Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic

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 high-and 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

Caregiver-related predictors of thermal burn injuries among Iranian children: a case-control study

Purpose Burns are a common and preventable cause of injury in children. The aim of this study was to investigate child and caregiver characteristics which may predict childhood burn injuries among Iranian children and to examine whether confounding exists among these predictors. Methods A hospital based case-control study was conducted using 281 burn victims and 273 hospital-based controls, which were matched by age, gender and place of residence (rural/urban). The characteristics of the children and their caregivers were analyzed using crude and adjusted models to test whether these were predictors of childhood burn injuries. Results The age of the caregiver was significantly lower for burn victims than for the controls (P<0.05). Further, the amount of time the caregiver spent outdoors with the child and their economic status had a significant positive association with the odds of a burn injury (P<0.05). A multivariate logistic regression found that Type A behaviour among caregivers was independently associated with the child's odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04–1.21). The research also found that children with ADHD (Inattentive subscale: Crude OR = 2.14, 95% CI: 1.16–3.95, Adjusted OR = 5.65, 95% CI: 2.53–12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23–2.41, Adjusted OR = 2.53, 95% CI: 1.65–3.87) also had increased odds of suffering a burn injury. However, several variables were identified as possible negative confounder variables, as the associations were stronger in the multivariate model than in the crude models

Epidemiologic characteristics of injuries among 1-5 year-old children in Hamadan Province: Analysis of 4523 hospitalized children over a 6-year period

Background: Unintentional injuries are one of the major causes of death in Iranian children. Information on epidemiological pattern of injury among one-to 5-year-old children is limited in Hamadan. The aim of this study was to clarify the person, space and time pattern of injury among 1-5 year-old children in Hamadan Province. Methods: All registered incidence cases of injury among 1-5 year-old children in Hamadan Province from March 2009 to March 2015 were included in this cross-sectional study. We analyzed the data on county, gender, age category, type of injury, season and outcome of injury. Temporal trend was explored using time series regression with accounting autocorrelation, seasonality, and short-term variation. Results: This study included 4523 injury cases. During the studied period, urban residents and boys had a higher number of injuries. Motor vehicle-related injuries were the most common type of injury. A seasonality pattern was found so that most of the cases were occurred in summer months. The lowest and highest incidence rate ratios (IRRs) were occurred in January 2011 (IRR = 0.61 with 95 confidence interval CI: 0.31, 1.18) and May 2014 and August 2013 (IRR = 6.78 with 95% CI: 4.38, 10.51), respectively. Conclusion: In Hamadan Province, childhood injury has a variation in person, place, and time pattern, as some groups such as boys and urban residents among 1-5 year-old children are at a higher risk for the incidence of injury. Therefore, it is recommended that health service managers and health policymakers devote more healthcare and resources to the high-risk groups

The prevalence of obesity among school-aged children and youth aged 6-18 years in Iran: A systematic review and meta-analysis study

Obesity is considered as a major health problem of children and adolescents. The present meta-analysis was conducted by extensive search of studies on the prevalence of obesity among school-aged children and youth aged 6-18 years in Iran. METHODS: All conducted cross-sectional studies on the prevalence of obesity in Iranian students in all grades were extracted, without applying any restriction on time in national and international databases including Magiran, Iranmedex, SID, Scopus, Google Scholar, and PubMed. Statistical software Stata 12 was used to analyze the data and to obtain the prevalence of obesity among Iranian students. The heterogeneity between the results was determined using statistical test I2. RESULTS: In this meta-analysis, 51 papers met our inclusion criteria and were therefore considered for the analysis. The prevalence of obesity was equal to 5.82% [95% confidence interval (CI): 5-6.66] in Iranian students. The prevalence of obesity was higher in boys than in girls (6.85% compared to 5.13%) (P = 0.300). The highest prevalence of obesity was related to students living in the North and Northwest areas with 7.07% (95% CI: 4.35-9.78). CONCLUSION: The prevalence of obesity among Iranian students is not high when compared to Western countries. However, due to lifestyle changes in recent years, it is necessary to plan intervention programs within families and schools to improve dietary patterns and physical activity of this age group. © 2017, Isfahan University of Medical Sciences. All rights reserved

