Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1555 1565 Rui LI Department of Clinical Pathogen Biology and Laboratory, School of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, China AND Laboratory of Tropical Translational Medicine of Ministry Education, Haikou, China AND Department of Microbiology, School of Medicine, Guangxi Medical University, Nanning, China Jie GAO Department of Microbiology, School of Medicine, Guangxi Medical University, Nanning, China Lingxi GAO Department of Microbiology, School of Medicine, Guangxi Medical University, Nanning, China Yajun LU Department of Clinical Pathogen Biology and Laboratory, School of Tropical Medicine and Laboratory Medicine, Hainan Medical University, Haikou, China AND Laboratory of Tropical Translational Medicine of Ministry Education, Haikou, China 2019 09 03 Background: Ancylostomiasis is a prevalent and global parasitic disease, including China. A systematic review is significant to understand the epidemiological features of hookworm and provide guidance for prevention and treatment. Methods: We systematically searched academic databases and assessed 944 papers published from1955-2015 to establish the comprehensive analysis of prevalence of hookworm disease in China. We searched Chinese databases, including CNKI, Wanfang and VIP, for literature with the subject word "Ancylostomiasis and hookworm". The data were analyzed with SPSS 19.0 software using Spearman correlation analysis. Results were statistically significant for a P-value of <0.01. Results: The search yielded 532,151 cases from epidemiological investigation and 7294 cases based on hospital diagnosis. Hookworm infection was highest (15.83%) in Fujian province, with high rates also found in East China, Southwest China, Central China and Southern China and lower rates in Northwest China, North China and Northeast China. In terms of occupation, farmers had the highest proportion of infections (72.54%). There was no correlation between epidemiological investigations and hospital-diagnosed cases. However, there was significant positive correlation between hospital-diagnosed cases and misdiagnosed cases. The proportion of hospital-misdiagnosed cases was 32.80%. Conclusion: Ancylostomiasis is a serious public health problem that negatively influences health and hinders socioeconomic development. Positive measures are required by both health services and individuals to prevent and control hookworm disease.      https://ijph.tums.ac.ir/index.php/ijph/article/view/18242 https://ijph.tums.ac.ir/index.php/ijph/article/download/18242/6494

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1566 1576 Zijun GUO Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Mei JIANG Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Wenting LUO Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Peiyan ZHENG Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Huimin HUANG Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Baoqing SUN Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China 2019 09 03 Background: We aimed to investigate the association between lung cancer and tea-drinking habits of different subgroup populations. Methods: Systematic search of the PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Sinomed databases from database construction until January 2017 for English and Chinese language articles on association of lung cancer and tea drinking. Meta-analysis was used to calculate the combined odds ratio (OR) value and its 95% confidence interval (95% CI). The Newcastle-Ottawa scale was used to evaluate the quality of the studies and Q-test and I2 was used for heterogeneity testing. Results: Forty two papers were included, 30 case-control studies included 14578 lung cancer patients and 180574 controls, 12 cohort studies included 543825 subjects, of which the outcome was 5085 with lung cancer. Tea drinkers were found to have a decreased OR of lung cancer compared with non-tea drinkers (OR 0. 80, 95% CI: 0. 73, 0. 87). Consumption of green, black or unspecified tea has a protective effect compared with not drinking tea at all. Increased intake of green tea to 7. 5 g per day can further reduce the OR of lung cancer (OR 0. 69, 95% CI: 0. 48-0. 98). Tea consumption had a protective effect against lung cancer in non-smokers, Further analysis found that drinking of one or more cups of tea a day has a protective effect on smokers (OR 0. 79, 95%CI: 0. 64–0. 96). Conclusion: Tea drinking could be a protective factor in lung cancer.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18243 https://ijph.tums.ac.ir/index.php/ijph/article/download/18243/6495

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1577 1588 Yu ZHAO Department of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, China Heng FAN Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, China Bei-Yan BAO Department of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, China 2019 09 03 Background: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) as the commonly used renin-angiotensin aldosterone system inhibitor are widely used in patients with IgA nephropathy (IgAN), but the effect is controversy. In this study, we used a meta-analysis to evaluate the efficacy and safety of ACEI and/or ARB for the patients with IgAN. Methods: Two investigators independently searched the PubMed, EMBASE, the Cochrane Library, EBSCO, and Wiley databases without language restrictions. We collected the clinical randomized controlled trials (RCTs) on “ACEI and/or ARB for the patients with IgAN” published before December 31, 2018, and performed data extraction and quality analysis on the included studies, and analyzed data using RevMan 5.2 software. Results: A total of 10 RCTs (635 patients) were included in our analysis. Alone use of ACEI (MD=-0.75, 95%CI: -1.28-0.21, P=0.006) or ARB (MD=-0.56, 95%CI: -0.82-0.30, P< 0.001) or a combination of ACEI and ARB (MD=-0.63, 95%CI: -0.87-0.38, P<0.001) significantly reduced the levels of proteinuria in patients with IgAN. However, whether using ACEI or ARB alone or in combination with ACEI and ARB, there was no significant effect on serum creatinine, 24-creatinine clearance and glomerular filtration rate in patients with IgAN. Conclusion: The use of ACEI and ARB significantly reduces the levels of proteinuria in patients with IgAN, but more large-sample RCTs with long-term follow-up are needed for confirming our results and guiding clinical treatment.   https://ijph.tums.ac.ir/index.php/ijph/article/view/18244 https://ijph.tums.ac.ir/index.php/ijph/article/download/18244/6496

