Determinants of road traffic injuries in Iranian children; results from a National Representative Demographic- Health Survey 2010.

BACKGROUND: Road Traffic Injuries (RTIs) are a leading cause of disabilities and mortalities in Iran. The occurrence of RTIs among children is increasing. This study aims are to assess RTIs among Iranian children and to determine the main socio-economics determinants. METHODS: The National Institute of Health Research (NIHR) in collaboration with the Iran Ministry of Health (MoH) conducted a nationwide survey: The Multiple Indicator Demographic and Health Survey 2010 (IrMIDHS 2010). The Survey was undertaken by Medical Universities in Iran. Based on multistage clustered randomized sampling, 30,960 households were included in the survey. We performed a multivariate logistic regression to determine the main socio-economic factors associated with RTIs among children. RESULTS: Approximately 0.9% of the children received RTIs in 2010. Main socio-economics contributors to RTIs involving Iranian children included household size (Adjusted OR: 1.06 (CI 95% 1.01, 1.14), sex (Adjusted ORfemale: 0.38 (CI 95% 0.29, 0.50), living with both parents (Adjusted OR: 0.55 (CI 95% 0.13, 0.95), being in the 2nd (Adjusted OR: 0.81 (CI 95%: 0.60, 0.90) or 4th income quartile (Adjusted OR: 0.13 (CI 95%: 0.02, 0.92) rather than the 1st income quartile, being aged five to nine (Adjusted OR: 1.39 (CI 95%: 1.10, 2.10), or aged 15 to 18 (Adjusted OR: 2.94 (CI 95%: 2.07, 4.97), and residency in a non- owned or non-tenancy house (Adjusted OR: 0.42 (CI 95%: 0.23 0.74). CONCLUSIONS: Children need safe places for playing and doing their daily activities. Policy and regulation development aimed at protecting children from road traffic injuries needs to take into consideration the socio-economic factors associated with risk of road traffic injury among children.

Hypothyroidism among pediatric patients with type 1 diabetes mellitus, from patients' characteristics to disease severity.

We performed this study to evaluate the associations of hypothyroidism with clinical severity and the occurrence of diabetic ketoacidosis (DKA) at initial diagnosis among pediatric patients with type 1 diabetes mellitus (T1DM). 330 children with T1DM who referred to Diabetes Clinic were enrolled. The medical records were e valuated and a blood sample was drawn from patients for measuring thyroid function and antibodies, blood glucose, and glycated hemoglobin (HbA1C) levels. Hypothyroidism was detected in 9.6% of children with T1DM and was associated with higher rates of DKA (OR = 3.15, 95%CI = 1.48-6.71) and younger age at initial diagnosis (7.3 ± 3.2 vs. 10.1 ± 2.5, p = 0.04), higher levels of HbA1C upon enrolment (9.8 ± 2.2 vs. 8.8 ± 1.9, p = 0.02) and the requirement for higher insulin doses to control the disease (0.9 ± 0.42 vs. 0.81 ± 0.2, p = 0.03) compared to children with T1DM and normal thyroid function. Additionally children with T1DM and hypothyroidism had significantly higher rates of anti-TPO antibodies (p < 0.001), consanguinity in their parents (p =0.01), and family history of diabetes mellitus (p = 0.02) in their first degree relatives. In conclusion autoimmune hypothyroidism is prevalent among children with T1DM and is associated with a more aggressive disease at initial presentation, poorly controlled T1DM, and requirement for higher Insulin doses for controlling the disease.

Psychological, Social, and Familial Problems of People Living with HIV/AIDS in Iran: A Qualitative Study.

BACKGROUND: HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. METHODS: In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. RESULTS: Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient's families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. CONCLUSIONS: It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control, but also enables patients to have a better response to complications caused by HIV/AIDS.

Socioeconomic Inequality of Non-Communicable Risk Factors among People Living in Kurdistan Province, Islamic Republic of Iran.

BACKGROUND: The most fundamental way to decrease the burden of noncommunicable diseases (NCDs) is to identify and control their related risk factors. The goal of this study is to determine socioeconomic inequalities in risk factors for NCDs using concentration index based on Non-Communicable Disease Surveillance Survey (NCDSS) data in Kurdistan province, Islamic Republic of Iran in 2005 and 2009. METHODS: The required data for this study are taken from two NCDSSs in Kurdistan province in 2005 and 2009. A total of 2,494 persons in 2005 and 997 persons in 2009 were assessed. Concentration index was used to determine socioeconomic inequality. To assess the relationship between the prevalence of each risk factor and socioeconomic status (SES), logistic regression was used and odds ratio (OR) was calculated for each group, compared with the poorest group. RESULTS: The concentration index for hypertension was -0.095 (-0.158, -0.032) in 2005 and -0.080 (-0.156, -0.003) in 2009. The concentration index for insufficient consumption of fruits and vegetables was -0.117 (-0.153, -0.082) in 2005 and -0.100 (-0.153, -0.082) in 2009. The concentration index for the consumption of unhealthy fat and oil was -0.034 (-0.049, -0.019) in 2005 and -0.108 (-0.165, -0.051) in 2009. The concentration index for insufficient consumption of fish was -0.070 (-0.096, -0.044) in 2005. The concentration index for physical inactivity was 0.008 (-0.057, 0.075) in 2005 and 0.139 (0.063, 0.215) in 2009. In all the cases, the OR of the richest group to the poorest group was significant. CONCLUSION: Hypertension, insufficient consumption of fruits and vegetables, consumption of unhealthy fat and oil, and insufficient consumption of fish are more prevalent among poor groups. There was no significant socioeconomic inequality in the distribution of smoking, excess weight, and hypercholesterolemia. Physical inactivity was more prevalent among the rich groups of society in 2009. The reduction of socioeconomic inequalities must become a main goal in health-care policies.