Iranian Journal of Public Health

Older Adults’ Yangsaeng (Oriental Health Management): A Systematic Review

2025-11-09T09:18:23+00:00

Background: Recently, along with the increase of the older adult population, the necessity of health management in daily life is emerging, and interest in the traditional oriental health management method, Yangsaeng, is increasing. This study was to provide a basis for future oriental health promotion intervention research by analyzing previous studies related to the Yangsaeng (oriental health management) of the older adults.

Method: This study was a systematic review on older adults’ Yangsaeng. The databases used for literature search for data collection include PubMed, Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library (CDSR), Research Information Sharing Service (RISS), Oasis, Korean Studies Information Service System (KISS), and DataBase Periodical Information Academic (DBpia). Analysis of the status by year, subject characteristics, study types, research design methods, and variables related to older adults’ Yangsaeng among previous studies related to older adults’ Yangsaeng published in academic journals from 1990 to 2021 was performed.

Results: Eighteen quantitative studies related to the older adults’ Yangsaeng have been published so far, and all of them were descriptive research studies using Yangsaeng measurement tool. The variables related to the older adults’ Yangsaeng identified in this study were activities of daily living, self-efficacy, instrumental activities of daily living, perceived health state, self-esteem, empowerment, life satisfaction, physical function, quality of life, social support, anxiety, and depression.

Conclusion: The study will be helpful in the development of integrative and complementary interventions for health promotion of the older adults.

Digital Health Communication Strategies for Supporting Healthy Lifestyles in Adults with Noncommunicable Diseases and Limited Health Literacy: A Scoping Review

2025-11-09T09:18:22+00:00

Background: Digital health technologies are pivotal in delivering the WHO-recommended healthy lifestyle messages to reduce premature mortality associated with noncommunicable diseases (NCDs). However, evidence on effective strategies to promote healthy lifestyle behaviours among patients with limited health literacy remains insufficient. This review explores current digital health communication strategies that support healthy lifestyles in adults with NCDs and low health literacy.

Methods: A scoping review was conducted using Arksey and O'Malley's framework, focusing on adults with NCDs and limited health literacy, digital health communication strategies, and healthy lifestyle behaviours. Searches were performed across 14 electronic databases and bibliographies of relevant studies from Jan 2012 to Nov 2022. Only primary studies published in English were included. Findings were reported following the PRISMA Extension for Scoping Reviews guidelines.

Results: Overall, 12 studies involving 15,175 participants, predominantly from high-income countries, met the inclusion criteria. Five digital health communication strategies were identified: telecommunication-based coaching, mobile applications, text messaging programs, eHealth and web-based tools, and bundled or multimodal interventions. These strategies demonstrated positive impacts on supporting healthy lifestyle behaviours.

Conclusion: This review highlights the potential of diverse digital health communication strategies to enhance healthy lifestyle behaviours in adults with NCDs and limited health literacy. Tailoring these strategies to individual preferences is critical for optimizing outcomes. Further research is required to validate these findings, particularly in low- and middle-income countries.

Utilization and Effectiveness of the PRECEDE-PROCEED Model as a Tool in Public Health Interventions: A Systematic Review

2025-11-09T09:18:21+00:00

Background: The PRECEDE-PROCEED Model (PPM) is a theoretical tool for comprehensively assessing population health priorities and practically guiding the planning, implementation, and evaluation of interventions. We aimed to analyze systematically the extent of PPM utilization in the development and evaluation of public health interventions and to appraise the effectiveness of PPM-based interventions.

Methods: PUBMED, Web of Science, ELSEVIER, EBSCO, and SCOPUS were systematically searched to identify relevant peer-reviewed studies from inception to June 2024. Data were extracted on study objectives, design, population, PPM utilization, interventions, and outcomes. Qualitative synthesis was performed to analyze how PPM was applied, to identify recurring themes, and to assess intervention effectiveness.

