[Using lms method in smoothing reference centile curves for lipid profile of iranian children and adolescents: a caspian study]

LMS is a general monitoring method for fitting smooth reference centile curves in medical sciences. They provide the distribution of a measurement as it changes according to some covariates like age or time. This method describes the distribution of changes by three parameters; Mean, Coefficient of variation and Cox-Box power [skewness]. Applying maximum penalized likelihood and spline function, the three curves are estimated and fitted and optimum smoothness is expressed by three curves. This study was conducted to provide the percentiles of lipid profile of Iranian children and adolescents by LMS. Smoothed reference centile curves of four groups of lipids [triglycerides, total-LDL- and HDL-cholesterol] were developed from the data of 4824 Iranian school students, aged 6-18 years, living in six cities [Tabriz, Rasht, Gorgan, Mashad, Yazd and Tehran-Firouzkouh] in Iran. Demographic and laboratory data were taken from the national study of the surveillance and prevention of non-communicable diseases from childhood [CASPIAN Study]. After data management, data of 4824 students were included in the statistical analysis, which was conducted by the modified LMS method proposed by Cole. The curves were developed with a degree of freedom of four to ten with some tools such as deviance, Q tests, and detrended Q-Q plot were used for monitoring goodness of fit models. All tools confirmed the model, and the LMS method was used as an appropriate method in smoothing reference centile. This method revealed the distributing features of variables serving as an objective tool to determine their relative importance. This study showed that the triglycerides level is higher and HDL-C level is lower in Iranian children and adolescents than their counterparts in Western countries. Future studies with larger sample size and with higher density at the end points and equal distribution of measurements in changing limits of covariates would hopefully reach more precise findings

nationwide survey of prevalence of pediculosis in children and adolescents in Iran

Since 2005, pediculosis is one of the obligatory reportable diseases from community to the Center of Disease Control. This study is the first nationwide survey on the prevalence of pediculosis and some associated risk factors in Iranian children and adolescents. National data of the Ministry of Health and Medical Education were gathered in 2005 through school screening programs and obligatory reports from the country health centers. 12,359,448 Iranian children and adolescents were screened in 2005. Overall, 213,450 students, consisting of 198,947 girls and 14,320 boys were reported have pediculosis. The prevalence of pediculosis was 581 per 100,000 population that varied from 1/100 000 to 8,303/100,000. In general, the highest prevalence of pediculosis was documented in south-eastern cities. The prevalence of pediculosis was significantly higher in girls than in boys [93% vs. 7%, respectively, p<0.0001]. In both genders, the highest prevalence of pediculosis was documented in the 6-10- year age group. Of those infected, 62% lived in rural areas, and 32% of those infected with pediculosis had a previous history of this infection. Most [99.37%] infected individuals had head lice, the rest had body and public pediculosis. The prevalence of pediculosis is low in Iranian children and adolescents, but this infestation is still a health problem in some south-eastern cities with warm climate and low to middle socioeconomic status

Nationwide report on the findings of integrated school health screening program in Iran

Screening of students' health problems could lead to timely prevention and control of many health disorders. This study aimed to determine the nationwide prevalence of common disorders through school health screening program in Iran. This cross-sectional national screening program was conducted in 2007-2008 among first-and third-grade-students in primary schools, first-grade-students of middle and high schools of all provinces in Iran. Data were obtained from 3,124,021 [81.9%] students reported from the whole country classified into 33 geographical zones. Of total students studied, 12.48% had weight abnormalities, 4.77% had visual disorders, 3.95% had head lice, 2.24% had behavioral disorders, and 0.6% had hearing disorders. Among students studied, 0.4%, 0.7%, 0.4% and0.8% had endocrine, psychological, neurological and genitourinary disorders, respectively. In addition, 2.1%, 1.9%, 1.8%, 0.8%0.5%, 0.3% and 0.3% of students had ear, nose and pharynx disorder, anemia, skin and hair, cardiac, abdominal, vertebral and lung problems, respectively. In elementary schools, 57.6% of first-grade-students with at least one disorder were managed in outpatient settings and 6% of them were hospitalized for more investigation. Among third-grade-students of elementary schools, these values corresponded to 13.2% and 1.1%, respectively. Among first grade students of middle and high schools, this prevalence was 58.5% and 44.6% and 1.2% and 0.3% of students were hospitalized for more investigation. This integrated school screening program revealed a considerably high prevalence of health disorders among school students. These results might help health policy makers to design future health promoting programs