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1589 1599 Yalda MALEKZADEGAN Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Mehrdad HALAJI Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran AND Poursina Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran Meysam HASANNEJAD-BIBALAN Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Saba JALALIFAR Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Javad FATHI Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Hadi Sedigh EBRAHIM-SARAIE Razi Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran 2019 09 03 Background: Clostridium difficile is the most common causes of hospital-acquired diarrhea affecting particularly hospitalized patients globally. This organism has re-emerged in recent years with significant morbidity and mortality. The present study aimed to estimate the burden of C. difficile infection (CDI) and to acquire information on the overall rates of community- and hospital-acquired CDI in western Asia. Methods: A systematic literature search was performed to identify articles published from the eight Persian Gulf countries in western Asia including Iran, Iraq, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates in the electronic databases within Jan of 2000 to Dec of 2017. Then, 20 publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. Results: Twenty studies reported the prevalence of toxigenic strains of C. difficile among patients from Persian Gulf countries, of these the pooled prevalence of CDI was 9% (95% CI: 6.5%-12.5%). Totally, 8 studies showed the prevalence of hospital-acquired CDI, from those studies the prevalence of CDI was estimated 8.4% (95% CI: 4.9%-14.1%). Moreover, 7 studies reported the prevalence of community-acquired CDI, from those studies the prevalence of CDI was estimated 1.8% (95% CI: 1.2%-2.9%). Conclusion: The prevalence of CDI in western Asia is lower than southern and eastern region. Moreover, the lower prevalence of community-acquired CDI compared to hospital-acquired CDI, indicate that the source of infection in western Asia is more likely in the hospitals.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18245 https://ijph.tums.ac.ir/index.php/ijph/article/download/18245/6497

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1600 1606 Rong PU Department of Laboratory, Third People's Hospital of Dongguan City, Dongguan 523000, P.R. China Meicen PU Department of Clinical Medicine, Fujian Medical University, Fuzhou 350000, P.R. China Qingsong XIN Department of Laboratory, Changan Hospital of Dongguan, Dongguan 523000, P.R. China Feng CHEN Department of Laboratory, Guangji Hospital of Dongguan, Dongguan 523000, P.R. China 2019 09 03 Background: We aimed to evaluate the basic performance and basic parameters of a new type of blood vacuum tube cap opening and closing machine for further application. Methods: From July 2013 to March 2018, 110, 000 cases involved in the clinical trials in Third People's Hospital of Dongguan City were selected as the instrument group, and 10,000 cases were selected as the manual operation group. The application demonstration and instrument performance assessment were performed by five units. Unified evaluation indicatory system and the standard of assessment were set up. The instrument assessments and demonstration tests were carried out by these 5 units. Finally, the basic parameters of the instrument were analyzed and compared. Results: The new instrument had excellent performance, and thirty parameters were excellent. Five patents had been granted already. There were no differences between the instrument groups in different units, and among different units. However, there were some differences in the manual operation group between different units. The average cap opening time was 21 "04 in the instrument group, and 152" 48 in the manual operation group (P<0.05); the cap closing time was 18 "56 in the instrument group, and 104"24 in the manual operation group (P<0.05). The instrument group outperformed the manual operation group in cap closing time, pollution rate, spill rate and failure rate (P<0.01). The design of the instrument was original. Conclusion: This blood vacuum tube cap opening and closing machine can perform a wide variety of functions, and it is stable, intelligent and superior to manual operation. More efforts need to be made for the industrialization of this instrument.   https://ijph.tums.ac.ir/index.php/ijph/article/view/18246 https://ijph.tums.ac.ir/index.php/ijph/article/download/18246/6498

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1607 1616 Kyoung-Lee KIM Asia Contents Institute, Konkuk University, Seoul, Korea Byung-Ro SEO Korea Department of Global MICE, Konkuk University, Seoul, Korea 2019 09 03 Background: After the revision of the Medical Service Act, Article 27-2, in 2009, Korea has been actively involved in the medical tourism industry. The number of foreign patients visiting Korea has consistently increased coming from various countries around the world. Currently, the industry is striving to achieve qualitative growth in medical tourism. Accordingly, there is a necessity to analyze and review policies for the development of medical tourism to create a sustainable market. Methods: We analyzed the information of foreign patients visiting Korea over a period of last 10 years. Statistical data were obtained from the Korea Health Industry Development Institute (KHIDI) and Korea Tourism Organization (KTO). Results: The number of foreign patients visiting Korea had increased from 60,201 in 2009 to 321,574 in 2017. Since 2017, the number of patients from the U.S., Russia and Middle East has been on an upward trend while the number of Chinese patients has decreased. This result clearly shows that international affairs and cultural aspects have a significant impact on the selection of medical tourism. Conclusion: It is suggested to i) establish the medical tourism information system and brand the Korean medical tourism offering a joint treatment of western and oriental medicine, ii) prepare the expansion of the industry to the medical wellness tourism industry by training global healthcare experts and iii) organize tailored medical services with consideration of various backgrounds and culture of foreign patients.   https://ijph.tums.ac.ir/index.php/ijph/article/view/18247 https://ijph.tums.ac.ir/index.php/ijph/article/download/18247/6499

