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Systematic Review
A meta-analysis of the association between adolescent pregnancy and the risk of gynecological cancers
Bita Azmi-Naei, Fatemeh Shahbazi, Nazanin Azmi-Naei, Jalal Poorolajal
Epidemiol Health. 2024;46:e2024094.   Published online November 26, 2024
DOI: https://doi.org/10.4178/epih.e2024094
  • 8,301 View
  • 132 Download
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Despite several investigations, the association between adolescent pregnancy and gynecological cancers has yet to be conclusively established. To further explore this association, we conducted a meta-analysis of observational studies.
METHODS
We conducted a comprehensive search of databases such as PubMed, Web of Science, and Scopus to identify studies investigating the link between adolescent pregnancy and gynecologic cancers. This search continued until February 20, 2023. To assess the heterogeneity among the studies, we used the I2-statistics. We also explored the potential presence of publication bias using the Begg and Egger tests. The overall effect sizes were reported as either risk ratio or odds ratio, accompanied by a 95% confidence interval (CI), using a random-effects model.
RESULTS
From an initial pool of 25,436 studies, a total of 76 studies involving 13,991,683 participants met the predefined eligibility criteria. The analysis indicated that the overall effect size for individuals having their first pregnancy at age 20 or older, compared to those having it before age 20, was 0.54 (95% CI, 0.50 to 0.59) for cervical cancer, 0.82 (95% CI, 0.77 to 0.88) for ovarian cancer, and 0.96 (95% CI, 0.89 to 1.04) for uterine cancer.
CONCLUSIONS
Our findings suggest that experiencing one’s initial pregnancy at the age of 20 or above is associated with a significantly reduced risk of cervical and ovarian cancer. However, no significant association was found between first pregnancy at this age and uterine cancer.
Summary
Original Article
National trends and projection of chronic kidney disease incidence according to etiology from 1990 to 2030 in Iran: a Bayesian age-period-cohort modeling study
Fatemeh Shahbazi, Amin Doosti-Irani, Alireza Soltanian, Jalal Poorolajal
Epidemiol Health. 2023;45:e2023027.   Published online February 17, 2023
DOI: https://doi.org/10.4178/epih.e2023027
  • 21,464 View
  • 249 Download
  • 10 Web of Science
  • 15 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Chronic kidney disease (CKD) is a major public health problem worldwide. Predicting CKD incidence rates and case numbers at the national and global levels is vital for planning CKD prevention programs.
METHODS
Data on CKD incidence rates and case numbers in Iran from 1990 to 2019 were extracted from the Global Burden of Disease online database. The average annual percentage change was computed to determine the temporal trends in CKD age-standardized incidence rates from 1990 to 2019. A Bayesian age-period-cohort model was used to predict the CKD incidence rate and case numbers through 2030.
RESULTS
Nationally, CKD cases increased from 97,300 in 1990 to 315,500 in 2019. The age-specific CKD incidence rate increased from 168.52 per 100,000 to 382.98 per 100,000 during the same period. Between 2020 and 2030, the number of CKD cases is projected to rise to 423,300. The age-specific CKD incidence rate is projected to increase to 469.04 in 2030 (95% credible interval, 399.20 to 538.87). In all age groups and etiological categories, the CKD incidence rate is forecasted to increase by 2030.
CONCLUSIONS
CKD case numbers and incidence rates are anticipated to increase in Iran through 2030. The high level of CKD incidence in people with diabetes mellitus, hypertension, and glomerulonephritis, as well as in older people, suggests a deficiency of attention to these populations in current prevention plans and highlights their importance in future programs for the national control of CKD.
Summary
Key Message
Based on our findings, it is predicted that the number of chronic kidney patients in Iran will reach 423,300 people by 2030. Additionally, the age-specific incidence rate of chronic kidney disease (CKD) is projected to increase to 469.04 in the same year. The CKD incidence rate is forecasted to increase by 2030 in all age groups and etiological categories, including type 1 diabetes mellitus, type 2 diabetes mellitus, hypertension, glomerulonephritis, and other causes.

