Search

Abstract Background Plasmodium falciparum is the dominant malaria species in the sub-Saharan Africa and the main cause of severe disease and death. Notwithstanding, severe malaria and death due to non-falciparum infections have been reported, but at much lower rates than P. falciparum infections. Following increasing use of molecular detection techniques in epidemiological studies, a higher prevalence of non-falciparum species has been reported in the region than previously thought. This article reviews the literature on the prevalence of non-falciparum malaria species in Uganda and the clinical figures of their severe diseases. It aims to elucidate the extent to which mono non-falciparum malaria infections in a highly malaria-endemic country contribute to malaria mortality and outline its policy implications on malaria case management. Methods The available English-language published peer-reviewed literature up to March 2024 was sought via PubMed and Google Scholar. The keywords used were severe malaria, AND P. falciparum, P. malariae, P. vivax, P. ovale spp., mixed infections AND Uganda. The review encompassed 53 articles. Articles using molecular diagnosis methods were accounted for analysis. Results The literature reported a substantial prevalence of non-falciparum infections in Uganda. Plasmodium malariae and Plasmodium ovale spp. were the second and third most prevalent reported malaria species respectively after P. falciparum as dominant species. Non-falciparum malaria infections often occur as mixed infections rather than mono-infections. Besides, molecular diagnostics revealed that 21% of initially reported mono-infections of P. falciparum were, in fact, mixed infections. No article was found on the prevalence of severe malaria or case fatality rate due to mixed or non-falciparum infections. Conclusion A critical knowledge gap exists regarding the impact of mixed and non-falciparum species on severe malaria and death in Uganda. Robust evidence on prevalence, recurrent parasitaemia, and severe clinical manifestations of mixed and non-falciparum malaria infections is crucial for evidence-based and effective policymaking regarding malaria case management.

Abstract Background Imported malaria cases could be considered one of the threats to malaria elimination. Therefore, increasing migrants’ access to malaria preventive measures can play an essential role in maintaining appropriate conditions and preventing malaria outbreaks. This study aimed to provide detailed information about access, utilization, and barriers to using malaria protection tools in migrants to Iran. Methods This study was conducted in a vast region consisting of 4 provinces and 38 cities located in the south and southeast of the country. Study participants were migrants who moved to the study area in the past three months. A sample of 4163 migrants participated in the study. They were selected through a multi-stage sampling method to obtain a representative community sample. Data were collected through interviewer-administered questionnaires about participants’ socio-demographic specification, commuting characteristics, travel aim, access, ways of preparing, and reasons to use or not to use malaria protection tools. Quantitative and qualitative variables were described and analyzed finally. Results The mean age of individuals was 28.6 ± 10.8, with a range of 3–88 years old. Migrants’ country of origin was Afghanistan (56.6%), Pakistan (38.4%), and Iran (5%). Most migrants (69.2%) did not have malaria protection tools while staying in Iran. Among those who procured the protection tools, 74% used long-lasting insecticidal nets (LLINs), 13.4% used mosquito repellent sticks and coil, and 12.7% did not use any tools. Respectively, lack of knowledge about where they can get LLINs, followed by being expensive, unavailability in the market, not cooperation of health officer, and no need to use were expressed as the causes for having no access. The main reasons for non-using the tools were lack of knowledge about their application, followed by a defect in protection tools, ineffectiveness, and being harmful, respectively. Migrants who were supported by an employer accessed more to LLINs. Conclusions This study reveals significant shortcomings in knowledge, access, and utilization of malaria protection tools among migrants in Iran. Inequitable access to public health services is predictable during migration; however, access to sustainable protection tools is recommended.

