Identification of Risk Factors Associated with Tuberculosis in Southwest Iran: A Machine Learning Method.

Background: Tuberculosis is a principal public health issue. Reducing and controlling tuberculosis did not result in the expected success despite implementing effective preventive and therapeutic programs, one of the reasons for which is the delay in definitive diagnosis. Therefore, creating a diagnostic aid system for tuberculosis screening can help in the early diagnosis of this disease. This research aims to use machine learning techniques to identify economic, social, and environmental factors affecting tuberculosis. Methods: This case-control study included 80 individuals with TB and 172 participants as controls. During January-October 2021, information was collected from thirty-six health centers in Ahvaz, southwest Iran. Five different machine learning approaches were used to identify factors associated with TB, including BMI, sex, age , marital status, education, employment status, size of the family, monthly income, cigarette smoking, hookah smoking, history of chronic illness, history of imprisonment, history of hospital admission, first-class family, second-class family, third-class family, friend, co-worker, neighbor, market, store, hospital, health center, workplace, restaurant, park, mosque, Basij base, Hairdressers and school. The data was analyzed using the statistical programming R software version 4.1.1. Results: According to the calculated evaluation criteria, the accuracy level of 5 SVM, RF, LSSVM, KNN, and NB models is 0.99, 0.72, 0.97,0.99, and 0.95, respectively, and except for RF, the other models had the highest accuracy. Among the 39 investigated variables, 16 factors including First-class family (20.83%), friend (17.01%), health center (41.67%), hospital (24.74%), store (18.49%), market (14.32%), workplace (9.46%), history of hospital admission (51.82%), BMI (43.75%), sex (40.36%), age (22.83%), educational status (60.59%), employment status (43.58%), monthly income (63.80%), addiction (44.10%), history of imprisonment (38.19%) were of the highest importance on tuberculosis. Conclusion: The obtained results demonstrated that machine-learning techniques are effective in identifying economic, social, and environmental factors associated with tuberculosis. Identifying these different factors plays a significant role in preventing and performing appropriate and timely interventions to control this disease.

Incidence trend analysis of tuberculosis in Khuzestan Province, southwest of Iran: 2010-2019.

Objectives: Identifying the trend of diseases and its changes over time can be highly important in evaluating the extent and method of achieving strategies for controlling them, developing health indicators, and health planning. This study aimed to investigate the incidence of tuberculosis. Methods: As a repeated cross-sectional study in which the population under study was a census, this study involved all tuberculosis cases registered in 21 cities of Southwest of Iran, from 2010 to 2019. Data were obtained from the National System of Notification of Tuberculosis and included variables related to age, sex and Disease consequence. Segmented regression models were used to analyze the trend of tuberculosis changes. Also, data analysis software- Join Point Regression version 5.0.2 was used for data analysis. Results: The results of evaluating the trend of tuberculosis from 2010 to 2019 showed no change in the general trend of tuberculosis and an annual 0.84% (95% CI: -5.17 to 6.82) increase in incidence rate is observed in the trend. Also, the findings of join point regression analysis show that between 2010 and 2013, an annual 18.10% (95% CI: 8.78 to 34.89) increase in the incidence of tuberculosis, and between 2013 and 2019, annual -5.42% (95% CI: -10.04 to -2.22) decrease in the incidence of tuberculosis was observed. From 2010 to 2012, a 33.10% (95% CI: 15.77 to 48.06) annual increase in the incidence of tuberculosis in males and - 9.47% (95%CI: -14.02 to -6.33) annual decrease in the incidence of tuberculosis in females was observed. Conclusions: The results of this study showed that the incidence of tuberculosis had an upward trend from 2010 to 2013 and a downward trend from 2013 onwards.

Investigating the intensity of social contacts associated with tuberculosis: a weighted networks model.

BACKGROUND: Tuberculosis is known as one of the principal health problems, especially in developing countries. This study aimed to visualize, statistically model, and describe the weighted networks to investigate the intensity of social contacts associated with tuberculosis. METHODS: In this case-control study, we applied weighted network analysis to assess the network of person-time spent in stores, workplaces, restaurants, mosques, Police bases, homes, hospitals, colleges, hairdressers, schools, contact homes, health centers, cinemas, parks, and markets. Modules will be determined based on the similarities between the variables in a topology overlap matrix. The most important variables will be found considering the association between each variable and module eigenvalues. RESULTS: The result shows the extracted modules of locations based on the connectivity followed by the person-time at each place. The correlation (p-value) between TB and the turquoise, blue, and brown modules was 0.058 (0.351), 0.004 (0.943), and 0.117 (0.039), respectively. The brown module is the most important one, demonstrating a significant connection between homes, contact homes, health centers, and hospitals. Therefore, an association was found between person-time in four places and the occurrence of TB. CONCLUSION: The finding of this study showed that most transmission of tuberculosis infection occurs in homes, contact homes, health centers, and hospitals. These place evaluations allow the identification of people with more contact and in need of screening, so critically leading to the identification of more patients with active TB.

