Iranian Journal of Epidemiology
Year:2006 | Volume:1 | Issue:4|Papers Count:11

Background & Objectives: Iron is a major essential micronutrient during pregnancy and has an important role in intrauterine fetal growth and safe delivery. This survey was designed to study the status of anemia, iron deficiency and iron deficiency anemia in pregnant Iranian women. The results can help health policy-makers with the design and implementation of targeted strategies to overcome these problems.Methods: This cross-sectional study involved 4368 women at gestational ages ranging from 6 to 9 months. Subjects were drawn through cluster sampling from 11 different regions of the country. Hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV) and serum ferritin levels were measured and the prevalence of anemia, iron deficiency and iron deficiency anemia (IDA) was determined both nationwide and separately in each region.Results: Overall, 21.5% of the women suffered from anemia; 42.7% were iron deficient and the prevalence of IDA was found to be 10.4%. The prevalence of anemia s was significantly greater in rural areas than in urban settings (22.2- 27.8% compared to 17.1 -21.6%, 95%CI). The highest prevalence of anemia and low Hct was seen in the women of region 5 (including Sistan and Baluchistan, South Kerman and South Khorasan with rates of 44.2% and 40.5% respectively). Region 6 (covering Isfahan, Yazd, Kohkilooyeh-Boyerahmad and North Kerman) had the lowest prevalence of anemia and low Hct (9% and 10.8% respectively). Use of iron supplements (even irregular) had a positive effect in reducing anemia. It affected Hct levels only when taken regularly.Conclusions: Anemia is still a major health issue for pregnant Iranian women. Although supplementation should be continued, there is a need for more comprehensive interventions addressing all target groups, especially women of child-bearing age.

Background & Objectives: Multiple Sclerosis (MS) is the most prevalent autoimmune disease of nervous system in young adults. The current number of diagnosed cases in Iran is above 40000 and is steadily increasing the objective of this study was to assess the daily macronutrient intake of MS patients and to compare this with reference values.Methods: We randomly selected 108 relapsing- remitting patients were randomly from the Iranian MS society in 2005. Two questionnaires containing personal and medical information were filled for each patient. We assessed food intake by three 24-hour recalls and a semi-quantitative food frequency questionnaire dealing with intake over the past year. Using the Manual for Household Measures, the data were changed to values in grams and then turned to nutrient ingredients by applying Nutritionist-3. Data analysis was done using the SPSS package: m mean and standard deviation were computed for each nutrient and t tests were run to compare the figures with reference values.Results: MS patients living in Tehran had a dietary intake of total fat, saturated fat and protein higher than recommended, while their intake of fibers was below the reference values. The body mass index was subnormal in 14.8% of the patients and above normal in 38%. Conclusions: In light of the current pattern of macronutrient ingestion in MS patients in Tehran, a lower intake of total and saturated fat, consumption of vegetable proteins instead of animal protein and more dietary fiber are recommended. To meet this goal, vegetables, fruit, whole grains and beans are good suggestions. It seems that Iranian MS patients need nutritional assessment, counseling and education to improve their diet.

Background & Objectives: For those with a chronic illness, suffering may result not only from physical limitations, but also from the psychosocial consequences of having a chronic condition. Therefore, simply measuring physical health is not enough anymore. It is necessary to evaluate quality of life as an important clinical outcome in these patients. We conducted the present study to measure quality of life (QoL) in multiple sclerosis (MS) patients and its predictors in comparison with the general population in Tehran, using a generic and overall QoL instrument, the WHOQOL-BREF (World Health Organization Quality of Life-BREIF). This questionnaire comprises four domains including physical health, mental health, social relationships, and environmental health. For each domain, scores range from 4 to 20, higher scores corresponding to a more favorable QOL.Methods: This study was of cross-sectional type and involved 145 selected systematically patients registered in the Iranian Multiple Sclerosis Society. The WHOQOL-Questionnaire was filled in for these patients through telephone interviews. The results were compared with quality of life scores from the general population obtained from a population-based study in Tehran. Multiple regressions were used for data analysis.Results: The response rate was 97%; 73.8% of participants were female, the mean age of participants was 36.5 (SD = 10.4) years, and the mean years of their formal education was 12.5 (SD=3.6). Mean scores for physical health, psychological health, social relationship and environmental health were 11.5 (SD=3.2), 11.8 (SD=3.2), 12.7 (SD=3.1), and 11.5 (SD=2.7), respectively. In comparison with the general population, the patients' scores in all domains were significantly lower than in the general population. Severity of disease and education level had a relationship with domain scores in regression analysis.Conclusions: The WHOQOL-BREF questionnaire can discriminate between these patients’ quality of life and that of the general population and show the effect of disease severity and demographic variables on quality of life. Therefore the questionnaire can be used in this group of patients, although it may be necessary to add some specific questions to make the tool more sensitive in evaluating quality of life from a clinical perspective. Educational interventions are recommended to improve quality of life in this group of patients.