Abstract Background Non-communicable diseases are imposing a considerable burden on Iran. This study aims to assess the Return on Investment (ROI) for implementation of Non-communicable diseases (NCDs) prevention program in Iran. Methods Four disease groups including cardiovascular diseases, diabetes, cancer, and respiratory diseases were included in our ROI analysis. The study followed four steps: 1) Estimating the total economic burden of NCDs using the Cost-of-Illness approach. 2) Estimating the total costs of implementing clinical and preventive interventions using an ingredient based costing at delivering level and a program costing method at central level.3) Calculating health impacts and economic benefits of interventions using the impact measures of avoided incidence, avoided mortality, healthy life years (HLYs) gained, and avoided direct treatment costs. 4) Calculating the ROI for each intervention in 5- and 15- year time horizons. Results The total economic burden of NCDs to the Iranian economy was IRR 838.49 trillion per year (2018), which was equivalent to 5% of the country’s annual Gross Domestic Product (GDP). The package of NCD will lead to 549 000 deaths averted and 2 370 000 healthy life years gained over 15 years, and, financially, Iranian economy will gain IRR 542.22 trillion over 15 years. The highest ROI was observed for the package of physical activity interventions, followed by the interventions addressing salt, tobacco package and clinical interventions. Conclusions NCDs in Iran are causing a surge in health care costs and are contributing to reduced productivity. Those actions to prevent NCDs in Iran, as well as yielding to a notable health impact, are giving a good economic return to the society. This study underscores an essential need for establishment of a national multi-sectorial NCD coordination mechanism to bring together and strengthen existing cross-agency initiatives on NCDs.

Speed management is one of the main dimensions of the Safe System Approach for reducing both the risk of crash involvement as well as injury severity. This study proposes a practical framework for setting safer speed limits on duplicated rural highways that has been applied to six pilot corridors (total carriageway length of approximately 1,250 km) in Iran. The safer speed limits determined from the proposed framework have been compared with the currently posted speed limits using several indicators and showed a considerable reduction in the total number of changes in speed limits while having very limited impact on reducing the mean travel speed and increase travel time along the study corridors. The study of the pilot corridors establishes that a clear approach and documented guidelines for setting speed limits provides a basis for quantifying engineering judgments about road hazards and determining more consistent speed limit values for similar conditions across Iran’s rural highway network, legitimising speed limit reductions aimed at saving

Introduction Amidst the COVID-19 pandemic, an international effort has been concerted to identify the factors associated with more adverse outcomes to better allocate resources and perform more effective targeted preventive measures. This study aims to describe the risk of COVID-19 adverse outcomes among individuals with a history of being ever cigarette smokers and being ever hookah users. Material and Methods We combined two databases, including the Iran national registry of COVID-19 patients, including 2020 with 656258 hospitalized patients and STEPs survey 2016 with 30541 participants. After merging the two databases using the national ID, the association was investigated between being ever smoker or hookah user and the adverse outcomes of COVID-19 including death, need for a ventilation therapy, and admission in the intensive care unit (ICU), among 474 severe acute respiratory infections (SARI) cases and 211 PCR-positive patients. Results Among 211 PCR-positive patients, 40 (19%) patients were ever hookah users and 28 (13.3%) were ever cigarette smokers. Death occurred in 27 (12.8%) patients and severe COVID-19 in 17 (11.6%). Among 211 PCR-positive patients, ever cigarette smokers had 4.2 times (95% CI: 1.1–15.4, p=0.03) higher odds of ICU admission and 4.2 times (95% CI: 1.1–15.4, p=0.03) increased odds for need of ventilation, compared with non-smokers. Besides, ever hookah users had 3.9 times (95% CI: 1.1–13.6, p=0.03) higher odds for need of ventilation therapy, compared with non-hookah users. Conclusions Tobacco use and hookah smoking were associated with adverse outcomes among COVID-19 patients in Iran.