Results: A total of 54 studies were included, of which 51 reported effective outcomes. These studies spanned 11 domains including disease prevention and control, healthy behaviors, preventing domestic violence, and so on. Education and ecological assessment was most frequently adopted (96%) in the PRECEDE stage, and outcome assessment was most commonly adopted (94%) in the PROCEED phase. All studied interventions incorporated health education. Nine key intervention elements were identified including sustained implementation, adequate duration, multiple educational topics, diverse formats, social support, providing educational materials, participant interaction, intervention monitoring, and practice support. Participant interaction was most frequently utilized (85%), whereas practice support was least frequently used (54%).

Conclusion: Our findings highlight the importance of educational and ecological assessment in the PRECEDE stage and outcome evaluation in the PROCEDE phase for effective intervention design and assessment. Future PPM-based interventions should consider the nine identified core elements, with emphasis tailored to the specific health domain.

Effectiveness and Safety of Acupuncture and Moxibustion in the Treatment of Insomnia: A Meta-Analysis Based on Randomized Controlled Trials

2025-11-09T09:18:20+00:00

Background: We aimed to conduct a systematic evaluation of the efficacy and safety of acupuncture and moxibustion in treating insomnia, and to provide evidence-based guidance for clinical practice.

Methods: A comprehensive literature search was performed using PubMed, CNKI, and other databases to identify randomized controlled trials (RCTs) and clinical controlled trials of acupuncture or moxibustion for the treatment of insomnia. The search was conducted up to May 2025. The articles were screened based on the inclusion and exclusion criteria and the quality of the literature was assessed using the Cochrane 5.1.0 bias risk assessment tool. Meta-analysis was conducted using Review Manager 5.4 software.

Results: A total of 1215 subjects were included in 25 relevant articles. Meta-analysis demonstrated that acupuncture or moxibustion significantly increased treatment effectiveness (odds ratio [OR] =4.94, 95% CI: 3.52-6.92, P<0.00001) while substantially reducing symptom scores: Pittsburgh Sleep Quality Index (weighted mean difference [WMD] =3.81, 95% CI: 2.95-4.66, P<0.00001), Self-rating Depression Scale (WMD=10.77, 95% CI: 5.43-16.11, P<0.00001), and Self-rating Anxiety Scale (WMD=8.25, 95% CI: 4.21-12.28, P<0.00001). The incidence of adverse reactions was relatively low.

Conclusion: Acupuncture or moxibustion therapy demonstrates potential advantages in the treatment of insomnia and warrants further investigation in a clinical setting.

The Acceptability of Implanon in Muslim-Majority Asian Countries: A Systematic Review

2025-11-09T09:18:19+00:00

Background: We conducted a systematic review which aimed to assess acceptability of implanon used based on reported side effects, continuation rates and user satisfaction in Muslim-majority Asian countries.

Methods: We followed PRISMA guideline and searched SCOPUS and Medline databases for original articles that dealt with implanon, conducted in Muslim-majority Asian countries and had either continuation rates or side effects or satisfaction rate. The risk of bias of the selected studies was assessed using ROBINS-I V2 Risk of Bias tool.

Results: The literature search successfully identified 7 potentially relevant articles, whereby 5 of them met the inclusion criteria. 5 articles were retained in the final synthesis with 619 total participants. Implanon’s documented side effects such as menstrual irregularity and weight gain, is tolerable due to its high efficacy. Implanon has low discontinuation rates among users and has a high satisfaction rate.

Conclusion: Implanon is widely accepted in Muslim-majority Asian countries with a positive impact on family planning.

mHealth Apps for Family Caregivers of Stroke Patients: A Systematic Review

2025-11-09T09:18:18+00:00

Background: Family caregivers of stroke patients play a critical role in post-stroke recovery, yet they often face significant challenges, including physical and emotional stress, lack of knowledge, and limited access to resources. Mobile health (mHealth) apps offer a promising solution to support caregivers by providing education, task management, and mental health resources. However, gaps remain in understanding the effectiveness, functionalities, and limitations of these apps. This study aimed to 1) identify and categorize existing mHealth apps for family caregivers of stroke patients, 2) evaluate the effectiveness of these apps in supporting caregivers, and 3) analyze the gaps in current mHealth offerings to inform future app development.

