Hosseinzadeh, Ali

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     داﻧﺷﮔﺎه ﻋﻠوم ﭘزﺷﮐﯽ  و ﺧدﻣﺎت ﺑﮫداﺷﺗﯽ درﻣﺎﻧﯽ ﮐرﻣﺎن   داﻧﺷﮐده ﺑﮫداﺷت  ( رﺷﺗﻪ اﭘﯾدﻣﯾوﻟوژیDhPی ﺗﺧﺻﺻﯽ )اﻧﺎﻣﻪ ﻣﻘطﻊ دﮐﺗﺮﭘﺎﯾﺎن    ﻋﻧواناﺧﺗﻼﻻت ﻧروﻟوژﯾک ﮐﻼﺳﯾک )ﻣﺎﻟﺗﯾﭘل  ﺟﻐراﻓﯾﺎﯾﯽﺑرآورد ﺷﯾوع و ﺗﺣﻠﯾل  ان ﺑﺎ اﺳﺗﻔﺎده از ﺳﯾﺳﺗم اﺳﮐﻠروزﯾس، ﺑﯾﻣﺎری ﭘﺎرﮐﯾﻧﺳون و دﻣﺎﻧس( در اﯾر  (SIG)اطﻼﻋﺎت ﺟﻐراﻓﯾﺎﺋﯽ     ﺗوﺳط  ﻋﻠﯽ ﺣﺳﯾن زاده    اﺳﺎﺗﯾد راھﻧﻣﺎ دﮐﺗر ﻣﺣﻣدرﺿﺎ ﺑﺎﻧﺷﯽ، دوﺳتاﮐﺑر ﺣقدﮐﺗر ﻋﻠﯽ   اﺳﺎﺗﯾد ﻣﺷﺎور  دﮐﺗر ﺑﮫﻧﺎز ﺻدﯾﻘﯽ، دﮐﺗر ﺟﻣﺷﯾد ﮐرﻣﺎﻧﭼﯽ  ﺳﺎل (                                                    ٠١/٨/٨٢٢ﻧﺎﻣﻪ: )ﺷﻣﺎره ﭘﺎﯾﺎن(٨٩)ﺧرداد  ﺗﺣﺻﯾﻠﯽ     ﮐﯾده اﺣﺗﻣﺎﻟﯽ و  ای ﺷدن، ﻋواﻣل ﺧطﺮﺧﺎطﺮ ﮐﻣک ﺑﻪ ﺷﻧﺎﺳﺎﺋﯽ اﻟﮔوھﺎی ﺟﻐﺮاﻓﯾﺎﺋﯽ، ﺧوﺷﻪﺑﻪ ﻣﻘدﻣﻪ و ھدف:ھﺎ از ﻣﺑﺎﺣث ﻣﮫم در اﭘﯾدﻣﯾوﻟوژی ﻧوﯾن ﻣﺣﺳوب ﺗﺧﺻﯾص ﻣﻧﺎﺳب ﻣﻧﺎﺑﻊ ﺑﺮرﺳﯽ ﺗوزﯾﻊ ﺟﻐﺮاﻓﯾﺎﺋﯽ ﺑﯾﻣﺎریدﻣوﮔﺮاﻓﯾﮐﯽ و اﭘﯾدﻣﯾوﻟوژﯾﮐﯽ در ﮐﺷورھﺎی در ﺣﺎل ﺗوﺳﻌﻪ ﺳﺑب ﺷده - ﺷود. رﺧداد ﮔذار اﺟﺗﻣﺎﻋﯽﻣﯽﺎﺑل ﭘﯾﺷﮔﯾﺮی ﺑﻪ ﺧط ﻣﻘدم ھﺎی ﻏﯾﺮﻗاﺳت اﻟﮔوھﺎی اﺑﺗﻼ و ﻣﯾﺮاﺋﯽ در ﺟواﻣﻊ ﻣﺧﺗﻠف ﺗﻐﯾﯾﺮ ﯾﺎﺑد و ﺑﯾﻣﺎریھﺎ اﺧﺗﻼﻻت ﻧﺮوﻟوژﯾک ﮐﻼﺳﯾک ﺑﺎر ﻧظﺎم ﻣﺮاﻗﺑت ﺑﮫداﺷﺗﯽ ﻣﻧﺗﻘل ﺷود. در ﻣﯾﺎن اﯾن ﮔﺮوه از ﺑﯾﻣﺎریھﺎی ﻣﺳﺗﻘﯾم ﻣﺮاﻗﺑت ﺑﮫداﺷﺗﯽ ﺑﺮ ﺻورت ھﺰﯾﻧﻪﺻورت ﻧﺎﺗواﻧﯽ و ﭼﻪ ﺑﻪاﺿﺎﻓﯽ ﻗﺎﺑل ﺗوﺟﮫﯽ را ﭼﻪ ﺑﻪﻟوژﯾک در زﻣﯾﻧﻪ ﺑﺮرﺳﯽ اﻟﮔوی ﺗوزﯾﻊ ﮐﻧﻧد. ﺑﺎ ﺗوﺟﻪ ﺑﻪ ﻋدم وﺟود ﻣطﺎﻟﻌﺎت اﭘﯾدﻣﯾوﺟﺎﻣﻌﻪ ﺗﺣﻣﯾل ﻣﯽای ﺷدن اﺧﺗﻼﻻت ﻋﺻﺑﯽ در اﯾﺮان، ھدف ﻣطﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺮرﺳﯽ ﺗوزﯾﻊ ﺟﻐﺮاﻓﯾﺎﺋﯽ ﺟﻐﺮاﻓﯾﺎﺋﯽ و ﺧوﺷﻪ  اﯾن اﺧﺗﻼﻻت در اﯾﺮان اﺳت. ﺑﺮای ﺗﻌﯾﯾن ﺗوزﯾﻊ ﺟﻐﺮاﻓﯾﺎﺋﯽ اﺧﺗﻼﻻت ﻧﺮوﻟوژﯾک ﮐﻼﺳﯾک اﺑﺗدا ﻣﯾﺰان ﺑﺮوز و ﺷﯾوع اﯾن روش ﮐﺎر: ھﺎی ﺛﺑت ﺷده )ﺑﺮای ام اس( و ﺑﺳﺎﻣد داروھﺎی ﺗﺧﺻﺻﯽ ﺗﺟوﯾﺰ ﺷده )ﺑﺮای دهھﺎ ﺑﺮ اﺳﺎس داﺑﯾﻣﺎریﺑﯾﻣﺎری ﭘﺎرﮐﯾﻧﺳون و دﻣﺎﻧس( در ﺳطﺢ ﻣﻠﯽ و اﺳﺗﺎﻧﯽ ﺑﺮآورد ﺷد. ﺳﭘس ﺗوزﯾﻊ ﺟﻐﺮاﻓﯾﺎﺋﯽ و ﻧواﺣﯽ ﺑﺎ ﻣﯾﺰان رﺧداد ﺑﺎﻻی ﺑﯾﻣﺎری )ﻧﻘﺎط ﮔﺮم( و ﻧواﺣﯽ ﺑﺎ ﻣﯾﺰان رﺧداد ﭘﺎﺋﯾن ﺑﯾﻣﺎری )ﻧﻘﺎط ﺳﺮد( ﺑﺎ اﺳﺗﻔﺎده از   ( ﺗﻌﯾﯾن ﺷدﻧد. SIGاطﻼﻋﺎت ﺟﻐﺮاﻓﯾﺎﺋﯽ ) ﺳﯾﺳﺗمﺗﺎ  ۱۹۳۱ﺑﺮ اﺳﺎس ﻧﺗﺎﯾﺞ ﺑﻪ دﺳت آﻣده از اﯾن ﻣطﺎﻟﻌﻪ، ﻣﺗوﺳط ﺑﺮوز ﺳﺎﻻﻧﻪ ام اس در دوره ھﺎ: ﯾﺎﻓﺗﻪو  ۲٫۳ﻧﻔﺮ ﺑود. اﯾن ﻣﯾﺰان در ﻣﺮدان و زﻧﺎن ﺑﻪ ﺗﺮﺗﯾب ﺑﺮاﺑﺮ ﺑﺎ  ۰۰۰۰۰۱در  ۱٫۷در اﯾﺮان  ۵۹۳۱  ۶٫۲۶ع اﺧﺗﻼﻻت ﻧﺮوﻟوژﯾک در اﯾﺮان ﺑﺮای ام اس ﻧﻔﺮ ﺑود. ﺑﺮآورد ﻣﯾﺰان ﺷﯾو ۰۰۰۰۰۱در  ۹٫۰۱ﻧﻔﺮ ﺑود. ﺑﺮای ھﺮ ﺳﻪ  ۰۰۰۰۰۱در  ۹٫۸۰۵و ﺑﺮای دﻣﺎﻧس ﺑﺮاﺑﺮ  ۱٫۱۶۲ﺑﺮای  ﺑﯾﻣﺎری ﭘﺎرﮐﯾﻧﺳون ﺑﯾﻣﺎری ﻣورد ﺑﺮرﺳﯽ ﺑﯾﺷﺗﺮﯾن رﺧداد ﺑﯾﻣﺎری در ﻧواﺣﯽ ﻣﺮﮐﺰی اﯾﺮان و ﮐﻣﺗﺮﯾن رﺧداد ﺑﯾﻣﺎری در   ود. ﻧواﺣﯽ ﺟﻧوب ﺷﺮﻗﯽ و ﻏﺮب ﮐﺷور اﺗﻔﺎق اﻓﺗﺎده ﺑ ﻪﺟﯾﺗﻧ و ثﺣﺑ :یرﯾﮔ ﻪﻘﺑط فﻼﺧﺮﺑ ﻪﻌﻟﺎطﻣ نﯾا زا لﺻﺎﺣ ﺞﯾﺎﺗﻧ سﺎﺳا ﺮﺑ زوﺮﺑ ناﺰﯾﻣ ﻪﮔﺰﺗروﮐ یدﻧﺑ عوﯾﺷ ناﺰﯾﻣ ﺎﻣا .