Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 1 8 Forouzan SALEHI Zahra ABDOLLAHI Zeinab AHADI Mostafa QORBANI Gita SHAFIEE Shayesteh KHOSRAVI Maryam SANAEI Mina MINAEI Ramin HESHMAT 2015 10 21 2015 10 21 Background: The goal of the current study was to investigate the association between socioeconomic status (SES) and knowledge, attitude and practice (KAP) of Iranian households toward use of iron and vitamin A&D supplements in infants and pregnant women. Method: Overall, 14,136 Iranian households from urban and rural areas of 31 provinces were considered as the study population. A multi-stage cluster sampling technique was applied in each province and the size of clusters was 8 people. Data were collected by interviewing the qualified person and using a structure questionnaire. Socioeconomic status was considered as three levels (good, moderate or weak) based on five variables: household assets, occupation and education levels of head of family and respondent and number of family members. The percentage of KAP in households was measured by questions about essential supplementation in pregnancy and infancy. Result: The percentage of knowledge of using vitamin A&D and the beginning time of iron intake was 67.4%, and 67.8%, respectively. More than three forth of respondents had a favorable attitude about iron intake in pregnancy and infancy. Almost 80% of households used iron and vitamin A&D for their infants and 78% of pregnant women used iron supplement. Generally, the percentage of KAP was significantly higher in urban households. There was a linear association between KAP and SES. Conclusion: KAP in urban and rural households was not desirable; however, urban households had better status than rural ones. One of the suggested ways of ameliorating nutritional issues in pregnant women and infants aged less than two years olds is educating households about the importance of supplementation in pregnancy and infancy.   Keywords: Socioeconomic status, Knowledge, Attitude, Practice, Iron, Vitamin A-D   https://ijph.tums.ac.ir/index.php/ijph/article/view/4899 https://ijph.tums.ac.ir/index.php/ijph/article/download/4899/4475

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 9 15 Forouzan SALEHI Zahra ABDOLLAHI Maryam SANAEI Mostafa QORBANI Zeinab AHADI Gita SHAFIEE Zeinab TIZNOBEYK Bahar AZEMATI Ramin HESHMAT 2015 10 21 2015 10 21 Background: Disparities in health may relate to differences in nutrition. Among dietary determinants, Socioeconomic Status (SES) plays an important role. Therefore, this study was aimed to investigate the association between SES and cooking pattern and consumed food among rural and urban Iranian households.     Methods: Overall, 14,136 households were selected through single-stage cluster sampling methods from urban and rural regions of 31 provinces of Iran in 2011-2012. Demographic, SES, cooking pattern and consumed food data were obtained through valid structured questionnaires by interviewing between trained interviewers with qualified people in households. Data were analyzed using STATA software ver. 11.0 (STATA Corp, College Station, Tex.) Results: In households with weak SES background, 70.4% of households cooked separately for any meal. The healthy cooking method for red meat and chicken, fish, celery, vegetables stew, onion and green bean was significantly higher in good SES ( P<0.001). Households with good SES had higher intake low fat dairy, liquid oil and iodized salt (P<0.001) compared with families with weak SES. Most consumed bread in three groups was Lavash (Local name).  Conclusion: Pattern of cooking and the type of consumed foods among different SES group and their relationship with each other. So based on this information will be facilitated for interventions and training for better nutrition pattern in society.     Keywords: Socioeconomic Status, KAP, Cooking pattern, Consumed food   https://ijph.tums.ac.ir/index.php/ijph/article/view/4901 https://ijph.tums.ac.ir/index.php/ijph/article/download/4901/4476

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 16 24 Ramin HESHMAT Gita SHAFIEE Roya KELISHADI Omid Reza TABATABAIE Shirin DJALALINIA Mohammad-Esmaeil MOTLAGH Hoda ZAHEDI Atefeh NOORI Gelayol ARDALAN Tahereh AREFIRAD Hamid ASAYESH Bagher LARI­JANI Mostafa QORBANI 2015 10 21 2015 10 21 Background: The aim of this study was to evaluate the association of Socioeconomic Status (SES) with anthropometric measures and BP in Iranian children and adolescents. Methods: This nationwide study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, selected by multistage, cluster-sampling method from rural and urban areas of 30 provinces of Iran. Anthropometric indexes and BP were measured by standard protocols and with calibrated instruments. SES was estimated based on family assets and parents’ job and education using principle component analysis method. SES was considered as “low”, “intermediate” and “high” in the statistical analysis. Results: Overall, 13486 children and adolescents out of 14,880 invited students (response rate 90.6%) participated in this study. They consisted of 50.8% boys, 75.6% urban residents, with a mean age of 12.47 ±3.36 years. The prevalence of overweight, obesity and abdominal obesity and also mean of all anthropometric measures increased linearly with increasing SES. Inversely, underweight decreased linearly with increasing SES. Association of BP measures with SES was not statistically significant. After adjustment for potential confounders, association of anthropometric measures and BP with SES did not change significantly. Conclusion: We found that obesity, overweight and abdominal obesity was prevalent in high SES group and underweight in low SES group. Our findings serve as confirmatory evidence that contrary to developed countries, in developing countries childhood obesity is more prevalent in families with higher SES.   Keywords: Anthropometric measures, Blood pressure, Socio-economic status, Children and adolescents, Iran https://ijph.tums.ac.ir/index.php/ijph/article/view/4902 https://ijph.tums.ac.ir/index.php/ijph/article/download/4902/4477