Methods: A systematic literature review was conducted, analyzing 30 studies published between 2014 and 2024 from databases such as IEEE Xplore, Scopus, Web of Science, and PubMed. The studies were evaluated based on app functionality and effectiveness in caregiver support, and limitations were identified.

Results: The findings revealed a diverse range of mHealth apps offering functionalities such as caregiver education, rehabilitation guidance, task management, communication tools, and health monitoring. However, notable gaps were identified, including limited multi-functionality, insufficient support for caregiver well-being, a lack of customization for diverse needs, and minimal validation through rigorous trials.

Conclusion: While mHealth apps provide valuable tools for family caregivers of stroke patients, addressing the identified gaps is essential to maximize their impact. Future Development should focus on creating comprehensive, user-centered, and evidence-based apps that integrate education, mental health support, and task management.

Technology Adoption in Tourism to Deal with Global Health Crisis: A Narrative Review

2025-11-09T09:18:16+00:00

Reviewing the research trends of technology adoption in tourism in reaction to the recent global health crisis provides insights into the evolution of the academic discourse of this topic and the role of technology adoption, especially in terms of attaining sustainability. This narrative review was conducted to explore the patterns of technology adoption in tourism in response to the health crisis. The findings reveal a growing scholarly focus on this topic, as well as geographical, methodological, and theoretical concentrations. Technology adoption was seen as the immediate reaction to the crisis and a tool to ensure sustainability by facilitating resilience and recovery after the pandemic. The review highlights the dual role of technology in emergency response and long-term sectoral resilience. However, ethical and structural challenges remain, necessitating better governance of tech integration in tourism.

The Economic Cost of Type 2 Diabetes in Indonesia: A Systematic Review

2025-11-09T09:18:25+00:00

Background: Type 2 diabetes (T2D) imposes a growing economic burden in Indonesia, driven by rising prevalence and associated complications. This review synthesizes current evidence on the economic costs of T2D in Indonesia to inform policy decisions aimed at alleviating these financial impacts.

Methods: A systematic review was conducted using the PRISMA guidelines and the PICOS framework, analyzing studies from major databases including PubMed, ProQuest, EBSCO, ScienceDirect, and Google Scholar published from 2019-2025. Studies included addressed both direct costs and/or indirect costs related to T2D in Indonesia, and reported annual or monthly per-patient costs.

Results: Six studies were included in the analysis, representing a diverse geographical coverage and various healthcare facilities, with the majority being tertiary facilities. The average annual direct cost per patient with complications reached USD 1,607.7, compared to USD 427.3 for patients without complications, a difference of 3.8 times. Limited indirect cost data show USD 35.2 for patients with complications versus USD 20.5 for cases without complications. Hospitalization, medications, and medical procedures are the main cost drivers. Only three studies reported indirect costs, indicating a potential underestimation of the total economic burden.

Conclusion: T2D complications increase healthcare costs by nearly four times. These findings support a shift in policy towards prevention, expansion of screening through insurance, and strengthening of primary services. Standardized methodologies and the inclusion of indirect costs are needed for more accurate study comparisons and policy guidance.

Advancing Cervical Cancer Care: A Comprehensive Study of Screening Approach for Tribal Women in Sub-Saharan Africa and Asia

2025-11-09T09:18:15+00:00

Background: Cervical cancer is one of the leading causes of cancer-related mortality among women in developing regions, particularly within tribal populations of Sub-Saharan Africa and Asia. This study aimed to evaluate existing screening strategies in tribal communities, compare them with global best practices, and explore the feasibility of smart colposcopy as an effective screening tool in low-resource settings.

Methods: A mixed-methods approach was employed, combining systematic literature review 2000-2024, case study analysis, and technical evaluation. Data were collected from peer-reviewed journals, healthcare databases, and open-access medical image repositories. The diagnostic utility and usability of smart colposcopy using the Eva System were assessed. Advanced image processing techniques, including CNN-based detection and partial convolution inpainting, were applied to improve visual clarity by mitigating artifacts like specular reflection.

Results: Findings reveal significant screening barriers in tribal regions, such as fear, stigma, and infrastructural deficits. Compared to structured programs in developed countries, tribal areas show lower compliance. Smart colposcopy demonstrated high potential for remote screening due to its portability and real-time AI support. Image quality enhancements improved diagnostic accuracy.

