Iranian Journal of Epidemiology
Year:2009 | Volume:4 | Issue:3-4|Papers Count:17

Background and Objectives: Hepatitis B virus (HBV) infection is a major public health problem worldwide. Islamic Republic of Iran is located in mesoendemic region (prevalence 2%-7%). The aim of this study was to assess prevalence of chronic HBV in Iran according to demographic characteristics.Methods: Medline, Embase, Science Citation Index Expanded, Ovid, Google Scholar, IranMedex, SID, Magiran and The Scientific Journal of Iran Blood Transfusion Organization (SJIBT) from 2000 till May 2008 were searched. Cross-sectional studies concerning prevalence of hepatitis B infection in Iran were included irrespective of language and date. The outcome of interest was prevalence of chronic HBV infection detected by blood specimen positive for HBsAg.Results: We icluded 34 studies. The prevalence of chronic HBV infection was estimated about 1.7% or lower in general population; 0.8% (95% CI: 0.6%-0.9%) in blood donors and 3.2% (95% CI: 2.3% - 4.1%) in intravenous drug users. Prevalence of chronic HBV infection in beta thalassemic patients varied from zero to 1.5%. Prevalence of chronic HBV infection was higher in middle aged and elders than children, adolescent and youth and was 25% higher in males than females.Conclusions: Since mass vaccination of hepatitis B in 1993, prevalence of chronic HBV infection has being reduced among children and adolescents. These age groups comprise a large proportion of general population and reduction of HBV infection in this age group may impact on total prevalence of hepatitis B infection, so that now Iran may be considered a hypoendemic region for HBV infection.

Background & Objectives: The objective of this study was to determine self efficacy, perceived benefit/ barriers to exercise of students in Hormozagan University of Medical sciences (HUMS).Methods: This was a cross-sectional study. Using stratified sampling, 350 current students of HUMS were studied from November to December 2007 in Bandar Abbass, Iran. Data regarding self efficacy, perceived benefits/barriers to exercise among participants were assessed through Exercise self efficacy scale and Exercise Benefits/Barriers Scale. Data were analyzed by SPPS version 13.Results: In all, the data of 249 participants with mean age of 21.7±2.7 were analyzed. Among them 65 participants (26.5%) including 36 girls and 30 boys were doing physical activity. Mean scores of self efficacy, perceived benefits, perceived barriers were 23±7.1, 96±12.5 and 31.9±6.1, respectively. There were statistically significant relationship between self efficacy and perceived barriers with physical activity (P<0.05).Conclusions: This study revealed perceived barriers such as insufficient time, money and also tiredness due of exercise could decrease physical activity. However perceived self-efficacy and encouraging by friends and family members have a key role of doing regular physical activities.

Background & Objectives: Recent reports indicated an increase in cutaneous Leishmaniosis (CL) cases. We designed the study in the context of community assessment process to identify and address the major public health related issues by explore the risk map of CL and assessing the environmental risk factors in Kerman.Methods: All the registered CL in the only referral center for CL from 2002 to 2006, localized on Kerman digital map. The level of data dissemination was townships. Based on data from the national statistics organization, we determined the population and calculated the incidence of CL of each township. Secondly, the highest endemic townships were observed deeply with a specific checklist to determine the environmental risk factors.Results: 771 cases were included. All the high endemic areas were located in the east part of Kerman. The eastern township, Sarasiyab, with 123 (15.9%) cases was the most infected region. The highest endemic townships were Sarasiyab, Emam and Sarbaz with 54.9, 52.8 and 51.2 cases per 10,000, respectively. Some minor endemic areas such as Shahab, Abouzar and Shahzadeh Mohammad (South and central regions) were going to be disappeared while Shariati, Naseriyeh-Seyedi (North and North-East regions) were the new high-risk townships (P<0.01).Conclusions: the east and central part of Kerman, were always the high endemic regions. Some other new high-risk areas were also detected. The most environmental factors were the bare lands between the houses, ground passages and the timeworn architecture on the buildings.

Background & Objectives: The main purpose of this study was to assess the pulmonary reactions associated with occupational inhalation exposure to raw materials used in ceramic production (RMCP).Methods: Thirty three male workers with current exposure to RMCP and 20 healthy male unexposed employees, with almost identical demographic and socioeconomic status were interviewed and respiratory symptom questionnaires were administered to them. Furthermore, they underwent chest X-ray and lung function tests. Additionally, personal dust monitoring was carried out at dusty work sites. To determine the chemical composition, possible silica phases and SiO2 contents of dust samples, they were analyzed by X-ray diffraction (XRD) and X-ray fluorescence (XRF) techniques.Results: Atmospheric concentrations of dust, that contained 69% SiO2, exceeded current permissible levels. Additionally, exposed workers had higher prevalence rates of regular cough, wheezing, phlegm and shortness of breath. Likewise, their chest radiographs showed some degrees of abnormalities. Furthermore, significant reductions in some parameters of pulmonary functions of exposed workers were noted.Conclusions: The findings of this study indicate that a strong association exists between exposure to RMCP, prevalence of respiratory symptoms, abnormal changes in chest radiographs and functional impairments of the lungs.

