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Background: Infection with hepatitis C virus (HCV) is increasingly recognized as a major global health problem. Objectives: The aim of this study was to measure the prevalence of HCV infection and determine the risk factors associated with HCV among male people who inject drugs (PWID) in Kermanshah, Iran. Methods: In this cross sectional study, the samples were recruited from 2 drop-in centers and related community outreach sites, using snowball sampling. The questionnaire consisted of 3 sections, including demographics, drug use patterns, and risky behaviors. HCV infection was tested in venous blood samples, collected from the participants, using the ABON rapid test kit. Logistic regression analysis was used to determine the association between HCV status and the associated factors, reported as odds ratio (OR) and 95% confidence interval (CI). Results: The mean age of the participants was 36.7 ± 8.5 years (range, 18 - 65 years). Over half of the participants (54.8%) tested positive for HCV antibodies; in other words, they had been exposed to the virus. Adjusted OR for people reporting shared equipments within the past month was 3.36 times higher than the OR of people who reported no shared equipments (P = 0.000). The adjusted OR of positive HCV among those who injected twice or more per day was 4.33 (P = 0.000), compared to those who injected only once a day (or less). With over half the participants having evidence of HCV exposure, there is a need to increase the coverage of harmreduction programs, especially sterile injection equipment programs. Moreover, increasing access to harm-reduction programs and HCV treatment can ultimately reduce the opportunities for HCV transmission.

Background and Objectives: The prevalence of HBV infection among injection drug users (IDUs) is higher than the general population due to high-risk sexual behaviors and the needle sharing. The aim of this study was to determine the prevalence of HBV infection and its effective factors among IDUs of Kermanshah Province in 2016. Methods: This ia descriptive-analytic study was performed in 606 male IDUs in Kermanshah Province in 2016. Data were collected through questionnaires and interviews. HBV was also evaluated through blood tests using the rapid test. Simple and multivariate logistic regression analyses were applied to investigate the factors affecting HBV infection. Data were analyzed using STATA-12 software. Results: The prevalence of positivity HBV antibody was 3% (95% CI: 1.61- 4.32) among male IDUs. According to the results of unit-variable logistic regression analysis, the duration of drug injection (OR = 1.08, 95% CI: 1.02-1.15) and the number of daily injections (OR = 1.38, 95% CI: 1.05-1.81) were risk factors for HBsAg positivity but there were no significant associations in the multivariate regression model. Conclusion: The prevalence of HBV is much higher among IDUs than in the general population. These populations are at risk for viral infections such as HBV; therefore, it is recommended to provide necessary education about the prevention methods as well as the necessary screening for them.

Background and Objectives: Colorectal cancer is the fourth most common cancer and the fifth cause of cancer-related mortality in Iran. This study aimed to determine the incidence of colorectal cancer in men and women and to investigate its relationship with the human development index (HDI) and its components in Iranian provinces. Methods: This ecological study was conducted to assess the correlation between age-specific incidence of colorectal cancer in men and women and the Human Development Index. We used the data of the Iranian Cancer Registry and Statistical Centre of Iran. We used a bivariate correlation method to assess the correlation of ASR and HDI. P values less than 0.05 were considered significant. All reported P-values are two-sided. Statistical analyses were performed using the SPSS software version 23. Results: The highest incidence of colorectal cancer in men was seen in Tehran (78.16), Eastern Azerbaijan (41.14), and Semnan (62.13), and the highest incidence of colorectal cancer in women was seen in Tehran (47.18), Semnan (80.14), and Eastern Azerbaijan (82.12), respectively. The results showed that the incidence of colorectal cancer in men (r = 0.605) and women (r = 0.661) had a positive significant correlation with the Human Development Index (P

