Epidemiology and Health

Original article

Effect of the human papillomavirus vaccine on the risk of genital warts: a nationwide cohort study of South Korean adolescent girls: Jaeyoung Cho, Eun Mi Kim, Jihye Kim, Ju-Young Shin, Eui Hyeok Kim, Jong Heon Park, Seunghyun Lewis Kwon, Geun-Yong Kwon, Soon-Ae Shin, Jaiyong Kim; Epidemiol Health. 2024;e2024040. Published online March 18, 2024; DOI: https://doi.org/10.4178/epih.e2024040 [Accepted]

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Abstract PDF: Abstract
OBJECTIVES
The purpose of this study was to assess the effectiveness of human papillomavirus (HPV) vaccination administered to adolescent girls through South Korea’s National Immunization Program.
METHODS
This retrospective cohort study included individuals who were 12 to 13 years old, whether vaccinated or unvaccinated, between July 2016 and December 2017. The incidence of genital warts (GWs) was monitored through 2021. Time-stratified hazard ratios (HRs) were estimated, adjusting for birth year, socioeconomic status, and the level of urbanization of the region, and were presented with 95% confidence intervals (CIs). Data were sourced from the Immunization Registry Integration System, linked with the National Health Information Database.
RESULTS
The study included 332,062 adolescent girls, with an average follow-up period of approximately 4.6 years. Except for the first year, the HRs for the vaccinated group were lower than those for the unvaccinated group. The HRs for specific cutoff years were as follows: year 2, 0.62 (95% CI, 0.31 to 1.13); year 3, 0.58 (95% CI, 0.35 to 0.96); and year 4 and beyond, 0.39 (95% CI, 0.28 to 0.52).
CONCLUSIONS
Our findings indicate that HPV vaccination was associated with a reduction in the risk of GWs among adolescent girls. Notably, this reduction became significant as the incidence of GWs increased with age.; Summary

Original Articles

Parental intention to vaccinate daughters with the human papillomavirus vaccine in Korea: a nationwide cross-sectional survey: Yejin Ha, Kyeongmin Lee, Bomi Park, Mina Suh, Jae Kwan Jun, Kui Son Choi; Epidemiol Health. 2023;45:e2023076. Published online August 17, 2023; DOI: https://doi.org/10.4178/epih.e2023076

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Abstract Summary PDF: Abstract
OBJECTIVES
We aimed to identify and compare the characteristics and factors associated with parental intention to vaccinate daughters under 12 years old against human papillomavirus (HPV), examining data from 2016 and 2020.
METHODS
Data were obtained from the Korean National Cancer Screening Survey conducted in 2016 and 2020. The present study included 3,510 parents with daughters under 12 years old. Changes in parental intention-to-vaccinate rates were calculated. To identify factors associated with parental intention to vaccinate their daughters, the chi-square test and logistic regression analysis were used.
RESULTS
The percentage of respondents intending to vaccinate their daughters increased from 33.4% in 2016 to 58.9% in 2020, constituting a 25.5 percentage point (%p) increase. Since 2016, the proportion of men expressing positive intention towards HPV vaccination increased by 31.5%p, while that of women demonstrated a 20.9%p increase. Logistic regression analysis indicated that parents with a strong intention to vaccinate their daughters tended to be younger, more educated, and aware of the free vaccination program available, as well as to have a history of HPV vaccination and to have undergone cervical cancer screening within 2 years, compared to those who did not intend to vaccinate. Being a mother with a history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.
CONCLUSIONS
The intention among parents to vaccinate daughters remains relatively low, although it is rising. To increase the HPV vaccination rate, strong recommendations and education should be provided to parents and the younger generation.; Summary

Korean summary
한국정부는 2016년부터 HPV 백신을 국가예방접종사업으로 도입하여 만 12세 여아를 대상으로 무료접종을 실시하고 있다. 12세 여아가 접종대상인만큼 부모의 HPV 백신에 대한 인식과 태도가 실제 예방접종에 중요한 영향을 미친다. 이 연구를 통해 2016년과 2020년을 비교했을 때 딸의 백신접종에 대한 의향이 증가하였음을 알 수 있었고, 특히 HPV 백신접종 경험이 있는 경우 딸의 백신접종에 대한 의향이 유의하게 높음을 확인하였다.

