RESUMO
BACKGROUND: Epidemiological information on tuberculosis (TB) is required to plan control and prevention strategies and to inform service delivery systems. The aim of present study was to determine the epidemiological status of TB in Hamadan Province covering a seven-year period. METHODS: In this cross-sectional study all registered TB patients suffering from any form of smear-positive, smear-negative or extra pulmonary from 2005 to 2011 were assessed. Age-adjusted incidence trend was studied. The Cochran-Armitage (C-A) test was used for testing the trends over time. RESULTS: The mean age of TB patients was 57.0 (±21.1), 49.9% were males, 52.8% were aged 61 years or older and 39.7% were rural residents. Previous history of jailed was present in 13 (2.2%) patients and 12 (2.0%) were HIV positive. From all TB patients, 60.8% were smear-positive, 87.6% were new cases, and 87.3% of smear-positive patients were cured cases. Also, 23.6% patients had history of hospitalization for TB. More than half (55.4%) of TB patients were reported by public health system. Age-adjusted incidence rates of all TB cases during 2005-11 was 3.4, 3.2, 3.6, 4.7, 3.3, 4.4 and 7.3 in 100,000 respectively (C-A trend test, P< 0.001). CONCLUSION: Although, the incidence rate of TB in Hamadan Province is lower than country's average, increasing trend of TB incidence is not concordant with its decreasing trend in Iran. An epidemiological study is required to evaluate risk factors associated with TB to identify ways to decrease the prevalence of TB.
RESUMO
OBJECTIVES: To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran. METHODS: A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis. RESULTS: During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ≤5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected. CONCLUSION: The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.
RESUMO
BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major global public health problems. This study was conducted to investigate the incidence rate of these infections over six successive years in Hamadan Province, the west of Iran. METHODS: This retrospective cohort study was conducted on the database of hepatitis registry. In this study, 1257 subjects infected by HBV and 705 subjects infected by HCV were detected and enrolled. HBV infection was detected by presence of HBsAg and HCV infection by presence of Anti-HCV. In order to estimate province-based age-specific incidence rates of HBV and HCV infections, we used the same age-specific population as the denominator. RESULTS: The incidence rate pre 100,000 population from 2004 to 2009 for HBV infection was 19.60, 12.29, 12.31, 11.13, 9.46, 7.70 (P<0.001) and for HCV infection was 6.73, 7.42, 7.57, 8.45, 5.30, 5.17 respectively (P<0.001). The incidence rate of HBV infection decreased continuously over time, while the incidence rate of HCV infection fluctuated and even increased from 2004 to 2007 then decreased. The rate ratio of trend for HBV infection across successive years was 0.85 [95% CI: 0.82, 0.88] and that of HCV infection was 0.94 [95% CI: 0.90, 0.99]. CONCLUSIONS: The decreasing trend in the incidence rate of HBV infection in current years may be the result of vast national immunization of newborn and adolescents against hepatitis B infection. On the other hand, fluctuating inci-dence rate of HCV infection with a temporarily increasing growth is critical and should be the focus of the health policymakers' special attention.