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1617 1626 Chunjing TU Qianjiang College, Hangzhou Normal University, Hangzhou, China AND China Institute of Sport Science, Beijing, China Chongmin JIANG China Institute of Sport Science, Beijing, China Sanhua ZHANG Department of Preschool Education, College of Education, Hangzhou Normal University, Hangzhou, China Yan-Feng ZHANG China Institute of Sport Science, Beijing, China Rui CAI China Institute of Sport Science, Beijing, China Dongming WU China Institute of Sport Science, Beijing, China Huan WANG China Institute of Sport Science, Beijing, China Xiaoming HAN Qianjiang College, Hangzhou Normal University, Hangzhou, China Botong XU Qianjiang College, Hangzhou Normal University, Hangzhou, China 2019 09 03 Background: We aimed to establish a reference standard of Body Mass Index (BMI) for the growth of preschool children in China. Methods: We monitored and obtained the height and weight of 50702 children aged 3-6 yr in 31 provinces in mainland China in 2014. The reference standard and percentile curve of BMI preschool children aged 3-6 yr old were formulated by using Lambda-Median-Sigma (LMS) method in China. Results: The common grounds of the male and female children were as follows: the percentile maps were similar in shape; the graphs of children aged 4-6 were approximately horn shaped. The differences between male and female children were as follows: the BMI values of male children in the same age group and the same percentile were higher than those of the female children. The change pattern of male children was larger than that of female children. BMI of 3 yr old and 6 yr old children was larger than those of 4 yr old and 5 yr old. During the change from low percentile to high percentile, the BMI values of Chinese male children exceeded WHO to a larger extent, and the BMI values of Chinese female children were substantially consistent with WHO, but the high percentile greater than P95 exceeded WHO. Conclusion: The BMI growth chart developed can be applied in monitoring the growth and nutrition of preschool children in China. We recommend the promotion of the results in the field of preventive health care.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18248 https://ijph.tums.ac.ir/index.php/ijph/article/download/18248/6500

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1627 1635 Yerbol BEKMUKHAMBETOV Administration, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Arstan MAMYRBAYEV Department of Hygiene and Occupational Diseases, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Timur JARKENOV Administration, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Talgar ABILOV Department of Molecular Biology and Medical Genetics, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Gulnar SULTANOVA Department of Children and Surgical Dentistry, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Gulnar ISAEVA Department of Children and Surgical Dentistry, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Mukhtar ZHAILYBAYEV Department of Clinical Anatomy with Operational Surgery, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan Raisa URAZ Department of Therapeutic and Prosthetic Dentistry, West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan 2019 09 03 Background: The health status of the population of different ages was examined. Since children are very vulnerable to environmental factors, our goal was to examine their health status and compare them with those of the older population. Also one of the important tasks of our study was the installation of carcinogenic and non-carcinogenic risks for children and adults of different sexes. Methods: During our research, we calculated the air pollution index, investigated the incidence statistics of the population, and calculated the lifetime average daily dose (LADD). We investigated the content of sulfur dioxide, hydrogen sulfide, nitrogen oxide, ammonium and hydrogen carbonates and compared it with safe level of exposure. Results: In Aktobe, the Republic of Kazakhstan the external environment is polluted with boron and chromium, and in Aktau - with organic hydrocarbons. High morbidity rates in adolescents were found for endocrine disorders, digestive system diseases, and musculoskeletal system disorders. Estimating the prevalence and incidence of newly diagnosed diseases among women in Aktau showed that the overall incidence rate, as well as the incidence of respiratory and skin diseases, declines with age. The incidence of the genitourinary system and the number of nervous disorders increase, and the number of neoplasms increases in men population. A study of carcinogenic risks showed that children with Aktau, especially boys, have the greatest risk of cancer. Conclusion: The conducted research shows that environmental factors have a big impact on the health of the population.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18249 https://ijph.tums.ac.ir/index.php/ijph/article/download/18249/6501

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1636 1646 Huanchun HUANG Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China Hailin YANG Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China Xin DENG Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China Peng ZENG Department of Urban Planning, School of Architecture, Tianjin University, Tianjin, China Yong LI People’s Hospital of Jiangsu Province, Nanjing Medical University, Nanjing, China Luning ZHANG Department of University Foreign Language Teaching Section, School of foreign Studies, Nanjing Forestry University, Nanjing, China Lei ZHU Center for Educational Research, Seoul National University, Seoul, South Korea 2019 09 03 Background: Urban heat island (UHI) is being intensified with the progress of urbanization. Meanwhile, respiratory diseases caused by high temperature become common. This study explores the influences of UHI on respiratory diseases (J00-J99) and the evolutionary characteristics of the spatial pattern of such influences. Methods: The pattern–process–function and the influencing mechanism of UHI on respiratory diseases were evaluated through landscape pattern indexes from 1992 to 2018 in Tianjin, China. The basis was on data from Landsat TM/OLI/TIRS remote-sensing images, meteorological stations, and mortality of respiratory diseases. Results: The fluctuating influence of UHI on the respiratory diseases in Tianjin has increased from 1992 to 2018, showing a significant phase-based characteristic. During 2011-2018, the influence has soared greatly, and mortality risk has increased by 101%, and the influenced area has reached 349 km². Furthermore, the regional space clustered, and the influenced patches are in irregular shape, and the highly influenced area is enlarged. Moreover, the indexes of the landscape level of the influenced areas all decrease. The patches at all levels are fragmented and distributed discontinuously. Spatially, the influenced areas gradually extend from the urban center to the suburbs. Conclusion: UHI causes a higher mortality of respiratory diseases because it increases daily average air temperature in summer. With respect to landscape pattern, the influenced areas at low level is highly interconnected and relatively concentrated, whereas the influenced area at high level is distributed in clusters. In general, the influenced area is fragmented and discontinuously distributed in urban center.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18250 https://ijph.tums.ac.ir/index.php/ijph/article/download/18250/6502

