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Ghamari SH, Mohebi F, Abbasi-Kangevari M, Peiman S, Rahimi B, Ahmadi N, Farzi Y, Seyfi S, Shahbal N, Modirian M, Azmin M, Zokaei H, Khezrian M, Sherafat R, Malekpour MR, Roshani S, Rezaei N, Fallahi MJ, Shoushtari MH, Akbaripour Z, Khatibzadeh S, Shahraz S. Patient experience with chronic obstructive pulmonary disease: a nationally representative demonstration study on quality and cost of healthcare services. Front Public Health 2023; 11:1112072. [PMID: 37397720 PMCID: PMC10308222 DOI: 10.3389/fpubh.2023.1112072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Due to insufficient data on patient experience with healthcare system among patients with chronic obstructive pulmonary disease (COPD), particularly in developing countries, this study attempted to investigate the journey of patients with COPD in the healthcare system using nationally representative data in Iran. Methods This nationally representative demonstration study was conducted from 2016 to 2018 using a novel machine-learning based sampling method based on different districts' healthcare structures and outcome data. Pulmonologists confirmed eligible participants and nurses recruited and followed them up for 3 months/in 4 visits. Utilization of various healthcare services, direct and indirect costs (including non-health, absenteeism, loss of productivity, and time waste), and quality of healthcare services (using quality indicators) were assessed. Results This study constituted of a final sample of 235 patients with COPD, among whom 154 (65.5%) were male. Pharmacy and outpatient services were mostly utilized healthcare services, however, participants utilized outpatient services less than four times a year. The annual average direct cost of a patient with COPD was 1,605.5 USDs. Some 855, 359, 2,680, and 933 USDs were imposed annually on patients with COPD due to non-medical costs, absenteeism, loss of productivity, and time waste, respectively. Based on the quality indicators assessed during the study, the focus of healthcare providers has been the management of the acute phases of COPD as the blood oxygen levels of more than 80% of participants were documented by pulse oximetry devices. However, chronic phase management was mainly missed as less than a third of participants were referred to smoking and tobacco quit centers and got vaccinated. In addition, less than 10% of participants were considered for rehabilitation services, and only 2% completed four-session rehabilitation services. Conclusion COPD services have focused on inpatient care, where patients experience exacerbation of the condition. Upon discharge, patients do not receive appropriate follow-up services targeting on preventive care for optimal controlling of pulmonary function and preventing exacerbation.
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Affiliation(s)
- Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California, Berkeley, CA, United States
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, United States
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sherafat
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Roshani
- The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Fallahi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Haddadzadeh Shoushtari
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Akbaripour
- Razi University Hospital, Guilan University of Medical Sciences, Guilan, Iran
| | - Shahab Khatibzadeh
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Saeid Shahraz
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, United States
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Abbasi-Kangevari M, Mohebi F, Ghamari SH, Modirian M, Shahbal N, Ahmadi N, Farzi Y, Azmin M, Roshani S, Zokaei H, Khezrian M, Seyfi S, Keykhaei M, Gorgani F, Rahimi S, Rezaei N, Khatibzadeh S, Shahraz S. Quality and cost of healthcare services in patients with diabetes in Iran: Results of a nationwide short-term longitudinal survey. Front Endocrinol (Lausanne) 2023; 14:1099464. [PMID: 37008899 PMCID: PMC10060949 DOI: 10.3389/fendo.2023.1099464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/14/2023] [Indexed: 03/18/2023] Open
Abstract
Aims To investigate the journey of patients with diabetes in the healthcare system using nationally-representative patient-reported data. Methods Participants were recruited using a machine-learning-based sampling method based on healthcare structures and medical outcome data and were followed up for three months. We assessed the resource utilization, direct/indirect costs, and quality of healthcare services. Results One hundred fifty-eight patients with diabetes participated. The most utilized services were medication purchases (276 times monthly) and outpatient visits (231 times monthly). During the previous year, 90% of respondents had a laboratory fasting blood glucose assessment; however, less than 70% reported a quarterly follow-up physician visit. Only 43% had been asked about any hypoglycemia episodes by their physician. Less than 45% of respondents had been trained for hypoglycemia self-management. The annual average health-related direct cost of a patient with diabetes was 769 USD. The average out-of-pocket share of direct costs was 601 USD (78.15%). Medication purchases, inpatient services, and outpatient services summed up 79.77% of direct costs with a mean of 613 USD. Conclusion Healthcare services focused solely on glycemic control and the continuity of services for diabetes control was insufficient. Medication purchases, and inpatient and outpatient services imposed the most out-of-pocket costs.
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Affiliation(s)
- Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California Berkeley, Berkeley, CA, United States
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Roshani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Feinberg Cardiovascular and Renal Research Institute, Northwestern University, School of Medicine, Chicago, IL, United States
| | - Fatemeh Gorgani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saral Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahab Khatibzadeh
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Saeid Shahraz
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, United States
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Shahraz S, Shahin S, Farzi Y, Modirian M, Shahbal N, Azmin M, Mohebi F, Naderian M, Amin-Esmaeili M, Ahmadi N, Seyfi S, Zokaei H, Samadi R, Mohajer B, Sherafat-Kazemzadeh R, Balouchi A, Mesgarpour B, Parsaeian M, Gorgani F, Rahimi S, Saeedi Moghadam S, Khezrian M, Amin A, Baheshmat S, Beyranvand MR, Haghjoo M, Mahdavi-Mazdeh M, Mehrpour M, Moradi G, Peiman S, Rahimi B, Rahimi-Movaghar A, Rikhtegar R, Roshani S, Saadatnia M, Samimi Ardestani SM, Khatibzadeh S. Iran Quality of Care in Medicine Program (IQCAMP): Design and Outcomes. Arch Iran Med 2023; 26:126-137. [PMID: 37543935 PMCID: PMC10685727 DOI: 10.34172/aim.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/08/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran. METHODS We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication. RESULTS Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits. CONCLUSION The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.
