Epidemiology of Suicide by Hanging in Fars Province, Iran (2011-2019): A Population-based Cross-sectional Study / 예방의학회지

Objectives@#Hanging is a common method of attempted suicide. This study investigated the epidemiological profile of attempted and completed suicides by hanging in southern Iran. @*Methods@#This cross-sectional study was performed on 1167 suicide attempts by hanging between 2011 and 2019. All data related to suicide attempts by hanging were collected from the Fars Suicide Surveillance System. The trends in suicide cases and the mean age of attempted and completed suicides were plotted. The chi-square test was used to identify suicide-related factors. Crude rates of incidence, mortality, and standardized fatality during the study period were calculated. Finally, logistic regression was used to identify the predictors of death in individuals who attempted suicide. @*Results@#The mean age of those who attempted suicide was 33.21±16.82 years; the majority were male (80.5%). The rate of attempted and completed suicide by hanging were 3.50 and 2.79 per 100 000 people, respectively. The case-fatality rate was calculated as 79.34%. The results of our study indicated an increasing trend in suicide attempts by hanging. The likelihood of death was 2.28 times higher in individuals with a previous history of suicide attempts and 1.85 times higher in those with a psychological disorder. @*Conclusions@#The findings of this study suggest an increasing trend in attempted and completed suicide by hanging, especially among individuals with a history of suicide attempts and psychological disorders. It is necessary to take action to reduce the rate of suicide attempts and identify the underlying causes of suicide attempts by hanging.

Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran / 한국역학회지

OBJECTIVES@#Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population. @*METHODS@#Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants’ diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants’ death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value. @*RESULTS@#Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null. @*CONCLUSIONS@#Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people.

Students' attitude and sleep pattern during school closure following COVID-19 pandemic quarantine: a web-based survey in south of Iran

BACKGROUND@#School closure is one of the main policies of global health care strategies performed worldwide. Despite all benefits, there might be some threats for younger groups spending their time in quarantine. This study aims to determine the impacts of lockdown and school closure on children's major lifestyle aspects, especially their leisure and sleep pattern during the COVID-19 pandemic.@*METHODS@#For the purpose of this study, an online questionnaire was distributed from 14th to 31st of March 2020 among the schools and students from the first grade to the 12th grade (before university) in Fars province, southern Iran. The questionnaire consisted of five sections which included data regarding the students' general information, activity priorities, adherence to quarantine, attitude toward school closure, and sleep patterns.@*RESULTS@#In our study, 20,697 filled questionnaires were received from the participants with an average age of 13.76 years; 29.7% of them were male, 80.6% were from urban areas, and 83.3% were from public schools. The overall first preference of students during school closure was mobile and computer games (30.1%), followed by studying (26.6%) and watching television (13.8%). Our results demonstrated that the majority of students adhered to social distancing and there was also a significant correlation among education levels and desire for schools to be closed till the end of the semester (P = 0.015). Also, regarding sleep patterns, the majority (53.5%) had above 12 h of sleep throughout the day.@*CONCLUSION@#It seems that lockdown following COVID-19 pandemic has changed various aspects of the students' lifestyle remarkably, especially by increasing screen time and even sleep duration and pattern. We believe that certain strategies should be implemented by the Health and Educational Ministry to control not only the visible side effects of the quarantine period, but also the collateral consequences on their psychological and mental health.

Prevalence and risk factors of low birth weight in Fars province, South of Iran, 2014

Background: This study was conducted to assess the prevalence of low birth weight and its risk factors in Fars province, south of Iran, 2014

Methods: In this cross-sectional study, we collected data of 3,600 neonates through multi-stage random sampling. At first, we divided the hospitals into two strata, private and public. Then by stratified random sampling, we selected the neonates from delivery list in each hospital. In univariate analysis, the variables in which the p-value was less than 0.2 were entered into multivariate logistic regression analysis model for adjusting. Two-sided P<0.05 were statistically considered significant

Result: The prevalence of low birth weight in Fars province was 8.7% [95% CI: 7.8%-9.7%]. In term birth, factors such as mother's age>35 years, multiple birth and duration <24 months with previous pregnancy were risk factors of low birth weight [P<0.05] and just the father's literacy was a protective factor for low birth weight

Conclusion: The prevalence of low birth weight in Fars province was low in comparison to that of the world and other districts of Iran. But we should plan for reduction of low birth weight to achieve world health organization's goal. Variables of pregnancy interval of less than 2 years, multiple births, mother's age over 35 years and father's level of education could predict low birth weight of the neonates

23-year analysis of dependency ratio in rural population in Fars province during 1990 - 2012: a trend analysis study

Background: The dependency ratio [DR] is defined as the ratio of the non-working population to the economically active population. Dependency ratio is calculated by the sum of population under fifteen years and over 65 years divided by 15-64 year old population. The interpretation of DR variation gives us the impact of health care services and some reproductive interventions. This study analyzed a 23-year DR trend in rural population of Fars province and the effect of some fertility variables on it

Methods: In this study, using data from vital horoscope and regression analysis, we analyzed a 23-year period of DR and some fertility indicators

Results: The total DR significantly declined from 102.5% in 1990 to 41.4% in 2012 [P<0.001]. Most of this reduction is attributed to reduction in young DR. Old dependency ratio [population of 65 years and more] was significantly growing [P<0.035]. Number of rural health house, family planning coverage, total fertility rate and general fertility rate was significantly associated with total dependency ratio [P<0.009]

