Prevalence and predictor factor of lifetime abortion in female sex workers in Iran: results of the national rapid assessment and response in 2017.

Female sex workers are at a high risk of abortion. This cross-sectional study included 855 female sex workers to determine the prevalence of lifetime abortion and its related factors. Logistic regression models were used to identify the factors related to lifetime abortion. The prevalence of lifetime abortion was reported at 40.8%. The chance of having a lifetime abortion was 7.8times higher in women aged >35years and 2.4times higher in financially dependent women. The high prevalence of lifetime abortion indicates that these women's health and fertility needs are not met.

Lifetime and past-month substance use and injection among street-based female sex workers in Iran.

BACKGROUND: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. METHODS: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were reported. RESULTS: Lifetime and past-month non-injection drug use were reported by 60.3% (95% CI 51, 84) and 47.2% (95% CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6% (95% CI 6.9, 10.7) and 3.7% (95% CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95% CI 1.07, 3.74), temporary marriage (AOR 4.31 [1.79, 10.40]), had > 30 clients per month (AOR 2.76 [1.29, 5.90]), ever alcohol use (AOR 3.03 [1.92, 6.79]), and history of incarceration (AOR 7.65 [3.89, 15.30]). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 [1.20-6.20]), ever incarceration (AOR 5.06 [2.48-10.28]), and ever group sex (AOR 2.44 [1.21-4.92]). CONCLUSIONS: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran.

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.

Population Size Estimates of Street Children in Iran: Synthesis of Multiple Methods.

We used four methods (direct count, indirect count, wisdom of the crowd, and unique object multiplier) to map and estimate the population size of street children in six major cities in Iran in 2017. In aggregate for the six cities, the number of street children was estimated at 5296 (interquartile range [IQR] 4122-7071) using the median of the four methods. This corresponds to a rate of 16.3 (IQR 12.5-24.5) per 10,000 children age 5-18 years old, or 3.2 (IQR 2.4-5.3) per 10,000 total population. The total number for street children in the country is estimated at 26,000 (IQR 20,239-34,719) children. Results can help policy-makers advocate for resources, plan programs, and evaluate the reach of programs for street children. The maps created through the course of the population size estimation exercise can also guide outreach efforts to provide street children with health and social welfare services.

Sexual Behaviors in Iranian Working Children and the Correlated Risk Factors: Result of the Large-Scale Rapid Assessment and Response (RAR) Survey.

This study aimed to investigate the sexual behaviors among working children and the associated factors. This cross-sectional study was conducted on a sample of 1937 working children in the 10-18 age range in 15 provincial capitals in 2019-20 (Feb-May); the Response rate was 94.9%. Univariate and multivariable logistic regression was used to examine the variable of sexual behaviors. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) are reported. The prevalence of sexual behaviors in working children was 4.2%. The results showed a significant difference between those who reported sexual behaviors and those who did not in terms of age, identity document (ID), running away from home, alcohol use, and substance use. There was a statistically significant relationship between fathers' unemployment and sexual behaviors among working children. Furthermore, we found that having divorced parents could increase the odds of sexual behaviors by 3.74 times. The findings showed that related welfare and support organizations should design and implement effective and continuous training and interventions to raise awareness and reduce the prevalence of high-risk sexual behaviors in working children. They should also provide family counseling and promote parental supervision of children.

Street Children in Iran: What Are Their Living and Working Conditions? Findings from a Survey in Six Major Cities.

Street children are among the most marginalized children, globally, who experience severe violations of their rights and face multiple deprivations. This study aimed to describe street children's characteristics and working conditions in Iran. METHOD: This cross-sectional rapid survey was conducted from March to May 2017 in six major cities in Iran. The sample group consisted of Iranian and non-Iranian girls and boys, aged 10 to 18, who worked on the streets for at least one month prior to the survey. Time-location based sampling was used. A total of 856 Children were randomly selected from 464 venues, including corners of streets, parks, metro gates, bus stations, shopping malls, and shopping centers frequented by street children. RESULTS: Findings showed that 90% of participants were boys, 60% were between 10 and 14 years old, almost 50% attended school, 12% were illiterate, and 32% had quit school. Children of Afghan nationality comprised 54% of the study participants, and the rest were Iranian. Of all participants, 85% resided with family or relatives. Most children (75.5%) worked more than 5 h daily, and vending (71.2%) and waste picking (16.1%) were common activities. Street children suffered, mainly, from harsh weather (22.7%), insults and beatings of everyday people (21%), starvation (20.7%), and police repression (15.4%). More than half of the study participants were not involved in intervention programs, and just 7% of them had attended any health education programs. CONCLUSION: Street children reported little to no service use, which may contribute to poor health. Street children require immediate attention to improve their wellbeing. Decision-makers and academicians should collaborate on intervention development research to design appropriate health and social interventions targeted at street children.

