Letter to the editor
Cancer Epidemiology
Zohreh Shahhosseini; Fatemeh Hamidi
Abstract
Dear Editor, Coronaviruses are important human and animal pathogens. In December 2019, a new virus from the coronavirus family, called coronavirus disease 2019 (COVID-19), triggered the outbreak of pneumonia from Wuhan across China. The virus originated in bats and was transmitted to humans through unknown ...
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Dear Editor, Coronaviruses are important human and animal pathogens. In December 2019, a new virus from the coronavirus family, called coronavirus disease 2019 (COVID-19), triggered the outbreak of pneumonia from Wuhan across China. The virus originated in bats and was transmitted to humans through unknown intermediate animals. Currently, the lives of millions of people around the world are affected by the crisis caused by the outbreak of COVID-19 diseases, which has brought huge economic and social costs. Despite the efforts made in many countries to reduce the risks and the negative effects of this crisis, the damage and the resulting costs are still increasing. People with cancer are among the groups that need more attention and are highlighted as high-risk groups. The risk of morbidity and mortality from COVID-19 as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is not uniform. Evidence show that patients with cancer have an increased risk of developing severe forms of COVID-19 compared with the non-cancer population. It seems that cancer patients are at a higher risk of respiratory viruses such as influenza because of their frequently observed immunocompromised state. Patients with blood malignancies, such as non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute myeloid leukemia, acute lymphoblastic leukemia, and multiple myeloma, along with those in active treatment for any type of cancer and people who have undergone bone marrow transplants are among the high-risk groups. According to the existing literature on COVID-19 pathogenesis and cancer, several shared features have been selected to define the risk assessment in cancer patients, including patient characteristics (such as older age, underlying diseases, obesity, and sex), disease characteristics, therapeutic characteristics, and clinical and laboratory variables. Given the competitive risks of cancer-related deaths and serious complications from SARS-CoV-2 and higher mortality, providing care for cancer patients in this crisis is a challenging task. Many cancer patients are seeking to find a cure for their disease due to cancellation or delay in treatment, including surgery, chemotherapy, and radiation therapy. There are also concerns that patients with curable cancers, who need timely treatments, find the risk of COVID-19 higher than the benefits of cancer treatment. New findings from researchers in the United States show that 13% of patients, including cancer patients, who used a combination of azithromycin and hydroxychloroquine or just hydroxychloroquine for treatment died within one month. However, further testing is needed to determine the risks and benefits of these drugs. It has recently been reported that using a combination of the two drugs to treat cancer patients infected with COVID-19 has tripled their risk of death within 30 days. Hence, it is recommended that these patients do not use the mentioned drugs. Insufficient provision of personal protective equipment for health care providers, limited hospital capacity, including intensive care units, may be effective in providing care to people with cancer. Early treatment of cancer patients should not be compromised during the pandemic. However, patient management should be tailored to the best available resources, and the need for any intervention should be balanced against the increased risk of pandemic. In addition, alternative modified procedures, including counseling and treatment services such as home care and tele-nursing should be considered for cancer patients. The goals, alternative modified procedures, including counseling and treatment services, were to ensure the continuity of care and to protect the health care professionals from the infection. Health scholars in different disciplines have proposed another method to manage cancer patients; according to these scholars, in special circumstances, cyberspace like “WhatsApp”, “Telegram”, or “Instagram” should be used to communicate with patients and share educational materials and information. Moreover, training nurses to respond appropriately to patient needs, such as stress management and proper nutrition, is essential. Outpatients should be treated with the safest level of care and away from any danger. Several measures may help reduce the virus transmission as follows: training the proper communication rules and hand hygiene protocols, explaining infection control measures, teaching the signs and symptoms of COVID-19, highlighting the importance of staying home and non-exposure to high-risk individuals, and emphasizing the importance of reporting any new symptoms to physicians and health care providers. Attendance at the clinic should be limited only to patients themselves and a maximum of one companion; in addition, outpatient care clinics, including chemotherapy injection units should have careful screening and be prepared to identify possible cases safely and without risk of transmission. Currently and due to the limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic, but for each patient, a separate decision should be made according to age, general condition, stage, and spread of the disease, and the patients should consult their physician about this issue. At present, more than ever, the world needs to espouse perspectives free of race, religion, ethnicity, and gender to help countries come together for the sake of the health of all populations. Community participation, attention to the health of all cancer patients in all age groups, non-discrimination, access to quality services and information, and appropriate collaboration can help in this regard.