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1647 1653 Sulistyawati SULISTYAWATI Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia Isnah FITRIANI Department of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia 2019 09 03 Background: In 2015, Indonesia government targeted to eliminate malaria in Java Island. Nevertheless, until now malaria still occurs, including in Samigaluh, Kulon Progo District although many malaria programs has been run. Complexity and dynamic of the population also limited budget may become the reason of malaria combat difficulties. Subsequently, a method to direct the policymaker on how to provide program effectively and efficiently was needed.  We examined malaria risk factor using statistical and cluster analysis. Methods: A quantitative study with case-control approach was conducted during Spring 2017 in Samigaluh II Public Health Centre, Indonesia. The structured questioner was used to collect the information from both of case and control which were people who had blood examination regarding malaria diagnosed during January-December 2016. Global Positioning System was used to record the geographical position of house participant which was used in cluster analysis. Results: Occupation was recognized as the significant risk factor to malaria. One most likely cluster was detected and translated as the source of transmission because of its fall in malaria hotspot. Conclusion: Satscan be able to detect a spatial cluster of malaria case and a promising method for supporting malaria control.    https://ijph.tums.ac.ir/index.php/ijph/article/view/18251 https://ijph.tums.ac.ir/index.php/ijph/article/download/18251/6503

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1654 1662 Yu HUANG Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Min LUO Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Junqing HUANG Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Shaoxin HUANG Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Liuxia WEI Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Yumei ZHANG Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China Zhiming ZHANG Department of Medical Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, P.R. China 2019 09 03 Background: We aimed to investigate the expression level of breast cancer susceptibility gene 2 (BRCA2) and its changes during chemotherapy in patients with different pathological types of mammary cancer (MC). Methods: Overall, 102 patients treated in Affiliated Tumor Hospital of Guangxi Medical University, China from April 2013 to August 2017 were enrolled as experimental group, including 58 patients with noninvasive MC (group A) and 44 with invasive MC (group B). Fifty healthy volunteers at the same time were enrolled as control group. The relative expression of BRCA2 in the blood of MC patients was detected by real-time fluorescence quantitative PCR (FQ-PCR). Results: In the experimental group, the expression level of BRCA2 in group A was higher than that in group B before chemotherapy (P<0.001); the expression level in group A and group B 1 month after chemotherapy was higher than that before chemotherapy (P<0.001); the expression level in the both groups 3 months after chemotherapy was higher than that 1 month after chemotherapy (P<0.001); the expression level of BRCA2 in blood of group A increased gradually before, 1 month and 3 months after chemotherapy (P<0.001). The expression level of BRCA2 in blood of group B increased gradually at the same time points (P<0.001). Conclusion: BRCA2 is over-expressed in noninvasive MC patient and under-expressed in invasive MC patient. And it can be used as an index for monitoring the condition of MC patients with different pathological types during chemotherapy.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18252 https://ijph.tums.ac.ir/index.php/ijph/article/download/18252/6504

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1663 1670 Jie GU Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China Haiying CHEN Xidu Community Health Center of the Fengxian District, Shanghai 201400, P.R. China Xiaoqing GU Xidu Community Health Center of the Fengxian District, Shanghai 201400, P.R. China Xiaomin SUN Health Development Institute of Pudong, Shanghai 201208, P.R. China Zhigang PAN Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China Shanzhu ZHU Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China Doris YOUNG Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia 2019 09 03 Background: Frailty is a common syndrome in elderly people, but has not been fully studied in China. We aimed to investigate the epidemiological characteristics of frailty and analyze its risk factors in elderly people in rural areas of China. Methods: This cross-sectional study was conducted between September and October 2016. Overall, 4323 elderly people over 60 yr were enrolled by cluster random sampling method from the Fengxian District of Shanghai, China. These subjects voluntarily participated in the health examination of the 2016 National Basic Public Health Service Program. In addition to regular examination items, frailty assessment was performed on the basis of Fried frailty phenotype criteria. Results: The prevalence of pre-frailty and frailty was 49.4% and 6.8%, respectively. Advanced age (OR=1.44 for pre-frailty and OR=2.01 for frailty, 65-74 years old; OR=3.02 for pre-frailty and OR=14.13 for frailty,75-84 years old; OR=8.17 for pre-frailty and OR=71.71 for frailty, ≥85 years old), female (OR=1.32 for pre-frailty and OR=1.97 for frailty), stroke history (OR=1.75 for pre-frailty and OR=2.43 for frailty), vision decrease (OR=1.98 for pre-frailty and OR=2.70 for frailty), and anemia (OR=1.95 for pre-frailty and OR=3.64 for frailty) were common risk factors for both pre-frailty and frailty. Conclusion: Healthy elderly people in the rural areas of Shanghai have relatively high prevalence of pre-frailty and frailty. Advanced age, female, stroke history, decreased vision, and anemia are the risk factors for pre-frailty and frailty.   https://ijph.tums.ac.ir/index.php/ijph/article/view/18253 https://ijph.tums.ac.ir/index.php/ijph/article/download/18253/6505

