Aim: To determine temporal trend of human and bovine brucellosis cases in southern Iran, 2009-2016. Methods: In this descriptive-analytical study, demographic and epidemiological data of all cases of human and bovine brucellosis reported and recorded by the relevant special care systems were enrolled, 2009-2016. Data analysis was carried out using SPSS-18. Results: The average annual incidence of new cases of human brucellosis, during 2009 to 2016 was 17.12 per 100000 populations and the incidence of bovine brucellosis was reduced from 17.6 per 100000 head of cattle in 2010 to 0 incidence rate in 2013 that showed a downward trend. Male patients accounted for 65.6 of 1140 patients with human brucellosis. A total of 79.7 of patients lived in rural areas and human brucellosis had the highest prevalence rate in 31-40 (56 patients=18) and then 21-30 years' age groups (55 cases=17.7). The highest prevalence rate was observed among livestock breeders (26) and housewives (15.8), respectively. Pearson correlation coefficient of (P=0.002, r=0.3), (P=0.006, r=-0.28) and (P=0.03, r=-0.79) was respectively obtained between number of cases of brucellosis and average monthly temperature, number of cases of brucellosis and the average relative humidity, the number of cases of bovine brucellosis and coverage percentage of bovine brucellosis vaccination. Conclusion: Malta fever is an occupational disease in Jahrom city, therefore, it is recommended to continue and strengthen dairy industry improvement and development program and livestock vaccination program, besides health education programs, as a strategy to prevent the disease in humans. © 2018 Lahore Medical And Dental College. All rights reserved.

Epidemiological characteristics and temporal trend of human and bovine brucellosis cases, Southern Iran, 2009-2016

Introduction:Brucellosis is a common infectious disease between humans and livestock, which can cause severe economic and health damage to the community. Considering the importance of this study, the aim of this study was to determine the prevalence of brucellosis in Kohgiluyeh and Boyer Ahmad Province in 2017.Materials and Methods:This retrospective cohort study was conducted to determine the rate and causes of brucellosis in Kohgiluyeh and Boyer Ahmad province in 1396. Sampling was done by census. Information about 300 patients with brucellosis, collected from April to July 1996, was collected. In order to collect data from a researcher-made list, data collection for brucellosis patients was used. Descriptive statistics and SPSS 21 series software were used to analyze the data.Results:17 cases had negative test. The highest number of occurrences in 2016 was 143 cases and the highest occurrence was 171 in the spring. Boyer Ahmad city has the highest rate with 107 cases and Bahmei city with the least amount of brucellosis in 9 cases. 360 people were from rural population. The group of livestock breeders with 147 cases was the most affected and the military group with the least one was the least.Conclusion:By planning properly and timely, you can prevent the disease, complications and dangers of brucellosis.

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Prevalence of brucellosis in Kohgiluyeh and Boyer Ahmad Province in 2017.

1Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran; 2Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran; 3Center for Health Education and Health Promotion, Torbat-e Heydarieh University of Medical Sciences, Torbat-e Heydarieh, Iran; 4Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran; 5HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Risk Factors of Human Brucellosis in the Northeast of Iran

Stress management delays the onset or exacerbation of symptoms of multiple sclerosis. The present study aimed to develop and psychometrically evaluate a questionnaire to measure the determinants of stress coping behaviors in patients with multiple sclerosis.This was a methodological study that was conducted in two stages: qualitative and quantitative phases. Participants in this study were patients with multiple sclerosis who referred to the MS Association and Charity Foundations for Special Diseases in Isfahan in 2021. Preliminary item pool was developed by qualitative part of the study. The validity of the questionnaire was determined with item impact, content validity ratio (CVR), content validity index (CVI), face validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).In the first stage, an item pool containing 97 items were generated and after removing duplicate items and merging some of them, a questionnaire containing 51 items was developed. Ten items were removed based on the results of face validity and content validity. The EFA revealed 11 factors containing 41 items that explained 64% of the total variance of test. In CFA, 9 other items were deleted, and the questionnaire was reduced to 32 phrases in general. The results of the CFA determined the 9-factor structure of the questionnaire including awareness, attitude, self-efficacy, access to resources, skills of using resources, social support, important others, behavioral consequences and social comparison. The Cronbach's alpha coefficient of the questionnaire was 0.726.The results showed that the designed questionnaire is a valid and reliable tool for assessing the determinants of stress coping behaviors in patients with multiple sclerosis. Identifying these factors and designing interventions based on them, in order to control or reduce stress in these patients, can help to improve the quality of life in these patients. 