Conclusion: Smart colposcopy, integrated with awareness initiatives and supportive policies, offers a scalable solution to improve early detection and reduce cervical cancer mortality in tribal and underserved populations.

Exploring the Interplay of Health Literacy and Non-Communicable Disease Health Outcomes in Southeast Asia: A Systematic Review

2025-11-09T09:18:14+00:00

Background: Non-communicable Diseases (NCDs) present a substantial challenge in low- and middle-income nations, especially in the Southeast Asia region. Health literacy (HL) is vital for managing NCDs and improving health outcomes by enhancing individuals' abilities to seek, understand, assess, and utilize health information.

Methods: A systematic review followed PRISMA guidelines, and relevant articles were sourced from PubMed, ProQuest, CINAHL, Scopus, Cochrane, and Google Scholar without limiting the publication year. Studies included were from Southeast Asia that examined the connection between HL and NCD outcomes. Sixteen cross-sectional studies from five countries were chosen for the final analysis.

Results: The review observed that higher HL was linked to better health outcomes for individuals with NCDs. Communicative and critical HL were found to be more impactful than functional HL in obtaining, analysing, and applying health information. Additionally, HL was influenced by sociodemographic aspects (age, gender, education, location, and marital status, socioeconomic factors (income and employment), and societal influences (patient-doctor relationships, cultural context, and family support). HL was important in managing NCDs and for better health outcomes.

Conclusion: Further studies are called for the evaluation of all three HL skills to comprehensively understand the HL of populations. Furthermore, the link between limited HL and employment status remains under-explored and deserves further attention.

Trade-offs between Accessibility and Practicality in Global Telemedicine: A Systematic Review

2025-11-09T09:18:13+00:00

Background: Telemedicine is increasingly vital in healthcare, offering remote consultations via message-based and video call-based platforms. These methods improve healthcare accessibility, particularly when in-person visits are limited. Telemedicine is increasingly vital in healthcare, offering remote consultations via message-based and video call-based platforms. These methods improve healthcare accessibility, particularly when in-person visits are limited.

Methods: A systematic search was conducted in ScienceDirect, PubMed, and up to August 2024. Studies evaluating the accessibility and practicality of global telemedicine were evaluated. From initial 439 records, 19 studies were finally in this systematic review. Studies were reviewed thoroughly with quality appraisal using the Newcastle Ottawa Scale, in which those rated for high quality studies were included.

Results: Most studies (74%) were from high-income countries, notably the United States (26%) and Denmark (11%). Observational studies dominated (95%), focusing on follow-up consultations (47%) and diagnostic services (32%), particularly in general care (32%), neurology (11%), and surgery (5%). Research peaked in 2022 (32%) during the COVID-19 pandemic. Common platforms included WhatsApp, AnyDesk, and QliqSOFT. Accessibility was the primary focus in 53% of studies, while 47% addressed feasibility. Challenges like technological barriers and privacy concerns were particularly noted in lower-income regions.

Conclusion: Telemedicine has enhanced healthcare accessibility and demonstrated feasibility. However, technological limitations and remote consultation challenges persist, particularly in lower-income regions. Continued research is needed to optimize telemedicine and equitable access.

Mask Usage in Healthcare Settings: Is It the Right Time for Easing Restrictions? A Narrative Review

2025-11-09T09:18:12+00:00

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment, particularly face masks, has been central to infection control and reducing associated mortality. Global mask mandates, combined with widespread vaccination, helped curb peak pandemic phases. In 2023, the WHO reclassified COVID-19 as an ongoing health priority rather than an emergency, prompting reassessment of mask policies in healthcare settings. Yet, hospitals remain high-risk, especially with the concurrent “triple epidemic” of COVID-19, influenza, and respiratory syncytial virus. This review summarizes current evidence on mask efficacy, adherence, and policy changes to determine whether, when, and under what conditions mask use can be safely eased in clinical settings.

