Journal of Education and Health Promotion

Abstract BACKGROUND: The prevalence of viral diseases is on the rise and has caused many problems
for public health. COVID‑19 is a new viral outbreak in the world. This study aimed to investigate the
trends of incidence and case fatality rate (CFR) of COVID‑19 in the world by April 30, 2020.
METHODS: This was a descriptive‑analytical study. We investigated the number of cases and deaths
in 35 selected countries and regions of the WHO that had at least 10,000 cases by the time of the
study. In addition, the incidence and CFR of COVID‑19 were investigated. Finally, time trends of the
number of cases, deaths, and CFR were investigated using ordinary least squares regression models.
RESULTS: The total number of confirmed cases of COVID‑19 was 3,090,184. The European region
had the highest number of COVID‑19 patients (1,434,649 [46.43%]). Ukraine with 10,406 and the
USA with 1,003,974 cases have reported the lowest and highest confirmed cases, respectively. In
addition, the European region and the African region with 157.13 and 2.50 patients per 100,000
population had the highest and the lowest incidence rate, respectively. India (2.44) and Spain (455.69)
had the lowest and the highest incidence rate per 100,000 population, respectively. In the world,
217,759 deaths have happened, of which 135,961 (62.44%) were reported in the European region.
Furthermore, the USA had the highest number of deaths (52,428) due to COVID‑19. CFR was 7.05%
in the world, which ranged from 3.74% in the African region and 9.48% in the European region. The
number of patients and deaths due to COVID‑19 had increasing trends in all countries, and the trend
of CFR just for Iran and Ukraine was negative.
CONCLUSION: The countries had different trends in the morbidity and mortality of COVID‑19.
However, regarding the increasing trend of the disease in the world, it will be more important to rely
on public prevention strategies. It is necessary to apply and continue public health policies at national
and global levels till the control of the disease.

Abstract Background and Objectives: Breast cancer is a major threat to women’s health. Evaluation
of the changes in trend of the incidence rate provides valuable information for the assessment
and planning of development indicators of each country. The aim of the present study was to
apply the JoinPoint regression model for determining changes in the trend of the breast cancer
incidence rate in Isfahan. Materials and Methods: In this cross‑sectional study, 3640 women
with breast cancer referring to oncology and radiotherapy departments of Seyed‑al‑Shohada
and Milad cancer treatment centers of Isfahan during 2001–2010 were studied and sampling
was not done. Joinpoint regression model was used to investigate the pattern of breast
cancer incidence rate. Response and independent variables were the natural logarithm of the
age‑standardized incidence rates and year of diagnosis of breast cancer, respectively, in which
various levels of cancer tumor characteristics (P < 0.05) were analyzed. Results: The incidence
rates increased annually in the age groups of 40–44 years (6.2%), 45–49 years (5.3%), and
55–59 years (5.3%). The trend of incidence rates in women with tumor size ≤2 cm (18.2%),
well (moderately) differentiated tumor grade [8% (10.2%)], positive estrogen (progesterone)
hormone receptor status [10.5% (6.9%)], and the proportion of positive lymph node to surgery
node ≤25% (nonsignificant) was upward. Conclusion: The trend of incidence rates with tumor
size ≤2 cm, well‑differentiated tumor grade, moderately differentiated tumor grade, and positive
estrogen and progesterone hormone receptors was upward. The pattern of breast cancer can
help in cancer prevention and prognosis, and in selecting the best type of surgery.

Abstract Background: Animal bite is one of the problems of public health which has the potential risk of
rabies disease. This study was conducted to determine the epidemiology of animal bite in Aq
Qala city from 2000 to 2009. Materials and Methods: In this descriptive cross‑sectional study,
13142 cases of animal bites which were recorded in Rabies Treatment Center of Aq Qala City
were entered into the study by census method. The data were collected from the registered
office profile of people who had referred to this center. The obtained data were analyzed using
descriptive statistics (frequency distribution, percentage, mean, and standard deviation) and
Chi‑square test. Findings: Of 13142 registered cases, 72.1% were men and 27.9% were
women. The mean age of the victims was 25.0 ± 17.8 years, most of whom (84%) lived in
villages. Also, most cases of animal bite were done by dogs, (97.8%) occurred in legs (69.6%).
Most of the victims were students (28.9%). The highest frequency of bites happened in spring
(28.8%). The incidence rate of animal bite was 1222/100,000 people. The highest and lowest
incidence rates were 1608/100 000 in 2004 and 1117/100,000 in 2009, respectively. There was
a significant relationship between season and the number of bites (P < 0.05). Conclusion: The
incidence of animal bite in Aq Qala city was higher than that in other studies in different parts
of the country. Considering the high cost of antirabies serum and vaccination, it is essential to
take necessary measures reduce the incidence of this problem.