Background and aims: Chronic kidney disease (CKD) is a common disorder that is associated with increased risk of cardiovascular disease, kidney failure, and other complications. The ageing of populations along with the growing global prevalence of diabetes and hypertension has led to a corresponding worldwide increase in prevalence of CKD. We studied the risk of diabetes, hypertension and interaction of diabetes with hypertension on the incidence of CKD, stratified by gender. Methods: This study is secondary study on the data of Tehran Lipid and Glucose Study. A population of 7342 participants (46.8% male) with a mean age of 46.8 years for males was investigated. At first, they were divided into 4 groups. First group: Patients without dabetes and without hypertension; the second group: Dabetes and without hypertension; the third group: Without diabetes and Hypertension; the forth group: With diabetes and Hypertension were. Then, each group was compared to the first group using multivariate Cox regression analysis adjusted for age, education, smoking, total cholesterol, Triglyceride, HDL, Glomerular filtration rate and Body Mass Index, and trend score. Results: In men of the second group, diabetes (without hypertension) with HR of 1.94 (CI 95%:1.39-2.69) and in men of third group, hypertension (without diabetes) with HR of 1.58 (1.27-1.96) were risk factors for CKD events. As the same way, the results were in women 1.18 (0.93-1.51) and 1.24 (1.05-1.47). Diabetes and hypertension had not any significant interaction in men and women with the prevalence of chronic kidney disease. Conclusion: The results of this study indicated that hypertension (regardless of the presence or absence of diabetes) is an independent risk factor for chronic kidney disease in men and women

The high prevalence of diabetes in Iran and other developing countries is chiefly attributed to urbanization. The objectives of the present study were to assess the prevalence of self-reported diabetes and to determine its associated risk factors. This study is a part of the national noncommunicable disease risk factor surveillance, conducted in 31 provinces of Iran in 2011. First, 10069 individuals, between 20 and 70 years old (3036 individuals from rural and 7033 from urban areas), were recruited. The major risk factors were studied using a modified WHO STEPS approach. Diabetes was considered based on self-reported diabetes. The prevalence of self-reported diabetes was 10% overall. The prevalence in the rural and urban settings was 7.4% and 11.1%, respectively. Moderate physical activity (OR=0.45, 95% CI=0.29–0.71) and family history of diabetes)OR=6.53, 95% CI=4.29–9.93) were the most important risk factors among the rural residents and systolic blood pressure (OR=1.01, 95% CI=1–1.02), waist circumference (OR=1.02, 95% CI=1.01–1.03), and overweight (OR=1.36, 95% CI= 1–1.84) were significantly associated with self-reported diabetes in the urban residents. The prevalence of self-reported diabetes in the urban setting was higher than that in the rural setting. Physical inactivity, abdominal obesity, and high blood pressure were the most important risk factors associated with self-reported diabetes in Iran.

Background and Objectives: Colorectal cancer is the third most common cancer in men and the second most common cancer in women in the world. The colorectal cancer screening program was conducted in Iran as a pilot in the late 2010 with the aim of reducing the burden of colorectal cancer. The aim of this study was to evaluate the colorectal cancer screening program in Iran. Methods: This cross-sectional study was conducted on data from the pilot colorectal cancer screening programs. First, the indicators of the colorectal cancer screening program were determined through a comprehensive review of scientific databases, interviews with experts and implementation of pilot evaluation. Then, the indicators were calculated through descriptive analysis using SPSS version 18. Results: The indicators and their values were as follows: coverage rate 33.04%, participation rate 53.3%, percentage of consulted people 99.6%, percentage of blood samples 37%, percentage of colonoscopy 54.8%, cancer detection rate 2.7%, and polyp detection rate 18.1%. Among people who gave blood samples 1.6% had familial adenomatous polyposis (FAP) syndrome, 43.06% had hereditary no polyposis colorectal cancer (HNPCC) syndrome, and 29% were sporadic cases. Conclusion: The screening program in Iran has differences with other countries which have affected the indicators.

