The Burden of Premature Mortality in Hamadan Province in 2006 and 2010 Using Standard Expected Years of Potential Life Lost: A Population-based Study / 한국역학회지

OBJECTIVES: Examining the premature death rate represents the first step in estimating the overall burden of disease, reflecting a full picture of how different causes affect population health and providing a way of monitoring and evaluating population health. The present study was conducted to assess the burden of premature mortality in Hamadan Province, Iran in 2006 and 2010. METHODS: To calculate years of potential life lost (YPLL), the dataset was categorized into 5-year age groups based on each person's age at death. Then the age groups were subtracted from the relevant age-based life table produced by the World Health Organization in 2009. The YPLL for each individual were then added together to yield the total YPLL for all individuals in the population who died in a particular year. Finally, we calculated the YPLL for all sex-, age-, and cause-specific mortality rates and reported them as percentages. RESULTS: We analyzed 18,786 deaths, 9,127 of which occurred in 2006 and 9,659 in 2010. Mortality rates were higher in men than women for all age groups both in 2006 and 2010. In addition, age-specific mortality rates in both genders for all age groups were higher in 2010 than in 2006. The percentage of YPLL from ischemic heart diseases, cerebrovascular diseases, transport accidents, and intentional self-harm were among the greatest sources of premature death. CONCLUSION: The results of the present survey indicate that the eight major causes of premature death in both 2006 and 2010 were non-communicable diseases, especially ischemic heart diseases, cerebrovascular diseases, transport accidents, and intentional self-harm. Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years.

Influenza A [H1N1] in Hamedan province, Western Iran in 2009: a case control study

The novel influenza A [H1N1] virus was first detected in March 2009 in Mexico and then disseminated to many other countries worldwide. In this study, we assessed the potential risk factors of swine flu as well as the most important clinical manifestations of this infectious disease among confirmed cases during early phase of pandemic H1N1. subjects [cases and controls] were selected from those patients with signs and symptoms of respiratory tract infection who referred to health centers of eight cities throughout Hamedan Province, western Iran from July to December 2009. characteristics of the participants were obtained by interviewers using pre-determined questionnaire. Cases were distinguished by pharyngeal soap specimens positive for influenza A virus using polymerase chain reaction [PCR]. Logistic regression model was conducted at 0.05 significance level using Stata 9.1 statistical software to assess the effects of various risk factors on H1N1 influenza infection. Totally, 245 confirmed cases of H1N1 influenza were compared with 388 controls. Case fatality rate of influenza infection was about 2.86%. In comparison with age group of 1-9 yr old, adjusted odds ratio estimates was 1.91 [95% CI: 1.06, 3.46] for age group of 20-39 yr old, 0.94 [0.37, 2.38] for age group of 40-59 yr old, and 0.34 [0.09, 1.37] for age group of 60-79 yr old. Adjusted odds ratio estimates of influenza A infection was 8.12 [95% CI: 3.11, 21.6] for pregnant women compared to non-pregnant women; 1.84 [95% CI: 1.32, 2.86] for high educated individuals in comparison with low educated individuals; 2.11 [95% CI: 1.25, 3.57] for whose who had close contact with suspected influenza patients; and 2.15 [95% CI: 1.16, 3.98] for individuals with normal body mass index [BMI= 25-30] compared with underweight individuals [BMI< 20]. There were no significant differences in clinical manifestations between cases and controls. The risk of influenza A infection is highest among children and adolescents, pregnant women, high educated individuals, and those who had close contact with suspected influenza patients during pandemic phase. In addition, there is no pathogonomonic sign or symptom to distinguish influenza infection clinically from other kinds of respiratory track infections