Journal of research in health sciences最新文献

Background: Healthcare workers (HCWs) run a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The HCWs are prone to the SARS-CoV-2 infection in the hospital despite being fully vaccinated. The present study aimed to address the factors associated with the coronavirus disease 2019 (COVID-19) vaccine breakthrough among HCWs.

Study design: A prospective cohort study.

Methods: Participants were 184 HCWs receiving two doses of inactivated SARS-CoV-2 vaccine (CoronaVac, Sinovac Life Science). All participants were followed for six months. Confirmed COVID-19 was defined as positive SARS-CoV-2 by reverse transcription-polymerase chain reaction (RT-PCR). Before undergoing RT-PCR, questionnaires were used to obtain information on demographic characteristics, profession, contact with COVID-19 cases, personal protective equipment (PPE), health protocols adherence, exercise, and nutritional habits.

Results: A number of 57 (31%) participants were COVID-19 positive. Close contact with COVID-19 cases (adjusted RR 6.82, 95% CI: 1.97, 47.98, P = 0.044), being a resident doctor (adjusted RR 4.72, 95% CI: 1.11, 20.11, P = 0.036), improper mask-wearing (adjusted RR 2.36, 95% CI: 1.15, 4.85, P = 0.019), and lower frequency of eating fruit and vegetables (adjusted RR 2.73, 95% CI: 1.34, 5.57, P = 0.006) increased the risk of vaccine breakthrough. Compared to single surgical masks, KN95 and N95 significantly reduced the risk of COVID-19 (adjusted RR 0.27, 95% CI: 0.07, 0.97, P = 0.045 and adjusted RR 0.25, 95% CI: 0.07, 0.87, P = 0.029), respectively.

Conclusion: As evidenced by the obtained results, being a resident doctor, close contact with confirmed COVID-19 cases, health protocol incompliance, as well as the lower frequency of fruit and vegetable consumption were associated with the risk of vaccine breakthrough among HCWs. Appropriate strategies are needed to prevent the risk of SARS-CoV-2 infection among HCWs.

Background: Cervical cancer, the most common gynecological cancer, is a matter of concern, especially in developing countries. The present study investigates survival rates, associated factors, and post-treatment follow-up status in cervical cancer patients.

Study design: A retrospective cohort study.

Methods: This study was conducted on 187 patients referred to an academic referral cancer center in Iran from 2014-2020. Overall survival (OS) and event-free survival (EFS) were evaluated using Kaplan Meyer analysis. The event was defined as recurrence, metastasis, or death.

Results: The patients came for post-treatment visits for a median of 36 months (interquartile range [IQR]: 18-51). The median OS and EFS were 24 and 18 months, respectively. The 1- and 3- year OS rates were 90% and 72%, respectively. The 1- and 3- year EFS rates were 76% and 61%, respectively. Stage ≥ III (hazard ratio [HR]: 3.1, 95% confidence interval [CI]: 1.5, 6.5, P < 0.001) and tumor size > 4 cm (HR: 2.5, 95% CI: 1.2, 4.9, P = 0.006) predicted lower OS. The most common histopathology was squamous cell carcinoma (SCC) (71.1%) with non-significant higher 3- year OS (HR: 0.62, 95% CI: 0.33, 1.16, P = 0.13). No significant difference in OS was found between adjuvant and definitive radiotherapy in both early and advance-staged patients (Log-rank = 0.7 P = 0.4, log-rank = 1.6, P = 0.2, respectively).

Conclusion: As evidenced by the obtained results, the survival of patients was lower compared to that in developed countries. Higher stage and tumor size led to shorter survival. The histopathology and type of treatment in comparable stages did not have any significant impact on survival.

Background: Kidney failure is a common public health problem around the world. The vast majority of kidney failure cases in Sub-Saharan African nations, including Ethiopia, go undetected and untreated, resulting in practically certain mortality cases. This study was aimed primarily to model the time to (right and left) kidneys failure in the patients at Adama Hospital Medical College using the copula model.

Study design: A retrospective cohort study.

Methods: The copula model was used to examine join time to the right and left kidneys failure in the patients by specifying the dependence between the failure times. We employed Weibull, Gompertz, and Log-logistic marginal baseline distributions with Clayton, Gumbel, and Joe Archimedean copula families.

Results: This research comprised a total of 431 patients, out of which, 170 (39.4%) of the total patients failed at least one kidney during the follow-up period. Factors such as sex, age, family history of kidney disease, diabetes mellitus, hypertension, and obesity were found to be the most predictive variables for kidney failure in the patients. There was a 41 percent correlation between the patients' time to the right and left kidneys failure.

