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Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
Epidemiol Health. 2023;45:e2023083.   Published online September 3, 2023
DOI: https://doi.org/10.4178/epih.e2023083
  • 15,075 View
  • 135 Download
  • 2 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The worldwide incidence of metabolic syndrome (MetS) has increased in recent decades. In this study, we investigated the socioeconomic inequalities associated with MetS and its components in a sample of the Iranian Kurdish population.
METHODS
We used data from 3,996 participants, aged 35 years to 70 years, from the baseline phase of the Dehgolan Prospective Cohort Study (February 2018 to March 2019). The concentration index and concentration curve were used to measure inequality and the Blinder-Oaxaca decomposition method was used to examine the contribution of various determinants to the observed socioeconomic inequality in MetS and its components.
RESULTS
The prevalence of MetS was 34.44% (95% confidence interval [CI], 32.97 to 35.93). The prevalence of MetS was 26.18% for those in the highest socioeconomic status (SES), compared with 40.51% for participants in the lowest SES. There was a significant negative concentration index for MetS (C=-0.13; 95% CI, -0.16 to -0.09), indicating a concentration of MetS among participants with a lower SES. The most prevalent component was abdominal obesity (59.14%) with a significant negative concentration index (C=-0.21; 95% CI, -0.25 to -0.18). According to decomposition analysis, age, gender, and education were the highest contributing factors to inequality in MetS and its components.
CONCLUSIONS
This study showed socioeconomic inequality in MetS. People with a low SES were more likely to have MetS. Therefore, policymakers and health managers need to develop appropriate strategies to reduce these inequalities in MetS across age groups, genders, and education levels, especially among women and the elderly.
Summary
Key Message
This study sheds light on the presence of socioeconomic inequalities in metabolic syndrome (MetS) among Iranian Kurds. Lower socioeconomic status (SES) is associated with a higher prevalence of MetS and its components. Addressing these socioeconomic factors is crucial to reduce health inequalities. Recognizing this association helps us understand the social determinants of health and design targeted interventions. Policymakers and health managers should prioritize developing strategies to reduce these inequalities in MetS across different age groups, genders, and educational levels, with a particular focus on vulnerable populations like women and the elderly.

Citations

Citations to this article as recorded by  
  • The Prevalence of Metabolic Syndrome and Hypertriglyceridemic Waist Based on Sociodemographic Variables and Healthy Habits in Healthcare Workers: A Retrospective Study
    Pedro Javier Tárraga Marcos, Ángel Arturo López-González, Emilio Martínez-Almoyna Rifá, Hernán Paublini Oliveira, Cristina Martorell Sánchez, Pedro Juan Tárraga López, José Ignacio Ramírez-Manent
    Life.2025; 15(1): 81.     CrossRef
  • The prevalence of metabolic syndrome and its economic inequality in an elderly population
    Farid Fotouhi, Hassan Hashemi, Abbasali Yekta, Mahtab Niroomand, Mehrdad Esmaeili, Reza Norouzirad, Nasim Vaghefi, Mehdi Khabazkhoob
    Scientific Reports.2025;[Epub]     CrossRef
  • Association between metabolic syndrome and hematological alterations: a review of the literature
    Cristian C. MARTÍNEZ, Daniel ROJAS GONZÁLEZ, Daniel A. NIEVA-POSSO, Marcela QUINTERO SANTACRUZ
    La Rivista Italiana della Medicina di Laboratorio.2024;[Epub]     CrossRef
The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
Reza Ebrahimoghli, Hassan Ghobadi, Davoud Adham, Parviz Jangi, Abbas Abbasi-Ghahramanloo, Eslam Moradi-Asl
Epidemiol Health. 2022;44:e2022060.   Published online July 18, 2022
DOI: https://doi.org/10.4178/epih.e2022060
  • 17,066 View
  • 307 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016.
METHODS
This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model.
RESULTS
A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period.
CONCLUSIONS
The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.
Summary
Key Message
A longitudinal analysis of tuberculosis surveillance data from northwest Iran showed that during the 12-year period from 2005 to 2016, a total of 1,367 tuberculosis cases were registered, of whom 942 patients had a prolonged diagnostic delay (>30 days) and the probability of a delay in tuberculosis diagnosis decreased by 5.0% each year.

Citations

Citations to this article as recorded by  
  • Factors associated with survival of tuberculosis patients in Southeast Iran: comparison of stepwise cox regression, survival tree, and random survival forest
    Mehdi Sharafi, Sakineh Narouee, Feizorrahman Rasoulizadeh, Maryam TalebiMoghaddam, Jamileh Dadgar, Mohsen Khaleghi, Abdoljabbar Zakeri, Najibullah Baeradeh
    BMC Public Health.2025;[Epub]     CrossRef
  • Assessing heterogeneity of patient and health system delay among TB in a population with internal migrants in China
    Ruoyao Sun, Zheyuan Wu, Hongyin Zhang, Jinrong Huang, Yueting Liu, Meiru Chen, Yixiao Lv, Fei Zhao, Yangyi Zhang, Minjuan Li, Jiaqi Yan, Hongbing Jiang, Yiqiang Zhan, Jimin Xu, Yanzi Xu, Jianhui Yuan, Yang Zhao, Xin Shen, Chongguang Yang
    Frontiers in Public Health.2024;[Epub]     CrossRef
Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran
Alireza Mirahmadizadeh, Mohammad Taghi Badeleh Shamooshaki, Amineh Dadvar, Mohammad Javad Moradian, Mohammad Aryaie
Epidemiol Health. 2022;44:e2022032.   Published online March 12, 2022
DOI: https://doi.org/10.4178/epih.e2022032
  • 17,738 View
  • 418 Download
  • 3 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population.
METHODS
Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants’ diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants’ death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value.
RESULTS
Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null.
CONCLUSIONS
Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people.
Summary
Key Message
This study adds new insights to the existing body of work on the topic of unemployment and COVID-19-related mortality. Unemployment prior to COVID-19 infection was found to increase the risk of COVID-19-related mortality, which disproportionately burdened unemployed female and younger unemployed people. It seems older unemployed people and unemployed males may tend to have more financial resources and savings when they lose a job, making younger unemployed people and unemployed female more vulnerable to financial stress, which can lead to deferred care and increase their risk of COVID-19-related mortality.

Citations

Citations to this article as recorded by  
  • How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis
    Nydile Ramesh, Beatrice Cockbain, Graham P. Taylor, Carolina Rosadas
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Modelling the spatial varying relationships between socioeconomic inequalities and COVID-19 mortality in the African subregion
    Yaw K. Awuah-Mensah, Eric N. Aidoo
    Earth Science Informatics.2024; 17(4): 2959.     CrossRef
  • The Anatomy of Unemployment: Determinants During and After the COVID-19 Crisis
    Matus Senci, Lucia Svabova, Tomas Kliestik
    Management Dynamics in the Knowledge Economy.2024; 12(1): 86.     CrossRef
  • Is there a relationship between internet access and COVID-19 mortality? Evidence from Nigeria based on a spatial analysis
    Richard Adeleke
    Dialogues in Health.2023; 2: 100102.     CrossRef
  • Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia
    Thresya Febrianti, Ngabila Salama, Inggariwati, Dwi Oktavia
    Journal of Preventive Medicine and Public Health.2023; 56(3): 231.     CrossRef
  • The gamma-Maxwell regression for COVID-19 mortality rates of the 50 U.S. largest cities
    N.S.S. da Costa, G.M. Cordeiro
    Model Assisted Statistics and Applications.2023; 18(3): 193.     CrossRef
Strongyloides stercoralis and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran: a closer look at risk factors
Leila Mirzaei, Keyhan Ashrafi, Zahra Atrkar Roushan, Mohammad Reza Mahmoudi, Irandokht Shenavar Masooleh, Behnaz Rahmati, Farshid Saadat, Hamed Mirjalali, Meysam Sharifdini
Epidemiol Health. 2021;43:e2021009.   Published online January 20, 2021
DOI: https://doi.org/10.4178/epih.e2021009
  • 23,339 View
  • 455 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The objective of this study was to evaluate the prevalence of <i>Strongyloides stercoralis</i> and other intestinal parasites in patients receiving immunosuppressive drugs in northern Iran and to investigate related risk factors.
METHODS
This cross-sectional study was conducted among 494 patients receiving immunosuppressive drugs, including cancer patients undergoing chemotherapy (n=188) and those treated with prolonged corticosteroid administration (n=306). All fresh fecal samples were examined using the direct wet-mount, formalin ethyl acetate concentration, and agar plate culture techniques.
RESULTS
In total, 16.8% of patients were positive for at least 1 intestinal parasite; the helminthic and protozoan infection rates were 5.1% and 12.3%, respectively. The infection rate was significantly higher in corticosteroid-treated individuals (19.6%) than cancer patients (12.2%) (p<0.05). The prevalence rate of <i>S. stercoralis</i> among patients receiving chemotherapy and those treated with corticosteroids were 4.3% and 5.2%, respectively. The prevalence rate of <i>S. stercoralis</i> infection was significantly higher in older patients (p<0.05).
CONCLUSIONS
Strongyloidiasis is one of the most common parasites among patients receiving immunosuppressive drugs in northern Iran. Early diagnosis and proper treatment of these patients are necessary to minimize the complications of severe strongyloidiasis.
Summary
Key Message
This study showed strongyloidiasis is one of the most common parasitic diseases among patients receiving immunosuppressive drugs in northern Iran and early diagnosis before chemotherapy or steroid therapy is necessary.

