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Objective: Although numerous studies have found higher rates of abortion and still births following consanguinity (familial marriages), the question of whether consanguinity significantly increases the risk of neonatal death has inadequately been addressed. This study aims to evaluate familial marriage effects on neonatal death in rural areas in Iran. Materials and methods: In this nested case-control study, 6900 new borns who were born in rural areas of Kohgiluyeh and Boyerahmad Province (South-West of Iran)were followed till the end of neonatal period, and neonatal death was the outcome of interest. Subsequently 97 cases and 97 controls were selected in study cohort by using risk set sampling model. Crude and adjusted odds ratios (OR) were estimated by using a conditional logistic regression model. Results: In the final model, prematurity (OR = 5.57), low birth weight (LBW) (OR = 7.68), consanguinity (first cousins) (OR = 5.23), C-section (OR = 7.27), birth rank more than 3 (OR = 6.95) and births interval less than 24 months (OR = 4.65) showed significant statistical association with neonatal mortality (p < 0.05). Conclusion: According to our findings, after adjusting the effects of other significant risk factors, familial marriage to first cousins is considered as an important risk factor for neonatal death. [ABSTRACT FROM AUTHOR]

Background: There is no information about the pattern of use of earphones and music players in Iranian adolescents. The aim of this study was to assess the prevalence and pattern of the use of earphone and music player devices as a main risk factor for hearing loss in adolescents of Tabriz city, northwest of Iran. Methods: In this cross-sectional study in November 2011, 2,359 high school students were randomly selected and were asked to complete a 20-item questionnaire about the pattern of using earphones and music players. Results: The results showed that 44.3% [confidence interval (CI) 95%: 38.3-50.3] of the respondents had a history of hearing problems that was significantly different between males and females (42.2% of males and 47% of females, p: 0.02). Notably, 36.8% of the participants stated that they listened to music without any rest or stop. Almost 49.6% (CI 95%: 44.4-54.4) of the students reported listening to 'somewhat loud' (gain setting at 50%) or 'very loud' (gain setting more than 50%) volume level of music. In terms of the kind of earphones, 17.1% of the participants used headphones, 34.8% used earbud-style headphones, 32.3% used supra-aural headphones, and 15.8% of them did not use any type of earphones. Conclusions: Students have risky patterns of using earphones and music-listening devices. Planning educational programs in this domain for adolescents especially in high schools is necessary. [ABSTRACT FROM AUTHOR]

Background: There is substantial lack of knowledge about the role of socioeconomic status (SES) indicators on life expectancy (LE) within-cities, especially within mega-cities. We aimed to investigate the disparities of LE within city districts of Tehran, Iran, and specify how SES inequalities play role on LE. Methods: The death and population data for 2010 by different age, gender, and residency district were obtained from the main cemetery of Tehran and statistical centre of Iran, respectively. Age-specific mortality rates and consequently LE were calculated for all 22 districts by different genders. Finally, based on the results of first Tehran's Urban Health Equity Assessment and Response Tool (Urban HEART) project in 2008, the influence of social classes (SCs), total costs, and education indicators were analyzed on LE at birth (e0). Results: The e0 for total males and females in Tehran were calculated as 74.6 and 78.4 years for 2010, respectively. The maximum LE of 80 years was observed in females of northern part with higher SES, and the minimum e0 of 72.7 years observed in males of southern part with lower SES. The e0 gender gap among districts was 5.5 years for females and 3.7 years for males. The highest and lowest mean of e0 observed in SC1 (highest class) and SC5 (lowest class), were 77.6 and 76.0 years, respectively. The lowest mean of e0 observed in the first group of total costs indicator and was 76.2 years. In addition, the lowest observed mean of e0 was in the first category of education indicator (illiterate) and was 76.0 years. Conclusion: Results indicate substantial disparities in LE within city districts. This confirms that SES disparities within-cities would have direct influences on LE. [ABSTRACT FROM AUTHOR]