Conclusion: The patients' kidney failure risk factors included being a male, older adult, obese, hypertensive, diabetic and also having a family history of kidney disease. The dependence between the patient's time to the right and left kidneys failure was strong. The best statistical model for describing the kidney failure datasets was the log-logistic-Clayton Archimedean copula model.

Background: Exposure to crystalline silica has long been identified to be associated with lung diseases. Therefore, the present study aimed to assess the risk of silicosis and lung cancer associated with occupational exposure to crystalline silica in Iran.

Study design: It is a systematic review study.

Methods: Different databases were searched, and the Cochrane method was used for the systematic review. Thereafter, cumulative exposure to crystalline silica (mg/m3-y) was calculated in every industry. The relative risk of death from silicosis was performed using Mannetje's method. Based on the geometric mean of exposure, the lung cancer risk of exposure to crystalline silica was also calculated.

Results: As evidenced by the results, worker's exposure to silica ranged from a geometric mean of 0.0212- 0.2689 mg/m3 (Recommended standard by the American Conference of Governmental Industrial Hygienists (ACGIH) was 0.025 mg/m3), which is generally higher than the occupational exposure limit recommended by National Institute for Occupational Safety and Health (NIOSH), ACGIH, and occupational exposure limits. The relative risk of silicosis was in the range of 1 to 14 per 1000 people, and the risk of lung cancer in workers ranged from 13-137 per 1000 people.

Conclusion: Since workers are at considerable risk of cancer due to exposure to silica in Iran, exposure control programs need to be implemented in workplaces to decrease the concentration of silica.

Background: Glaucoma is a worldwide problem that causes vision loss and even blindness, with a prevalence rate ranging from 1.9% to 15%. In Ethiopia, glaucoma is the fifth cause of blindness. This study aimed to explore the dependence between blindness of the right and the left eyes of glaucoma patients and assess the effects of the covariates under the dependence structure.

Study design: A retrospective cohort study.

Methods: The study population included the glaucoma patients at Alert hospital from January 1, 2018, to December 30, 2021. The copula model was used to estimate the time to the blindness of the right and the left eyes of the glaucoma patients by specifying the dependence between the event times.

Results: Out of 537 glaucoma patients, 224 (41.71%) became blind at least in one eye during the follow-up period. The results of the Clayton copula model revealed that factors, such as age, residence, diabetes mellitus, stage of glaucoma, and hypertension are considered the most prognostic factors for blindness in glaucoma patients. The findings also revealed that there was a strong dependence between the time to the blindness of the right and the left eyes in the glaucoma patients (τ = 0.43).

Conclusion: Based on the obtained results, high age, urban residence, hypertension, diabetes mellitus, and higher stage of glaucoma were factors associated with time to the blindness in the glaucoma patients. There was also a dependence between the right and the left eyes of the glaucoma patients. The results revealed that the Clayton Archimedean copula model was the best statistical model for accurate description of glaucoma patients' datasets.

Background: Glaucoma is a significant public health problem due to its substantial increase in the projected number of glaucoma cases. In Ethiopia, glaucoma accounts for 5.2% of irreversible blindness and is the fifth main cause of blindness. The main objective of this study was to modeling time to blindness of left and right eyes of glaucoma patients.

Study design: An institution-based retrospective cohort study.

Methods: This study was conducted among 315 glaucoma patients admitted to the Ophthalmology Department of Jimma University Medical Center (JUMC), Southwest Ethiopia, from January 1, 2016, to August 30, 2020. Kaplan-Meier survival analysis and semiparametric and parametric copula models were applied to identify factors that affect time to the blindness in glaucoma patients and the dependence between time to the blindness of the left and right eyes, respectively. An Akaike information criterion (AIC) was used to select the best non-nested model.

Results: In total, 211 (66.9%) out of 315 glaucoma patients were blind, whereas 104 (33.1%) patients were censored. The median time to the blindness of the left and right eyes was determined to be 12 months. The result suggested that the risk of the blindness in male patients was 1.005 (P = 0.01) times higher than that in female patients, and the risk of the blindness in patients who had early, moderate, and advanced glaucoma was estimated to be 0.582 (P = 0.002), 0.485 (P = 0.001) and 0.887 (P = 0.003) times less than that in the patients with absolute glaucoma, respectively.

Conclusions: Age, place of residence, gender, type of medication, diabetes disease, stage of glaucoma, duration of treatment, intraocular pressure (IOP), and cup-disk ratio were significantly associated with and affected by the time to the blindness of left and right eyes in glaucoma patients. Awareness should be given to the community to reduce the burden of glaucoma.

