[Patient education barriers from nurses' opinions]

Introduction: Patient education is one of the important aspects of nursing care and is among nursing key roles in delivery of health services

Objective: This study aimed to determine the barriers to patient education from nurses' viewpoint employed in educational hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd

Methods: This study was a cross-sectional and descriptiveanalytical study in which 162 nursing personnel were selected by stratified-random sampling method. In order to perform the sampling according to the population of each hospital, the numbers of samples were determined. Data were collected with a two-part questionnaire. First part contained personal and demographic information such as age, sex, marital status, education and working experience. The second part included 19 questions on patient education barriers which evaluated four domains of working conditions, management, nursing attitude and training skills. The data were analyzed by descriptive statistics and chi-square statistical test. Answers were designed based on a Likert scale from low to average and high impact with scores of 1-3, respectively. In management domain, the scores ranged from 6 to 18. Scores less than 10 showed "low impact", 10 to 14 "average impact" and more than 14 "high impact". In the domain of working conditions, similar scores were obtained. The findings displayed that nurses' attitude ranged from 2 to 6 scores. Scores less than 3 showed "low impact", 3-4.5 "average impact" and more than 4.5 "high impact". In domain of training skills, scores ranged from 5 to 15. Scores less than 8 indicated "low impact", 8 to 11.5 "average impact" and more than 11.5 "high impact". The data were analyzed with descriptive statistics and chi-square. The study was approved by the Ethics Committee of Health Faculty, Shahid Sadoughi University of Medical Sciences in Yazd

Results: In this study, 149 of the 162 questionnaires were answered indicating92% response rate. The data showed that 45.2% of male nurses and 47.3% of female nurses blamed working condition barriers with highest impact on the implementation of patient education. Moreover, 45.8% of single and 47.5% of married nurses had the same opinion. Chi-square test found no significant relationship between the variables of age, sex, working experience, employment status, marital status, and educational level with patient education barriers [P>/=0.05]. The data showed that 31.5% of nurses believed that barriers related to management had the greatest impact on the implementation of patient education followed by 47.7% barriers to working condition, 2.7% attitude of nurses and 14.1% training skills. Chi-square test showed a significant correlation between the domains of working condition and type of hospital [P=0.048]. Working condition was proved as the most important factor. Management was the second factor followed by training skills as the third. Finally, attitude of nurses was identified as the least important patient education barrier. The results of the present study revealed three factors with highest impact as education barriers in nurses' opinion; high working load [74.5%], insufficient nursing stuff in wards [71.8%] and nursing shifts in a row [70.4%] in working condition domain. The study population reported three factors with lowest impact; training as a specific task assigned for doctors [54.4%], lack of nurses 'self-confidence for training [43.5%] and not delivering the trainings to patients [40.3%]

Conclusion: In attention to that the domain of nurses working conditions had the greatest impact on the education of the patients, it is recommended that official authorities to maintain nursing resource in hospitals and reduce their workload and provide facilities and conditions for educational programs to encourage nurses to consider this important issue

Molecular evaluation of M2 protein of Iranian avian influenza viruses of H9N2 subtype in order to find mutations of adamantane drug resistance

Background: the H9N2 subtype of influenza A viruses is considered to be widespread in poultry industry. Adamantane is a group of antiviral agents which is effective both in prevention and treatment of influenza A virus infections. These drugs inhibit M2 protein ion channel which has role on viral replication

Objectives: the main objective of this study is to evaluate M gene of avian influenza viruses [AIVs] of H9N2 subtype in order to find adamantane drug resistance mutations

Methods: over 100 suspected samples were collected from different geographical regions of Iran during 2012-2013. Samples were injected via allantoic sac of 9-11 day-old chicken embryos. A total of 11 out of 100 were AIV. The H9N2 subtype was confirmed by specific RT-PCR. The RT-PCR was conducted for full length M gene. PCR amplified products were purified and then conducted for commercial direct sequencing. Finally, sequences were checked for possible sites of adamantane resistance mutations

Results: overall, 8 out of 11 viruses harbored the adamantine resistance-associated mutations. Of which, four viruses were isolated in 2013 and four viruses in 2012. Two different resistance- associated mutations were observed during different years

Conclusions: the present study provided clear evidence concerning resistance AIVs of H9N2 subtype that were circulating in Iranian poultry sector. This concern is always present as M segment might be introduced into human influenza viruses by reassortment phenomenon

