Iranian Journal of Epidemiology
Year:2017 | Volume:13 | Issue:2|Papers Count:12

Background and Objectives: Epidemiology is a tool and a field of science which provides evidences necessary to make decisions. It is known as one of the basic sciences of public health. This study aimed to identify strategies for the promotion of epidemiology by Iranian Epidemiological Association so that people graduated in this field would become able to play an effective and positive role in different parts of the country.Methods: This study was conducted in 2015. The views and opinions of the members of Iranian Epidemiological Association were collected by email. The views of the members were classified using qualitative methods.Results: The results of this study helped to identify some of the strategies for the promotion of the position of epidemiology in Iran’s health system by the members of Iranian Epidemiological Association.Conclusion: Iranian Epidemiological Association can play a more effective role in the promotion of epidemiology in the health system. Effective communication with the members, holding group meetings, advocacy and negotiation, reporting the activities of the Association continuously, identifying national problems and seeking solutions are some of the strategies that can help to enhance the role of the Association and promote the position of epidemiologists in Iran.

Background and Objectives: Neuropathy is a common complication of diabetes that can cause disability in diabetic patients. The aim of this study was to determine of effective factors in the Event Time of neuropathy in type 2 diabetic patients using the Cox proportional hazards model.Methods: This study included 371 patients with type II diabetes without neuropathy who were registered at Fereydunshahr Diabetes Clinic. Subjects were followed up for the development of neuropathy between 2006 until March 2016. The data were analyzed using the R software (ver.3.2.3). The test was conducted at an error level of 5%.Results: At the end of 10 years of study, the cumulative incidence and prevalence of neuropathy was 30.7% and 41.6%, respectively. The Kaplan-Meier method showed the mean time to detection of neuropathy was 76.6 ± 5 months after the first diagnosis of diabetes (83.8 ± 8 in men and 72.7 ± 6 in women). The semi-parametric Cox regression model revealed the one-year, two-year, five-year, and eight-year disease-free survival was 0.867, 0.819, 0.647, and 0.527, respectively. Also, four variables of duration of diabetes, sex, family history of diabetes, and HbA1c can be considered as strong determinants of the time of development of neuropathy in the semi-parametric model (COX) (P<0.05).Conclusion: Optimal glycemic control and regular evaluation of legs in elderly patients, especially women with a positive family history, decrease the occurrence and progression of neuropathy and improve the quality of life in diabetic patients.

Background and Objectives: The aim of this study was to compare the intrinsic estimator method and the age, period and cohort accounting model used for identifying age, period, and cohort trends in incidence, prevalence, and mortality rates.Methods: The data of 2 studies "Age, Period, and Cohort Effects on Alcohol and Drug use Among Students of Tehran University of Medical Sciences from 2006 to 2009" and "The Role of Age, Period, and Cohort Effects on Smoking among the Students of Tehran University of Medical Science" were used. First the age, period and cohort accounting model and then The IE method are explained, their advantages and disadvantages are discussed, and their results are compared.Results: Both methods showed an increasing, decreasing, and increasing trend for age, cohort, and cohort effect for the prevalence of smoking. IE could predict a preventing effect for an early age factor for smoking. In the descriptive model, a decreasing trend was seen from old cohorts to younger cohorts in nearly all age groups. However, the IE method did not show any cohort effects for alcohol consumption in female studnets.Conclusion: Currently, the IE method is the best method for solving linear dependence between three variables of age, birth cohort, and period in this type of studies. However, researchers should use it with caution because it has many pitfalls.

