Iranian Journal of Epidemiology
Year:2016 | Volume:12 | Issue:1|Papers Count:11

Background and Objectives: Reproductive factors are in close relationship with breast carcinogenesis. This matched case-control study was conducted to study the association of reproductive risk factors with the risk of breast cancer (BC) among women in Tehran and northwest of Iran.Methods: This hospital-based case-control study was performed on a total of 432 patients diagnosed with BC with confirmed histopathology who were recruited from hospitals affiliated with Shahid Beheshti and Tabriz University of Medical Sciences between 2007 and 2012, and 543 regionally matched controls without a prior history of BC.Results: The average number of pregnancy and breast-fed children were significantly higher in cases than controls (P<0.01). The duration of breast-feeding was longer in patients (18.0・} 8.4 months) than controls (16.0±9.1; P<0.001). Most of the patients were diagnosed with BC above the age of 48 years old which was higher than the mean age of the recruited matched controls. Older age was associated with a 3.87 higher risks of BC development (95% CI: 2.94-5.10). The higher frequency of lactation in patients was significantly associated with the elevated risk (OR=2.22, 95% CI 1.62-3.04). The duration of breast-feeding within14-24 months was correlated with OR=0.52 to protect BC development during the reproductive age (<48 years) (95% CI: 0.32-0.86).Conclusion: High frequency of pregnancy, lactation, and older ages at first pregnancy are associated with the risk of BC, while older age at puberty, menopause, and longer duration of breast-feeding (age above 48 years) have inverse associations with the risk of BC.

Background and Objectives: Determining and monitoring the age at myocardial infarction (MI) and its comparison in various regions is one of the vital and basic principles for the management of MI.This study was conducted to determine the age at the first MI in Iran.Methods: In this cross-sectional, analytical study at a national level, the data of 20750 new MI patients registered in 2012 in 31 provinces of Iran according to the cardiologist’s diagnosis, World Health Organization criteria, and the codes ICD10: I21-I22 were used. The calculations were done using the Stata 12 software.Results: The mean±SD of age at the first MI was 61.2±13.4 years in all patients in Iran. Moreover, 15033 (72.4%) patients were male with a mean age of 59.6±13.3 years. The mean age at MI in men was lower than women (65.4±12.6 years), showing a statistical significance (P<0.001).The mean age at MI was different among Iran provinces, with a statistical significance (P<0.001). The lowest mean age at the first MI was seen in the patients living in Semnan (59.1±12.9 years), followed by Tehran (60.4±13.5 years), Sistan va Balouchestan (60.3±13.9 years), and Lorestan (60.1±14.5 years), with a significant difference from the mean age of the patients in Ardabil (63.2±15.1 years) and Zanjan (64.4±112.8 years) (P<0.019).Conclusion: Our study demonstrated that the age at MI was approximately five years younger in men than women. This studyprovided the ground for monitoring the age at MI, and more effective management of cardiovascular diseases in Iran.

Background and Objectives: Influenza is an acute, highly contagious disease of a variety of both domestic and wild bird species. The aim of this study was to estimate subclinical infections or previous exposure to H5 and H7 subtypes and to discover potentially important determinants of the prevalence of this disease in industrial and backyard poultry in Iran.Methods: A survey was conducted from September to December 2014 in Iran using a cross-sectional design throughout the entire country. The Enzyme-Linked Immunosorbent Assay (ELISA) was used as the screening test and all ELISA-positive samples were examined with the HI test to differentiate H5 and H7. A total of 1378 places and 31547 birds were sampled.Results: One place (bird garden) out of 1378 was positive for the H7 subtype and six places (2 bird gardens, 3 villages, and 1 ostrich farm) out of 1378 were positive for the H5 subtype on HI test. The results of this study showed that the presence of a lake (OR=12.20, CI 95% 2.19-68.09) and live bird marketing (11.73, CI 95% 1.32-104.42) were risk factors for the H5 subtype.Conclusion: Sampling migratory waterfowl birds is recommended for early detection of probable infections and preventing the spread of infection to the backyard and industrial poultry because of their role in the transmission of the disease and probability of circulation of the virus.

Background and Objectives: Anthroponotic cutaneous leishmaniasis (ACL) is restricted to humans; thus, prompt diagnosis and early treatment are significant measures to control the disease. This study was conducted to determine the effect of direct active case- detection and early treatment on the control of ACL in Bam District.Methods: This retrospective cohort study was performed based on intervention and nonintervention. After the 2003 earthquake, an equipped treatment center was established to actively detect CL cases following the CL epidemic. This intervention was carried out in 2007 and the suspected cases were referred to the center for diagnosis and treatment Another comparable CL treatment center was selected as the control in Kerman. The recorded data of the patients were analyzed with statistical tests atp<0.05.Results: The incidence rate steadily increased to 30% from 2003 to 2007 whereas the incidence gradually decreased to 1% after the intervention. However, by contrast, the incidence rate increased significantly in the control area. The treatment failure and relapse rate of ACL showed no significant difference with the control group before and after the intervention. The effectiveness of the intervention was calculated to be 85%.Conclusion: Active case-detection and early treatment of ACL could be an effective measure in controlling ACL, particularly during epidemics. Lessons learned from the 2003 Bam earthquake could be used as a suitable model for ACL endemic areas, nationally and globally.

