Background With the unprecedented expansion of COVID-19 in the world since December 2019, Iran’s health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. Methods The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. Results Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. Conclusions According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.
BACKGROUND: In recent years, the prevalence of dust events has increased in the region and the world. According to the Meteorological Organization, the most frequent days with dust events are on stations located in Khuzestan province. Objective: Assessment of the effects of dust events and meteorological elements on stroke morbidity in health in Iran: a health promotion approach. MATERIALS AND METHODS: The present study was a retrospective cohort study 2020 and 2013 provided between based on ecological data-based on population. Information about patients with stroke was obtained from the hospital. Information on the dust events and meteorological elements was also from the data center of the Meteorological Organization of Iran. Using STATA the correlation between the diseases and the, 14 statistical software version occurrence of dust events and changes in meteorological elements was obtained and the statistical model (Spearman correlation coefficient) individually estigate the equation was used inv modified by Poisson regression simultaneous effect of variables. RESULTS: the results of adjusted statistical models show that increasing the severity of dust event increases the risk of stroke in males (lag 0–21 confidence interval [CI] 95% = 1.496–1.0067 relative risk [RR] = 1.03 P = 0.01). Increasing the average wind speed also increases the risk of stroke in males (lag 0–3 CI 95% = 1.0491–0.9996 RR = 1.02 P = 0.05). Increased rainfall and average relative humidity increase the risk of stroke in people under 60 years (lag 0–7 CI 95% = 1.0012–0.9058 RR = 1.95 P = 0.05). Increasing the average daily temperature reduces the risk of stroke in males (lag 0–3 CI 95% = 0.9874–0.9254 RR = 0.51 P < 0.001). CONCLUSION: Increasing the intensity of dust storms along with meteorological elements has increased the risk of stroke. However, increasing the average temperature has had a protective effect on the risk of stroke.
New epidemiological studies acknowledge the detrimental effects of dust storms on health. The aim of this study was to systematically review the effects of dust storms on the morbidity and mortality rates of cardiovascular and respiratory diseases. The results of this study were obtained based on articles published in English-language journals. For the purpose of this study, all articles published until the end of 2020 based on the search in the “Scopus,” “Web of Science,” and “PubMed” databases were selected. Articles were searched independently by two trained researchers. Dust storms are the cause of many diseases and health-related complications, of which cardiovascular and respiratory diseases are common. It is necessary to recognize and investigate the harmful effects of dust storms to prevent serious harms to human societies. In the reviewed articles, the impact of dust storms on several diseases, including cardiovascular and respiratory diseases, has been analyzed. Most of these articles acknowledge the effect of dust storms on increasing the incidence and mortality rate of these diseases, although in some articles this effect is not statistically significant. Many studies conducted around the world confirm the harmful effects of dust storms on cardiovascular and respiratory diseases, including increase in the number and duration of hospitalizations, as well as increase in mortality and exacerbation of these diseases. However, some studies do not consider the harmful effects of dust storms on the above diseases to be statistically significant.
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