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Affiliation(s)
- Saeid Shahraz
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- School of Agriculture and Food Science, The University of Queensland, Brisbane, Australia
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California, Berkeley, CA, USA
| | - Mohammadreza Naderian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoume Amin-Esmaeili
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Samadi
- Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sherafat-Kazemzadeh
- Institute for Global Health and Development, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Abbas Balouchi
- Nursing Department, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Bita Mesgarpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Fatemeh Gorgani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saral Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghadam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Cardiogenetics Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahab Baheshmat
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Beyranvand
- Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Haghjoo
- Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Mahdavi-Mazdeh
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mehrpour
- Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, Florida, USA
| | - Besharat Rahimi
- Advanced Thoracic Research Centre, Tehran University of Medical Science, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Rikhtegar
- Institute for Diagnostic and Interventional Radiology, Alfried Krupp Hospital Ruttenscheid, Essen, Germany
| | - Shahin Roshani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saadatnia
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahab Khatibzadeh
- Heller School of Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Azmin M, Mohebi F, Yoosefi M, Ahmadi N, Shirazi S, Modirian M, Farzadfar F. The incremental cost of implementing the world health organization Package of essential non-communicable (PEN) diseases interventions in Iran. PLOS Glob Public Health 2023; 3:e0000449. [PMID: 36962715 PMCID: PMC10021820 DOI: 10.1371/journal.pgph.0000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 12/15/2022] [Indexed: 02/11/2023]
Abstract
World-Health-Organization's PEN package proposes a minimum set of cost-effective interventions for early diagnosis and management of Non-Communicable-Disease (NCD). IraPEN (the PEN package implemented in Iran), adopted from PEN and Iran National Action Plans for NCDs, addresses challenges regarding NCD prevention and control. IraPEN was piloted in four districts of Iran. In this research, we estimate incremental per-capita cost of IraPEN program implementation in two of the pilot districts. We utilized a bottom-up, ingredient-based costing approach. Institutional expenditure data was collected via information forms. Information pertaining to personnel costs was gathered by performing task time measurements using Direct Observation Method. An individual-level survey was conducted in under-study districts to determine program coverage and its users' demographic information via systematic random cluster sampling. Sampling of districts was based on systematic random cluster sampling. In each district, 250 families in 25 clusters proportional to urban or rural populations were randomly selected by postal codes. All family members eligible for the program were interviewed. Interviews were organized and conducted in each district by NCD experts in provincial Universities of Medical Sciences. Costs were re-categorized into fixed and variable costs based on their dependency on the program's coverage. Fixed and variable costs were, respectively, divided by total eligible populations and covered populations in each district to calculate cost per-capita for each protocol. Total per-capita cost per-service was then calculated for each protocol and whole program by adding these figures. All costs are reported in US$ 2015-2016. The incremental costs of IraPEN implementation per user, with and without introduction cost, were US$24.90 and US$25.32, respectively. Total incremental cost per-capita for each protocol ranged between US$1.05 to US$7.45. The human resources and supplies had the highest contribution in total program cost (74.97% and 15.76%, respectively). The present study shows that IraPEN program implementation to be a high-cost package within Iranian context, that necessitates cautions in other similar contexts for implementation. It is, however, difficult to make decisions on implementation of NCD prevention and control programs purely based on their cost. Informed decision making requires assessment of a programs' effectiveness and justifications and alterations to the current package could reduce the costs, leading to increased efficiency of the program.
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Affiliation(s)
- Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Haas School of Business, University of California, Berkeley, California, United States of America
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shirazi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Rezaei N, Ahmadi N, Shams Beyranvand M, Hasan M, Gohari K, Yoosefi M, Djalalinia S, Saeedi Moghaddam S, Modirian M, Pazhuheian F, Mahdavihezaveh A, Moradi G, Delavari F, Larijani B, Farzadfar F. Alcohol consumption and related disorders in Iran: Results from the National Surveillance of Non-Communicable Diseases' Survey (STEPs) 2016. PLOS Glob Public Health 2022; 2:e0000107. [PMID: 36962484 PMCID: PMC10021244 DOI: 10.1371/journal.pgph.0000107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/28/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Alcohol consumption is a public health concern which is illegal in Iran. Moreover, due to cultural and religious beliefs, the available population-based research findings on alcohol consumption are inadequate. We aimed to provide an estimate on alcohol consumption using a large-scale population-based survey in Iran. MATERIALS AND METHODS The National Surveillance of Non-Communicable Risk Factors in Iran was a population-based survey conducted in 2016. The epidemiologic distribution of alcohol consumption and its related disorders were assessed using weighted survey methods and multiple logistic regression models. Age standardized rates were calculated using Iran's national population census in 2016. RESULTS At the national level, the prevalence rates of lifetime and current alcohol consumption were 8.00% (95% CI: 7.67-8.32) and 4.04% (95% CI: 3.81-4.27), respectively. The highest prevalence was reported among 25 to 34 year-olds. Individuals of higher socioeconomic status consumed significantly greater levels of alcohol. At provincial level, the highest and lowest percentages of the current alcohol drinking rates in Iran's provinces were, 23.92% (95% CI: 17.56-30.28) and 0.4% (95% CI: 0-1.18) in males, 1.58% (95% CI: 0.22-2.94) and 0% in females, respectively. In urban regions, the highest alcohol consumption rate was more than 22 times greater than the lowest alcohol consumption rate. Current alcohol drinkers were 2 times more prone to injury as compared to nondrinkers (ORadj: 2.0, 95%CI: 1.7, 2.3). CONCLUSION In Iran, the prevalence of alcohol consumption is low, although there is a considerable variation of alcohol consumption at provincial level as well as in different gender groups. Therefore, preventive WHO-recommended measures should be adopted more seriously by vulnerable groups.
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Affiliation(s)
- Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Shams Beyranvand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Hasan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farnaz Delavari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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6
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Shahraz S, Saeedi Moghaddam S, Azmin M, Peykari N, Yoosefi M, Mohebi F, Khatibzadeh S, Mohammadi Fateh S, Djalalinia S, Modirian M, Mahmoudi N, Mahmoudi Z, Dashti S, Mahdavi Hezaveh A, Larijani B, Farzadfar F. Prevalence of Diabetes and Prediabetes, and Achievements in Diabetes Control in Iran; The Results of the STEPS of 2016. Arch Iran Med 2022; 25:591-599. [PMID: 37543884 PMCID: PMC10685770 DOI: 10.34172/aim.2022.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/10/2022] [Indexed: 08/07/2023]
Abstract
BACKGROUND Using the WHO STEPwise approach to NCD risk factor surveillance (STEPS), first round of Iran's STEPS completed in 2005. It has been repeated six times afterward. Here we report the results of 2016 round on the population characteristics and prevalence of diabetes and prediabetes, along with an assessment of the country-level performance on diabetes care in Iran. METHODS Using a proportional-to-size cluster random sampling method, the STEPS 2016 included 18947 subjects aged≥25 years who matched the criteria (non-missing information on diabetes self-report, and biomarkers). For the analyses, survey design methods with weighted samples were employed. Different definitions of diabetes (biomarker-based, self-report, anti-diabetes medication use, or a combination) and prediabetes (different cutpoints of the biomarker) were calculated and presented. RESULTS An estimated 5171035 persons aged≥25 years or 10.6% (95% CI: 10.0%-11.1%) had diabetes according to the serologic diagnosis of diabetes (FPG≥126 mg/dL) or the use of at least one anti-diabetes medication (1896 out of 18947). Employing the serologic diagnosis of diabetes among those who responded no to the self-reported question, 2.7% (2.5%-3.0%) of the population were not aware of their diabetes compared to 11.5% (10.9%-12.0%) who were diabetics according to the just self-reported question. Defining prediabetes as 100≤FPG<126 mg/dL or 5.7≤HbA1c<6.5%, an estimated 15244299 persons had prediabetes (5885 out of 18947). Overall, 52.1% (49.4%-54.7%) of patients with self-reported diabetes were under strict glycemic control (HbA1c<7%). Poor diabetes control (HbA1c>9%) was found in 18.4% (16.3%-20.6%) of the patients with self-reported diabetes. CONCLUSION Since 2005, the prevalence of diabetes in Iran has been on a gradual increase in both genders with an increasing gap between females and males.