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 25 34 Moloud PAYAB Roya KELISHADI Shirin Hasani RANJBAR Mohammad Esmaeil MOTLAGH Gelayol ARDALAN Hoda ZAHEDI Maryam SANAEI Gita SHAFIEE Hamid ASAYESH Bagher LARIJANI Mostafa QORBANI Ramin HESHMAT 2015 10 21 2015 10 21 Background: This study was aimed to investigate the association of consuming white rice and potato, as well as the bread type with anthropometric measures and blood pressure (BP) in a national sample of Iranian children and adolescents. Methods: This nationwide study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, selected by multistage cluster sampling from 30 provinces of Iran. Weight, height, waist circumference (WC), hip circumference (HC), waist -to-hip ratio (WHR), waist-to- height ratio (WHtR), as well as systolic and diastolic blood pressure (SBP, DBP) were measured. The self-reported frequency consumption of white rice and potato (daily or non-daily), as well as consumed bread type were asked. Results: The mean (SD) age of participants was 12.47 (3.36). They were consisted of 50.76% girls and 75.57% urban residents. The intake of white rice had significant positive association with anthropometric indices and SBP levels (P-value<0.05). In crude and adjusted models, white rice consumption was significantly associated with BMI (0.29(0.06-0.51 and 0.19(0.02-0.35)). Likewise, significant association existed between the type of the bread and anthropometric indices (except for WHR). Potato consumption was significantly associated with anthropometric indices (except for WHR and WHtR) and BP levels. In adjusted model, potato consumption had significant positive association with BMI. For every increase in the frequency of daily consumption of white rice, 0.19 units were added to BMI. Conclusion: White rice consumption increases the risk of general and abdominal obesity in children and adolescents. Consequently, for prevention and control of obesity, the consumption of refined grains should be limited by moderating nutrition policies.   Keywords: Grains, High blood pressure, Obesity, Anthropometric indices, Iran   https://ijph.tums.ac.ir/index.php/ijph/article/view/4903 https://ijph.tums.ac.ir/index.php/ijph/article/download/4903/4478

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 35 44 Saeid SAFIRI Roya KELISHADI Mostafa QORBANI Abbas ABBASI-GHAH­RAMANLOO Mohammad Esmaeil MOTLAGH Gelayol ARDALAN Gita SHAFIEE Zeinab AHADI Maryam SANAEI Hamid ASAYESH Bagher LARI­JANI Ramin HESHMAT 2015 10 21 2015 10 21 Background: Among chronic non-communicable diseases (CNCDs), the occurrence of cardiovascular diseases and diabetes is more prominent. CNCDs origin in early life; with sedentary habits, notably prolonged screen time (ST), leisure time spent on watching TV and working computer, suggested as one of their risk factors. We aimed to investigate the relationship between ST and cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents. Methods: In this analytical cross-sectional study, 5,625 school students aged 10-18 were studied in the third national survey of a school-based surveillance program. For ensuring representativeness of sample, subjects were selected using multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran (2009-10). ST was assessed through validated self-administered questionnaire, and cardiometabolic factors were determined. In addition, metabolic syndrome components were defined based on the Adult Treatment Panel III criteria modified for the pediatric age group. In addition, high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and generalized obesity were assessed as other cardiometabolic risk factors. Results: Mean age was 14.73±2.41. While, positive significant association was found between ST and abdominal obesity, blood pressure, levels of LDL-C and triglycerides (P <0.05), it was reversely correlated with HDL-C level (P <0.05). However, there was positive but not statistically significant association between ST and odds of metabolic syndrome (P =0.32). Conclusion: The association between ST and some metabolic syndrome components, reducing ST should be considered as one of the preventive strategies among children and adolescents.   Keywords: Metabolic syndrome, Screen time, Physical activity, Children, Adolescent, Cardiometabolic risk factors, Iran  https://ijph.tums.ac.ir/index.php/ijph/article/view/4904 https://ijph.tums.ac.ir/index.php/ijph/article/download/4904/4479

