Erratum: Determinants of health volunteer training in natural hazard management in Iran.

[This corrects the article DOI: 10.4102/jamba.v15i1.1384.].

Determinants of health volunteer training in natural hazard management in Iran.

Both natural and man-made dangers cause bodily harm, as well as social, economic and environmental harm. In order to minimise the complications of these threats, proper training and preparedness are crucial. The purpose of this study was to look at the factors that affect how well-trained healthcare volunteers are for natural hazards in Iran. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a systematic review of literature on the factors influencing the training of healthcare volunteers in natural hazard published between 2010 and 2020 was conducted. The Google Scholar search engine, PubMed (Medline and Central), Science Direct and Web of Science databases were searched using both individual and combined key phrases. The Strengthening the Reporting of Observational studies in Epidemiology checklist was used to select and evaluate 592 observational and quasi-experimental articles. Finally, the study comprised 24 papers that satisfied the research criteria and made good use of good technique, sample size and adequate tools for validity and reliability. The most useful variables for disaster preparedness were job self-efficacy, strategic decision-making and quality of work-life, job performance, job motivation, knowledge, awareness and health literacy. Contribution: To avoid calamity, a thorough training program is required. Therefore, the most crucial objectives for health education specialists are to identify the factors that determine disaster preparedness, train volunteers and provide fundamental techniques to reduce natural dangers.

Association between meal frequency with anthropometric measures and blood pressure in Iranian children and adolescents.

BACKGROUND: This study aimed to assess the association of meal frequency with anthropometric measures and blood pressure in Iranian children and adolescents. METHODS: In this national survey, 14,880 students with 6-18 years of age were selected by stratified multistage sampling method from urban and rural regions of 30 provinces of Iran. Meal frequency was assessed by a questionnaire prepared based on global school-based student health survey. Physical measurements included height, weight, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP). RESULTS: The participation rate was 90.6% including 49.24% girls and 75.5% urban residents. Skipping breakfast and dinner were more frequent in girls than in boys (71.6% vs. 64.1%, 91.2% vs. 86.9%, respectively, P<0.05). Overweight, obesity, and abdominal obesity were more prevalent in those who had two meals, one meal, or very low intake (P<0.001) than those had three meals. There were no significant differences in SBP, DBP, and blood pressure across to different meal frequency groups (P>0.05). Students who had very low intake and one meal per week had a higher risk of abdominal obesity compared with those who had three meals (OR 1.7, 95% CI: 1.3-2.3, and OR 1.6, 95% CI: 1.4-2.0, respectively). CONCLUSIONS: An inverse significant association between higher meal frequency and anthropometric indices was observed. Therefore, encouraging children and adolescents for regular meal intake should be considered as a health priority in the pediatric population.

Performance of modified blood pressure-to-height ratio for diagnosis of hypertension in children: The CASPIAN-V study.

This study aimed to evaluate the accuracy and performance of modified blood pressure-to-height ratio (MBPHR) for identifying high blood pressure (HBP) in a large population of children. This multicentric cross-sectional study was conducted on a nationally representative sample of 7349 Iranian students aged 7-12 years living in 30 provinces in Iran. High systolic blood pressure and diastolic blood pressure were defined according to the 2017 American Academy of Pediatrics (AAP) guidelines. The BP-to height ratio (BPHR) was calculated as BP (mmHg)/height (cm), MBPHR3 as BP (mmHg)/(height (cm) + 3 (13-age)), and MBPHR7 as BP (mmHg)/(height (cm) + 7 (13-age). The receiver-operating characteristic curve analysis was used to evaluate the performance of these three ratios for identification of HBP in children compared to the 2017 AAP guidelines as the gold standard. Mean age of participants was 12.29 ± 3.15 years and 3736 (50.8%) were girls. The prevalence of HBP was 11.9% (11.5% in boys, 12.3% in girls). The area under the curve (AUC) was higher for MSBPHR3/MDBPHR3 (0.97/0.98) than MSBPHR7/MDBPHR7 (0.96/0.97) and SBPHR/DBPHR (0.96/0.95) for identifying high Systolic and diastolic BP. The optimal cut-off points for MSBPHR3/MDBPH, MSBPHR7/MDBPHR7, and SBPHR/DBPHR were 0.76/0.50, 0.69/0.46, and 0.81/0.52 respectively. Negative predictive value was nearly perfect for three ratios (≥98%). Positive predictive value was higher for MBPHR3 (52.7%) than MBPHR7 (51.0%) and BPHR (39.8%). Overall, MBPHR3 had better performance than MBPHR7 and BPHR for identification of HBP in Iranian children and it may improve early hypertension recognition and control in primary screening.

Impact of dyslipidemia on estimated glomerular filtration rate in apparently healthy children and adolescents: the CASPIAN-V study.

BACKGROUND: Chronic kidney disease (CKD) is a leading risk factor for development of cardiovascular disease (CVD). Dyslipidemia is also known as risk factor for CVD development. However, the association of dyslipidemia with glomerular injury among healthy children and adolescents remains controversial. We aimed to investigate the relationship between estimated glomerular filtration rate (eGFR) and lipid profile risk factors among healthy children and adolescents. METHODS: In this nationwide survey, 3808 participants (1992 males, 1816 females), aged 7-18 years, were selected by cluster random sampling method from 30 provinces in Iran. Body mass index (BMI) and systolic and diastolic blood pressures were measured. Blood samples were obtained for serum creatinine, fasting blood glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) determinations. GFR was estimated using Schwartz equation. RESULTS: Girls had higher eGFR than boys (P = 0.04). In a multiple regression analysis, eGFR demonstrated a positive correlation with systolic blood pressure, BMI, fasting glucose, TC, HDL-C, and TG. By the analysis of covariance, TC, HDL-C, and TG showed a negative correlation with eGFR after adjustments for BMI, systolic and diastolic blood pressures, and fasting glucose (OR = 0.56, 95% CI = 0.29-0.89). CONCLUSION: The study showed that dyslipidemia is associated with reduced eGFR among the healthy children and adolescents.

