fa بررسی سرواپیدمیولوژی هپاتیت A در زائران مازندرانی پیش از سفر به کربلای معلی در اربعین سال 1397 عفوني infection پژوهشي-کامل Research(Original) <span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">اخیرا به دلیل کاهش شیوع<b> </b>هپاتیت </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black">A</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> در ایران، احتمال وجود افراد با فقدان یا تیتر ناکافی </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black">HAV-Ab</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> وجود دارد، بنابراین زائرانی که به کربلا سفر می‌کنند، در خطر ابتلا به هپاتیت </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black">A</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> هستند. این مطالعه با هدف بررسی وضعیت </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black">HAV-Ab</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> زائران مازندرانی قبل از سفر به کربلا، در ایام اربعین سال 1397 انجام پذیرفت.</span></span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:#0e101a"></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">این مطالعه مقطعی توصیفی-تحلیلی، بر روی 200 نمونه از مجموع 40 هزار زائر، از شهرهای منتخب <span style="letter-spacing:-.2pt">استان مازندران انجام</span>‌<span style="letter-spacing:-.2pt">گرفت. </span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.2pt">نمونه<span style="color:black">‌</span>های سرمی برای سنجش</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">HAV-Ab</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"> ارزیابی شدند و</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">داده‌های مرتبط یا ویژگی‌های دموگرافیک</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> و سوابق مصونیت در برابر هپاتیت </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black">A</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> گردآوری و ثبت گردید. </span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar="">پردازش آماری داده<span style="color:black">‌</span>ها با نرم<span style="color:black">‌</span>افزار </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">SPSS16</span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""> انجام شد.<span style="color:black"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">‌</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">137 نفر (68/5 درصد) از نمونه‌ها آقا و 63 نفر (31/5 درصد) خانم بودند. تعداد 156 نفر(78 درصد) </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.1pt">HAV-Ab</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"> مثبت و 44 نفر (22 درصد) منفی بودند. میانگین سنی افراد </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">HAV-Ab</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"> مثبت (50 سال) و </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">HAV-Ab</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"> منفی (47 سال)</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> <span style="letter-spacing:-.1pt">مشابه بود. وضعیت </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.1pt">HAV-Ab</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"> مستقل از جنسیت، سطح تحصیلات و محل سکونت، سابقه دریافت واکسن هپاتیت </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.1pt">A</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">، ابتلای</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"> <span style="letter-spacing:-.2pt">قبلی به هپاتیت </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">A</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">، بیماری</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">‌<span style="letter-spacing:-.2pt">های زمینه</span>‌<span style="letter-spacing:-.2pt">ای شناخته شده و سابقه سفر به مناطق اندمیک (0/05</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"><</span></span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">P</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">) و مرتبط با شغل (0/05</span></span></span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">></span></span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="color:black"><span style="letter-spacing:-.2pt">P</span></span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt">) بود.</span></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="line-height:90%"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">با توجه به این</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">که در بالغین احتمال ابتلا به هپاتیت فولمینانت (شدید و برق</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">آسا) افزایش می</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">یابد و به تعمیم نتیجه شیوع 22 درصدی افراد فاقد </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.1pt">HAV-Ab</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> در جمعیت چندین میلیونی زائران کربلا، واکسیناسیون افراد برای ویروس هپاتیت </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.1pt">A</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt"> قبل از سفر</span></span></span> <span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">اربعین پیشنهاد می</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black">‌</span></span></span><span lang="FA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="letter-spacing:-.1pt">گردد.