Clinical and Genetic Variant Profile of Asian Charcot‐Marie Tooth Patients: A Systematic Review

2025-11-09T09:18:11+00:00

Background: Charcot-Marie-Tooth disease (CMT) is the most common inherited peripheral neuropathy by high clinical and genetic heterogeneity. Although many studies reported from East Asian countries, data from West/South Asia remain limited. The current study aimed to summarize available epidemiological, clinical and genetic data of CMT patients in Asia.

Methods: We searched PubMed, Scopus, Web of Sciences, Nature, Google Scholar, Science Direct, and Willey for relevant published articles between 2003 until Feb 2023, according to PRISMA guidelines. Articles were screened for epidemiological, clinical and genetic information. Inclusion required published mutation frequency or genetic variant in CMT patients. The Q-Genie tool and Newcastle-Ottawa (NOS) were used to evaluate the quality of genetics and observational studies, respectively.

Results: Out of 320, 32 screened articles met the inclusion criteria. Most studies were reported from China (n = 12), Japan (n=7), and Korea (n=6). The axonal CMT was the frequent type (50%), followed by demyelinating (28%) and intermediate (9%) types. Autosomal dominant (AD) inheritance was observed in 62% of genetically confirmed cases. Frequently mutated genes were GDAP1, MPZ, and JGB1, which have been found mostly in the East Asia.

Conclusion: This systematic review reports substantial knowledge gap in West/South Asian CMT research. The review emphasized the urgent need to use comprehensively of next-generation sequencing (NGS) to uncover new mutations and improve diagnostics in West/South Asian. Future region-specific cohort studies and registries can be essential to identify frequent variants and fill the diagnostic gaps.

Causal Relationship between Immune Cells and Postpartum Depression: A Bidirectional Two-Sample Mendelian Randomization Study

2025-11-09T09:18:10+00:00

Background: Postpartum depression (PPD) is influenced by immune factors, particularly immune cells. The causal relationship between these cells and PPD is unclear.

Methods: Bidirectional two-sample Mendelian randomization (TSMR) analysis was performed to determine the causal relationship between immune cell characteristics and PPD. The main analysis method used was the inverse variance weighted (IVW) method. To ensure the robustness, heterogeneity, and horizontal pleiotropy of the results, a comprehensive sensitivity analysis was conducted.

Results: Overall, 28 immune cell phenotypes were identified as causally related to the onset of PPD. Most of them were distributed in the B cell group and the Treg cell group. Further analysis revealed that 13 types of immune cells had a promoting effect on PPD, whereas 15 types of immune cells had a protective effect. In addition, the incidence of PPD was found to be causally related to CD62L on granulocyte [IVW: OR (95%): 1.183 (1.037 to 1.348), P = 0.012].

Conclusion: The study unveils the causal link between immune cells and susceptibility to postpartum depression from a genetic standpoint, providing new directions for drug development and precision medicine for PPD treatment.

Effect of Regular Exercise Assessed by Pedometer on Pregnancy Outcomes and Maternal Mental Health

2025-11-09T09:18:08+00:00

Background: We sought to analyze the impact of physical activity and exercise ability, measured with a pedometer, on obstetric and neonatal outcomes.

Methods: Women who engaged, Türkiye in exercise for 30 minutes or longer during pregnancy were classified as the exercise group, whereas those who did not exercise were classified as the control group. The exercise capacity of women was evaluated by a 6-minute walking test utilizing a step counter, and its correlation with pregnancy outcomes was established. Postpartum anxiety levels and satisfaction were evaluated on the first and eighth days postpartum.

Results: The exercise group exhibited a significantly increased step count and length, alongside a reduced incidence of pregnancy problems (P < .05). The duration of labor, initial breastfeeding time, and neonatal intensive care unit (NICU) requirements were significantly reduced in the exercise group (P < .05). A notable disparity was detected between the two groups for anxiety levels and satisfaction and postpartum depression (P < .05).

Conclusion: Regular physical activity throughout gestation positively influences pregnancy outcomes and maternal well-being, without inducing difficulties for either the mother or the infant.