Original Article
Health Promotion
Pegah Mohaghegh; Ehsan Abedi; Masomeh Sofian; Fatemeh Rafiei
Abstract
Background and aims: The prevalence of coronavirus disease 2019 (COVID-19) resulted in health anxiety among general population and unreasonable referring to health centers. This study aimed to assess health anxiety related to COVID-19 in individuals referring to healthcare centers of Arak, Iran in 2020. ...
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Background and aims: The prevalence of coronavirus disease 2019 (COVID-19) resulted in health anxiety among general population and unreasonable referring to health centers. This study aimed to assess health anxiety related to COVID-19 in individuals referring to healthcare centers of Arak, Iran in 2020. Methods: Using convenient sampling method, the participants of this cross-sectional study were selected from 16 urban health centers of Arak. Salkovskis 18-item Health Anxiety Inventory (HAI-18) was completed by 392 participants. The collected data entered in SPSS software version 24 and was analyzed by Mann-Whitney U and Kruskal-Wallis tests. Results: Mean ± SD of total score of health anxiety was 28.96 ± 7.62. Most participants (74.7%) had medium anxiety and 19.1% had high anxiety. The mean of total score of health anxiety was higher in the 30-59 age range, higher education, single people and students. Participants with chronic diseases and symptoms of cold and people who referred to health centers due to COVID-19 screening had a higher anxiety level. Conclusion: Most people referring to health centers of arak had moderate anxiety. COVID-19-related health anxiety was higher in middle age range, higher education, students, people with chronic diseases, and people with symptoms of common cold.
Original Article
Epidemiology
Saleh Jafarian; Ali Ahmadi; Masoud Amiri; Rahman Biokani; Zohreh Abbaspour; Masoud Mahmoudzadeh
Abstract
Background and aims: Motorcycle accidents are a major concern for countries. One of the most important risk factors for motorcyclists is the lack of helmet use. This study aimed to measure the rate of the helmet use and predictive factors in Shahrekord, Iran. Methods: Using simple random ...
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Background and aims: Motorcycle accidents are a major concern for countries. One of the most important risk factors for motorcyclists is the lack of helmet use. This study aimed to measure the rate of the helmet use and predictive factors in Shahrekord, Iran. Methods: Using simple random sampling method, this cross-sectional study was conducted in 2018 with a sample size of 350 motorcyclists. A researcher-made questionnaire was used to collect data, and the SPSS software version 24 was used to analyze the data. Results: The mean age of participants was 28.8 ± 10.1 years. Out of 350 participants, 15.1% and 1.4% of motorcyclists and their passengers used helmets. The most important predictors of helmet use were age more than 35 years, high education, and having a driving license. The most important reason for using the helmet was protection against injuries in accidents. Conclusion: According to our results, the rate of helmet use was low. Thus, more efforts should be made to intervene and train for the helmet use among community members with an emphasis on younger people, individuals with governmental jobs, and people with lower education level.
Original Article
Epidemiology
Shervin Assari
Abstract
Background and aims: Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including, but not limited to, problematic substance use. Negative urgency is also shaped by family socioeconomic position (SEP), such as parental educational ...