Cytotoxic effects of hydro-alcoholic extracts of cress [Lepidium Sativum] - made from different stages of the plant - on k562 leukemia cell line

Chronic myeloid leukemia [CML] is a malignant clonal disorder of hematopoietic stem cells resulting in the increase of myeloid cells, erythroid cells and platelets in the peripheral blood and hyperplasia in bone marrow. The research evaluated the cytotoxic effects of hydro-alcoholic extracts of Lepidium Sativum [Cress plant] shoots before and after flowering on K562 cell line as a model of CML. In this laboratory experimental study, the Lepidium Sativum shoots including stems and leaves of the plant before flowering and its shoots after flowering including stems, leaves and flowers were collected from Afoos city [Iran]. They were extracted using maceration [50% Ethanol 96% and 50% water] method. K562 cells were cultured. Then the cells were treated with different concentrations of the extract [12.5-100 micro g/ml] at different time intervals [24, 48 and 72 hour]. The Lepidium Sativum cytotoxicity was evaluated by the MTT test method before and after flowering against K562 leukemia cells. The absorption was measured using an ELISA plate reader at 540 nm wave length. Data were analyzed using SPSS15 software and one-way ANOVA test analysis as well as Tukey test; where P<0.05 was considered significant. Hydro-alcoholic extracts of Lepidium Sativum showed the most optimum cytotoxicity both before and after flowering with a dose of IC50=25 micro g/ml and 72 hour after treatment on K562 cell line. In other words, hydro-alcoholic extracts of Lepidium Sativum prepared before and after flowering exhibited a dose and time dependent cytotoxic effect on K562 cell line. Considering the cytotoxic effect of hydro-alcoholic extracts of Lepidium Sativum shoots before and after flowering on K562 cells, the plant can be considered as a potential candidate for further studies on CML treatment

[Prehospital services by focus on road traffic accidents assessment developed and developing countries]

Prehospital services in road traffic accidents are one of the critical aspects of prehospital services. The goals of these services in traffic accidents is providing services to clients who need to on time interventions, prevention of disabilities and rapid and safe transportation by trained practitioners. The aim of this article was review the prehospital services by focus on road traffic accidents, in developed and developing countries. In this review article for data gathering, data bases of Google Scholar, PubMed, CINAHL and Science Direct searched by key word strategies. Eventually 43 articles since 1999 to 2012 selected. There are differences in structure, level of services and human resources in prehospital systems that created different patterns in countries. Many countries by strategies such as continuous public and professional education have compensated the weakness of other aspects. Prehospital service systems have several aspects such staffing, education, technology, management and organization. Each country must design their appropriate pattern to provide the best service to community

Lessons learnt from malaria epidemics in the Islamic Republic of Iran

The Islamic Republic of Iran is in the pre-elimination phase of malaria control, but malaria epidemics are still a concern in the south of the country. This retrospective study presents the epidemiological characteristics and predisposing factors of 60 of the malaria epidemics reported in Sistan va Baluchestan province during 2005-09. A zero-truncated negative binomial model was used to investigate the relation between predictor variables and the total number of malaria cases. Malaria epidemics occurred mainly in the southern part of the province, mostly between July and October, peaking in August. Most malaria epidemics were small-scale [8.3% were < 100 cases] and short [51.7% lasted < 1 month]. Plasmodium falciparum was present in 46.7% of the epidemics. An increase in the rainfall rate as well as population movements were the most significant predisposing factors. The results may help inform an epidemic investigation and reporting system as the country approaches the malaria elimination phase

survey on the Yazd pre-hospital emergency medical services' performance assessment, 2009-2010