</span></span></span><span lang="AR-SA" style="line-height:90%"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br> &nbsp; &nbsp;<br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">Recently, due to the reduction of hepatitis A in Iran there are people with low or no </span></span><span lang="EN-GB" style="font-size:10.0pt"><span style="line-height:115%">Hepatitis A Virus- Antibody</span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%"> (HAV-Ab), therefore, people at Arbaeen Pilgrimage are at risk for hepatitis A. This study aimed at examining HAV-Ab in pilgrims traveling from Mazandaran province, Iran to Karbala in </span></span><span style="font-size:10.0pt"><span style="line-height:115%">2018</span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">.</span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:115%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">This cross-sectional study was performed in<b> </b></span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">200 people selected from 40,000 pilgrims in Mazandaran province. Serum samples were evaluated for presence of HAV-Ab and data for demographic characteristics and history of hepatitis A immunity were recorded. Data analysis was performed in SPSS V16.</span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span arial="" style="font-family:">Results:</span></span></span></b><b> </b><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">The participants were 137 (68.5%) males and 63 (31.5%) females. </span></span><span style="font-size:10.0pt"><span style="line-height:115%">Positive and negative HAV-Ab were seen in 156 (78%) and 44 (22%), respectively. Mean ages of people with positive and negative HAV-Ab were almost similar (50 years and 47 years, respectively). </span></span><span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">HAV-Ab status was found to be significantly associated with job (P<0.05) but it was independent of gender, level of education, area of residence, history of hepatitis A vaccination, previous history of hepatitis A infection, known underlying diseases, and history of travel to endemic areas (P>0.05).</span></span><span style="font-size:10.0pt"><span style="line-height:115%"></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span arial="" style="font-family:">Conclusion:</span></span></span></b> <span lang="EN" style="font-size:10.0pt"><span style="line-height:115%">Twenty-two percent of people who were travelling to Karbala had no HAV-Ab, which is significant because the risk of developing fulminant hepatitis increases in adults, therefore, vaccination of Karbala pilgrims for hepatitis A virus is suggested.</span></span><i><span style="font-size:10.0pt"><span style="line-height:115%"></span></span></i></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:135%"><span style="tab-stops:121.45pt"><span new="" roman="" style="font-family:" times=""><b><i><span style="font-size:10.0pt"><span style="line-height:135%"></span></span></i></b></span></span></span></span><br> &nbsp; هپاتیت A, سرواپیدمیولوژی, آنتی‌بادی ضد ویروس هپاتیت A, سفر اربعین, کربلا hepatitis A, seroepidemiology, HAV-Ab, Arbaeen Pilgrimage, Karbala 94 101 http://jmums.mazums.ac.ir/browse.php?a_code=A-10-172-3&slc_lang=fa&sid=1 Farhang Babamahmoodi فرهنگ بابامحمودی Farhang.baba@yahoo.com 1003194753284600144139 1003194753284600144139 No Professor, Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran استاد، گروه عفونی، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران Shakiba Heydari شکیبا حیدری shakiba.hdr@gmail.com 1003194753284600144140 1003194753284600144140 No General Practitioner, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran پزشک عمومی، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران Sogand Shahabinia سوگند شهابی نیا sogandshahabinia93@gmail.com 1003194753284600144141 1003194753284600144141 No General Practitioner, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran پزشک عمومی، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران Mohammad Reza Mahdavi محمدرضا مهدوی mahdavi899@gmail.com 1003194753284600144142 1003194753284600144142 No Assistant Professor, Department of Clinical Laboratory, Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran استادیار،گروه علوم آزمایشگاهی، مرکز تحقیقات تالاسمی، دانشگاه علوم پزشکی مازندران، ساری، ایران Jamshid Yazdani جمشید یزدانی jamshid.charati@gmail.com 1003194753284600144143 1003194753284600144143 No Associate Professor, Department of Biostatistics and Epidemiology, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran دانشیار ،گروه آمار زیستی و اپیدمیولوژی، مرکز تحقیقات علوم بهداشتی، دانشگاه علوم پزشکی مازندران، ساری، ایران Lotfollah Davoodi لطف الله داوودی lotfdavoodi@yahoo.com 1003194753284600144144 1003194753284600144144 Yes Assistant Professor, Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran استادیار، گروه عفونی، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران Elaheh Bali الهه بالی 1003194753284600144145 1003194753284600144145 No General Practitioner, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran پزشک عمومی، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران