Trend of Bloody Diarrhea in Kerman Province, Iran: A Time Series Study From 2013 to 2023

伊朗克尔曼省血性腹泻趋势:2013年至2023年时间序列研究

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Abstract

BACKGROUND: Bloody diarrhea is a significant infectious disease of the gastrointestinal tract that poses a serious public health concern. OBJECTIVE: This study aims to elucidate the epidemiological profile of bloody diarrhea in Kerman Province, Iran, highlighting the necessity for targeted public health interventions. METHODS: This longitudinal study analyzed data from 3111 patients diagnosed with bloody diarrhea between 2013 and 2023 in Kerman Province, Iran. The Generalized Estimating Equations (GEE) method was employed to identify predictors of bloody diarrhea incidence. To investigate trends over time, the Box-Jenkins approach was utilized to model the autoregressive integrated moving average (ARIMA) time series (p, d, q). RESULTS: The findings revealed a significantly higher incidence of bloody diarrhea among men (55.5%), children under 6 years old (48.0%), and individuals residing in urban areas (76.7%). The clinical assessment indicated that a substantial majority of patients were hospitalized (72.1%). Laboratory analyses identified Shigella species as the most prevalent pathogen (56.0%). The GEE analysis demonstrated that the risk of developing bloody diarrhea was particularly elevated in children under six and urban residents. The ARIMA model indicated seasonal components in the incidence of bloody diarrhea, with a mild decreasing trend observed over the study period. CONCLUSIONS: Given the clinical significance of this disease and its impact on vulnerable populations, particularly children, we advocate for enhanced community education and the strict implementation of health protocols to improve disease management and prevention.

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