Association of caesarean section and neonatal death: a population-based case-control study in Islamic Republic of Iran

The high caesarean section rate in the Islamic Republic of Iran could be a risk for adverse neonatal outcomes. This population-based, case-control study investigated the association of caesarean section and neonatal death. A total of 146 mothers whose babies had died during 28 days after birth were compared with 549 mothers with live newborns, according to delivery route and reasons for undergoing caesarean section. The crude odds ratio [OR] for the association of caesarean section and neonatal death was 1.97 [1.35-2.87]. The adjusted OR was 2.19 [1.48-3.24] controlled for mother's education, parity and age. Adjusted ORs for elective caesarean, previous caesarean and emergency caesarean were 0.65 [0.26-1.62], 2.77 [1.64-4.66] and 2.51 [1.56-4.03] respectively. The ORs for caesarean delivery and neonatal death varied by mother's education, parity and age. The association of caesarean section with neonatal death is complex and is modified by other influencing factors

Lessons learnt from malaria epidemics in the Islamic Republic of Iran

The Islamic Republic of Iran is in the pre-elimination phase of malaria control, but malaria epidemics are still a concern in the south of the country. This retrospective study presents the epidemiological characteristics and predisposing factors of 60 of the malaria epidemics reported in Sistan va Baluchestan province during 2005-09. A zero-truncated negative binomial model was used to investigate the relation between predictor variables and the total number of malaria cases. Malaria epidemics occurred mainly in the southern part of the province, mostly between July and October, peaking in August. Most malaria epidemics were small-scale [8.3% were < 100 cases] and short [51.7% lasted < 1 month]. Plasmodium falciparum was present in 46.7% of the epidemics. An increase in the rainfall rate as well as population movements were the most significant predisposing factors. The results may help inform an epidemic investigation and reporting system as the country approaches the malaria elimination phase

[Comparison of nested case-control and cohort analysis methodologies using a district TB registry data]

The nested case-control study has become popular as an efficient alternative to the full-cohort design. This study compares the results of a nested case-control analysis approach with the full cohort analysis. A cohort of 276 subjects [new cases from a TB registry] was used for this study. Cox Regression model was used for the full cohort analysis. In order to do the nested case-control analysis, for each death, three random controls were selected from those who did not suffer from the outcome at the time of the outcome took place. Case control data was analyzed by the conditional logistic regression model. Results from both cohort and nested case-control analyses show that treatment group is the only variable that affects on the outcome. Gender, place of residence, and age has no effect on the outcome. For binary exposure variables with trivial effects [e.g. Gender and place of residence], the relative efficiency of nested case-control study design is approximately 75%. Results of this study show that nested case-control study is not only an easy and cost-effective method for data analysis but also is as robust as cohort analysis in rate ratio and its variance estimation