Citations

Citations to this article as recorded by  
  • Association of cardiovascular risk factors with diabetic kidney disease severity in the Iranian population
    Rad Ghannadzadeh Kermani Pour, Maryam Karimi Ghahfarokhi, Ali Golestani, Shahrzad Mohseni, Sepehr Khosravi, Alireza Azarboo, Mohammadreza Mohajeri-Tehrani, Mahnaz Pejman Sani, Ozra Tabatabaei-Malazy
    Scientific Reports.2026;[Epub]     CrossRef
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    Mc Neil Valencia, Jun Kim, Zeeshan Abbas, Seung Won Lee
    Healthcare.2026; 14(3): 405.     CrossRef
  • Healthy eating index and kidney function in adults: findings from the Ravansar non-communicable disease cohort
    Azad Ayenehpour, Neda Izadi, Fatemeh Sheikhi, Narges Shahnazi, Amir Saber, Hawal Lateef Fateh, Yahya Pasdar
    BMC Nephrology.2026;[Epub]     CrossRef
  • Efficacy and safety of prolyl hydroxylase inhibitors for anemia in chronic kidney disease: a network meta-analysis
    Yuanchen Niu, Tenghua Wang, Yaoxuan Zhan, Haimei Xu, Chen Li, Zhiqin Hu, Jin He, Yongmei Li, Yi Fang
    Renal Failure.2026;[Epub]     CrossRef
  • Nationwide trends and incidence of blindness in patients with diabetic retinopathy identified using an age-period-cohort analysis
    Ju-Yeun Lee, Kunho Bae, Sangjun Lee, Sue K. Park
    Eye.2025; 39(1): 118.     CrossRef
  • Global, regional, and national burden of chronic kidney disease and its underlying etiologies from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021
    Ling Deng, Shujin Guo, Yuping Liu, Yaojia Zhou, Youren Liu, Xiaoxia Zheng, Xijie Yu, Ping Shuai
    BMC Public Health.2025;[Epub]     CrossRef
  • Application progress of bio-manufacturing technology in kidney organoids
    Runqi Mao, Junming Zhang, Haoxiang Qin, Yuanyuan Liu, Yuxin Xing, Wen Zeng
    Biofabrication.2025; 17(2): 022007.     CrossRef
  • Burdens of idiopathic developmental intellectual disability attributable to lead exposure from 1990 to 2021 and projection to 2035 in China: findings from the 2021 global burden of disease study
    Chaoqun Song, Feidan Deng, Lichun Qiao, Minghao Lin, Hui Zhang, Miaoqian Li, Changwei Zhao
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Investigating the impact of interdisciplinary training programs on self-efficacy and life satisfaction among Hemodialysis patients: a randomized controlled clinical trial
    Mohadese Bahmani, Mostafa Bijani, Zhila Fereidouni, Azizallah Dehghan, Amene Modreki
    BMC Nephrology.2025;[Epub]     CrossRef
  • Trajectory Patterns of Metabolic Syndrome Severity Score and Risk of Chronic Kidney Diseases
    Ladan Mehran, Atefeh Amouzegar, Safdar Masoumi, Maryam Adib, Fereidoun Azizi, Atieh Amouzegar
    Kidney Diseases.2025; 11(1): 530.     CrossRef
  • Enhancement of Chronic Kidney Disease Health Literacy in Young Generation: Community Service in Islamic Boarding School
    Astri Dewayani, Rimbun Rimbun, Langgeng Agung Waskito, Dewi Ratna Sari, Viskasari Pintoko Kalanjati, Lucky Prasetiowati, Tania Ardiani Saleh, Fernanda Toriq Ainur, Abdillah Juang Airlangga, Fathiy Zakaria Aslama, Aafi Baharuddin Attamimi, Dinda Rachma
    Wikrama Parahita : Jurnal Pengabdian Masyarakat.2025; 9(2): 181.     CrossRef
  • Supporting Caregivers of Hemodialysis Patients: Applying the 5-A Self-management Model to Alleviate Caregiver Burden
    Zahra Zarmohammadi, Marzieh Khatooni, Mehdi Ranjbaran, Seyedeh Zahra Hosseinigolafshani
    Journal of Nursing and Midwifery Sciences.2024;[Epub]     CrossRef
  • Improving Drug- and Disease-related Knowledge of Patients with Chronic Kidney Disease: Randomized Controlled Trial from a Sri Lankan Outpatient Clinic
    Dilmi Wickramasinghe, Catherine Lynch, Judith Coombes, Shaluka Jayamanne, Shamila De Silva
    Asian Journal of Pharmaceutical Research and Health Care.2024; 16(2): 208.     CrossRef
  • Global forecasting of chronic kidney disease mortality rates and numbers with the generalized additive model
    Fatemeh Shahbazi, Amin Doosti-Irani, Alireza Soltanian, Jalal Poorolajal
    BMC Nephrology.2024;[Epub]     CrossRef
  • Exploring the Lived Experiences of Family Caregivers Who Provided End-of-Life Care to Hemodialysis Patients: A Phenomenological Study in Iran
    Sakineh Moghaddam Zeabadi, Ali Razaghpoor, Seyedehzahra Hosseinigolafshani
    Jundishapur Journal of Chronic Disease Care.2024;[Epub]     CrossRef
Methods
Equivalence model: A new graphical model for causal inference
Jalal Poorolajal
Epidemiol Health. 2020;42:e2020024.   Published online April 9, 2020
DOI: https://doi.org/10.4178/epih.e2020024
  • 23,542 View
  • 233 Download
  • 14 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Abstract
