ABSTRACT
Background: Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present.Methods: In addition to the three main steps of this survey, including questionnaires, physical measurements, and laboratory assessments, we adapted the survey with the situation caused by the COVID-19 pandemic, by adding to various aspects of study phases and changing some scientific and executive procedures in this round of STEPS survey in Iran. These changes were beyond the initial novelties embedded within the survey before the pandemic, by refining the study protocol benefiting from the previous experiences of the STEPS survey.Results: By amending the required changes, we could include a total of 27 874 individuals in the first step of the survey. This number was 27 745 and 18119 for the second and third steps. Comparing the preliminary results with the previous nationwide surveys, this study was highly representative on both national and provincial levels. Also, implementing the COVID-19 prevention and control strategies in all stages of survey led to the least infection transmission between the study investigators and participants.Conclusion: The novel initiatives and developed strategies in this round of Iran STEPS survey provide a state-of-the-art protocol for national surveys in the presence of an overwhelming catastrophe like the COVID-19 pandemic and the triggered limitations and shortages of resources.
ABSTRACT
Coronavirus disease 2019 (COVID-19) as a severe and rapid spread disease is a global health emergency since December 2019. During the outbreak of COVID-19, infected pregnant women were treated with different pharmacological regimens;however, trial studies are still investigating their safety and effectiveness. In the present study, we reviewed all recently published studies related to the pharmaceutical management of COVID-19 in pregnancy to discuss the rapid evolving pattern of administered medications. A review study was conducted to investigate the pharmacological management of COVID-19 in pregnancy. All types of full English and recent articles through detailed research on Cochrane Library, PubMed, UpToDate, ScienceDirect and Google Scholar databases were collected. Several medical sites were also investigated. The implemented keywords for the search were COVID-19, SARS-CoV-2, coronavirus, pregnancy, management, treatment, medication, drug, antiviral, teratogenicity, possible effect, therapeutic effect, adverse effect and pregnancy outcome. There are no definitely specific approved pharmacological treatments for COVID-19 in pregnancy. Evaluating published literature showed that different treatment options, including chloroquine, favipiravir and ribavirin, convalescent plasma, interferons and remdesivir, have been used to stop or decline viral replication. We reviewed published evidence for drug selection and its safety during pregnancy, but conflicting results associated with numbers of trials show that we need further investigation for newer antiviral drugs for use in pregnancy. It seems that management of COVID-19 needs a multidisciplinary approach, and a consultant medical team should be arranged to decide about medications for the management of COVID-19-infected pregnant women.
ABSTRACT
Background & Objective: Screening and timely diagnosis of positive individuals is one of the important issues in controlling pandemic of Covid-19. Early and timely diagnosis of asymptomatic individuals, contact tracking, disconnection of Covid-19 transmission chain through early detection of patients and decreasing R0 were the main objectives of the current study. Materials & Methods: The Covid-19 outpatient sampling detection project started in Zanjan province on March 26, 2020 and samples were taken from people suspected of having Corona Virus and people in contact with these patients. Results: All 31,937 cases (48% male, 52% female) who had referred to Comprehensive Health Care Centers until May 16, 2020, were selected. A considerable percentage of incidences were observed in Zanjan and Khodabandeh cities. 20% of the examined samples had positive results. A substantial incidence was found in the age group of over 70-year-old. Following implementation of the outpatient screening project, R0 fell below 1 in the province. Conclusion: Prior to the implementation of Covid-19 laboratorial outpatient screening project, the value of R0 was 1.4 in Zanjan province. However, this value fell below 1, after implementation of the laboratorial outpatient screening indicating that the principal way to effectively control Covid-19 is to detect positive cases and manage them.