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 Supple 1 2015 10 21 45 52 Silva HOVSEPIAN Masoumeh RASHIDI Mostafa QORBANI Gita SHAFIEE Mohammad Esmaeil MOTLAGH Mehdi EBRAHIMI Gelayol ARDALAN Roya KELISHADI Ramin HESHMAT 2015 10 21 2015 10 21 Background: Iran is a vast country with great variability in ethnicity and geographical regions as well as higher diversity in socioeconomic and demographic factors in different provinces. All these differences could influence the growth indicators of children and may result in a substantial inequality in the distribution of growth indexes across Iranian provinces. This study aimed to determine the distribution of growth disorders of Iranian children according to the geographical and climatic conditions.  Methods: In this nationwide cross-sectional study, students aged 6-18 years, living in urban and rural areas of 30 provinces in Iran, were studied. The prevalence of underweight, overweight, obesity, abdominal obesity and short stature were determined in different geographical regions of Iran using the geographic information system (GIS) and ArcGIS software. Results: Overall, 13486 children with mean age of 12.5 (CI: 12.3 - 12.6) years were studied. The prevalence of overweight and obesity as well as underweight ranged between 5-15%, in most provinces. Underweight was more prevalent in very hot and hot regions than in cold regions. The prevalence of overweight and obesity was higher in regions with cold and rainy weather. The prevalence of short stature in most of the provinces ranged between 5-15%. Conclusion: The findings provide geographic disparities of growth disorders among Iranian pediatrics population. They could be used as baseline information for planning further studies to determine the causal pathway for reported wide range of reported growth disorders and their association with different geographical and climatic regions.   Keywords: Obesit>ARSHAD 2015 11 25 2015 11 25 Background: Electrolytes play an important role in the normal functioning of human body. Electrolyte imbalance and mineral disturbances is the common clinical manifestation in several infectious diseases including malaria. Malaria is a mosquito borne serious infectious disease of the world. Plasmodium vivax and P. falciparum are the main agents responsible for malaria in Pakistan. Electrolyte imbalance in malarial infection may lead towards the severity of disease. Methods: The present study analyzed the electrolytes levels (Na, K, Ca and Mg) in malarial patients and healthy individuals. Patients were categorized into two groups, P. falciparum and P. vivax, based on causative species of Plasmodium. Study consisted of 173 individuals, out of which 73 were malarial patients and 100 were normal healthy individuals. Results: Concentrations of Na, K, and Ca were low in the blood of malarial patients as compared to healthy individuals (P<0.05). No significant difference for these electrolytes exists between P. falciparum and P. vivax infected groups (P>0.05). The concentration of Mg was changed based on exposure to the type of parasite. In P. falciparum infection, the level of Mg was lower than healthy individuals was (P<0.05). Discordantly, in case of P. vivaxinfection, Mg level was higher than healthy individuals were (P<0.05). No variation was noticed in electrolytes levels due to gender differences (P>0.05). Conclusion: Variation in Mg levels occurs due to exposure of Plasmodium depending on its type. The levels of Na, K and Ca are also changed due to Plasmodium, regardless of its type.   Keywords: Malaria, Electrolytes, Plasmodium falciparum, Plasmodium vivax https://ijph.tums.ac.ir/index.php/ijph/article/view/5305 https://ijph.tums.ac.ir/index.php/ijph/article/download/5305/4525

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 11 2015 11 25 1559 1560 Salman KHAZAEI Hamid SALEHINIYA Abdollah MOHAMMADIAN-HAFSHE­JANI 2015 11 25 2015 11 25 No Abstract.     https://ijph.tums.ac.ir/index.php/ijph/article/view/5317 https://ijph.tums.ac.ir/index.php/ijph/article/download/5317/4537

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 11 2015 11 25 1498 1505 Jalal POOROLAJAL Mehrdokht MAZDEH Mohammad SAATCHI Elaheh TALEBI GHANE Azam BIDERAFSH Bahar LOTFI Mohammad FERYADRES Khabat PAJOHI 2015 11 25 2015 11 25 Background: Hamadan Province is one of the high-risk regions in Iran for Multiple sclerosis (MS). A majority of the epidemiological studies conducted in Iran addressing MS are descriptive. This study was conducted to assess MS and its associated risk factors in Hamadan Province, the west of Iran. Methods: This case-control study compared 100 patients with MS (case group) and 100 patients with acute infectious diseases (control group) from September 2013 to March 2014. A checklist was used to assess the demographic, medical, and family history of the patients. The Friedman-Rosenman questionnaire was also used to assess personality type. Statistical analysis was performed using logistic regression model with Stata 11 software program. Results: The adjusted odds ratio (OR) estimate of MS was 4.37 (95% CI: 2.33, 8.20) for females compared to males; 0.15 (95% CI: 0.06, 0.43) for people aged above 50 years compared to aged 14 to 29 years; 0.44 (95% CI: 0.21, 0.91) for overweight or obese people compared to normal weights. Crude OR indicated a significant association between the occurrence of MS and exclusive breast feeding, season of birth, and smoking. However, the association was not statistically significant after adjustment for other covariates. Conclusion: The risk of MS is significantly lower in male gender, obese/overweight, and old people. Furthermore, non-smoking, non-exclusive breast-feeding, and born in autumn may increase the risk of MS but need further investigation. However, long-term large prospective cohort studies are needed to investigate the true effect of the potential risk factors on MS.   Keywords: Multiple sclerosis, Risk factors, Case-control study, Iran https://ijph.tums.ac.ir/index.php/ijph/article/view/5306 https://ijph.tums.ac.ir/index.php/ijph/article/download/5306/4526

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 11 2015 11 25 1561 1562 Veda VAKILI Maliheh ZIAEE Ahmadreza ZARIFIAN 2015 11 25 2015 11 25