Background: The most fundamental way to decrease the burden of noncommunicable diseases (NCDs) is to identify and control their related risk factors. The goal of this study is to determine socioeconomic inequalities in risk factors for NCDs using concentration index based on Non Communicable Disease Surveillance Survey (NCDSS) data in Kurdistan province, Islamic Republic of Iran in 2005 and 2009. Methods: The required data for this study are taken from two NCDSSs in Kurdistan province in 2005 and 2009. A total of 2,494 persons in 2005 and 997 persons in 2009 were assessed. Concentration index was used to determine socioeconomic inequality. To assess the relationship between the prevalence of each risk factor and socioeconomic status (SES), logistic regression was used and odds ratio (OR) was calculated for each group, compared with the poorest group. Results: The concentration index for hypertension was 0.095 ( 0.158, 0.032) in 2005 and 0.080 ( 0.156, 0.003) in 2009. The concentration index for insufficient consumption of fruits and vegetables was 0.117 ( 0.153, 0.082) in 2005 and 0.100 ( 0.153, 0.082) in 2009. The concentration index for the consumption of unhealthy fat and oil was 0.034 ( 0.049, 0.019) in 2005 and 0.108 ( 0.165, 0.051) in 2009. The concentration index for insufficient consumption of fish was 0.070 ( 0.096, 0.044) in 2005. The concentration index for physical inactivity was 0.008 ( 0.057, 0.075) in 2005 and 0.139 (0.063, 0.215) in 2009. In all the cases, the OR of the richest group to the poorest group was significant. Conclusion: Hypertension, insufficient consumption of fruits and vegetables, consumption of unhealthy fat and oil, and insufficient consumption of fish are more prevalent among poor groups. There was no significant socioeconomic inequality in the distribution of smoking, excess weight, and hypercholesterolemia. Physical inactivity was more prevalent among the rich groups of society in 2009. The reduction of socioeconomic inequalities must become a main goal in health care policies. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. Methods: This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Results: Mortality was significantly associated with breastfeeding duration (OR: 0.87, 95% CI: 0.81-0.93), total health care visits (OR: 0.90, 95% CI: 0.83-0.98) and low birth weight (LBW) (OR: 7.38, 95% CI: 1.37-39.67). Conclusion: In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators. [ABSTRACT FROM AUTHOR]

Elders have long been recognised as among the most vulnerable people in disaster events. This paper reports a qualitative study of the self-perceived needs of older people in the aftermath of the Bam earthquake in Iran in 2003. A total of 56 people aged from 65 to 88 years were recruited to the study using purposive sampling, including 29 men and 27 women. Six focus group discussions and ten semi-structured individual interviews were conducted. Each focus group involved six to ten people from the cities of Bam and Baravat and their rural suburbs. Content analysis was used to analyse the transcribed data. The analysis identified four major themes among the informants' concerns: inappropriate service delivery, affronts to dignity, feeling insecure and emotional distress. A disaster-prone country like Iran needs to be appropriately prepared with culturally sensitive plans to meet the needs of those who suffer from their effects, not least older people. Emergency relief managers should note that for many older people in a disaster zone, customary forms of relief are neither required nor appropriate, and that their distinctive immediate and long-term needs should be assessed and met. Relief agencies need to be trained to be age-sensitive and should mainstream older people's rights in the planning and implementation of both the response and recovery phases of assistance. [ABSTRACT FROM AUTHOR]

Objectives: Several cases of Crimean-Congo hemorrhagic fever (CCHF), an arboviral disease, have been reported since summer 1999 in different areas of Iran. The main objectives of this research were to determine the most important means and patterns of transmission and the epidemiologic characteristics of this disease.Design: In this population-based case-control study, 24 patients from Zabol and Zahedan Districts in the Sistan and Baluchestan province, reported to the Center for Disease Control of Iran, were compared with 300 controls. The controls were sampled through the ‘probability proportional to size cluster sampling’ method from the general population of the same districts. The following variables were checked: age, sex, living environment (rural versus urban), education years, job, past history of tick bite, contact history with livestock, history of livestock slaughtering, presence of a designated place for animals at home, history of keeping livestock in the house.Results: Variables which increased the chance of disease include: history of slaughtering (OR = 7.57, CI: 2.21–25.91), high-risk occupations (OR = 4.97, CI: 0.97–25.43), history of tick bite (OR = 105.89, CI: 9.32–1202.44), age above 40 years (OR = 7.32, CI: 1.06–50.26).Conclusion: The results of this study confirm that the scheme of risk factors and risk groups for Crimean-Congo hemorrhagic fever (CCHF) in Iran do not differ substantially from the other parts of the world. Even though tick bite is one of the most important risk factors for CCHF, it cannot explain all cases and there are other important risk factors such as high-risk occupations and having contact with livestock. Even taking care of livestock for a short period at home can increase the chance of contracting CCHF. [Copyright &y& Elsevier]