Purpose The right to health for all people means that everyone should have access to the needed healthcare services without suffering from severe financial hardship. The purpose of this paper is to investigate the prevalence as well as the effective factors on facing catastrophic health expenditures (CHE) among gastrointestinal cancer patients and families in Kurdistan province in west of Iran after the implementation of Health Transformation Plan (HTP). Design/methodology/approach A cross-sectional study was carried out on 189 households with gastrointestinal cancer patients in Kurdistan province in 2018. Data were collected using World Health Survey questionnaire. A method developed by World Health Organization with the threshold of 40 percent household’s capacity to pay was used in order to measure the proportion of households facing CHE. Also, logistic regression was applied for identifying the effective factors on household’s exposure to CHE. Data were analyzed using STATA version 13. Findings Almost 73 percent (72.7 percent) of the households (n=117) faced the CHE. Not having supplementary health insurance (adjusted odds ratio (AOR): 3.8; 95% confidence interval: 1.3–10.8 (and having low socio-economic status (AOR: 7.1; 95% CI: 1.8–28.1) were the significant factors affecting the households’ exposure to CHE. In total, 57 and 1 percent of the studied households reported that having a gastrointestinal cancer patient at home had a significant effect on refraining from using health services by other family members. Originality/value The proportion of the studied households facing CHE was very high. This may indicate the weakness of health system as well as health insurance or the weakness of HTP in financial protection of fragile population.
Background: People in prisons are at high risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Objectives: This study aimed to evaluate the prevalence of HBV and HCV exposure and associated risk factors in Iranian prisons. Methods: This cross-sectional study was conducted in 2016, among 29 prisons in Iran, blood samples were collected using multistage sampling. HBV and HCV diagnostic tests were conducted using enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate logistic regression were used for the evaluation of factors associated with HBV and HCV exposure. Results: Among 6,481 people in prisons, the prevalence of HCV and HBV antibodies were 8.21% (95% CI: 7.55 -8.90) and 3.06% (95% CI: 2.65 -3.50), respectively. Based on multivariate analysis, the most important risks associated for HCV exposure were the history of drug use (AOR 5.75, 95% CI 3.54 -9.35) followed by the age of 30 years and older (AOR: 5.02, 95% CI: 3.65 -6.9), the history of tattooing (AOR 2.42, 95% CI 1.96 -3), the history of imprisonment (AOR 2.23, 95%CI 1.76 -2.82), being single (AOR 1.91, 95% CI 1.54 -2.37), low education (AOR 1.81, 95%CI 1.01 -3.27), and the history of piercing (AOR 1.26, 95% CI 1.04 -1.52). There was no significant association between HBV prevalence and independent variables (P > 0.05). Conclusions: These findings highlight a high prevalence of HCV infection in Iranian prisons. Efforts are needed to improve HCV screening and interventions, particularly among people with a history of drug use, and linkage to care.
Background This study aimed at determining the prevalence and risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran during 2015-16. Methods The required data was obtained from the Iranian national bio-behavioral surveillance surveys (BBSSs), which examined 11988 prisoners who were selected using multi-stage sampling from 55 prisons in 19 provinces during 2015-16. The demographic and behavioral status of these subjects were measured through interviews and HBV and HCV exposure were examined using ELISA test of blood samples. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into this study. Survey analysis was used to analyze the data. The univariate and multivariate logistic regression were used to investigate the relationships between risk factors and outcome. Results The mean age of the incarcerated PWID was 36.83 ± 8.13; of all, 98.46% were male, 50.97% were married, and 96.57% had non-academic education. The prevalence of HCV and HBV was 40.52% and 2.46%, respectively. HCV prevalence was associated with an age≥30 years, being single, non-academic education, prison term>5 years, history of piercing, and extramarital sex in lifetime (P<0.05). Conclusions The prevalence of HCV is alarmingly high. However, prison by facilitating the easy access to infected group can be considered as an opportunity to achieve the goal of eliminating HCV in the country. It is recommended to design interventions while considering the risk factors of prison term, piercing, and extramarital sex.
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