Although several causal models relevant to epidemiology have been proposed, a key question that has remained unanswered is why some people at high-risk for a particular disease do not develop the disease while some people at low-risk do develop it. The equivalence model, proposed herein, addresses this dilemma. The equivalence model provides a graphical description of the overall effect of risk and protective factors at the individual level. Risk factors facilitate the occurrence of the outcome (the development of disease), whereas protective factors inhibit that occurrence. The equivalence model explains how the overall effect relates to the occurrence of the outcome. When a balance exists between risk and protective factors, neither can overcome the other; therefore, the outcome will not occur. Similarly, the outcome will not occur when the units of the risk factor(s) are less than or equal to the units of the protective factor(s). In contrast, the outcome will occur when the units of the risk factor(s) are greater than the units of the protective factor(s). This model can be used to describe, in simple terms, causal inferences in complex situations with multiple known and unknown risk and protective factors. It can also justify how people with a low level of exposure to one or more risk factor(s) may be affected by a certain disease while others with a higher level of exposure to the same risk factor(s) may remain unaffected.
Summary

Citations

Citations to this article as recorded by  
  • Association between birth weight and risk of nonneurological childhood cancers: a systematic review and meta-analysis
    Roya Rashti, Faezeh Ghasemi, Jalal Poorolajal
    European Journal of Cancer Prevention.2025; 34(1): 40.     CrossRef
  • Updated dose–response meta-analysis of sexual activity and prostate cancer risk
    Abouzar Raeisvandi, Sanaz Omidi, Massoumeh Javaheri, Hanieh Moradi, Jalal Poorolajal
    BMC Cancer.2025;[Epub]     CrossRef
  • The association between major gastrointestinal cancers and red and processed meat and fish consumption: A systematic review and meta-analysis of the observational studies
    Jalal Poorolajal, Younes Mohammadi, Marzieh Fattahi-Darghlou, Fatemeh Almasi-Moghadam, Atalel Fentahun Awedew
    PLOS ONE.2024; 19(6): e0305994.     CrossRef
  • The Role of Social Support in Preventing Suicidal Ideations and Behaviors: A Systematic Review and Meta-Analysis
    Nahid Darvishi, Jalal Poorolajal, Bita Azmi-Naei, Mehran Farhadi
    Journal of Research in Health Sciences.2024; 24(2): e00609.     CrossRef
  • A meta-analysis of the association between adolescent pregnancy and the risk of gynecological cancers
    Bita Azmi-Naei, Fatemeh Shahbazi, Nazanin Azmi-Naei, Jalal Poorolajal
    Epidemiology and Health.2024; 46: e2024094.     CrossRef
  • The role of problem-solving skills in the prevention of suicidal behaviors: A systematic review and meta-analysis
    Nahid Darvishi, Mehran Farhadi, Bita Azmi-Naei, Jalal Poorolajal, Humayun Kabir
    PLOS ONE.2023; 18(10): e0293620.     CrossRef
  • Risk of primary lung cancer after breast cancer radiotherapy: a systematic review and meta-analysis
    Bushra Zareie, Mohammad Aziz Rasouli, Jalal Poorolajal
    Breast Cancer.2022; 29(2): 361.     CrossRef
  • The effect of silica exposure on the risk of lung cancer: A dose-response meta-analysis
    Fatemeh Shahbazi, Mina Morsali, Jalal Poorolajal
    Cancer Epidemiology.2021; 75: 102024.     CrossRef
  • Factors for the Primary Prevention of Breast Cancer: A Meta-Analysis of Prospective Cohort Studies
    Jalal Poorolajal, Fatemeh Heidarimoghis, Manoochehr Karami, Zahra Cheraghi, Fatemeh Gohari-Ensaf, Fatemeh Shahbazi, Bushra Zareie, Pegah Ameri, Fatemeh Sahraei
    Journal of Research in Health Sciences.2021; 21(3): e00520.     CrossRef
  • The Epidemiology of Aggression and Associated Factors among Iranian Adult Population: A National Survey
    Jalal Poorolajal, Bahram Ebrahimi, Forouzan Rezapur-Shahkolai, Amin Doosti-Irani, Mahnaz Alizadeh, Jamal Ahmadpoor, Leila Moradi, Azam Biderafsh, Fateme Nikbakht, Zakie Golmohammadi, Ehsan Sarbazi, Samira Bahadivand, Marzieh Jahani Sayad Noveiri, Maryam R
    Journal of Research in Health Sciences.2020; 20(4): e00499.     CrossRef
Systematic Review
Risk factors for stomach cancer: a systematic review and meta-analysis
Jalal Poorolajal, Leila Moradi, Younes Mohammadi, Zahra Cheraghi, Fatemeh Gohari-Ensaf
Epidemiol Health. 2020;42:e2020004.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020004
  • 49,686 View
  • 1,230 Download
  • 202 Web of Science
  • 210 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.