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Affiliation(s)
- Saeid Shahraz
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Peykari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Deputy for Education, Ministry of Health and Medical Education, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Haas School of Business, University of California, Berkeley, CA 94720, USA
| | - Shahab Khatibzadeh
- Brandeis University, Heller School for Social Policy and Management, Waltham, Massachusetts, USA
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Mahmoudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarina Dashti
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mahdavi Hezaveh
- Center for Noncommunicable Disease Control and Prevention, Ministry of Health and Medical Education, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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7
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Naderimagham S, Gohari K, Sheidaei A, Jamshidi H, Namazi Shabestari A, Modirian M, Rezaei N, Kompani F, Damerchilu B, Bahrami-Taghanaki H, Larijani B, Farzadfar F. Twenty-Six-Year Trend of Mortality Rate due to Ischemic Heart Diseases (IHDs) in Iran: 1990-2015. ijph 2022; 51:416-425. [PMID: 35866131 PMCID: PMC9273501 DOI: 10.18502/ijph.v51i2.8695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/16/2020] [Indexed: 12/04/2022]
Abstract
Background: Ischemic Heart Diseases (IHDs) are the main causes of deaths all over the world. Since there is no comprehensive study on IHDs mortality rate in Iran, the present study aimed to estimate age-standardized IHDs mortality rate by sex, age, geography, and time trends at both national and sub-national levels in Iran. Methods: We used the Death Registration System (DRS) data from 1990 to 2015 collected by the Iranian Ministry of Health and Medical Education across the country, Tehran, and Isfahan main cemetery, not included in the DRS. Utilized death distribution methods to overcome the incompleteness of data. Statistical models including Spatio-temporal and Gaussian-Process Regression models were used to extrapolate all-cause and cause-specific mortality rates. Results: Age-standardized IHDs mortality rate in Iran almost doubled from 1990 to 2015. Forty-nine deaths per 100.000 population in 1990, which increased to 91.6 deaths per 100.000 in 2015). Male to female age-standardized mortality rate increased from 1.07 to 1.32 during the studied period. Aging was associated with an increase in age-standardized IHDs mortality rate in both sexes, all provinces, and all of the years. The range of age-standardized IHDs mortality rate for both sexes was from 58 to 136.2 deaths per 100,000 across provinces in 2015. Conclusion: Due to the increase in age-standardized IHDs mortality rate in Iran, it seems necessary to design and implement appropriate public health interventions by health authorities to prevent and control this group of diseases.
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Affiliation(s)
- Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamshidi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- National Institute for Medical Research Development (NIMAD), Ministry of Health and Medical Education, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Division of Hematology and Oncology, Children’s Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Damerchilu
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Bahrami-Taghanaki
- Department of Complementary and Chinese Medicine, Faculty of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author:
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8
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Varmaghani M, Sharifi F, Mehdipour P, Sheidaei A, Djalalinia S, Gohari K, Modirian M, Pazhuheian F, Peykari N, Haghshenas R, Khajavi A, Zokaei H, Moradi G, Mahdavihezaveh A, Farzadfar F. Prevalence of Smoking among Iranian Adults: Findings of the National STEPs Survey 2016. Arch Iran Med 2020; 23:369-377. [PMID: 32536173 DOI: 10.34172/aim.2020.29] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 01/18/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Tobacco smoking is one of the most important avoidable causes of mortality from non-communicable diseases (NCDs). This study aimed to report the crude and standardized prevalence of current, ever, and secondhand smoking at national and provincial levels. METHODS This study was performed through an analysis of the results of the STEPs survey 2016, which was conducted as a cross-sectional national study. The samples were selected via multistage cluster sampling and they were representative of general population aged ≥18 years in all provinces of Iran. All the data were analyzed via survey analysis while considering population weights. Age-standardized prevalence was also calculated for the Iranian national population in 2016 and the World Health Organization (WHO) Population 2000-2025. RESULTS A total of 29963 subjects aged ≥18 years from all provinces of Iran, except for Qom, participated in this study. The age standardized prevalence of current tobacco smoking among adult males and females were 24.4% (95% CI: 23.6%-25.1%) and 3.8% (95% CI: 3.5%-4.1%), respectively. Among the participants, the majority of the current smokers were among those aged 45-54 years (14.5%; 95% CI: 13.6%-15.5%). With increase in age, the prevalence of secondhand smoking decreased to 34.8% (95% CI: 33.3%-36.7%) among people aged 18-24 years and to 22·6% (95% CI: 21.0%-24.3%) among subjects over 70 years. CONCLUSION The result of the study can be used to inform policy makers about the status of smoking and help them to design policies for setting rules on and limiting the import of cigarettes and their components to the country.
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Affiliation(s)
- Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Peykari
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Ministry of Health and Medical Education, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khajavi
- Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Farshad Farzadfar
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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9
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Mahdavi M, Parsaeian M, Mohajer B, Modirian M, Ahmadi N, Yoosefi M, Mehdipour P, Djalalinia S, Rezaei N, Haghshenas R, Pazhuheian F, Madadi Z, Sabooni M, Razi F, Samiee SM, Farzadfar F. Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines. BMC Public Health 2020; 20:347. [PMID: 32183754 PMCID: PMC7076938 DOI: 10.1186/s12889-020-8450-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/03/2020] [Indexed: 01/13/2023] Open
Abstract
Background We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA –with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies. Methods Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2–30.6), which soared to 53.7% (52.9–54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0–60.3), 80.2% (78.9–81.4), and 39.1% (37.4–40.7) based on JNC8, which dropped to 37.1% (36.2–38.0), 71.3% (69.9–72.7), and 19.6% (18.3–21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25–34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by − 3.56(− 4.38, − 2.74), − 2.04(− 2.58, − 1.50), and 0.48(0.42, 0.53) mmHg, respectively. Conclusions Switching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services.