Abstract Cancer patients are at risk for severe complications or death from COVID-19 infection. Therefore, the need for routine COVID-19 testing in this population was evaluated. Between 1st August and 30th October 2020, 150 cancer patients were included. Symptoms of COVID-19 infection were evaluated. All eligible individuals went through RT-PCR and serological tests for COVID-19. At the same time, 920 non-cancer patients were recruited from a random sample of individuals who were subject to routine molecular and anti-body screening tests. Of 150 cancer patients, 7 (4.7%) were RT-PCR positive. Comorbidity made a significant difference in the RT-PCR positivity of cancer patients, 71.4% positive versus 25.8% negative (P-value = 0.02). The average age for negative and positive groups was 53.3 and 58.2 respectively (P-value = 0.01). No significant difference was observed between cancer and non-cancer patients regarding COVID-19 antibody tests. However, cancer patients were 3 times less likely to have a positive RT-PCR test result OR = 0.33 (CI: 0.15–0.73). The probability of cancer patients having a positive routine test was significantly lower than non-cancer patients, and the concept that all cancer patients should be routinely tested for COVID-19 may be incorrect. Nevertheless, there may be a subgroup of patients with comorbidities or older age who may benefit from routine COVID-19 testing. Importantly, these results could not be subjected to multivariate analysis.

The Government of the Islamic Republic of Iran (Iran) has embarked on a challenging project aiming to demonstrate how to make road travel safer through speed management measures based on Safe System Approach (SSA) and Result Based Management (RBM). This follows from mounting concern in curbing a high death rate from motor vehicle crashes in recent years. However, despite the Government’s commitment to address this problem, there have been setbacks owing to the challenges of putting in place a strong collaborative framework involving all the agencies charged with responsibilities for road engineering, traffic law enforcement and public education. Iran has established a National Road Safety Commission (NRSC) to lead and coordinate actions. In implementing a demonstration project, specific partnership arrangements have been established at national and provincial levels, as well as pillar-based project teams in 3 provinces. This paper examines the governance structure and opportunities to strengthen the collaborative management of the project and how similar programs can be established and executed in other countries to improve road safety based on SSA and RBM.

The level of road trauma is high in the Eastern Mediterranean Region with the Islamic Republic of Iran having a particularly high fatality rate at 20.5 per 100,000 population. The Government, assisted by the World Health Organisation (WHO), committed to implementing demonstration projects in three provinces that will form the basis of road safety actions to be advanced by the WHO across the Region. In recognition that speed management is a pivotal factor in achieving a safer road and traffic system, and as a component of the project, a review was carried out in 2019 by a team of international experts in the field in collaboration with national consultants. This review was undertaken in consideration of the Safe System Approach and the Results-Based Management Approach. The findings of this review and their implications for future actions in Iran are discussed in this paper.

Background and purpose: Paying attention to the changing needs of society in health and the need for a responsive education system in line with the needs of society, shows the need to review educational and research structure of medical universities in a country. The purpose of this study was to explain the learned experiences of academic members on the structure of educational and research institutions. Materials and methods: This qualitative study was performed in 26 faculty members of medical sciences graduated from foreign universities using purposeful sampling. Individual semi-structured interviews were performed and the participants were asked about organizational structure, the function, and organizational hierarchy of the university where they had studied. Interviews were recorded and handwritten, coded, and analyzed according to the conventional content analysis approach. Results: We extracted four main themes, 12 sub-themes, and 75 items from the data. Main themes included type of organizational structure, strategies, management of resources, and educational infrastructures. The sub-themes were as follows: the organizational structure of educational and research institutions and traditional structure, new structure, entrepreneurship, change management, interdisciplinary insight, human resources, national resources, physical resources, educational centers, educational groups, fields of study, and research centers. Conclusion: Planning system of every country (centralized/decentralized) was found to affect the type of organizational structure of educational and research institutions. Therefore, universities and research institutions are needed to design a suitable structure consistent with the needs of society and their own goals.

