Journal of preventive medicine and hygiene最新文献

{"title":"1985: Forty years ago, the world opened its eyes to AIDS. History of the early years of the HIV epidemic.","authors":"Davide Orsini, Mariano Martini","doi":"10.15167/2421-4248/jpmh2025.66.3.3730","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3730","url":null,"abstract":"<p><p>At the end of 1980, Michael Gottlieb, a researcher at the University of California, was conducting a clinical study on deficiencies of the immune system when he heard of the case of a young man with a rare form of pneumonia due to Pneumocystis carinii (now known as Pneumocystis jirovecii), a protozoon that usually affects only people with a weakened immune system [1]. In the following months, Gottlieb discovered further cases of patients with Pneumocystis carinii pneumonia, oral candidiasis and a very low level of T lymphocytes. All were male and active homosexuals [2]. In reality the infection had already manifested itself in previous years but had always been mistaken for something else [3]. HIV probably originated from a virus found in chimpanzees and began infecting humans in the first half of the 20th century. It probably emerged when members of the Bantu tribe, who lived in the forests of central Africa, consumed chimpanzee meat infected with a virus called simian immunodeficiency virus (SIV). This may have caused a so-called spillover from chimpanzees to humans [4, 5].</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E433-E441"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating Infectious Diseases in Low-Resource Communities: Socioeconomic, Environmental, Climate Change and Gender-Based Strategies.","authors":"Idris Zubairu Sadiq","doi":"10.15167/2421-4248/jpmh2025.66.3.3508","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3508","url":null,"abstract":"<p><p>Infectious diseases continue to pose a significant challenge to global health, particularly within resource-limited communities, where socioeconomic and environmental health determinants amplify their prevalence and impact. This letter to editor examines comprehensive strategies aimed at alleviating the burden of communicable diseases by addressing essential factors such as water, sanitation, and hygiene (WASH), housing conditions, climate change, gender equity, sociocultural influences, and poverty. Common infectious diseases such as tuberculosis, malaria, HIV/AIDS, cholera, and dengue fever are significantly influenced by poor sanitation, inadequate housing, climate change, and gender disparities. Key interventions, including enhancing access to clean water, promoting sufficient sanitation, improving housing quality, and fostering climate resilience, are identified as vital measures to prevent disease transmission. Moreover, empowering women through equitable healthcare and education, implementing culturally responsive health campaigns, and engaging community members in preventive actions are distinctly highlighted. Strategies for poverty alleviation, encompassing economic development and social protection initiatives, play a crucial role in breaking the cycle of disease and poverty. This letter highlights the need for a multidisciplinary strategy and cross-sector collaboration to tackle the complex relations of these health determinants, promoting health equity and improving the well-being of vulnerable populations.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E341-E344"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Surgical Site Infections: Insights from an Italian Teaching Hospital.","authors":"Giovanni Guarducci, Giuliana Fabbri, Marco Tiseo, Niccolò Bolognesi, Cinzia Ravaioli, Luca Lavazza, Paola Antonioli","doi":"10.15167/2421-4248/jpmh2025.66.3.3534","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3534","url":null,"abstract":"<p><strong>Background: </strong>Surgical Site Infections (SSIs) are among one of the most frequent and costly healthcare-associated infections (HAIs), leading to increased patient morbidity, prolonged hospital stays, and higher healthcare costs. Surveillance programs are essential for detecting, monitoring, and preve nting SSIs. However, the implementation and effectiveness of these programs varies across healthcare facilities. This study aims to provide effective data gathered from SSI trend assessment at Ferrara Teaching Hospital to improve surveillance systems.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted on data collected between 2020 to 2023 from the SIChER surveillance system and Hospital Discharge Cards at Ferrara Teaching Hospital. The analysis examined infection rates across various surgical procedures, applying two primary indicators: SSI Percentage by Category and Incidence Density of Hospital-Onset SSIs. Statistical analyses were performed using STATA software.</p><p><strong>Results: </strong>An average of 5,158 surgical procedures were executed annually between 2020 to 2023, and SIChER-monitored procedures steadily increased during this period, reaching 80.7% coverage in 2023. The highest infection rates were recorded in colon surgery, while cardiac surgery consistently recorded no infections. The overall incidence density of hospital-onset SSIs was 0.18 per 1,000 follow-up days, with significant variations across surgical categories. The accuracy of HDCs in documenting SSIs improved over time, achieving a 97.2% match in 2023.