Conclusion: We passed the first stage of demographic transition, i.e. young dependency ratio declining. But the old dependency ratio slowly increased; it is recommended that the health care services should be promoted in future, especially services for old age people

Iodine deficiency disorders in the South of Iran during 1989-2012: a surveillance system report

Background: Iodine deficiency disorders [IDD] have been recognized as a major public health problem worldwide. Consequences of IDD include goiter, hypothyroidism, and intellectual disability followed by retarded growth and development of the brain. This report aimed to determine the state of IDD in Fars province, south of Iran

Methods: In this study, we gathered data from all scientific papers, published and unpublished reports of IDD surveillance system, results of IDD-related surveys and all data from the center for disease control [CDC] at provincial and national levels during 1989-2012. Five main IDD indices are summarized, interpreted, and then organized in graphs and tables

Resuits: After formation of national committee of IDD followed by launching of extensive iodine delivery, most of IDD indices have improved. The percentage of iodized salt intake has increased from 0 to near 100%, and that of salt with adequate amount of iodine has increased to 94.5%. Median of urinary iodine concentration [UIC] has always been higher than the acceptable value [>/=100 microg/L] and 68% of people had a mean of UIC >/=100 microg/L. The percentage of TSH [Thyroid-Stimulating Hormone] >5 mU/L in the screened newborns has persistently been less than 1% during 2005-11. Prevalence of goiter has declined from 68% in 1989 to 1.3% in 2007

Conclusion: Present findings address those efforts to combat iodine deficiency which were effective. According to the small sample size and also the fact that some data have been derived at the national level, we recommend that a comprehensive population-based survey should be carried out with sufficient sample size to achieve information with high accuracy and precision

[20 - Year period [1990-2009] of infant mortality Rate in rural area of Fars province south lran: a time-series study]

Reforming and providing primary health care services in the past two decades had a wonderful impact on health indicators, particularly in rural communities. Infant Mortality Rate [IMR] always regarded as an important indicator of health system. This study conducted to show the twenty-year IMR tend and its relationship with some of socio-economic indicators in Fars province, south of lran, during 1990 -2009. In this time-series study, using ecological data from vital horoscope and also regression model, we showed trend of IMR and also affecting some health and non-health indicators on twenty-year IMR trend. P value under 0.05 was considered as significant level. During this 20-years period IMR had a downward trend from 31.5 to 16.2 in 1000 live births [p<0.001]. There is a significant relation [p<0.05] exist between IMR and predictive variables such as Gross Domestic Product [GDP], literacy of women above 15 and rate of deliveries in hospital, and IMR. Decreasing and improving IMR during the past two- decades period showed that the government health policy and investment had achieved a successful result. However, with promotion and renewing primary health cares, we can improve IMR and other health indicators than before.

High titers of hemagglutination inhibition antibodies against 2009 H1N1 influenza virus in southern Iran

Pandemic flu had at least two waves in Iran. Knowing how many of the general population were already exposed to this infection has a major impact on national preventive measures. As of December 30, 2009, a total of 3672 confirmed cases of human infection with a novel Influenza A [2009 H1N1] virus had been reported in Iran with 140 deaths. In this study we aim to measure, as a pilot study, the seroprevalence of positive antibody titer [humoral immunity] against 2009 H1N1 virus in Iranian population in Shiraz, Southern Iran. Through cluster random sampling of families residing in Shiraz, 2553 subjects were selected and after a medical interview blood samples were taken and checked for polyclonal antibody against 2009 H1N1 antigen using hemagglutination inhibition assay. An antibody titer of more than 1:40 dilution was considered positive. Data were analyzed considering the demographic characteristics of the population and were compared among different age groups. 1504 [58.91%] samples were tested positive for the presence of polyclonal antibody against 2009 H1N1 virus. The prevalence of positive titers were significantly higher in 60 to 64 years old group and significantly lower in 20 to 24 years old group [p<0.05]. Data did not differ based on other demographic characteristics or the history of flu like illnesses in the past 6 months. High seroprevalence of antibody against 2009 H1N1 in the sera of our subjects describes either a high level of preexisting immunity against H1N1 in Iranian population or a high rate of asymptomatic infection in our area compared to other countries

Prevalence of waterpipe smoking among rural pregnant women in Southern Iran

To estimate the prevalence of waterpipe smoking among rural pregnant women in Southern Iran and to identify the impact of maternal waterpipe smoking on baby's birth weight. Subjects and Methods: A population-based survey was conducted in rural areas of Southern Iran in 2004 using existing health records and interviewing all mothers during the 10 days after delivery. Maternal exclusion criteria included cigarette smoking during pregnancy, a history or occurrence of epilepsy, diabetes and hypertension [gestational and/or essential] during pregnancy, factors that have been proved to have detrimental effects on birth weight. Of the 2,808 mothers interviewed, 224 [8%] were waterpipe smokers of which 90 [3.2%] and 134 [4.8%] were occasional [smoking less than once per day] and daily [at least once per day] smokers, respectively. Six hundred and seventy-four [24%] were passively exposed to waterpipe smoke during pregnancy and 322 [11.5%] were exposed to second-hand cigarette smoke. Mothers who started smoking during the first trimester had lower birth weight babies [3,215 +/- 612 g] compared to those who started smoking during the second or third trimesters [3,447 +/- 550 g, p = 0.04]. Waterpipe smoking during pregnancy is prevalent in Southern Iran and appears to be a risk factor for low birth weight babies