The Trend of Years of Life Lost due to Gastrointestinal Cancers in Fars (Iran) 2004-2019.

Background: Gastrointestinal cancers can cause major health problems globally since their burden is increasing in many countries. We aimed to investigate the trend of years of life lost due to gastrointestinal cancers in Fars Province, southern Iran during the 2004-2019. Methods: In this cross-sectional survey study, we obtained the information regarding all deaths due to gastrointestinal cancers in Fars Province from the electronic population-based death registration system (EDRS). Years of Life Lost (YLL) was calculated using the YLL template of 2015 by the WHO. To examine the trend for different years, join point regression based on the log-linear model was used. Joinpoint regression analysis describes changing trends over successive periods of time and the increasing or decreasing rate within each period. Results: During the years of 2004-2019, 9742 deaths due to gastrointestinal cancers occurred in Fars Province. 6013 (61.72%) cases were male and 3729 (38.28%) cases were female (Male / Female Sex Ratio: 1.61). Overall, 4152 cases (42.63%) were due to gastric cancer and 2112 cases (21.68%) were due to liver cancer. Total years of life lost due to premature death from gastrointestinal cancers during the 16-year study period was 73565 yr (2.33 per 1000 persons) in men, 52766 yr (1.71 per 1000 persons) in women, and 126331 yr (2.02 per 1000 persons) in both sexes. Conclusion: Among all cancers, the highest mortality rates in both sexes belong to gastric cancer. This study showed the trend of YLL rate of malignant neoplasms of liver and intrahepatic bile ducts, esophagus, oral cavity, and colon cancer were increasing in both sexes, however, the trend of YLL rate for malignant neoplasms of the small intestine was decreasing in both sexes. Variation of GI cancers patterns and trends around the Fars Province indicated that a more comprehensive control plan is needed to control these variations.

Trend Analysis of Lung Cancer Mortality and Years of Life Lost (YLL) in South of Iran, 2004-2019.

Background: We aimed to determine the mortality rate and Years of Life Lost (YLL) due to lung cancer in Fars, Iran, during the period from 2004 to 2019. Methods: All deaths due to lung cancer in Fars Province, Iran from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated and trends examined. Results: During 2004-2019, 3346 deaths occurred due to lung cancer in Fars Province, which was 10.8% (3346/30936) of the total cancer deaths in this period. Crude mortality rate of lung cancer had increased 70% and 53% in male and female respectively from 2004 to 2019. The total YLL of lung cancer during the 16-year study period was 28,094 (0.9 per 1000) in men, 14,174 (0.5 per 1000) in women, and 42,268 (0.8 per 1000) in both sexes (sex ratio male/female=2). According to the join point regression, the 16- year trend of YLL rate due to premature mortality was increasing: APC was 2.5% (95% CI 0.9 to 4.2, P=0.005) for males, 1.4% (95% CI 0.3 to 2.6, P=0.017) for females. Conclusion: The mortality rate and YLL due to lung cancer in Fars Province is increasing, although the standardized mortality has a constant trend. Tobacco control is the most effective and least expensive way to reduce the number of lung cancer patients worldwide. National and local media can also play an important role in informing people about the risk factors.

Correlation between socioeconomic indices and epidemiological indices of thyroid cancer from 1990 to 2019 year: a global ecologic study.