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Affiliation(s)
- Mahdi Mahdavi
- National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.,Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Madadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sabooni
- Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | - Farideh Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Mirab Samiee
- Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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10
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Soleimanzadehkhayat M, Yoosefi M, Zamaninour N, Shahbal N, Gohari K, Sheidaei A, Naderimagham S, Khajavi A, Modirian M, Mahmoudi N, Mahmoudi Z, Dilmaghani-Marand A, Rezaee K, Chegini M, Khosravi A. Mortality Attributable to Nutritional Deficiencies among Iranian Children under the Age of Five at National and Subnational Level: 1995-2015. Arch Iran Med 2020; 23:75-83. [PMID: 32061069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Under-five mortality is considered an indicator of population well-being and health equality in societies. Under-five mortality caused by nutritional deficiencies is a public health concern in developing countries. In this study, we aimed to report the trend and mortality rate of nutritional deficiencies from 1995 to 2015 in children aged under five years. METHODS In this study, we used the death registration system (DRS) data to estimate age- and sex-specific nutritional deficiency mortality rates at national and sub-national levels in Iran from 1995 to 2015. The Iranian DRS used the 10th revision of International Classification of Diseases (ICD-10) but we report our results based on Global Burden of Diseases (GBD) study codes. We used the average annual percent change (AAPC) to quantify trend in under-five mortality rate attributable to nutritional deficiencies from 1995 to 2015. RESULTS At national level, mortality rates in both sexes were 8.53 (95% uncertainty interval [UI]: 7.69-9.47), 1.04 (0.86-1.36), and 0.37 (95% UI: 0.28-0.57) per 100,000 in 1995, 2005, and 2015, respectively. AAPC was estimated between 1995 and 2015. At sub-national level, the highest and lowest mortality rates across provinces ranged from 17.7 per 100000 in 1995 to 1.1 per 100000 in 2015. In the latest years, protein-energy malnutrition (PEM) was the most frequent cause of mortality among other nutritional deficiencies. CONCLUSION The results show a substantial reduction in terms of mortality caused by nutritional deficiencies at national, as well as provincial, level among children under-five years of age.
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Affiliation(s)
- Mojdeh Soleimanzadehkhayat
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Zamaninour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khajavi
- Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Mahmoudi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoudi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Rezaee
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chegini
- Arak University of Medical Sciences, Arak, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
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11
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Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, Zokaei H, Yoosefi M, Gohari K, Kousha A, Abdi Z, Naderimagham S, Soroush AR, Larijani B, Farzadfar F. Patterns of Obesity and Overweight in the Iranian Population: Findings of STEPs 2016. Front Endocrinol (Lausanne) 2020; 11:42. [PMID: 32174887 PMCID: PMC7055062 DOI: 10.3389/fendo.2020.00042] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/23/2020] [Indexed: 01/28/2023] Open
Abstract
Background: Obesity has become a common health problem all over the world. Benefiting from a national representative sample, the present study aimed to estimate the prevalence of overweight/obesity and the distribution of Body Mass Index (BMI) levels in the Iranian adult population, by sex, age, and geographical distribution. Methods: This was a large-scale national cross-sectional study of Non-communicable Diseases risk factor surveillance in Iran. Through a systematic random sampling cluster, 31,050 Iranian adult participants aged 18 years and over were enrolled in the study. The main research tools were used to assess three different levels of data, namely: (1) demographic, epidemiologic, and risk-related behavioral data, (2) physical measurements, and (3) lab measurements. Anthropometric measurements were taken using standard protocols and calibrated instruments. Results: In 2016, the national prevalence rates of normal weight, obesity, and overweight/obesity among Iranian adults were, 36.7% (95% CI: 36.1-37.3), 22.7% (22.2-23.2), and 59.3% (58.7-59.9), respectively. There was a significant difference between the prevalence of obesity among males [15.3% (14.7-15.9)] and females [29.8% (29.0-30.5)] (p < 0.001). The 55-64 [31.5% (30.1-33.0)] and the 18-24 [8.3% (7.3-9.4)] year-old age groups had the highest and lowest prevalence of obesity, respectively. The results show a geographical pattern at provincial level, where the level of BMI increases among populations ranging from the southeastern to the northwestern regions of the country. The highest provincial prevalence of obesity was almost 2.5-fold higher than the lowest provincial prevalence. Conclusion: We found a significant difference between the prevalence of obesity in males and females. Moreover, there was a considerable difference in the geographical pattern of the prevalence of obesity and overweight. Further evidence is warranted to promote strategies and interventions related to prevention and control of factors that are associated with weight gain.
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Affiliation(s)
- Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Sina Naghibi Iravani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zhaleh Abdi
- Department of Research and Education, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Soroush
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Farshad Farzadfar
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12
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Rezaei N, Pishgar F, Yoosefi M, Sheidaei A, Saeedi Moghaddam S, Mansouri A, Tahernia L, Naderimagham S, Modirian M, Pazhuheian F, Rezaei N, Namazi Shabestari A, Kompani F, Farzadfar F. National and Sub-National Pediatric Cancer Mortality in Iran, 2000-2015. Arch Iran Med 2019; 22:293-300. [PMID: 31356095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 04/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cancer, a common disease in adulthood, is a rare albeit slowly increasing condition among children. Currently, limited data are available on the incidence, prevalence, and mortality of these diseases in many regions, including developing countries. Herein, we are reporting national and sub-national estimates on deaths due to childhood cancers between 2000 and 2015 in Iran. METHODS Cancer mortality rates were estimated using the national death registration system's data after addressing its incompleteness and misclassification, using demographic (complete birth history and summary birth history) and statistical analysis (spatiotemporal, Gaussian process regression, and generalized linear mixed models). We included data from cemeteries of two cities (Tehran and Isfahan) that were not included in the death registration system. We used census data and household expenditure and income surveys for data on population and other covariates used in the modeling. RESULTS The overall age-standardized death rate (ASDR) of childhood cancers have decreased by 69.52% (80.67-49.71) in Iran (equal to an annual percent change of -3.63 [-4.53- -2.24]), declining from 12.24 (95% UI: 10.52-14.49) in 2000 to 3.73 (2.8-5.29) deaths per 100000 in 2015. This decrement was equal to an annual percent change of 4.35% over these years. Leukemia, brain, and nervous system malignancies accounted for about 66% of all cancer-related mortalities among children and adolescents in 2015, which had a 10% increase compared to 2000. Moreover, trends at the sub-national level showed that the highest and lowest ASDR of childhood cancers ranged from 2.12 to 4.99 across provinces of Iran in 2015. CONCLUSION Although the overall mortalities have decreased, there is still inequality in the distribution of the recorded deaths. This inequality should be addressed with the improvement of the quality of care and better access to pediatric hospitals and oncologists in these areas.