Key Message
In Korea, HPV vaccination was included in the national immunization program in 2016 for 12-year-old girls. The decision to undergo the HPV vaccination is closely associated with their parents’ perceptions of and attitudes toward the HPV vaccine. This study identified that parental intention increased from 2016 to 2020, and maternal history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.

The associations of tobacco use, sexually transmitted infections, HPV vaccination, and screening with the global incidence of cervical cancer: an ecological time series modeling study: Luyan Zheng, Yushi Lin, Jie Wu, Min Zheng; Epidemiol Health. 2023;45:e2023005. Published online December 13, 2022; DOI: https://doi.org/10.4178/epih.e2023005

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OBJECTIVES
We aimed to quantify the temporal associations between cervical cancer incidence and cervical cancer-related factors and to predict the number of new cervical cancer cases averted under counterfactual scenarios compared to the status quo scenario.
METHODS
We described temporal trends in cervical cancer and associated factors globally from 1990 to 2019. We then used generalized linear mixed models to explore the impact of tobacco use, sexually transmitted infections (STIs), human papillomavirus (HPV) vaccination, and cervical screening on cervical cancer incidence. A counterfactual analysis was performed to simulate the most effective scenario for reducing cervical cancer incidence.
RESULTS
The worldwide incidence of cervical cancer showed a downward trend over the past 3 decades (estimated annual percentage change, -0.72%), although the incidence remained high (>30 cases per 100,000 persons) in sub-Saharan Africa, Latin America, and the Caribbean. Higher smoking and STI prevalence showed significant direct associations with the incidence of cervical cancer, whereas HPV vaccination and screening coverage showed significant inverse associations. If the strategic goals for accelerating the elimination of cervical cancer and tobacco control programs had been achieved in 2019, the largest decrease in the number of new cervical cancer cases would have been observed, with 54,169 fewer new cases of cervical cancer in 2019.
CONCLUSIONS
Our counterfactual analysis found that a comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence.; Summary

Key Message
A comprehensive intervention program emphasizing scaled-up cervical screening coverage (70%), HPV vaccination coverage (90%), and tobacco control (30% relative reduction) would be the most effective program for reducing cervical cancer incidence in our counterfactual analysis.

Misconceptions and stigma against people living with HIV/AIDS: a cross-sectional study from the 2017 Indonesia Demographic and Health Survey: Desi Suantari; Epidemiol Health. 2021;43:e2021094. Published online November 6, 2021; DOI: https://doi.org/10.4178/epih.e2021094

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Abstract

OBJECTIVES
Data are not available in Indonesia to measure the main indicators of zero new infections, zero acquired immune deficiency syndrome (AIDS)-related deaths and zero discrimination. This study aimed to determine factors related to misconceptions about human immunodeficiency virus (HIV) transmission and the stigma against people living with HIV/AIDS (PLWHA) in Indonesia

METHODS

This cross-sectional study used secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS). The sample was women and men aged 17-45 years and married (n=3,023).

RESULTS

Education and wealth index quintile were significantly related to misconceptions about HIV transmission. Respondents with low levels of education were more likely to have misconceptions about HIV transmission. Respondents who were in the poorest, poorer, middle, and richer quintiles of the wealth index were more likely to have misconceptions about HIV transmission than those in the richest quintile. Educational level, employment status, and wealth index quintile were predictors of stigma against PLWHA.

CONCLUSIONS

There are still many Indonesian people with misconceptions about HIV transmission and stigma against PLWHA. Future studies should focus on educational programs or interventions aimed at increasing public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA. These interventions are particularly important for populations who are uneducated and living in poverty.

Summary

Key Message
Many Indonesians still experience misconceptions about HIV transmission and stigmatize PLWHA. Educational programs or interventions are needed to increase public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA, particularly among the poor and uneducated.