BACKGROUND: The incidence of thyroid cancer as the most common type of endocrine gland malignancy has risen more significantly than any malignancies in recent years. Estimated new cases of thyroid cancer in the United States in 2024 were 12,500 and 31,520 for men and women, respectively, and estimated deaths were 1,180 for women and 990 for men. Indices of socio-economic have been commonly used to measure the development of countries. Therefore, this study aimed to examine the correlation between indices of socioeconomic status and epidemiological indices of thyroid cancer throughout the world. In addition, this study has compared two indices of human development and a socio-demographic index. METHOD: This worldwide ecological study used data on thyroid cancer incidence, mortality, human development index (HDI), and sociodemographic index (SDI) between 1990 and 2019 from the Global Burden of Disease (GBD). We evaluated the correlation between incidence and mortality rates with socioeconomic indices by using Pearson's correlation coefficient. Furthermore, for the first time, the generalized additive model (GAM) was employed for modeling. The statistical software R, version 4.2.2, was used to conduct all statistical analyses. RESULTS: The correlation between the incidence of thyroid cancer and the HDI was significant and positive (r = 0.47, p-value < 0.001). While the correlation between thyroid cancer mortality and HDI was not statistically significant (r = 0.01, p-value = 0.076). Besides, the incidence of thyroid cancer was significantly positively correlated with SDI (r = 0.48, p-value < 0.001). The multiple GAM showed that for one unit increase in HDI, the risk of thyroid cancer was increased by 2.1 times (RR = 2.1, 95%CI = 2.04 to 2.19), and for one unit increase in SDI, the risk of thyroid cancer was shown to increase by 2.2 times. (RR = 2.2, 95%CI = 2.19 to 2.35). CONCLUSION: It has been evident that countries with higher incidence of thyroid cancer display higher socioeconomic indices. While, countries with higher socioeconomic indices, report lower mortality rates. However, based on the modeling results, it can be concluded that the SDI is slightly more useful in this regard. Therefore, examining the epidemiological indices of thyroid cancer by socio-economic indices can be useful to reflect a clear image of the distribution of this cancer in each country, and can be used for planning cancer prevention strategies.

The effects of powdered drinks enriched with curcumin and probiotics on lipid profile and atherogenic indices in patients with metabolic syndrome: A randomized, double-blinded, placebo-controlled clinical trial.

Cardiovascular disease is prevalent globally and is the most common complication of metabolic syndrome (MetS). Previous studies have suggested that curcumin and probiotics may improve the lipid profile, so we aimed to investigate the effects of the edible powder enriched with these substances on lipid profile level and atherogenic indices such as Atherogenic Coefficient (AC), Castelli Risk Index-I (CRI-I), Castelli Risk Index-II (CRI-II), and Atherogenic Index of Plasma (AIP). In the present parallel randomized double-blinded placebo-controlled clinical trial, 124 people with MetS with overweight or obesity were randomly allocated to 4 groups and were followed up for 8 weeks. The participants received a low-calorie diet and a daily sachet of enriched powder drink. The sachets contained either 109 CFU of probiotics or 1 g of curcumin, or probiotic + curcumin (pro + cur), or placebo, respectively. The fasting lipid profile and atherogenic indices were measured at the beginning and end of the study. One hundred and fourteen participants completed the study. At the end of the study, the within- and between-group comparisons showed no significant differences in lipid profile and atherogenic indices (p > .05). Based on the results of the current study, taking an oral powder containing 1 g curcumin and 109 CFU probiotics for 8 weeks had no effect on the lipid profile level and atherogenic indices; however, more studies are recommended.

Factors associated with late initiation of antiretroviral therapy in Iran's HIV/AIDS surveillance data.

Early initiation of Antiretroviral Treatment (ART) in HIV patients is essential for effectively suppressing the viral load and prognosis. This study utilized National HIV/AIDS Surveillance Data in Iran to identify factors associated factors with the duration to initiate ART. This hybrid cross-sectional historical cohort study was conducted on Iran's National HIV/AIDS Surveillance Data from 2001 to 2019. Sociodemographic characteristics, route of transmission, HIV diagnosis date, and ART initiation date were collected. Multivariable linear and quantile regression models were employed to analyze the duration to initiate ART by considering predictor variables. This study included 17,062 patients (mean age 34.14 ± 10.77 years, 69.49% males). Multivariate quantile regression coefficients varied across different distributions of the dependent variable (i.e., duration to initiate ART) for several independent variables. Generally, male gender, injecting drug use (IDU), and having an HIV-positive spouse were significantly associated with an increased duration to initiate ART (p < 0.05). However, a significant decrease was observed in older patients, those with a university level education, men who had sex with men (MSM), and patients diagnosed after 2016 (p < 0.05). Despite improvements in the duration to initiate ART after implementing the WHO's 2016 program in Iran, various sociodemographic groups were still vulnerable to delayed ART initiation in the region. Therefore, programs including early testing, early ART initiation, active care, educational and cultural interventions, and appropriate incentives are required for these groups.