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Affiliation(s)
- Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pishgar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Tahernia
- Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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13
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Pishgar F, Amini E, Gohari K, Aminorroaya A, Sheidaei A, Rostamabadi Y, Ebrahimi H, Yoosefi M, Naderimagham S, Rezaei N, Modirian M, Namazi Shabestari A, Kompani F, Farzadfar F. National and subnational mortality of urological cancers in Iran, 1990-2015. Asia Pac J Clin Oncol 2018; 15:e43-e48. [PMID: 30270510 DOI: 10.1111/ajco.13074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/11/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE To study trends of urological cancers mortalities in Iran between 1990 and 2015 as a part of a larger project named national and subnational burden of diseases, injuries, and risk factors. METHODS The primary dataset of this project comprises data of national death registration system. Cause-specific mortality fraction for each age, sex, province, and year group was calculated using a two-stage mixed effects and spatiotemporal models, and then these fractions were applied to all-cause mortality rates, obtained from a parallel study to estimate mortality rates attributable to each cause. RESULTS In 2015, urological cancers constituted 8% of cancer-related deaths in Iran, and number of deaths due to prostate, bladder, testicular, and kidney and other urinary organs cancers were estimated as 2,128 (1,565-2,891), 297 (230-385), 301 (144-639), and 195 (143-267), respectively. Our estimates show that age-standardized death rates (ASDRs) of these cancers reached 6.8 (5-9.23), 0.47 (0.37-0.61), 0.96 (0.46-2.04), and 0.24 (0.18-0.33) deaths per 100,000 individuals in 2015, a reduction in the three latter cancers, from 4.09 (2.92-5.76), 13.04 (10.04-16.95), 1.23 (0.46-3.34), and 1.76 (1.28-2.42) deaths per 100,000 individuals in 1990, respectively. CONCLUSIONS In conclusion, despite disparities among different provinces, overall mortality rate of urological cancers decreased significantly since 1990s in Iran.
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Affiliation(s)
- Farhad Pishgar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Amini
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arya Aminorroaya
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasna Rostamabadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Ebrahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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14
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Djalalinia S, Saeedi Moghaddam S, Rezaei N, Rezaei N, Mansouri A, Abdolhamidi E, Naderimagham S, Modirian M, Marzban M, Khademiureh S, Rezaee K, Hasan M, Namazi Shabestari A, Farzadfar F. National and sub-national patterns of mortality from stroke in the Iranian population (1990-2015): Complementary results from the NASBOD study. Int J Stroke 2018; 15:132-148. [PMID: 30226449 DOI: 10.1177/1747493018799974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Iran lacks a population level comprehensive assessment of stroke epidemiology. Using data from the NASBOD Study, we estimated the mortality of stroke among the Iranian population from 1990 to 2015. METHODS Data were collected from all the available sources including the national death registration system and two major cemeteries. After addressing incompleteness of child and adult death data and by using mixed effect model, spatio-temporal model and Gaussian Process Regression, levels and trends of child and adult mortality were estimated. By considering cause fraction to these estimates; cause specific mortality was estimated. In these process wealth index, urbanization, and years of schooling were used as covariates. RESULTS In 2015, the age-standardized stroke mortality rate due was 47.76 (95% UI: 34.68-65.03) for males and 40.16 (30.38-5 2.72) for females, per 100,000 population. Stroke occurrence for both ischemic and non-ischemic strokes showed decreasing trends in both sexes after 2001-2002, at national and sub-national levels. The highest and lowest mortality rates between provinces ranged from 52.11 (40.3-66.66) to 24.47 (18.71-31.79) in men and from 65.51 (47.13-89.41) to 30.43 (21.95-41.82) in women per 100,000 population. CONCLUSION Although age-standardized rates of stroke mortality are falling, in the past three decades, the absolute number of people who have had a stroke has increased. Stroke mortality remains high in Iran.
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Affiliation(s)
- Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Marzban
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Khademiureh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,The Eco College of Insurance, Allameh Tabataba'i University, Tehran, Iran
| | - Kamyar Rezaee
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Hasan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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15
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Djalalinia S, Modirian M, Sheidaei A, Yoosefi M, Zokaiee H, Damirchilu B, Mahmoudi Z, Mahmoudi N, Hajipour MJ, Peykari N, Rezaei N, Haghshenas R, Mohammadi MH, Delavari A, Gouya MM, Naderimagham S, Kousha A, Moghisi A, Mahdavihezaveh A, Abachizadeh K, Majdzadeh R, Sayyari AA, Malekzadeh R, Larijani B, Farzadfar F. Protocol Design for Large-Scale Cross-Sectional Studies of Surveillance of Risk Factors of Non-Communicable Diseases in Iran: STEPs 2016. Arch Iran Med 2018; 20:608-616. [PMID: 29048923 DOI: 0172009/aim.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The rise in non-communicable diseases (NCDs) has gained increasing attention. There is a great need for reliable data to address such problems. Here, we describe the development of a comprehensive set of executive and scientific protocols and instructions of STEPs 2016. METHODS/DESIGN This is a large-scale cross-sectional study of Surveillance of Risk Factors of NCDs in Iran. Through systematic proportional to size cluster random sampling, 31,050 participants enrolled in three sequential processes, of completing questionnaires; physical measurements, and lab assessment. RESULTS Out of 429 districts, samples were taken from urban and rural areas of 389 districts. After applying sampling weight to the samples, comparing the distribution of population and samples, compared classification was determined in accordance with the age and sex groups. Out of 31,050 expected participants, 30,541 participant completed questionnaires (52.31% female). For physical measurements and lab assessment, the cases included 30,042 (52.38% female) and 19,778 (54.04% female), respectively. DISCUSSION There is an urgent need to focus on reviewing trend analyses of NCDs.To the best of our knowledge, the present study is the first comprehensive experience on systematic electronic national survey. The results could be also used for future complementary studies.
