Sero-epidemiology of hepatitis E virus infection in Isfahan-Iran: a community-based study

Hepatitis E virus [HEV] is an enterically transmitted acute viral hepatitis with the highest incidence in Asia, Africa, Middle East and Central America. There is little published data on the epidemiology of the infection in Iran. Thus, this study was carried out to evaluate anti-HEV sero-prevalence in Isfahan Province [Iran]. In a cross sectional study extending over 6 years, 816 subjects were selected from urban and rural areas of Isfahan Province in 2005 using multi stage cluster sampling method. Demographic data and blood samples were collected and anti-HEV antibodies were measured by ELISA method. Chi-square test was used for statistical analysis and P<0.05 was considered significant. The subjects of this study included 428 females [52.5%] and 388 males [47.5%]. The overall anti-HEV sero-prevalence rate was 3.8%. There was no significant difference in HEV sero-positivity between the subjects grouped according to sex [4.2% in females and 3.4% in males, P=0.78], household number [P=0.095] and living area [2.7% in rural and 4.1% in urban areas, P=0.09]. HEV sero-prevalence increased with age from 0.9% in children 6-9 years to 8% in persons over 50 years without statistical differences in them [P=0.08]. There was statistical difference between HEV sero-positivity in different regions of Isfahan Province, with the highest prevalence in Khomeini Shahr [13.3%] [P< 0.001]. HEV sero-prevalence in Isfahan Province is lower than previous reports from other parts of Iran and Middle East. Further -studies in other parts of Iran are needed to obtain a prevalence map for planning preventional strategies

Assessment of preparedness of the ambulances in Isfahan in 1384

In developed countries, good management and automatic equipments work together to ensure the response to emergencies as soon as possible. It is being included ambulances as a main vehicle for transporting and referring patients. Now ambulances with experienced personnels are used to patient' satisfy transfer. Though there were some reports about mortality during transporting due to impairs in these vehicles in Isfahan province, we decided to assess preparedness of ambulances there in 1384[2005]. In a descriptive study, all of 204 ambulance in Isfahan were assessed. A checklist was designed based on standards of ambulance equipment and supplies, and used for gathering required information. Urgency and governmental, private and charity hospitals, had 60, 28, 34 and 44 ambulances respectively. 38 ambulances belonged to other health centers. 87.86% of ambulances were prepared form techicical1y. The preparedness was sufficient in only 25.41%, 29.l8% 7l.67% and 31.71 of ambulnces respectively in necessary equipments, essential drugs, observation health and welfare. We can prepare essential drugs and necessary equipments at first step. It is possible to mobilize the ambulances on the basis of kind of referring

[Evaluation of satisfaction and its factors in patients in emergency departments of Isfahan province in 2005]

Patient satisfaction is an indicator of service quality in hospitals, especially in the emergency departments. We evaluated this item and its factors in hospitals in Isfahan province in 2005. In a cross-sectional study 1372 patients in 48 emergency departments were assessed and data were collected on the basis of a questionnaire. Mean and total scores and percent of amounts of satisfaction were used. Anova and T-test were used and p < 0.05 was considered significant. 82.8 percent of patients were satisfied with services with mean score of 111.9+1- 14.8 from maximum score of 145. Care givers' speed, accuracy and behavior were domains with most score drug availability and costs took least scores. Private hospitals and those affiliated to special organizations and foundations and all university hospitals exhibited decreasing scores as 116.9, 113.6 and 109.6 respectively. Patients' educational level showed a reverse relation to satisfaction, singles were more satisfied than married. This study reveals costs and drug availability as the major causes of dissatisfaction, hence demanding more attention

Comparison of HBs-antibody serum levels between patients with type 2 diabetes mellitus and controls following vaccination against hepatitis B

Diabetic patients are at risk to viral hepatitis. It is reported that vaccination with routine doses is not sufficient for diabetic patients especially those with type I, but there is some controversies. The aim of this study was to the assessment and compare of HBs-Ab titer in type II diabetics and controls after vaccination against hepatitis B. In a semi-experimental study, 91 patients with type II diabetes mellitus and 55 non diabetic healthy individuals matched in age, sex, body mass index and smoking were selected by simple non-random sampling. The positive cases for HBs-Ag, HBs-Ab and HBc-Ab were excluded. Vaccination against hepatitis B was carried in 3 times [0, 1, 6 month] with a dose of 20 microg. Then, 3 and 6 months after the last dose, Hb-A1C and HBs-Ab were tested. HBs-Ab titers were compared between two groups using Mann-Whitney U test and the correlation between HBs-Ab and Hb-A1C in two groups. Three months after vaccination, both in diabetics and controls, the mean HBs-Ab level was 335.8 +/- 275.7 and 420.1 +/- 348.4 mIU/ml, and 6 months after vaccination it was 530.7 +/- 387.9 and 552.5 +/- 410.7 mIU/ml respectively [p > 0.05]. There was an inverse but non-significant correlation between HB A1C and HBs-Ab in diabetics. The findings of the current study confirm that the routine vaccination is sufficient for patients with type II diabetes

Survey of hepatitis B risk factors in blood donors at Isfahan province

Viral hepatitis B is a dangerous disease with high mortality and morbidity rate in the world. It has been prevalence in different areas depends on risk behaviors and people's awareness level. This paper was prepared to detect the risk factors of hepatitis B in blood donors in Isfahan province. In cross-sectional study, 39 seropsitive blood donors and 261 seronegeative ones in 2004 were studied. HBsAg was examined via ELISA. Standard hepatitis B risk factor questionnaires were completed for all of the samples and the prevalence of each risk factor in case and control subjects was compared through X[2] test, using SPSS-10 software with p<0.05. This study indicated that history of surgeries, use of shared razors, jaundice of mother, presence of HBsAg+ patients and drug addicts in families were statistically significant in the two groups. There was not any heamodialysis history, accident of needle sticks and needle sharing by drug addicts. Since the relative frequency of surgery history in the two groups was significant different, attending to hospital and operation room hygine seems to be important. Moreover, since hepatitis B can be prevented with education and vaccination, the families of HBsAg+ patients and drug addicts should be encouraged to use education and vaccination. Using the results of this study, it is necessary to pay attention to hospitals and raise people awareness about hepatitis B transmission routes vaccination of high risk individuals