</p><p><strong>Conclusion: </strong>The study highlights an increasing trend in SSI surveillance coverage and accuracy, demonstrating the effectiveness of the SIChER system in monitoring infections. However, variations in infection rates among different procedures suggest the need for targeted strategies, particularly for high-risk surgeries such as colorectal and orthopaedic procedures.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E375-E381"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of using artificial intelligence in Iran's health system: a qualitative study.","authors":"Meysam Behzadifar, Samad Azari, Negin Sajedimehr, Afshin Aalipour, Maryam Nematkhah, Banafsheh Darvishi Teli, Mariano Martini, Mohammad Yarahmadi, Masoud Behzadifar","doi":"10.15167/2421-4248/jpmh2025.66.3.3698","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3698","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is transforming healthcare globally, enhancing diagnostics, treatment, and efficiency. However, low- and middle-income countries (LMICs) like Iran face significant barriers to AI integration. Iran's health system, challenged by an aging population, increasing non-communicable diseases, and limited resources, could benefit from AI-driven, patient-centered care. Yet, its adoption remains limited. Understanding the barriers to AI implementation is critical for informed policymaking.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with 15 stakeholders from healthcare management, policymaking, and AI sectors in Iran, conducted between January and April 2025. Participants were selected purposively to represent government, academia, healthcare, and technology. Data were analyzed thematically using Braun and Clarke's framework. Rigor was ensured through member checking, triangulation, and adherence to qualitative research standards.</p><p><strong>Results: </strong>Five major barriers to AI adoption emerged: (1) organizational and structural limitations, including poor infrastructure and fragmented governance; (2) legal and policy challenges, marked by regulatory gaps and ethical concerns; (3) data-related issues such as low data quality, lack of standardization, and security risks; (4) shortage of skilled professionals and limited training opportunities; and (5) challenges in integrating AI into policymaking, including concerns about losing human oversight in decision-making.</p><p><strong>Conclusion: </strong>AI implementation in Iran's health system faces complex and interrelated challenges. Addressing these requires a coordinated strategy focused on legal reform, infrastructure investment, capacity building, and cultural adaptation. Balancing technological innovation with ethical and human-centered care is essential for successful and sustainable integration.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E331-E340"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitude and Practices Towards Breast Cancer Among Undergraduate Female Pharmacy Students in Pakistan.","authors":"Numaira Qasim, Ahmed Umer Sohaib, Ruksana Ashruf, Hebatallah Ahmed Mohamed Moustafa","doi":"10.15167/2421-4248/jpmh2025.66.3.3608","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3608","url":null,"abstract":"<p><strong>Background: </strong>Lack of knowledge, attitude and perception towards breast cancer still a major public health issue disease in many developed and under-developed countries including Pakistan. In 2024 in Pakistan, one in every 8 females is affected by Breast Cancer.</p><p><strong>Objective: </strong>To determine the awareness, attitude, and practices of Pharmacy (Pharm-D) students towards Breast Cancer (BC) and their correlation with participants' age and level of study.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted on 401 female students of Pharmacy from December 2023 to March 2024, using a self-administered questionnaire assessing awareness, attitude, and practices towards BC. For sample size calculation, Raosoft^® online sample size calculator with a 5.0% margin of error and a 95.0% confidence interval was used. The respondents were sampled via convenience sampling.</p><p><strong>Results: </strong>Our sample included 401 participants. The majority gained knowledge about BC from the media (69.8%). About 73.4% of participants did not participate in breast self-examination (BSE), and about 41.3% of them believed they were not at risk. About 92.6% of participants didn't undergo clinical breast examination (CBE). Nearly half of the participants (44.9%) agreed that BC is more common in older women. About four-fifths of the respondents (79.3%) agreed that regular examination can reduce the risk of BC.</p><p><strong>Conclusion: </strong>The practice of BSE by the Pharm.D students is lagging. There were notable gaps in CBE by pharmacy students due to the belief that breast cancer predominantly affects older women. Therefore, it is important to make future pharmacists aware of practicing BSE and CBE regularly.