Citations

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  • Human Strongyloides stercoralis infection
    Ruibing Yang, Meiyining Xu, Lichao zhang, Yao Liao, Yuheng Liu, Xiaoyan Deng, Lifu Wang
    Journal of Microbiology, Immunology and Infection.2025; 58(2): 164.     CrossRef
  • Evaluation of strongyloidiasis prevalence in immunocompromised patients referred to hospitals: a case study of Iran’s capital
    Zahra Arab-Mazar, Tahereh Kanani, Mahdi Toulabi, Arian Karimi Rouzbahani, Shirzad Fallahi, Anahita Behzadi, Maysam Yousefi, Seyyed Javad seyyed tabaei
    BMC Infectious Diseases.2025;[Epub]     CrossRef
  • Nematocidal Activity of a Variety of Plants Used in Mexico Against Strongyloides venezuelensis
    Joel H. Elizondo-Luévano, Abelardo Chávez-Montes, Antonio Muro, Belén Vicente-Santiago, Miroslava Kačániová, David G. García-Hernández, Aldo F. Bazaldúa-Rodríguez, Horacio Larqué-García, Uziel Castillo-Velázquez, Julio López-Abán
    Parasitologia.2025; 5(2): 18.     CrossRef
  • Strongyloidiasis Treatment Outcomes: A Prospective Study Using Serological and Molecular Methods
    Ana Lucas Dato, Philip Wikman-Jorgensen, José María Saugar Cruz, Elisa García-Vázquez, Jara Llenas-García
    Tropical Medicine and Infectious Disease.2025; 10(4): 91.     CrossRef
  • In Vitro Anthelmintic Effect of Mexican Plant Extracts and Partitions Against Trichinella spiralis and Strongyloides venezuelensis
    Nancy E. Rodríguez-Garza, Ricardo Gomez-Flores, Ramiro Quintanilla-Licea, Joel H. Elizondo-Luévano, César I. Romo-Sáenz, Miguel Marín, Javier Sánchez-Montejo, Antonio Muro, Rafael Peláez, Julio López-Abán
    Plants.2024; 13(24): 3484.     CrossRef
  • Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study
    Taehwa Kim, Seungjin Lim
    The Korean Journal of Parasitology.2022; 60(3): 181.     CrossRef
  • The Coexistence of Blastocystis spp. in Humans, Animals and Environmental Sources from 2010–2021 in Asia
    Adedolapo Aminat Rauff-Adedotun, Farah Haziqah Meor Termizi, Nurshafarina Shaari, Ii Li Lee
    Biology.2021; 10(10): 990.     CrossRef
  • Comparison of Molecular and Parasitological Methods for Diagnosis of Human Trichostrongylosis
    Mehdi Pandi, Meysam Sharifdini, Keyhan Ashrafi, Zahra Atrkar Roushan, Behnaz Rahmati, Nayereh Hajipour
    Frontiers in Cellular and Infection Microbiology.2021;[Epub]     CrossRef
Copro-molecular diagnosis of the Toxoplasmatinae subfamily in dog and cat populations in northern Iran
Leila Izadi, Shahabeddin Sarvi, Seyed Abdollah Hosseini, Afsaneh Amouei, Mehdi Sharif, Mohammad Taghi Rahimi, Tooran Nayeri, Ahmad Daryani
Epidemiol Health. 2020;42:e2020074.   Published online December 4, 2020
DOI: https://doi.org/10.4178/epih.e2020074
  • 25,376 View
  • 144 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The oocysts of the Toxoplasmatinae subfamily (<i>Neospora caninum, Hammondia hammondi</i> and <i>H. heydorni</i>, and <i>Besnoitia besnoiti</i>) are morphologically similar to <i>Toxoplasma gondii</i>, and indistinguishable from each other. This study investigated the prevalence of the Toxoplasmatinae subfamily in dog and cat fecal samples using a nested polymerase chain reaction method.
METHODS
Overall, 200 fecal samples from domestic dogs (n=120) and cats (n=80) were collected from 15 farms in northern Iran. The samples were homogenized in 2.5% potassium dichromate solution and subsequently concentrated with sucrose solution. DNA was extracted from samples using a genomic DNA kit. Specific primers and the 18S rDNA gene were used to screen and detect all Toxoplasmatinae oocysts.
RESULTS
Overall, 2.5% (3 of 120) and 22.5% (18 of 80) of the fecal samples collected from dogs and cats were infected with Toxoplasmatinae. In dogs, 2 samples were positive for <i>N. caninum</i> and 1 sample was positive for <i>T. gondii</i>. In cats, all 18 positive samples belonged to <i>T. gondii</i>. No contamination with <i>H. heydorni</i> was observed in dog fecal samples or <i>H. hammondi</i> and <i>B. besnoiti</i> in cat fecal samples. A phylogenetic analysis revealed that the <i>T. gondii</i> (cat) and <i>N. caninum</i> (dog) found had similarities with parasites reported from other regions of the world.
CONCLUSIONS
This is the first study to provide data on the epidemiology of Toxoplasmatinae oocysts in Iran. The findings suggest that public-health monitoring for the effective control of feces from cats and dogs and improved pet hygiene habits are needed.
Summary

Citations

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  • Prevalence of Toxoplasma gondii in Endangered Wild Felines (Felis silvestris and Lynx pardinus) in Spain
    Pablo Matas Méndez, Isabel Fuentes Corripio, Ana Montoya Matute, Begoña Bailo Barroso, Rebeca Grande Gómez, Ariadna Apruzzese Rubio, Francisco Ponce Gordo, Marta Mateo Barrientos
    Animals.2023; 13(15): 2488.     CrossRef
  • Endoparasites of European Wildcats (Felis silvestris) in Greece
    Anastasia Diakou, Despina Migli, Dimitris Dimzas, Simone Morelli, Angela Di Cesare, Dionisios Youlatos, Petros Lymberakis, Donato Traversa
    Pathogens.2021; 10(5): 594.     CrossRef
Epidemiologic Investigation
How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time
Meysam Olfatifar, Seyed Mehdi Hosseini, Payam Shokri, Soheila Khodakarim, Naghmeh Khadembashi, Sajjad Rahimi Pordanjani
Epidemiol Health. 2020;42:e2020058.   Published online August 10, 2020
DOI: https://doi.org/10.4178/epih.e2020058
  • 19,537 View
  • 191 Download
  • 7 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis.
METHODS
An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas.
RESULTS
The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables.
CONCLUSIONS
The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.
Summary

Citations

Citations to this article as recorded by  
  • Spatiotemporal epidemiology of brucellosis in Iran from 2009 to 2018: A mixed ecological study
    Sajjad Rahimi Pordanjani, Ghobad Moradi, Behrad Pourmohammadi, Elaheh Mazaheri, Farshid Farivar, Somayeh Derakhshan
    Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Asymmetric Effects of Weather‐Integrated Human Brucellosis Forecasting System Using a New Nonlinear Autoregressive Distributed Lag Model
    Yongbin Wang, Chenlu Xue, Bingjie Zhang, Yuchun Li, Chunjie Xu, Daniel Diaz
    Transboundary and Emerging Diseases.2024;[Epub]     CrossRef
  • Spatio-temporal Analysis of COVID-19: A Global Study
    Sajjad Rahimi Pordanjani, Maryam Mohammadian, Somayeh Derakhshan, Fatemeh Hadavandsiri, Seyed Saeed Hashemi Nazari, Mohammad Hossein Panahi
    Middle East Journal of Rehabilitation and Health Studies.2023;[Epub]     CrossRef
  • Factors Associated With Diagnostic Delays in Human Brucellosis in Tongliao City, Inner Mongolia Autonomous Region, China
    Jingbo Zhai, Ruihao Peng, Ying Wang, Yuying Lu, Huaimin Yi, Jinling Liu, Jiahai Lu, Zeliang Chen
    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Clinical Effect of Doxycycline Combined with Compound Sulfamethoxazole and Rifampicin in the Treatment of Brucellosis Spondylitis
    Xin-Ming Yang, Yong-Li Jia, Ying Zhang, Pei-Nan Zhang, Yao Yao, Yan-Lin Yin, Ye Tian
    Drug Design, Development and Therapy.2021; Volume 15: 4733.     CrossRef
Original Articles
Temporal trend and spatial distribution of acute lymphoblastic leukemia in Iranian children during 2006-2014: a mixed ecological study
Sajjad Rahimi Pordanjani, Amir Kavousi, Babak Mirbagheri, Abbas Shahsavani, Koorosh Etemad
Epidemiol Health. 2020;42:e2020057.   Published online July 29, 2020
DOI: https://doi.org/10.4178/epih.e2020057
  • 21,978 View
  • 216 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The present study investigated the spatiotemporal epidemiological status of acute lymphoblastic leukemia (ALL), the most common childhood cancer, in Iran.
METHODS
Using an exploratory mixed design, this ecological study examined 3,769 under-15 children with ALL recorded in the National Cancer Registry of Iran during 2006-2014. Data were analyzed using the Mann-Whitney U test, the Getis-Ord general G (GOGG) index, optimized hot spot analysis, and Pearson correlation coefficients (PCC) at a significance level of 0.05.
RESULTS
The average annual incidence of the disease was 2.25 per 100,000 under-15 children, and the cumulative incidence rate (CIR) was 21.31 per 100,000 under-15 children. Patients’ mean age was 5.90 years (standard deviation, 3.68), and the peak incidence was observed among 2-year to 5-year-olds. No significant difference was found in mean age between boys and girls (p=0.261). The incidence of ALL was more common during spring and summer than in other seasons. The GOGG index was 0.039 and significant (p<0.001). Hot spots were identified in south, central, and eastern Iran and cold spots in the north and west of Iran. The PCC between the CIR and latitude was negative (r=-0.507; p=0.003) but that between the CIR and longitude was positive (r=0.347; p=0.055).
CONCLUSIONS
The incidence of ALL in Iranian children was lower than that observed in developed countries, but showed an increasing trend. It can be argued that the incidence of ALL is due to synergistic interactions between environmental, infectious, geographical, and genetic risk factors.
Summary

Citations

Citations to this article as recorded by  
  • Spatiotemporal epidemiology of brucellosis in Iran from 2009 to 2018: A mixed ecological study
    Sajjad Rahimi Pordanjani, Ghobad Moradi, Behrad Pourmohammadi, Elaheh Mazaheri, Farshid Farivar, Somayeh Derakhshan
    Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Epidemiology of the Incidence, Prevalence, and Mortality of Thalassemia in Iran: A Secondary Analysis of Global Burden of Disease 2019
    Kazhaal Sheikhi, Saba Nouri Vahed, Sajjad Rahimi Pordanjani, Victoria Momenabadi, Zaher khazaei, Mehrshad Azizi, Elham Goodarzi
    Health Science Reports.2025;[Epub]     CrossRef
  • Epidemiology of childhood acute leukemias in marginalized populations of the central-south region of Mexico: results from a population-based registry
    Janet Flores-Lujano, Aldo Allende-López, David Aldebarán Duarte-Rodríguez, Erika Alarcón-Ruiz, Lizbeth López-Carrillo, Teresa Shamah-Levy, Mariano E. Cebrián, Ma. del Rocío Baños-Lara, Diana Casique-Aguirre, Jesús Elizarrarás-Rivas, Javier Antonio López-A
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Disability-adjusted Life Years of Hepatitis B in Iran during 2009–2019: An Analysis Based on the Global Burden of Disease Study 2019
    Zaher Khazaei, Sayyad Khanizadeh, Moslem Taheri Soodejani, Sajjad Rahimi Pordanjani, Elham Goodarzi
    The Open Public Health Journal.2024;[Epub]     CrossRef
  • Trends in childhood leukemia incidence in urban countries and their relation to environmental factors, including space weather
    Olga Khabarova, Sergey K. Pinaev, Vladimir V. Chakov, Alexey Ya. Chizhov, Olga G. Pinaeva
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • The relationship between seasonality and the diagnosis of acute leukaemia in central South Africa
    Leriska Haupt, Wilhelm Burger, Nosipho Dimba, Salomina Joubert, Karina Kemp, Relebohile Makhalima, Jean Mudima, Kayla Swanepoel, Janco Viljoen, Anne-Cecilia Van Marle
    South African Journal of Oncology.2024;[Epub]     CrossRef
  • Spatio-temporal Analysis of COVID-19: A Global Study
    Sajjad Rahimi Pordanjani, Maryam Mohammadian, Somayeh Derakhshan, Fatemeh Hadavandsiri, Seyed Saeed Hashemi Nazari, Mohammad Hossein Panahi
    Middle East Journal of Rehabilitation and Health Studies.2023;[Epub]     CrossRef
  • Persistently high incidence rates of childhood acute leukemias from 2010 to 2017 in Mexico City: A population study from the MIGICCL
    Janet Flores-Lujano, David Aldebarán Duarte-Rodríguez, Elva Jiménez-Hernández, Jorge Alfonso Martín-Trejo, Aldo Allende-López, José Gabriel Peñaloza-González, María Luisa Pérez-Saldivar, Aurora Medina-Sanson, José Refugio Torres-Nava, Karina Anastacia Sol
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Epidemiological characteristics and temporal-spatial analysis of overseas imported dengue fever cases in outbreak provinces of China, 2005–2019
    Xinchang Lun, Yiguan Wang, Chunchun Zhao, Haixia Wu, Caiying Zhu, Delong Ma, Mingfang Xu, Jun Wang, Qiyong Liu, Lei Xu, Fengxia Meng
    Infectious Diseases of Poverty.2022;[Epub]     CrossRef
  • Temporal Trend and Spatial Distribution of Drug Poisoning in Semnan Province: A Retrospective Longitudinal Study
    Masoudeh Babakhanian, Khadijeh Mamashli, Faezeh Ansariniya, Somayeh Rezaie, Hamed Azadi, Masumeh Ghazanfarpour, Sajjad Rahimi Pordanjani
    Middle East Journal of Rehabilitation and Health Studies.2022;[Epub]     CrossRef
  • Crude incidence, age-specific incidence, and standardized incidence rates of leukemia in children under 14 years of age in Iran: an updated meta-analysis
    Ayda Hasanpour Dehkordi, Hasan Askarpour, Farshid Karami Pordanjani, Mohammad Rafiee, Sajjad Rahimi Pordanjani
    Przeglad Epidemiologiczny.2022; 75(4): 546.     CrossRef
Impact of simulated cigarette excise tax increase on its consumption in Iran
Behzad Raei, Sara Emamgholipour, Amirhossein Takian, Mehdi Yaseri, Ghahreman Abdoli
Epidemiol Health. 2020;42:e2020054.   Published online July 23, 2020
DOI: https://doi.org/10.4178/epih.e2020054
  • 20,632 View
  • 191 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To assess the impact of a simulated tax-induced cigarette price increase on its consumption by different expenditure clusters in Iran.
METHODS
Employing consecutive cross sections for cigarette consumption, a two-part model was applied for different expenditure groups.
RESULTS
A 75% price increase in cigarettes noticeably— as is common in some countries with strong tobacco control policies—reduces current consumption in all five social classes, causing nearly 8% of current male smokers to quit or not to start.
CONCLUSIONS
Findings of the current study suggest that Iranian policy makers go through to implement tobacco taxation policies to control smoking prevalence, which in turn might lead to a reduction in national healthcare expenditures as well as enhance the global community’s capacity to meet Sustainable Development Goals.
Summary