Pre-hospital care has an important role in the management of critical patients. The more this management is appropriate, accurate and rapid, the less there is mortality and morbidity. It is therefore imperative to assess the current status of Emergency Medical Services [EMS] is to improve its performance. Three measures that can be considered in such assessments are the status of EMS staffing and equipments and more important, the response time of EMS system. This study had a main objective to survey these measures in Yazd pre-hospital EMS stations and to compare them with the existing standards. In a descriptive, analytical and cross- sectional study, we surveyed all 7 EMS stations of Yazd. We extracted the staffing status and the ambulance equipments through checklist and compared them with reference standards. Also, we surveyed 11961 run report forms from all stations that had been submitted to central station during 2008-2009. By using Excell software and descriptive statistics [percent, cumulative distribution and standard deviation],we calculated tractile response times for Yazd EMS and compared it with reference standards of Iran and North America. The results of the study showed that Yazd EMS system has major deficiencies in terms of staffing and access to advanced EMS equipments. Based on the results, only 1 station [14/3%] had sufficient staff. Also, none of the ambulances had the necessary equipments required for critical patients' management. Despite these deficiencies, 81/15% of response time was within 8 minutes, a reference standard for EMS. We concluded that the majority of call services in Yazd EMS have been responded in a suitable time interval compared with reference standards and country's approved EMS response time goal. Although, response time is an important factor in reducing morbidity and mortality in emergencies but deficiencies of personnel and equipments can affect the effectiveness of delivered services. There fore improving in staffing and equipments is an inevitable necessity to reach the goal

Pre-hospital emergency medical services in developing countries: a case study about EMS response time in Yazd, Iran

Pre-hospital emergency medical services, a subsystem of Emergency Medical Services [EMS], provides early care to critically ill and injured patients in the field. Time is an important factor in pre-hospital care and the length of time it takes to reach care, has a significant impact on patient outcome. This study aims to calculate the response time in EMS stations of Yazd, Iran. During 2008-2009, 11961 run report forms from all 7 EMS stations in Yazd that had been submitted to central station were surveyed. By using Excell statistical software and descriptive statistics [percent, cumulative distribution and standard deviation], we calculated fractile response times for Yazd EMS. 81.15 percent of response times were within 8 minutes as a referenced standard for EMS. The majority of call services in Yazd EMS have been responded in a suitable time interval comparing with reference standards and country's approved EMS response time goal, but there are still rooms for improvement

comparative survey of organizational commitment based on personal traits: a case study on nurses in Yazd training hospitals

Organizational commitment has been defined as [the relative strength of an individual's identification with and involvement in a particular organization]. Organizational commitment and factors that predict it has emerged as a promising area of research in recent decade for there is a strong evidence of link between high levels of commitment and favorable organizational outcomes. The main objective of this study was to investigate the relationship between the staffs personality traits [introversion - extraversion] and organizational commitment. This comparative - applied study was carried out in 2009-2010. The research population consisted of nurses working at Shahid Sad doghi and Shahid Rahnemoon hospitals. The sample [n=175] was selected by random sampling method. The data were collected by 2 valid questionnaires.organizational diagnosis questionnaire [ODQ] and Eysenck personality questionnaire [EPQ]. Data analysis was performed through SPSS[14] software using descriptive statistics and independent T-Test. The results of research indicated that the introvert and extrovert nurses are different in regards with their organizational commitment [p-v = 0/000]. Also, the organizational commitment was significantly different in both personality groups [introvert, extrovert] in terms of age group [P=0.003, 0.046] and job tenure group [p = 0/002, 0/042]. In the introvert group, organizational commitment was different based on the employment status [p = 0/017] but there was no difference in any group in terms of sex and marital status. The research results indicated that personality traits as a predictor of organizational commitment should be considered in human resources management

Gap analysis between perceptions and expectations of service recipients through servqual approach in Yazd, Afshar hospital

The quality of service is a key ingredient in the success of health care, organizations. Parasuraman, et al [1985] defined service quality as the differences between predicted or expected service [customer expectations] and perceived service [customer perception].Recently, service quality has become an important research topic for of its significant relationship to costs, profitability, customer satisfaction, customer retention and service guarantee. Several tools have therefore been developed to measure service quality but the Parasuraman 22 item servqual questionnaire created based on the gap model remains the most widely used tool in a variety of industries. This study attempts to replicate the servqual measurement of Parasuraman et al in determining the gap between perceptions and expectations of service recipients in Afshar hospital. This descriptive - applied study was carried out cross-sectionally in 2010. The research population consisted of patients admitted to Afshar hospital wards. Totally 84 patients were selected by sample size formula. The data were collected by 22-item servqual questionnaire designed according to gap model. Data analysis was carried out through SPSS and LISREL software using Kolmosrof - Smirnoff and paired sample t -test. The results demonstrated that there was a quality gap in Afshar hospital,that is, there were significant differences between expectations and perceptions of patients in servqual dimensions. Also, the study identified some critical and problematic items that have main roles in constructing observed quality gap. The existing quality gap means patients' expectations exceed their perceptions.Thus improvements are needed to be made across servqual dimensions

survey of satisfaction rate and the effective factors on the aged peoples satisfaction regarding to the given services in the hospitals Tehran university of medical sciences