Citations

Citations to this article as recorded by

Prevalence and sociodemographic determinants of public stigma towards people with HIV and its impact on HIV testing uptake: A cross‐sectional study in 64 low‐ and middle‐income countries
Ana Mendez‐Lopez, Trenton M. White, María José Fuster‐RuizdeApodaca, Jeffrey V. Lazarus
HIV Medicine.2024; 25(1): 83. CrossRef
The Pandemics of Mass Destruction: A Comparative Analysis of HIV/AIDS and Coronavirus (COVID-19)
Robert Kajiita, Simon Kang'ethe
Journal of Multidisciplinary Healthcare.2024; Volume 17: 889. CrossRef
The Unheard Stories: Experiences of Young People Living with Human Immunodeficiency Virus in Dealing with Discrimination in the Philippines
Donna Sombrea, Sofia Liane Santarin, Trixie Gayle Verde, Andrea Tidalgo, Coleen Tolosa
HIV/AIDS - Research and Palliative Care.2024; Volume 16: 33. CrossRef
Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI)
Sineenart Chautrakarn, Parichat Ong-Artborirak, Warangkana Naksen, Aksara Thongprachum, Jukkrit Wungrath, Suwat Chariyalertsak, Scott Stonington, Surasak Taneepanichskul, Sawitri Assanangkornchai, Pattapong Kessomboon, Nareemarn Neelapaichit, Wichai Aekpl
Journal of Global Health.2023;[Epub] CrossRef
Factor Associated with HIV/AIDS knowledge among males: Findings from 2017-18 Pakistan Demographic and Health Survey
Jamal Abdul Nasir, Muhammad Danish Khan, Syed Arif Ahmed Zaidi
Journal of Biosocial Science.2023; 55(6): 1169. CrossRef
Knowledge of HIV/AIDS and its determinants in India: Findings from the National Family Health Survey-5 (2019– 2021)
Mansi Malik, Siaa Girotra, Debolina Roy, Saurav Basu
Population Medicine.2023; 5(May): 1. CrossRef

Estimated incidence of juvenile-onset recurrent respiratory papillomatosis in Korea: Jin-Kyoung Oh, Hwa Young Choi, Minji Han, Yuh-Seog Jung, Sang Joon Lee, Moran Ki; Epidemiol Health. 2021;43:e2021019. Published online March 10, 2021; DOI: https://doi.org/10.4178/epih.e2021019

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Abstract Summary PDF

Abstract

OBJECTIVES
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea.

METHODS

We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1).

RESULTS

During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis.

CONCLUSIONS

The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.

Summary

Korean summary
재발성호흡기유두종증은 사람유두종바이러스에 의해 발현되는 희귀 질환이다. 건강보험 청구자료를 활용하여 2002년 이후 출생아 전수 중 2014년까지 후두양성종양으로 2회이상 입원 또는 2회이상 외래진료를 받은 어린이 코호트를 관찰하여 재발성호흡기유두종증 발생률을 추정하였다. 총 123명의 재발성호흡기유두종증 환자가 발생하였으며 (발생률 10만인년당 0.30명), 평균 첫 진단시기는 4세인 것으로 나타났다. 2회 이상 수술적 치료를 받은 경우는 18.7%였다.

Key Message
Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV). We conducted a cohort study using claims data to estimate the incidence of RRP. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits with diagnosis for benign neoplasms of the larynx. During 2002-2014, 123 children were diagnosed with RRP. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years. Twenty three patients (18.7%) underwent 2 or more surgical procedures.

Citations

Citations to this article as recorded by

Global epidemiology of HPV-associated recurrent respiratory papillomatosis and effect of vaccination
RY Seedat, FG Dikkers
Future Virology.2022; 17(5): 265. CrossRef

Human papillomavirus: footprints in the population of western India: Ashi Robert Thobias, Kinjal Ankit Patel, Supreet Dhananjay Bhatt, Kruti Ashvinkumar Mehta, Chetana Deepal Parekh, Pariseema Sharad Dave, Prabhudas Shankarbhai Patel; Epidemiol Health. 2021;43:e2021013. Published online February 3, 2021; DOI: https://doi.org/10.4178/epih.e2021013

