• Parasites, Hosts and Diseases
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• v.53 no.4
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• pp.379-383
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• 2015

Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of ${\geq}1:800$. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of ${\geq}1:3,200$ indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran.

• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.201-209
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• 2017

Objectives: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.386-393
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• 2016

Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1875-1879
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• 2016

Background: Breast cancer is the most common cancer among women worldwide. A very important factor in the timely treatment and prevention of progression is high breast cancer awareness. Rural women are at risk of latte stage breast cancer due to poor education and lack of access to medical facilities. Materials and Methods: This cross-sectional-descriptive study was conducted on 266 women (out of 300) aged over 18 in rural areas of Zabol, Southeastern Iran during July 2015 to October 2015. The data collection tool was a researcher-made questionnaire that measured participant knowledge of breast cancer in four aspects (general awareness, risk factors, mammography, and symptoms). SPSS 22 was used for statistical analysis. Results: Out of 266 participants, age information was available for 261. The age range was between 19 and 62, with a mean of $27{\pm}2.1years$. Most participants (154, 57.9%) had an average overall awareness of breast cancer. In the general awareness dimension, most participants (130, 48.9%) had poor scores. Most (166, 62.4%) also had average awareness about risk factors and many (137, 51.5%) had good awareness about mammography. Most participants did not know that changes in breast shape (232, 88.2%), dimpling of breast skin (192, 72.3%) and nipple discharge (183, 69.6%) are the main symptoms of breast cancer. ANOVA statistical analysis showed a significant relationship between awareness level and participant education and occupation (P<0.05). Conclusions: This study indicated average awareness of participants about breast cancer. Since rural women have lower levels of education, it is recommended that educational courses with contents about breast cancer, its risk factors, and symptoms be held for these women.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2333-2336
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• 2013

Background: The aim of this paper was to present the incidence rates of leukemia and multiple myeloma (MM) in Golestan province located in northeastern Iran during 2004-2009. Materials and Methods: This was a descriptive cross-sectional study. Data on newly diagnosed (incident) leukemia and MM cases were obtained from collected from Golestan population-based cancer registry. Data was entered into CanReg-4 software. Age standardized incidence rates (ASR) (per 100000 person-years) for leukemia and MM were calculated. Data on Golestan population was obtained from the data of Iranian national census in 2006. Results: Totally, 11036 new cancer cases were registered in GPRC from 2004-2009. Leukemia and MM accounted for 693 and 124 of cases, respectively. The mean age in patients with leukemia and MM was 43.8 and 62.4 years, respectively. The ASRs for leukemia among men and women were 10.4 and 7.8, respectively (p<0.001). The ASRs for MM were 2.1 and 2 in men and women, respectively (p=0.93). The rate of leukemia was significantly higher in rural areas (p=0.02) whereas the incidence of MM was higher in urban areas (p<0.001). Conclusions: Our results showed a high incidence rate of leukemia in Golestan province of Iran. The incidence of leukemia was significantly higher in males and residents of rural areas. High exposure to pesticides and other agricultural related products may be a possible explanation for epidemiological pattern of leukemia in this area. Determining and controlling important risk factors, especially environmental factors, of leukemia may lead to decrease in its burden in Golestan province of Iran.

• Advances in Energy Research
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• v.5 no.2
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• pp.129-145
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• 2017

In this study, the use of a micro gas turbine system using biogas to supply heating, cooling and electricity loads of a rural building located in rural area around Tehran has been studied. Initially, the amount of energy needed by the farmhouse was calculated and then the number of needed microturbines was determined. Accordingly, the amount of substances entering biogas digester as well as tank volume were determined. The results of this study showed that village house loads including electrical, heating and cooling and hot water loads can be supplied by using a microturbine with a nominal power of 30 kW and $33.5m^3/day$ of biogas. Digester tank and reservoir tank volumes are $67m^3$ and $31.2m^3$, respectively. The cost of electricity produced by this system is 0.446 US$/kWh. For rural area in Iran, this system is not compatible with micro gas turbine and IC engine system use urban natural gas due to low price of natural gas in Iran, but it can be compatible by wind turbine, photovoltaic and hybrid system (wind turbine& photovoltaic) systems.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3391-3396
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• 2014

Background: Vitamin D has been suggested as one of the critical factors for female reproductive health with protective activities against different cancers but there are conflicting facts regarding its role on breast cancer without any clear data on premenopausal cases. This study aimed to evaluate the role of vitamin D from dietary sources and sunlight exposure on the incidence of premenopausal breast cancer. Materials and Methods: We conducted a case control study on 60 newly diagnosed premenopausal breast cancer patients and 116 normal women who lived in Sabzevar and surrounding villages in Razavi, Khorasan, a rural and conservative area of Iran. Results: The mean concentrations of 25-OH vitamin D in cases and controls were $15.2{\pm}8.15$ vs $15.5{\pm}7/45ng/ml$, both well below normal values elsewhere. In fact 50% of analyzed individuals showed very severe or severe vitamin D deficiency and the rest (25%) were detected in suboptimal levels. Although the lack of vitamin D and calcium supplementation increased slightly the risk of premenopausal breast cancer (p=0.009, OR=1.115, CI 95%=1.049-1.187), higher prevalence of weekly egg consumption (86.66% vs 96.55%, p=0.023, OR=0.232, CI 95% 0.065-0.806) showed a slight protective role. The last but the most important risk factor was lack of sunlight exposure because the breast cancer patients had total body coverage from sun (p=0.007, OR=10.131, CI 98% 0.314-78.102). Conclusion: This study pointed out the role of vitamin D and other possible risk factors on the development and growth of breast tumors in this special geographical region. Although this study has revealed the interactions between hormonal and environmental factors in this province of Iran, understanding the deficiency pattern and its contribution to other lifestyle factors elsewhere is also necessary.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.73-80
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• 2021

Objectives: Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran. Methods: Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI. Results: The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC. Conclusions: The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.

• Journal of Preventive Medicine and Public Health
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• v.57 no.2
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• pp.167-175
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• 2024

Objectives: Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives. Methods: A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21. Results: The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (p<0.05). Conclusions: This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants' model structures and their stages of change.

• Safety and Health at Work
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• v.6 no.2
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• pp.120-127
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• 2015

Background: Musculoskeletal pain (MSP) is a common and disabling problem among carpet weavers and is linked to physical and psychosocial factors of work. This study aimed to determine the prevalence of MSP, its psychosocial risk factors, and association of pain in each pair of anatomical sites among carpet weavers. Methods: A cross-sectional study was performed among 546 hand-woven carpet weavers in rural small-scale workshops of Iran. Data were collected by using parts of a standardized CUPID (Cultural and Psychosocial Influences on Disability) questionnaire focused on MSP in 10 body sites, including the low-back, neck, both right and left shoulders, elbows, wrists/hands, individual, physical and psychosocial risk factors. Statistical analysis was performed applying logistic regression models. Results: Prevalence of MSP in at least one body sitewas 51.7% over the past month. The most common sites were low back and right shoulder pain 27.4% and 20.1%, respectively. A significant difference was found between the mean number of painful anatomical sites and the level of education, age, physical loading at work, time pressure, lack of support, and job dissatisfaction. In pairwise comparisons, strongest association was found between pain in each bilateral anatomical site (odds ratio = 11.6-35.3; p < 0.001). Conclusion: In home-based workshops of carpet weaving, psychosocial factors and physical loading were associated with MSP. This finding is consistent with studies conducted among other jobs. Considering the preventive programs, the same amount of attention should be paid to psychosocial risk factors and physical loading. Also, further longitudinal studies are needed to investigate the relationship of psychological factors.