Background & Objectives: The widely differing casualty rates in earthquakes of similar magnitude indicate a need for assessing the factors that determine the extent of damage to life and property. The present study looks at the structural factors and individual characteristics that had an effect on the risk of death and injury directly caused by the December 2003 earthquake in Bam. Methods: The study population consisted of the residents of Bam on the 19th and 20th days after the earthquake of December 25, 2003. Using a cluster sampling method based on geographic location, we selected 420 households for study and asked them for information on the family members who were inside their houses at the time of the quake. The information covered the following range of items: occurrence of death or injury leading to ambulatory treatment or hospitalization, and characteristics of the building. We used logistic regression and the software package Stata 8.0 for data analysis.Results: A total of 2089 individuals, including 1089 men (52.1%) and 1000 women (47.9%) took part in this study. There were 369 cases of death (17.7%, 95%CI=12.6-17.8%), 122 injuries needing hospitalization (5.8%, 95%CI=4.5-7.1%), and 319 cases of injury treated on an ambulatory basis (15.3%, 95%CI=12.6-17.8%), all as a direct result of the earthquake. Factors associated with increased risk of death were building destruction (OR=6.34, 95%CI=3.56-11.29), living in adobe structures (OR=1.87, 95%CI =1.03-3.4), age under 6 years (OR=3.93, 95%CI=2.17-7.11) and age 56-65 years (OR=2.52, 95%CI=1.23-5.15). Risk factors for injuries were the same as for death, with the notable exception of the building material.Conclusions: This was the first analytic study of the risk factors for earthquake-related deaths in Iran. It revealed that total building destruction, residing in houses built with non-resistant materials, and extremes of age are significant risk factors for death in an earthquake. As for injuries, the risk factors were total building destruction and extremes of age.

Methods: A single cluster study was conducted in 2005, based on a sample of households, representative of the population aged 25-65 years in Golestan. All participants were invited for face-to-face interviews to gather demographic data. Blood samples were drawn and analyzed for serum markers of HBV infection such as HBsAg and HBcAb by the ELISA method. Factors associated with hepatitis B seroprevalence were analyzed using SPSS13 and STATA /8.Results: A total of 1850 subjects were screened. The age- & sex-standardized prevalence for HBsAg positivity was 9.7% (95%CI=0.07-0.11). Rates were higher in males than in females (10.8% vs. 8.6%) (OR=1.28; 95% CI=0.9-1.7). HBV seroprevalence in unmarried individuals was significantly higher than in those who were married (OR=2.13; 95%CI=1.29-3.5). HBsAg(+) status was more frequent in urban areas (OR=1.46; 95% CI=0.9-2.3). Thirty-six percent of population was HBcAb positive. HBcAb(+) prevalence was significantly higher in females (OR=1.46; 95% CI=1.19-1.8) and married people (OR=1.58; 95%CI=1.02-2.45), and also in urban areas (OR=1.34; 95% CI=1.09-1.6). Conclusions: This study shows that the prevalence of HBsAg(+) status  in the Iranian province of Golestan is at a level regarded as "high" by the World Health Organization. It is higher than reported by pervious studies in Iran so it is important- especially for health providers and policy makers- to recognize risk factors and design appropriate prevention programs.

