Volume 15, Issue 3 (Vol.15, No.3 2019)
irje 2019, 15(3): 300-312 |
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Ghaderi E, Salehi Vaziri M, Mostafavi E, Moradi G, Rahmani K, Zeinali M, et al . Evaluation of Crimean-congo Hemorrhagic Fever (CCHF) Surveillance System in Iran. irje 2019; 15 (3) :300-312
URL: http://irje.tums.ac.ir/article-1-6390-en.html
URL: http://irje.tums.ac.ir/article-1-6390-en.html
E Ghaderi1 
, M Salehi Vaziri2 , E Mostafavi3 , GH Moradi4 , KH Rahmani5 , M Zeinali6 , MR Shirzadi7 , H Erfani8 , SH Afrasiabian9 , S Eybpoosh * 10
, M Salehi Vaziri2 , E Mostafavi3 , GH Moradi4 , KH Rahmani5 , M Zeinali6 , MR Shirzadi7 , H Erfani8 , SH Afrasiabian9 , S Eybpoosh * 10
1- Associate Professor of Epidemiology, Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
2- Assistant Professor of Virology, Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
3- Professor of Epidemiology, Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Tehran, Iran
4- Associate Professor of Epidemiology, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
5- Assistant Professor of Epidemiology, Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
6- Expert in Zoonoses surveillance, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
7- Assistant Professor of Infectious Disease, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
8- MD, Head of Surveillance Office, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
9- Associate Professor of Infectious Diseases, Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
10- Assistant Professor of Epidemiology, Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran , S_eybpoosh@pasteur.ac.ir
2- Assistant Professor of Virology, Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
3- Professor of Epidemiology, Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Tehran, Iran
4- Associate Professor of Epidemiology, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
5- Assistant Professor of Epidemiology, Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
6- Expert in Zoonoses surveillance, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
7- Assistant Professor of Infectious Disease, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
8- MD, Head of Surveillance Office, Centre for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
9- Associate Professor of Infectious Diseases, Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
10- Assistant Professor of Epidemiology, Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran , S_eybpoosh@pasteur.ac.ir
Abstract: (3771 Views)
Background and Objectives: To provide an overview of the national program of Crimean-Congo hemorrhagic fever surveillance in Iran, its current achievements, and challenges.
Methods: In this mixed method study, the relevant reports, documents, and guidelines, as well as published literature and surveillance data were gathered and critically reviewed. The opinions of the key informants at local and governmental levels were assessed through structured interviews.
Results: The program was integrated into Iran’s primary healthcare (PHC) network in 1999. The involved organizations include CDC, medical universities, Pasteur Institute of Iran (PII), and Veterinary Organization. Case finding is based on standard definitions of suspected, probable, and confirmed cases. Laboratory confirmation is necessary for diagnosis and is provided within 48 hours after receipt of the specimen by the National Reference Laboratory of PII. CCHF treatment is primarily supportive. Antiviral therapy with ribavirin is also considered. Both therapeutic services are free. Education mainly focuses on high-risk groups and healthcare workers. Major achievements of the program include rapid diagnosis and treatment of cases, prevention of nosocomial transmission, identification of high-risk provinces and major transmission routes, improved outbreak preparedness, development of laboratory tests for detection of other arboviruses, and reduction of CCHF case fatality rate.
Conclusion: Program implementation has had a positive impact on early detection and proper control of annual outbreaks. However, some aspects of the program still need improvement, including promotion of the general and high-risk populations’ awareness and regional collaborations (especially among neighboring countries) for infection control in humans, livestock, and vectors.
Methods: In this mixed method study, the relevant reports, documents, and guidelines, as well as published literature and surveillance data were gathered and critically reviewed. The opinions of the key informants at local and governmental levels were assessed through structured interviews.
Results: The program was integrated into Iran’s primary healthcare (PHC) network in 1999. The involved organizations include CDC, medical universities, Pasteur Institute of Iran (PII), and Veterinary Organization. Case finding is based on standard definitions of suspected, probable, and confirmed cases. Laboratory confirmation is necessary for diagnosis and is provided within 48 hours after receipt of the specimen by the National Reference Laboratory of PII. CCHF treatment is primarily supportive. Antiviral therapy with ribavirin is also considered. Both therapeutic services are free. Education mainly focuses on high-risk groups and healthcare workers. Major achievements of the program include rapid diagnosis and treatment of cases, prevention of nosocomial transmission, identification of high-risk provinces and major transmission routes, improved outbreak preparedness, development of laboratory tests for detection of other arboviruses, and reduction of CCHF case fatality rate.
Conclusion: Program implementation has had a positive impact on early detection and proper control of annual outbreaks. However, some aspects of the program still need improvement, including promotion of the general and high-risk populations’ awareness and regional collaborations (especially among neighboring countries) for infection control in humans, livestock, and vectors.
Type of Study: Research |
Subject:
Epidemiology
Received: 2019/12/15 | Accepted: 2019/12/15 | Published: 2019/12/15
Received: 2019/12/15 | Accepted: 2019/12/15 | Published: 2019/12/15
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