Citations

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  • The effect of price on cigarette consumption, distribution, and sale in Tehran: a qualitative study
    Younes Panahi Golestan, Mohammad Ebrahimi Kalan, Ziyad Ben Taleb, Kenneth D. Ward, Mehdi Fazlzadeh, Raed Bahelah, Mohammad Reza Masjedi, Abdurrahman Charkazi, Nasir Dehghan, Shirin Shahbazi Sighaldeh
    BMC Public Health.2021;[Epub]     CrossRef
Changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Iran
Daryoush Pahlevan, Amir Shomali, Sara Pooryahya, Kamyar Mansori, Majid Mirmohammadkhani, Farhad Malek
Epidemiol Health. 2020;42:e2020041.   Published online June 6, 2020
DOI: https://doi.org/10.4178/epih.e2020041
  • 15,708 View
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  • 1 Web of Science
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016.
METHODS
This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient’s exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24.
RESULTS
The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (β=-0.40), body mass index (BMI) (β=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (β=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (β=-0.35; 95% CI, -0.70 to -0.01), BMI (β=0.80; 95% CI, 0.20 to 1.41) and type of mask (β=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (β=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF.
CONCLUSIONS
All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.
Summary
Factors associated with in-hospital death in patients with nosocomial infections: a registry-based study using community data in western Iran
Salman Khazaei, Erfan Ayubi, Ensiyeh Jenabi, Saeid Bashirian, Masud Shojaeian, Leili Tapak
Epidemiol Health. 2020;42:e2020037.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020037
  • 24,502 View
  • 283 Download
  • 2 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Objectives
Determining the predictors of in-hospital death related to nosocomial infections is an essential part of efforts made in the overall health system to improve the delivery of health care to patients. Therefore, this study investigated the predictors of in-hospital death related to nosocomial infections.
Methods
This registry-based, longitudinal study analyzed data on 8,895 hospital-acquired infections (HAIs) in Hamadan Province, Iran from March 2017 to December 2019. The medical records of all patients who had been admitted to the hospitals were extracted from the Iranian Nosocomial Infections Surveillance Software. The effects of the type and site of infection, as well as age group, on in-hospital death were estimated using univariate and multivariable Cox regression models.
Results
In total, 4,232 (47.8%) patients with HAIs were males, and their mean age was 48.25±26.22 years. In both sexes, most nosocomial infections involved Gram-negative bacteria and the most common site of infection was the urinary tract. Older patients had a higher risk of in-hospital death (adjusted hazard ratio [aHR], 2.26; 95% confidence interval [CI], 1.38 to 3.69 for males; aHR, 2.44; 95% CI, 1.29 to 4.62 for females). In both sexes, compared with urinary tract infections, an increased risk of in-hospital death was found for ventilator-associated events (VAEs) (by 95% for males and 93% for females) and bloodstream infections (BSIs) (by 67% for males and 82% for females).
Conclusion
We found that VAEs, BSIs, and fungal infections were independently and strongly associated with increased mortality.
Summary

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  • Predictors of In-ICU Mortality Among Older Patients with Healthcare-Associated Infection: A Cohort Study
    Fereshteh Rezaie, Farahnaz Mohammadi-Shahboulaghi, Reza Fadayevatan, Mohsen Shati, Gholamreza Ghaedamini Harouni
    Journal of Kermanshah University of Medical Sciences.2023;[Epub]     CrossRef
  • Barriers to hand hygiene compliance in intensive care units to prevent the spread of healthcare-associated infections
    Gurjeet Singh, Raksha Singh, Ranga Reddy Burri
    MGM Journal of Medical Sciences.2023; 10(4): 667.     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • Prevalence of Nosocomial Infections During the COVID-19 Pandemic: A Systematic Review and Meta-analysis
    Sima Rafiei, Zahra Nejatifar, Rana Soheylirad, Samira Raoofi, Fatemeh Pashazadeh Kan, Ahmad Ghashghaee
    Journal of Health Reports and Technology.2022;[Epub]     CrossRef
  • The Impact of COVID-19 Outbreak on Nosocomial Infection Rate: A Case of Iran
    Maryam Jabarpour, Mahlagha Dehghan, Giti Afsharipour, Elham Hajipour Abaee, Parvin Mangolian Shahrbabaki, Mehdi Ahmadinejad, Mahboobeh Maazallahi, Aseer Manilal
    Canadian Journal of Infectious Diseases and Medical Microbiology.2021; 2021: 1.     CrossRef
  • Survival rate in patients with ICU-acquired infections and its related factors in Iran’s hospitals
    MEDSKorosh Etemad, Yousef Khani, Seyed-Saeed Hashemi-Nazari, Neda Izadi, Babak Eshrati, Yadollah Mehrabi
    BMC Public Health.2021;[Epub]     CrossRef
Oral colonization by Candida species and associated factors in HIV-infected patients in Ahvaz, southwest Iran
Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
Epidemiol Health. 2020;42:e2020033.   Published online May 24, 2020
DOI: https://doi.org/10.4178/epih.e2020033
  • 24,393 View
  • 199 Download
  • 15 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Abstract
Objectives
Oropharyngeal candidiasis is one of the most common opportunistic fungal infections among human immunodeficiency virus (HIV)-infected individuals. The most common cause is <i>Candida albicans</i>, followed by non-<i>albicans Candida</i>. This study aimed to identify colonized <i>Candida</i> species in HIV-infected patients from Ahvaz, Iran. Additionally, the relationships between immunity-related factors, lifestyle, and colonization of <i>Candida</i> spp. were studied.
Methods
Oral swabs were taken from 201 HIV-positive patients referred for consultations at the Behavioral Modification Center. Oral <i>Candida</i> colonization was detected using culture-based and molecular assays. Data were assessed by descriptive statistics and analyzed to investigate the correlation between <i>Candida</i> colonization and various factors, including the CD4<sup>+</sup> cell count and viral load.
Results
It was found that 43.8% of patients were positive for <i>Candida</i>. The most common species was C. <i>albicans</i> (48.0%), followed by non-<i>albicans Candida</i> isolates, including <i>C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. guilliermondii, C. kefyr</i>, and <i>C. krusei.</i> Colonization of <i>Candida</i> spp. in patients was associated with a CD4 count ≤200 cells/mm<sup>3</sup> (odds ratio [OR], 4.62; p<0.05), history of shared injections (OR, 6.96; p<0.001), and sex (OR, 3.59; p<0.05).
Conclusions
The results of this study showed that C. <i>albicans</i> was the dominant pathogen. The risk factors for colonization of <i>Candida</i> spp. were a CD4 count ≤ 200/mm<sup>3</sup> , a history of shared injections, and sex. Other factors with potential relationships include viral load, age, and opportunistic infections, but further investigations are needed.
Summary

Citations

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  • Distribution of Candida Species Causing Oral Candidiasis in High-Risk Populations: A Systematic Review
    João Pedro Carvalho, Jéssica Rodrigues, Célia Fortuna Rodrigues, José Carlos Andrade, António Rajão
    Healthcare.2026; 14(2): 159.     CrossRef
  • Prevalence and Associated Risk Factors of Oropharyngeal Candidiasis among Sero-positive HIV Patients in Southwestern Nigeria
    Ismail Akinlade Lawal, Olubunmi Adetokunbo Osinupebi, Oyinlola O. Oduyebo
    Nigerian Journal of Medicine.2025; 34(3): 160.     CrossRef
  • Evaluation of Antifungal Activity Against Candida albicans Isolates From HIV-Positive Patients with Oral Candidiasis in a Major Referral Hospital, West Java, Indonesia
    - Yuliana, Irna Sufiawati, Intan Dewi, Yovita Hartantri
    HIV/AIDS - Research and Palliative Care.2025; Volume 17: 351.     CrossRef
  • Antifungal Susceptibility and Candida sp. Biofilm Production in Clinical Isolates of HIV-Positive Brazilian Patients under HAART Therapy
    Anelise Maria Costa Vasconcelos Alves, Érika Helena Salles de Brito, Márcio Flávio Moura de Araújo, Juliana Jales de Hollanda Celestino, Ana Caroline Rocha de Melo Leite, Gabriela Silva Cruz, Nuno Filipe Azevedo, Célia Fortuna Rodrigues
    Biomedicines.2024; 12(2): 310.     CrossRef
  • Exploring the diversity of uncommon oral yeast species and associated risk factors among substance abusers in southwestern Iran
    Aynaz Ghojoghi, Sadegh Khodavaisy, Ali Zarei Mahmoudabadi, Eisa Nazar, Mahnaz Fatahinia
    Scientific Reports.2024;[Epub]     CrossRef
  • Etiopathogenetic Features of Dermatomycosis in HIV- Infected Patients
    Iryna Kravchuk
    The Ukrainian Scientific Medical Youth Journal.2024; 150(4): 60.     CrossRef
  • Recuento de linfocitos CD4, carga viral y colonización oral por Candida en personas viviendo con VIH/SIDA
    Esperanza Gissela Vargas-Díaz, Graciela Albino Cornejo, Hans Ramón Quiroz-Ruiz
    Gaceta Médica Boliviana.2023; 46(1): 18.     CrossRef
  • Low level of antifungal resistance inCandidaspecies recovered from Iranian HIV-associated oral infection
    Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
    Letters in Applied Microbiology.2023;[Epub]     CrossRef
  • Epidemiology, prevalence, and associated factors of oral candidiasis in HIV patients from southwest Iran in post-highly active antiretroviral therapy era
    Maryam Erfaninejad, Ali Zarei Mahmoudabadi, Elham Maraghi, Mohammad Hashemzadeh, Mahnaz Fatahinia
    Frontiers in Microbiology.2022;[Epub]     CrossRef
  • Meyerozyma guilliermondii species complex: review of current epidemiology, antifungal resistance, and mechanisms
    Reza Ghasemi, Ensieh Lotfali, Kamran Rezaei, Seyed Ataollah Madinehzad, Mahdi Falah Tafti, Nikta Aliabadi, Ebrahim Kouhsari, Mahsa Fattahi
    Brazilian Journal of Microbiology.2022; 53(4): 1761.     CrossRef
  • HIV-infected patients rarely develop invasive fungal diseases under good immune reconstitution after ART regardless high prevalence of pathogenic filamentous fungi carriage in nasopharynx/oropharynx
    Xiaoman Chen, Yi Cao, Meijun Chen, Haodi Wang, Peishan Du, Hong Li, Huolin Zhong, Quanmin Li, Santao Zhao, Zhenjiang Yao, Wanshan Chen, Weiping Cai, Xiaoping Tang, Linghua Li
    Frontiers in Microbiology.2022;[Epub]     CrossRef
  • Neglected mycobiome in HIV infection: Alterations, common fungal diseases and antifungal immunity
    Shuang Li, Xiaodong Yang, Christiane Moog, Hao Wu, Bin Su, Tong Zhang
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • Identification & Correlation of Candida Strains with CD4+ Count Among HIV Patients on HAART and Evaluation of In-Vitro Susceptibility to Fluconazole and Voriconazole
    Naidu Harika, Koduri Sridevi, Buduru Krishnaveni, Nalli Prasanth Kumar, Gutta Mounika, Adari Devi Naga Deepika
    Journal of Indian Academy of Oral Medicine and Radiology.2022; 34(1): 38.     CrossRef
  • Update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA 13: suitability of taxonomic units notified to EFSA until September 2020
    Kostas Koutsoumanis, Ana Allende, Avelino Alvarez‐Ordóñez, Declan Bolton, Sara Bover‐Cid, Marianne Chemaly, Robert Davies, Alessandra De Cesare, Friederike Hilbert, Roland Lindqvist, Maarten Nauta, Luisa Peixe, Giuseppe Ru, Marion Simmons, Panagiotis Skan
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  • Transcription Factors of CAT1, EFG1, and BCR1 Are Effective in Persister Cells of Candida albicans-Associated HIV-Positive and Chemotherapy Patients
    Elham Aboualigalehdari, Maryam Tahmasebi Birgani, Mahnaz Fatahinia, Mehran Hosseinzadeh
    Frontiers in Microbiology.2021;[Epub]     CrossRef
Systematic Reviews
Medication errors among Iranian emergency nurses: A systematic review
Zohreh Hosseini Marznaki, Somaye Pouy, Waliu Jawula Salisu, Amir Emami Zeydi
Epidemiol Health. 2020;42:e2020030.   Published online May 13, 2020
DOI: https://doi.org/10.4178/epih.e2020030
  • 27,034 View
  • 399 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran.
METHODS
We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran.
RESULTS
Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses.
CONCLUSIONS
Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.
Summary