Mortality Rate and Years of Life Lost Due to Road Traffic Accidents in Fars Province, 2004-2019.

Background: Traffic accidents are one of the most critical health problems and the ninth leading cause of death globally. We aimed to determine the Mortality rate and the number of Years of Life Lost (YLL) due to road traffic accidents. Methods: In this retrospective cohort study, mortality rate and YLL due to road traffic accidents were examined in Fars province, central Iran during the years 2004-2019. Mortality statistics were collected through death registration of ministry of health and medical education for Fars Province. Age Standardized mortality Rate (ASR) was calculated and join point regression analysis carried out to examine the trend of YLL rate. Data were analyzed using Excel spreadsheet version 2016 and Join point Regression Program 4.9.0.0. Results: During the 16-year study period, 25,858 deaths due to road traffic accidents occurred in the province. 79.2% (20483 cases) were in men, and 33.7% (8703 cases) were aged 15-29 years. Total YLL during the 16-year study period were 458,975 (14.6 per 1000 people) in men, 117,999 (3.8 per 1000 people) in women. According to the join point regression, the 16- year trend of YLL rate due to premature mortality was decreasing: AAPC was -4.9% (95% CI: -8.8 to -0.9; P=0.018) for male, and -3.5% (95% CI: -6.3 to-0.5; P=0.011) for female. Conclusion: Considering that the number of deaths, mortality rate and YLL has decreased in Fars province during the 16 years under study. Therefore, because the mortality rate due to road traffic accidents in Iran is higher than the global average, the need for training programs for drivers, compliance with standards and retrofitting of vehicles, road safety, driving supervision and the use of seat belts are essential.

The Burden of Premature Mortality in Southern Iran during 2004-2019 Using Standard Expected Years of Life Lost: A Population-Based Study.

Background: Traditionally, mortality rates are used to estimate public health problems and determine the relative significance of different causes of mortality, but they cannot necessarily determine the burden of premature death. We aimed to investigate the 16-year trend of burden of premature mortality in Southern Iran. Methods: In this cross-sectional study, all deaths due to various causes of death in Fars Province from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, Years of Life Lost (YLL) and YLL rate data were calculated and to examine the trend, joinpoint regression was used. Results: During the study period, 281,903 deaths occurred, of which, 59.85% (n=168,735) occurred in men. Also, 42.18% of these deaths (n=118,610) occurred due to cardiovascular diseases (CVDs). The total number of YLLs due to premature death was 4,154,828 years. Of these, 2,591,564 years (62.37%) were in men. The highest number of YLL was due to CVDs, external causes of death and cancer. Trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -2.1% (95% CI -2.6 to -1.6, P<0.001) for males, -0.9% (95% CI -1.4 to -0.4, P=0.002) (P=0.002) for females. Conclusion: Although the trend of premature death has been decreasing during the years of study, but the seven major causes of premature death in 2004 to 2019 were non-communicable diseases, especially ischemic heart diseases, stroke, external cause of morbidity, and cancer. Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years.

Trend analysis of asthma mortality and years of life lost from 2004 to 2019 in Southern Iran.

Objective: Asthma is a globally important non-communicable disease with major public health consequences. The aim of this study was to determine the mortality rate and years of life lost (YLL) due to asthma in southern Iran. Methods: All deaths due to asthma in Fars province from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated. The JoinPoint Regression method was used to examine the trend. Results: During the 16-year study period (2004-2019), 1167 deaths due to asthma occurred in Fars province among which 54.7% (638 cases) were men and 29.6% (346 cases) were in the age group of 70-79 years. Crude mortality rate of asthma had decreased by 121% and 84% in males and females, respectively from 2004 to 2019. The total years of life lost due to asthma during the 16-year study period were 7697 (0.24 per 1000 people) in men, 6882 (0.22 per 1000 people) in women. According to the join point regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -5.6% (95% CI -8.2 to -2.9, P = 0.001) for males, -4.4% (95% CI -7.3 to -1.4, P = 0.008) for females. Conclusion: The trend of mortality and years of life lost due to asthma has decreased significantly during the years of study, although in some age groups, especially the age group of 45-59 years which has the highest number of years of life lost, this trend has been constant and unchanged. It is necessary to conduct other studies to investigate the possible reasons for this unchanged trend in vulnerable age groups.