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Background and aims: Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including, but not limited to, problematic substance use. Negative urgency is also shaped by family socioeconomic position (SEP), such as parental educational attainment (PEA). This study aimed to explore sex differences regarding protective effects of PEA on children’s negative urgency in the US. Methods: This cross-sectional study used the Adolescent Brain Cognitive Development (ABCD) study data. Baseline ABCD data included 10,535 American children in the age range of 9-10 years old. The independent variable was PEA, treated as a 5-level categorical variable. The primary outcome was negative urgency measured by the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-SS). Mixed-effects regression models were applied for data analysis. Results: In sex-stratified regression models, high PEA was predictive of lower levels of negative urgency in female but not male children. In the overall sample, sex showed a statistically significant interaction with PEA on children’s negative urgency, indicating a stronger protective effect of high PEA for female compared to male children. Conclusion: PEA was a more salient determinant of negative urgency in female children than male ones. Our results also showed that American boys tend to have high levels of negative urgency, which is a risk factor of drug use, at all parental education levels.
Original Article
Infectious Disease
Paul I Oyegoke; Busayo O Olayinka; Joseph O Ehinmidu; Babajide A Tytler
Abstract
Background and aims: The spread of antimicrobial resistance (AMR) is a serious public health threat complicating treatment and resulting in prolonged hospitalization. The prevalence of AMR threat is not well defined due to the dearth of appropriate surveillance systems. This study sought to assess ...
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Background and aims: The spread of antimicrobial resistance (AMR) is a serious public health threat complicating treatment and resulting in prolonged hospitalization. The prevalence of AMR threat is not well defined due to the dearth of appropriate surveillance systems. This study sought to assess the prevalence of AMR among bacterial isolates from sputum specimens obtained from patients with pneumonia presenting at two secondary healthcare facilities in Zaria from June 1 to August 31, 2018. Methods: Standard methodology was followed in processing sputum samples that met the acceptance criteria. The antibiotic susceptibility patterns of bacterial pathogens cultured from sputum specimens obtained from June 1 to August 31, 2018) were evaluated using the recommendation of the Clinical and Laboratory Standards Institute. Finally, data were analyzed using descriptive statistics. Results: Acinetobacter spp. were the predominant pathogens accounting for 32% of recovered isolates, followed by Staphylococcus spp. (18%) and Klebsiella spp. (17%), respectively. AMR was found in 91% of the isolates. Most isolates were resistant to erythromycin (ERY) (80%) and amoxicillin (83.3%). Eventually, the multiple antibiotic resistance index ≥0.3 was observed in 76% of the isolates. Conclusion: Based on the findings, AMR rates were observed to be high, and may display a serious therapeutic challenge to the management of community-acquired pneumonia. Concerted efforts are needed to combat the worrisome AMR trends revealed in this study.
Original Article
Epidemiology
Shervin Assari
Abstract
Background and aims: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority ...
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Background and aims: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups such as Blacks and Latinos than non-Latino Whites, which is due to racism and social stratification. In this study, we investigated the association between parental education and children’s sleep problems, as a proxy of sleep problems, by race. Methods: This cross-sectional study included 11718 American children aged 9-10. All participants were recruited to the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education, a five-level nominal variable. The dependent variable – sleep problems, was a continuous variable. Race/ethnicity was the effect modifier. Age, sex, and marital status were the covariates. Mixed-effects regression models were used for data analysis. Results: Parental education was associated with children’s sleep problems. However, there was a weaker inverse association seen in non-Latino Black and Latino families compared to non-Latino White families. This was documented by a significant statistical interaction between race and ethnicity and parental education on children’s sleep problems. Conclusion: Diminished protective effect of parental education on children’s sleep problems for non- Latino Black and Latino families compared to non-Latino White families is similar to the MDRs in other domains. Worse than expected sleep may contribute to higher-than-expected health risks of middle-class Black and Latino children.