Association of healthy foods intake with anthropometric measures and blood pressure in a national sample of Iranian children and adolescents: the CASPIAN-IV Study.

BACKGROUND: This study aims to evaluate the association of consuming healthy foods with anthropometric measures and blood pressure (BP) in a national sample of Iranian children and adolescents. METHODS: This nationwide study was conducted in 2011-2012 among 13,486 students, aged 6-18 years, selected by multistage cluster sampling from 30 provinces. Weight, height, waist circumference (WC), hip circumference (HC), wais to height ratio (WHtR), waist to hip ratio (WHR), as well as systolic and diastolic blood pressures (SBP, DBP) were measured. Healthy foods were considered as four categories including fresh fruits, dried fruits, vegetables, and dairy products. The frequency consumption of each of these foods was recorded as daily, weekly, and seldom. RESULTS: The intake of fruits was significantly associated with anthropometric indices. Moreover, a significant association was found between vegetables consumption, DBP levels, and anthropometric indices (except for WHtR and WHR). Milk consumption was significantly associated with anthropometric indices (except for WHtR and WHR). The odds of general obesity among participants who seldom consumed dried fruits was less than those who consumed daily (OR: 0.84, 95%CI: 0.74-0.96). We did not find any significant association for the frequency of fresh fruits and vegetables consumption with obesity, abdominal obesity, DBP and SBP. CONCLUSIONS: Consumption of dried fruits was associated with general obesity in children and adolescents. These results highlight the effect of dietary quality and food choices on weight control in children and adolescents.

Does the socioeconomic status affect the prevalence of psychiatric distress and violent behaviors in children and adolescents? The CASPIAN-IV study.

BACKGROUND: This nationwide study aims to investigate the prevalence of psychiatric distress and violent behaviors in a nationally-representative sample of Iranian children and adolescents according to the socioeconomic status (SES) of their living region. METHODS: In this study, 14,880 school students, aged 6-18 years, were selected from 30 provinces in Iran. The World Health Organization Global School-based Health Survey questionnaire was used. Data were compared at national and subnational levels according to the SES of the living region. RESULTS: Overall, 13,486 students (49.2% girls) with mean (SD) age of 12.47 (3.36) years completed the study. At national level, the prevalence of psychiatric distress ranged between 9 to 38%; the most and least prevalent psychiatric distresses were angriness (37.73%, 95% CI: 36.5-38.99) and confusion (8.65%, 95% CI: 8.04-9.29), respectively. Students living in regions with highest SES experienced angriness (41.24%, 95% CI: 38.94-43.59) more than in those from the regions with lowest SES (31.18%, 95% CI: 26.71-36.02). The prevalence of bullying, being bullied and physical fight was 17.56% (95% CI: 16.73-18.42), 27.36% (95% CI: 26.34-28.42), and 39.94% (95% CI: 38.69-41.20), respectively. The prevalence of violent behavior did not differ significantly in various regions of Iran. CONCLUSIONS: The relatively high prevalence of psychiatric distress in Iranian children and adolescents necessitates paying more attention to mental health of this vulnerable age group. Differences in the prevalence of such disorders according to the SES of the living area should be considered in planning evidence-based preventive programs and in international comparisons.

Prevalence study of clinical disorders in 6-year-old children across Iranian provinces: Findings of Iranian national health assessment survey.

OBJECTIVE: To assess the national prevalence of clinical disorders in 6-year-old Iranian children before school entry using a national health assessment survey. MATERIALS AND METHODS: In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels. RESULTS: The study population consisted of 955388 children (48.5% girls and 76.1% urban). Of the whole children, 3.1% of the 6-year-old children had impaired vision. In addition, 1.2, 1.8, 1.4, 10, 10.9, 56.7, 0.7, 0.8 and 0.6% had color blindness, hearing impaired, speech disorder, height to age retardation, body mass index extremes, decayed teeth, having disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces. CONCLUSIONS: Our results confirmed that the prevalence of clinical disorders among 6-year-old children across Iranian provinces was not similar. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identify the reason for different distribution among provinces.

Double burden of nutritional disorders in young Iranian children: findings of a nationwide screening survey.

OBJECTIVE: To assess the national prevalence of short stature, underweight, overweight and obesity in 6-year-old Iranian children before school entry. DESIGN: Cross-sectional nationwide survey. SETTING: Mandatory national screening programme before entrance to elementary school in 2008 in Iran. SUBJECTS: All Iranian children entering public and private elementary schools. RESULTS: The study population comprised 862,433 children (48.4% girls, 77.2% urban resident). Overall, 6.5% of children had short stature, 19.1% were underweight, 12.8% were overweight and 3.4% were obese. There was no significant difference in terms of gender, but considerably larger differences were documented among various provinces. CONCLUSIONS: The double burden of nutritional disorders among young children warrants a multi-faceted national policy with evidence-based local programmes. Such planning needs a comprehensive surveillance system and centralized data registry for children's growth.