ABSTRACT
Malaria threatens more than half of the world's population in about 100 countries. During the period 1921-1951 malaria was one of the most important public health issues in Iran, no other disease causing as much financial loss and mortality as malaria did. The objective of this study was to investigate malaria epidemiology in Iran during the period 1940-2006 [65 years], in the hope that the information and experience will be used in the future. This study included a review of the available literature on the subject, as well as a study of health systems, existing records, and analysis of data and information on malaria in Iran. Data were collected from three main sources: national or international electronic sources [26 sources]; non-electronic sources, including theses, journal articles, and various documents and reports, as well as data obtained from the national malaria surveillance system [a total of 180]; and interviews with five informed and expert individuals. In addition, national documents prepared by the Center for Disease Control, Ministry of Health and Medical Education, during the previous 6 months were made available to, and used by, the research team. The findings show that, despite several annual fluctuations, the trend of incidence of the disease during the 65-year period, from 1940 to 2006, was a downward trend. The incidence declined from 250-333 per 1000 people in the early 1940's to 0.22 per 1000 people in 2006. The changes in incidence of malaria show that elimination of malaria is a possible and feasible goal. The experiences achieved in controlling this disease can be utilized for controlling other diseases as well.
ABSTRACT
In 1991, the world health organization initiated a project to simultaneously develop an instrument for measuring quality of life in 15 countries. The study yielded two questionnaires, namely WHOQOL-100 and WHOQOL-BREF. These were intended as generic QOL measurement tools to be used in a broad range of diseases, for different degrees of disease severity, and in various cultural subgroups. The objective of the current study was to evaluate the Iranian version of the WHOQOL-BREF. This 26-item instrument comprises four domains: Physical Health, Psychological, Social Relationship, Environment and the overall QOL/health. We administered the questionnaire to 1167 adults in Tehran. The stratified sample consisted of 476 diseased subjects and 700 healthy ones. We tested the instrument's reliability [internal consistency, test-retest], discriminant validity and factorial structure. The participants had an age mean of 36.3 years [SD = 13.2] and had an average 11.5 years of education. Using Cronbach's alpha and intraclass correlation, all domains met the minimum reliability standards, with the exception of social relationship domain [alpha = 0.55]. The latter could be attributed the small number of questions in this domain and the sensitive nature of the questions themselves. Since 83% of the questions show maximum correlation with their original domain, the factorial structure of the questionnaire was regarded as acceptable. The questionnaire has the ability to discriminate different groups after adjustment for confounding factors in regression analysis. This study demonstrated good to excellent reliability and acceptable validity in various groups of subjects in Iran. The instrument may be used in future studies, albeit with minor modifications in the domain of social relations, as determined by expert opinion