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Background and Aim: Covid-19 pandemic has caused significant disruptions in the provision of non-communicable disease prevention and management services in many countries and there is a concern that this disorder will lead to long-term complications of these diseases;This study aimed to quantitatively analyze the status of some prevention and management services of non-communicable diseases in the primary health care system of Iran during the Covid-19 pandemic. Materials and Methods: In this study, the routine data of 8 services related to the prevention and management of non-communicable diseases in the integrated electronic health record system (SIB) within 10 months after the outbreak of Covid-19 were compared to the same period last year.
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Background and Aim: Overweight and obesity disrupt people's quality of life and increase the risk of cardiovascular diseases, diabetes, hypertension, gastrointestinal diseases and cancer. It also reduces the immunity of people against epidemic diseases. Materials and Methods: In this article, extensive search of electronic databases, review of national upstream documents as well as review of documents and reports of the Ministry of Health were conducted to comprehensively review the prevalence of obesity and its associated factors, measures taken to control this risk factor, and challenge of a syndemic of obesity and Covid-19 in Iran.
ABSTRACT
Background and Aim: Overweight and obesity disrupt people's quality of life and increase the risk of cardiovascular diseases, diabetes, hypertension, gastrointestinal diseases and cancer. It also reduces the immunity of people against epidemic diseases. Materials and Methods: In this article, extensive search of electronic databases, review of national upstream documents as well as review of documents and reports of the Ministry of Health were conducted to comprehensively review the prevalence of obesity and its associated factors, measures taken to control this risk factor, and challenge of a syndemic of obesity and Covid-19 in Iran. Results: Based on the results of the national non-communicable diseases risk factors study (STEPS) in Iran, the prevalence of overweight and obesity was estimated to be 59.3% in people aged 18 years and older. Moreover, overweight and obesity were not homogeneously distributed in the country and the mean body mass index (BMI) changed from the lowest in the Southeastern to the highest in the Northwestern provinces. Covid-19 pandemic has made the situation even worse as the social distancing measures along with mental problems have made tremendous changes in people's lifestyles including physical activity and eating behaviors and this resulted in higher prevalence of non-communicable diseases (NCDs) risk factors especially overweight and obesity. Moreover, obesity increased the risk of hospitalization, admission to the intensive care units, the need for mechanical ventilation, and even mortality in patients with Covid-19. Meanwhile, anti-obesity services faced problems during the epidemics and posed a serious challenge to the world. Conclusion: This study highlighted the need for targeted national policies to simultaneously control the obesity and Covid-19 pandemics. © 2018 the Author (s). Published by Kurdistan University of Medical Sciences.
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Background: Serological surveillance of COVID-19 through conducting repetitive population-based surveys can be useful in estimating and monitoring changes in the prevalence of infection across the country. This paper presents the protocol of nationwide population-based surveys of the Iranian COVID-19 Serological Surveillance (ICS) program. Methods: The target population of the surveys is all individuals ≥6 years in Iran. Stratified random sampling will be used to select participants from those registered in the primary health care electronic record systems in Iran. The strata are the 31 provinces of the country, in which sampling will be done through simple random sampling. The sample size is estimated 858 individuals for each province (except for Tehran province, which is 2574) at the first survey. It will be recalculated for the next surveys based on the findings of the first survey. The participants will be invited by the community health workers to the safe blood sampling centers at the district level. After obtaining written informed consent, 10 mL of venous blood will be taken from the participants. The blood samples will be transferred to selected reference laboratories in order to test IgG and IgM antibodies against COVID-19 using an Iranian SARS-CoV-2 ELISA Kit (Pishtaz Teb). A serologically positive test is defined as a positive IgG, IgM, or both. After adjusting for the measurement error of the laboratory test, nonresponse bias, and sampling design, the prevalence of COVID-19 will be estimated at the provincial and national levels. Also, the approximate incidence rate of infection will be calculated based on the data of both consecutive surveys. Conclusion: The implementation of these surveys will provide a comprehensive and clear picture of the magnitude of COVID-19 infection and its trend over time for health policymakers at the national and subnational levels. © Iran University of Medical Sciences