding showed that 33% of health center workers and 32% of VCT workers had burnout, but the difference was not statistically significant. Most Health Center (HC) workers who showed burnout were working in the southern province of Iran (Bushehr and Bandar Abbas), and the most VCT workers who showed burnout were working in the western province of Iran (Kermanshah and Kurdistan).

Although the rate of burnout in the staff of these two centers is very similar, it can be concluded that due to the small number of people referred to AIDS centers compared to the large number of patients in health centers, working with people with HIV/AIDS is so difficult.

AIDS is one of the most important causes of death among adults. The effect of prognostic factors on HIV-positive patients has not been properly investigated, but it can be estimated by retrospective studies. The present study was conducted with the aim of determining the survival rate among HIV-positive and AIDS patients as well as identifying important survival factors in these patients in Isfahan province.
The present study is a retrospective cohort study, in which the information of 594 HIV-positive patients of Isfahan province, were extracted from behavioral diseases counseling center and recorded in checklist. The patient's survival period for tow outcomes of the time interval between diagnosis to the progression to AIDS stage and the time interval between progression to AIDS and death, were drawn using life table and Kaplan-Meier graph. The effect of several prognostic factors on the survival time was investigated with cox proportional regression. Cox regression model was used to examine the simultaneous effect of variables on the survival time. The significance level was considered p Out of total 594 studied patients, 504 subjects (84.8%) were male and 50.8% were in the age group of 25-34 years. The main route of transmission was intravenous drug use (70.2%). The one-year, 5-year, and 10-year survival rates after diagnosis were 97%, 75%, and 62%, respectively. The risk of death in patients with tuberculosis co-infection, was 2.1 times higher (CI, 95%: 1.35, 3.11) than patients with no history of tuberculosis. The risk of death in patients with a history of imprisonment was 12.1 times higher (CI, 95%: 1.69, 17.86).
based on the results of this study, the survival rate of HIV-positive patients in Isfahan province was favorable compared to other studies. Tuberculosis comorbidity as well as a history of imprisonment are also among the most important prognostic factors for survival time in the patients. Therefore, it is necessary that imprisoned patients have appropriate and favorable access to care and treatment services.

Hepatitis B and C and human immunodeficiency virus (HIV) infection are a serious health issue in Iran. Knowledge of the designed standard precautions can reduce occupational injuries which result in the transmission of these viruses. This study was conducted to determine the rate of occupational injuries and awareness of the standard precautions among laboratory staff and nurses of Dehaghan and Shahreza, Iran.
This cross-sectional study was conducted on 77 laboratory staff and nurses of governmental centers affiliated to Isfahan University of Medical Sciences, Iran, who were selected through census method. A researcher-made questionnaire was used to assess knowledge of standard precautions and occupational injuries. Data were analyzed using descriptive indices, and chi-square and Mann-Whitney tests in SPSS software.
Findings: None of the subjects had awareness of Standard precautions at adequate level. The findings showed that 15.6% and 84.4% of subjects had a medium and poor level of knowledge. In this study, a significant association was found between gender and immunization against hepatitis B (P Given the low level of awareness and frequent recurrence of injuries such as the needlestick injury, cutting and scratching of the skin, and etcetera in the subjects, an integrated and consistent planning for training on the standard precautions seems necessary.

One of the groups predisposed to viral coinfection of hepatitis B and C (HCV and HBV) is injecting drug prisoners. The crimes, they were sentenced to prison for, are often the same high risk behavior, which predispose individuals to high risk diseases like AIDS and hepatitis. Because coinfection of hepatitis B and C complicates the clinical course, management, and therapy, the literature on the prevalence of HBV/HCV coinfection among intravenous drug abuse inmates in Iran is sparse.. This study aimed to investigate the prevalence of hepatitis B and C coinfection in drug abuse prisoners and its association with demographic characteristics and high risk behaviors..Patients and This cross-sectional study was carried out on drug abuse prisoners during 2009 in Isfahan. Data were collected by questionnaire, including high risk behaviors, medical and surgery record, and demographic characteristics. Blood samples were tested for HBsAg and HCV Ab. Data were analyzed using descriptive statistics and Pearson test.. The results showed that 20 inmates (2.1%) had coinfection of HBV and HCV. Also a significant correlation exists between coinfection of HBV and HCV and dental care (P = 0.02), using a shared needle (P = 0.01), and history of imprisonment (P = 0.01).. With regard to the results of the present research, in order to lower the risk of these diseases transmission in prison, some interventions are recommended as follows: informing the prisoners and enhancing their awareness about high risk behaviors, screening them prior to entry and during their stay, giving them sterile syringes, and supervising more carefully over entrance of drugs into the prison..

Drug injection is one of the most prominent risk factors for transmission of viral hepatitis. Prevalence of hepatitis B virus (HBV) is generally higher in prisoners compared with the general population. Th e object of this study was to assess the markers of HBV and related risk factors among intravenous drug users (IVDU) in prisoners.