Biodegradation of Polystyrene Paper Using Chewing Insects

2025-11-09T09:18:07+00:00

Background: Plastic pollution, particularly from polystyrene, has emerged as a serious environmental concern, prompting growing interest in its biodegradation. We investigated the potential of four chewing insects; mealworm (Tenebrio molitor), superworm (Zophobas morio), American cockroach (Periplaneta americana), and cricket (Gryllus bimaculatus) to biodegrade polystyrene paper (PSP).

Methods: Using a randomized complete block design, four chewing insects were divided into two groups after 48-hour fasting with water. One group received PSP only; the other received PSP mixed with tapioca starch. Weight loss of PSP was recorded after 72 hours.

Results: Z. morio demonstrated the highest degradation efficiency for PSP (92.10%), followed by P. americana (32.17%). When tapioca starch was added, Z. morio remained the highest effective (95.45%), followed by T. molitor (59.15%). Supplementing starch significantly enhanced degradation rates (P < 0.05). Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM) revealed signs of depolymerization, oxidation, and surface cracking. FTIR indicated new functional groups of carbonyl (C=O, 1650 cm⁻¹) and hydroxyl (O–H, 3200–3550 and 3584–3700 cm⁻¹).

Conclusion: Certain chewing insects, especially Z. morio and T. molitor, possess strong potential for PSP degradation, likely aided by their gut microbiota. Notably, this study is the first to report PSP degradation by P. americana and G. bimaculatus. Further research is needed to explore the microbial mechanisms within insect guts that facilitate plastic biodegradation.

Comparison of Blood Parameters in Crimean-Congo Hemorrhagic Fever and Upper Respiratory Infection Patients with Similar Complaints

2025-11-09T09:18:06+00:00

Background: Crimean-Congo Hemorrhagic Fever (CCHF) often presents with non-specific flu-like symptoms that resemble upper respiratory tract infections (URTI), especially in endemic areas. We aimed to evaluate whether complete blood count (CBC) parameters could distinguish between CCHF and URTI in emergency settings.

Methods: We conducted a retrospective comparative analysis of 503 patients: 203 confirmed CCHF cases and 300 URTI cases. The study was carried out at Erzurum City Hospital, Erzurum, Turkey, between 2023 and 2024. Hematological parameters including WBC, PLT, RDW, MPV, and others were analyzed. ROC analysis was used to evaluate the prognostic value in CCHF patients.

Results: Significant differences in multiple CBC parameters were observed between the two groups. CCHF patients had significantly lower WBC, PLT, and lymphocyte counts, and higher MPV and RDW values compared to URTI patients (P-value<0.001). Among CCHF cases, 40.4% were initially misdiagnosed as URTI. ROC analysis indicated moderate prognostic power for HGB and PLT in predicting mortality.

Conclusion: CBC parameters can assist in distinguishing CCHF from URTI in endemic areas, especially when RT-PCR is unavailable. Emergency physicians should consider CCHF in differential diagnosis when specific hematological abnormalities are present.

A Spatial-Temporal Study of the Incidence of Fatal Suicide during the Years 2009 to 2023

2025-11-09T09:18:05+00:00

Background: This ecological cross-sectional study examines suicide incidence and identifies high- and low-risk clusters across Iranian districts from 2009 to 2023. This study aimed to determine district-specific suicide rates and map spatial risk patterns.

Methods: Overall, 52,665 suicide cases of recorded in forensic medicine were analyzed, with incidence rates calculated per 100,000 population. Spatial autocorrelation techniques were used to identify clusters of high and low suicide risk, and GIS software facilitated mapping. Hanging was the most prevalent method, accounting for 50.88% of cases. Temporal trends across months were also assessed.

Results: The average age of individuals who died by suicide was 33.98 years. High-incidence districts were located in parts of different provinces of Iran, including Eshtehard (Alborz), Firuzeh (Razavi Khorasan), Varzeghan (East Azerbaijan), Sahneh (Kermanshah), Famenin (Hamadan), and Miami (Semnan). High-risk clusters were primarily concentrated in the western provinces of Kermanshah and Hamadan, particularly in Sahneh and Famenin. Conversely, districts in Sistan and Baluchestan in southeastern Iran showed markedly lower suicide rates, possibly due to underreporting or systemic differences in data collection practices, which warrants cautious further investigation.