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  • Prevalence and Types of Medication Errors in Intensive Care Unit Nurses in Iran: A Systematic Review and Meta-Analysis
    Mojgan Mohajeri Iravani, Mohammad Raiszadeh, Akbar Haji Ghasemalian, Zia Navidi, Hamid Pakzad Moghadam, Ali Sarkoohi, Romina Golpayegani, Mohammad Teymurizadeh, Ebadallah Shiri Malekabad, Saeed Khorramnia
    Nursing and Midwifery Journal.2025; 23(1): 74.     CrossRef
  • A SEGURANÇA DO PACIENTE NOS SERVIÇOS DE URGÊNCIA E EMERGÊNCIA HOSPITALAR: UMA REVISÃO INTEGRATIVA
    Rossana Gomes Machado Arruda, Roberta Teixeira Prado, André Luiz Silva Alvim, Denise Rocha Raimundo Leone, Fábio da Costa Carbogim, Daniel da Silva Rodrigues, Isabella Lusvardi do Pinho Mellado, Maria Paula Taligliatti Luciano
    Arquivos de Ciências da Saúde da UNIPAR.2025; 30(1): 19.     CrossRef
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    Fateme Mohammadi, Sanaz Rustaee, Mostafa Bijani
    Nursing Open.2024;[Epub]     CrossRef
  • Medication errors in emergency departments: a systematic review and meta-analysis of prevalence and severity
    Phuong Thi Lan Nguyen, Thu Anh Thi Phan, Van Bich Ngoc Vo, Nhi T. N. Ngo, Ha Thi Nguyen, Toi Lam Phung, Mai Thi Tuyet Kieu, Thao Huong Nguyen, Khanh N. C. Duong
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  • Recurrence of medical errors despite years of preventive measures: A grounded theory study
    Aidin Aryankhesal, Negar Aghighi, Pouran Raeissi, Zhila Najafpour
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  • Frequency and influential factors on occurrence of medical errors: A three-year cross-sectional study
    Negar Aghighi, Aidin Aryankhesal, Pouran Raeissi, Zhila Najafpour
    Journal of Education and Health Promotion.2023;[Epub]     CrossRef
  • Medication Errors among Iranian Intensive Care Nurses: A Systematic Review
    Zohreh Hosseini Marznaki, Amir Emami Zeydi, Mohammad Javad Ghazanfari, Waliu Jawula Salisu, Mehdi Mohammadian Amiri, Samad Karkhah
    Iranian Journal of Nursing and Midwifery Research.2023; 28(2): 123.     CrossRef
  • Predictors of patient safety competency among emergency nurses in Iran: a cross-sectional correlational study
    Aghil Habibi Soola, Mehdi Ajri-Khameslou, Alireza Mirzaei, Zahra Bahari
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    Hayato Kizaki, Daisuke Yamamoto, Hiroki Satoh, Kotaro Masuko, Hideyuki Maki, Yukari Konishi, Satoko Hori, Yasufumi Sawada
    BMC Geriatrics.2022;[Epub]     CrossRef
  • Intravenous medication errors in the emergency department, knowledge, tendency to make errors and affecting factors: An observational study
    Sümeyye Arslan, Özlem Fidan, Arife Şanlialp Zeyrek, Durdu Ok
    International Emergency Nursing.2022; 63: 101190.     CrossRef
  • An umbrella review of systematic reviews on contributory factors to medication errors in health-care settings
    Lina Naseralallah, Derek Stewart, Ruba Azfar Ali, Vibhu Paudyal
    Expert Opinion on Drug Safety.2022; 21(11): 1379.     CrossRef
  • Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review
    Miguel Pereira, Patricia Concheiro-Moscoso, Alexo López-Álvarez, Gerardo Baños, Alejandro Pazos, Javier Pereira
    Applied Sciences.2021; 11(6): 2880.     CrossRef
  • Towards an Application Helping to Minimize Medication Error Rate
    Ali I. Alharbi, Valerie Gay, Mohammad J. AlGhamdi, Ryan Alturki, Hasan J. Alyamani, Fazlullah Khan
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Food frequency questionnaires developed and validated in Iran: a systematic review
Arezoo Rezazadeh, Nasrrin Omidvar, Katherine L. Tucker
Epidemiol Health. 2020;42:e2020015.   Published online March 30, 2020
DOI: https://doi.org/10.4178/epih.e2020015
  • 26,106 View
  • 331 Download
  • 21 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To systematically review and identify food frequency questionnaires (FFQs) developed for the Iranian population and their validation and reproducibility in order to determine possible research gaps and needs.
METHODS
Studies were selected by searching for relevant keywords in the PubMed, Scopus, Science Direct, Google Scholar, SID, and Iranmedex databases, unpublished data, and theses in November 2016 (updated in September 2019). All English-language and Persian-language papers were included. Duplicates, articles with unrelated content, and articles only containing a protocol were excluded. The FFQs were categorized based on: (1) number of food items in to short (≤80 items) and long (>80 items) and; (2) the aim of the FFQ to explore total consumption pattern/nutrients (general) or to detect specific nutrient(s)/food group(s) (specialized).
RESULTS
Sixteen reasonably validated questionnaires were identified. However, only 13 presented a reproducibility assessment. Ten FFQs were categorized as general (7 long, 3 short) and 6 as specialized (3 long, 3 short). The correlation coefficients for nutrient intake between dietary records or recalls and FFQs were 0.07-0.82 for long (general: 0.07-0.82 and specialized: 0.26-0.67) and 0.20-0.67 for short (general: 0.24-0.54 and specialized: 0.20-0.42) FFQs. Long FFQs showed higher validity and reproducibility than short FFQs. Reproducibility of FFQs was acceptable (0.32-0.89). The strongest correlations were reported by studies with shorter intervals between FFQs.
CONCLUSIONS
FFQs designed for the Iranian population appear to be appropriate tools for dietary assessment. Despite their acceptable reproducibility, their validity for assessing specific nutrients and their applicability for populations other than those they were developed for may be questionable.
Summary

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    Ariel Fangting Ying, Shazma Khan, Ying Wu, Aizhen Jin, Aidan S.Y. Wong, Eng‐King Tan, Jian‐Min Yuan, Woon‐Puay Koh, Louis C.S. Tan
    Movement Disorders.2020; 35(10): 1765.     CrossRef
Original Articles
Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?
Elham Khatooni, Isa Akbarzadeh, Elham Abdalmaleki, Zhaleh Abdi, Elham Ahmadnezhad
Epidemiol Health. 2019;41:e2019045.   Published online October 11, 2019
DOI: https://doi.org/10.4178/epih.e2019045
  • 21,996 View
  • 185 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.
METHODS
This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.
RESULTS
Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.
CONCLUSIONS
Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.
Summary

Citations

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  • Iranian women's birth experiences: a cross-sectional study
    Mona Ghobadi, Farzaneh Pazandeh, Barbara Potrata, Ehsan Kazemnejad Lili
    British Journal of Midwifery.2022; 30(12): 685.     CrossRef
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    Yasmin Madani-Lavassani
    Medicine, Conflict and Survival.2020; 36(4): 359.     CrossRef
The relationship between maternal mental health and communication skills in children in Shiraz, Iran
Najmeh Maharlouei, Hossein Alibeigi, Abbas Rezaianzadeh, Pedram Keshavarz, Hadi Raeisi Shahraki, Hamid Nemati, Kamran B. lankarani
Epidemiol Health. 2019;41:e2019035.   Published online July 19, 2019
DOI: https://doi.org/10.4178/epih.e2019035
  • 22,924 View
  • 248 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children.
METHODS
This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children.
RESULTS
The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01).
CONCLUSIONS
The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
Summary