Social Contact Patterns Associated With Tuberculosis: A Case-control Study in Southwest Iran.

OBJECTIVES: Tuberculosis (TB) is a major public health concern worldwide. Social contact patterns can affect the epidemiology and risk of airborne diseases such as TB. This study was designed to investigate the social contact patterns associated with TB. METHODS: In this case-control study, groups of participants with and without TB were matched by age and sex. Participants reported the nature, location, frequency, and average duration of social contacts over 1 month. The duration and number of social and spatial contacts were compared between groups using the chi-square test and the t-test. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to quantify the relationship between social contact time and TB status. Data were analyzed using Stata version 11 statistical software. A p-value of <0.05 was considered to indicate statistical significance. RESULTS: In this study, 80 patients with TB and 172 control participants were included, and a total of 3545 social contacts were registered. Social contact with family members (OR, 1.72; 95% CI, 1.10 to 2.40), contact with a person with TB (OR, 1.53; 95% CI, 1.16 to 2.01), and contact at the participant's home (OR, 1.42; 95% CI, 1.19 to 1.82) were significantly associated with TB status. CONCLUSIONS: The duration of long-term social contact, rather than the number of contacts, may be the main contact-related factor associated with TB transmission in this population. The focus of contact-tracing efforts should be on finding and treating both family members and long-term contacts in non-household settings.

Postpartum screening practices, progression to abnormal glucose tolerance and its related risk factors in Asian women with a known history of gestational diabetes: A systematic review and meta-analysis.

AIMS: Rate of postpartum screening and progression to glucose intolerance (diabetes and/or pre-diabetes) in Asian women with prior GDM and risk factors of diversion to abnormal glucose tolerance were reviewed. MATERIALS AND METHODS: We searched Pub Med, Cochrane Library, Web of Science, EMBASE, and Ovid data base. About 1300 studies were screened and 27 articles were selected. Meta-analysis using Comprehensive Meta -Analysis software was conducted. All results were reported at the pooled ORs and 95% CI. Quantitative heterogeneity (I2) was assessed. To estimate the variances between studies, the statistical method "tau-squared" was applied. Statistical models like fixed effect or Mantel-Haenszel, and random effect (REM) or Dersimonian-laird were used for the analysis and integration of results. RESULTS: Rate of glucose testing ranged from 13.1% to 81.9%. Prevalence of pre-diabetes was 3.9%-50.9%. Diabetes was reported in 2.8%-58% of women with history of gestational diabetes based on length of follow-up. Factor associated with postpartum diabetes mellitus included family History of diabetes mellitus, gestational age at diagnosis of GDM, insulin use during pregnancy and pre-pregnancy BMI. CONCLUSIONS: Rate of postpartum screening in most of the Asian countries population is sub-optimal, in spite of high rate of glucose intolerance in this high risk group of women. Risk factors of progression to pre-diabetes and diabetes are similar to previous reported in developed countries.

Epidemiology Characteristics and Trends of Lung Cancer Incidence in Iran.

BACKGROUND: Lung cancer is one of the most common cancers in the world and a major cause of death from cancer. One of the important indicators to compare the prevalence and incidence of the disease is a change in the trend. The aim of this study was to investigate the changes in the incidence of lung cancer in Iran. MATERIALS AND METHODS: This study was conducted based on existing data obtained from a national registry of cancer cases and the Disease Management Center of Ministry of Health in Iran. All cases registered in the country were included during 2003-2008. Incidence rates were reported based on the direct method and standard population of World Health Organization. The study also examined the morphology of common lung cancers. Trends in incidence underwent joinpoint regression analysis. RESULTS: Based on the results of this study, 14,403 cases of lung cancer have been recorded of which 10,582 cases were in men and 3,821 in women. Highest incidence rates were observed in the 80-84 age group. Considerable variation across provinces was evident. In females squamous cell carcinoma (SCC) demonstrated a reduction from 24% to 16% of lesions over the period of study, while adenocarcinoma rose from 21% to 29%. In males a similar reduction in SCC was apparent (42% to 29%, again with increase in AC (13 % to 18%). CONCLUSIONS: The results show that the increase in the incidence of lung cancer the trend is that more men than women and in men and may be caused by changes in smoking pattern. The incidence of lung cancer in the North West and West provinces was higher than in other regions.