Gender-Age Disparity of Cancers' Incidence in Iran

Cancer is one of the leading causes of death worldwide and among Iranian population; cancer is the third important causes of death. It is a critical issue to identify sex and age group difference of cancer pattern for planning and management of cancer patients, therefore the aim of present study was to examine sex and age difference in cancer incidence during 2003-2008 in Iran. The National Cancer Registry (NCR) reports from 2003 to 2008 have been applied to test trend of cancer incidence and illustrating sex-age disparity of most common cancers in Iran. Direct adjustment method was used for computing the age-specific rates (ASRs) and Cochran-Armitage tests for trends were used to test statistical significance of cancer incidence rate in both genders during 2003-2008. Our findings indicated that male and female incidence rate is increased from 64.2 to 117.5 and from 50.1 to 105.8, respectively during 2003-2008 (P for trend <0.001). Highest Age-Specific Rate of cancer in male was for stomach cancer (ASR=12.8), beside of skin cancer and in female was for breast cancer (ASR=33.2). Highest incidence rate of cancers was found in people aged 80-84 years in both genders. In elderly people, incidence rate of cancer was higher in male than female. The observed sex-age disparity of common cancers in this study indicated that male cancer of stomach and bladder and female cancer of breast and colorectal can be targeted in cancer control and prevention programs are required to reach remarkable reduction of cancer burden in Iran

Trends in epidemiology of Hepatitis B and C Infections in Ilam Province: National Notifiable Diseases Surveillance System data

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the main causes of severe liver failure worldwide. This study was conducted to evaluate the incidence rate and trend of these infections over six successive years from 2008 to 2013 in Ilam Province, western Iran. Methods: We studied the registered data of HBV and HCV based on the National Notifiable Diseases Surveillance System in Ilam Province from 2008 to 2013. Incidence rate per 100,000 populations was estimated for HBV and HCV infections through location, years and age groups of patients. Results: The overall incidence rate per 100,000 populations from 2008 to 2013 for HBV infection was 9.57, 5.83, 16.26, 12.44, 21.89 and 13.93, respectively. The corresponding values for HCV infection were 0.55, 0.72, 1.44, 2.69, 1.24 and 1.93, respectively and these trends for both the HBV and HCV infections were increasing. The major distribution of HBV and HCV infections was 25-44 years of age. Both HBV and HCV infections were more common in males, urban areas and married patients. Forty-one percent of cases were carriers and history of surgery was the common risk factor. Conclusions: Our results showed that HBV and HCV are prevalent in the middle-age group. Despite effective vaccination against hepatitis B, optimized blood donor screening and better sterilization procedures for blood products, trend of HBV and HCV in Ilam are increasing. Further studies should address the role other risk factors in the trend of HBV and HCV

The association of Socio-demographics characteristics and social support from family and community with depression: The National Health and Nutrition Examination Survey 2005-2006

Aims & objectives: Protective effect of social support networks on depressive symptoms has been reported. The aim of this study was to examine the association between depressive symptoms and social support from family and community using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. Methodology: This is a cross-sectional population-based study of 10,348 people participating in the NHANES 2005-2006. Participants were interviewed on their level of social support and depressive symptoms. Logistic regression and analysis of variance was used to assess the effects of demographic variables and social support with depression. Results: Bing married and having a high education level is inversely related to depressive symptoms. Also social supports from family had protective effect on depression symptoms and impacts of each family member were different. It also became clear that family support in associated with social support had a protective effect on the emergence of depressive symptoms. In this effect, the interaction between spouse and professional support on depressive symptoms were more prominent. In addition to, interaction between children’s emotional support and religious practices was important. Conclusion: The result of this study adherent with the protective theory of social support on depression