Background and Objectives: Ahvaz has become one of the most polluted cities in the world. Only on 11 November 2013, over one thousand residents in Khuzestan Province attended the nearest health center with severe symptoms, particularly shortness of breath, cough, wheezing, and high blood pressure. During a week, more than 7 thousand patients were registered with this syndrome. This study was conducted to investigate the evidence for the confirmation of an epidemic in acute respiratory syndrome among the residents of Ahwaz in November 2013. Methods: In this cross-sectional study, we evaluated the data of the use of drugs related to acute respiratory attacks from November 2008 to 2013 in Ahvaz. Then, we conducted a descriptive study on the general population. The sample size was 120 and the study participants included different segments of the general population. The data collection tool was a researcher-made questionnaire and the data were analyzed using SPSS.18. Results: The use of the respiratory drugs increased from 2008 to 2013. The drug consumption was markedly higher in November 2013. In the study of the general population, 93% of the participants declared that they had never seen a similar event, and 92.5% mentioned that they had never heard of a similar occurrence. Conclusion: Due to the significant increase in respiratory medicine in November 2013 and the unexpected nature of the event, an epidemic seems to be obvious.

Background and Objectives: Determining and monitoring the age at myocardial infarction (MI) and its comparison in various regions is one of the vital and basic principles for the management of MI.This study was conducted to determine the age at the first MI in Iran. Methods: In this cross-sectional, analytical study at a national level, the data of 20750 new MI patients registered in 2012 in 31 provinces of Iran according to the cardiologist’s diagnosis, World Health Organization criteria, and the codes ICD10: I21-I22 were used. The calculations were done using the Stata 12 software. Results: The mean±SD of age at the first MI was 61.2±13.4 years in all patients in Iran. Moreover, 15033 (72.4%) patients were male with a mean age of 59.6±13.3 years. The mean age at MI in men was lower than women (65.4±12.6 years), showing a statistical significance (P

Background: The latest WHO report indicates that refractive errors are the leading cause of visual impairment throughout the world. The aim of this study was to determine the prevalence of myopia, hyperopia, and astigmatism in 7 yr old children in Iran. Methods: In a cross-sectional study in 2013 with multistage cluster sampling, first graders were randomly selected from 8 cities in Iran. All children were tested by an optometrist for uncorrected and corrected vision, and non-cycloplegic and cycloplegic refraction. Refractive errors in this study were determined based on spherical equivalent (SE) cyloplegic refraction. Results: From 4614 selected children, 89.0% participated in the study, and 4072 were eligible. The prevalence rates of myopia, hyperopia and astigmatism were 3.04% (95% CI: 2.30-3.78), 6.20% (95% CI: 5.27-7.14), and 17.43% (95% CI: 15.39-19.46), respectively. Prevalence of myopia (P=0.925) and astigmatism (P=0.056) were not statistically significantly different between the two genders, but the odds of hyperopia were 1.11 (95% CI: 1.01-2.05) times higher in girls (P=0.011). The prevalence of with-the-rule astigmatism was 12.59%, against-the-rule was 2.07%, and oblique 2.65%. Overall, 22.8% (95% CI: 19.7-24.9) of the schoolchildren in this study had at least one type of refractive error. Conclusion: One out of every 5 schoolchildren had some refractive error. Conducting multicenter studies throughout the Middle East can be very helpful in understanding the current distribution patterns and etiology of refractive errors compared to the previous decade.