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E398-E403"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High prevalence and associated factors of <i>Mycoplasma pneumoniae</i> infection in children aged from 2 to 59 months with atypical pneumonia from June 2023 to May 2024.","authors":"Dung LE Kieu, Minh Manh To, VAN Nghiem Dang, VAN Thuan Hoang","doi":"10.15167/2421-4248/jpmh2025.66.3.3574","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3574","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the prevalence of Mycoplasma pneumoniae infection and association with age and gender among children aged from 2 to 59 months, hospitalized with atypical pneumonia in Vietnam from June 2023 to May 2024.</p><p><strong>Methods: </strong>A retrospective descriptive study was performed using data collected from the electronic medical records. M. pneumoniae infection was determined by the IgM serology test.</p><p><strong>Results: </strong>1,296 patients aged from 2 to 59 months hospitalized with atypical pneumonia were included. The majority of patients were aged 12 months or older, with only 3.6% of cases being under 12 months of age. Male patients accounted for 58.7% of the cases. Prevalence of M. pneumoniae infection was 47.3%. Compared to children under 12 months of age, those aged 12 to under 36 months had a 10 times higher risk of M. pneumoniae infection, with OR = 9.44, 95% CI = [2.90-30.77]. Compared to children under 12 months of age, those aged 36 months to under 5 years had a 20 times higher risk of M. pneumoniae infection, with OR = 20.19, 95% CI = [6.20-65.69]. Compared to female children, male children had nearly twice the lower risk of M. pneumoniae infection, with OR = 0.62, 95% CI = [0.50-0.78].</p><p><strong>Conclusion: </strong>Our study provides additional evidence on the role of M. pneumoniae in atypical pneumonia in children aged from 2 to 59 months, while also highlighting significant risk factors for M. pneumoniae infection.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E358-E362"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter \"Breaking the Stalemate: How Italy's Non-Medical Health Professions Are Trapped by Redundant Roles and Ineffective Degrees\".","authors":"Roberto Gasparini","doi":"10.15167/2421-4248/jpmh2025.66.3.3754","DOIUrl":"https://doi.org/10.15167/2421-4248/jpmh2025.66.3.3754","url":null,"abstract":"","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E420"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Field Report from War-Torn Remote Villages in South-Eastern Ukraine: Enhancing Healthcare Access Through a Community-Oriented Primary Care Model.","authors":"Dario Lupica Spagnolo, Eleonora Colpo, Marco Peretti, Alessandro Manno, Viorel Iesanu, Samuele Cirnigliaro, Dafina Shtefan, Gabriela Bianchi, Elisa DE Checchi, Daniele Giacomini, Alessandro Lamberti-Castronuovo","doi":"10.15167/2421-4248/jpmh2025.66.3.3694","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3694","url":null,"abstract":"<p><p>The ongoing conflict in Ukraine has severely disrupted healthcare infrastructure, displaced medical personnel and restricted access to care, prompting an unprecedented international support. Since October 2023, the non-governmental organization EMERGENCY has conducted a field assessment to identify critical barriers to healthcare delivery in remote villages of Donetsk to inform an effective intervention. The assessment revealed that many health needs, particularly those related to chronic diseases and mental health, were pre-existing but had been exacerbated by the war, resulting in a secondary surge of unmet needs in rural communities facing growing barriers to basic care. In response, a Community Health Worker (CHW)-led intervention was developed to bridge gaps between communities and health services. Locally recruited CHWs conduct door-to-door assessments, monitor treatment adherence for chronic diseases, address mental health needs, arrange home-based care for bedridden individuals, deliver health education sessions, and facilitate timely referrals in close collaboration with nurse-led clinics. To strengthen resilience, CHWs are trained in basic emergency and disaster preparedness, including life support skills, improving community-level readiness for health emergencies. To address sustainability challenges, the intervention is integrated into Ukraine's primary care network, and provides CHWs with ongoing training and compensation through regular contracts. Aligned with national health priorities and the Health Cluster's strategy, the model targets marginalized groups, engages communities, and strengthens local health systems, ensuring efficient use of resources and continuity of care. This report outlines a scalable, context-sensitive approach to enhancing healthcare access in conflict settings, with relevance for other humanitarian contexts.