Iranian Journal of Epidemiology

Assessing the Hope of Life and its Relationship with Attitudes to Aging in Different Age Groups

Tahereh Ramezani

Background and Objectives: Considering the documented impact of attitudes towards aging on quality of life, this study aimed to explore hope in life and its association with attitudes towards aging across various age groups in Qom, Iran.
Methods: This cross-sectional study, conducted in 2021-2022, included 83 children (8-15 years old) and 340 adults (16 years old and above) selected from different age groups based on the Statistical Center of Iran's classification. The systematic random sampling method was used, considering the frequency percentage of each group from the 2015 census. Data were collected through a demographic form, Kogan's Attitudes Toward Older People Scale (KAOPS), and Snyder's Hope questionnaire. Statistical analysis was performed using SPSS-24, incorporating Pearson's correlation coefficient, independent sample t-tests, ANOVA, and linear regression.
Results: The mean and standard deviation of hope in life and attitude towards aging were 25.97±5.81 (ranging from 6 to 36) and 137.38±21.65 (ranging from 34 to 238) in the children's group, and 27.54±4.92 (ranging from 8 to 32) and 154.66±17.30 (ranging from 34 to 238) in the adults' group, respectively. Pearson's correlation coefficient revealed a significant relationship between hope in life and attitude towards aging only in the age groups of 16-24 years (r=0.220, P<0.05) and 25-44 years (r=0.273, P<0.01), while this relationship was not significant in other groups (P>0.05).
Conclusion: Although the relationship between attitude towards aging and hope in life was not strong or significant across all age groups, given the average levels of hope in life across all age groups, promoting positivity and elucidating the positive attributes of aging and the importance of elderly individuals in society can enhance individuals' outlook towards their future life.

Inequality in the Distribution of Bone Densitometer Devices in Iran

Afshin Ostovar

Background and Objectives: In Iran, a substantial number of individuals at risk of osteoporosis lack access to osteoporosis diagnostic services, highlighting a significant gap in the diagnosis and subsequent treatment of osteoporosis. This study aims to investigate the distribution of bone densitometer devices in Iran.
Methods: Bone densitometry devices across the country in 2018 were assessed through a comprehensive census. Information regarding these devices was gathered based on their location (urban or rural), ownership (government or private), adherence to standards, and years of operation. To calculate the inequality index in the distribution of devices among cities within a province, the frequency of devices in the provincial center was compared to those outside the center. To assess the inequality in the distribution of devices among the provinces of the country, the Lorenz curve and concentration index were utilized. All values were calculated per one million people over 50 years of age.
Results: Of the total 492 bone density measurement devices in the country, 399 devices (81.0%) were located in provincial centers. Out of these, 103 (20.9%) devices were in government-owned centers, while 389 (79.0%) devices were in privately-owned centers. For every one million individuals over 50 years old, the total number of devices, standard devices, standard devices with less than 10 years of operation, and devices in government-owned centers were calculated as 33.4, 20.3, 9.9, and 7, respectively. The inequality index in the distribution of devices in the cities was found to be 4.7. Furthermore, the inequality index in the distribution of devices between provinces was estimated as 0.13 (95%CI: 0.005-0.25) (P value=0.05).
Conclusion: There exists a significant disparity in the distribution of bone densitometry devices across the provinces and cities within the country.

Investigation of Economic Losses of Foot and Mouth Disease in Dairy Farms of West Azerbaijan Province in the Period of 2017-2018

Saeed Bokaie

Background and Objectives: Foot and mouth disease (FMD) is the most significant livestock disease in the world and can cause great economic losses to the population of domestic ruminants. This study aims to investigate the economic impacts of FMD on dairy farms in West Azerbaijan province during the period of 2017-18.
Methods: Employing a questionnaire survey, this study covered all industrial dairy farms affected by the disease in eight units during the specified period. The results underwent descriptive analysis using Excel software version 2013 and SPSS version 18.
Results: Absolute (in million Rials) and relative (percent) losses attributable to FMD were categorized as follows: mortality losses amounted to 2,170 million Rials (60.6%), distress sale of livestock reached 713 million Rials (19.9%), treatment incurred 288.65 million Rials (8.1%), short-term reduction of milk production accounted for 193.35 million Rials (5.4%), extra labor costs totaled 152.4 million Rials (4.3%), abortion amounted to 35 million Rials (1%), and sampling costs were 32 million Rials (0.9%). The total losses from FMD in dairy industrial farms were estimated at 3584.4 million Rials, equivalent to 38,758 dollars at the average exchange rate of one dollar to 92,487 Rials in 2018.
Conclusion: The substantial investment in dairy farms amplifies the economic impact of FMD, resulting in prolonged recovery periods and contributing to a decline in livestock and dairy production in the province and the country.