Background and purpose: Improving patient safety is one of the main goals of health systems and employees need to be continuously examined for patient safety culture. The aim of this study was to assess patient safety culture in hospitals affiliated with Mazandaran University of Medical Sciences in 2020. Materials and methods: A descriptive-analytical study was performed in 370 employees working in public, private, and social security hospitals. The sample size was calculated using the Cochran's formula and the subjects were selected using simple random sampling. The Hospital Survey on Patient Safety Culture (HSOPSC) consisting of 42 questions and 12 dimensions was administered. Data analysis was done applying independent t-test and one-way analysis of variance. Results: Among the participants, 43.47% aged 40-50 years old, 42.74% had 1-10 years of work experience, and 60.07% had shift works. The dimensions of HSOPSC with highest and lowest scores were organizational learning and continuous improvement (4.00±0.89) and hospital delivery (2.51±0.97), respectively. Almost half of participants (51.36%) had no record of any incident in the past 12 months. Conclusion: Patient safety culture was moderate in hospitals studied. Hospitals are recommended to focus more on patient safety by holding training courses for transfer of patients, and establish a reporting system and encourage staff to report errors.

Background and Aim: In order to survive in the competitive market of various products and services, the use of marketing strategies is inevitable so that the success or failure of companies depends on it. Therefore, the present study was conducted with the aim of presenting a model of insurance marketing strategies for Hafez Atieh Sazan Insurance Company. Materials and Methods: This research was conducted qualitatively using the grounded theory method. Participants were selected by purposive sampling method and after 11 semi-structured interviews, theoretical saturation was obtained and the gathered data were analyzed by Strauss and Corbin approach with Atlas.ti Software. Results: As a result of data analysis, 1340 codes derived from open coding, 57 concepts and 13 categories were classified into six dimensions. "Strategic management" was identified as causal conditions, categories of "public relations", "personal selling", "direct marketing", "electronic marketing", "advertising", "technology tools", and "management tools" as strategic conditions "strategic marketing" as an axial phenomenon, "investment management" as context condition, "corporate social responsibility" and "market orientation" as intermediary/ intervening conditions, and "performance" was identified as outcome. Conclusion: According to the identified concepts and categories related to the marketing strategies, it was suggested that Hafez Atieh Sazan Insurance Company must improve and expand the marketing strategies by providing the model conditions presented in this study.

The failure of the credit market resulting from the asymmetric information space leads to adverse selection and moral hazard. While exploiting the game theory's signaling effect approach, it is possible to modify the phenomena, which provides the motivation for designing the optimal financial contract. Based on this, while explaining the effect of signaling the profit sharing ratio of Mudarabah, we seek to answer the following questions. Is the variable profit sharing ratio of Mudarabah a motivational signaling effect for contracting parties in arranging an optimal financial contract? Based on the ROE, how is Mudarabah's performance compared to the other alternative financing methods (debt and equity)? Accordingly, due to the lack of realization of the conditions for the realized Islamic contracts, a simulated model has been used to investigate and answer these questions; so that, when the variable profit sharing ratio decreases the equity returns index increases. Also, based on the sensitivity analysis of the reported return index, Mudarabah contracts are more efficient than the other financing methods mentioned, while reducing the cost of representation, it makes this contract attractive.

In the article published in volume 31, issue 199, 2021, the affiliations of Mansour Ranjbar and Siavash Moradi, also, the names of Gholam Ali Godazandeh, Maryam Khazaee-pool, and Armin Allahverdy were published incorrectly, which are now corrected.

Background and purpose: Internal evaluation is the systematic process of collecting and analyzing information to determine the benefits and disadvantages of a program and the extent to which its objectives are achieved. The aim of this study was to investigate the status of internal evaluation in clinical departments of Mazandaran University of Medical Sciences in two consecutive academic years. Materials and methods: This descriptive cross-sectional study was performed in all clinical departments of Mazandaran University of Medical Sciences during 2015-2016 and 2016-2017. Data from eight domains of internal evaluation were collected using a checklist and some researcher-made questionnaires. Then, we studied the status of departments in eight domains of internal evaluation in relation to the standards and the status of all departments in two consecutive academic years. The evaluations for the years were compared and the dynamic trend was assessed. Data analysis was done applying descriptive statistics in SPSS. Results: A good status of clinical departments was seen in most of the domains. Best performances within the two academic years studied were associated with courses, educational curriculum, and graduate affairs (74.53%, 78.66%, and 88.61%, respectively). Total scores for all clinical departments were 64.22% and 70.69% in 2015-2016 and 2016-2017, respectively. Conclusion: Continuous internal evaluation reveals the strengths and weak points of the clinical departments. Therefore, more appropriate planning would be done and the departments could apply for further residency programs.