METHODS
PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ<sup>2</sup>, τ<sup>2</sup>, and I<sup>2</sup> statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
RESULTS
Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: <i>Helicobacter pylori</i> infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.
CONCLUSIONS
This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.
Summary

Citations

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Original Articles
Life expectancy of HIV-positive patients after diagnosis in Iran from 1986 to 2016: A retrospective cohort study at national and sub-national levels
Mohammad Mirzaei, Maryam Farhadian, Jalal Poorolajal, Parvin Afasr Kazerooni, Katayoun Tayeri, Younes Mohammadi
Epidemiol Health. 2018;40:e2018053.   Published online November 7, 2018
DOI: https://doi.org/10.4178/epih.e2018053
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AbstractAbstract PDF
Abstract
OBJECTIVES
Little is known about the life expectancy of individuals with human immunodeficiency virus (HIV) in Iran. This study therefore aimed to estimate the life expectancy of HIV-positive patients in Iran.
METHODS
In this retrospective cohort study, we extracted data from the Center for Disease Control and Prevention of the Ministry of Health and Medical Education and the Death Registration System. We included patients aged 20 years and older who had a specified date of diagnosis. We estimated life expectancy and its 95% confidence intervals (CIs) using Chiang’s methodology.
RESULTS
The overall life expectancy at the national level was 23.1 years (95% CI, 22.6 to 23.5). Life expectancy was 21.6 years (95% CI, 21.1 to 22.0) for men and 32.7 years (95% CI, 31.4 to 34.0) for women. The life expectancy of patients who did or did not receive antiretroviral therapy (ART) was 37.0 years (95% CI, 36.2 to 37.8) and 15.5 years (95% CI, 15.1 to 15.9), respectively. The life expectancy of patients with or without tuberculosis (TB) was 21.6 years (95% CI, 20.4 to 22.9) and 36.5 years (95% CI, 35.7 to 37.4), respectively.
CONCLUSIONS
The life expectancy of Iranian HIV-positive patients was found to be very low. To improve their longevity, improvements in ART coverage and the control and treatment of TB are advised.
Summary

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Spatial inequalities and predictors of HIV/AIDS mortality risk in Hamadan, Iran: a retrospective cohort study
Somayeh Momenyan, Amir Kavousi, Jalal Poorolajal, Narges Momenyan
Epidemiol Health. 2018;40:e2018038.   Published online August 5, 2018
DOI: https://doi.org/10.4178/epih.e2018038
  • 21,072 View
  • 217 Download
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AbstractAbstract PDF
Abstract
OBJECTIVES
Understanding the geographic variation of HIV/AIDS mortality risk and human immunodeficiency virus (HIV) infection could help identify high-burden areas. The aim of our study was to evaluate the effects of predictors of the time interval between HIV diagnosis to death, while accounting for spatial correlations across counties, and to assess patterns of spatial inequalities in the risk of HIV/AIDS mortality in Hamadan Province, Iran.
METHODS
This retrospective study was conducted on 585 patients. The outcome in this study was the time period between the date of HIV/AIDS diagnosis and the date of death. A Weibull regression model with spatial random effects was used.
RESULTS
According to multivariate analysis, there were significant associations between age, tuberculosis co-infection, and marital status and the risk of death. In terms of spatial inequalities, a cluster of counties was identified with a somewhat higher death hazard in the north, northwest, northeast, and central regions. Additionally, a cluster with a somewhat lower hazard was identified in the south, southwest, southeast, and west regions.
CONCLUSIONS
The spatial pattern of HIV/AIDS death risk could reflect inequalities in access to antiretroviral therapy and public health services. Our results underscore the importance of attention to vulnerable groups in urban areas.
