Low birth weight in Iran: Implications from a systematic review of the literature and meta-analysis in the period 1999-2017

Background: Low birth weight (LBW), a crucial determinant of neonatal complications, represents a major public health concern worldwide. Epidemiological research is of crucial importance for designing and implementing ad hoc interventions for this issue, helping and guiding decision- and policy-makers in each country to prevent the increased prevalence of LBW in infants through estimating the prevalence rate, identifying and controlling major risk factors. The present investigation aimed to systematically assess LBW prevalence rate in Iran and its determinants. Methods: PubMed/Medline via Ovid, Embase, Web of Science and Scopus as well as Magiran, SID and Irandoc were searched from inception until November 2016. Also, the grey literature (via Google Scholar) was mined. The DerSimonian-Laird model was exploited. The I2 and Q-test tests were used to investigate heterogeneity between the studies. Sensitivity and subgroup analyses were performed to ensure the robustness and validity of our findings. Different cumulative meta-analyses were conducted stratifying according to the year of publication and sample size. Any potential bias in publication was assessed carrying out the Egger's test. Results: LBW prevalence rate was estimated to be 8 (95CI: 7-9) in Iran. Sensitivity analysis confirmed the stability of finding. Studies were cumulated by the year of publication, and the results did not change pre- and post-cumulative meta-analysis. No publication bias could be observed. Conclusion: LBW prevalence rate in Iran is well comparable with the prevalence figures of both developed and developing countries. This could be due to the health reforms implemented in Iran throughout the years. © 2018 Iran University of Medical Sciences

Prevalence of nosocomial infections in Iran: A systematic review and meta-analysis

Background: Nosocomial infections represent a serious public health concern worldwide, and, especially, in developing countries where, due to financial constraints, it is difficult to control infections. This study aimed to review and assess the prevalence of nosocomial infections in Iran. Methods: Different databases were searched between January 2000 and December 2017. To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95 confidence interval. To examine the heterogeneity among studies, the I2 test were conducted. The reporting of observational studies in epidemiology (STROBE) checklist was used to assess the methodological quality of observational studies. To further investigate the source of heterogeneity, meta-regression analyses stratified by publication year, sample size and duration of hospitalization in the hospital were carried out. Results: 52 studies were included. Based on the random-effects model, the overall prevalence of nosocomial infection in Iran was 4.5 95% CI: 3.5 to 5.7 with a high, statistically significant heterogeneity (I2=99.82%). A sensitivity analysis was performed to ensure the stability results. After removing each study, results did not change. A cumulative meta-analysis of the included studies was performed based on year of publication and the results did not change. In the present study, a high rate of infections caused by Klebsiella pneumoniae (urinary tract, respiratory tract, and bloodstream infections) was found. Conclusion: Preventing and reducing hospital infections can significantly impact on reducing mortality and health-related costs. Implementing ad hoc programs, such as training healthcare staff on admission to the hospital, may play an important role in reducing infections spreading. © Iran University of Medical Sciences