Original Article
Epidemiology
Eidha Ali Bin-Hameed; Huda Ameen Joban
Abstract
Background and aims: Cholera is a disease of acute watery diarrhea caused by Vibrio cholerae usually transmitted through contaminated water. In this study, we collected and analyzed the related epidemiological data to determine cholera outbreak in Hadhramout, Yemen during the disease epidemic in 2019. ...
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Background and aims: Cholera is a disease of acute watery diarrhea caused by Vibrio cholerae usually transmitted through contaminated water. In this study, we collected and analyzed the related epidemiological data to determine cholera outbreak in Hadhramout, Yemen during the disease epidemic in 2019. Methods: A cross-sectional study was conducted according to screening rapid diagnostic and confirmatory laboratory culture testing methods for diagnosing clinically cholera cases. Results: Suspected cholera cases were tested by rapid diagnostic test (RDT) and 399 (50.5%) out of 794 cases were determined positive, and 76(9.6%) of them were confirmed by laboratory culture test (LCT) with statistically significant difference. Serotype V. cholerae O1 was also detected in patients’ diarrhea. Females were the most affected by the disease manifested in 201 (25.3%) and 43 (5.4%) when tested by RDT and LCT, respectively, with no statistically significant difference. The highest proportion of cholera cases (224) were reported in the age group less than 15 years (56.1%) with statistically significant difference when tested by RDT, and 45(13.3%) when tested by LCT with insignificant statistics difference. Hajr directorate was revealed to be the most affected with 242 (30.47%) followed by Mukalla city directorate with 108 (13.60%) when the cases were tested by RDT; while Hajr and Mukalla city directorates reported 55 (7.0%) and 15 (2.0%), respectively, when it was confirmed by LCT with a statistically significant difference. Conclusion: Severe cholera outbreak occurred during the epidemiological weeks in 2019 in Hadhramout coast. V. cholerae O1 serotype was the causative agent of cholera. Females and age group less than 15 years were the most affected by the disease. Hajr and Mukalla city directorates reported serious outbreak cholera cases.
Original Article
Epidemiology
Sajad Bagherian; Majid Mardaniyan Ghahfarrokhi; Ebrahim Banitalebi
Abstract
Background and aims: According to the World Health Organization (WHO), immediate self-quarantine is assumed as the best course of action for highly contagious diseases. Since the coronavirus disease 2019 (COVID-19) pandemic, many individuals have become overweight and are also suffering from physical ...
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Background and aims: According to the World Health Organization (WHO), immediate self-quarantine is assumed as the best course of action for highly contagious diseases. Since the coronavirus disease 2019 (COVID-19) pandemic, many individuals have become overweight and are also suffering from physical problems. The present study aimed to evaluate the effect of the COVID-19 pandemic on interest in home-based exercise. Methods: This digital epidemiological study used data sources outside the health system. This descriptive study with a comprehensive electronic systematic search in the Google Trends database using the keyword of “home-based exercise” retrieved the relevant data about the Internet search activity of Iranian community members. The data were accordingly obtained within two time intervals, i.e., from February 18, 2020 to October 18, 2020 and eight months prior to the outbreak of COVID-19 (June 18, 2019 to February 18, 2020). To analyze the data, the Wilcoxon test and the Spearman’s correlation coefficient were used. Results: The results showed significant increase in “home-based exercise” Google search in the eight-month time interval during COVID-19 compared with the same period before the pandemic (P < 0.001). Moreover, there was a significant correlation between “home-based exercise” Google search and positive COVID-19 cases in the time intervals of February 18, 2020 to April 18, 2020 (r = 0.756, P = 0.0001), April 18, 2020 to June 18, 2020 (r = -461, P = 0.0001), but not June 18, 2020 to August 18, 2020 (r = 0.044, P = 0.737), August 18, 2020 to October 18, 2020 (r = 0.246, P = 0.056), and over time (r = -0.083, P = 0.0195). Conclusion: The prevalence rate of the COVID-19 pandemic and social constraints including self-quarantine seem to have raised people’s interest in doing exercises, especially home-based exercises.
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