Lack of association between using aspirin and development of non-Hodgkins lymphoma: a meta-analysis.

BACKGROUND: Non-Hodgkins lymphoma (NHL) is a heterogeneous group of malignancies, originating in the lymphatic organs, whose incidence is increasing in developed as well as developing countries. Epidemiological evidence suggests that aspirin may reduce the incidence and mortality of several cancers. The main objective of this study was to evaluate the potential relationship between using aspirin and development of NHL with a meta-analysis. MATERIALS AND METHODS: A total of 7 studies were included. Outcome was calculated and reported as odds ratios (ORs). Heterogeneity was assessed with Cochrane Q and I2 statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. RESULTS: Our analysis showed OR of developing NHL overall of 1(95% CI: 0.87-1.16, p=0.9), and in females this was 0.81 (95%CI: 0.72-.92, p=0.001) and in males 1.01 (95%CI: 0.82-1.26, p=0.86). The odds ratio (OR) of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 0.85 (95%CI: 0.75-0.97, p=0.02), The ORs of follicular lymphoma (FL) and large B-cell lymphoma (DLBCL) in individuals exposed to aspirin were 1.12 (95%CI: 0.86-1.45, p=0.37) and 1.03 (95%CI: 0.9-1.19, p=0.6) respectively. CONCLUSIONS: In conclusion, individuals taking aspirin do not demonstrate any change in risk of Non-Hodgkins lymphoma.

Incidence of cancers in Kuzestan province of iran: trend from 2004 to 2008.

BACKGROUND: Cancer is an increasing cause of mortality and morbidity worldwide. Incidences of common cancers has been growing in different provinces of Iran in recent years but trends in Khuzestan which shares a border with Iraq and is located in south west of Iran have not been investigated. This study aimed to assess secular changes in incidences of common cancers in Khuzestan province from 2004 to 2008. MATERIALS AND METHODS: Data were collected from Khuzestan cancer registry which is a branch of Iranian Ministry of Health Cancer Registry (http://ircancer.ir) for the period 2004-2008. Data were presented as incidence rates by site, sex, age, using the crude rate and age-standardized rate (ASR) per 105 persons. A direct method of standardization was applied according to the WHO guideline and data analysis was performed using the SPSS package. RESULTS: During the 2004-2008 period, 14,893 new cases of cancer were registered in Khuzestan cancer registry. The age- standardized incidence rate of all cancers was 153.7 per 105 in males and 156.4 per 105 in females. The incidence was increased over the period of five years. The most incident cancers among males were skin cancer (ASR =18.7/105), stomach cancer (ASR13.8/105), lung cancer (ASR12.9/105), leukemia (ASR=12.6/105) and prostate cancer (ASR=12.4/105). In females, the most incident cancers were breast cancer (ASR=41/105), skin cancer (ASR=16.4/105), colorectal cancer (ASR=10.0/105), leukemia (ASR=8.1/105) and lung cancer (ASR=6.9/105). CONCLUSIONS: Incidences of various cancers are rising in Khuzestan. It is necessary to develop and implement comprehensive cancer control programs in this region which could be monitored and evaluated by the future trend data from cancer registry.

Red meat intake and risk of non-Hodgkin lymphoma: a meta-analysis.

BACKGROUND: While the incidence of non-Hodgkins lymphoma (NHL) has been rising worldwide, the reasons remain undefined. Recent research has focused on effect of red andf processed meat intake as a risk factor, but with inconclusive results. We therefore conducted a meta-analysis of data published to date, to ascertain the overall association between intake and NHL. MATERIALS AND METHODS: A published literature search was performed through Pubmed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using random or fixed effects models. Heterogeneity was assessed using Chi-square and I2 statistics. Dissemination bias was evaluated by funnel plot analysis.We performed a formal meta-analysis using summary measures from these studies. RESULTS: In total, 11 published studies were included in the final analysis. The combined analysis revealed that there was significant association between the red meat and NHL risk (OR=1.10, 95%CI: 1.02 to 1.19, p=0.01). Additionally, there was showed significance association between processed red meat and NHL risk (OR=1.17, 95%CI: 1.06 to 1.29, p=0.001). In subgroup analysis, a statistical significant association was noted between diffuse large B-cell lymphoma (DLBCL) (OR=1.20, 95%CI: 1.04 to 2.37, P=0.01) and red meat intake. CONCLUSIONS: In this meta-Analysis, there was evidence for association between consumption of red meat, or processed meat and risk of NHL, particularly with the DLBCL subtype in the red meat case.