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Affiliation(s)
- Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaiee
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Damirchilu
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoudi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Mahmoudi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Hajipour
- The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Niloofar Peykari
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Mohammadi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Gouya
- Center for Communicable Disease Control (CDC), Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Shohreh Naderimagham
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Kousha
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Moghisi
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Kambiz Abachizadeh
- Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Knowledge Utilization Research Center and Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Sayyari
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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16
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Salimzadeh H, Delavari F, Sauvaget C, Rezaee N, Delavari A, Kompani F, Rezaei N, Sheidaei A, Modirian M, Haghshenas R, Chegini M, Gohari K, Zokaiee H, Farzadfar F, Malekzadeh R. Annual Trends of Gastrointestinal Cancers Mortality in Iran During 1990-2015; NASBOD Study. Arch Iran Med 2018; 21:46-55. [PMID: 29664654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Gastrointestinal (GI) neoplasms are among the most common cancers in Iran. This study aimed to measure annual trends in mortality rates from GI cancers in Iran between 1990 and 2015. METHODS This study was part of an ongoing study termed the 'National and Subnational Burden of Diseases' study in Iran. Data used in this study was obtained from the Iranian Death Registration System (1995 to 2010) and from 2 major cemeteries in Tehran (1995 to 2010) and Isfahan (2007 to 2010). All-cause mortality rates were estimated using the spatio-temporal model and the Gaussian process regression model. Age-standardized mortality rates (ASMR) per 100 000 person-years was calculated using data from Iran and the standard world population for comparison. RESULTS Among GI cancers, gastric cancer represented the leading cause of mortality followed by cancers of the esophagus, liver, and colorectal cancers with the ASMR of 20.5, 5.8, 4.4, and 4.0 per 100 000 persons-years, respectively, between 1990 and 2015. While a decreasing trend occurred in mortality of esophageal, gastric, and colorectal cancers, particularly in the recent decade, we recorded an upward pattern and steady rise in mortality rates from liver, pancreatic, and gallbladder cancers during the study period. The ASMR of all studied causes were enhanced by advancing age and were found to be more prominent in adults aged 50 or older. Among all age-groups, higher death rates were detected in males versus females for all studied cancers except for gallbladder and biliary tract cancers. CONCLUSION Gastric cancer mortality is still high and death rates from several other GI cancers are increasing in the nation. Interventions for cancer prevention, early detection, and access to high quality cancer treatment services are needed to reduce GI cancer burden and death rates in Iran and in the region.
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Affiliation(s)
- Hamideh Salimzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Delavari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Catherine Sauvaget
- Screening Group, Early Detection and Prevention, International Agency for Research on Cancer, 150 cours Albert Thomas 69008 Lyon, France
| | - Negar Rezaee
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Division of Hematology and Oncology, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chegini
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department for Health, Arak University of Medical Sciences, Arak, Iran
| | - Kimiya Gohari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaiee
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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17
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Djalalinia S, Ramezan Ghorbani N, Tajbakhsh R, Modirian M, Esmaeili Abdar Z, Mahdavi Gorabi A, Mansourian M, Kazemzadeh Atoofi M, Asayesh H, Safiri S, Noroozi M, Qorbani M. Hepatitis B Virus Infection in Iranian Hemodialysis Patients: a Systematic Review and Meta-Analysis. Iran J Kidney Dis 2018; 12:1-9. [PMID: 29421769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/14/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Hepatitis B virus (HBV) infection in hemodialysis patients and its associated adverse health consequences are a worldwide health priority. This systematic review aimed to provide evidence on HBV infection in Iranian hemodialysis patients. MATERIALS AND METHODS Through a comprehensive systematic review of literature, which led to meta-analysis of findings, we estimated the pooled prevalence of HBV infection in Iranian hemodialysis patients. The main international electronic data sources were MEDLINE, Institute of Scientific Information, and Scopus. We also search several Persian-language databases. All cross-sectional and analytical studies conducted in Iran concerning HBV infection were included irrespective of date and language. RESULTS Of 602 publications retrieved from literature search, 66 met the inclusion criteria, and 36 were eligible for including in the study. The prevalence rate varied from zero to 9.75% across different provinces. The national prevalence of HBV was reported between 2.1% and 18.2%. Significant heterogeneity was found between reported prevalence rates (I2 = 83.5%, P < .001), as a result of which, we used random effect analysis. Results of meta-analysis showed that the estimated pooled prevalence was 4% (95% confidence interval, 3.3% to 4.7%). CONCLUSIONS To our knowledge, this was the first comprehensive systematic review of HBV infection in the hemodialysis patients of Iran. Results could be useful for informed health policy making and planning further studies in this field.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Ghorbani NR, Djalalinia S, Modirian M, Abdar ZE, Mansourian M, Gorabi AM, Asayesh H, Ansari H, Atoofi MK, Tajbakhsh R, Noroozi M, Safiri S, Qorbani M. Prevalence of hepatitis C infection in Iranian hemodialysis patients: An updated systematic review and meta-analysis. J Res Med Sci 2017; 22:123. [PMID: 29259634 PMCID: PMC5721496 DOI: 10.4103/jrms.jrms_223_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/02/2017] [Accepted: 09/03/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality. This study aims to provide a comprehensive evidence on HCV Infection in Iranian hemodialysis (HD) patients we conducted a systematic review. MATERIALS AND METHODS In this systematic review and meta-analysis, through a comprehensive search of literature until January of 2016, we estimated the pooled prevalence of hepatitis C infection in Iranian HD patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words for Iranian databases and also international databases of PubMed and NLM Gateway (for MEDLINE), and SCOPUS. Interest outcome of HCV infection prevalence was confirmed based on positive hepatitis B surface antigen of blood samples. Random effect meta-analysis was used to estimate pooled prevalence of HCV infection in Iranian HD patients, date and language, HD patients, in adult HD patients, Institute of Scientific Information, Iran-doc, irrespective of age, living in Iran. Searches run through main domestic databanks of Iran-Medex, renal transplantation, Scientific Information Database, the relevant literature-searched concentrating on HCV infection. RESULTS Through searching steps, 305 publications were found from them following the excluding duplicates and overlapping studies 54 studies relevant to HCV prevalence in Iranian HD zcxw patients, with number of 23921 participants, remained in our analyses. The overall results of test of heterogeneity demonstrate sever heterogeneity between reported prevalence (I2 = 96.62%, Chi-square = 1566, P < 0.001). Due to sever heterogeneity results of random effect meta-analysis showed that the estimated pooled prevalence was 11% (95% confidence interval [CI] =10%-13%). The pooled prevalence base on polymerase-chain reaction, recombinant immunoblot assay, and enzyme-Linked Immunosorbant Antibody method were 11% (95% CI = 6%-15%), 9% (95% CI = 5-13) and 12% (95% CI = 10-14), respectively. In line with previous studies, the present finding shows the significant variation in the rate of HCV in dialysis units among the regions in Iran. CONCLUSION Present paper is the comprehensive updated systematic review on HCV prevalence in the Iranian HD patients. Our findings provide the reliable evidence for promotion of policies and interventional programs.