Citations

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  • Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China
    Zuguo Qin, Lei Shi, Yaqing Xue, Huang Lin, Jinchan Zhang, Pengyan Liang, Zhiwei Lu, Mengxiong Wu, Yaguang Chen, Xiao Zheng, Yi Qian, Ping Ouyang, Ruibin Zhang, Xuefeng Yi, Chichen Zhang
    JAMA Network Open.2021; 4(1): e2035487.     CrossRef
  • Antenatal Depression Symptoms Among Pregnant Women Seeking Health Services in Erbil, Iraq
    Kathryn Mishkin, Shaymaa Samir Maqsood, Hamdia Mirkhan Ahmed
    Maternal and Child Health Journal.2021; 25(7): 1043.     CrossRef
  • Comparing Growth and Development of Low and Normal Birth Weight Children at Age of 60 Months
    Najmeh Maharlouei, Sogand Farhangian, Hadi Raeisi Shahraki, Abbas Rezaianzadeh, Kamran Bagheri Lankarani
    Shiraz E-Medical Journal.2020;[Epub]     CrossRef
Severe complications of tramadol overdose in Iran
Paria Habibollahi, Alireza Garjani, Samad Shams Vahdati, Seyyed-Reza Sadat-Ebrahimi, Neda Parnianfard
Epidemiol Health. 2019;41:e2019026.   Published online June 16, 2019
DOI: https://doi.org/10.4178/epih.e2019026
  • 36,535 View
  • 292 Download
  • 12 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Severe complications of tramadol overdose have been reported; however, few large-scale studies have investigated this issue. Therefore, this study aimed to explore the presentation and complications of tramadol overdose in patients admitted to an intoxication referral center in northwestern Iran.
METHODS
Patients with tramadol overdose admitted to Sina Teaching Hospital in Tabriz, Iran during 2013-2017 were included. For each patient, the following data were collected: demographics, previous drug or medication overdose, whether the patient was in the process of quitting drug use, ingested dose of tramadol and co-ingestants, Glasgow Coma Scale (GCS) score, clinical symptoms at the time of admission, and admission characteristics. Serotonin toxicity was diagnosed in patients who fit the Hunter criteria. Multiple logistic regression was performed to identify variables associated with the incidence of severe complications of tramadol overdose.
RESULTS
In total, 512 cases of tramadol overdose were evaluated, of which 359 patients were included, with a median age of 41 years (range, 16-69) and a median tramadol dose of 1,500 mg (range, 500-4,000). The most frequent complications associated with tramadol overdose were hypertension (38.4%), tachycardia (24.8%), and seizure (14.5%). No serotonin toxicity was detected in patients. Having a GCS score <15, having taken a tramadol dose of >1,000 mg, being in the process of quitting drug use, being 30-49 years old, and male sex were significantly related to the incidence of severe complications of tramadol overdose.
CONCLUSIONS
Although seizure was prevalent among Iranian patients with tramadol poisoning, serotonin toxicity and cardiogenic shock were rare findings.
Summary

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    Adanech Shifarew Legasse, Wudinesh Tamiru, Fatiya Mohammed, Getu Ataro, Joseph Olusesan Fadare
    PLOS ONE.2025; 20(3): e0318634.     CrossRef
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    Francesco Salis, Salvatore Sardo, Gabriele Finco, Gian Luigi Gessa, Flavia Franconi, Roberta Agabio
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  • Investigation of clinical and paraclinical consequences of tramadol poisoning and related factors
    Pantea Ramezannezhad, Mahmoud Hashemzaei, Zohreh Pajohesh, Khadijeh Saravani, Omid Bameri
    Journal of Shahrekord University of Medical Sciences.2024; 26(3): 132.     CrossRef
  • Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study
    Farhad Iranmanesh, Hamide Arvan, Habibeh Ahmadipour, Faranak Gadari, Hussien Barzegar, Mahdiyeh Khazaneha
    International Journal of High Risk Behaviors and Addiction.2023;[Epub]     CrossRef
  • Clinical and Laboratory Factors Related to Seizure and Serotonin Toxicity in Tramadol Intoxication: An Egyptian Study
    Ahmed Amin Ali, Mahmoud Mohamed Abdeshafy, Khaled Abdelkawy, Ramy M. Elsabaa, Fawzy Elbarbry
    Clinical Drug Investigation.2023; 43(12): 963.     CrossRef
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    Babak Nejati, Zohreh Kourehpaz, Roya Dolatkhah, Mojtaba Varshochi, Maryam Farmani, Alireza Parviz
    Journal of Medical Science.2023; 92(4): e836.     CrossRef
  • Increase of high‐risk tramadol use and harmful consequences in France from 2013 to 2018: Evidence from the triangulation of addictovigilance data
    Anne Roussin, Thomas Soeiro, Charlotte Fouque, Emilie Jouanjus, Elisabeth Frauger, Nathalie Fouilhé, Michel Mallaret, Joëlle Micallef, Maryse Lapeyre‐Mestre
    British Journal of Clinical Pharmacology.2022; 88(8): 3789.     CrossRef
  • Determination of Tramadol and Fluoxetine in Biological and Water Samples by Magnetic Dispersive Solid-Phase Microextraction (MDSPME) with Gas Chromatography – Mass Spectrometry (GC-MS)
    Banafsheh Sefaty, Mahboubeh Masrournia, Zarrin Es’haghi, Mohammad Reza Bozorgmehr
    Analytical Letters.2021; 54(5): 884.     CrossRef
  • Machine learning algorithms to predict seizure due to acute tramadol poisoning
    B Behnoush, E Bazmi, SH Nazari, S Khodakarim, MA Looha, H Soori
    Human & Experimental Toxicology.2021; 40(8): 1225.     CrossRef
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    Mavis Danso, Francis Anto
    Drugs - Real World Outcomes.2021; 8(3): 337.     CrossRef
  • Evaluation of mitochondrial dysfunction due to oxidative stress in therapeutic, toxic and lethal concentrations of tramadol
    Leila Mohammadnejad, Kambiz Soltaninejad, Mohammad Seyedabadi, Seyed Khosro Ghasem Pouri, Mohammad Shokrzadeh, Hamidreza Mohammadi
    Toxicology Research.2021; 10(6): 1162.     CrossRef
  • Rapport de cas d’un choc cardiogénique et syndrome sérotoninergique sur une synergie entre tramadol et venlafaxine
    G. Barthélemy, D. Gusu, D. Glorieux
    Journal Européen des Urgences et de Réanimation.2021; 33(4): 201.     CrossRef
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    Jonah Sydney Aprioku, Benjamin Toochukwu Okpe, Doupere Ben
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Reviews
A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country
Abolghasem Siyadatpanah, Davood Anvari, Amir Emami Zeydi, Seyed Abdollah Hosseini, Ahmad Daryani, Shahabeddin Sarvi, Christine M. Budke, Reza Esmaeelzadeh Dizaji, Mohammad Ali Mohaghegh, Mohammad Hasan Kohansal, Samira Dodangeh, Reza Saberi, Shirzad Gholami
Epidemiol Health. 2019;41:e2019024.   Published online June 15, 2019
DOI: https://doi.org/10.4178/epih.e2019024
  • 25,319 View
  • 340 Download
  • 18 Web of Science
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AbstractAbstract PDF
Abstract
Human echinococcosis is an infectious disease caused by tapeworms belonging to the species Echinococcus. This parasite has a worldwide distribution and is considered a neglected tropical disease by the World Health Organization. Due to the diversity of Echinococcus spp. hosts, as well as variation in geographical, climatic, and socio-ethnic conditions, the question of the strains or genotypes of Echinococcus spp. that are involved in human infections is important. The aim of this study was to provide a summary of the available data on genotypes of Echinococcus obtained from the Iranian population. Four international databases (PubMed, Scopus, Science Direct, and Web of Science) and 4 Persian databases (Magiran, Scientific Information Database, Iran Medex, and IranDoc) were searched for cross-sectional studies that reported the genotypes of Echinococcus spp. in human echinococcosis cases using molecular methods in Iran through July 2018. The Newcastle-Ottawa Scale was used to assess the quality of the selected studies. A total of 559 cases of human cystic echinococcosis were reported in the 21 included articles. The majority of cases belonged to genotype G1 (89.2%; 95% confidence interval [CI], 80.1 to 95.8), genotype G6 (8.2%; 95% CI, 2.8 to 15.9), and genotype G3 (2.3%; 95% CI, 1.1 to 3.9). Since genotype G1 of Echinococcus appears to be the most prevalent genotype affecting humans in Iran, disease control initiatives aimed at sheep intermediate hosts may be the most beneficial. In addition, educational programs and serological screening in individuals may help reduce the national impact of the disease.
Summary

Citations

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Congenital toxoplasmosis among Iranian neonates: a systematic review and meta-analysis
Shahabeddin Sarvi, Tooran Nayeri Chegeni, Mehdi Sharif, Mahbobeh Montazeri, Seyed Abdollah Hosseini, Afsaneh Amouei, Zahra Hosseininejad, Davood Anvari, Reza Saberi, Shaban Gohardehi, Ahmad Daryani
Epidemiol Health. 2019;41:e2019021.   Published online May 17, 2019
DOI: https://doi.org/10.4178/epih.e2019021
  • 26,247 View
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  • 19 Web of Science
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AbstractAbstract PDFSupplementary Material
Abstract
Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
Summary

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Original Articles
Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study
Hamideh Feiz Disfani, Mostafa Kamandi, Seyed Mohammad Mousavi, Sayyed Majid Sadrzadeh, Roohie Farzaneh, Najme Doolabi, Kazem Rahmani
Epidemiol Health. 2019;41:e2019016.   Published online April 23, 2019
DOI: https://doi.org/10.4178/epih.e2019016
  • 21,439 View
  • 249 Download
  • 16 Web of Science
  • 17 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.
METHODS
This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.
RESULTS
Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.
CONCLUSIONS
Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
Summary

Citations

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  • Patterns and Outcomes of Acute Poisoning Among Children Presenting to Emergency Department in AlAhsa, Saudi Arabia
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Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran
Shabnam Asfaram, Ahmad Daryani, Shahabeddin Sarvi, Abdol Sattar Pagheh, Seyed Abdollah Hosseini, Reza Saberi, Seyede Mahboobeh Hoseiny, Masoud Soosaraei, Mehdi Sharif
Epidemiol Health. 2019;41:e2019009.   Published online March 28, 2019
DOI: https://doi.org/10.4178/epih.e2019009
  • 25,995 View
  • 303 Download
  • 12 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Blastocystis hominis is a very common large intestinal protozoan with global prevalence in humans and non-human hosts. No precise statistics exist regarding the geographical distribution of Blastocystis that would enable the identification of high-risk communities. Therefore, the current research aimed to characterize the spatial patterns and demographic factors associated with B. hominis occurrence in northern Iran.
METHODS
The current study was performed among 4,788 individuals referred to health centers in Mazandaran Province, from whom stool samples were obtained. Socio-demographic data were gathered using a questionnaire. Samples were examined by a direct wet mount, the formalin-ethyl acetate concentration technique, and trichrome staining. Moran local indicators of spatial association and a geographically weighted regression model were utilized to analyze the results.
RESULTS
Generally, the infection rate of Blastocystis parasites was 5.2%, and was considerably higher in the age group of 10-14 years (10.6%) than in other age groups (p=0.005). Our data showed important associations between the occurrence of B. hominis and age, residence, job, contact with domestic animals, anti-parasitic drug consumption, and elevation above sea level (p<0.001).
CONCLUSIONS
The current study characterized for the first time the infection rate and risk of B. hominis in the north of Iran, and produced a prediction map. It is expected that this map will help policymakers to plan and implement preventive measures in high-risk areas and to manage already-infected patients.
Summary