Background: The highest-income countries procured 50 times as many COVID-19 vaccines as low-income countries, a global health inequity that resulted in only 4.6% of the poorest 5th of the world receiving a COVID-19 vaccine. High-income countries are considering vaccine mandates and passports to contain the spread of COVID-19. This study is a curated discourse aimed at examining how vaccine mandates and passports may impact global vaccine equity from an ethics perspective.

Study design: Narrative review adapted for a debate.

Methods: In November 2021, we conducted a review of studies examining global vaccine mandates for an upper-level global health course at Northeastern University, Boston, United States (U.S.). In total, 19 upper-level students, one research assistant, and one instructor participated in the data collection, analysis, and discussion.

Results: The review showed vaccine mandates are ethical and effective if autonomy-centered alternatives like soft mandates are first exhausted. Unwarranted stringent public health measures degrade public trust. In the U.S. alone, COVID-19-related deaths hovered above 300 000 before COVID-19 vaccination began in mid-December 2020. Since then, the number of COVID-19 deaths more than doubled, despite the wide availability of the vaccine. For many low- and middle-income countries (LMICs) vaccines are not available or easily accessible. Global collaboration to facilitate vaccine availability in LMICs should be a priority.

Conclusions: It is essential to get as many people as possible vaccinated to return to some normality. However, vaccine mandates and passports need to be used only sparingly, especially when other options have been exhausted.

Background: Suicide is a significant public health problem and one of the leading causes of death worldwide. The effect of religion on suicidal behaviors (i.e., ideation, plan, attempt, and death) is an important issue worthy of consideration.

Methods: Major electronic databases, including MEDLINE, Web of Science, and Scopus, were searched for the articles published until 26 April 2021. Reference lists were also screened. Observational studies addressing the associations between religion and suicidal behaviors were also examined. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests, as well as trim-and-fill analysis. The effect size was expressed as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model.

Results: Out of 11 389 identified studies, 63 articles were eligible, involving 8,053,697 participants. There was an inverse association between religion and suicidal ideation OR  =  0.83 (95% CI: 0.78, 0.88; P < 0.001), suicidal plan OR  =  0.93 (95% CI: 0.83, 1.04; P =  0.200), suicide attempt OR  =  0.84 (95% CI: 0.79, 0.89; P < 0.001), and completed suicide OR  =  0.31 (95% CI: 0.14, 0.72; P =  0.006). There was a no evidence of publication bias.

Conclusions: The results of this meta-analysis support the notion that religion can play a protective role against suicidal behaviors. Nonetheless, the effect of religion on suicidal behaviors varies across countries with different religions and cultures. Although this association does not necessarily imply causation, an awareness of the relationship between religion and suicide risk can be of great help in suicide prevention policies and programs.

Background: Brucellosis runs rampant endemically with sporadic outbreaks in Algeria. The present study aimed to provide insights into the epidemiology of brucellosis and compare the performance of some prediction models using surveillance data from Tebessa province, Algeria.

Study design: A retrospective study.

Methods: Seasonal autoregressive integrated moving average (SARIMA), neural network autoregressive (NNAR), and hybrid SARIMA-NNAR models were developed to predict monthly brucellosis notifications. The prediction performance of these models was compared using root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).

Results: Overall, 13 670 human brucellosis cases were notified in Tebessa province from 2000-2020 with a male-to-female ratio of 1.3. The most affected age group was 15-44 years (56.2%). The cases were reported throughout the year with manifest seasonality. The annual notification rate ranged from 30.9 (2013) to 246.7 (2005) per 100 000 inhabitants. The disease was not evenly distributed, rather spatial and temporal variability was observed. The SARIMA (2,1,3) (1,1,1)12, NNAR (12,1,6)12, and SARIMA (2,0,2) (1,1,0)12-NNAR (5,1,4)12 were selected as the best-fitting models. The RMSE, MAE, and MAPE of the SARIMA and SARIMA-NNAR models were by far lower than those of the NNAR model. Moreover, the SARIMA-NNNAR hybrid model achieved a slightly better prediction accuracy for 2020 than the SARIMA model.

Conclusion: As evidenced by the obtained results, both SARIMA and hybrid SARIMA-NNAR models are suitable to predict human brucellosis cases with high accuracy. Reasonable predictions, along with mapping brucellosis incidence, could be of great help to veterinary and health policymakers in the development of informed, effective, and targeted policies, as well as timely interventions.