Th rough a cross-sectional study in 2012 HBV infection and its risk factors were assessed in prisoners with a history of intravenous drug use in Isfahan, Iran. A checklist was fulfi lled for each participant and 5 ml blood was taken from each subject. Sera were analyzed for markers of the hepatitis B: Hepatitis B virus surface antigen (HBsAg), antibody to hepatitis B virus surface antigen (HBsAb) and hepatitis B virus core antibody (HBcAb) by ELISA. We used Chi-square test and logistic regression model to analyze data and P < 0.05 was considered to be signifi cant.

All of the studied participants (n = 970) were men. Th e mean ± standard deviation of the age of the subjects was 32.61 ± 8.1 years and the majority of them had less than high school education. More than 40% of these men had a history of injection drug inside prison and 2.27% of them self-reported history of HBV infection. Of the 970 IVDU, 32 (3.3%) were positive for HBsAg. Among HBsAg + subjects, 23 (71.88%) were HBcAb+. 120 (12.37%) were found positive for isolated HBsAb, 45 (4.64%) for isolated HBcAb and 67 (6.9%) for both HBsAb and HBcAb. History of sharing needle (odds ratio: 2.25, 95% confi dence interval: 1.09-4.65) had a signifi cant association with HBsAg positivity.

Th e results suggest that history of sharing needle had a signifi cant association with HBsAg positivity. It seems that educational programs for injecting drug related behaviors, especially syringe sharing, are needed for IVDU.

Background and Expanding of acquired immune deficiency syndrome (AIDS) is such an important issue that one of the main goals of World Health Organization (WHO) is increasing of knowledge about human immunodeficiency virus (HIV)/AIDS in general population. Thus, in Iran forth developing program, prevention programs for HIV/AIDS has been mentioned. AIDS is a behavioral disease, so education is necessary for changing high-risk behaviors. In this descriptive study, 9207 married women at the age of 10-49 years who were coming to health centers were selected by systematic method sampling. We collected data by a valid questioner. Total score for knowledge and attitude was 100. 85.4% of women were living in cities and 14.6% in villages. Most of them were homemaker (93.4%). The women were trained about HIV/AIDS but just 13.4% of them had complete awareness. The first source for getting information was television and then, health care providers. The mean score for knowledge was 81.6 ± 17.7 and there was a significant relation between the score of knowledge and women''s age, educational level and career (P < 0.001). Findings showed limited knowledge about HIV/AIDS so we need to improve methods of training and use variety in our awareness program for married women at the age of 10 to 49. It is necessary to keep the rights of patients and increase social marketing for voluntary counseling and testing (VCT), care and treatment of people live with HIV/AIDS.

Injection drug use plays the most important role in transmission of hepatitis C. In Iran, surveys have been conducted on various high risk groups but this is the first announcement based study for hepatitis C virus HCV prevalence among cases with history of intravenous drug using (IVDU) in the country. The announcement-based detection and follow-up of patients with anti-HCV positive project in volunteers with history of intravenous drug using was conducted in Isfahan province. At the first step, six focus groups were conducted and 2 pilot studies were carried out in two cities to design the main study. Comprehensive community announcement was done in all of public places and for physicians. The volunteers were invited to Isfahan reference laboratories and the serum samples were sent to Infectious Diseases Research Center Laboratory in standard conditions and HCV-Ab was tested by ELISA method. In this study, 1,747 individuals that are estimated 50% of all expected intravenous drug users in the community were presented themselves. The most important reasons of success in recruiting volunteers in this study were the perfect propaganda, appropriate cooperation of lab staffs, continuous evaluation and good cooperation in Isfahan province administrations. HCV-Ab was detected in 34% of them and the HCV-Ab positives were sent for further follow-up procedures including confirmatory test, education, and treatment. In spite of some limitations to select real cases, this study was considered as a successful experience. Compared to the surveys in Iran on HCV prevalence in intravenous drug users, the results of this study, which was based on volunteers by announcement seems to be noteworthy.

Hepatitis C virus (HCV) is one of the major public health problems worldwide which is transmitted through contact with infected blood or blood products. One of the most prevalent modes of HCV transmission is injecting drug with unclean needles or syringes. Therefore intravenous drug users (IVDUs) are the most important group who should be considered. The aim of this study was to evaluate seroprevalence and risk factors of hepatitis C virus in IVDUs population. The cross-sectional study was carried out on intravenous drug users who attended health and social care Drop-in centers during November 2008 to February 2009 in Isfahan province, Iran. Data was gathered using interviewer-administered questionnaire including demographic characteristics and main risk factors for HCV infection. 5ml venous blood sample was obtained from each subject. The HCV-Ab test was performed on all blood samples by ELISA. The data was analyzed using descriptive statistical methods and multiple logistic regressions by SPSS software, version 15. The mean age of participants was 31.77 ± 8.51. 503 (94.7%) were men and 28 (5.3%) were women. HCV seroprevalence was 47.1% (95% CI: 42.9, 51.3). The multiple logistic regressions demonstrated that history of tattooing (OR 1.72, 95% CI 1.02-2.90), history of imprisonment (OR 2.49, 95% CI 1.40-4.42) and sharing needles/syringes (OR 2.76, 95% CI 1.54-4.95) are significant predictors of risk of HCV in IVDU population. In conclusion, according to the high prevalence of HCV infection among IVDUs and high adds of HCV infection from tattooing, sharing of needles/syringes and imprisonment, effective harm reduction programs should be expanded among IVDUs to prevent new HCV infections.

