mehdi shafiei-bafti

COVID-19 vaccination is one of the most successful ways to control the ongoing pandemic and prevent severe diseases, hospitalization, and death. Current evidence suggests COVID-19 vaccine hesitancy (a delay in accepting or rejecting the vaccine despite the availability of vaccination services) is a barrier to successful vaccination programs worldwide. This study aimed to explore the underlying factors associated with COVID-19 vaccine hesitancy among the Iranian population. This qualitative content analysis study was conducted using in-depth semi-structured interviews. A total of 32 Iranian participants with diverse ethnicity, language, age, and gender were selected through purposive sampling. Interviews were analyzed using Graneheim and Lundman’s qualitative content analysis method. MAXQDA software was used for data analysis. Three themes and eight subthemes emerged from the qualitative interviews. Individual underlying factors included knowledge, beliefs, and the fear of COVID-19 infection. Social factors included social media, the health system, and governance. Institutional factors included vaccine opponents and health experts that fueled COVID-19 vaccine hesitancy and refusal among the participants. Poor knowledge, misbelief, and fear were the most commonly reported causes of vaccine hesitancy and refusal among Iranians. Therefore, targeted interventions are recommended to address misinformation among the Iranian population.

Bladder cancer is the 10th most common cancer worldwide. We aimed to assess the prevalence of bladder cancer in the Kerman Province, in southeast Iran.

In this cross-sectional study, we used data on 1272 patients with bladder cancer registered in the Kerman population-based cancer registry from 2014 to 2017. There were two parts of data including observed data, including those cases whose information was recorded by the cancer registry, and the unobserved part, including cases before the registry department, was established, to calculate the complete prevalence. The latter was estimated using modeling to be included in the prevalence calculation. The complete prevalence of three-, five-, ten-, and twenty-year of bladder cancer up to the end of 2017 was calculated using rprev package.

A total of 185 (14.54%) women and 1,087 (85.45%) men were recruited. The overall three-, five-, ten-, and twenty-year prevalence of bladder cancer at the end of 2017 was 26.54, 43.46, 80.3, and 142.36 per 100,000 inhabitants, respectively. The prevalence was estimated to be at its lowest rate among both males and females under the age of 45, and at its highest rate among those over 61 and older. In all age groups, males were affected more than females.

The prevalence of bladder cancer in the Kerman Province was higher than the national average and increased with age. Regarding the aging population, policies and programs for prevention, early intervention, and awareness-raising in the community about this cancer are essential.

Foodborne and waterborne diseases are currently considered significant causes of death and related outbreaks throughout the world. Accordingly, this study investigated foodborne and waterborne disease outbreaks in Kerman Province.
The foodborne and waterborne disease outbreaks data in this descriptive-analytical study were collected from 2015 to 2019 in 9 cities that were registered in the Health Department of Kerman University of Medical Sciences. The outbreaks were examined and compared in terms of time (year, season, and month), county, etiological factors, type of food, and the place of the outbreak.
A total of 160 waterborne and foodborne disease outbreaks occurred in 9 cities in Kerman province from 2015 to 2019, which led to 3111 diseases, 824 hospitalizations, and 3 deaths. Most outbreaks were reported in Kerman in the spring and were mainly caused by food containing meat. Moreover, the most important known factor was E. coli. Residential houses were also the most common site of the reported outbreaks.
Given the high incidence of outbreaks in Kerman province, further education is necessary to improve the food health system and food safety.

This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran. Using convenience sampling and a standard questionnaire, we recruited 104 HIV-positive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma. The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=<0.001) experienced less internal stigma. In contrast, those who were a member of support group of PLHIV (Adj. ᵦ=2.8; p=0.04), and those infected by sexual contact (Adj. ᵦ=2.1; P=0.006) experienced a higher internal stigma. Moreover, married people (Adj. ᵦ=-1.4; p=0.01), those with high school or higher education (Adj. ᵦ=-1.7; p=0.002), and those with other transmission routes (Adj. ᵦ=-1.4; P=0.01) experienced lower external stigma. People living with HIV feel considerable internal and external stigma. Addressing HIV stigma should be tailored based on gender, education, marriage, peer groups, and risk groups as these factors have different effects on stigma experiences.

 Although seasonal influenza vaccination decreases infection rate and associated complications, its coverage rate is suboptimal in healthcare workers worldwide.

 The present study aimed at assessing the predictors of influenza vaccination and reasons for accepting or refusing it among nursing staff.