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1671 1680 Enayat DARABI Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Elahe MOTEVASELI Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza KHORRAMIZADEH Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Mehdi MOHEBALI Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mohammad Bagher ROKNI Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Farzaneh ZAHABIUN Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Eshrat Beigom KIA Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2019 09 03 Background: Cystic echinococcosis (CE), larval stage of Echinococcus granulosus, immunodiagnostics is still a challenge due to asymptomatic nature of CE during the early phase of infection and imperfection of diagnostic antigens. In silico design and assessments of hydatid cyst antigens provide preeminent information for novel and favorable diagnostic methods. Methods: This study was performed at the Tehran University of Medical Sciences, Tehran, Iran in 2018. The sequences of B2, EPC1, B1 and B4 antigens were collected and analyzed for sequence conservancy by protein BLAST search and CLUSTALW multiple sequence alignment. The secondary and 3D structures were predicted using ab initio and threading methods. The antigens were analyzed for their B cell epitopic content using linear and conformational B cell epitope prediction tools. The final diagnostic antigen was designed by fusing the selected epitopic determinants form each antigen. Results: Given the conservancy results and B cell epitope predictions, the whole B2 antigen along with amino acids spanning 1-50, 1-30, and 30-81 regions of EPC1, B1 and B4 antigens were selected to design the final antigen. High surface accessibility (75%), protein stability, low free energy and high number of amino acids involved in B cell epitopes were desirable properties for the final antigen to interact with antibodies against CE. Conclusion: In silico design of such antigens is useful for better diagnosis of CE, decrease the cost and the time required for antigen design, while avoiding the ethical aspects of in vivo studies.     https://ijph.tums.ac.ir/index.php/ijph/article/view/18254 https://ijph.tums.ac.ir/index.php/ijph/article/download/18254/6506

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1681 1689 Edris KAKEMAM Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medi-cal Sciences, Tabriz, Iran Hossein DARGAHI Department of Management Sciences and Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ANDHealth Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran 2019 09 03 Background: Iranian public hospitals have been excessively changing during the healthcare reform since 2014. This study aimed to examine the technical efficiency of public hospitals during before and after the implementation of Health Sector Evolution Plan (HSEP) and to determine whether, and how, efficiency is affected by various factors. Methods: Forty-two public hospitals were selected in Tehran, Iran, from 2012 to 2016. Data envelopment analysis was employed to estimate the technical and scale efficiency sample hospitals. Tobit regression was used to relate the technical efficiency scores to seven explanatory variables in 2016, the last year. Results: Overall, 24 (57.1%), 26 (61.9%), 26 (61.9%), 24 (57.1%) and 21 (50%) of the 42 sample hospitals ran inefficiently in 2012 to 2016, with average technical efficiency of 0.859, 0.836, 0.845, 0.905 and 0.934, respectively. The average pure technical efficiency in sample hospitals increased from 0.860 in 2010 (before the HSEP) to 0.944 in 2012 (after the HSEP). Tobit regression showed that average length of stay had a negative impact on technical efficiency of hospitals. In addition, bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusion: Despite government support, public hospitals operated relatively inefficien. Managers can enhance technical efficiency by increasing bed occupancy rate through shortening the average length of stay, proportioning the number of doctors, nurses, and beds along with service quality assurance.   https://ijph.tums.ac.ir/index.php/ijph/article/view/18255 https://ijph.tums.ac.ir/index.php/ijph/article/download/18255/6507

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 9 2019 09 03 1690 1696 Ali Akbar HAGHDOOST Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Mohammad Reza ciatus larvae (P<0.05). The value of brusatol Lethal Concentration 50 to larvae Cx. quinquefasciatus was 0.010 ± 0.122 and value of brusatol Lethal Concentration 90 to larvae Cx. quinquefasciatus was 0.654 ± 0.081 ppm. The higher the concentration of brusatol, the morphological damage of Cx. quinquefasciatus larvae was getting worse and widespread to cause damage to the digestive tract and cuticle. Conclusion: Brusatol isolated from the seed of B. javanica (L) Merr have larvicidal activity to the Cx. quinquefasciatus which is potential to be natural larvicide.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16860 https://ijph.tums.ac.ir/index.php/ijph/article/download/16860/6356

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 16 621 631 Wenwen WU School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China AND School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, Hubei Province, China Yaofei XIE School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China Xiangxiang LIU School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China Yaohua GU School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China Yuting ZHANG School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China Xinlong TU School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China Xiaodong TAN School of Health Sciences, Wuhan University, Wuhan 430071, Hubei Province, China 2019 04 16 Background: Studies related to the prevention and control of myopia in adolescents have increased rapidly, but only a few have measured the levels of scientific collaboration among authors, institutions and countries in this field. Thus, in this study, we aimed to reveal the status and levels of scientific collaboration in this field. Methods: The research population included all published papers in the field of adolescent myopia prevention and control indexed in the Web of Science databases from 1997-2016. The co-authorship networks were drawn using SATI (Statistical Analysis Toolkit for Informetrics), Ucinet and VOS viewer (Visualisation of Similarities viewer). Active authors and some measures of co-author network, including degree centrality, closeness, betweenness, density and diameter, were also assessed. Results: Overall, 610 records were obtained, and a number of publications developed through an increase in different collaboration types, with cooperation among authors and institutions as the most apparent ones. The top ten active authors and institutions were identified. The density of cooperative networks of the top 70 authors and the first 69 institutions were 0.043 and 0.011, respectively, with corresponding diameters of five and six, respectively. Seven distinct clusters formed the cooperation network among 38 countries. The top three clusters were centered in China, the United States and Australia, also identified as the most productive countries. Conclusion: The flow of information is slow and the collaboration among authors and institutions in the network are not close enough. Thus, multiple collaboration types should be encouraged in this field, especially among countries.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16852 https://ijph.tums.ac.ir/index.php/ijph/article/download/16852/6349