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Abstract Summary PDF: Abstract
OBJECTIVES
Cancer is a multi-factorial disease, with various intrinsic and environmental factors contributing to its occurrence. Human papillomavirus (HPV) has been associated with the occurrence of many cancers. India severely suffers from 3 HPV-associated cancers (cervical cancer, oral cancer, and oropharyngeal cancer). Hence, the present study aimed to evaluate the HPV burden in these 3 cancers among patients from the western region of India.
METHODS
DNA was isolated from samples from 400 cervical cancer, 127 oral cancer, and 75 oropharyngeal cancer patients. Polymerase chain reaction was performed using degenerate primers for HPV infection.
RESULTS
Overall, HPV infection was observed in 87% of cervical cancer cases, 12.5% of oral cancer cases, and 26.7% of oropharyngeal cancer cases when analyzed with a cumulative detection method using the MY 09/11, GP 5+/6+, and CP I/II primer sets.
CONCLUSIONS
A significant prevalence of HPV infection was detected in all 3 cancers using the degenerate primer sets. This finding implies that testing for HPV infection using multiple primer sets is crucial for determining its actual prevalence in various malignancies.; Summary

Key Message
The study emphasised the need to screen population of India for HPV infection for better prognosis and disease management and showcases a perfect screening module to efficiently screen the HPV strains.

Associations of depression and anxiety with cardiovascular risk among people living with HIV/AIDS in Korea: Kyong Sil Park, Seon Young Hwang, Bo Youl Choi, June Kim, Sang Il Kim, Woo-Joo Kim, Chun Kang; Epidemiol Health. 2021;43:e2021002. Published online December 24, 2020; DOI: https://doi.org/10.4178/epih.e2021002

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk.

METHODS

Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety.

RESULTS

Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD.

CONCLUSIONS

Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.

Summary

Korean summary
본 연구를 통해 우울과 불안이 심혈관질환 발생위험을 증가시키는 영향요인임을 확인하였다. 따라서, HIV 감염자의 우울과 불안에 대한 정기적인 검사 및 상담이 필요하며, 우울 또는 불안한 환자의 심혈관질환의 발병 위험을 줄이기위해 좋은 생활 습관을 위한 행동 수정 및 동기 부여 교육프로그램의 개발이 필요하다.

Key Message
healthcare providers need to provide motivational education for behavioral modifications to decrease patients’ risk of developing CVD, especially among those with depression or anxiety symptoms.

Citations

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Comorbidities among persons living with HIV (PLWH) in Florida: a network analysis
Shyfuddin Ahmed, Angel B. Algarin, Hsu Thadar, Zhi Zhou, Tanjila Taskin, Krishna Vaddiparti, Karina Villalba, Yan Wang, Nicole Ennis, Jamie P. Morano, Charurut Somboonwit, Robert L Cook, Gladys E. Ibañez
AIDS Care.2023; 35(7): 1055. CrossRef
Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease
Ilex Beltran-Najera, Andrea Mustafa, Desmond Warren, Zach Salling, Maria Misiura, Steven Paul Woods, Vonetta M. Dotson
Journal of Psychiatric Research.2023; 160: 78. CrossRef
MENTE X CORAÇÃO: AS DOENÇAS PSIQUICAS E AS CONSENQUÊNCIAS CARDIOVASCULARES: UMA REVISÃO DA LITERATURA
Beatriz da Silva Araújo, Morgana Gonçalves da Silva
Revista interdisciplinar em saúde.2021; 8(Único): 292. CrossRef

Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran: Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh; Epidemiol Health. 2020;42:e2020033. Published online May 24, 2020; DOI: https://doi.org/10.4178/epih.e2020033

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Abstract PDF

Abstract

Objectives
Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is Candida albicans, followed by non-albicans Candida. This study aimed to identify colonized Candida species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of Candida spp. were studied.

Methods

Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral Candida colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between Candida colonization and various factors, including the CD4+ cell count and viral load.

Results

It was found that 43.8% of patients were positive for Candida. The most common species was C. albicans (48.0%), followed by non-albicans Candida isolates, including C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr, and C. krusei. Colonization of Candida spp. in patients was associated with a CD4 count ≤200 cells/mm3 (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05).

Conclusions

The results of this study showed that C. albicans was the dominant pathogen. The risk factors for colonization of Candida spp. were a CD4 count ≤ 200/mm3 , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.