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Affiliation(s)
- Nahid Ramezan Ghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili Abdar
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Ansari
- Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Tehran, Iran
| | - Mehrdad Kazemzadeh Atoofi
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Tajbakhsh
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Zayeri F, Mansouri A, Sheidaei A, Rahimzadeh S, Rezaei N, Modirian M, Khademioureh S, Baghestani AR, Farzadfar F. Evaluation of the Trends of Stomach Cancer Incidence in Districts of Iran from 2000-2010: Application of a Random Effects Markov Model. Asian Pac J Cancer Prev 2017; 17:661-5. [PMID: 26925660 DOI: 10.7314/apjcp.2016.17.2.661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stomach cancer is the fifth most common cancer and the third leading cause of death among cancers throughout the world. Therefore, stomach cancer outcomes can affect health systems at the national and international levels. Although stomach cancer mortality and incidence rates have decreased in developed countries, these indicators have a raising trend in East Asian developing countries, particularity in Iran. In this study, we aimed to determine the time trend of age-standardized rates of stomach cancer in different districts of Iran from 2000 to 2010. MATERIALS AND METHODS Cases of cancer were registered using a pathology-based system during 2000-2007 and with a population-based system since 2008 in Iran. In this study, we collected information about the incidence of stomach cancer during a 10 year period for 31 provinces and 376 districts, with a total of 49,917 cases. We employed two statistical approaches (a random effects and a random effects Markov model) for modeling the incidence of stomach cancer in different districts of Iran during the studied period. RESULTS The random effects model showed that the incidence rate of stomach cancer among males and females had an increasing trend and it increased by 2.38 and 0.87 persons every year, respectively. However, after adjusting for previous responses, the random effects Markov model showed an increasing rate of 1.53 and 0.75 for males and females, respectively. CONCLUSIONS This study revealed that there are significant differences between different areas of Iran in terms of age-standardized incidence rates of stomach cancer. Our study suggests that a random effects Markov model can adjust for effects of previous. responses.
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Affiliation(s)
- Farid Zayeri
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail :
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Modirian M, Cheraghi Z, Rahimzadeh S, Moghaddam SS, Jarrahi AM. Burden Assessment of Thyroid cancer in Iran from 1990 to 2010: Lessons Obtained from Global Burden of Disease Report 2010. Asian Pac J Cancer Prev 2016; 16:7743-8. [PMID: 26625791 DOI: 10.7314/apjcp.2015.16.17.7743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thyroid tumors are generally regarded as rare malignancies. Nowadays, however, their global incidence is growing continuously partially due to western life style and utilization of more sensitive methods of early detection. It is approximately three times more prevalent in females than in males. Most cases of thyroid cancer are asymptomatic nodules or just have local cervical symptoms or adenopathy in early stages. MATERIALS AND METHODS The Global Burden of Diseases report 2010 study (released 3/2013) profited from 100 collaborators worldwide and used a vast network of data on health outcomes, vital registries, and population surveys. It shared many of the Global Burden of Diseases 1990 principal databases such as all available data on injuries, diseases, risk factors, as well as comparable metrics, and used different scientific approved methods to estimate important health status data like: death rate, life expectancy, healthy adjusted life expectancy, disability-adjusted life years (DALY), years of living lost due to premature death and years of life with disabilities. RESULTS DALY as thyroid cancer burden per 100,000 Iranian populations had increased by about 14% during 1990 to 2010 in all ages; from 6.1 (95% UI 4.2-9.74) years in 1990 to 6.95 (95% UI 5.06-9.18) years in 2010 in both sex. The 2010 peak age-group was estimated at 45-49 years in males and 40-45 years in females.
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Affiliation(s)
- Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran E-mail :
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Modirian M, Rahimzadeh S, Cheraghi Z, Saeedi Moghaddam S, Rezaei N, Tohidinik HR, Kasaeian A, Jamshidi HR, Ghobadi R, Kompani F. Burden of Cancers in Iran from 1990 to 2010: findings from the Global Burden of Disease study 2010. Arch Iran Med 2016; 18:629-37. [PMID: 26443246 DOI: 0151810/aim.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cancer is one of the most common non-communicable diseases in both sexes and a major cause of disability and death around the world, as well as in Iran. The aim of the present manuscript is to report the results of the Global Burden of Disease study 2010 (the GBD 2010) to compare the results with the other similar findings. The paper also discusses the existing deficiencies of the GBD study. Our aim was to describe and criticize the attributed burden of cancers according to the GBD results by sex and age. METHODS The GBD 2010 has profited from 100 collaborators worldwide and provides a vast network of data on health outcomes, vital registries, and population surveys. The GBD has used various scientific-approved methods to estimate important health statuses like death rates, life expectancy, and healthy adjusted life expectancy, disability-adjusted life years, years of living lost due to premature death and years of life with disabilities. In the present study, we extracted and graphed the GBD results for Iran in order to present a better scheme for readers. RESULTS The mortality rate of cancers in Iranians has increased by about 8.5%, the disability-adjusted life year rates have declined by about 9%, and years lost due to premature death have also decreased by about 10% from 1990 to 2010 compared to an 85% increase in years of life with disabilities in the same time period. CONCLUSION The burden of all non-communicable diseases (NCDs) including cancers showed decrease during the past two decades. However, these diseases still remain worldwide health challenge. Prevention should be considered as an important priority and responsibility. The health authorities also need to determine the burden of cancers at the national and sub-national levels for implementation of effective preventive strategies.