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 777 778 Ivana LJILJANA ZUBIC Department of Psychology, Faculty of Philosophy, University of Niš, Niš, Serbia 2019 04 17 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/16883 https://ijph.tums.ac.ir/index.php/ijph/article/download/16883/6370

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 16 697 703 Jian SUN Department of Endodontics, Xuzhou Stomatological Hospital, Xuzhou 221003, P.R. China Yuanyuan WEI Department of Prosthodontics, Xuzhou Stomatological Hospital, Xuzhou 221003, P.R. China Xiaobei TIAN Department of Endodontics, Xuzhou Stomatological Hospital, Xuzhou 221003, P.R. China AND Teaching and Research Office of Stomatology, Xuzhou Medical University, Xuzhou 221003, P.R. China Qinglin MEN Department of Prosthodontics, Xuzhou Stomatological Hospital, Xuzhou 221003, P.R. China 2019 04 16 Background: We aimed to evaluate the efficacy of mineral trioxide aggregate (MTA) in the treatment of endodontic disease. Methods: Oversell, 384 patients with endodontic disease treated in Xuzhou Stomatological Hospital, Xuzhou, China, from June 2015 to June 2017 were selected, and randomly divided into four groups with 96 cases per group. The repair effects of MTA, zinc phosphate cement (ZPC), silver amalgam and light-curing calcium hydroxide (LCH) on the teeth and dental pulp of patients in the four groups were compared. Meanwhile, the ill symptoms of the patients were observed to confirm whether they could be alleviated. Besides, whether the repair effects were related to ages of patients, perforation diameters of diseased teeth and repair materials was discussed. Results: The success rates of MTA group, ZPC group, LCH group and silver amalgam group were 90.6%, 68.7%, 70.8% and 52.1%, respectively. The success rate of MTA group was significantly higher than that of ZPC group, silver amalgam group and LCH group. When the success rates of four groups were compared, the differences were statistically significant (P=0.0072). The patient's age, repair material and perforation diameter were positively correlated with MTA repair effect (P=0.003, P=0.002, P=0.01). The patients' teeth in each group were repaired with different materials, and the reexamination was conducted 4 weeks later. Three patients in the silver amalgam group were found to have gingival swelling. Conclusion: The therapeutic effect of MTA was significant in the treatment of endodontic disease, and it is worthy of clinical application.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16861 https://ijph.tums.ac.ir/index.php/ijph/article/download/16861/6357

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 16 632 643 Azmawati Mohammed NAWI Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia AND Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Siok-Fong CHIN Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia Shamsul AZHAR SHAH Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia AND Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Rahman JAMAL Universiti Kebangsaan Malaysia Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia 2019 04 16 Background: Trace elements play a pivotal role in Colorectal Cancer (CRC) inhibition and development process. This systematic review provides the basic comparison of case-control studies focusing on concentration of trace elements between those with CRC and controls Methods: The systematic review searched through two databases of Medline and Cochrane up to 24th June 2017. The search strategy focused on Population, Intervention, Comparison, and Outcomes (PICO). We searched the role of trace elements in cancer and focusing on case-control studies in CRC to obtain an insight into the differences in trace element concentrations between those with and without cancer. Results: The serum concentrations of Ca, Cu, Mg, Mn, Se, Si, and Zn were lower in CRC patients but for Co and S the levels were higher in CRC patients. The concentrations of Cd, Cr, Cu, Mg, Mn, Pb, and Zn were increased in patients with metastasis, but not in Se. As for colon tissue specimens, inconsistent levels were reported between studies, notably in Cu, Se, and Zn. No changes were reported for B and Ca levels. Most of the trace elements in the tissue specimens showed higher concentrations of Cr, Fe, K, Mg, P, Rb, S, and Si compared to Br. Conclusion: With the growing interest to understand the link between trace elements in carcinogenesis and the possible interactions, multi assessment analysis of a larger cohort of samples is necessary.   https://ijph.tums.ac.ir/index.php/ijph/article/view/16853 https://ijph.tums.ac.ir/index.php/ijph/article/download/16853/6350

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 779 781 Behrouz EZATPOUR Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran Seyed Mahmoud Reza TAHERIAN Department of Public Health, School of Health, Lorestan University of Medical Sciences, Khorramabad, Iran Saeid BAJALAN Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Mohammad Hassan KAYEDI Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran Hossein MAHMOUDVAND Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran Khatereh ANBARI Department of Social Medicine, Medical School, Lorestan University of Medical Sciences, Khorramabad, Iran 2019 04 17 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/16884 https://ijph.tums.ac.ir/index.php/ijph/article/download/16884/6371

