Objective: Iron deficiency anemia is the most common cause of anemia during pregnancy. Other causes of anemia include parasitic diseases, micronutrient deficiencies, and genetic hemoglobin apathies. Maternal anemia during pregnancy is the most important public health problem. Since, the relationship between maternal anemia by the months of pregnancy and premature birth has been reported differently in various studies; thus, this study aims to determine the relationship between maternal anemia during pregnancy and premature birth. Methods: This systematic review and meta-analysis article was designed based on the recommendations of PRISMA. This study was performed from 1990 to 2018. Articles extracted using related keywords such as maternal, anemia, premature birth, and pregnancy in databases, including: Cochrane, Medline, Medlib, Web of Science, PubMed, Scopus, Springer, Science Direct, Embase, Google Scholar, Sid, Irandoc, Iranmedex and Magiran. Relative risk and its confidence interval were extracted from each of the studies. The random effects model was used to combine study results and heterogeneity among the studies measured using I² index. Results: Overall 18 studies with sample sizes of 932 090 were entered into the meta-analysis. The overall relationship between maternal anemia during pregnancy and premature birth was not significant (1.56 [95% CI: 1.25–1.95]). Maternal anemia in the first trimester increases the risk of premature birth (relative risk, 1.65 [95% CI: 1.31–2.08]). But, this relationship was not significant in the second (relative risk, 1.45 [95% CI: 0.79–2.65]) and third trimester (relative risk, 1.43 [95% CI: 0.82–2.51]). Conclusion: Maternal anemia during pregnancy can be considered as a risk factor for premature birth.

Asymptomatic T.gondii transmitted from blood donors to receiving patients has become a concern. Numerous articles have been published on the epidemiology of T.gondii in blood donors in Iran and a systematic review of the results shows quite different findings, hence this study was aimed to determine the seroprevalence of T.gondii in Iranian blood donors using meta-analysis. We searched for epidemiological studies that were published until by July 2016 in eight English databases including: Scopus, PubMed, Ovid, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library, and four Iranian databases: Magiran, Iranmedex, SID and Medlib; besides Google Scholar. To estimate pooled estimator, regarding that the high heterogeneity and the significance of I² index, Random effects model was used. Data analysis was conducted using Review Manager Ver5.3.5 software and a significance level of 0.05 was considered significant. Among 10 studies with a sample of 4538 Iranian blood donors, the seroprevalence of T.gondii was calculated 34.4% (CI95%: 24.9-43.9). The rate in males and females was 33.36% (CI95%: 19.92-46.81) and 37.63% (CI95%: 20.81-54.45), respectively. IgM and IgG antibodies seroprevalence among blood donors were 2.74% (CI95%: 0.55-4.92) and 31.84% (CI95%: 20.61-43.08), respectively. The seroprevalence of T.gondii was significantly associated with blood group (P = 0.04), but this relation was not significant with blood transfusion (P = 0.62). The results of this review indicate a high seroprevalence of T.gondii (about a third) is in Iranian blood donors and emphasizes the importance of screening seroprevalence of T.gondii of donated blood in Iranian Blood Transfusion Organization.

Patients with Tuberculosis (TB) still have barriers in accessing high quality care and treatment services. In this qualitative study, we investigated barriers in accessing TB health services including confirmatory diagnosis, treatment adherence and recurrence of pulmonary TB using patients, physicians, and policy makers point of view. In this qualitative research from November to March 2021, 3 policy makers from the Ministry of Health, 12 provincial TB experts and physicians from the TB control program and 33 patients diagnosed with TB from 4 provinces were enrolled for a semi-structured in-depth interview. All interviews were audio recorded and then transcribed. Framework analysis was done by MAXQDA 2018 software to identify key themes. Several barriers reported for TB care and treatment: Poor knowledge of patents about TB symptoms, failure to screen for TB among at-risk patients by physicians, similar symptoms between TB and other lung diseases, low sensitivity of TB diagnostic tests, incomplete case finding and contact-tracing, stigma related to TB, and patients poor adherence due to long TB treatment. In addition, COVID-19 pandemic disrupted TB services and decreased detection, care and treatment services for TB patients. Our findings highlight the need for interventions to increase public and healthcare providers awareness about TB symptoms, using more sensitive diagnostic tests, and interventions to reduce stigma, and improve case finding and contact tracing effort. Improving patients' adherence required better monitoring and shorter effective treatment regimes.