Epidemiology and Health System Journal
Volume:1 Issue: 1, Autumn 2014

Epidemiology can be considered as a very old science. For example, John Graunt, a statistician, published Natural and Political Observations. In the Bills of Mortality in 1662, he analyzed the mortality rolls in London before the Great Plague, presented one of the first life tables, and reported time trends for many diseases. He provided statistical evidence for many theories on disease, and challenged some common beliefs about them. Later, a Greek physician Hippocrates was the first person known to have examined the relationships between the disease occurrence and environmental influences. He believed that the cure to the sickness was to remove or add the humor in question to balance the body; he also mentioned the terms endemic (for diseases usually found in some places but not in others) and epidemic (for diseases seen sometimes but not always). Epidemiology could also be considered as a modern science. Dr. John Snow is indeed famous for his investigations about the causes of the 19th century cholera epidemics in London, and is also known as the father of (modern) epidemiology.

Coronary heart diseases (CHDs) contribute to mortality, morbidity, disability, productivity and quality of life. This study was aimed to determine the prevalence of major risk factors for CHD in the provinces of Iran. This study reported pre-existing data and was of secondary, descriptive type. Prevalence of non-communicable disease (NCD) risk factors was defined for the provinces of Iran. A reliable report of NCD risk factors, the national surveillance program conducted in Iran, such as type II diabetes, hypertension and mean body mass index (BMI), smoking, hookah smoking, high cholesterol and obesity was used. The highest and lowest prevalence of hypertension was obtained in Bushehr (20.85%) and Yazd (12.86%) provinces, respectively. The highest mean BMI was reported from Mazandaran province (26) and the lowest from Sistan and Baluchestan province (22.50). Qom province had the highest prevalence of diabetes (27.65%). The highest prevalence of high cholesterol was obtained in Lorestan province (50.87 %) and the lowest in the Khouzestan province (22.71%). East Azarbaijan province had the highest prevalence of smoking (14.8%) and Kurdistan province the lowest (0.16%). Hookah smoking was most prevalent in Hormozgan province (7.62%). The highest prevalence of physical activities was reported from Sistan and Baluchestan province (47.84%) and the lowest from Kohgiluyeh and Boyer-Ahmad (22.2%). Prevalence of CHD risk factors is the main priority for the Iranian health system. There is a need for intervention programs in the provinces which are at greater risk as well as for modification of people’s lifestyle.

Internet addiction is one of the problems emerged with the development of technology. Considering the potential negative effects of internet addiction on health, the present study aimed to determine the prevalence of internet addiction in university students in Ilam, west of Iran, in 2014. In this cross– sectional study, 1066 university students in both public and private sectors were assessed in 2014. The samples were selected by multi-stage random sampling method. Data were collected by a two-part questionnaire: the personal characteristics and Internet Addiction Test (IAT)-20. This 20-itemed questionnaire measures internet addiction in mild, moderate and severe levels. Each answer is scored based on a Likert scale from 1 to 5. The higher score represents a greater level of addiction. The total score between 20 and 49 represented mild, 50-79 showed moderate and 80-100 was severe addiction. Overall, 466 (43.7%) of students were placed in the Internet addiction group. Generally, 39.6% of students had mild and 4.1% had moderate addiction. No case of sever Internet addiction was seen. Prevalence of internet addiction in the medical students was higher compared to nonmedical students (P< 0.0001). Based on the results, internet addiction should be considered as a serious problem in adolescents and young adults. So, it is necessary that proper use of internet to be educated to adolescents and young adults to prevent the risk of internet addiction.

This study aimed to evaluate the effect of enforcement of new traffic laws on the fatal and non- fatal injury rates in Iran. In a longitudinal, interventional controlled trial study, all subjects with history of fatal and non-fatal injuries were studied. Their injuries were caused by six risky violations (unauthorized speed, illegal overtaking, red traffic light crossing, reverse gear movement in the highways, and vehicle arrestment due to two simultaneous violations) from June 2010 to November 2010 (as control) and from June 2011 to November 2011 (as case). Available forensic data were used and the outcome of new road traffic laws was analyzed. The new traffic laws led to reduction of fatal and non-fatal road traffic injuries in urban and metropolitan roads after implementation, with a continuing trend during six months. Reduction of fatal and non-fatal road traffic injuries was higher for 20-29 years age group. The effect of new traffic laws on reduction of fatal and non-fatal injuries was 8.7% and 33.3%, respectively. Reduction of fatality and injury rate at crash scene, after six months of intervention, was 0.4 and 11.1 per 100,000 populations, respectively. The enforcement of the first phase of new traffic laws has reduced fatal and non-fatal rates of road traffic injuries in Iran. It seems that strict enforcement and amendment of new traffic regulations could further increase their efficiency.