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 16 704 712 Jasmina PLUNCEVIC GLIGOROSKA Institute of Physiology and Anthropology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, Republic of Macedonia Serjoza GONTAREV Faculty of Physical Education, Health and Sport, University Ss Cyril and Methodius, Skopje, Republic of Macedonia Beti DEJANOVA Institute of Physiology and Anthropology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, Republic of Macedonia Lidija TODOROVSKA Institute of Physiology and Anthropology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, Republic of Macedonia Daniela SHUKOVA STOJMANOVA Faculty of Physical Education, Health and Sport, University Ss Cyril and Methodius, Skopje, Republic of Macedonia Sanja MANCHEVSKA Institute of Physiology and Anthropology, Faculty of Medicine, University Ss Cyril and Methodius, Skopje, Republic of Macedonia 2019 04 16 Background: This study aimed to assess the basic red blood cell variables and hematological indices in children and adolescents and analyze the differences regarding age and sex. Methods: Overall, 320 young participants, age 8 to 18 yr, were enrolled at Laboratory of Sport’s Medicine, Medical Faculty, Skopje, Macedonia in 2016. Capillary blood samples were drawn and following hematologic parameters were measured: the red blood cell count (RBC), hemoglobin concentration (Hb), hematocrit level (Hct) and hematological indexes: mean corpuscular volume (MCV), mean hemoglobin concentration (MCH), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW). Results: RBC variables in male group showed high statistical level of significance between age different groups (P=0.001) for all studied parameters except MCHC (P=0.423) and RDW (P=0.174). ANOVA test and multivariate tests in female group showed that there was no significant difference for all hematological parameters between age different groups. Regarding the sex differences, male participants had significantly higher red blood count (P<0.001), hemoglobin content (P<0.001) and hematocrit (P<0.001). Conclusion: Hematological parameters in adolescent as inhomogeneous population are not quantified sufficiently, especially hematological indices. RBC variables, regardless of the age, differ very much between male and female examinees, in favor of the male examinees. Hematological indices were insignificantly higher in males. Regarding the age of examinees, RBC variables showed significant inter-groups differences only within male adolescents. While with girls, ages span 8 to 18 yr, we did not find significant differences for most of the hematological variables.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16862 https://ijph.tums.ac.ir/index.php/ijph/article/download/16862/6358

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 782 783 Mohsen Bayati Health Human Resources Research Center, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2019 04 17 No Abstract### https://ijph.tums.ac.ir/index.php/ijph/article/view/16885 https://ijph.tums.ac.ir/index.php/ijph/article/download/16885/6372

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 713 721 Dongqing XU Department of Surgery (I), Yiling Hospital of Yichang, Yichang 443100, P.R. China Jianwen LI Department of Surgery (I), Yiling Hospital of Yichang, Yichang 443100, P.R. China Fangfang JIANG Department of Surgery (II), Yiling Hospital of Yichang, Yichang 443100, P.R. China Kaishuang CAI Department of Surgery (I), Yiling Hospital of Yichang, Yichang 443100, P.R. China Guangxue REN Department of Surgery (I), Yiling Hospital of Yichang, Yichang 443100, P.R. China 2019 04 17 Background: To investigate the effect of vascular endothelial growth factor (VEGF) on tumor angiogenesis in gallbladder carcinoma. Methods: Fifty one patients with gallbladder carcinoma were enrolled as observation group. Thirty healthy people were included as control group. Chemically synthesized siRNA sequences targeting VEGF was transfected with VEGF-siRNA. A blank group (group B), a negative control group (transfected with independent sequence, group C), and an inhibition group (transfected with VEGF siRNA, group D) were established. Physiological saline was set as group A. The expression of VEGF was detected by qRT-PCR. The expression of VEGF protein was detected by Western blot. MVD was used to measure microvessel density. CCK-8, Transwell and flow cytometry were used to detect cell proliferation, invasion and apoptosis. Results: The tumor volume of nude mice and VEGF mRNA expression in group D was significantly smaller than that in group B and C (P<0.05). The MVD density in group B and C was significantly higher than that in group D (P<0.01). The proliferation of cells was detected from the 3rd day, and the proliferation of cells in the blank and negative control groups was faster than that of the inhibition group (P<0.05). The apoptosis rate of the blank group and the negative control group was lower than that of the inhibition group (P<0.001). Conclusion: VEGF is highly expressed in serum of patients with cholangiocarcinoma, it promotes angiogenesis, proliferation and invasion of gallbladder cancer cells, and inhibits apoptosis of tumor cells.   https://ijph.tums.ac.ir/index.php/ijph/article/view/16871 https://ijph.tums.ac.ir/index.php/ijph/article/download/16871/6359

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 722 729 Guangjian WU School of Public Health, Jilin University, Changchun, China AND Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Liansen WANG Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Qiang WANG Department of Preventive Medicine and Public Health Laboratory Science, School of Medicine, Jiangsu University, Zhenjiang, China Ru HAN Shandong Academy of Occupational Health and Occupational Medicine, Shandong Academy of Medical Sciences, Jinan, China Jinshan ZHAO Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Zunhua CHU Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Maoqiang ZHUANG Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Yingxiu ZHANG Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Kebo WANG Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Peirui XIAO Shandong Center for Disease Control and Prevention, Jinan, China AND Shandong Center for Food Safety Risk Assessment, Jinan, China AND Academy of Preventive Medicine, Shandong University, Jinan, China Ya LIU School of Public Health, Jilin University, Changchun, China Zhongjun DU Shandong Academy of Occupational Health and Occupational Medicine, Shandong Academy of Medical Sciences, Jinan, China 2019 04 17 Background: In order to generate data on the burden of foodborne diseases in Shandong Province, we aimed to use the case monitoring data of foodborne diseases from 2016 to 2017 to estimate. Methods: Data were obtained from the foodborne disease surveillance reporting system with dates of onset from Jan 1, 2016, to Dec 31, 2017, in Shandong, China. Results: The places of food exposure were categorized by settings as follows: private home, catering facility, collective canteens, retail markets, rural banquets and other. Exposed food is divided into 23 categories. Overall incidence rate and proportions by exposure categories, age, and sex-specific incidence rates were calculated and sex proportions compared. Approximately 75.00% of cases who had at least one exposure settings were in private homes. The most frequently reported exposed food was a variety of food (meaning more than two kinds of food). The two-year average incidence rate was 75.78/100,000, sex-specific incidence rate was much higher for females compared to males (78.23 vs. 74.69 cases per 100,000 population). An age-specific trend was observed in the cases reported (Chi-Square for linear trend, χ2=4.39, P=0.036<0.05). Conclusion: A preliminary estimate of 14 million cases of foodborne diseases in Shandong province each year. Future studies should focus on cross-sectional and cohort studies to facilitate the assessment of the distribution and burden of foodborne disease of the population in Shandong. Considering strengthening the burden of foodborne diseases in foodborne disease surveillance is also a feasible way.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16872 https://ijph.tums.ac.ir/index.php/ijph/article/download/16872/6360