The elderly population in Iran is increasing. The aim of this study is the survey of satisfaction rate and the effective factors on the elderly - aged peoples satisfaction regarding to the given services in the hospitals affiliated to the Tehran university of medical sciences. This research is a descriptive - analytical study with applied results. It shows the problems cross - section ally. The research society involves the whole elderly - aged people whit 65 years old and more than that used the bedridden services of the hospitals affiliated to the Tehran university of medical sciences. The sample involves 360 elderly. For collecting the data, a questionnaire with three parts was used. The validity of questionnaire by the content measurement and the reliability of questionnaire by test re test [r = 0.84] were achieved. And also we used SPSS software for data analysis. Results showed that 25/6%patients from management type, 41/9%from facilities, 17/2% from behavior personality and 30/3% from public services are dissatisfaction. A total of 12 variable were analyzed, and the results showed that: The education level, age, sex, type of refer, dealing with the bed shortage and occupations have the meaningful relation with their satisfaction rate. The one -variable - analyzers in the logistic regration model showed that among the whole meaningful variables, the education level has the strongest relation with satisfaction. With increasing the education level, the satisfaction rate have been decreased. Due to results satisfaction rate among participant of this study is good and accepted. Using of results is effective step in increase productivity services and further evaluation needed to be done for functional styles patient elderly satisfaction

[Evaluating the effect of continuous care on quality of life in discharged schizophrenic patients from Sina educational and medical center, Hamedan]

Considering chronic nature of schizophrenia and failure of current plans, developing an effective continuous care model is needed. One of the methods to promote quality of life is applying continues care nursing model. The present study aimed at evaluating the effects of continuous care model on quality of life of schizophrenic patients in Hamadan. All 36 patients have been selected based on inclusion criteria [census], and divided randomly in two similar control and interventional groups of research. The data gathered from demographic, [QLS: alpha=0.81] questionnaires and control check list [alpha=0.92]. The orientation and sensitivization phases of the model applied on the interventional group in the hospital [6 sessions of education, A quasi-experimental study was conducted with a sample of 36 schizophrenic patients. They have been drawn from Sina Hospital, among 89 patients who fulfilled the inclusion criteria. The participants were allocated to two groups of control and intervention through simple random allocation. Data were collected using questionnaires of Heinrich Quality of Life and self-control check list. Continuous care model was applied for intervention group through orientation and sensitivization [six educational sessions: two times a week] in hospitals, then control and evaluation [6 home visits: two times a week] at their home. Data were analyzed using independent T-test, paired T-test and analysis of variance. There was no significant difference between quality of life mean scores of two groups prior to the intervention [P>0.05]. After the intervention, mean score of quality of life in interpersonal relationship was significantly different [P=0.03] but Independent T-test didn't show any significant differences between groups in spite of increased scores of quality of life and its dimensions in intervention group [P>0.05]. The study demonstrated the effect of continuous care model on interpersonal relationship. Since improving interpersonal relationship is the most important aim of care for chronic patients, and it could consequently have an effect on other dimensions of quality of life, using the model could improve total quality of life and other dimensions. Results of present study and similar studies illustrate the necessity of providing nursing care after discharge for chronically ill patients. It could decrease the relapse rate and hospitalization, besides valuable impact on their quality of life

Effects of dietary Aloe vera on some specific and nonspecific immunity in the common carp [Cyprinus carpio]

In this study, the immunostimulatory effect of dietary Aloe vera crude extract was investigated in Cyprinus carpio. Three hundred fish were randomly divided into four groups. The first group was immunized with Aeromonas hydrophila bacterin [A.h] and was fed a diet contained 0.5% Aloe vera. The second group was immunized with A.h and fed a diet without Aloe vera. The third group was not immunized and fed with a diet that contained 0.5% Aloe vera. The fourth group remained as the control group and was neither immunized nor fed with Aloe vera supplements. Blood samples were taken every 14 d for eight weeks and samples were analyzed for hematological and immunological parameters. White blood count [WBC], red blood count [RBC], packed cell volume [PCV], lysozyme activity, serum bactericidal activity, complement activity, total protein, IgM concentration and specific A. hydrophila antibody were assessed. At the end of treatment, 20 fish from each group were challenged with A. hydrophila. WBC value, antibody level, lysozyme and bactericidal activity were significantly increased in the serum of fish treated with Aloe vera [p<0.05]. No significant differences were seen in the RBC, PCV or complement activity among the groups. The relative percent survival [RPS] was found to be increased in fish fed with Aloe vera. This study indicates that the oral administration of Aloe vera is able to enhance some specific and non-specific immune responses in the common carp

