Levels and Trends of Maternal Mortality and Morbidity by Cause in North Africa and Middle East, 1990 to 2019: An Analysis for the Global Burden of Disease Study 2019

Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.

Lived Experiences of Healthcare Workers Infected with COVID-19 in Teaching Hospitals

Background: With the onset of the coronavirus crisis, the medical treatment staffs were at the forefront of dealing with the disease. The lived experiences in the face of this disease can help better manage the epidemic and identify organizational and individual barriers and challenges. This study aimed to investigate the experiences of medical staff working in COVID-19 wards in Shiraz teaching hospitals. Methods: The present study is a qualitative study conducted in 2021-2022. A semi-structured interview was used to collect data. Eighteen nurses, physicians, and health workers of Shiraz University of Medical Sciences were employed for the interview. The snowball sampling technique based on the target group was used. Data were analyzed by The Colaizzi seven-step analysis method. Results: Three themes, including "tensions”, "material and spiritual support”, and "pleasant feeling” and eight sub-themes were extracted. The sub-themes were "resilience”, "insufficient knowledge”, "depression”, "expressing gratitude by friends”, "public attention”, "organizational support”, "feeling proud”, and "altruism”. Conclusion: The present study shows that COVID- 19 caused a lot of pressure on the medical staff during the pandemic, which led to psychological and emotional damage. On the other hand, material and spiritual support played an important role in reducing distress in times of crisis. © 2023 Authors. All rights reserved.

Emotional Reactions to COVID-19 and Coping Strategies in Nursing Students

Introduction: Nursing students are continuously exposed to carriers or patients with COVID-19 during the pandemic. The COVID-19 pandemic and its consequences can lead to many emotional reactions in nursing students. The aim of this study was to investigate emotional reactions to COVID-19 and coping strategies in nursing students. Methods: This descriptive and correlational study was conducted in 2021 at Saveh University of Medical Sciences, Iran, on 106 nursing students chosen by census method. The tools used in this study included two standard questionnaires of emotional reactions to COVID-19 Huang et al. and Carver's coping strategies questionnaire (brief form). Data analysis was performed using SPSS version 19. Results: The mean score of the dimensions of emotional reactions was 4.06 ±0.56, 4.19 ±0.77, 3.08 ±0.56, and 2.89 ±0.56, in the field of fear, anxiety, sadness, and anger, respectively. There was a statistically significant difference between the mean scores of fear and anxiety with gender (P<0.05). The mean scores of problem-focused and emotion-focused coping strategies were 2.97 ±0.97 and 3.06 ±0.97, respectively (P>0.05). There was a significant positive correlation between emotion-based coping strategies with fear, anxiety, and anger (P<0.05 (. Conclusion: Months after the beginning of the COVID-19 pandemic outbreak, the rate of negative emotional reactions (including fear, anxiety, anger, and sadness) is high in nursing students. There was a positive correlation between emotion-based coping strategies and emotional reactions. Therefore, particular emphasis should be placed on providing psychological support to nursing students as well as teaching coping strategies. © 2021 by the Author(s).

The Relationship between Mental Distress and Perception of COVID-19 Stress in Healthcare Students

Introduction/Aim: Healthcare students are among the groups affected by the COVID-19 pandemic in various ways. This study aimed to investigate the relationship between mental distress and perceptions of COVID-19 stress in healthcare students. Methods: The present analytical cross-sectional study included all students of Saveh University of Medical Sciences in 2021 as the statistical population. Through convenience sampling, 419 students were included in the study. A 12-item general health questionnaire (GHQ-12) and a 19-item the COVID-19 related healthcare students stress scale were used to collect data. Data analysis was performed using SPSS and descriptive and analytical statistical methods methods (Pearson correlation coefficient, paired t-test and analysis of variance). Results: The mean score of students' mental health status was 12.91, and 41.05% (N = 172) of them had some degree of mental distress. There was a significant relationship between mental distress score with the perception of COVID-19 stress, gender and field of study (P < 0.05). Conclusion: A significant number of students had some degree of mental distress, which had a direct and significant correlation with the perception of COVID-19 stress. Therefore, planning to identify and reduce the stressors associated with COVID-19 is one of the most beneficial actions for the students in restoring their mental health.

Clinical features and outcomes of suspected and confirmed covid-19 patients in Saveh, Iran, 2020

Background and purpose: The outbreak of Coronavirus Disease 2019 (COVID-19) pneumonia is a major threat to global public health because it is very contagious and spreads quickly by human-tohuman transmission. This study aimed to investigate the clinical characteristics and outcome of patients infected with COVID-19 in Saveh, Iran. Materials and methods: A descriptive-analytical study was conducted in 1537 patients with suspected or confirmed COVID-19 from 18 February-2 June 2020. Medical records were studied and a researcher-made questionnaire consisting of demographic information, epidemiological, and clinical manifestations were used to collect the data. Results: There were significant differences between patients tested positive and negative for COVID-19 in terms of gender, age, duration of hospitalization, and contact with a patient with confirmed COVID-19 (P<0.05). The main symptoms of patients included cough (43.8%), fever (41.4%), and dyspnea (40.3%). The most common chronic diseases in these patients were cardiovascular disease (12.9%), diabetes (11.5%), and hypertension (9.7%). The mean age of death due to COVID-19 was 70.2±15.6 years and higher rate of mortality was seen in men (66.2%). Conclusion: While responding to COVID-19, health authorities should consider vulnerable groups (older patients and those with underlying diseases) and provide them with more information on the modes of transmission of COVID-19 and the risks of infection.

The COVID-19 pandemic: Public knowledge, attitudes and practices in a central of Iran

Aims There is a rapid increase in the number of people infected with COVID-19 throughout the world. The present study aimed to determine people’s knowledge, attitudes, and practices (KAP) regarding COVID-19 in an Iranian sample. Instruments & Methods This was a population-based cross-sectional study conducted on people over 18 years of age in Saveh city, of Iran, in 2020. A multiple-stage sampling method was used. Participants (N=471) completed an anonymous and self-report questionnaire assessing socio-demographic variables and KAP. Data were analyzed using ANOVA and independent t-tests by SPSS 21. The significance level was considered to be ≤0.05. Findings Of participants, 74.5% did not have accurate knowledge of how the coronavirus is spread. In terms of attitudes, more than 63.2% considered COVID-19 to be a dangerous disease. About 59.6% of participants reported regular use of a mask in the past week. As compared to men, women reported attitudes and practices more aligned with recommended safety standards. Higher education level was significantly related to the mean KAP score (p<0.05). Conclusions Although the sample evidenced appropriate attitudes and some safety practices in general, a significant percentage of individuals did not engage in protective behaviors. Copyright© 2021, the Authors ;Publishing Rights, ASPI. This open-access article is published under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License which permits Share (copy and redistribute the material in any medium or format) and Adapt (remix, transform, and build upon the material) under the Attribution-NonCommercial terms.

Clinical features and outcomes of suspected and confirmed COVID-19 patients in Saveh, Iran, 2020

Background and purpose: The outbreak of Coronavirus Disease 2019 (COVID-19) pneumonia is a major threat to global public health because it is very contagious and spreads quickly by human-to-human transmission. This study aimed to investigate the clinical characteristics and outcome of patients infected with COVID-19 in Saveh, Iran. Materials and methods: A descriptive-analytical study was conducted in 1537 patients with suspected or confirmed COVID-19 from 18 February- 2 June 2020. Medical records were studied and a researcher-made questionnaire consisting of demographic information, epidemiological, and clinical manifestations were used to collect the data.