Rationale, methods and first results of the Iranian national programme for prevention of chronic diseases from childhood: caspian study

The CASPIAN Study aims to implement a school-based surveillance system for prevention of noncommunicable diseases from childhood in the Islamic Republic of Iran. The baseline survey was conducted from November 2003 to May 2004 in 23 provinces among 21 111 school students aged 6-18 years and their parents. The data collected included: birth weight and current anthropometric measurements; dietary and exercise habits; family history of chronic diseases; and knowledge about prevention. Fasting blood sugar and lipid profile were assessed in a subsample of 4811 students

Physical activity in iranian students CASPIAN study

Sedentary behavior in childhood is one of the strongest risk factors for many chronic diseases and somatic conditions in adulthood, including cardiovascular disease, hypertension, obesity, and osteoporosis. This study was an investigation to design a surveillance system for non-communicable diseases. The present national survey was performed as a multi-centric cross-sectional study for the baseline survey of a project entitled: "Childhood and Adolescence Surveillance and PreventIon of Adult Non- communicable Diseases-CASPIAN Study. The study was supported by the World Health Organization and performed by the Ministry of Health, the Ministry of Education, with collaboration of 23 universities of Medical Sciences. One of the items studied was the physical activity. Physical activity data is evaluated by metabolic equivalent [METs] accelerometers. 21111 school pupils aged 6 to 18 years consisting of 10858 girls [51.4%] and 10253 boys [48.6%] have been studied. 5.2% of them were obese and 9.4% overweight. The mean times of moderate and vigorous physical activity were 4.7 and 0.8 hours everyday. Boys were more active than girls [p<0.05] and primary school students were more active than high school students [p<0.05]. Watching television, using the computer, or playing video games were the most common sedentary activity in students. Physical activity in our subjects was in acceptable level. Boys tend to be more active than girls, and there is a decrease in activity over the adolescent years

[Do the dietary habits of our community warrant health of children and adolescents now and in future? CASPIAN study?]

We performed this study considering the fact that many chronic diseases have their origin in early life, their risk factors in childhood and adulthood are identical, and an early primary prevention is of great importance. The present national survey was performed as a multi-centric cross-sectional study for the baseline survey of a project entitled: 'Childhood and Adolescence Surveillance and PreventIon of Adult Noncommunicable Diseases': CASPIAN Study. The study was supported by the World Health Organization and performed by the Ministry of Health, the Ministry of Education, with collaboration of 23 universities of Medical Sciences. One of the items studied was the dietary habits in relating to non-communicable diseases [NCDs]. 21111 school pupils aged 6 to 18 years consisting of 10858 girls [51.4%] and 10253 boys[48.6%], as well as one of their parents have been studied. 84.6% of them lived in urban and 15.4% in rural areas, 90% visited public and 10% private schools. The most frequent type of fat used for food preparation in home was hydrogenated solid fat [73.8%], and most families consumed bread prepared with white flour [58.4%], only 19.7% of pupils never added salt to their table foods. The mean consumption frequency of fruits and vegetables, sweets, salty/fat snacks and deep fried foods was 16.5, 10,4.9 and 3.98 times/week respectively, without significant difference between different school levels. The unhealthy dietary habits of the children and adolescents of our community are a major threat for the health of this age group and make our community prone to an epidemic of NCDs in the next two decades, and emphasizes the role of the pediatricians and other related health professionals in the primary prevention of chronic diseases