Background and Objectives: People with high risk alcohol use disorders are influenced by behaviors that have devastating consequences for them and those around them. The main objective for alcohol screening is to identify people with alcohol use disorders, or people who are at high risk for progression to these disorders. Several screening tools have been designed for this purpose. The aim of this study was to introduce and review important screening tools for identification of alcohol use disorders and problems in the world.Methods: In this narrative review study, we searched the Web of Science (ISI), PubMed, and Scopus databases using Alcohol, Tools or Instruments, Test, Problem, Use and Use disorder as keywords for finding screening tools for identification of alcohol use problems and disorders. Finally, 10 instruments were introduced.Results: The most common screening tools for identification of alcohol use disorders and problems were Alcohol Use Disorder Identification Test (AUDIT), CAGE, Michigan Alcoholism Screening Test (MAST), as well as T-ACE and TWEAK that are specifically used for evaluation of alcohol consumption in pregnant women. The short forms of the AUDIT, RAPS, POSIT, and CRAFFT are other tests for alcohol consumption.Conclusion: Several screening tools have been designed for identification of alcohol use disorders and problems; therefore, n appropriate screening test should be selected and implemented with regards to the purpose of screening, research questions, and study population.

Background and Objectives: A feasible and cost-effective tool is required to investigate young children' behaviors with regard to the risk of injury. The aim of this study was to assess the psychometrics of the Persian version of the Injury Behavior Checklist (IBC).Methods: After validating the translation (backward-forward translation), the final version of the checklist was developed through content analysis and face validity and according to the comments of a panel of experts. The final version was distributed among 300 mothers of children aged 2-5 years referring to the kindergartens of Tehran. Convergent validity was evaluated by internal consistency through calculation of Cronbach's alpha coefficient, as well as item-total correlation. The reliability of the checklist was assessed through the test-retest method with participating 55 mothers and comparison of the scores of the two steps by correlation coefficient and interclass correlation coefficient (ICC).Results: The content validity ratio was acceptable (0.6-1) for 100% of the items, and the content validity index was 0.93 for relevancy and clarity and 0.92 for simplicity. The Cronbach's alpha coefficient was 0.87. All 24 items of the IBC were acceptably and directly correlated with the total score of the tool (r=0.25-0.65).Reliability results also confirmed the test-retest reliability of the Persian version of the IBC (r=0.90; ICC=0.86).Conclusion: The Persian version of the IBC is a reliable tool for investigation of risk taking and its association with different injuries in children aged 2-5 years.

Background and Objectives: Using the anthropometric indicators of children is one of the ways of monitoring their growth. Because of the racial divisions and levels of health and welfare, comparing these indicators with the global reference is not reasonable; therefore, designing a local reference seems necessary. This study aimed to evaluate the growth indices for boys and girls aged 5 to 18 years old living in Isfahan and to compare the indices with standard values.Methods: In this cross-sectional study, 53, 839 subjects were included. Percentiles of body mass index, height, and weight were calculated using the LMS method in the LMS Light software. After normalization of the growth indices, their mean and standard deviation were calculated for each age group and anthropometric indices curves were plotted versus the 5th, 50th and 95th percentiles of the NCHS reference.Results: In all age categories, the mean SDS scores of BMI in boys and girls was -0.004±0.029 and 0.014 ±0.062, respectively, indicating no difference with reference values. However, the 95th percentile of the body mass index for the reference population was consistent with the 90th percentile for the population studied. Also, weight in boys below 13 years of age was higher than the reference line while in girls, weight was always higher than the reference value.Conclusion: Due to differences in the pattern of growth and also lower anthropometric values, particularly among boys, it seems that a national growth curve can be a better guide for future decisions.

Background and Objectives: Suicide is one of the public health challenges. It involves the individual, family, and even society. Epidemiological study of suicide is one of the most important measures in primary prevention and integration program for suicide in primary health care system. This study evaluated cases who attempted suicide in Khorasan Razavi Province in 2014-2015.Methods: This cross-sectional study was performed on individuals who were visited at health care centers of Mashhad University of Medical Sciences from August 2014 to July 2015. Seventeen trained interviewers from 14 countries and three major referral centers collected demographic data, time, reason, and method of suicide. Data were analyzed using descriptive statistics, chi-square test and Mann-Whitney test. P-value<0.05 was considered significant.Results: Totally, 893 individuals were evaluated which was equals to an annual incidence rate of 21.2 per 100000. Seventy-six percent (675) were female and 57% (496) were in the age group 15-24 years. In both genders, married individuals (61%, 543), high school degree (63%, 548) and a monthly income below 160$ were dominant (80%, 438). The most frequent reason and method for committing suicide was family dispute (47%, 380) and drug poisoning (81%, 632), respectively.Conclusion: Suicide is mostly being dealt with caution. However, the very first step is to know the current situation completely, so epidemiological studies can elucidate different dimensions of this public health problem.