 The present study was conducted from February to March 2019 on nurses of three teaching hospitals affiliated to Kerman University of Medical Sciences in the Southeast of Iran. Data were collected using a validated questionnaire, including demographic data, knowledge, and attitude toward influenza and its vaccine, and reasons for accepting or refusing the vaccine. Data were analyzed by SPSS version 22. Independent samples t- and the chi-squared tests and the binary logistic regression were employed for data analysis.

 The influenza vaccination coverage rate was 10.1% among the nursing staff. Male gender (adjusted odds ratio (AOR) = 4.77, 95% confidence interval (CI) =2.13 - 10.64), receiving a recommendation for influenza vaccination in hospital (AOR = 1.86, 95% CI = 1.06 - 3.26), influenza vaccination of the family members (AOR = 2.61, 95% CI = 1.55 - 4.41), and a higher score of attitude toward influenza vaccination (AOR = 1.05, 95% CI = 1.03 - 1.07) increased the likelihood of influenza vaccination in the nursing staff. Fear of vaccine adverse effects (64.7%), lack of trust in vaccine manufacturers (36.0%), and being healthy (29.7%) were the most common reasons for refusing vaccination. Likewise, self-protection (79.6%), patient protection (73.0%), and family protection (72.4%) were the most common reasons for undergoing vaccination. The odds of influenza vaccine uptake was four times more among males than females (AOR = 4.77, 95% CI = 2.13 - 10.64), and odds of influenza vaccination was 1.86 times more among nursing staff receiving recommendations for influenza vaccination in hospital than the ones not receiving such recommendations (AOR = 1.86, 95% CI = 1.06 - 3.26). Also, odds of influenza vaccination increased 2.73 times in nursing staff whose family members received influenza vaccine (AOR = 2.61, 95% CI = 1.55 - 4.41). Furthermore, the model showed that one unit increase in the attitude score increased odds of influenza vaccination by 1.05 units (AOR = 1.05, 95% CI = 1.03 - 1.07).

 The influenza vaccination rate was suboptimal among the nursing staff. Also, there were poor knowledge and improper attitude toward influenza and its vaccine among healthcare workers. Therefore, appropriate policies should be made at national and regional levels on increasing the rate of influenza vaccination.
 

 Different aspects of coronavirus disease 2019 (COVID-19) in children have not been well understood so far.

 In this paper, we reported the clinical, Paraclinical, and epidemiological features of the hospitalized children infected with COVID-19 in the southeast of Iran.

 This cross-sectional study was conducted in six hospitals affiliated to Kerman University of Medical Sciences. All children who were under the age of 15 years old hospitalized with acute respiratory infection from February 20 to May 14, 2020, were included in this study. Demographic characteristics, past medical history data, and disease-related data such as symptoms, signs, radiologic, and laboratory data were collected.

 Of 97 hospitalized children with an acute respiratory infection, 13 cases (13.4%) had been diagnosed to be infected by COVID-19. The mean (standard deviation) and median of age of the patients with COVID-19 were 68.0 (55.9) and 60 months, respectively. Fever (n = 11, 84.6%), cough (n = 8, 61.5%), respiratory distress (n = 5, 38.5%), and gastrointestinal symptoms (n = 5, 38.5%) were known as the most common symptoms in patients with COVID-19. Frequency fever (84.6% vs 47. 6%, P = 0.016) and respiratory distress (38.8% vs 13.1%, P = 0.022) were significantly higher in patients with COVID-19 compared to non-COVID individuals. Frequency of admission in the intensive care unit (38.5% vs. 27.4%, P = 0.668) and death rate (15.4% vs. 7.1%, P = 0.291) were higher in patients with COVID-19 compared to non-COVID-19 subjects, but there were no significant differences between the two groups in term of these variables.

 A low proportion of children hospitalized with acute respiratory syndrome were infected by COVID-19. Most of the children with COVID-19 recovered with supportive care with no need for any specific treatment.

The aim of this study was to investigate the effectiveness of the harm reduction group therapy based on Bandura's self-efficacy theory on risky behaviors of sex workers in Kerman, Iran.
A quasi-experimental two-group design (a random selection with pre-test and post-test) was used. A risky behaviors questionnaire was used to collect. The sample was selected among sex workers referring to drop-in centers in Kerman. Subjects were allocated to two groups and were randomly classified into two experimental and control groups. The sample group consisted of 56 subjects. The experimental design was carried out during 12 sessions, and the post-test was performed one month and two weeks after the completion of the sessions. The results were analyzed statistically.
Findings: By reducing harm based on Bandura's self-efficacy theory, the risky behaviors of the experimental group, including injection behavior, sexual behavior, violence, and damage to the skin, were significantly reduced in the pre-test compared to the post-test (P The harm reduction group therapy based on Bandura's self-efficacy theory can reduce the risky behaviors of sex workers.