Summary

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Using the capture-recapture method to estimate the human immunodeficiency virus-positive population
Jalal Poorolajal, Younes Mohammadi, Farzad Farzinara
Epidemiol Health. 2017;39:e2017042.   Published online October 10, 2017
DOI: https://doi.org/10.4178/epih.e2017042
  • 24,467 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The capture-recapture method was applied to estimate the number of human immunodeficiency virus (HIV)-positive individuals not registered with any data sources.
METHODS
This cross-sectional study was conducted in Lorestan Province, in the west of Iran, in 2016. Three incomplete sources of HIV-positive individuals, with partially overlapping data, were used, including: (a) transfusion center, (b) volunteer counseling and testing centers (VCTCs), and (c) prison. The 3-source capture-recapture method, using a log-linear model, was applied for data analysis. The Akaike information criterion and the Bayesian information criterion were used for model selection.
RESULTS
Of the 2,456 HIV-positive patients registered in these 3 data sources, 1,175 (47.8%) were identified in transfusion center, 867 (35.3%) in VCTCs, and 414 (16.8%) in prison. After the exclusion of duplicate entries, 2,281 HIV-positive patients remained. Based on the capture-recapture method, 14,868 (95% confidence interval, 9,923 to 23,427) HIV-positive individuals were not identified in any of the registries. Therefore, the real number of HIV-positive individuals was estimated to be 17,149, and the overall completeness of the 3 registries was estimated to be around 13.3%.
CONCLUSIONS
Based on capture-recapture estimates, a huge number of HIV-positive individuals are not registered with any of the provincial data sources. This is an urgent message for policymakers who plan and provide health care services for HIV-positive patients. Although the capture-recapture method is a useful statistical approach for estimating unknown populations, due to the assumptions and limitations of the method, the population size may be overestimated as it seems possible in our results.
Summary

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Predictors of miscarriage: a matched case-control study
Jalal Poorolajal, Parvin Cheraghi, Zahra Cheraghi, Masoomeh Ghahramani, Amin Doosti Irani
Epidemiol Health. 2014;36:e2014031.   Published online November 20, 2014
DOI: https://doi.org/10.4178/epih/e2014031
  • 31,711 View
  • 220 Download
  • 16 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The risk factors for miscarriage vary across communities and countries. This study was conducted to investigate the predictors of miscarriage in the west of Iran.
METHODS
This matched case-control study was conducted in Hamadan Province from April 2013 to March 2014. Cases were selected from women who had a recent spontaneous abortion and controls were selected from women who had a recent live birth. Two controls were selected for every case and matched for date of pregnancy and area of residence. Multivariate conditional logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
RESULTS
Five hundred fifty cases were compared with 1,091 controls. The OR of miscarriage was 1.58 (95% CI=1.30-1.92) for every five-year increase in age, 0.20 (95% CI=0.14-0.28) for every live birth, and 3.43 (95% CI=2.03-5.79) for a history of previous spontaneous abortion. Compared to nulliparous women, primiparous or multiparous women had an OR of 17.85 (95% CI=6.65-47.91) for miscarriage. There was a strong association between miscarriage and abnormal amniotic status (OR, 2.46; 95% CI, 0.46-13.09) and also abnormal placenta status (OR, 10.44; 95% CI, 0.95-114.92); however, these associations were not statistically significant. No significant associations were observed between miscarriage and body mass index, previous history of stillbirth, low birth weight, congenital anomaly, ectopic pregnancy, impaired thyroid function, or high blood pressure.
CONCLUSIONS
Our study suggests that miscarriage is a multifactorial outcome associated with several modifiable and non-modifiable risk factors that may vary among different communities.
Summary

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Risk factors for maternal mortality in the west of Iran: a nested case-control study
Jalal Poorolajal, Behnaz Alafchi, Roya Najafi Vosoogh, Sahar Hamzeh, Masoomeh Ghahramani
Epidemiol Health. 2014;36:e2014028.   Published online November 8, 2014
DOI: https://doi.org/10.4178/epih/e2014028
  • 28,021 View
  • 157 Download
  • 7 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
With a gradual decline in maternal mortality in recent years in Iran, this study was conducted to identify the remaining risk factors for maternal death.
METHODS
This 8-year nested case-control study was conducted in Hamadan Province, in the west of Iran, from April 2006 to March 2014. It included 185 women (37 cases and 148 controls). All maternal deaths that occurred during the study period were considered cases. For every case, four women with a live birth were selected as controls from the same area and date. Conditional logistic regression analysis was performed and the odds ratio (OR) and its 95% confidence interval (CI) were obtained for each risk factor.