Conclusion: This study highlights substantial regional disparities in suicide incidence across Iran, with specific high-risk areas identified for targeted intervention. These findings have important implications for public health policy, emphasizing the need for regionally tailored suicide prevention strategies and improved surveillance systems. Further research is needed to understand better the low suicide rates that observed in some districts and to assess potential reporting inconsistencies.

Epidemiological Study and Time Series Modeling of Waterborne and Foodborne Disease Outbreaks in Northwestern Iran: 2016-2023

2025-11-09T09:18:04+00:00

Background: Outbreaks of waterborne and foodborne illnesses arise from the consumption of contaminated food or water. Factors contributing to these outbreaks include improper food storage, inadequate hygiene during food preparation, and environmental contamination. This descriptive-analytical study aimed to investigate the epidemiology and time series modeling of waterborne and foodborne disease outbreaks in West Azerbaijan Province from Jan 2016 to Dec 2023.

Methods: Data recorded in the health deputy's portal system were utilized for analysis. The variables examined included age, sex, number of patients, hospitalizations, fatalities, presenting symptoms, and spatial and geographical data related to the outbreaks. Box–Jenkins models were employed for time series analysis. Descriptive statistics were computed using SPSS 26 software, while modeling was conducted using R Studio 2021.09.2 and Minitab 22.2.1 software

Results: During the study period, 1306 outbreaks were reported, resulting in 2686 cases of illness, 792 hospitalizations, and 7 fatalities. The causative agent of waterborne and foodborne outbreaks was identified through laboratory testing in 43% the cases. Entamoeba histolytica (31%) was the most commonly identified pathogen, followed by E. coli (27%), and Shigella (18%). The most common locations of outbreaks were in cities (57.9%) and at home (86.9%). The ARIMA(0,0,0)(1,0,0)12 model was determined to be the most effective model for predicting future cases.

Conclusion: Water- and foodborne diseases pose a significant threat due to their rapid spread, with incidence rates increasing from 5.25 per 100,000 (2016) to 9.51 per 100,000 (2023). Fruits, juices, meat, and drinking water were primary contamination sources. Public education on food handling and safe water access are crucial for reducing disease transmission.

A 10-Year Atherosclerotic Cardiovascular Disease Risk Assessment and 5-Year Follow-Up in the Sabzevar PERSIAN Cohort Center, Northeast Iran

2025-11-09T09:18:03+00:00

Background: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of global morbidity and mortality. This study assessed the 10-year ASCVD risk and evaluated 5-year follow-up outcomes among adults in the Sabzevar PERSIAN Cohort Center, northeast Iran.

Methods: Baseline data were collected in 2018, with follow-up completed in 2023. Risk factors including age, gender, blood pressure, cholesterol levels, smoking status, and diabetes were assessed. The 10-year ASCVD risk was calculated using the American College of Cardiology's risk estimator and categorized as low (<5%), borderline (5–7.4%), intermediate (7.5–19.9%), or high (≥20%). A Cox proportional hazards model evaluated the association between age, gender, diabetes, and ASCVD events.

Results: Among 2,871 participants, men had higher blood pressure, while women had higher levels of total cholesterol, HDL, and LDL (P < 0.05). Hypertension was more prevalent in men than in women (P < 0.001). Diabetes was present in 13.8% (n = 397) of participants, with no significant difference between men and women. The distribution of 10-year ASCVD risk was as follows: low (74.58%), borderline (9.3%), intermediate (13.96%), and high (2.16%). Men had a significantly higher ASCVD risk than women (P < 0.001). During the 5-year follow-up, 1.2% (n = 34) of participants experienced ASCVD events. In multivariable analysis, age (P < 0.001), male gender (P < 0.001), and diabetes (P = 0.013) were significant predictors of ASCVD events.

Conclusion: ASCVD risk estimation and early intervention, particularly for older adults and individuals with diabetes, are essential. These findings support targeted prevention efforts in northeast Iran and similar populations.

Diabetes Care and Complications: A Comparison between Individuals with Disabilities and the General Population

2025-11-09T09:18:02+00:00