Seroprevalence of Helicobacter pylori in Nahavand: a population-based study

In this cross-sectional study, we evaluated H. pylori seroprevalence and the relevant factors in 1518 people aged > /= 6 years from the general population of Nahavand, western Islamic Republic of Iran. Questionnaires covering sociodemographic variables were completed by interview. Blood samples were taken from each individual. Sera were tested for anti-H. pylori IgG using commercial enzyme immunoassay. Overall, seroprevalence of H. pylori was high, 71.0% [95% CI: 69.0%-73.0%]. There was a gradual increase with age. Based on multivariate adjustment, only female sex and age could be considered risk factors

Neurobrucellosis: report of a rare disease in 20 Iranian patients referred to a tertiary hospital

We reviewed the clinical manifestations and outcome of 20 cases of neurobrucellosis out of 1375 patients with brucellosis admitted to the infectious diseases ward of a tertiary hospital in Hamedan, Islamic Republic of Iran. Of the 20 cases, 12 had meningitis [acute and subacute], 4 had meningoencephalitis, 2 had myelopathy, 1 had polyradiculopathy and 1 had meningovascular complications manifested by stroke. The most prevalent symptoms were headache [75%], vomiting and fever [50%] and unconsciousness [35%]. Among 20 neurobrucellosis patients, 1 died and the other 19 recovered; 14 fully recovered and 5 patients had residual neurological deficits. In endemic areas, the disease should be ruled out in all patients who develop unexplained neurological symptoms

Survey of antibiogram tests in cholera patients in the 2005 epidemic in Hamadan, Islamic Republic of Iran

An analytical cross-sectional study determined the serogroups and serotypes of Vibrio cholerae, and their antibiotic resistance rates, in the 2005 cholera epidemic in Hamadan. All 190 patients with positive stool cultures had V. cholerae serogroup O1, biotype El Tor and serotype Inaba positive. Of 60 cases selected randomly for antibiogram testing, sensitivity to norfloxacin, ciprofloxacin, kanamycin, amikacin, tetracycline and doxycycline was 97%, 92%, 88%, 85%, 77% and 67% respectively. Resistance to furazolidone, trimethoprim-sulfamethoxazole and erythromycin was 100%, 98% and 62% respectively. Comparison with the results of the 1998 epidemic suggests a worrying increase in the resistance of V. cholerae to erythromycin, doxycycline and ciprofloxacin

Patient concerns regarding chronic hepatitis B and C infection

Counselling of patients with viral hepatitis is often limited to discussions about how the virus is transmitted. The aim of the present study was to document the principal concerns of patients suffering from chronic hepatitis B and C infection. The most common volunteered concerns were infecting family members [80.6%], infecting others [66.7%], side-effects of treatment [50.0%], disease progression to cirrhosis [44.4%], loss of employment [41.7%], liver transplantation [36.1%], social stigma [36.1%], change in lifestyle [33.3%], development of liver cancer [25%], costs and money [22.2%], fear of disease [5.6%] and psychological disease [5.6%]. Health care providers who focus counseling efforts exclusively on viral transmission are unlikely to address other important concerns

Health management in disasters with focusing on rehabilitation

Disasters should never be considered as routine. Disasters of ! any kind-natural or manmade-clearly disrupt the normal 1 functioning of any community and frequently overwhelm both personal and community resources. In the post-disaster context, following the initial shock of the disaster, returning lives and livelihoods to normalcy becomes a primary concern of the affected communities and nations. Traditionally, this has been known as the recovery and rehabilitation phase, where [normalcy] refers to the return of the community to the state it was in prior to the disaster event. Rehabilitation is this process of returning the community to [normal] that may extend for many years and involves the physical, social and economic components of the community. Disasters can take on a life of their own, therefore being prepared is the single most effective way to improve outcomes. Proper pre-event planning and providing mechanisms for resource coordination are critical which will be resulted a successful response. It should focus on increasing the participation of civil authorities in order to reestablish local authorities. In order to develop safer communities with fewer deaths, physical injuries, and psycho-social trauma following disasters, health systems must be capable of providing a coordinated response during disasters and of delivering effective mitigation and preparedness programs before disaster impact. The health sector has a vested interest and a key role in this process. In addition, prior to the occurrence of disasters, national, provincial, and local planning should be blueprinted by managers. The public must be educated regarding the importance of individual and family preparation for disaster