Unintentional injuries in children in the south of Iran, 2004-2019: a trend analysis of mortality rates.

INTRODUCTION: Injury is one of the main causes of death and disability in the world. This study was designed to determine the trend of mortality rate and years of life lost (YLLs) due to unintentional injuries in children in southern Iran. METHOD: In this cross-sectional study, we extracted all death reports due to unintentional injuries based on age, gender and the year of death based on International Classification of Diseases (ICD-10)from the Electronic Death Registration System. The YLL analysis due to premature death related to unintentional injuries was executed by the 2015 YLL template from the WHO using the Excel V.2016 software. To examine the trend of crude mortality rate and YLL rates for different years, joinpoint regression was used based on the log-linear model. RESULTS: During the 16-year study period (2004-2019), 6590 deaths due to unintentional injuries in children aged 0-19 years have occurred. The total YLLs due to unintentional injuries were 138 482 in males and 53 168 in females. The three main causes of YLLs in our study were transportation injuries (67.37%), drowning (7.19%) and burns (6.70%). According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing; the annual per cent change was -5.2% (95% CI -6.5% to -3.9%, p<0.001) for males and -4.3% (95% CI -5.7% to -3.0%, p<0.001) for females. CONCLUSION: Based on the findings of this study, the trend of mortality and YLL rate has been decreasing. Road traffic injuries were the most frequent injuries and the most common cause of death. Mortality rates fell by half. To improve child survival, injuries must now be recognised as a major child health problem, and to prevent deaths from injuries in children, early and preventive measures should be taken into account.

Trend Analysis of Homicide Mortality and Years of Life Lost in the South of Iran, 2004-2019.

BACKGROUND: This study was conducted to determine the mortality rate and years of life lost (YLL) due to homicide in Fars province. STUDY DESIGN: This was a cross-sectional study. METHODS: All data related to deaths due to homicide in Fars province were obtained from the Populationbased Electronic Death Registration System. Crude and age-standardized mortality rate, YLL, and YLL rate data were calculated and joinpoint regression was used to examine the trend. RESULTS: During 2004-2019, 2148 deaths due to homicide occurred in Fars province, and (1782 cases (83.0%) were men. The crude mortality rate in men decreased by 44.0% from 2004 to 2019, but a stable trend was observed in women. The total YLL due to homicide during these 16 years was 43230 (1.37 per 1000 people) in men and 8931 (0.29 per 1000 people) in women. According to the joinpoint regression analysis, the 16-year trend of the YLL rate due to premature mortality in men was decreasing, and the annual percent change (APC) was -4.00% (95% confidence interval [CI]: -6.60 to -1.20, P=0.008). However, women demonstrated stable trends in this respect, and APC was -0.50% (95% CI: -3.10 to 2.20, P=0.704). CONCLUSION: The crude and standardized mortality rates and the number of YLL due to homicide in the study period had a significant decreasing trend in men but a stable trend in women. To control this issue, officials and policymakers should identify the areas of homicide and control its risk factors such as economic and social issues, drug addiction, and the state of violence.

Environmental factors and incidence of thyroid cancer in the world (1990-2019): an ecological study.

Thyroid cancer (TC) is the most common endocrine malignancy. Environmental risk factors such as presence of pollutants in air as well as the combustion of fossil fuels or carbon as a cooking habit in closed environments inside houses affect thyroid hormonal homeostasis and diseases. This study aimed to estimate the association between environmental risk factors and the incidence of thyroid cancer worldwide from 1990 to 2019 including particulate pollutants coming from fossil fuels employed in closed environments. Data on the incidence of thyroid cancer and some environmental risk factors were extracted from the Global Cancer Observatory (GLOBOCAN) for 204 countries and territories from 1990 to 2019. Pearson's correlation coefficient was used to determine the correlation between the thyroid cancer incidence and environmental risk factors. Finally, a generalized additive model was fitted for modeling. R 3.5.0 was used for analysis of the data. The most relevant results showed that the age-standardized incidence rate (ASIR) of thyroid cancer has a positive and significant correlation with environmental air pollution by O3 (r=0.63, P value<0.001), by particulate matter pollution (r=0.23, P value<0.001), and by household PM2.5 air pollution (r=0.52, P value≤0.001). In contrast, the correlation between ASIR and high temperature (T>25.6°C) (r=-0.27, P value<0.001) is negative and significant. The modeling results showed that particulate matter pollution and O3 pollution and household PM2.5 air pollution which originated from solid fuels are risk factors for thyroid cancer. Therefore, more research in this field is necessary in areas with high levels of air pollution at the national and international levels.