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Affiliation(s)
- Mitra Modirian
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- 3)Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Cheraghi
- Department of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- 5)Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Kasaeian
- 7)Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Jamshidi
- School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Ghobadi
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Department of Hematology and Oncology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Rezaei N, Naderimagham S, Ghasemian A, Saeedi Moghaddam S, Gohari K, Zareiy S, Sobhani S, Modirian M, Kompani F. Burden of Hemoglobinopathies (Thalassemia, Sickle Cell Disorders and G6PD Deficiency) in Iran, 1990-2010: findings from the Global Burden of Disease Study 2010. Arch Iran Med 2016; 18:502-7. [PMID: 26265518 DOI: 015188/aim.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Hemoglobinopathies are known as the most common genetic disorders in Iran. The paper aims to provide global estimates of deaths and disability adjusted life years (DALYs) due to hemoglobinopathies in Iran by sex and age during 1990 to 2010 and describe the challenges due to limitations of the Global Burden of Disease Study 2010 (GBD 2010). METHODS GBD 2010 estimates of the numbers of deaths and years of life lost (YLLs) due to premature mortality were calculated using the Cause of Death Ensemble model (CODEm). Years of life lost due to disability (YLDs) were computed by multiplication of prevalence, the disability weight for occurrence of sequelae, and the duration of symptoms. Prevalence was estimated through a systematic search of published and available unpublished data sources, with a Bayesian meta-regression model developed for GBD 2010. Disability weights were produced using collected data from population-based surveys. Uncertainty from all inputs was incorporated into the computations of DALYs using simulation methods. We aim to prepare and criticize the results of GBD 2010 and provide some recommendations for reaching better conclusions about the burden of hemoglobinopathies in Iran. RESULTS Between 1990 and 2010, the overall deaths attributed to hemoglobinopathies decreased from 0.51% to 0.36% of total deaths, with the corresponding burden declining from 1% to 0.82% of total DALYs. There was a reduction in deaths and DALYs rates for all ages and the rates attributed to all ages followed the same pattern in Iranian men and women. The highest DALYs for hemoglobinopathies, thalassemia, sickle cell disorder, and glucose-6-phosphate dehydrogenase deficiency (G6PD-D) were found in those aged less than 5 years. The collective burden of all of these hemoglobin disorder was lower in 2010 than in 1990. CONCLUSION Although the screening programs in Iran have been very successful in reducing the number of thalassemia patients between 1990 to 2010, in order to provide a better estimation of the burden of hemoglobin disorders, it is necessary to perform a national and sub-national study of hemoglobinopathies using multiple national and sub-national surveys.
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Affiliation(s)
- Nazila Rezaei
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.2)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Naderimagham
- 2)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute,Tehran University of Medical Sciences, Tehran, Iran
| | - Anoosheh Ghasemian
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 3)Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- 4)Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimia Gohari
- 4)Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Zareiy
- Department of Aerospace and Subaquatic Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Sahar Sobhani
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.2)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.2)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Department of Hematology and Oncology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Naderimagham S, Alipour S, Djalalinia S, Kasaeian A, Noori A, Rahimzadeh S, Modirian M, Khosravi A, Etemad K, Jamshidi HR, Farzadfar F. National and sub-national burden of breast cancer in Iran; 1990-2013. Arch Iran Med 2015; 17:794-9. [PMID: 25481316 DOI: 0141712/aim.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Estimating the burden of diseases, injuries and major risk factors is necessary for adopting appropriate health policies in every country, and this paper aims to explain the study protocol of national and sub-national burden of breast cancer in Iran from 1990 to 2013. METHODS We will perform a systematic review of the confirmed databases and literature to gather data on breast cancer epidemiology in Iran. The definitions, data sources, organizing the team, methods of data gathering and data generating will be explained in this paper. The methodology of estimating the trend of prevalence, years of life lost due to premature death (YLLs), years of life lost due to disability (YLDs) and disability-adjusted life years lost (DALYs) of breast cancer by age groups, provinces and probable inequalities will be explained. We will tackle possible data problems due to the lack of data points on provinces and years and also geographical misalignment by using two advanced statistical methods, namely Bayesian autoregressive multilevel and Spatio-temporal models. Trend estimation will be reported using these two models together with uncertainty intervals. CONCLUSION This study provides a comprehensive assessment of breast cancer and its specific pattern in Iran. The results will help policy makers to know the trend of prevalence, the distribution, and the inequalities of breast cancer in Iran to allocate resources in a better way.
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Affiliation(s)
- Shohreh Naderimagham
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sadaf Alipour
- Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute,Tehran University of Medical Sciences, Tehran, Iran.5)Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Amir Kasaeian
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 4)Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Noori
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute,Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 6)Departement of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Khosravi
- 7)Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran. 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Etemad
- 6)Departement of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 7)Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Reza Jamshidi
- School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fashad Farzadfar
- 1)Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2)Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Modirian M, Rahimzadeh S, Cheraghi Z, Khosravi A, Salimzadeh H, Kompani F, Rezaei N, Qorbani M, Delavari A, Moradi-Lakeh M, Farzadfar F. Quality evaluation of national cancer registry system in Iran: study protocol. Arch Iran Med 2014; 17:193-7. [PMID: 24621363 DOI: 0141703/aim.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cancer registry can be a very important component of health information system in developing countries. Routine collection of data and ongoing monitoring of their quality can have a crucial role in priority setting and evidence-based policy making for controlling cancers and trends follow-up in low and middle-income countries. Evaluation of cancer registered data consists of four important components including: comparability, completeness, validity, and timeliness. Similar frameworks are utilized in different countries all over the world. METHODS AND MATERIALS We will use the national annual cancer registry reports in Iran alone or perhaps along with other Iranian published reports about childhood cancer incidence to determine the stability and trend of incidence rates over time and compare above mentioned reports with childhood cancer incidence data reported by other countries through a systematic review as well as in some cases meta-analysis in order to assess data quality. Data will also be collected from other sources such as death certificates to estimate mortality rates and other different methods will also be additionally applied, by use of which death certificates would be utilized to assess the quality of data, too. CONCLUSION As the first step for proper measuring incidence rate of all types of cancers all over the country, we will assess and evaluate reported national cancer registry data in Iran in order to estimate the national burden of cancers in 1990 - 2013.
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Affiliation(s)
- Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. ,
| | - Shadi Rahimzadeh
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, TehranUniversity of Medical Sciences, Tehran, Iran, Departement of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Cheraghi
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Departement of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Khosravi
- Iran Ministry of Health and Medical Education,Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamideh Salimzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Kompani
- Department of Hematology and Oncology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, TehranUniversity of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Departement of Public Health, Alborz University of Medical Sciences, Karaj, Iran, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, TehranUniversity of Medical Sciences, Tehran, Iran, Departement of Epidemiology, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Iran Ministry of Health and Medical Education,Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Community Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, TehranUniversity of Medical Sciences, Tehran, Iran, Endocrinology and Metabolism Research center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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