Background & Objectives: Recognition of epidemiology of acute myocardial infraction (AMI) in every region could be a need for design the programs for prevention of AMI. In this study we assessed the epidemiology of changes in AMI from 2002-2006 in Birjand (east of Iran).Methods: All of the patients which hospitalized by AMI diagnosis from 2002-2006 years, included in this study. We compared mean of age, gender, location of living, medications used, condition at discharge and cardiac risk factors in this period.Results: From 1233 patients, 880 were male (71.4%). Overall, mean age of patients was 62.2±12.8 years and in five years was increased (from 61.7±13.2 in 2002 to 63.5±12.4 in 2006 & p=0.37). The most risk factors in patients were: Hypertension (HTN) (34.8%), cigarette smoking (32.1%) & dyslipidemia (24%). These risk factors did not show any significantly changes during 5 years. But the the prevalence of HTN (30.9% in 2002 to 38% in 2006, p=0.62) and DM (15.5% in 2002 to 21% in 2006, p=0.23) raised. Cardiac drugs use tended to increase during 5 years, however only this increase about STK & Statin was statistically significant. The hospital mortality rate was decreased in 5 years (11.3%) but it was not statistically significant (p=0.48).Conclusions: Regarding the accelerating the rate of AMI, designing an appropriate prograrme for prevention and modifying cardiac risk factors is recommended.

Background & Objectives: This study aimed to determine of the seroprevalence of visceral leishmaniasis to design a prevention and control program in Bojnoord district.Methods: This was a descriptive and cross sectional study with multistage random sampling method. The study was carried out on children up to 12 years old and 10% of adult’s population in 8 rural areas of Bojnoord district in 2007. In total, 1608 blood samples were collected to detect anti-Leishmania antibodies. All the samples were tested by direct agglutination test (DAT). In order to determine Leishmania species, necropsy was performed on four suspected dogs in the studied areas. The species of Leishmania was determined by RAPD-PCR and PCR-RFLP methods using to amplify the ribosomal internal transcribed spacer 1 (ITS1).Results: Thirty and eight (2.36%) out of 1608 collected blood samples had anti-Leishmania antibodies at titer 1:800 and nine (0.56%) were just positive at 1:3200 by DAT. There was no statistically significant difference between female and male seroprevalence (p>0.05). The seoprevalence in children <=12 years old compared to individuals greater than 12 years old did not show any statistically significant (p>0.05). Amastigotes were observed in all 4 necropsied dogs. The species of Leishmania isolated from 2 dogs, was determined as L.Infantum. Their ITS1 sequences were registered with Accession numbers EU810776 and EU810777 in NCBI.Conclusions: These findings showed that visceral leishmaniasis has been circulated with low endemicity in Bojnoord district. Therefore an appropriate monitoring system is needed for health services in this area.

Background & Objectives: Burden of disease studies has been implemented in many countries using the disability adjusted life year (DALY) to assess major health problems. This study was designed to assess the burden of transport accident in South Khorasan (SK) province of Iran for 2005.Methods: Years of life lost (YLLs), Years lived with Disability (YLDs) and DALYs were calculated by using methodology developed for the global burden of disease study (GBD) in 2003. The total population of SK was included in this study.Results: In the 2005 year, the DALYs from transport accident in the south Khorasan province were 7456. DALYs for males and females were 5775 (77%), 1691 (23%) years respectively. The total rate of DALYs was 13.28 (per 1000) and with higher rates in age groups 30-44 years (20.86 per 1000), 15-29 years (16.96 per 1000) and 45-59 years (13.28 per 1000).Conclusions: The age group 15– 44 years was more at risk of transport accidents and injuries than others. The findings suggest that adequate interventional programs for transport accidents prevention and control should be taken to minimize at different levels.