Background and Objectives: The awareness of the health knowledge level of a population and the weaknesses in people's health literacy is essential for educational planning. This community assessment study, which was conducted to develop an appropriate infrastructure for educational planning, examined the level of health literacy in Hormuz Island's residents.Methods: This analytical cross-sectional study was done on a sample of people over 18 years in Hormuz Island. Data were collected by two questionnaires which included basic information such as age, sex, marital status, age at marriage, and also indirect questions regarding the economic status of the individuals. Also, the Short Test of Functional Health Literacy in Adult (S-TOFLHA) was used to measure the patient's ability to read and understand health-related concepts. The linear regression analysis was performed.Results: The data provided by 486 individuals were analyzed in this study. The mean age was 39 years (18-79) and 48% were female. The mean household size was 4.5 people. The mean score of the subjects was 58.06. Thirty-five percent had less-than-sufficient health literacy, 18.21% had sufficient health literacy, 12.29% had insufficient, and 7.14% had higher health literacy. Education level (P<0.001), economic status (P<0.001), and age (P<0.001) were the main variables influencing health literacy in the sample.Conclusion: Community assessment showed that older age groups did not have sufficient health literacy. Low economic status accompanied by low levels of literacy makes individuals less motivated to improve their health knowledge and, consequently, leads to low levels of health literacy in Hormuz.

Background and Objectives: Regular blood transfusions in patients with hereditary hemolytic anemia, especially thalassemia, increase the survival of most patients but also may result in infection with viruses like hepatitis. In order to identify these diseases and other complications in people with thalassemia, this study aimed to investigate epidemiological and clinical findings in patients with thalassemia in Dezful in 2015.Methods: In this descriptive-analytic study, data were collected from medical records in Dezful thalassemia Clinic by the census method. The collected data included gender, age, location, ethnicity, blood type, transfused blood type, time between blood transfusions, medications, vaccinations, underlying diseases, and operations and their time.Results: The records of 174 thalassemia patients with a mean age of 23.60 years were evaluated. Of these, 23 patients (13.2%) had thalassemia intermediate and 151 (86.8%) had thalassemia major. The last mean serum ferritin was 2760.60. Independent T test showed a significant relationship between the type of thalassemia and age at diagnosis (P=0.000). There was a significant positive correlation between age and blood transfusion intervals so that the intervals increased with age (P=0.004) (r=0.21).Conclusion: The high mean age in the center compared to other studies as well as the low frequency of side effects indicate the effectiveness of new treatments and increased survival of these patients.

Background and Objectives: Changes in ideals and aspirations of childbearing are important factors in fertility behavior. Nowadays, fertility rate reduction below the replacement level and decreased childbearing ideals are the most common fertility challenges in Iran. So, with the decrease in the fertility rate, it is necessary to be aware of the ideal number of children and its determinants in order to adopt suitable population policies contexts. The main objective of this study was to investigate factors affecting the ideal number of children using Poisson regression model.Methods: In 2012, 389 ever married women aged 15-49 in Semnan Province were selected using two-phase stratified random sampling method and studied through applying a structured questionnaire. To model the ideal number of children by Poisson regression model, marriage duration has taken as offset and the number of children, job status, education level, marriage type, and resident place were considered as predictors. The model was fitted with SPSS software version 22.Results: All predictors in this study had significant effects on ideal number of children in Semnan (p-value<0.05). Women's ideal number of children who had 2 or fewer children, were employed, and had university education with consanguineous and rural marriage was higher than those who had 3 and more children, were unemployed, and had elementary and secondary education with inter-family and urban marriage.Conclusion: To model the ideal number of children, since it is discrete and count, a Poisson regression model is more efficient as compared to linear regression model.