Gender difference in the perceived cause of fall leading to fracture and its potentially contributing factors among older adults.

BACKGROUND: the present study aimed to investigate gender difference in the perceived cause (intrinsic or extrinsic) of falls leading to fracture (FLF) and its association with selected social, health, and environmental factors. METHODS: All patients aged 60 years or older who were admitted to two referral hospitals due to FLF from August 1, 2018, to the end of May 2019, were included in the study. An interview-administered questionnaire was used to collect the required data from 300 participants (136 men and 164 women). RESULTS: When compared to men, women were less physical active, were less smoker, had lower education, had more vision problems, used more sedatives, and were more satisfied with their life (P less than 0.05 for all). No statistical difference was observed between men and women about the perceived cause of Fall. CONCLUSIONS: Although women and men were the same in the perceived cause of fall, they had considerably riskier lifestyles and lower health status. These factors include education, vision condition, physical activity, occupation, and taking sleeping pills. On the other hand, men were more smoker and alcohol user.

Knowledge and practice of high school students regarding HIV/AIDS prevention and transmission: Results from a cross-sectional study in an Iranian less-developed, high-risk region.

BACKGROUND: Some residents of the Persian Gulf Coastline (PGC) areas are circular migrants due to geo-commercial issues. They have a higher risk of HIV infection and non-disclosure of their HIV/AIDS status. These people who live with HIV (PLHIV) are considered as the bridge population for HIV transmission to general population, especially adolescents. This study sought to investigate the knowledge and behavior of adolescents regarding HIV/AIDS prevention and transmission in a less-developed, high-risk area located along the PGC. MATERIALS AND METHODS: In this cross-sectional study, using multistage cluster random sampling, 1450 students were invited to complete a standardized questionnaire previously used in a 2013 Iranian national high-risk behaviors survey. The prevalence of adequate knowledge, condom use, and stigmatization of HIV/AIDS and their 95% confidence intervals (CIs) were estimated. Adjusted odds ratios (ORs) were estimated using ordinal logistic regression. RESULTS: Totally, 17.09% (CI: 15.0-19.3) of the students had adequate knowledge. Social networks and the internet were the most important sources of information (20.9%, CI: 18.6-23.3). Socioeconomic status (OR: 2.0, 95% CI: 1.7-2.3), gender (0.6, CI: 0.5-0.8), residential area (0.08, CI: 0.05-0.1), and using social networks and the internet as the main sources of information (1.5, CI: 1.1-1.9) were correlated to the level of knowledge. Furthermore, 29.8% (CI: 27.2-32.5) of the students respected the social rights of PLHIV, and 12.6% (CI: 10.7-14.6) reported condom use. CONCLUSION: HIV/AIDS-related education is needed in the PGC. Such education should be focused on males, students from marginalized areas, and people with lower socioeconomic status. Social networks and the internet may be the most effective way to improve people's knowledge about HIV/AIDS.

Duration of delayed diagnosis in HIV/AIDS patients in Iran: a CD4 depletion model analysis.