تﺳا ﻪﺗﻓﺎﯾ ﻪﻌﺳوﺗ یﺎھروﺷﮐ ﻪﯾﺑﺷ شﯾﺑ و مﮐ و هدوﺑ ﻻﺎﺑ ناﺮﯾا رد سا ما عوﯾﺷ وناﺰﯾﻣ ﺎﺑ و هدوﺑﻧ ﻻﺎﺑ ناﺮﯾا رد سﻧﺎﻣد و نوﺳﻧﯾﮐرﺎﭘ یرﺎﻣﯾﺑ هدﺷ شراﺰﮔ عوﯾﺷ یﺎھ لﺎﺣ رد یﺎھروﺷﮐ زاصﺧﺎﺷ ﻪﮐ دوﺷ ﻪﺟوﺗ ﻪﺗﮐﻧ نﯾا ﻪﺑ دﯾﺎﺑ ﻪﭼﺮﮔا .تﺳا ﻪﺳﯾﺎﻘﻣ لﺑﺎﻗ ﻪﻌﺳوﺗیرﺎﻣﯾﺑ نﯾا ﻼﺗﺑا یﺎھ ناﺮﯾا رد ﺎھنﺎﺗﺳا نﯾﺑ و ﻪﺗﺷاد ﻪﺟوﺗ لﺑﺎﻗ ﯽﺋﺎﯾﻓاﺮﻐﺟ تاﺮﯾﯾﻐﺗتوﺎﻔﺗ ﺎھ  .دراد دوﺟو ﯽﮫﺟوﺗ لﺑﺎﻗ  هژاو دﯾﻠﮐ :ﺎھﺮﻠﮐﺳا لﭘﯾﺗﻟﺎﻣ ،ﯽﺋﺎﯾﻓاﺮﻐﺟ ﻊﯾزوﺗ ،کﯾژوﻟوﺮﻧ تﻻﻼﺗﺧاسﻧﺎﻣد و نوﺳﻧﯾﮐرﺎﭘ یرﺎﻣﯾﺑ ،سﯾزو  Abstract Background and objectives: In recent years, investigation of geographical distribution of diseases is one of the important issues in modern epidemiology. Geographical distribution of diseases helps to identify geographic patterns, clustering, potential risk factors, and appropriate allocation of resources. Socio- demographic and epidemiological transition in developing countries has led to changes in the patterns of morbidity and mortality in different societies, and chronic diseases are transmitted to the front of the health care system. Among this group of diseases, classic neurological disorders impose a significant additional burden on society as either disability or direct health care costs. Due to the lack of epidemiological studies in the field of geographical distribution and clustering of neurological disorders in Iran, the aim of this study is to investigate the geographical distribution of these disorders in Iran. Methods: To determine the geographical distribution of classical neurological disorders, the incidence, and prevalence of MS was firstly  estimated based on the recorded data. For Parkinson's disease and dementia, the frequency of prescribed drugs was used to estimate the incidences and prevalence at the national and provincial level. Then, geographic distribution and areas with high incidence of disease (hot spots) and areas with low incidence of disease (cold spots) were determined