Summary

Citations

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Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy
Anelise Maria Costa Vasconcelos Alves, Érika Helena Salles de Brito, Márcio Flávio Moura de Araújo, Juliana Jales de Hollanda Celestino, Ana Caroline Rocha de Melo Leite, Gabriela Silva Cruz, Nuno Filipe Azevedo, Célia Fortuna Rodrigues
Biomedicines.2024; 12(2): 310. CrossRef
Exploring the diversity of uncommon oral yeast species and associated risk factors among substance abusers in southwestern Iran
Aynaz Ghojoghi, Sadegh Khodavaisy, Ali Zarei Mahmoudabadi, Eisa Nazar, Mahnaz Fatahinia
Scientific Reports.2024;[Epub] CrossRef
Recuento de linfocitos CD4, carga viral y colonización oral por Candida en personas viviendo con VIH/SIDA
Esperanza Gissela Vargas-Díaz, Graciela Albino Cornejo, Hans Ramón Quiroz-Ruiz
Gaceta Médica Boliviana.2023; 46(1): 18. CrossRef
Low level of antifungal resistance inCandidaspecies recovered from Iranian HIV-associated oral infection
Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
Letters in Applied Microbiology.2023;[Epub] CrossRef
Epidemiology, prevalence, and associated factors of oral candidiasis in HIV patients from southwest Iran in post-highly active antiretroviral therapy era
Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
Frontiers in Microbiology.2022;[Epub] CrossRef
Meyerozyma guilliermondii species complex: review of current epidemiology, antifungal resistance, and mechanisms
Reza Ghasemi, Ensieh Lotfali, Kamran Rezaei, Seyed Ataollah Madinehzad, Mahdi Falah Tafti, Nikta Aliabadi, Ebrahim Kouhsari, Mahsa Fattahi
Brazilian Journal of Microbiology.2022; 53(4): 1761. CrossRef
HIV-infected patients rarely develop invasive fungal diseases under good immune reconstitution after ART regardless high prevalence of pathogenic filamentous fungi carriage in nasopharynx/oropharynx
Xiaoman Chen, Yi Cao, Meijun Chen, Haodi Wang, Peishan Du, Hong Li, Huolin Zhong, Quanmin Li, Santao Zhao, Zhenjiang Yao, Wanshan Chen, Weiping Cai, Xiaoping Tang, Linghua Li
Frontiers in Microbiology.2022;[Epub] CrossRef
Neglected mycobiome in HIV infection: Alterations, common fungal diseases and antifungal immunity
Shuang Li, Xiaodong Yang, Christiane Moog, Hao Wu, Bin Su, Tong Zhang
Frontiers in Immunology.2022;[Epub] CrossRef
Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 13: suitability of taxonomic units notified to EFSA until September 2020
Kostas Koutsoumanis, Ana Allende, Avelino Alvarez‐Ordóñez, Declan Bolton, Sara Bover‐Cid, Marianne Chemaly, Robert Davies, Alessandra De Cesare, Friederike Hilbert, Roland Lindqvist, Maarten Nauta, Luisa Peixe, Giuseppe Ru, Marion Simmons, Panagiotis Skan
EFSA Journal.2021;[Epub] CrossRef
Transcription Factors of CAT1, EFG1, and BCR1 Are Effective in Persister Cells of Candida albicans-Associated HIV-Positive and Chemotherapy Patients
Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
Frontiers in Microbiology.2021;[Epub] CrossRef

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?: Elham Khatooni, Isa Akbarzadeh, Elham Abdalmaleki, Zhaleh Abdi, Elham Ahmadnezhad; Epidemiol Health. 2019;41:e2019045. Published online October 11, 2019; DOI: https://doi.org/10.4178/epih.e2019045

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Abstract PDF

Abstract

OBJECTIVES
Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.

METHODS

This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.

RESULTS

Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.

CONCLUSIONS

Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.

Summary

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Iranian women's birth experiences: a cross-sectional study
Mona Ghobadi, Farzaneh Pazandeh, Barbara Potrata, Ehsan Kazemnejad Lili
British Journal of Midwifery.2022; 30(12): 685. CrossRef
Sanctions on Iran and their impact on child health*
Yasmin Madani-Lavassani
Medicine, Conflict and Survival.2020; 36(4): 359. CrossRef

Review

A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country: Abolghasem Siyadatpanah, Davood Anvari, Amir Emami Zeydi, Seyed Abdollah Hosseini, Ahmad Daryani, Shahabeddin Sarvi, Christine M. Budke, Reza Esmaeelzadeh Dizaji, Mohammad Ali Mohaghegh, Mohammad Hasan Kohansal, Samira Dodangeh, Reza Saberi, Shirzad Gholami; Epidemiol Health. 2019;41:e2019024. Published online June 15, 2019; DOI: https://doi.org/10.4178/epih.e2019024