Prevalence of HIV, hepatitis B virus, hepatitis C virus, drug use, and sexual behaviors among street children in Iran: A systematic review and meta-analysis.

Background and Aims: Street children face a disproportionately higher risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) due to high-risk sexual and drug use practices. We aimed to estimate the prevalence of these infections and related risk behaviors among street children in Iran. Methods: We searched PubMed, Web of Science (ISI), Embase, Scopus, and Google Scholar for the English-language records and Iranian databases, including SID, Magiran, and IRANDOC for the Farsi-language records up to September 18, 2022. Random effects analysis was used to obtain prevalence estimates for each condition. Homogeneity across included studies was assessed using I 2. Results: We extracted data from 18 eligible studies, representing 5646 children (83.2% boys), with a mean age of 10.2 (range: 5-18). The prevalence of HIV, HBV, and HCV were 0.79% (95% confidence intervals [CIs]: 0.0-5.56), 1.97% (95% CI: 1.01-3.19), and 1.88% (95% CI: 0.74-3.46), respectively. The prevalence of lifetime drug use and sexual abuse was 8.32% (95% CI: 4.83-12.62) and 10.18% (95% CI: 3.02-20.67) among street children, respectively. Conclusion: The estimated prevalence of HIV, HBV, and HCV among street children in Iran was higher than the estimates in the general population. Moreover, drug use and the experience of sexual abuse were prevalent among this population. These findings suggest the need for targeted prevention programs for street children in Iran.

Life-time HIV testing among people who inject drugs in Iran: results from the National Rapid Assessment and Response survey.

Background: HIV testing is recommended for people who inject drugs (PWID). The aim of this study was to determine the prevalence of lifetime HIV testing among PWID and to better understand the predictors for HIV testing in a convenience sample across Iran. Materials and methods: This study is a secondary analysis of Iran's National Rapid Assessment and Response survey conducted between October 2016 and March 2017. Analysis includes the 999 people who reported injecting drugs across the capital cities of 21 provinces. Data were collected by using the venue-based application of the Time Location Sampling (TLS) frame. Chi-square tests were used to examine the difference between HIV testing across different quantitative variables. Logistic regression was used to determine the predictors of life-time HIV testing. Analysis was performed using STATA V.12 software with a significance level of 95%. Results: Most participants were male (n = 902, 93.50%), and over half (n = 555, 59.17%) were older than 35 years old. About one-third, (n = 326, 38%) of people interviewed were single and another one-third (n = 251, 29%) reported being divorced. Over two-thirds of participants (n = 678, 69.78%) in this study reported lifetime HIV testing. The results from a multiple variable logistic regression showed people with a university education were more likely to have been previously tested for HIV than illiterate people (OR = 18.87, 95%CI 2.85-124.6, value of p = 0.002). Those individuals who reported ever receiving methadone treatment were 2.8 times more likely to have been tested for HIV than individuals without methadone treatment experience (OR = 2.89, 95%CI 1.53-5.42, value of p < 0.001). Needle syringe sharing in last month, was negatively associated with life-time HIV testing (OR = 0.29, 95%CI 0.17-0.48, value of p < 0.001). Conclusion: Despite Iran's wide availability and access to counseling services for HIV testing in key populations, the proportion of PWID being tested for HIV could be improved. Developing effective strategies to increase people's understanding and awareness of the importance of and need for HIV prevention and familiarity with HIV testing sites is an essential step in increasing HIV testing for this population. Studies on more recent HIV testing are required to better assess and understand the frequency of HIV testing among PWID in Iran.

Lifetime alcohol-use prevalence and correlated factors among street children in Iran.