Survey of Epidemiology and Burden of Sexually Transmitted Diseases in The Eastern Mediterranean Regional Office Countries from 1990 to 2019 Based on the Results of the Global Burden of Diseases Study

Mohammad Reza Karami Ghezeli

Background and Objectives: The World Health Organization estimates that over a million people contract sexually transmitted diseases daily. Given the significant impact of these diseases on public health in developing countries, this study aims to investigate the epidemiology and burden of sexually transmitted diseases in the Eastern Mediterranean countries.

Methods: This study utilized global disease burden data from The Institute for Health Metrics and Evaluation to examine sexually transmitted disease indicators in the Eastern Mediterranean region, encompassing 22 countries from 1990 to 2019. Analyses related to the lost years index, considering premature death and disability (DALY), incidence rate, prevalence rate, mortality rate, and standardized age rates, were conducted. All estimates are reported with 95% uncertainly interval due to various sources of error, including measurement bias and modeling. Microsoft Office Excel 2016 was employed for all analyses.
Results: The age-standardized incidence and prevalence of sexually transmitted diseases in the Eastern Mediterranean region decreased from 9053 and 13424 in 1990 to 8658 and 13143 in 2019, respectively, and the age-standardized death rate increased from 2 to 4 per 100,000 people.
Conclusion: Considering the economic burden caused by these diseases in the Eastern Mediterranean region, it is necessary for the health policy makers to develop intervention strategies for prevention and health planning.

The Concept and Application of the Joinpoint Regression Model in Analyzing the Time Trend in Epidemiological Studies (Case: Liver Cancer due to Alcohol Use in Iran)

Yunes Jahani

Background and Objectives: Time trend analysis of factors such as disease and mortality rates is a crucial component of health planning for any community. It allows for a more accurate interpretation of changes over time. This study was conducted to examine the performance of the Joinpoint regression model in analyzing time trends.
Methods: This study aims to first provide a simplified understanding of the Joinpoint regression model and then demonstrate its application on data regarding the 30-year trends of liver cancer mortality due to alcohol consumption in Iran.
Results: The results of the time trend analysis indicate that the age-standardized mortality rate of liver cancer due to alcohol use consumption has decreased by an average of 0.8% per year over the 30-year period in Iran (1990 to 2019). The projections also suggest that this declining trend will continue.
Conclusion: In general, the main advantage of the Joinpoint regression model over other models is its ability to identify periods where significant changes in trends have occurred. Based on the results, the mortality rate of liver cancer due to alcohol use consumption over the 30-year period in Iran can be divided into five periods with different rates of change.

A Study of School-Based Surveillance System of COVID-19: A Systematic Review

Manoochehr Karami

Background and Objectives: The disease surveillance system provides essential information about the population at risk and the disease pattern. This review aimed to describe the experiences of countries in establishing COVID-19 school-based surveillance systems.
Methods: We conducted a systematic review. Four databases were searched between January 2019 and December 2022 using relevant keywords. The studies were screened by two people according to the inclusion and exclusion criteria. The findings were extracted using a standard form and aligned to the objectives of the review.
Results: The data from 12 studies were extracted using the standard form. All studies related to the school-based surveillance system of COVID-19. Most of studies were conducted in the United States of America and England. The reports did not conform to the standard. The number of schools covered in surveillance systems ranged from 2 to more than 6000 schools. The age group in these studies was 0 to 19 years. Schools submitted data daily or weekly.
Conclusion: The results of the COVID-19 surveillance systems in schools should be reported according to standard Instructions. This is considered a necessity to monitor and evaluate the surveillance system. It also allows other countries and researchers to share and use the results. In addition, sensitivity, timeliness, and positive predictive value were not reported in implemented surveillance systems.

Iranian Men's Attitude Towards Childbearing and Related Factors - A Systematic Review

Nooshin Peyman

Background and Objectives: In recent years, there have been significant demographic changes. One of the most important changes has been the decrease in the fertility rate in many countries, including Iran. In recent decades, considering the vital role of men in having children, the question is whether domestic research on the issue of men's attitude towards having children has enough maturity. Moreover, what are the gaps in the research process of this issue in the country?
Methods: The present study used Iranian research articles published in domestic and foreign journals. To obtain relevant articles from domestic Iran databases (magiran, SID) and international databases (Web of Science, Scopus PubMed,) as well as the Google Scholar search engine was used from the beginning until May 2022 with the keywords: attitude, motivation, intention, childbearing, childbirth, fertility, reproduction.
Results: 18 articles related to the purpose of the research were included in the study. The pattern of two children was the dominant pattern of childbearing among men. A large proportion of men had a positive attitude towards childbearing. Among the variables related to men's attitude towards childbearing were education, socio-economic class, a feeling of loneliness, place of residence, and the amount of internet usage.
Conclusion: It is necessary to increase encouragement policies, raise awareness about the importance of having children, provide proper occupations for men, suitable housing, and implement comprehensive educational programs to strengthen men's optimistic view of having children.