Background & Objectives: Job stress is common among different groups of professionals. It might be regarded as a defensive reaction allowing the individuals to cope with negative inputs and risk factors. Because of the rise in the mass production of motor vehicles in Iran over the last 2 decades, many managers in the car industry describe their jobs as highly stressful. However, there have not been any studies in Iran on the pattern of job stress in these managers. The aim of this study was to outline the epidemiologic pattern of job stress among managers of car companies in Iran.Methods: This study was carried out among 496 managers of car industry in Iran. Using 12 different instruments the job stress of subjects was assessed. The main domains employed to assess job stress were time pressure, scheduling and timing, management at work, decision-making at work, organizational roles, development and structure, communication at work, work condition, and interaction between work and home duties.Results: The mean age of subjects was 43.6 years with 12.1 years of job experience (SD=7.7). All subjects were males and 95% were married. The prevalence rate of job stress among subjects was 49.5%. The top four stressors were from decision-making at work (99.1%), time pressure (97.3%), time-table and scheduling (73.5%), and management at work place (50.5%). The prevalence of job stress was more common among the managers of lower level, and the younger ones (P<0.001). However, there was no significant difference by marital status and educational attainments.Conclusions: This study showed that the Iranian managers working at car manufacture companies are at a higher risk of job stress and its effects compared to other managers in developed countries. Job stress may play a part in making them vulnerable to illness. It should be recognize as a priority of occupational health in this community. Stress management and appropriate interventions needs to be employed to control the negative effects of job stress among this group of managers.

Background & Objectives: Pediculosis is a ubiquitous and contagious parasitic dermatosis. Throughout the world, infestation by the head louse (Pediculus humanus capitis) is more common among schoolchildren, especially in those aged 6-11 years.  This descriptive/analytical study was carried out in 2003 to determine the prevalence of pediculosis capitis and risk factors involved in the epidemiology of pediculosis in primary school pupils in Amlash, Gilan province.Methods: The children were selected by cluster random sampling of schools and classes, and then examined for head lice using hair conditioners and a fine-toothed head lice comb. We screened a total of 4244 pupils from 95 primary schools. We used a comprehensive questionnaire to evaluate the effects of school type and location, education level, parent job, regular baths, number of persons sharing the same bed, combing frequency, host sensitivity, family size, hairstyle, gender, and hair length. Results: Statistical analysis using X2 tests showed that school type, school location, parent job, regular baths, number of person who share the same bed, frequency of combing, gender, host sensitivity, family size, and hairstyle are significantly associated with infestation. Infestation rate showed no correlations with hair color, season, age, or education level. Results showed that pediculosis is more prevalent in rural than in urban areas. The average rate of infestation for the area was 9.2%, indicating an epidemic situation by standard criteria.Conclusions: The high prevalence of P. capitis infestation among these children was probably due to poor environmental hygiene and scarcity of water. Hygienic controls of schoolchildren by nurses are important for elimination of Pediculus humanus capitis. This is the first community-based study describing in detail the epidemiology of head louse infestation in the Amlash district of Gilan province in Iran and confirms that Pediculosis capitis is still a problem in many environments, particularly those with low life standards and poor health care.

Background & Objectives: There are near two million people from around the world have planning to journey for Hadje ceremony. Old age, Crowding dormitory, close contact, poor sanitation, poor health services, different community pattern, high temperature and other factors cause the infectious diseases particularly respiratory infection more than ever Influenza occur more common and cause more discomfort during this ceremony. This study in 1381 Clear the effect of influenza vaccine compare with placebo in this group of population Pilgrimage group.Methods: This study had interventional randomize clinical design on 156 pilgrims in Abhar City. The pattern of the cases selection for reducing of bias effect was every other pilgrim for vaccine injection. All of the cases before, during and three week after return back from this ceremony had close health services. All the pilgrims had private document for recording the events.Results: About 147 of pilgrims experienced had pulmonary infection (93% in case and 96% in control). There was no difference in either cases or control groups.Conclusions: There is no benefit for using influenza vaccine other than its indications in the patients but it needs additional studies.