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1- MPH Student, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2- PhD Student, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- PhD Department of Health in Emergencies and Disasters, School of Public Health, National Institute of Health Research, School of Public Health, Tehran, Iran
4- PhD Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , holakoik@hotmail.com
Abstract:   (3476 Views)
Background & Objectives: Epidemic of diarrheal diseases caused by contaminated food and water occur frequently worldwide , especially in developing countries .The  aim of this study was to identify the factors contributing to the development and spread of epidemic of diarrheal disease caused by Shigella  Flexneri  agent  in Isfahan city , during spring of 2015.
Methods: Following the first reports and activation of  the surveillance system, a matched  case-control study conducted on 360 cases with diarrhea and 360 controls. Data  was gathered using a questionnaire, and conditional logistic regression was used to provide adjusted  Odds Ratios and 95% confidence intervals.
Results: Consumption of contaminated fresh vegetables (OR=4.50; 95%CI=2.88-7.01) was the source of epidemic. Contact  with similar patient (OR=7.19; 95%CI=4.26-12.12), presence of similar patients in the family (OR=33.2 ; 95%CI=13.64-80.82) , consumption of  foods in special events (party ,wedding ,funeral)(OR=1.67;95%CI=1.06-2.62),being a government employee (OR=3.08; 95%CI=1.64-5.78) and being illiterate (OR=2.91 ; 95%CI=1.10-7.67)were the risk factors for the spread of the epidemic .
Conclusions: In this study, the consumption of fresh vegetables contaminated with Shigella-  flexneri was determined as the source of the infection. The contamination was recognized by epidemic management team due to non- standard wastewater irrigation of agricultural lands. Therefore, it is important to consider the standards of agricultural production and the compilation of the comprehensive program to improve the status of the wastewater purification system in the environmental sciences by the relevant organizations in the prevention of the epidemic of diarrheal diseases.
     
Type of Study: Research | Subject: General
Received: 2018/01/1 | Accepted: 2018/01/1 | Published: 2018/01/1

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