RESULTS
The majority of cases were aged 20-34 years, died in hospital, and lived in urban areas. The most common causes of death were bleeding, systemic disease, infection, and pre-eclampsia. The OR estimate of maternal death was 8.48 (95% CI=1.26-56.99) for advanced maternal age (≥35 years); 2.10 (95% CI=0.07-65.43) for underweight and 10.99 (95% CI=1.65-73.22) for overweight or obese women compared to those with normal weight; 1.56 (95% CI=1.08-2.25) for every unit increase in gravidity compared to those with one gravidity; 1.73 (95% CI=0.34-8.88) for preterm labors compared to term labors; and 17.54 (95% CI= 2.71-113.42) for women with systemic diseases.
CONCLUSIONS
According to our results, advanced maternal age, abnormal body mass index, multiple gravidity, preterm labor, and systemic disease were the main risk factors for maternal death. However, more evidence based on large cohort studies in different settings is required to confirm our results.
Summary

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Predictors of tuberculosis and human immunodeficiency virus co-infection: a case-control study
Leila Molaeipoor, Jalal Poorolajal, Minoo Mohraz, Nader Esmailnasab
Epidemiol Health. 2014;36:e2014024.   Published online October 30, 2014
DOI: https://doi.org/10.4178/epih/e2014024
  • 28,964 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis co-infection is a major global challenge. It is not clear why some HIV-positive people are co-infected with tuberculosis (TB) while others are not. This study addressed that question.
METHODS
This case-control study was conducted in Tehran, Iran in June 2004, enrolling 2,388 HIV-positive people. Cases were selected from those who were co-infected with TB and controls from those without TB. Multiple logistic regression analysis was performed to assess the association between M. tuberculosis/HIV co-infection and several predictors. Odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated.
RESULTS
In this study, 241 cases were compared with 2,147 controls. Sex, age, marital status, educational level, imprisonment, smoking, narcotic use, route of HIV transmission, previous TB infection, isoniazid preventive therapy (IPT), antiretroviral therapy (ART), and low CD4 count (<350 cells/mm3) were independently associated with M. tuberculosis/HIV co-infection (p<0.001). However, after adjusting for all other variables in the model, only the association between M. tuberculosis/HIV co-infection and the following predictors remained statistically significant: imprisonment (odds ratio [OR], 3.82; 95% confidence interval [CI], 2.11-6.90), previous TB infection (OR, 5.54; 95% CI, 1.99-15.39), IPT (OR, 0.13; 95% CI, 0.06-0.31), ART (OR, 1.81; 95% CI, 1.26-2.61), and CD4 count <350 cells/mm3 (OR, 2.34; 95% CI, 1.36-4.02).
CONCLUSIONS
Several predictors are associated with M. tuberculosis/HIV co-infection, but only a few indicators were significantly associated with M. tuberculosis/HIV co-infection. It is estimated that a number of predictors of M. tuberculosis/HIV co-infection remain unknown and require further investigation.
Summary

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    Egyptian Journal of Chest Diseases and Tuberculosis.2016; 65(4): 825.     CrossRef
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    J. Poorolajal, E. Hooshmand, H. Mahjub, N. Esmailnasab, E. Jenabi
    Public Health.2016; 139: 3.     CrossRef
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    Salman Khazaei, Leila Molaeipoor, Shahab Rezaeian, Erfan Ayubi, Mehran Yari, Ali Asghar Valipour, Somayeh Khazaei
    Shiraz E-Medical Journal.2016;[Epub]     CrossRef
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    Chantal L Edge, Emma J King, Kate Dolan, Martin McKee
    Journal of the International AIDS Society.2016;[Epub]     CrossRef
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    Venkataramana Kandi
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Estimation of the Frequency of Intravenous Drug Users in Hamadan City, Iran, Using the Capture-recapture Method
Salman Khazaei, Jalal Poorolajal, Hossein Mahjub, Nader Esmailnasab, Mohammad Mirzaei
Epidemiol Health. 2012;34:e2012006.   Published online October 31, 2012
DOI: https://doi.org/10.4178/epih/e2012006
  • 25,486 View
  • 105 Download
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Abstract