Objective: Delayed diagnosis of HIV can lead to an inappropriate response to antiretroviral therapy (ART), rapid progression of the disease, and death. It can also carry harmful effects on public health due to the increment of transmission. This study aimed to estimate the duration of delayed diagnosis (DDD) in HIV patients in Iran. Methods: This hybrid cross-sectional cohort study was conducted on the national HIV surveillance system database (HSSD). Linear mixed effect models with random intercept, random slope, and both were used to estimate the parameters required for the CD4 depletion model to determine the best-fitted model for DDD, stratified by the route of transmission, gender, and age group. Results: The DDD was estimated in 11,373 patients including 4,762 (41.87%) injection drug users (IDUs), 512 (4.5%) men who had sexual contact with men (MSM), 3,762 (33.08%) patients with heterosexual contacts, and 2,337 (20.55%) patients who were infected through other routes of HIV transmission. The total mean DDD was 8.41 ± 5.97 years. The mean DDD was 7.24 ± 0.08 and 9.43 ± 6.83 years in male and female IDUs, respectively. In the heterosexual contact group, DDD was obtained as 8.60 ± 6.43 years in male patients and 9.49 ± 7.17 years in female patients. It was also estimated as 9.37 ± 7.30 years in the MSM group. Furthermore, patients infected through other transmission routes were found with a DDD of 7.90 ± 6.74 years for male patients and a DDD of 7.87 ± 5.87 years for female patients. Conclusion: A simple CD4 depletion model analysis is represented, which incorporates a pre-estimation step to determine the best-fitted linear mixed model for calculating the parameters required for the CD4 depletion model. Considering such a noticeably high HIV diagnostic delay, especially in older adults, MSM, and heterosexual contact groups, regular periodic screening is required to reduce the DDD.

Falls leading to fracture and nutrition among older adults: a case-control study.

OBJECTIVES: Injurious falls, especially those leading to bone fracture, are major causes of death and disability among older people. Our aim was to measure the association of nutritional factors and physical activity with falls leading to fracture among Iranian older adults. METHODS: This is the second phase of a previously published case-control study on 300 patients and 590 controls. RESULTS: In addition to the socio-economic factors that were reported before, our results revealed that consumption of fish, vegetables, fruits, and nuts reduced the risk of falling, whereas consumption of cheese, red meat, and sweets raised the risk of falls among the participants. CONCLUSION: The results of our study suggested that diets rich in fish meat fruits and vegetables should be encouraged in the everyday life of older adults. We suggest health officials to take these important results into consideration when planning protective measures.

The effect of COVID-19 pandemic on diabetes care indices in Southern Iran: an interrupted time series analysis.

BACKGROUND: Type 2 diabetes mellitus (T2DM) requires a continues bulk of cares. It is very probable COVID-19 pandemic is affected its healthcare coverage. METHODS: The interrupted time series analysis is used to model the trend of diabetes healthcare indices, such as the health worker visits, physician visits, body mass index (MBI), fasting blood sugar (FBS), and hemoglobin A1c (HbA1c), before and after the start of COVID-19 pandemic. The reference of data was the totals of all T2DM patients living in Fars Province, Southern Iran, areas covered by Shiraz University of Medical Science (SUMS), from 2019 to 2020. RESULTS: A significant decrease for visits by the health workers, and physicians was observed by starting COVID-19 pandemic (ß2 = -0.808, P < 0.001, ß2 = -0.560, P < 0.001); Nevertheless, the coverage of these services statistically increased by next months (ß3 = 0.112, P < 0.001, ß3 = 0.053, P < 0.001). A same pattern was observed for the number of BMI, FBS and HbA1c assessments, and number of refer to hospital emergency wards (ß3 = 0.105, P < 0.001; ß3 = 0.076, P < 0.001; ß3 = 0.022, P < 0.001; ß3 = 0.106, P < 0.001). The proportion of T2DM patients with HbA1C < 7%, and controlled hypertension during study period was statistically unchanged. CONCLUSIONS: When the COVID-19 pandemic was announced, T2DM healthcare coverage drastically decreased, but it quickly began to rebound. The health monitoring system could not have any noticeable effects on diabetes outcomes.

Trend of Mortality Rate and Years of Life Lost due to Cerebrovascular Diseases in Fars Province, Iran (2004-2019).