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E421-E427"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumococcal Vaccination of Adults in Italy: What Strategies?","authors":"Elvira Massaro, Giovanni Gabutti","doi":"10.15167/2421-4248/jpmh2025.66.3.3756","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3756","url":null,"abstract":"&lt;p&gt;&lt;p&gt;S. pneumoniae has been classified by the World Health Organization (WHO) as one of the 12 priority pathogens with the greatest global health impact. Although many individuals (approximately 20-30% of adults and nearly 40-50% of children) may carry the bacterium asymptomatically, certain groups are considered at higher risk of disease (non-invasive illnesses and invasive diseases). These include young children, the elderly and individuals who are immunocompromised or affected by pre-existing medical conditions. Italian surveillance data show a significant increase in Invasive Pneumococcal Disease (IPD) incidence in 2023 in comparison with 2021 and 2022, rising from 0.84 cases per 100,000 population in 2021 to 3.02 in 2023. The highest rates were observed in children under 1 year of age [10.41/100,000 (2023)] and in adults aged 65 and over (7.45/100,000 in 2023 compared with 2.11 in 2021 and 4.49 in 2022). Surveillance systems and epidemiological studies on the global distribution of the different pneumococcal serotypes associated with disease continue to be essential to determining which serotypes to include in new vaccines, in order to produce preparations capable of preventing an increasing number of cases, hospitalizations, sequelae and deaths. A milestone in pneumococcal vaccination was the development of conjugate vaccines (PCVs), which started in the 2000s. The first PCV, which covered seven serotypes (PCV7: 4, 6B, 9V, 14, 18C, 19F, and 23F), was introduced in Italy in 2005 for the pediatric population. The introduction of this vaccination strategy leading to a significant reduction in disease among children and an overall decline in the pneumococcal disease burden across all age-groups. However, an increase in disease caused by serotypes not included in PCV7 was observed. This phenomenon, named serotype replacement, led to the development of higher-valency conjugate vaccines. In 2010, the 13-valent pneumococcal vaccine (PCV13) and 10-valent pneumococcal vaccine (PCV10) were approved. However, the phenomenon of serotype replacement continued to be observed, and consequently, the need for broader-spectrum vaccines remained a public health priority. In 2021 and 2022 PCV15 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F) and PCV20 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F) were authorized for immunization in individuals aged ≥18 years, respectively. In March 2025, the use of a new 21-valent pneumococcal vaccine was approved (serotypes: 3, 6A, 7F, 19A, 22F, 33F, 8, 10A, 11A, 12F, 9N, 17F, 20, 15A, 15C, 16F, 23A, 23B, 24F, 31 and 35B) and it included some serotypes particularly aggressive or emerging. Maximizing the effectiveness of a vaccination program in combating diseases related to S. pneumoniae is based on the integration of three key elements: epidemiological need, immunological need and vaccine compliance. From an epidemiological perspective, the 20","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E345-E357"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the social networks of key actors in the development of health technology assessment in Iran.","authors":"Meysam Behzadifar, Saeed Shahabi, Ahad Bakhtiari, Samad Azari, Banafsheh Darvishi Teli, Mohammad Yarahmadi, Mariano Martini, Masoud Behzadifar","doi":"10.15167/2421-4248/jpmh2025.66.3.3729","DOIUrl":"10.15167/2421-4248/jpmh2025.66.3.3729","url":null,"abstract":"<p><strong>Background: </strong>Health Technology Assessment (HTA) is vital for evidence-based policymaking and resource allocation. In Iran, HTA development involves diverse actors with varying levels of power, influence, and support. Understanding their interactions is key to strengthening HTA processes.</p><p><strong>Methods: </strong>We applied Social Network Analysis (SNA) to map relationships among 27 stakeholders identified through document review and expert interviews. Data were collected via an online questionnaire completed by 83 experts (response rate: 72.2%), assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree, closeness, betweenness, and eigenvector centrality, were analyzed using R Version 4.4.1.</p><p><strong>Results: </strong>The Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and Parliament were perceived as the most influential actors. The Plan and Budget Organization (degree centrality 0.34) and National Institute of Health Research (0.26) emerged as key connectors with high bridging roles. Overall, the network exhibited low density (0.13) and limited clustering (0.11), indicating sparse connectivity. Peripheral actors, such as the Chamber of Commerce, were largely disconnected from the network.</p><p><strong>Conclusion: </strong>HTA development in Iran is shaped by a few central institutions, but weak connectivity and limited engagement of peripheral actors hinder collaboration. Strengthening stakeholder communication, enhancing inclusiveness, and securing sustainable funding are critical for more effective HTA implementation and evidence-informed health policy.</p>","PeriodicalId":94106,"journal":{"name":"Journal of preventive medicine and hygiene","volume":"66 3","pages":"E318-E330"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12643085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}