Population-based data on myocardial infarction rates in the Islamic Republic of Iran have not been reported on a national or provincial scale. In a cross-sectional study, data were collected on 20 750 new cases of myocardial infarction (ICD10 codes I21-22) admitted to hospitals and registered by the Iranian Myocardial Infarction Registry in 2012. The crude and age-adjusted incidence for the 31 provinces and the whole country were directly calculated per 100 000 people using the WHO standard population. Overall, males comprised 72.4% of cases and had a significantly lower mean age at incidence than women [59.6 (SD 13.3) years versus 65.4 (SD 12.6) years]. The male:female incidence ratio was 2.63. The age-standardized myocardial infarction incidence rate was 73.3 per 100 000 in the whole country (95% CI: 72.3%-74.3%) and varied significantly from 24.5 to 152.5 per 100 000 across the 31 provinces. The study provides baseline data for monitoring and managing cardiovascular diseases in the country.معدّل وقوع احتشاء عضل القلب الحاد في جمهورية إيران الإسلامية: دراسة باستخدام بيانات السجل الوطني في عام 2012.علي أحمدي، حامد سوري، يادولا مهرابي، كوروش اعتماد، طاهرة سماوات، أرسلان خالديفار.لم يتم إعداد تقارير عن بيانات سكانية حول معدّلات احتشاء عضل القلب في جمهورية إيران الإسلامية على النطاق الوطني أو على نطاق المحافظات. ولذلك قام الباحثون - في دراسة مستعرضة - بجمع بيانات عن 750 20 حالة جديدة من حالات احتشاء عضل القلب (التصنيف الدولي للأمراض 10 الرواميز 121-22) أدخِلَت إلى المستشفيات وسُجلت من قِبَل مكتب التسجيل الإيراني لاحتشاء عضل القلب في عام 2012. وتم حساب معدّل الوقوع الخام والمصحَّح حسب السن لكل 000 100 شخص - بشكل مباشر - في كل من المحافظات الـ 31 وفي البلد ككل باستخدام معيار منظمة الصحة العالمية لعدد السكان. وقد شكل الذكور بوجه عام 72.4% من الحالات، وكان العمر الوسطي لديهم عند الوقوع أقل بكثر من النساء [59.6 (SD 13.3) سنة مقابل 65.4 (SD 12.6) سنة]. وكانت نسبة وقوعات الذكور إلى الإناث: 2.63. وكان معدَّل وقوع احتشاء عضل القلب المعيَّر حسب السن 73.3 لكل 000 100 في البلد ككل (72.3%-74.3% CI: %95)، وتباين بين المحافظات الإحدى والثلاثين بشكل كبير من 24.5 إلى 152.5 لكل 000 100. وهذه الدراسة تقدم بيانات أولية لرصد وإدارة الأمراض القلبية الوعائية في البلد.Incidence de l'infarctus aigu du myocarde en République islamique d'Iran : étude à partir des données du registre national en 2012.Les données en population sur les taux d'infarctus du myocarde en République islamique d'Iran n'ont pas été rapportées à l'échelle régionale ou nationale. Dans une étude transversale, des données ont été recueillies sur 20 750 nouveaux cas d'infarctus du myocarde (CIM-10 codes I21–22) admis dans des établissements hospitaliers et enregistrés dans le Registre iranien des infarctus du myocarde en 2012. L'incidence brute et l'incidence ajustée pour l'âge dans les 31 provinces et l'ensemble du pays ont été directement calculées pour 100 000 personnes à l'aide de la population type de l'OMS. Globalement, les hommes représentaient 72,4 % des cas et étaient nettement moins âgés en moyenne à l'incidence que les femmes (59,6 ans [ET 13,3 ans] contre 65,4 ans [ET 12,6 ans]). Le rapport d'incidence homme-femme était de 2,63. Le taux d'incidence standardisé en fonction de l'âge pour l'infarctus du myocarde était de 73,3 pour 100 000 dans l'ensemble du pays (IC à 95 % : 72,3 %–74,3 %) et variait significativement, de 24,5 à 152,5 pour 100 000, entre les 31 provinces. L'étude fournit des données initiales pour le suivi et la prise en charge des maladies cardio-vasculaires dans le pays.

Background and Objectives: Colorectal cancer is the fourth leading cause of cancer death worldwide. Annually 1430000 cases would be diagnosed and half of these people would die of the disease. In Iran, colorectal cancer is the fifth common cancer among men and is the thirdamong women. This study was designed to estimate survival rates for patients with colorectal cancer and related factors. Methods: During the 1384 to 1388 years 24,807 patients diagnosed with colorectal cancer were recorded in the Cancer Registry of the Ministry of Health and Medical Education. Age, gender, marital status, education, occupation, place of residence, tumor diagnosis, the clinical and demographic factors in colorectal cancer as effective on survival entered in Aalen’s additive hazard model and diagram Aalenchr('39')s was used to study the effects of these factors over time. R 3.2.0 software was used for data analysis. Results: Stage of tumor had a significant association with survival rates. In this study 1 to 5 year survival rate for patients with stage II tumors, was 100%, 98%, 96%, 93% and 93% respectively and for patients with stage III tumors 99%, 97%, 94%, 90% and 84%, respectively. Conclusion: In spite of using Cox model in survival analysis by many researchers, Aalen’s model may yield new insights in prognostic studies of survival time of patients with colorectal cancer over time. Our results suggest that early detection of patients in primary stage is important to increase survival.

