مجله اپیدمیولوژی ایران
سال نهم شماره 4 (پیاپی 32، زمستان 1392)

We studied the risk of Chronic Kidney Disease (CKD)، Metabolic Syndrome (MetS)، and their interaction on the incidence of Coronary Heart Disease (CHD). A population of 6568 participants (43. 4% male) with a mean age of 48. 4 years for males and 46. 7 years for females and a median follow-up of 10. 1 years was investigated. They were divided into 4 groups at baseline: CKD-/MetS-، CKD+/MetS-، CKD-/MetS+، CKD+/MetS+. Hazard Ratios (HRs) were calculated for each group and were compared to the first group using multivariate Cox regression analysis adjusted for age، education، smoking، total cholesterol، and the family history of cardiovascular diseases. Men with CKD (without MetS) showed an HR of 1. 74 (CI 95%: 1. 16-2. 60) for CHD events. The measured value was 2. 34 (1. 77-3. 08) for men with MetS (without CKD). The respective results were in women 1. 18 (0. 64-2. 19) and 2. 59 (1. 73-3. 88). CKD and MetS had a significant negative interaction with CHD events (HR=0. 40، 0. 24-0. 66). The interaction was not significant in women (P value=0. 48). The results of this study indicated that CKD without MetS was a risk factor for coronary heart disease in men but not in women.

Bam is one of the old CL centers and this study aimed to determine and compare the period prevalence among its population and housing units in two periods of 1990-92 and 2010-2012. In this descriptive–analytical study، data were collected in the questionnaires through door-to-door visits environmental hygiene، and inquiring the history of the CL disease. A questionnaire was completed for each household، the data were analyzed using SPSS software and t- and X2 tests. P<0. 05 was considered significant. The prevalence rates in the periods 1998-1999 and 2010-2012 were 10. 3% and 2. 1%، in the study population and 33. 6% and 5. 5% in the residential units in the period of the last 3 years، respectively with a very significant difference (P<0. 0001). The environmental hygiene of the houses in terms of vector breeding was significantly lower in the period 1990-1992 than 2010-2012 (P<0. 0001). The mean score of environmental hygiene was 11. 5 and 16. 6 out of 20 during the two periods، respectively. According to the results of this study، urban CL is extremely reflective of the environmental changes and probably the best preventive measure is to improve the environmental hygienic conditions in and around the households. Public participation and commitment of the health authorities in this regard could be an important measure for planning preventive programs.

Tuberculosis (TB) is one of the major infectious diseases in Iran and has pulmonary and extra-pulmonary manifestations. Considering the differences in the distribution of the cases across different regions، we decided to study the geographical distribution، epidemiologic characteristics، and disease pattern in Lorestan. This ecologic (descriptive analytical) survey was done in Lorestan between 2002 and 2008. The data was collected from the Health Department of Lorestan University of Medical Sciences and included the history of 1481 patients suffering from TB. The study variables were sex، disease type، residential location، age، and year. The data were analyzed using statistical package SAS 9. 2 and descriptive and inferential statistics were applied. From 1481 registered patients 58. 4% were male and 41. 6% were female among which 68. 74% and 29. 98% lived in urban and rural areas and 1. 28% were nomads. The mean age of the patients was 41. 87. The highest and lowest incidence rates were observed in Khoram Abad (19. 38 per 100000) and Azna (7. 04 per 100000)، respectively. Using Poisson regression، it was observed that the effects of age structure and residency on the incidence rate were significant. The percentage of nomads was identified as the most important demographic factor in the incidence rate of TB in Lorestan. Allocation of better resources and appropriate training can be effective in controlling and preventing the disease.

Smoking is a global problem and is the most important cause of death due to non- communicable diseases. This study was conducted to evaluate smoking and its correlates in male students in South Khorasan. This descriptive-analytical study was undertaken in South Khorasan on high school male students. A sample of 2371 cases was selected through cluster multi stage sampling. The data was collected through a structured questionnaire and analyzed by SPSS software using chi-square and logistic regression tests. The prevalence of smoking was 12. 3 per cent (285 cases). The most important motivating factors for smoking for the first time were curiosity، joy. The most important predictors of smoking were hookah consumption، the presence of a smoker in or outside the living place، and a negative attitude to smoking. Working father and education regarding smoking risks were preventive factors. Special education and public awareness about the risks of smoking and establishment of consultation centers for adolescents can be major steps toward the prevention and control of smoking among students.