Background and Objectives: Ahvaz has become one of the most polluted cities in the world. Only on 11 November 2013, over one thousand residents in Khuzestan Province attended the nearest health center with severe symptoms, particularly shortness of breath, cough, wheezing, and high blood pressure. During a week, more than 7 thousand patients were registered with this syndrome. This study was conducted to investigate the evidence for the confirmation of an epidemic in acute respiratory syndrome among the residents of Ahwaz in November 2013.Methods: In this cross-sectional study, we evaluated the data of the use of drugs related to acute respiratory attacks from November 2008 to 2013 in Ahvaz. Then, we conducted a descriptive study on the general population. The sample size was 120 and the study participants included different segments of the general population. The data collection tool was a researcher-made questionnaire and the data were analyzed using SPSS.18.Results: The use of the respiratory drugs increased from 2008 to 2013. The drug consumption was markedly higher in November 2013. In the study of the general population, 93% of the participants declared that they had never seen a similar event, and 92.5% mentioned that they had never heard of a similar occurrence.Conclusion: Due to the significant increase in respiratory medicine in November 2013 and the unexpected nature of the event, an epidemic seems to be obvious.

Background and Objectives: Spatial epidemiology is the description and analysis of geographic variations of diseases with respect to demographic, environmental, behavioral, socioeconomic, genetic, and infectious risk factors. Disease mapping includes a set of statistical techniques that lead to providing clean maps based on estimation of the incidence, prevalence and mortality rates for the users to enable them to reliably estimate the distribution of the diseases. In this study, the spatial epidemiology of diarrhea was evaluated in Mazandaran.Methods: In the present study, statistical methods like the Moran’s I spatial autocorrelation, Anselin local Moran’s I, K function and Ripley index were used to evaluate 4924 cases between 1385-1390, based on certain factors detected in diarrheal diseases.Results: The results of the global Moran index showed that this disease provided adherence to a cluster pattern in the province. The results of the K function also showed that apart from the western regions of the province, the diarrheal disease followed the above-mentioned cluster pattern. The results of Anselin local Moran and sensitive indicators revealed that the central region of the province, including the cities of Sari, Qaymshmhr, and Babol had the highest prevalence of the disease.Conclusion: The results showed that the prevalence of syndrome diarrhea follows the pattern cluster and the use of spatial analysis methods in a specific geographic area is appropriate for programs to reduce health risks.And in epidemiological studies, analysis and risk assessment diarrhea syndrome are very important.

Background and Objectives: Taking into account the roles and positions of WHO Collaborating Centers (WHOCCs) in the furtherance of national goals and the great impact of their interaction as well as cooperative relations between these centres, this study was conducted to assess the current status of WHOCCs, identify opportunities and threats, and provide practical solutions to solve WHOCCs problems.Methods: This cross-sectional study was conducted using an open-ended questionnaire in 2014. The questionnaire revolved around the WHOCCs' status in terms of goal achievement, manpower problems, financial resources, communications, as well as suggestions to solve problems in these domains. These findings were approved in the second convention of the heads of WHOCCs in Kerman in 2014 and the questionnaires of the second phase were distributed and completed by participants. Data were analyzed using the content analysis method.Results: The majority of the centres assessed their performance regarding the national goals (11.59) in comparison with international goals (14.20), and self-regulated goal setting (14.7o) in an unfavorable condition.Financial problems and lack of recruitment were the most important problems for WHOCCs. The support of the Ministry of Health, WHO, supporting universities, and establishing research networks at national and international levels to foster communication, contracts to share experiences and resources, considering the authors' rights as well as introducing the competencies of centres at national and international levels, were some of the suggestions proposed.Conclusion: It seems that more support of the WHO, Ministry of Health, and supporting universities is needed to increase financial resources and recruit staff.

Background and Objectives: Foot-and-mouth disease (FMD) is one of major contagious animal. The purpose of this study was to evaluate the determinants associated with FMD occurrence in farms.Methods: A case- control study was carried out in cattle farms. The cases were farms with new reports of FMD and controls were units without any report of FMD in last 6 month. For assessing the risk factors, a researcher- made questionnaire was used. Statistical analyses were done with SPSS version 16 using the logistic regression test.Results: Purchase of new livestock [OR: 14.69 (CI95%: 4.29, 50.36)] and passing migratory livestock [OR: 13.32 (CI 95%: 1.74, 101.87) were identified as the risk factors of the disease. Visiting the farm by the vaccinator in last 2 weeks [OR: 0.17 (CI 95%: 0.05, 0.63)] and buying new livestock from the same village/ city where the farm is located [OR: 0.16 (CI 95%: 0.04, 0.58)] were considered as protective factors.Conclusion: Considering the role of infected livestock in the country, the most important steps for effective preventation are: areadherence to biosecurity as well as quarantining new purchased animals, and informing and training farmers to not purchase new animals from farms that are located in the infected areas and around the times of outbreak.