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Abstract

Human echinococcosis is an infectious disease caused by tapeworms belonging to the species Echinococcus. This parasite has a worldwide distribution and is considered a neglected tropical disease by the World Health Organization. Due to the diversity of Echinococcus spp. hosts, as well as variation in geographical, climatic, and socio-ethnic conditions, the question of the strains or genotypes of Echinococcus spp. that are involved in human infections is important. The aim of this study was to provide a summary of the available data on genotypes of Echinococcus obtained from the Iranian population. Four international databases (PubMed, Scopus, Science Direct, and Web of Science) and 4 Persian databases (Magiran, Scientific Information Database, Iran Medex, and IranDoc) were searched for cross-sectional studies that reported the genotypes of Echinococcus spp. in human echinococcosis cases using molecular methods in Iran through July 2018. The Newcastle-Ottawa Scale was used to assess the quality of the selected studies. A total of 559 cases of human cystic echinococcosis were reported in the 21 included articles. The majority of cases belonged to genotype G1 (89.2%; 95% confidence interval [CI], 80.1 to 95.8), genotype G6 (8.2%; 95% CI, 2.8 to 15.9), and genotype G3 (2.3%; 95% CI, 1.1 to 3.9). Since genotype G1 of Echinococcus appears to be the most prevalent genotype affecting humans in Iran, disease control initiatives aimed at sheep intermediate hosts may be the most beneficial. In addition, educational programs and serological screening in individuals may help reduce the national impact of the disease.

Summary

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Original Articles

Life expectancy of HIV-positive patients after diagnosis in Iran from 1986 to 2016: A retrospective cohort study at national and sub-national levels: Mohammad Mirzaei, Maryam Farhadian, Jalal Poorolajal, Parvin Afasr Kazerooni, Katayoun Tayeri, Younes Mohammadi; Epidemiol Health. 2018;40:e2018053. Published online November 7, 2018; DOI: https://doi.org/10.4178/epih.e2018053

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Abstract PDF

Abstract

OBJECTIVES
Little is known about the life expectancy of individuals with human immunodeficiency virus (HIV) in Iran. This study therefore aimed to estimate the life expectancy of HIV-positive patients in Iran.

METHODS

In this retrospective cohort study, we extracted data from the Center for Disease Control and Prevention of the Ministry of Health and Medical Education and the Death Registration System. We included patients aged 20 years and older who had a specified date of diagnosis. We estimated life expectancy and its 95% confidence intervals (CIs) using Chiang’s methodology.

RESULTS

The overall life expectancy at the national level was 23.1 years (95% CI, 22.6 to 23.5). Life expectancy was 21.6 years (95% CI, 21.1 to 22.0) for men and 32.7 years (95% CI, 31.4 to 34.0) for women. The life expectancy of patients who did or did not receive antiretroviral therapy (ART) was 37.0 years (95% CI, 36.2 to 37.8) and 15.5 years (95% CI, 15.1 to 15.9), respectively. The life expectancy of patients with or without tuberculosis (TB) was 21.6 years (95% CI, 20.4 to 22.9) and 36.5 years (95% CI, 35.7 to 37.4), respectively.

CONCLUSIONS

The life expectancy of Iranian HIV-positive patients was found to be very low. To improve their longevity, improvements in ART coverage and the control and treatment of TB are advised.

Summary

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Factors related to baseline CD4 cell counts in HIV/AIDS patients: comparison of poisson, generalized poisson and negative binomial regression models
Maryam Farhadian, Younes Mohammadi, Mohammad Mirzaei, Nasrin Shirmohammadi-Khorram
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Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS: A qualitative study
Fatemeh Gh.Barkish, Rostam Jalali, Amir Jalali
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Effects of human and organizational deficiencies on workers’ safety behavior at a mining site in Iran: Mostafa Mirzaei Aliabadi, Hamed Aghaei, Omid Kalatpour, Ali Reza Soltanian, Maryam SeyedTabib; Epidemiol Health. 2018;40:e2018019. Published online May 18, 2018; DOI: https://doi.org/10.4178/epih.e2018019

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Abstract PDF

Abstract

OBJECTIVES
Throughout the world, mines are dangerous workplaces with high accident rates. According to the Statistical Center of Iran, the number of occupational accidents in Iranian mines has increased in recent years. This study investigated and analyzed the human and organizational deficiencies that influenced Iranian mining accidents.