Mental disorders may negatively affect on the quality of life in hemodialysis patients and their response to treatment. The aim of present study was to examine the prevalence of depression and related risk factors in hemodialysis patients. In this cross-sectional study, during June 2013 to September 2013, 217 patients with hemodialysis whom were admitted to Kerman hemodialysis center were examined. The depression level of patients was assessed using Iranian version of Beck Depression Inventory. The mean score of depression was 24.2±12.6 (range: from 2-59). Totally, 29%, 30% and 27.4% were reported as suffering from mild, moderate and severe level of depression, respectively. The results of the present study also showed that diabetic patients and patients with hypertension were significantly at a higher risk of depression. Results of the present study indicates that depression is highly prevalent in hemodialysis patients. It is important that all patients with maintenance hemodialysis be frequently screened for signs and symptoms of psychiatric disorders such as depression.

Pelvic organ prolapse (POP) is a common condition which affects on a large proportion of women. The objective of this study was to determine the risk factors of POP in Iranian women. This cross-sectional study was carried out to examine the role of demographic, anthropometric and clinical characteristics in POP disease in a sample of 365 females in Ilam, Iran. Examinations were performed according to Pelvic Organ Prolapse Quantification (POPQ) technique in dorsal lithotomic position. Then, the sample divided into two groups as with and without prolapse. Then, unilabiate and multivariate analyses were performed. Totally, 365 women participated in this study. The prevalence of POP was 80.8%. Univariate logistic regression analysis showed a significant differences between groups with and without POP based on age, maximum birth weight, BMI, pregnancy, delivery mode, delivery operative and delivery position. But after multivariate analysis, the most significant factors identified as risk factors for POP were age (OR= 1.12, 95% CI= 1.02-1.23, P= 0.02), normal vaginal delivery (NVD; OR= 6.18, 95% CI= 1.43-26.75, P= 0.01) and episiotomy (OR= 30, 95% CI= 5.69-158.11, P= 0.000). Findings of the study showed that several risk factors could collaborate in creating of POP. However; body mass index and number of pregnancies are modifiable factors. So, maternal care providers should educate women for maintaining the ideal weight and decreasing the number of pregnancy in order to prevent POP.

Infertility is one of the most important conditions in reproductive system and there is no reliable estimates for global prevalence of infertility. Therefore, knowing the prevalence of infertility is important and can be effective in decision making. We systematically reviewed all published papers in Medline database and Scopus (1988–2010). Univariate and multivariate approaches were applied to assess the causes of heterogeneity among the selected studies. Meta-regression was used to examine the relationship between the prevalence of infertility and the year of study. Data manipulation and statistical analyses were performed using Stata 11.1. The study population was not similar in all papers. Studies evaluated the prevalence of infertility in the general population, the total female population, women and couples. Some studies defined infertility as failure to conceive within 12 months of regular sexual life without contraception methods while other studies defined it as failure to conceive within 24 months of regular sexual life without contraception methods. Overall, 52 studies met our inclusion criteria and the pooled worldwide of infertility was obtained about 10%. The correlation between prevalence of secondary infertility and year of study was significant (P=0.039). Approximately 10% of the world''s population suffers from infertility. Due to the negative impact of infertility on couples in various aspects of life, and the need for treatment and support programs, accurate estimate of infertility is essential worldwide.

Annually, many women become pregnant worldwide; however, pregnancy and childbirth is not a pleasant event for all them. In fact, more than 90% of maternal anxiety could be related to the delivery process. It should be noted that delivery is also a stressful event that sometimes, due to different reasons and in order to avoid its potential hazards which could threaten the lives of mother and baby, it is not possible to deliver through the natural channel and Caesarean section delivery is necessary. However, nowadays, many of cesarean sections are unnecessary. The unnecessary cesarean delivery has an important impact on maternal and neonatal health and reducing (unnecessary) caesarean section is one of the health priorities. That’s why many countries are trying to reduce unnecessary cesarean and promote natural childbirth. In Iran, Maternal Health Office at Ministry of Health and Medical Education in 2002, initiated the design of a national program for mother-friendly hospitals to reduce the cesarean rate by 25 % until 2015. In addition, previous research has shown that through education of mothers and reducing their fear about childbirth and correcting some wrong beliefs about natural childbirth, the unnecessary cesarean section could be reduced. By systematic training to control of the fear and anxiety in pregnant women, they will believe that they have ability to do natural childbirth and in turn could increase their self-confidence. Finally, it will lead to increased cases of vaginal delivery.