<sec><title>OBJECTIVES</title><p>The number of illicit drug users is prone to underestimation. This study aimed to use the capture-recapture method as a statistical procedure for measuring the prevalence of intravenous drug users (IDUs) by estimating the number of unknown IDUs not registered by any of the registry centers.</p></sec><sec><title>METHODS</title><p>This study was conducted in Hamadan City, the west of Iran, in 2012. Three incomplete data sources of IDUs, with partial overlapping data, were assessed including: (a) Volunteer Counseling and Testing Centers (VCTCs); (b) Drop in Centers (DICs); and (c) Outreach Teams (ORTs). A log-linear model was applied for the analysis of three-sample capture-recapture results. Two information criteria were used for model selection including Akaike's Information Criterion and the Bayesian Information Criterion.</p></sec><sec><title>RESULTS</title><p>Out of 1,478 IDUs registered by three centers, 48% were identified by VCTCs, 32% by DICs, and 20% by ORTs. After exclusion of duplicates, 1,369 IDUs remained. According to our findings, there were 9,964 (95% CI, 6,088 to 17,636) IDUs not identified by any of the centers. Hence, the real number of IDUs is expected to be 11,333. Based on these findings, the overall completeness of the three data sources was around 12% (95% CI, 7% to 18%).</p></sec><sec><title>CONCLUSION</title><p>There was a considerable number of IDUs not identified by any of the centers. Although the capture-recapture method is a useful and practical approach for estimating unknown populations, due to the assumptions and limitations of the method, the results must be interpreted with caution.</p></sec>
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  • The prevalence of opioid use disorder in Kentucky’s counties: A two-year multi-sample capture-recapture analysis
    Katherine Thompson, Joshua A. Barocas, Chris Delcher, Jungjun Bae, Lindsey Hammerslag, Jianing Wang, Redonna Chandler, Jennifer Villani, Sharon Walsh, Jeffery Talbert
    Drug and Alcohol Dependence.2023; 242: 109710.     CrossRef
  • Estimating the Population Size of Female Sex Worker Population in Tehran, Iran: Application of Direct Capture–Recapture Method
    Manoochehr Karami, Salman Khazaei, Jalal Poorolajal, Alireza Soltanian, Mansour Sajadipoor
    AIDS and Behavior.2017; 21(8): 2394.     CrossRef
  • Using the capture-recapture method to estimate the human immunodeficiency virus-positive population
    Jalal Poorolajal, Younes Mohammadi, Farzad Farzinara
    Epidemiology and Health.2017; 39: e2017042.     CrossRef
  • Estimation of perinatal mortality rate for institutional births in Rajasthan state, India, using capture–recapture technique
    Prem K Mony, Beena Varghese, Tinku Thomas
    BMJ Open.2015; 5(3): e005966.     CrossRef
  • Estimating the size of the population of persons who inject drugs in the island of Montréal, Canada, using a six-source capture–recapture model
    Pascale Leclerc, Alain C. Vandal, Aïssatou Fall, Julie Bruneau, Élise Roy, Suzanne Brissette, Chris Archibald, Nelson Arruda, Carole Morissette
    Drug and Alcohol Dependence.2014; 142: 174.     CrossRef
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The Burden of Premature Mortality in Hamadan Province in 2006 and 2010 Using Standard Expected Years of Potential Life Lost: A Population-based Study
Jalal Poorolajal, Nader Esmailnasab, Jamal Ahmadzadeh, Tahereh Azizi Motlagh
Epidemiol Health. 2012;34:e2012005.   Published online August 31, 2012
DOI: https://doi.org/10.4178/epih/e2012005
  • 27,098 View
  • 126 Download
  • 14 Crossref
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Abstract
<sec><title>OBJECTIVES</title><p>Examining the premature death rate represents the first step in estimating the overall burden of disease, reflecting a full picture of how different causes affect population health and providing a way of monitoring and evaluating population health. The present study was conducted to assess the burden of premature mortality in Hamadan Province, Iran in 2006 and 2010.</p></sec><sec><title>METHODS</title><p>To calculate years of potential life lost (YPLL), the dataset was categorized into 5-year age groups based on each person's age at death. Then the age groups were subtracted from the relevant age-based life table produced by the World Health Organization in 2009. The YPLL for each individual were then added together to yield the total YPLL for all individuals in the population who died in a particular year. Finally, we calculated the YPLL for all sex-, age-, and cause-specific mortality rates and reported them as percentages.</p></sec><sec><title>RESULTS</title><p>We analyzed 18,786 deaths, 9,127 of which occurred in 2006 and 9,659 in 2010. Mortality rates were higher in men than women for all age groups both in 2006 and 2010. In addition, age-specific mortality rates in both genders for all age groups were higher in 2010 than in 2006. The percentage of YPLL from ischemic heart diseases, cerebrovascular diseases, transport accidents, and intentional self-harm were among the greatest sources of premature death.</p></sec><sec><title>CONCLUSION</title><p>The results of the present survey indicate that the eight major causes of premature death in both 2006 and 2010 were non-communicable diseases, especially ischemic heart diseases, cerebrovascular diseases, transport accidents, and intentional self-harm. Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years.</p></sec>