METHODS

In this study, the data associated with 305 mining accidents were analyzed using a systems analysis approach to identify critical deficiencies in organizational influences, unsafe supervision, preconditions for unsafe acts, and workers’ unsafe acts. Partial least square structural equation modeling (PLS-SEM) was utilized to model the interactions among these deficiencies.

RESULTS

Organizational deficiencies had a direct positive effect on workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.23). The effect of unsafe supervision on workers’ violations and workers’ errors was also significant, with path coefficients of 0.14 and 0.20, respectively. Likewise, preconditions for unsafe acts had a significant effect on both workers’ violations (path coefficient, 0.16) and workers’ errors (path coefficient, 0.21). Moreover, organizational deficiencies had an indirect positive effect on workers’ unsafe acts, mediated by unsafe supervision and preconditions for unsafe acts. Among the variables examined in the current study, organizational influences had the strongest impact on workers’ unsafe acts.

CONCLUSIONS

Organizational deficiencies were found to be the main cause of accidents in the mining sector, as they affected all other aspects of system safety. In order to prevent occupational accidents, organizational deficiencies should be modified first.

Summary

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Perspective

National human genome projects: an update and an agenda: Joon Yong An; Epidemiol Health. 2017;39:e2017045. Published online October 16, 2017; DOI: https://doi.org/10.4178/epih.e2017045

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Abstract

Population genetic and human genetic studies are being accelerated with genome technology and data sharing. Accordingly, in the past 10 years, several countries have initiated genetic research using genome technology and identified the genetic architecture of the ethnic groups living in the corresponding country or suggested the genetic foundation of a social phenomenon. Genetic research has been conducted from epidemiological studies that previously described the health or disease conditions in defined population. This perspective summarizes national genome projects conducted in the past 10 years and introduces case studies to utilize genomic data in genetic research.

Summary

Korean summary
지난 10년동안, 유전체 해독 기술의 발전과 유전학 데이터 공유로 인해 인간 유전학에 대한 연구가 활발히 진행되고 있다. 이에 따라, 세계의 몇몇 국가들이 국가 단위의 유전체 연구를 시작했으며, 의생물학 연구 및 해당 국가의 거주민의 유전적 조성을 연구하고 있다. 해당 리뷰에서는 국가 단위의 유전체 연구를 소개함으로써, 향후 우리나라에서 진행할 국가 단위의 유전체 연구에 대한 방향을 제시한다.

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Original Articles

Infectious disease-related laws: prevention and control measures: Mijeong Park; Epidemiol Health. 2017;39:e2017033. Published online July 25, 2017; DOI: https://doi.org/10.4178/epih.e2017033

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Abstract

OBJECTIVES
This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law.

METHODS

The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS) coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency.

RESULTS

When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease.

CONCLUSIONS

To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s) in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

Summary

Korean summary
본 연구의 목적은 2015년 메르스 발생 후, 감염병의 예방 및 관리에 관한 법률의 입법경과를 검토하여 감염병으로 인한 공중보건위기 대응과 관련된 법률의 보다 구체적인 개선방안을 제시하는 것이다. 중앙정부와 지자체의 협력을 위한 거버넌스, 응급상황에서의 긴급의약품 제공을 위한 절차, 격리 대상자의 인권보장과 관련된 부분의 충분한 법적 상당성을 갖추기 위해 국가 보건의료체계 하부구조 측면에서 문제점을 분석한 후 법률 개정방안을 제언하였다.

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Effect of antiretroviral therapy on changes in the fertility intentions of human immunodeficiency virus-positive women in Addis Ababa, Ethiopia: a prospective follow-up study: Hussen Mekonnen, Fikre Enquselassie; Epidemiol Health. 2017;39:e2017028. Published online July 16, 2017; DOI: https://doi.org/10.4178/epih.e2017028

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Abstract PDF

Abstract

OBJECTIVES
With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia.

METHODS

An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women.

RESULTS

Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women.

CONCLUSIONS

ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.

Summary

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