Background: Healthcare providers are competitive, owing to heightened customers’ awareness and expectations of health care services. Objective: The aim of this study was to determine the relationship between customer value creation and loyalty with mediator trust and customer satisfaction. Methods: This is a cross sectional survey study. Participants were 196 patients referred to private hospitals in Sari city, Iran from May to June 2014 which were selected by convenience sampling method. Data were collected using questionnaires. Data were analyzed using the structural equation modeling software Smart PLS. Results: The results revealed a relationship between customer value creation and customer loyalty in a Sari city private hospital, and customer satisfaction and trust, mediate the relationship between customer value creation and customer loyalty. The results also revealed significant positive relationship between customer satisfaction and trust (p=0.000 r=0.585). Conclusion: customer satisfaction and trust mediate the relationship between customer value creation and customer loyalty

By considering the different importance of collateral variable in Islamic and in conventional banking, theoretical and experimental studies show that the necessary convergence in the credit relationship between bank and customer has not been achieved. In this article, in addition to the explaining feasibility of studying and accepting empirical role of collateral in commercial profit - loss sharing contracts, we have studied the dual role of collateral as screening and motivation tool in banking relations. We have also used credit data of Bank Refah Kargaran with application of Logit estimation to test our hypotheses regarding the role of collateral. Based on our results, the hypothesis that borrowers with lower risk have provided safer collateral, has been confirmed. This result shows the existence of adverse selection phenomenon. So, low-risk individuals tend to send signals of their quality and reveal their situation to banks. In addition, other economic and social variables of contract could use the potential of signaling and contribute to reduce the role of collateral. In the data under consideration, except for the variable of account history-interest rate, this hypothesis was rejected and other economic and social variables have failed to have the expected impact.

Background & Aim: We aimed to assess the relationship between job rotation and the psychological empowerment of nurses working in the teaching hospital of Mazandaran University of Medical Sciences. Methods & Materials: This is a cross-sectional study that was conducted in 2016. Its population consists of 1000 nurses working in the teaching hospital of Mazandaran University of Medical Sciences, 277 of them were selected as sample size using random sampling method. Spritzer’s psychological empowerment questionnaire and a researcher-made questionnaire was used to measure nurses’ view to job rotation efficacy. Results: In this study, 75% and 25% of nurses were female and male, respectively with mean age of 32.6 (SD=2.26). The mean score of nurses’ psychological empowerment in competence, autonomy, effectiveness, significance and trust was obtained, 12.68, 13.2, 14.5, 14.23 and 14.9, respectively. In addition, the mean score of overall psychological empowerment was obtained 69.51 while the mean score of job rotation efficacy was obtained 61.2. An also results showed that job rotation efficacy in the nurses of the studied hospital is related with psychological empowerment. Conclusions: The obtained results indicate that the efficacies of job rotation in nursing staff working in the studied hospitals are not independent from their psychological empowerment.

Calculating rate of efficiency and Determing effective factors in the‌ ‌bank’s competitive environment, because of numerous definitions of inputs and outputs is complex. therefore, due to the different orientations, Intermediate approach via income-based attitude in adapting to the interest-free banking operations have been selected. after that, by using data envelopment analysis method, the efficiency of sixteen public and private banks in variable return state and with the input Oriented assumption have been computed. Then by applying a random effect of panel data model this research investigates the internal and external determinants of banks efficiency. Accordingly to the results, the average efficiency of country’s banks during the Investigation Period is up to 83 percent. based on results of fix effects model , credit risk factor, the share of banks based on the from the per capita deposits(branch)in deposit market, has a negative effect on the efficiency ,and there is a significant and positive relationship between the numbers of ATMs, consumer price Index and dummy variables represent the private and specialized banks.