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  • Alcohol consumption associated with suicidal ideation, and suicide attempts in substance users: A cross-sectional study of an addiction registry in western Iran
    Vahid Farnia, Mahsa Mohebian, Omran Davarinejad, Denise A. Hien, Safora Salemi, Sara Hookari, Hafez Bajoghli, Bahareh Rahami, Anthony A. Olashore
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    Wendy N. Nembhard, Suman Maity, Emine Bircan, Maria D. Politis, Elijah H. Bolin, Jun Ying
    Journal of the American Heart Association.2025;[Epub]     CrossRef
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    Journal of Substance Use.2024; 29(1): 10.     CrossRef
  • The Role of Social Support in Preventing Suicidal Ideations and Behaviors: A Systematic Review and Meta-Analysis
    Nahid Darvishi, Jalal Poorolajal, Bita Azmi-Naei, Mehran Farhadi
    Journal of Research in Health Sciences.2024; 24(2): e00609.     CrossRef
  • Anticipating influential factors on suicide outcomes through machine learning techniques: Insights from a suicide registration program in western Iran
    Nasrin Matinnia, Behnaz Alafchi, Arya Haddadi, Ali Ghaleiha, Hasan Davari, Manochehr Karami, Zahra Taslimi, Mohammad Reza Afkhami, Saeid Yazdi-Ravandi
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    Habibollah Azarbakhsh, Mohammad Hossein Sharifi, Jafar Hassanzadeh, Rebecca Susan Dewey, Maryam Janfada, Alireza Mirahmadizadeh
    International Journal of Diabetes in Developing Countries.2023; 43(4): 574.     CrossRef
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    Jalal Poorolajal, Tahereh Haghtalab, Mehran Farhadi, Nahid Darvishi
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    Jalal Poorolajal, Nahid Darvishi, Osama Ali Abulseoud
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  • Alcohol-Related Risk of Suicidal Ideation, Suicide Attempt, and Completed Suicide: A Meta-Analysis
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Evaluation of Acute Flaccid Paralysis in Hamadan, Iran from 2002 to 2009
Jalal Poorolajal, Shadi Ghasemi, Leila Nezamabadi Farahani, Atefeh Sadat Hosseini, Seyyed Jalal Bathaei, Ali Zahiri
Epidemiol Health. 2011;33:e2011011.   Published online November 16, 2011
DOI: https://doi.org/10.4178/epih/e2011011
  • 25,494 View
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran.</p></sec><sec><title>METHODS</title><p>A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis.</p></sec><sec><title>RESULTS</title><p>During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ≤5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected.</p></sec><sec><title>CONCLUSION</title><p>The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.</p></sec>
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    Sarah E. Alland, Philip N. Britton, Bruce Thorley, Linda Hobday, Matthew Kelly, Ololade Fasugba, Margaret Wilson, Anne Morris, David N. Durrheim
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    Bassey Enya Bassey, Vaz Gama Rui, Alex Ntale Gasasira, Mkanda Pascal, Goitom Weldegbriel, Ticha Johnson Mulum, Sylvester T. Maleghemi, Emem Abasi Bassey
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Brief Communication
Quality of Cohort Studies Reporting Post the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement
Jalal Poorolajal, Zahra Cheraghi, Amin Doosti Irani, Shahab Rezaeian
Epidemiol Health. 2011;33:e2011005.   Published online June 7, 2011
DOI: https://doi.org/10.4178/epih/e2011005
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Abstract
<p>The quality of reporting of cohort studies published in the most prestigious scientific medical journals was investigated to indicate to what extent the items in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist are addressed. Six top scientific medical journals with high impact factor were selected including New England Journal of Medicine, Journal of the American Medical Association, Lancet, British Medical Journal, Archive of Internal Medicine, and Canadian Medical Association Journal. Ten cohort studies published in 2010 were selected randomly from each journal. The percentage of items in the STROBE checklist that were addressed in each study was investigated. The total percentage of items addressed by these studies was 69.3 (95% confidence interval: 59.6 to 79.0). We concluded that reporting of <italic>cohort</italic> studies published in the most prestigious scientific medical journals is not clear enough yet. The reporting of other types of observational studies such as case-control and cross-sectional studies particularly those being published in less prestigious journals expected to be much more imprecise.</p>
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