Background & Objectives: Suicide is considered as an important cause of death in many societies. Although many factors involve, there are inadequate information in this field. The aim of this study was to determine related factor in individual who attempted suicide in Arak University of medical sciences (AUMS) hospitals in 1384 to 1386.Methods: This study was an observational study which was carried out in all attempted suicide in all hospitals affiliated to (AUMS) from 2004 to 2007 year. Demographic information, time of suicide, the number of suicide, the result of suicide, the form of suicide, emotion and history of suicide, material chronic and mental disorder were asked by completing a questionnaire and/or interview with individuals.Results: Totally 4226 persons attempted to suicide during the 3 years. The mean age for attempted suicide was 24.95±9.72 years and for successful suicide were 29.79±13.72 years. Approximately 60% was female. Near 80% of female were lower than 30 years old. Around 60 percent had high school degree. Familial dispute was the major risk factor in attempting to suicide. 82.5 % of persons used drug for their attempt to suicide. Nearly three percent of all suicide was successful.Conclusions: With regard to the lower rate of attempting suicide in this area, this important issue should be considered for health policy makers in Arak area.

Background & Objectives: The youth group is more prone to HIV infection. Education is a cornerstone to prevention. This study was conducted to compare the efficacy of peer education and traditional lectureship and distribution of pamphlet on high school students.Methods: 1500 female high school students, third graders, were selected based on stratified random sampling studying in 21 high schools in Kermanshah. In each high school, 73 third grades were selected as the sample of the study. We designed a questionnaire as an assessment tool for interventions. Peer education was done by 502 students, and AIDS awareness pamphlet was distributed on 500 students, and the rest of students were attended a one-day workshop which was ran by a female physician in their high school.Results: The mean average age was 16.78 (SD=±0.7) years. The mean scores of pretest and post-test in each groups were statistically significant different (P=0.0001). Mean score of difference in workshop by female physician was greater than peer education group, 10.7 and 8.8, respectively. The group whome received their knowledge about AIDS by pamphlet obtained the least mean score than other groups and this was statistically significant (P=0.0001).Conclusions: The findings of this study indicate that educating students by general practitioners is more effective way to increase students’ knowledge about prevention of AIDS.

Background & Objectives: Triglyceride/HDL-cholesterol ratio (TG/HDL-C) has been shown as an indicator for metabolic syndrome (MetS). This study aimed to detect the role of this ratio to predict coronary heart disease (CHD) outcome in an Iranian men population with high prevalence of MetS.Methods: 1824 men ³ 40 years old, free of clinical cardiovascular disease at baseline, were included in the study from February 1999 to August 2001. Serum level of total cholesterol (TC), HDL-C, TG, and risk factors of CHD; including age, systolic blood pressure, diastolic blood pressure, body mass index, diabetes, smoking and family history of cardiovascular diseases were measured at initial phase of study.Results: During a median follow up of 6.5 years until March 2007, a total of 163 new CHD events occurred. According to a Cox proportional hazard modeling, after adjustment for TC and other risk factors, men in the top quartile of  TG/HDL-C relative to first quartile had a significant hazard ratio (HR) of 1.85 (95% CI, 1.07-3.17). Combined HR for TC and TG/HDL-C (men in the top quartiles of both TC and TG/HDL-C relative to first quartiles) after adjustment for other risk factors was 6.13 (95% CI, 2.37-15.86).Conclusions: The evaluation of both TG/HDL-C ratio and TC should be considered for CHD risk prediction in Iranian male population.

Background and Objectives: Injury by sharp instruments and needles are major occupational health hazard for healthcare workers. This study was conducted to determine the prevalence rate and causes of injuries due to needle stick in healthcare workers in Zahedan University of Medical Sciences.Methods: In a cross-sectional study, 231 healthcare workers of university hospitals of Zahedan University of Medical Sciences were selected at random in 2007. Data were collected through questionnaire and were analyzed by SPSS 13.Results: From all cases 77.1% were female 56.4% of them were expert, and 50.7% were nurses. Their mean age was 34±8.1 years. Needle stick prevalence was 64.9% during the whole history of career, and 57.2% of them had experiences of needle stick more than twice. Most cases of injuries were related to using needle 55.4%, and they were mostly prone to injury during injection and phlebotomy, 55.6%. The multivariate regression analysis showed that injury due to sharp instruments in university graduates was 60% less compared to those with high school or less, and the injury risk increases 5% in each year of increase in working experience.Conclusions: The findings of this study highlight the importance of training and preventive measures in healthcare centers particularly among high risk group.

Background & Objectives: There is geographic variability in the prevalence of asthma. Since there is inadequate of study on asthma in Iran, this study was performed in order to determine the prevalence of asthma in Kurdistan province.Methods: This cross-sectional study was performed as part of Iranian national survey to determine the  risk factors of non communicable disease.Results: This study includes 500 men and 500 women. Prevalence of history of asthma was 2.3%. There was no statistically significant association between asthma and place of residence, smoking and body mass index. Asthma were found in 6 (1.8%) of men and 17 (5%) of women (p=0.02). Prevalence of asthma increased with increasing age (p<0.001).Conclusions: The prevalence of asthma in this study was similar with other studies in Iran and seems lower than similar countries.