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How to improve Iranians' vision health: on the national policy of preventing Iranians' blindness

International Journal of Ophthalmology(English edition) 2019年第1期12卷 114-122页

作者： Behzad damari Alireza Mahdavi Maryam Hajian Neuroscience Institute Tehran University of Medical Sciences Ministry of Health and Medical Education Minimally Invasive surgery Research Center Iran University of Medical Sciences

AIM: To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education(MOHME). METHODs: This was a rapid situation analysis with a qualitative approach in three parts of recognition, orientation and implementation. The data were gathered via review of upstream documents, national and international experiences, and experts and stakeholders' opinions. REsULTs: Eradicating trachoma, increasing human resources, increasing educational and research centers and promotion of ophthalmic technologies were important achievements in the field of vision health in Iran. Through these achievements, it seemed that the pattern of causes of blindness and low vision was similar to that of the developed countries. However, the review of Iranians' vision health indicators showed that a considerable percent of the blindness and low vision was avoidable through a national program demanding 3 types of interventions in social determinants of health(sDH), community education, and increasing the access to health care services by integrating the necessary services in primary health care system. CONCLUsION: Managing the issue requires attentions from a national committee for preventing blindness with participation of all stakeholders, implementing a national survey on vision health, preparation of the primary level health centers including employment and education of community health workers(Behvarzes), optometristsand general practitioners, fair distribution of specialized human resources and establishing at least one specialized center in each province for referring patients from the primary levels.

关键词： vision health policy document primary health care

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The Contribution of Tanzanian National Parks in Controlling the Vectors of sleeping sickness

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Open Journal of Ecology 2015年第7期5卷 306-314页

作者： Epaphras A. Muse Inyasi Lejora James Wakibara Morris Kilewo Idrissa s. Chuma Emilian Kihwele damari s.mwel Abel Mtui Calvin sindato Imna Malele Ruaha National Park Iringa Tanzania Tanzania National Parks Headquarters Arusha Tanzania Tarangire National Park Manyara Tanzania serengeti National Park Mara Tanzania National Institute for Medical Research Tabora Tanzania Vector & Vector Borne Diseases Research Institute Tanga Tanzania

This paper summarises efforts to control sleeping sickness [Human African Trypanosomiasis (HAT)] by Tsetse flies and Trypanosomiaisis (T & T) control for the 7 consecutive years although started a decade ago in Tanzania National Parks (TANAPA). These efforts are critical for curbing HAT incidences and HAT epidemics. HAT cases have had profound negative impacts on human health, affecting local residents and international travel as well as tourism industry resulting into human and animal health burden and reduction in tourism income. Understanding the current efforts is essential in the proper planning and decision making on developing effective control strategy against T & T control. In this paper, we summarize the recent efforts in the control of T & T in National Parks and discuss the constraints faced. The information will enable TANAPA and other concerned authorities to make informed decision on optimal ways of controlling HAT in National Parks. The results show that much control efforts have so far concentrated in serengeti, Ruaha, Tarangire and Katavi National Parks where tsetse fly challenges are high. A total 21,143 (average 3020) Insecticide Treated Targets (ITT) were deployed in different areas in the parks and 82,899 (average 20,725) cars entering these parks were sprayed from 2007/2008 to 2014/2015 and 2007/2008 to 2010/2011 respectively. Deployed ITTs lead to a drastic reduction of FTDs of the two dominant tsetse species to 1.3 and 1.4 of G. swynnertoni and G. pallidipes respectively, and the decline was significant at P = 0.011. The major challenges faced include tsetse re-invasion in controlled areas;resurgence of HAT cases when control efforts are relaxed, ITT maintenance and inadequate health education programs. The control strategy should be continuous and scaled up as failure to implement an effective and sustainable system for HAT control will increase the risk of new epidemic that would impede tourism development.

关键词： Tsetse Fly Insecticides Targets sleeping sickness Tanzania

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