BACKGROUND: According to the Global Burden of Disease Study (GBD), cerebrovascular diseases are the second leading cause of death in the world. This is a cross-sectional study on deaths due to cerebrovascular diseases in southern Iran. METHODS: In this cross-sectional study, data on all deaths caused by cerebrovascular diseases in the Fars province between 2004 and 2019 was extracted from the Electronic Death Registry System (EDRS). To eliminate or minimize the influence of age composition, standardized mortality rate was used based on the 2013 Segi standard populations of low- and middle-income countries. In order to measure the years of life lost (YLL) from cerebrovascular diseases, the standardized life table was considered. The Joinpoint Regression method was used to examine the trend of the crude and standardized mortality rate and the YLL rate. RESULTS: Over the study period, 24,051 deaths occurred due to cerebrovascular diseases in Fars with 12,586 cases in men (52.3%). The trend of standardized mortality rate in males and females was decreasing (P value=0.001 and<0.001 for males and females, respectively). All YLL due to premature mortality from cerebrovascular disease during the 16-year study period were 119,436 (3.8 per 1000 persons) in men, and 111,172 (3.6 per 1000 persons) in women. Based on the joinpoint regression, the 16-year trend of YLL rate due to premature death was decreasing: annual percent change (APC) was -1.6% (95% CI -3.4 to 0.3, P=0.098) for males, and -2.0% (95% CI -3.6 to -0.4, P=0.017) for females. CONCLUSION: The trend of mortality rate and YLL caused by cerebrovascular diseases has decreased in our study. Necessary measures, mainly primary and secondary prevention, should be taken to continue the diminishing trend of cerebrovascular diseases.

Mortality Rate and Years of Life Lost Due to Burns in Southern Iran During 2004-2019: A Population-Based Study.

BACKGROUND: Burns constitute one of the most important etiologies of infection and mortality worldwide, with the most significant number of cases in low- and middle-income countries. This is a cross-sectional study on deaths due to burns in southern Iran. METHODS: In this study, data on all deaths due to burns in southern Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of crude mortality rate, standardized mortality rate, and years of life lost (YLL) rate. In order to measure YLL, the number of deaths and life expectancy for different age and gender groups were used, for which the standard life table was considered. RESULTS: During this study, 2175 deaths due to burns occurred, 50.6% (1106 cases) of which were in men and 38.7% (841 cases) were in the 15-29 age group. The crude and the standardized mortality rate had a decreasing trend during the study years. The total number of YLL was 25260 (0.8 per 1000) in men, 25,785 (0.8 per 1000) in women, and 51,045 (0.8 per 1000) in both genders during the 16 years of the study. CONCLUSION: Considering the high mortality rate in the 15-29 age group, which consists of the active and productive labor force, necessary actions are needed in order to improve safety equipment and to make the workplace safe.

Trend Analysis of Leukemia Mortality and Years of Life Lost (YLL) from 2004 to 2019 in the Fars Province, Iran.

BACKGROUND: Although the incidence of leukemia's is not high, many of these cancers lead to death over a short period. This is a cross-sectional study on leukemia deaths in southern Iran. METHODS: All deaths due to leukemia in the Fars province were obtained from the population-based electronic death registration system (EDRS). Crude and age-standardized mortality rate (ASMR), YLL, and YLL rate data were calculated, and joinpoint regression was used to examine the trend. RESULTS: Totally, 3141 deaths from leukemia occurred in the Fars province during the study period (2004-2019). Of these, 61.5% (1933 cases) pertained to men. The crude mortality rate was 6.1 (95% CI: 5.8 to 6.4) in men and 3.9 (95% CI: 3.7 to 4.2) in women. Also, ASMR was 6.6 (95% CI: 6.3 to 6.9) and 4.2 (95% CI: 4.0 to 4.4) in men and women, respectively. The total YLLs due to leukemia were 32804 in men and 23064 in women. The joinpoint regression analysis demonstrated that the trend of YLL rate due to premature mortality was stable: the annual percent change (APC) was -1.2% (95% CI: -2.5 to 0.2, P=0.090) for males, and -1.0% (95% CI: -2.9 to 0.9, P=0.274) for females. CONCLUSION: The mortality and YLL due to leukemia had a stable trend. However, this trend has been decreasing or increasing in some age groups. Determining and controlling essential risk factors, especially the environmental factors of leukemia, may reduce its burden in the Fars province.