The recent researches on mortality in Iran in the past 3 decades have obviously emphasized cardiovascular diseases، unintentional injuries، and neoplasms as the most important causes of shortening Iranian’s lives. We investigated the role of these major causes on the mortality patterns in Fars in 2006. The number of registered deaths by age and sex and the distribution of death by cause in Fars in 2006 were derived from the Death Register System of Ministry of Health (MoH). We used the 2006 census to obtain the information on the population exposed to death. The mortality of the people over 5 years of age was estimated and corrected using the Brass Growth Balance method. The mortality rate of the children under the age of 5 was estimated by indirect methods and the data were analyzed using the multi-decrement life table. Life expectancy was 70. 3 years in Fars، about 69 years in males and 72 years in females، in 2006. The results showed that 3 main causes of death were responsible for reducing life expectancy of about 11 years in men and women in Fars. Detailed results revealed that cardiovascular diseases and unintentional injuries played more important roles in the decrease. Unintentional injuries plays more major role in decreasing life expectancy in males than females. Special attention should be paid to the risk factors of cardiovascular diseases in both genders and unintentional injuries in males in Fars to reduce the mortality level and increase the life expectancy.

The world population is growing old. The rising proportion of the elderly is creating new health care challenges in the current century. This study aimed to determine the quality of life and the associated factors in the elderly population of Azerbaijan district in the city of Tehran، Iran. This cross-sectional study was conducted on 287 elderly persons aged 60 and older. Participants were selected through systemic random sampling. The WHOQOL-BREF questionnaire، the Activities of Daily Living (ADL) questionnaire، and a questionnaire for demographic characteristics were used for data collection. Each domain was given a score between 0 to100 based on the WHO manual. The final variables were determined in a multivariate linear regression model using SPSS16. The mean score of the 4 domains of quality of life (physical، psychological، environmental، and social health) of the elderly population living in Azerbaijan district was 58. 41، 53. 13، 59. 53، and 42. 82، respectively. A variety of correlates affect the quality of life of the elderly. Recognizing and considering these factors are important for planning more effective programs for the elderly and empowering them.

Obesity is associated with increased resistance to insulin، hypertension، hyperlipidemia، hyperinsulinemia، and cardiovascular diseases. The purpose of this study was to investigate some factors associated with overweight and obesity among normal، overweight، and obese women aged 30 to 50 years from Sabzevar. A questionnaire with 56 questions was prepared. The Beck questionnaire was used to measure the physical activity level. Weight، height، and waist circumference of the participants were measured using standard methods. Overweight (BMI ≥25 kg/m2)، obesity (BMI ≥30 kg/m) and abdominal obesity (WHR ≥0. 85) were also evaluated. MANOVA، Tukey post-hoc test، Pearson and Spearman correlation coefficients، Kruskal-Wallis and chi-square test were used for the statistical analysis of test variables. P ≤0. 05 was considered significant. The results showed that 22. 5% of women had normal weight، 42. 4 percent were overweight، 31. 6 percent were obese، and only 3. 5 percent of women were underweight. Our results showed that the prevalence of overweight and obesity was 74% in women living in Sabzevar، indicating the necessity of using educational methods to familiarize people، especially women، with weight control issues and prevention of obesity. The findings revealed that age، number of children، number of pregnancies، age at menarche، number of family members، working with the computer، and high-fat meals may increase the risk of obesity. Lifestyle modification and physical activity، as the most affordable and safest methods of preventing obesity، require more attention.

One of the major questions in epidemiological and social science researches is studying the relationship of the living place with social and health outcomes. In this study، we measured segregation indices for a number of important socioeconomic indices using the 2006 Iranian census data to find out whether residential segregation is correlated with the available differences in the health level in the subgroups of certain variables. Twenty percent of the 2006 national census data was used for measuring segregation indices. Residential segregation indices were measured once for Hormozgan Province among its eleven cities and then for each city among theirs sections. Six segregation indices were measured. We used the common cut points for interpreting the values of dissimilarity index and information theory index. According to the dissimilarity and information theory index، the segregation of most of the variables in the province fell within the category of mild segregation. Segregation of the variables in some cities fell within the category of moderate، severe، and even extreme. The results indicated improper distribution of some of these variables in geographic units in some of the cities of Hormozgan Province. This information can help the authorities who are committed to implementing the health equity and social justice.