Background: The aim of this study was to evaluate different concentrations of deltamethrin combined with formulated piperonyl butoxide (PBO) synergist on various surfaces against the wild strain of Anopheles stephensi, the main malaria vector in Southern Iran under semi-field condition. Methods: Four concentrations of deltamethrin WG 25% (Tagros) and PBO 800EC-UV (Endura) were prepared and sprayed on the pre-designed surfaces in accordance with WHO alliance line of the IRS Micronair®. The WHO’s rec­ommended bioassay kit and method was used during this study. Results: Comparing the mortality rate of mosquitoes, the results showed a significant difference between months after treatment of IRS (Indoor Residual Spraying) (P< 0.05) but didn’t show any significant differences between days during the first and second months (P> 0.05).Statistical test revealed a significance difference between mortality rate of mosquitoes in exposing to concentrations of 1 and 4 (P< 0.05) which demonstrated effect of synergizing PBO on mortality rate. Conclusion: This research as the first semi-field trial on deltamethrin added to different concentrations of formulated PBO for IRS, indicates that deltamethrin+10X PBO is more effective than other concentrations. Therefore, using syner­gists can be suggested as a new tool for prevention of pyrethriod resistance, although more studies are recommended.

Background: According to willingness of the Ministry of Health, Iran and presence of appropriate conditions for disease elimination, national malaria control program decided to conduct a research to clarify malaria status in 2007 and to provide required information to perform the elimination program. This review is comprised of the basis of national malaria elimination program in vision of 2025, which was started in 2010.Methods: In this descriptive study, data were analyzed by applications of different variables at district level. All districts in the three south eastern provinces, in which malaria has local transmission, were considered. Malaria cases has been determined and studied based on the national malaria surveillance system.Results: Since vivax malaria is predominant in Sistan & Baluchestan Province, number of vivax cases is equal to malaria positive cases approximately. The important point is that Nikshahr contains the maximum number of local vivax cases in this province and the maximum number of falciparum cases is reported from Sarbaz district. Among all districts of Hormozgan Province, no case of autochthonous falciparum was detected except in Bandar Jask and one case in Minab. There was no case of autochthonous falciparum in Kerman Province, except in Kahnoj and Ghale Ganj that each of them had one case in 2007.Conclusion: It appears that the report of locally transmitted cases in Iran is increasing over the past few years, before starting malaria elimination plan. Since the Afghan refugees started to return to their own country so the main source of reporting of imported malaria cases reduced and local cases would be demonstrated more clearly.

Background : The main objective of this study was predicting student′s mental health using social problem solving- ability . Methods : In this correlational- descriptive study, 369 (208 female and 161 male) from, Mazandaran University of Medical Science were selected through stratified random sampling method. In order to collect the data, the social problem solving inventory-revised and general health questionnaire were used. Data were analyzed through SPSS-19, Pearson′s correlation, t test, and stepwise regression analysis. Results : Data analysis showed significant relationship between social problem solving ability and mental health (P < 0.01). Social problem solving ability was significantly associated with the somatic symptoms, anxiety and insomnia, social dysfunction and severe depression (P < 0.01). Conclusions: The results of our study demonstrated that there is a significant correlation between social problem solving ability and mental health.

Background & Objective: Nowadays early clinical experience (ECE) in Medical education has been developed with the aim of establishing efficient relationship between basic sciences courses and clinical education This study was done to evaluate the effect of early clinical experience on the attitudes of students in Sari School of Medicine toward basic sciences courses Methods: This interventional study (before and after) was done on all Sari Medical students in the 4th semester of basic sciences program An ECE program in 8 sessions was designed and developed during the 4th academic semester Attitudes of the students toward clinical importance of basic sciences courses were asked before and after the program by a valid and reliable questionnaire Data were analyzed using Wilcoxon Chisquare and McNemar tests and through SPSS 13 software package Results: From 47 students 42 ones were participated in the study (response rate= 89%) of whom 25 ones were female (60%) Early clinical experience could only affect the attitude of students in neuroanatomy course (P