Citations

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Dietary patterns, nutrition, and risk of breast cancer: a case-control study in the west of Iran
Behjat Marzbani, Javad Nazari, Farid Najafi, Behnaz Marzbani, Sara Shahabadi, Mahin Amini, Mehdi Moradinazar, Yahya Pasdar, Ebrahim Shakiba, Saeed Amini
Epidemiol Health. 2019;41:e2019003.   Published online January 24, 2019
DOI: https://doi.org/10.4178/epih.e2019003
  • 35,877 View
  • 1,036 Download
  • 47 Web of Science
  • 49 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim of this study was to assess the relationship between dietary patterns and the risk of breast cancer among under-50 year women in the west of Iran.
METHODS
All women under 50 years old with pathologically confirmed breast cancer between 2013 and 2015 who were referred to oncology clinics in the west of Iran, and 408 under-50 women referred to other outpatient clinics who were without breast or other cancers at the time of the study and 2 years later were selected as the control group. The data were collected using the middle-aged periodical care form of the Iranian Ministry of Health and analyzed using univariate and multivariate logistic regression in Stata.
RESULTS
The most powerful risk factor for breast cancer was fried foods; the odds ratio of consuming fried foods more than once a month for breast cancer was 4.5 (95% confidence interval, 2.1 to 9.4). A dose-response model indicated that increasing vegetable and fruit consumption up to 90 servings per month decreased the odds of breast cancer, but consuming more than 90 servings per month increased the risk.
CONCLUSIONS
Inadequate consumption of vegetables and consumption of soft drinks, industrially produced juices, fried foods, and sweets were identified as risk factors for breast cancer. In response to these findings, it is necessary to raise awareness and to provide education about healthy diets and the need to change unhealthy dietary patterns.
Summary

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Review
Freshwater snails as the intermediate host of trematodes in Iran: a systematic review
Samira Dodangeh, Ahmad Daryani, Mehdi Sharif, Shirzad Gholami, Elham Kialashaki, Mahmood Moosazadeh, Shahabeddin Sarvi
Epidemiol Health. 2019;41:e2019001.   Published online January 7, 2019
DOI: https://doi.org/10.4178/epih.e2019001
  • 31,323 View
  • 469 Download
  • 19 Web of Science
  • 21 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
Freshwater snails, as the first intermediate hosts of trematodes, can cause health hazards in animals and humans. Recently, the World Health Organization has included Iran in a list of 6 countries known to have serious problems with fascioliasis. In addition, cercarial dermatitis is a job-related disease that is seen often in paddy workers, agricultural labourers, and fishermen in Iran, particularly in Mazandaran Province. Many studies have been conducted in Iran to survey larval trematodes in freshwater snails. However, to the best of our knowledge, no comprehensive data exist regarding infections in gastropods. Therefore, the aim of the present study was to estimate the types and prevalence of cercarial infections in snails in Iran. Electronic English-language and Persian-language databases were searched to identify 24 published articles reporting the prevalence of trematode infections in snails (9 species from 6 families) in various provinces of Iran. In total, 4.4% of gastropods were infected with the larval stages of trematodes. According to the studies reviewed in this meta-analysis‚ the highest infection prevalence was found in Radix auricularia (9.9%). Twelve larval species of trematodes were identified, and the highest prevalence of cercariae was found for Echinostomatidae cercariae (4.3%). Among the provinces explored, West Azerbaijan had the highest prevalence of infected snails (16.9%). The presence of trematodes in snails could pose a serious health problem in Iran. Thus, further studies are necessary to characterize these infections in other provinces.
Summary

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Original Articles
Domestic elder abuse and associated factors in elderly women in Tehran, Iran
Negar Piri, Parisa Taheri Tanjani, Soheila Khodkarim, Koorosh Etemad
Epidemiol Health. 2018;40:e2018055.   Published online November 10, 2018
DOI: https://doi.org/10.4178/epih.e2018055
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  • 228 Download
  • 20 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
Elderly people are often abused in many ways, with serious and lasting consequences. Elder abuse remains one of the most hidden forms of family conflict, and its frequency is anticipated to be rising in many countries that are rapidly experiencing population aging. The purpose of this study was to investigate the status of domestic elder abuse in elderly women in Tehran, Iran and to identify associated factors.
METHODS
This cross-sectional study was conducted in 2017 among 260 women aged 60 and over, selected through multistage random sampling. Information on abuse and its risk factors was collected through interviews with the elderly in their homes. In order to measure domestic elder abuse, the validated Domestic Elderly Abuse Questionnaire was used. The ordinal logistic test was used in Stata version 12 to identify factors related to elder abuse.
RESULTS
Overall, 90.4% of the subjects had experienced at least 1 type of abuse, among which authority deprivation (68.5%) was the most common and rejection (11.2%) the least common. The ordinal logistic analysis showed that the likelihood of experiencing more severe severe abuse was significantly higher in elderly people over 72 than in those aged 60-62 years (odds ratio, 2.07; 95% confidence interval, 1.03 to 4.17).
CONCLUSIONS
Domestic elder abuse was found to be common in older women. Old age was an important risk factor for domestic elder abuse in elderly women in Tehran. Managing and preventing elder abuse is an important issue that needs to be addressed.
Summary

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  • Examination of Elder Abuse and Death Anxiety in Older Adults With a Chronic Disease
    Seda Karaman, Gülcan Bahçecioğlu Turan, Merve Çayır Yılmaz, Elanur Yilmaz Karabulutlu
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    Sima Siadat, Narges Motamedi
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    Roger Flores Ceccon, Carlos Alberto Severo Garcia-Jr
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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
  • 23,292 View
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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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The survival rate of patients with beta-thalassemia major and intermedia and its trends in recent years in Iran
Alireza Ansari-Moghaddam, Hossein Ali Adineh, Iraj Zareban, Mehdi Mohammadi, Mahtab Maghsoodlu
Epidemiol Health. 2018;40:e2018048.   Published online October 3, 2018
DOI: https://doi.org/10.4178/epih.e2018048
  • 27,095 View
  • 311 Download
  • 30 Web of Science
  • 30 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Thalassemia is a common genetic disease in Iran, especially in the north and south of Iran. The present study sought to determine the survival rate of patients with thalassemia in highly endemic regions of Iran and its variation in patients born before and after 1971.
METHODS
The present historical cohort study extracted data from the health records of patients with beta-thalassemia major, beta-thalassemia intermedia, and sickle beta-thalassemia who had presented to thalassemia treatment centers in the past years. The collected data were analyzed using the Kaplan-Meier test, the log-rank test, and the chi-square test.
RESULTS
Of the total of 5,491 medical records (2,647 men and 2,634 women; mean age, 23.81±11.32 years), 3,936 belonged to patients with beta-thalassemia major, and 999 and 89 to patients with beta-thalassemia intermedia and sickle beta-thalassemia, respectively. In 467 cases, the type of thalassemia was not clear. The cumulative survival rate was calculated as 0.92, 0.83, 0.74, and 0.51 by ages 25, 35, 45, and 55, respectively. The hazard ratio of death was 4.22 (p<0.05) for beta-thalassemia major and 0.77 for beta-thalassemia intermedia (p=0.70). It was calculated as 1.45 for men patients and as 3.82 for single patients.
CONCLUSIONS
The present study showed relatively high survival rates in patients with thalassemia. The survival of patients was unfavorable in poorer regions (Zahedan and Iranshahr). Factors including women gender, a higher level of education, being married, and living in metropolises decreased the risk of death at younger ages and improved survival.
Summary

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Application of a non-parametric non-mixture cure rate model for analyzing the survival of patients with colorectal cancer in Iran
Mehdi Azizmohammad Looha, Mohamad Amin Pourhoseingholi, Maryam Nasserinejad, Hadis Najafimehr, Mohammad Reza Zali
Epidemiol Health. 2018;40:e2018045.   Published online September 17, 2018
DOI: https://doi.org/10.4178/epih.e2018045
  • 20,053 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) patients are considered to have been cured when the mortality rate of individuals with the disease returns to the same level as expected in the general population. This study aimed to assess the impact of various risk factors on the cure fraction of CRC patients using a real dataset of Iranian CRC patients with a non-mixture non-parametric cure model.
METHODS
This study was conducted on the medical records of 512 patients who were definitively diagnosed with CRC at Taleghani Hospital, Tehran, Iran from 2001 to 2007. A non-mixture non-parametric cure rate model was applied to the data after using stepwise selection to identify the risk factors of CRC.
RESULTS
For non-cured cases, the mean survival time was 1,243.83 days (95% confidence interval [CI], 1,174.65 to 1,313.00) and the median survival time was 1,493.00 days (95% CI, 1,398.67 to 1,587.33). The 1- and 3-year survival rates were 92.9% (95% CI, 91.0 to 95.0) and 73.4% (95% CI, 68.0 to 79.0), respectively. Pathologic stage T1 of the primary tumor (estimate=0.58; p=0.013), a poorly differentiated tumor (estimate=1.17; p<0.001), a body mass index (BMI) between 18.6 and 24.9 kg/m2 (estimate=−0.60; p=0.04), and a BMI between 25.0 and 29.9 kg/m2 (estimate=−1.43; p<0.001) had significant impacts on the cure fraction of CRC in the multivariate analysis. The proportion of cured patients was 64.1% (95% CI, 56.7 to 72.4).
CONCLUSIONS
This study found that the pathologic stage of the primary tumor, tumor grade, and BMI were potential risk factors that had an impact on the cure fraction. A non-mixture non-parametric cure rate model provides a flexible framework for accurately determining the impact of risk factors on the long-term survival of patients with CRC.
Summary

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  • Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis
    Nerea Becerra‐Tomás, Georgios Markozannes, Margarita Cariolou, Katia Balducci, Rita Vieira, Sonia Kiss, Dagfinn Aune, Darren C. Greenwood, Laure Dossus, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark‐Wahnefried, Melissa M. Hudson, Anne M. Ma
    International Journal of Cancer.2024; 155(3): 400.     CrossRef
  • Assessment of prognostic factors in long-term survival of male and female patients with colorectal cancer using non-mixture cure model based on the Weibull distribution
    Mehdi Azizmohammad Looha, Elaheh Zarean, Fatemeh Masaebi, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali
    Surgical Oncology.2021; 38: 101562.     CrossRef
  • Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study
    Inge van den Berg, Robert R. J. Coebergh van den Braak, Jeroen L. A. van Vugt, Jan N. M. Ijzermans, Stefan Buettner
    World Journal of Surgical Oncology.2021;[Epub]     CrossRef
Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran
Hamed Akbari, Fakhradin Ghasemi, Hesam Akbari, Amir Adibzadeh
Epidemiol Health. 2018;40:e2018042.   Published online August 20, 2018
DOI: https://doi.org/10.4178/epih.e2018042
  • 28,106 View
  • 302 Download
  • 30 Web of Science
  • 31 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries.
METHODS
This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended.
RESULTS
The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors’ attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed.
CONCLUSIONS
To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.
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
  • 20,495 View
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  • 6 Web of Science
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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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Knowledge of and attitudes toward HIV/AIDS among Iranian women
Ehsan Zarei, Roghayeh Khabiri, Maryam Tajvar, Shirin Nosratnejad
Epidemiol Health. 2018;40:e2018037.   Published online August 3, 2018
DOI: https://doi.org/10.4178/epih.e2018037
  • 23,648 View
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  • 18 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study investigated the knowledge of Iranian women about HIV/AIDS and whether they had accepting attitudes towards people living with human immunodeficiency virus (HIV), and sought to identify factors correlated with their knowledge and attitudes.
METHODS
The data analyzed in the present study were taken from Iran’s Multiple Indicator Demographic and Health Survey, a national survey conducted in 2015. In total, 42,630 women aged 15-49 years were identified through multi-stage stratified cluster random sampling and interviewed. Associations of the socio-demographic characteristics of participants with their knowledge and attitudes were examined using multiple logistic regression analysis.
RESULTS
The majority (79.0%) of Iranian women had heard about HIV/AIDS, but only 19.1% had a comprehensive knowledge. In addition, only 15.4% of women had accepting attitudes toward people with HIV. Being older, married, more highly educated, and wealthier were factors associated with having more comprehensive knowledge of HIV/AIDS, and living in urban areas was associated with having more positive attitudes toward people with HIV.
CONCLUSIONS
The relatively poor knowledge of Iranian women and the low prevalence of accepting attitudes toward people living with HIV highlight the need to develop policies and interventions to overcome this issue, which would be a basis for further prevention of HIV/AIDS in Iran.
Summary