[Frequency of hepatitis A virus antibodies in patients with hepatitis B and hepatitis C in Iran]

Superinfection of hepatitis A in chronic hepatitis B and C may worsen the course of disease. This study attempted to study frequency of hepatitis A virus antibodies in patients with hepatitis B and hepatitis C. 115 hepatitis C and 56 hepatitis B patients who visited the Hepatitis Association of Hamedan province during 2004-2005 were enrolled. Hepatitis A virus antibodies [IgM, IgG] by ELISA, WBC, hemoglobin, platelet, AST and ALT were evaluated. 32 patients with hepatitis B and 39 patients with hepatitis C refused the study. In 71 [85.5%] patients with hepatitis B, IgG-HAV-Ab and in one patient IgM-HAV-Ab was detected. 36 [92.3%] patients with hepatitis C had IgG-anti-HAV. Due to high frequency of HAV Ab, it is preferable to evaluate patients with hepatitis B and C for HAV-Ab instead of vaccination of all patients

[ comparison of maternal endometritis in meconium - stained amniotic fluid and clear amniotic fluid]

Metritis is one of the causes of maternal morbidity and there are many risk factors for it. Because of the importance of possible association of meconium-stained amniotic fluid and maternal metritis the present study was done to determine whether meconium stained amniotic fluid [MSAF] is associated with puerperal infection. In this case-control study 150 women with MSAF and 150 women with clear amniotic fluid [gestational age > 37 weeks] were compared for puerperal metritis. Subjects' educational level, gestational age, gravida, mean vaginal exams, route of delivery and mean neonatal weight were not significantly different between the two groups. But mean maternal age and neonatal Apgar were significantly different in the two groups. That is, post partum metritis in women with clear amniotic fluid occured less than women with MSAF [2.7% vs 10%, P<0.014]. Since meconium stained amniotic fluid is associated with metritis, special care in this regard is recommended

[Comparison of knowledge, attitude and practice [KAP] regarding malaria transmission and protection between afghan refugees and Iranian residents in Iranshahr, 2005-2006]

The aim of present study is to compare Afghan refugees and Iranian residents in terms of their knowledge, attitude and practice concerning malaria transmission and protection in an endemic area in Southeast Iran. This cross sectional study was conducted over a period of 10 months [2004-2005] and involved a total of 775 people, including Iranian and Afghan subjects. The age range of participants was 15 to 55 years. Data collection was done through a structured questionnaire consisting of open and close questions and comprising several, namely personal characteristics details, history of malaria infection and treatments, type of residence, mobility, self protection, facilities, and access to health services. Both Iranians and Afghans were familiar with the three typical symptoms of the disease [fever, chills and muscle aches]: 67.1% of Iranians and 78% of Afghans were able to name least one of the three typical symptoms. In both groups the majority of subjects were aware that malaria transmission occurs through mosquito bite but there was a significant difference regarding knowledge of malaria transmission [CHI2 = 142.2, P<0.001]. Chi-square test for goodness of fit showed that the distribution of symptom indicators is significantly different between the two groups. For Iranians, the most important source of information about malaria was the health facilities [44.5% of the total] while most Afghans [65.3%] had obtained the information through friends and relatives. In both groups, the mass media had acted as the source of information in only 3.4%. Altogether, 24% of the participants reported the use of mosquito bed nets; almost 90% of Afghans and 62% of Iranians said that they did not used bed nets at all. However, the number of Iranians who used bed nets was four times greater than the Afghans who did so. Although the majority of subjects were familiar with malaria transmission and protection methods, they largely neglected safety precautions. Moreover, it seems that the high prevalence of malaria among Afghans is due to their life style rather than cross-border travel. The study also revealed that Afghan people have poor communication with the local health facilities, a point that must receive special attention in future malaria control programs