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Determinants of stress coping behaviors in patients with Multiple Sclerosis (MS-DSCB): development and psychometrics of a PRECEDE model-based questionnaire

The relative contribution of a theory-based intervention to modify high-risk behaviors in training programs is a major priority that remains an open question. Here, we tested whether the family-centered empowerment model used in the educational intervention was effective to modify high-risk behaviors of brucellosis via mother education. A quasi experimental study was conducted on 200 women presenting to healthcare practices in rural areas of Torbat-e Jam, Iran, from April 2020 to February 2021. Four rural areas were randomly assigned to the control and intervention groups. The intervention group received the training program, which included four 2-h sessions and consulting support via social network and messaging service. The control group did not receive any training. SPSS16 was implemented to test multiple statistical analyses. Our finding showed in the intervention group compared with the control group, knowledge, attitude, self-efficacy, self-esteem, and behavior outcomes were significantly changed (P < 0.001) across time during baseline through follow-up. Likewise, there are no differences (P > 0.05) in the change in construct of the family-centered empowerment model and risk behaviors in the control group from baseline to follow-up. Intervention based on a family-centered empowerment model is possible and very acceptable to modify high-risk behaviors of brucellosis by increasing an individual's knowledge, changing attitude, and promoting self-efficacy and self-esteem.Trial registration: Iranian Registry of Clinical Trials (IRCT), IRCT20160619028529N12. Registration date: 24/03/2020. 

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An educational intervention based on family-centered empowerment model to modify high-risk behaviors of brucellosis via mother education

Introduction: Brucellosis is one of the most prevalent diseases in Torbate Heidarieh, Iran; it is a common disease between human and animals. The present study aimed to review the psychometric properties of a questionnaire on brucellosis prevention behaviors based on the PRECEDE model among rural farmers and their family members (PRECEDE-QBPB).
Materials and Methods: The study was a combination of qualitative and quantitative stages. In the qualitative stage, an 86-item questionnaire including interviews with 30 farmers, their family members and other effective people, as well as literature review, was designed. In the quantitative stage, psychometric properties of the PRECEDE-QBPB including the face, content, and constructs validities, as well as reliability measurement of the questionnaire were evaluated. Item impact, content validity ratio (CVR) and content validity index (CVI) for all items were calculated. Besides, confirmatory factor analysis (CFA) was done to evaluate the construct’s validity; AMOS 20 was used for this purpose. In this stage, a cross-sectional study was conducted on 500 rural farmers and their family members. To estimate the internal consistency of this questionnaire, Cronbach’s alpha was used for each variable. Further, descriptive statistics and Kaiser–Meyer–Olkin and Bartlett’s test of sphericity were used to describe the characteristics of the participants and collect samples, respectively.
Results: Based on the results of face validity and content validity (CVR, CVI and CFA 9), 19 and 22 items were removed, respectively, leaving the final questionnaire with 36 items and eight subscales including knowledge, attitude, self-efficacy, social support, enabling factors, environmental factors, behavioral factors, and reinforcing factors. The Cronbach’s coefficient alpha was calculated for the total questionnaire (α= 0.92, 0.69– 0.87 for subscales). The evaluation of model fit indices showed that all indices confirmed the suitability of the final model fit; therefore, the questionnaire has suitable construct validity.
Conclusion: A questionnaire, as a valid tool, was designed in the present study. Healthcare providers, policymakers, planners, researchers may use this tool to find a comprehensive understanding of enabling, reinforcing, environmental and behavioral factors that affect brucellosis before implementing health education and health promotion programs.

Keywords: behaviors, brucellosis, questionnaire, validation, PRECEDE

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Psychometric Properties of a Questionnaire on Brucellosis Prevention Behaviors Based on the PRECEDE Model Among Rural Farmers and Their Family Members

INTRODUCTION: Brucellosis is one of the common diseases between humans and animals. The purpose of this study was to investigate behavioral determinants of brucellosis incidence among stockbreeders and their family members in a rural area based on the PRECEDE model. MATERIALS AND METHODS: This cross-sectional study was carried out among 540 stockbreeders and their family members in Northeastern Iran in 2019. Sampling was done in two stages including stratified sampling and random sampling method. Data collection was conducted by a valid and reliable questionnaire developed based on the PRECEDE model. Data were analyzed using SPSS16 through Pearson correlation coefficient, independent t-test, and ANOVA. Furthermore IBM SPSS AMOS version 20 was used for the path analysis. RESULTS: The mean age of the participants was 39.02 ± 16.41 years, of whom 53.1% and 46.9% were men and women, respectively. About 23.9% of the participants had a history of brucellosis in their families. Enabling factors were the most important determinant of self-efficacy and self-efficacy was the most important determinants of behavior. Evaluation of the chi-square indicators, chi-square ratio to degree of freedom, root mean square error of approximation, adjusted goodness of fit index, parsimony comparative fit index, comparative fit index, incremental fit index, and parsimonious normed fit index indices indicated that the model was well fitted and there was a positive and significant relationship between the predisposing, enabling, and reinforcing factors on the one hand and behavior on the other. chi-square indicators, chi-square ratio to degree of freedom, root mean square error of approximation, adjusted goodness of fit index, parsimony comparative fit index, comparative fit index, incremental fit index, and parsimonious normed fit index CONCLUSION: Designing and implementing health plans based on the PRECEDE model with more emphasis on self-efficacy as the most important behavioral determinants can bring about a positive effect on enhancing the brucellosis preventing behaviors.

Mehdi Gholian-Aval

Papers

Psychometric Properties of a Questionnaire on Brucellosis Prevention Behaviors Based on the PRECEDE Model Among Rural Farmers and Their Family Members

Behavioral determinants of brucellosis incidence among stockbreeders and their family members in rural area based on PRECEDE model