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Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic
Erfan Ayubi, Mohammad Barati, Arasb Dabbagh Moghaddam, Ali Reza Khoshdel
Epidemiol Health. 2018;40:e2018032.   Published online July 13, 2018
DOI: https://doi.org/10.4178/epih.e2018032
  • 22,943 View
  • 274 Download
  • 9 Web of Science
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to map the incidence of cutaneous leishmaniasis (CL) in Iranian army units (IAUs) and to identify possible spatial clusters.
METHODS
This ecological study investigated incident cases of CL between 2014 and 2017. CL data were extracted from the CL registry maintained by the deputy of health of AJA University of Medical Sciences. The standardized incidence ratio (SIR) of CL was computed with a Besag, York, and Mollié model. The purely spatial scan statistic was employed to detect the most likely highand low-rate clusters and to obtain the observed-to-expected (O/E) ratio for each detected cluster. The statistical significance of the clusters was assessed using the log likelihood ratio (LLR) test and Monte Carlo hypothesis testing.
RESULTS
A total of 1,144 new CL cases occurred in IAUs from 2014 to 2017, with an incidence rate of 260 per 100,000. Isfahan and Khuzestan Provinces were found to have more CL cases than expected in all studied years (SIR>1), while Kermanshah, Kerman, and Fars Provinces were observed to have been high-risk areas in only some years of the study period. The most significant CL cluster was in Kermanshah Province (O/E, 67.88; LLR, 1,200.62; p<0.001), followed by clusters in Isfahan Province (O/E, 6.02; LLR, 513.24; p<0.001) and Khuzestan Province (O/E, 2.35; LLR, 73.71; p<0.001), while low-rate clusters were located in the northeast areas, including Razavi Khorasan, North Khorasan, Semnan, and Golestan Provinces (O/E, 0.03; LLR, 95.11; p<0.001).
CONCLUSIONS
This study identified high-risk areas for CL. These findings have public health implications and should be considered when planning control interventions among IAUs.
Summary

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Functional disorders of the lung and symptoms of respiratory disease associated with occupational inhalation exposure to wood dust in Iran
Masoud Neghab, Zeinab Jabari, Fatemeh Kargar Shouroki
Epidemiol Health. 2018;40:e2018031.   Published online July 4, 2018
DOI: https://doi.org/10.4178/epih.e2018031
  • 25,481 View
  • 305 Download
  • 22 Web of Science
  • 26 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The possible adverse respiratory effects of airborne pollutants in sawmills have not been thoroughly investigated in Iran. Additionally, the extent to which workers are exposed to this organic dust and its associated bioaerosols has not been extensively quantified. Likewise, the predominant bacterial and fungal species associated with wood dust have not been characterized. The present study was undertaken to address these issues.
METHODS
One hundred male individuals exposed to wood dust and 100 unexposed male subjects were investigated. They completed a standardized respiratory symptom questionnaire and underwent spirometry testing. Additionally, airborne concentrations of respirable and inhalable dust particles, bacteria, and fungi were measured.
RESULTS
The mean concentrations of inhalable and respirable dust particles, bacteria, and fungi were found to be 2.44, 6.76 mg/m3 , 756.38, and 299.15 colony-forming units/m3 , respectively. The predominant Gram-negative bacteria in the sawmills included the Pseudomonadaceae, Klebsiella pneumoniae, and Rhinoscleromatis spp., and the predominant fungi consisted of the zygomycetes and Aspergillus spp. Respiratory symptoms were significantly more prevalent among exposed workers. Significant cross-shift decrements were noted in some pulmonary function parameters. Similarly, pre-shift spirometry results indicated that some pulmonary function parameters were significantly lower in the exposed group.
CONCLUSIONS
Exposure to wood dust and its bioaerosols was associated with significantly higher prevalence of respiratory symptoms and both acute (i.e., partially reversible) and chronic (i.e., irreversible) decrements in the functional capacity of the lung. Additionally, the characterized bioaerosols did not differ significantly from those isolated in other parts of the world.
Summary

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    Kodchapan Noochana, Sitthichok Puangthongthub
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    Serge Ade, Mariano Efio, Josiane Patricia Mapto Foupossia, Ibrahim Mama Cissé, Anthony David Harries
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Substance abuse behaviors among university freshmen in Iran: a latent class analysis
Kourosh Kabir, Ali Bahari, Mohammad Hajizadeh, Hamid Allahverdipour, Mohammad Javad Tarrahi, Ali Fakhari, Hossein Ansari, Asghar Mohammadpoorasl
Epidemiol Health. 2018;40:e2018030.   Published online July 2, 2018
DOI: https://doi.org/10.4178/epih.e2018030
  • 22,315 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.
METHODS
Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup.
RESULTS
The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.
CONCLUSIONS
Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.
Summary

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Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study
Ahmad Khosravi, Mohammad Hassan Emamian, Hassan Hashemi, Akbar Fotouhi
Epidemiol Health. 2018;40:e2018026.   Published online June 23, 2018
DOI: https://doi.org/10.4178/epih.e2018026
  • 21,569 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.
METHODS
In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.
RESULTS
The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.
CONCLUSIONS
Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Summary

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Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors
Seyed Mohammad Navabi, Jafar Navabi, Abbas Aghaei, Zahra Shaahmadi, Ruhollah Heydari
Epidemiol Health. 2018;40:e2018022.   Published online May 27, 2018
DOI: https://doi.org/10.4178/epih.e2018022
  • 27,526 View
  • 290 Download
  • 25 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning.
METHODS
This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2 . Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis.
RESULTS
In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment.
CONCLUSIONS
The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.
Summary

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Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran
Maryam Eghbali, Alireza Khosravi, Awat Feizi, Asieh Mansouri, Behzad Mahaki, Nizal Sarrafzadegan
Epidemiol Health. 2018;40:e2018020.   Published online May 18, 2018
DOI: https://doi.org/10.4178/epih.e2018020
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AbstractAbstract PDF
Abstract
OBJECTIVES
Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population.
METHODS
This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire.
RESULTS
The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN.
CONCLUSIONS
The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.
Summary

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Review
A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran
Masoud Foroutan, Ali Rostami, Hamidreza Majidiani, Seyed Mohammad Riahi, Sasan Khazaei, Milad Badri, Elham Yousefi
Epidemiol Health. 2018;40:e2018016.   Published online April 23, 2018
DOI: https://doi.org/10.4178/epih.e2018016
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran.
METHODS
We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied.
RESULTS
A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals.
CONCLUSIONS
The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients.
Summary

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Original Articles
Income-related inequality in completed suicide across the provinces of Iran
Mohammad Hassan Kazemi-Galougahi, Asieh Mansouri, Samaneh Akbarpour, Mahmood Bakhtiyari, Majid Sartipi, Rahmatollah Moradzadeh
Epidemiol Health. 2018;40:e2018012.   Published online April 2, 2018
DOI: https://doi.org/10.4178/epih.e2018012
  • 22,685 View
  • 217 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran.
METHODS
This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran.
RESULTS
The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06).
CONCLUSIONS
This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.
Summary

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Relationship between happiness and tobacco smoking among high school students
Maryam Ataeiasl, Parvin Sarbakhsh, Hossein Dadashzadeh, Christoph Augner, Masoumeh Anbarlouei, Asghar Mohammadpoorasl
Epidemiol Health. 2018;40:e2018009.   Published online March 24, 2018
DOI: https://doi.org/10.4178/epih.e2018009
  • 23,836 View
  • 315 Download
  • 18 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Recent research has described negative relationship between happiness and habitual smoking among adolescents. No study of this relationship has been conducted among Iranian adolescents. The aim of the present study was to characterize the relationship between happiness and cigarette or hookah smoking among a sample of high school students.
METHODS
A sample of 1,161 10th-grade students in Tabriz (northwest Iran) was selected by multi-stage proportional cluster sampling. Participants completed a self-administered multiple-choice questionnaire including information on cigarette smoking, hookah smoking, happiness score, substance abuse, self-injury, general risk-taking behavior, attitudes towards smoking, socioeconomic information, and demographic characteristics. An ordinal logistic regression model was used for data analysis.
RESULTS
It was found that 5.9 and 5.0% of students were regular cigarette smokers and regular hookah smokers, respectively. After controlling for potential confounders, higher happiness scores were found to protect students against more advanced stages of cigarette smoking (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p=0.013). However, no significant relationship was found between happiness scores and hookah smoking status (OR, 1.01; 95% CI, 0.97 to 1.02; p=0.523).
CONCLUSIONS
Happiness scores were associated with less advanced stages of habitual cigarette smoking among high school students. Our findings underscore the necessity of conducting longitudinal or interventional studies aiming to determine the effects of enhancing happiness on preventing the transition through the stages of cigarette and hookah smoking.
Summary

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The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran
Shahrzad Nematollahi, Mohammad Ali Mansournia, Abbas Rahimi Foroushani, Mahmood Mahmoodi, Azin Alavi, Mohammad Shekari, Kourosh Holakouie-Naieni
Epidemiol Health. 2018;40:e2018008.   Published online March 13, 2018
DOI: https://doi.org/10.4178/epih.e2018008
  • 22,107 View
  • 230 Download
  • 21 Web of Science
  • 20 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Consecutive community health assessments revealed that water-pipe smoking in women and impaired growth in children were among the main health concerns in suburban communities in southern Iran. The aim of the present study was to identify the effects of water-pipe smoking during pregnancy on birth weight.
METHODS
Data from a population-based prospective cohort study of 714 singleton live pregnancies in the suburbs of Bandar Abbas in southern Iran in 2016-2018 were used in this study. Data about water-pipe smoking patterns and birth weight were collected by questionnaires during and after the pregnancy. Low birth weight (LBW) was defined as a birth weight below 2,500 g. Statistical analyses were performed using generalized linear models, and the results were presented in terms of relative risk (RR) and 95% confidence intervals (CI).
RESULTS
Fifty (8.2%) of the study subjects smoked water-pipe. The adjusted risk of LBW increased 2-fold in water-pipe smokers (adjusted RR [aRR], 2.09; 95% CI, 1.18 to 3.71), and by 2.0% for each 1-year increase in the duration of water-pipe smoking (aRR, 1.02; 95% CI, 0.99 to 1.05).
CONCLUSIONS
Our results showed that water-pipe smoking during pregnancy was an important risk factor for LBW in this population sample from southern Iran. The introduction of regulations onto prevent water-pipe smoking and the implementation of community health action plans aiming at empowering women and increasing women’s knowledge and awareness regarding the health consequences of water-pipe smoking are proposed.
Summary

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    Radha Sharma, Mona Kanaan, Kamran Siddiqi
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Application of an artificial neural network model for diagnosing type 2 diabetes mellitus and determining the relative importance of risk factors
Shiva Borzouei, Ali Reza Soltanian
Epidemiol Health. 2018;40:e2018007.   Published online March 10, 2018
DOI: https://doi.org/10.4178/epih.e2018007
  • 23,050 View
  • 292 Download
  • 18 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To identify the most important demographic risk factors for a diagnosis of type 2 diabetes mellitus (T2DM) using a neural network model.
METHODS
This study was conducted on a sample of 234 individuals, in whom T2DM was diagnosed using hemoglobin A1c levels. A multilayer perceptron artificial neural network was used to identify demographic risk factors for T2DM and their importance. The DeLong method was used to compare the models by fitting in sequential steps.
RESULTS
Variables found to be significant at a level of p<0.2 in a univariate logistic regression analysis (age, hypertension, waist circumference, body mass index [BMI], sedentary lifestyle, smoking, vegetable consumption, family history of T2DM, stress, walking, fruit consumption, and sex) were entered into the model. After 7 stages of neural network modeling, only waist circumference (100.0%), age (78.5%), BMI (78.2%), hypertension (69.4%), stress (54.2%), smoking (49.3%), and a family history of T2DM (37.2%) were identified as predictors of the diagnosis of T2DM.
CONCLUSIONS
In this study, waist circumference and age were the most important predictors of T2DM. Due to the sensitivity, specificity, and accuracy of the final model, it is suggested that these variables should be used for T2DM risk assessment in screening tests.
Summary