Background: High cholesterol levels are associated with increased risk of coronary heart disease and stroke. Understanding the distribution of serum cholesterol levels in each country is valuable index for use in public health planning. This study aimed to construct nomograms of total cholesterol (TC) levels and establish the cut-points specific to Iranian population. Methods: Data on serum TC levels of 19,630 non-institutionalized individuals aged 25–64 years from third national survey on non-communicable diseases (SuRFNCD) in 2007 were used to construct cholesterol nomograms. We proposed cutoff values for borderline and high TC levels based on rounded 75th and 90th percentiles in three age groups (25–34, 35–44 and 45–64) respectively. Results: Average yearly increase of TC for males up to the age of 45 and females up to 64 were 1.15 and 1.03 mg/dl, respectively. TC levels were higher in females. In males, cutoff values for “borderline and high” TC levels were 195 and 220 mg/dl in 25–34, 210 and 240 mg/d in 35–44 and 215 and 245 mg/dl in 45–64 years old individuals. In women, these values were 200 and 225 mg/dl in 25–34,215 and 240 mg/dl in 35–44 and 235 and 265 mg/dl in 45–64 years old individuals respectively. Conclusion: Since TC levels are different in two sexes and change with age, we proposed different cutoffs for sex and age group. We think these cutoffs could be used in national public health planning.

Background and Aim: Provision of timely healthcare for children under 5 years of age specially children with congenital hypothyroidism and also regular monitoring of growth through measuring weight, height and head circumference have been of great importance. The aim of this study was to make a comparison between healthy children and children with congenital hypothyroidism in regard to health-care coverage in Iran. Materials and Methods: This study was conducted in five provinces in different geographical areas of Iran in 2015. 240 children with congenital hypothyroidism and 240 healthy children were entered into the study. Children with congenital hypothyroidism were selected randomly from the national registere database. The children in the control group were matched with the children with hypothyroidism in regard to age, gender and place of residence. Anthropometric indices including weight, height and head circumference of the children of less than 3 years of age were recorded as the health care indices. STATA software version 13 was used for data analysis. Results: The mean percentage of measurement and record of weight, height and head circumference in children below 3 years of age with congenital hypothyroidism were 82.1, 78.7 and 55.4%, respectively. The mean percentage of measurement and record of weight, height and head circumference in healthy children (control group) below 3 years of age were 82.2%, 80.9 and 55.1%, respectively. There was a statistically significant difference between the two groups in relation to the percentage of height measurement (P =0.02). Conclusion: According to the results of this study, percentage of measurement and record of the anthropometric indices in Iranian children of less than 3 years of age is low. More attention to the measurement and record of these physical growth indices in children of less than 3 years of age specially children with congenital hypothyroidism who need regular follow up, is essential.

Trends in cholesterol level of different populations have been investigated in several studies. This study is conducted to determine the trend of cholesterol level of Iranian adults from 1990 to 2007. Data on cholesterol measurements of four national health surveys that have been carried out in Iran used in this study. Cholesterol level of 12728 adults aged 25-64 were measured in 1990-1 survey. Also in 1999, 2005, and 2007 surveys, blood cholesterol level of 18398, 52344 and 19630 have been sampled, respectively. The median of cholesterol were modeled with age for men and women separately for the four surveys using fractional polynomials. Then, trends in the median of cholesterol across these four surveys were studied. The analysis of cholesterol data over four national health surveys showed that the change in males' cholesterol level had a decreasing trend. This decreasing trend was more pronounced in ages younger than 45 years. However, the medians of cholesterol of females during 16 years of four national surveys had a varying trend. It was decreasing in ages younger than 45; but increasing in ages over 45 years. The median of the cholesterol level of males and females in 2005 survey was on average about 10 mg/dl higher in comparison with the other surveys. Our findings showed that the pattern of trend in cholesterol level of Iranian men and women adults have a considerable difference with those of the other developing and developed countries.