Intravenous drug abuse is a worldwide problem with side effects as hepatitis C. Hepattis C infection, which has severe complications like cirrosis and hepatocellular carcinoma, is a tragedy for communities; so, screening it in intravenous drug abusers has a lot of benefits. According to lack of a community based study in Isfahan, Iran, this pilot study carried out in Golpayegan city in Isfahan Province. In a cross sectional pilot study, hepatitis C in intravenous drug abusers population in Golpaygan, Isfahan was screened by community annaouncement method. After co-opperation with managers, administrative stafs and all of the stakeholders, the study population was invited to refference laboratories where blood samples were chpsen and tested for anti-HCV-Ab. The results were sent privately and patients were invited to participate in educational and treatment procedure. From 136 persons participated voluntarily, 28 were anti-HCV-Ab positive (19.8%). In this pilot study, 85% of estimated population was participated that is excellent experience for larger studies.

Hepatitis C, as a major public health problem, has serious complications and intravenous drug users are the most high risk group for it. This study was performed to determine hepatitis C seroepidemiolgy and related risk factors among intravenous drug users in Isfahan province. In this cross-sectional study, intravenous drug users (IVDUs) in central prison, Assadabad camp and Drop in Centers in Isfahan province were selected using census sampling method. After completion validated questionaire including demographic and risk factors by interiew, a 5 cc blood sample was obtained and HCV-Ab was detected using ELISA method. Among 1485 intravenous drug users (1457 male) with mean age of 32 ± 7 years, 644 (43.4%) were HCV-Ab positive. Not being married, tatooing, needle share, prison history, history of going to dentist and duration of intravenous drug abuse were indepenedent risk factors for hepatitis C. Also, men with men sex, sex with intravenous drug users and unprotected sex (without condom) had significant relationship with hepatitis C. Among HCV risk factors, needle share and prison history had hightest relative and attributable risks. Using ROC curve, the cut off point for duration of intravenous drug abuse was estiamted as three months. The main results of this study indicated high prevalence rate of hepatitis C and the major role of needle share and prison history among intravenous drug users population in Isfahan province that needs to pay attention by governments.

Injection drug use plays the most important role in transmission of hepatitis C. In Iran, surveys have been conducted on various high risk groups but this is the first announcement based study for anti-HCV prevalence among cases with history of intravenous drug using (IVDU) in the country.

The announcement-based detection and follow-up of patients with anti-HCV positive project in volunteers with history of intravenous drug using was conducted in Isfahan province. At the first step, six focus groups were conducted and 2 pilot studies were carried out in two cities to design the main study. Comprehensive community announcement was done in all of public places and for physicians. The volunteers were invited to Isfahan reference laboratories and the serum samples were sent to Infectious Diseases Research Center Laboratory in standard conditions and HCV-Ab was tested by ELISA method.

In this study, 1747 individuals that are estimated 50% of all expected intravenous drug users in the community were presented themselves. The most important reasons of success in recruiting volunteers in this study were the perfect propaganda, appropriate cooperation of lab staffs, continuous evaluation, and good cooperation in Isfahan province administrations. HCV-Ab was detected in 34% of them and the HCV-Ab positives were sent for further follow-up procedures including confirmatory test, education, and treatment.

In spite of some limitations to select real cases, this study considered as a successful experience. Compared to the surveys in Iran on HCV prevalence in intravenous drug users, the results of this study which was based on volunteers by announcement seems to be noteworthy.

Hepatitis C virus (HCV) is a major public health problem in the world which drug injection is a primary mode of transmission for it. So, this study was conducted to determine seroprevalence of HCV in intravenous drug abusers (IVDA) in Isfahan province Drop in centers (DIC). This qualitative/quantitave study used triangulation method in data collection and analysis. Five semi-structured focus groups with open-ended questions were disposed to evaluate and discuss on aspects of the study. Intravenous drug abusers in Isfahan province Drop in centers by non-probable purposive sampling method entered into the study voluntarily and blood sample was obtained from them. Serum samples were tested for HCV-Ab using ELISA method. There were seven govermental Drop in centers including 4 related to Isfahan University of Medical Sciences and 3 related to welfare organization which contained 1581 intravenous drug abusers members. From them, 539 patients (34%) enterd into the study from which, 250 (47.1%) patients were positive for HCV-Ab without significant differences between men and women. The main impressive factors for the project were wage for blood obtaning, occupational insurance, problems in interview and sampling, and time restriction. This was a good experience for other investigators and health directors’ strategies to design simillar studies or harm reduction.