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    Similien Ndagijimana, Ignace Kabano, Emmanuel Masabo, Jean Marie Ntaganda
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    Faten Al-hussein, Laleh Tafakori, Mali Abdollahian, Khalid Al-Shali, Ahmed Al-Hejin, Salim Heddam
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    Juan P. González-Rivas, Seyed Arsalan Seyedi, Jeffrey I. Mechanick
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    Aijuan Jiang, Jiajie Li, Lujie Wang, Wenshu Zha, Yixuan Lin, Jindong Zhao, Zhaohui Fang, Guoming Shen
    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
  • Artificial intelligence-driven transformations in diabetes care: a comprehensive literature review
    Muhammad Iftikhar, Muhammad Saqib, Sardar Noman Qayyum, Rehana Asmat, Hassan Mumtaz, Muhammad Rehan, Irfan Ullah, Iftikhar Ud-din, Samim Noori, Maleeka Khan, Ehtisham Rehman, Zain Ejaz
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  • Evaluation of the Risk Factors for Type 2 Diabetes Using the Generalized Structure Equation Modeling in Iranian Adults based on Shahedieh Cohort Study
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    Journal of Diabetes & Metabolic Disorders.2022; 21(1): 919.     CrossRef
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    Xiaoqian Yan, Ximin Li, Ying Lu, Dongfang Ma, Shenghong Mou, Zhiyuan Cheng, Yuan Ding, Bin Yan, Xianzhen Zhang, Gang Hu, Muhammad Zia-Ul-Haq
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Decomposing economic disparities in risky sexual behaviors among people who inject drugs in Tehran: Blinder-Oaxaca decomposition analysis
Mehdi Noroozi, Hamid Sharifi, Alireza Noroozi, Fatemah Rezaei, Mohammad Rafi Bazrafshan, Bahram Armoon
Epidemiol Health. 2017;39:e2017049.   Published online November 5, 2017
DOI: https://doi.org/10.4178/epih.e2017049
  • 21,871 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.
METHODS
Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.
RESULTS
Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.
CONCLUSIONS
Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Summary

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  • Prevalence and predictors of condom use among people who inject drugs in Georgia
    Maia Kajaia, Maia Butsashvili, Jack A. DeHovitz, George Kamkamidze, Lasha Gulbiani, Tinatin Abzianidze, Mamuka Djibuti
    Harm Reduction Journal.2025;[Epub]     CrossRef
  • FACTORS OF SEXUALLY TRANSMITTED INFECTION SYMPTOMS AMONG WOMEN IN INDONESIA: A CROSS-SECTIONAL STUDY
    Aulia Salmaddiina, Almira Nur Hanifah
    Journal of Public Health Research and Community Health Development.2024; 8(1): 31.     CrossRef
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    Maria Clara Sales do Nascimento, Luiz Ricardo Cerqueira Freitas Junior, Isabel Carmen Fonseca Freitas, Katia de Miranda Avena, Bruno Bezerril Andrade
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A comparison of breast cancer survival among young, middle-aged, and elderly patients in southern Iran using Cox and empirical Bayesian additive hazard models
Samane Nematolahi, Seyyed Mohammad Taghi Ayatollahi
Epidemiol Health. 2017;39:e2017043.   Published online October 16, 2017
DOI: https://doi.org/10.4178/epih.e2017043
  • 20,125 View
  • 216 Download
  • 9 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
A survival analysis of breast cancer patients in southern Iran according to age has yet to be conducted. This study aimed to quantify the factors contributing to a poor prognosis, using Cox and empirical Bayesian additive hazard (EBAH) models, among young (20-39 years), middle-aged (40-64 years), and elderly (≥ 65 years) women.
METHODS
Data from 1,574 breast cancer patients diagnosed from 2002 to 2012 in the cancer registry of Fars Province (southern Iran) were stratified into 3 age groups. The Kaplan-Meier method was used to estimate the overall survival rates. Cox and EBAH models were applied to each age category, and the Akaike information criterion was used to assess the goodness-of-fit of the 2 hazard models.
RESULTS
As of December 2012, 212 women (13.5%) in our study population had died, of whom 43 were young (15.3%), 134 middle-aged (11.8%), and 35 elderly (22.3%). The 5-year survival probability by age category was 0.83 (standard error [SE], 0.03), 0.88 (SE, 0.01), and 0.75 (SE, 0.04), respectively.
CONCLUSIONS
The Nottingham Prognostic Index was the most effective prognostic factor. The model based on Bayesian methodology performed better with various sample sizes than the Cox model, which is the most widely used method of survival analysis.
Summary

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  • Cancer Unveiling: A Profile of Incidence and Trends in Bam City, Southeast Iran
    Maryam Jalali, Navid Reza GHasemi, Sajad KHosravi, Mahnaz Hasani, Samane Nematolahi, Najaf Zare
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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
  • 23,899 View
  • 272 Download
  • 14 Web of Science
  • 14 Crossref
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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Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study
Satar Rezaei, Mohammad Hajizadeh, Ali Kazemi, Masoud Khosravipour, Farid Khosravi, Shahab Rezaeian
Epidemiol Health. 2017;39:e2017038.   Published online August 15, 2017
DOI: https://doi.org/10.4178/epih.e2017038
  • 24,696 View
  • 234 Download
  • 20 Web of Science
  • 17 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran.
METHODS
Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants.
RESULTS
The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems (‘some’ and ‘severe’ problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index.
CONCLUSIONS
Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.
Summary

Citations

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    Satar Rezaei
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    Ali Kazemi Karyani, Satar Rezaei, Behzad Karami Matin, Saeed Amini
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    Yuxuan Gu, Hao Zhang, Shahmir H. Ali, Minzhuo Huang, Jingming Wei, Shuyan Gu, Xuemei Zhen, Xiaoqian Hu, Xueshan Sun, Hengjin Dong
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  • What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition
    Satar Rezaei, Mohammad Hajizadeh, Yahya Salimi, Ghobad Moradi, Bijan Nouri
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Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level
Enayatollah Homaie Rad, Vahid Yazdi-Feyzabad, Shahrokh Yousefzadeh-Chabok, Abolhasan Afkar, Ahmad Naghibzadeh
Epidemiol Health. 2017;39:e2017029.   Published online July 18, 2017
DOI: https://doi.org/10.4178/epih.e2017029
  • 28,009 View
  • 206 Download
  • 31 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.
METHODS
Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.
RESULTS
Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).
CONCLUSIONS
The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.
Summary

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  • To what extent has the Iranian Health Transformation Plan addressed inequality in healthcare financing in Iran?
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  • Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation


    Ali Kazemi-Karyani, Abraha Woldemichael, Moslem Soofi, Behzad Karami Matin, Shahin Soltani, Jafar Yahyavi Dizaj
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Review
Occupational risk factors among Iranian farmworkers: a review of the available evidence
Mahin Ghafari, Zahra Cheraghi, Amin Doosti-Irani
Epidemiol Health. 2017;39:e2017027.   Published online July 2, 2017
DOI: https://doi.org/10.4178/epih.e2017027
  • 24,913 View
  • 270 Download
  • 13 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Abstract
Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.
Summary

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Original Articles
Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015
Mehdi Moradinazar, Farid Najafi, Mohammad Reza Baneshi, Ali Akbar Haghdoost
Epidemiol Health. 2017;39:e2017023.   Published online June 15, 2017
DOI: https://doi.org/10.4178/epih.e2017023
  • 22,221 View
  • 175 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.
METHODS
We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n<sub>0</sub> , was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.
RESULTS
The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.
CONCLUSIONS
Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
Summary

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    Bruno Pereira Dos Santos, Letícia Birk, Patrícia Schwarz, Viviane Cristina Sebben, Ângela Malysz Sgaravatti, Giovanna Cristiano de Gouveia, Adriana Ubirajara Silva Petry, Francisco Paz de Menezes, Alexsandro Pinto Gonzaga, Paula Flores Schlickmann, Marcel
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    Hamid Sharif Nia, Mohammad Heidari, Navaz Naghavi, Rebecca H. Lehto, Ali Akbar Haghdoost, Azar Jafari-Koulaee, Yasaman Hatef Matbue, Ameneh Yaghoobzadeh, Amir Hossein Goudarzian, Saeed Pahlevan Sharif
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Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting
Afshin Fathi, Mohammad Hajizadeh, Khalil Moradi, Hamed Zandian, Maryam Dezhkameh, Shima Kazemzadeh, Satar Rezaei
Epidemiol Health. 2017;39:e2017022.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017022
  • 36,549 View
  • 608 Download
  • 50 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.
METHODS
A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.
RESULTS
The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).
CONCLUSIONS
Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Summary

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Exploring neighborhood inequality in female breast cancer incidence in Tehran using Bayesian spatial models and a spatial scan statistic
Erfan Ayubi, Mohammad Ali Mansournia, Ali Ghanbari Motlagh, Alireza Mosavi-Jarrahi, Ali Hosseini, Kamran Yazdani
Epidemiol Health. 2017;39:e2017021.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017021
  • 24,674 View
  • 237 Download
  • 14 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to explore the spatial pattern of female breast cancer (BC) incidence at the neighborhood level in Tehran, Iran.
METHODS
The present study included all registered incident cases of female BC from March 2008 to March 2011. The raw standardized incidence ratio (SIR) of BC for each neighborhood was estimated by comparing observed cases relative to expected cases. The estimated raw SIRs were smoothed by a Besag, York, and Mollie spatial model and the spatial empirical Bayesian method. The purely spatial scan statistic was used to identify spatial clusters.
RESULTS
There were 4,175 incident BC cases in the study area from 2008 to 2011, of which 3,080 were successfully geocoded to the neighborhood level. Higher than expected rates of BC were found in neighborhoods located in northern and central Tehran, whereas lower rates appeared in southern areas. The most likely cluster of higher than expected BC incidence involved neighborhoods in districts 3 and 6, with an observed-to-expected ratio of 3.92 (p<0.001), whereas the most likely cluster of lower than expected rates involved neighborhoods in districts 17, 18, and 19, with an observed-to-expected ratio of 0.05 (p<0.001).
CONCLUSIONS
Neighborhood-level inequality in the incidence of BC exists in Tehran. These findings can serve as a basis for resource allocation and preventive strategies in at-risk areas.
Summary

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Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study
Fatemeh Khosravi Shadmani, Erfan Ayubi, Salman Khazaei, Mohadeseh Sani, Shiva Mansouri Hanis, Somayeh Khazaei, Mokhtar Soheylizad, Kamyar Mansori
Epidemiol Health. 2017;39:e2017020.   Published online May 17, 2017
DOI: https://doi.org/10.4178/epih.e2017020
  • 28,384 View
  • 303 Download
  • 33 Web of Science
  • 26 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.
METHODS
This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.
RESULTS
We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.
CONCLUSIONS
Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.
Summary

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