ABSTRACT
Objectives@#The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. @*Methods@#Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. @*Results@#In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48-11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. @*Conclusion@#The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6-10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.
ABSTRACT
Annually, around six million patients are admitted to hospitals in Iran. Information about the prevalence of nosocomial infections [NIs] is necessary for both appropriate management and establishment of preventative measures in hospitals. This article is based on the findings of the Nosocomial Infection Surveillance System [NISS] which has been providing information on NIs in Iran since March 2007. NISS covers 95 hospitals throughout Iran, each with over 200 beds. There are four main infections; urinary tract infection [UTI] surgical site infection [SSI], bloodstream infection [BSI] and pneumonia [PNEU] included in NISS. Reports are completed on forms that have been provided based on national guidelines. In all selected hospital there is one designated nurse who conducts infection control activities and is trained in the detection and reporting of NIs based on NISS guidelines. During March 2007 - March 2008, a total of 1, 879, 356 patients were admitted to the selected hospitals. The total detected NIs were 10557 with a prevalence of 0.57%. Of these, UTI was the most prevalent infection [32.2%] and BSI was the least [16.3%]. Based on gender, females had more UTI, whereas PNEU was the highest in males. Of reported NIs, 9% were detected in children less than five years of age and included BSI [45%], PNEU [20%], SSI [19%] and UTI [16%]. There were 26% reported NIs in the age group over 65 years, of which the most prevalent infections were UTI [42%] followed by PNEU [31%], SSI [15%] and BSI [12%] NIs were most often detected in intensive care units [ICUs; 26.7%], followed by surgery wards [12.8%]. In comparison with other studies and the World Health Organization [WHO] estimates, the rate of NIs appears to be less according to NISS. NISS has the capability to provide basic information for efficient management and control measures, in addition to indicating variations in NIs based on gender, age and location [hospital ward]. In order to have a more estimate of NIs and strengthen NISS, it is advisable to conduct a point prevalence study
ABSTRACT
The study of the effect of age, especially children under 15 years, on cholera morbidity during a period often years [1996-2005] was carried out in Iran. There are no other studies on this topic in Iran and other countries. In this cross sectional study, we used cholera surveillance data collected in Center for Disease Control. All cholera cases were divided into two groups: under 15 years and above 15 years. Incidence rate of cholera per 100000 was calculated in total population and the two mentioned groups during 10 years. The relative risk of less than 15 year-olds group to above 15 year-olds was calculated with95% CI for 10 years by EPI6 and SPSS software. The trend of cholera incidence during the past 10 years shows two epidemic peaks in 1998 and 2005 by the rate of 15.7 and 1.63 per 100000, respectively. During the year with no epidemic and the years between two peaks, the age group under 15 year-olds was more affected with significant relative risk. For example, in 2001 this rate was 4.53. So, we can consider this age group as a risk factor to cholera morbidity. The age group of above 15 year-olds was more affected to cholera during epidemic years [1998, 2005] and relative risk was less than one. So, the age was protective on cholera morbidity for children in these years. One of the most important causes of periodic cholera epidemics every 5-6 years is changing of herd immunity. During the years between two epidemics adults have sufficient immunity and children are more affected because of first exposure and less immunity. With reduced herd immunity epidemics occur. We recommend continuing and strengthening of cholera surveillance system for detection of epidemics and treatment of highly sensitive age groups