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 730 739 Hossein MASOUMI-ASL Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Khadijeh KHANALIHA Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Farah BOKHARAEI-SALIM Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Abdoulreza ESTEGHAMATI Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran Saeed KALANTARI Department of Infectious Diseases, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Maryam HOSSEINYRAD Consult Center of Behavior Diseases, West Health Center, Iran University of Medical Sciences, Tehran, Iran 2019 04 17 Background: Opportunistic parasites have been identified as human pathogens, especially in immunodeficient patients. Microsporidian and coccidian infections cause chronic diarrhea as common clinical manifestation in HIV positive patients. In this study, the frequency of opportunistic infections, including microsporidian and coccidian infections, was evaluated in HIV/AIDS patients from Tehran and phylogenic analysis was performed for E. bieneusi isolates from these patients.  Methods: One hundred and two stool samples were collected from confirmed HIV/AIDS patients, referred to Consult Center of Behavior Diseases, West Health Center, Iran University of Medical Sciences in Tehran, Iran. The samples were transferred to Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences from Jan 2016 to Dec 2016. After conventional formalin-ether concentration, aniline blue staining method and acid-fast staining technique were used for detection of microsporidian spores and Cyclospora oocysts. DNA was extracted and nested PCR was performed. Results: Two (1.96%) cases were found to be positive for intestinal microsporidia infection using aniline blue staining method and were confirmed as E. bieneusi by nested PCR. One patient was found with Cyclospora cayetanensis infection by acid-fast staining method and PCR. Giardia lamblia and Blastocystis hominis were detected as non-opportunistic parasites in 1/102 (0.98%) and 2/102 (1.96%) of the HIV positive patients, respectively. Conclusion: With respect to the use of antiretroviral therapy (ART) in HIV positive patients, we found a low frequency of infection.     https://ijph.tums.ac.ir/index.php/ijph/article/view/16873 https://ijph.tums.ac.ir/index.php/ijph/article/download/16873/6361

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 740 747 Saber RAEGHI Department of Laboratory Sciences, Maragheh University of Medical Sciences, Maragheh, Iran Soheila ROUHANI Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Majid FASIHI HARANDI Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran Adel SPOTIN Department of Parasitology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Sahar GHODSIAN Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2019 04 17 Background: Fascioliasis is one of important zoonotic disease caused by Fasciola gigantica and F. hepatica. The final hosts of this parasite are ruminants and humans. Iran is one of the endemic areas in the world, about six million people at risk of infection. The aim of this study was to identify and determine the genetic diversity of Fasciola species in cattle after distinguish of their species. Methods: One hundred and seventeen liver specimens collected from naturally infected cattle in 5 geographical regions in 2014-2017. Flukes stained with Hematoxylin-Carmine dye to examine for the existence of sperm within seminal vesicles. DNA was extracted from each individual, and ITS1, ND1and CO1 genes were amplified using specific primers. For discrimination of Fasciola species, ITS1 PCR-RFLP was used based on digestion pattern of RsaI enzyme. Genetic analyses and diversity and neutrality indices estimated by Dnasp5 based on NDI. Results: Six nonspermic and 111 spermic flukes were diagnosed. All of nonspermic specimens were F. gigantica and collected from South East, South West and North West of Iran. Genetic haplotype diversity has been observed in F. gigantica based on ND1. Fst value analysis showed that minimum and maximum genetic difference between Iranian F. gigantica with Bangladesh (Fst = 0.01414) and Egypt (Fst = 0.36653) respectively. Conclusion: It is the first report of existing of nonspermic Fasciola. High haplotype and nucleotide diversity could be due to ecological factors in life cycle, animal migration and coexisting of the final host of this parasite. Haplotype and nucleotide diversity of spermic F. gigantica in Iran and other countries in the world led to creating a variety of haplogroups.   https://ijph.tums.ac.ir/index.php/ijph/article/view/16874 https://ijph.tums.ac.ir/index.php/ijph/article/download/16874/6362

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 748 757 Abdollah ALMASIAN KIA Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Sahar GOODARZI Department of Health Economics, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Heshmatollah ASADI Department of Public Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran Ardeshir KHOSRAVI Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran Aziz REZAPOUR Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran 2019 04 17 Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.   https://ijph.tums.ac.ir/index.php/ijph/article/view/16875 https://ijph.tums.ac.ir/index.php/ijph/article/download/16875/6363

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 48 4 2019 04 17 758 763 Sima TOZANDEHJANI Department of Biological Sciences, Faculty of Science, University of Kurdistan, Sanandaj, Iran Rasoul NASIRI KALMARZI Lung Diseases and Allergy Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Mazaher KHODABANDEHLOO Cellular & Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Hajar KASHEFI Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 2019 04 17 Background: Most influenza vaccines are grown in embryonated eggs and residual egg proteins can cause allergic reactions in patients with egg allergy. The aim of the present study was to determine the safety of inactivated influenza vaccine in patients with egg allergy in K