Background & Objective : Faculty members are one of the most important parts of Input in the Educational system so fine determination of effective factors on their Job satisfaction is critically important This study was designed to evaluate effective factors on faculty members job satisfaction in Mazandaran University of Medical sciences 2006 Methods : In this descriptive cross sectional study all faculty members (135 ones) of medical college who participated as the study samples completed a questionnaire (based on Herzberg theory) consisted demographic variables 40 items in 11 domains for assessment of effective factors on job satisfaction according to 4 point Likert seal degree Results : Among our sample 106 faculty members participated in the study (875% response rate) majority of them were clinical specialists and sub specialists and mostly were assistant professors (735%) The highest mean score (±SD) for effective domains on job satisfaction were as follow: salary 381(±061) condition of work environment 372(±075) job position 33(±081) The least important domains include: method of monitoring and supervising 191(±063) gratitude 2(±074) and communications 202(±085) Basic sciences faculties cared significantly more about salary steady job environment career promotion and quality while for assistant professors environment and responsibility were more significant Conclusion : This study showed that external factors including salary and job environment were the most effective factors on job satisfaction of faculty members but factors related to organizational position of faculty members (communications and supervision) were less important In Overall this study indicated less importance of organizational and team spirit in faculty members and predominance of individual benefits which should be modified by appropriate programs

Burnout is a popular research topics in service providing jobs, including the health care field. This study aimed at assessing the level of job burnout and to consider the important antecedents which might be related to job burnout among primary health care providers in Iran.The participants in this applied cross-sectional study which was conducted in 2013 were 548 primary health care providers who were randomly selected from among those working in Shahroud, Sabzevar, Neishabour, Bojnord (provinces located in the north east of Iran). Maslach Burnout Inventory (MBI) was administered to the participants and the collected data were analyzed using SPSS through chi-square test and ordinal logistic regression model.The burnout mean score among the participants was 54.1 ± 27.2 and the mean scores of burnout components i.e., emotional exhaustion, depersonalization and personal accomplishment were 15.5 ± 13.6, 3.7 ± 5.4 and 35.5 ± 13.5 respectively. In terms of levels of burnout, 64.2% of the participants showed low levels (n = 352), 18.4% average levels (n = 101) and 17.3% high levels (n = 95). A significant relationship was observed between burnout, job resources and interest in job (p ≤ 0.05). However, no significant relationship was observed between burnout and the place (university) of working, age, satisfaction with income, experience, gender, level of education, marital status, housing status, having a second job and place of residence (p ≥0.05).Lack of personal accomplishment was highly prevalent among the participating primary health care providers. Lack of career advancement and job transfer opportunities may play a role in the burnout of primary health care providers. Therefore, paying attention to this aspect may help to reduce burnout and even increase job engagement.

According to willingness of the Ministry of Health, Iran and presence of appropriate conditions for disease elimination, national malaria control program decided to conduct a research to clarify malaria status in 2007 and to provide required information to perform the elimination program. This review is comprised of the basis of national malaria elimination program in vision of 2025, which was started in 2010.In this descriptive study, data were analyzed by applications of different variables at district level. All districts in the three south eastern provinces, in which malaria has local transmission, were considered. Malaria cases has been determined and studied based on the national malaria surveillance system.Since vivax malaria is predominant in Sistan & Baluchestan Province, number of vivax cases is equal to malaria positive cases approximately. The important point is that Nikshahr contains the maximum number of local vivax cases in this province and the maximum number of falciparum cases is reported from Sarbaz district. Among all districts of Hormozgan Province, no case of autochthonous falciparum was detected except in Bandar Jask and one case in Minab. There was no case of autochthonous falciparum in Kerman Province, except in Kahnoj and Ghale Ganj that each of them had one case in 2007.It appears that the report of locally transmitted cases in Iran is increasing over the past few years, before starting malaria elimination plan. Since the Afghan refugees started to return to their own country so the main source of reporting of imported malaria cases reduced and local cases would be demonstrated more clearly.