using the Geographic Information System (GIS). Results: Our findings show that the mean annual incidence of MS was 7.1 per 100,000 in Iran. This rate in men and women was 3.2 and 10.9 per 100,000, respectively. Estimation of the prevalence of neurological disorders was 62.6 for MS, 261.1 for Parkinson's disease, and 508.9 for dementia per 100,000 in Iran. For all three diseases, the highest incidence of disease in the central regions of Iran and the lowest incidence of disease occurred in the southeastern and western parts of the country. Conclusion: Based on the results of this study, the MS incidence and prevalence in Iran is high and more and less similar to developed countries. However, the prevalence of Parkinson's disease and dementia in Iran is not high and is comparable to that reported for developing countries. However, it should be noted that the incidence and prevalence of these diseases have considerable geographical variations and there is a significant difference between the provinces in Iran. Keywords: Neurologic disorder, Geographical distribution, Multiple Sclerosis, Parkinson’s Disease, Dementia      Kerman University  of Medical Sciences Faculty of Health In Partial Fulfillment of the Requirement for the PhD Degree Title Perevalence Estimate and Spatial Analysis of Classical Neurological Disorders (Multiple Sclerosis, Alzheimer, Parkinson), Using Geographical Information System (GIS)  By Ali Hosseinzadeh  Supervisors 1- Dr. Ali Akbar Haghdoost | 2- Dr. Mohammad Reza Baneshi  Advisors 1- Dr. Behnaz Sedighi | 2- Dr. Jamshid Kermanchi Thesis No: (10/8/228)                                                Date (June, 2  

Perevalence Estimate and Spatial Analysis of Classical Neurological Disorders (Multiple Sclerosis, Alzheimer, Parkinson), Using Geographical Information System (GIS)

http://eprints.kmu.ac.ir/31376/1/7206.pdf

Perevalence Estimate and Spatial Analysis of Classical Neurological Disorders (Multiple Sclerosis, Alzheimer, Parkinson), Using Geographical Information System (GIS)

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