BACKGROUND: Several studies on street children in Iran reported a high prevalence of alcohol consumption among this group. This study assessed the prevalence of lifetime alcohol use and correlated factors among street children in Iran. METHODS: We conducted a cross-sectional survey among 856 street children from six provinces of Iran. Behavioral data were collected by trained interviewers using a structured questionnaire. Our target outcome was lifetime alcohol use. We examined associations between individual variables and lifetime alcohol use using the chi-square. A multiple logistic regression model included variables with a p-value < .2. Lastly, we reported the adjusted odds ratio (an OR) point estimate and 95% confidence interval (95% CI) as the effect measure. RESULTS: Mean age and standard deviation (SD) of alcohol drinkers were 14.94 ± 2.16. Overall, 16.6% (CI95%: 14.38%, 19.55%) of participants reported lifetime alcohol use, and almost 60% of children reported alcohol use over three past months. In the final model, factors that were independently associated with alcohol use included the 15-18 age range (AOR 2.35, 95% CI 1.48-3.73), Iranian nationality (AOR 3.36, 95% CI 2.07-5.45), working longer than 5 years in the streets (AOR 2.90, 95% CI 1.72-4.88), father's drug use (AOR 1.93, 95% CI 1.22-3.01), and illiteracy (AOR 1.65, 95% CI 1.03-2.66). CONCLUSIONS: The results of the present study demonstrated that preventive plans for alcohol use among street children must be addressed using the services provided by governmental and nongovernmental organizations.

Availability of Physical Rehabilitation Facilities for People with Disabilities in Iran: A Comparative Study on Universal Health Coverage.

BACKGROUND: Iran, like many other countries, has committed to providing universal and equal access to health care and rehabilitation for people with disabilities by joining the Convention on the Rights of People with Disabilities. Thus, this study aimed to examine the availability of rehabilitation facilities on national and sub-national levels. METHODS: This cross-sectional study was conducted between May and December 2019. The data of rehabilitation facilities including infrastructure and rehabilitation workforce in health system settings were obtained using rehabilitation master list. The data were collected from the Vice-Chancellor for the Treatment Ministry of Health and Medical Education, the Rehabilitation of the State Welfare Organization, and Licensing and Planning the Medical Council in the 32 provinces of Iran and analyzed using Excel version 2016. RESULTS: On the national level, the following situation was found: in inpatient settings: 1.1 beds per million population; in outpatient settings: physiotherapy 42.6, optometry 16.4, audiology 10.5,occupational therapy 8.2, speech therapy 8.1, orthotic & prosthetic 4.5, physical medicine & rehabilitation 3.8 centers; day-care centers 11.7 and rehabilitation centers 1.3 centers, community-based rehabilitation (CBR): 15.9 units, rehabilitation home care 2 centers, rehabilitation nursing home care 1.6 centers and medical rehabilitation home care 0.3; Long-term care centers: residential care 4.1 centers per million population. Regarding rehabilitation work force: physiotherapists 84, speech therapists 34.8, occupational therapists 32.5, optometrists 31.2, audiologists 27.9, prosthetists and orthotists 10.3 therapists and physical medicine & rehabilitation 5.1 specialists per million populations. On the sub-national level, there were no outpatient rehabilitation centers in 12 of the provinces and the distribution of day rehabilitation centers in the rich provinces was 10 times higher. The number of CBR units, rehabilitation home care and rehabilitation nursing home were 40, 22, and 23 times higher in rich provinces than in poor provinces, respectively and there were no medical rehabilitation home care centers in 21 provinces. Regarding long-term care, the residential care centers in the richest province were 8 times higher. CONCLUSION: According to the WHO report and the rehabilitation expert panel, it was concluded that the number of rehabilitation facilities including rehabilitation centers and workforce was limited in Iran and that the available centers were also poorly distributed in the provinces of the country. This made it difficult for people to have fair access to rehabilitation services. It appears that health policymakers should pay special attention to further developing rehabilitation facilities.

The Economic Burden of Smoking-Attribution and Years of Life Lost due to Chronic Diseases in Mashhad, 2015-2016.

BACKGROUND: Tobacco smoking is one of the most preventable causes of mortality related to noncommunicable diseases (NCDs). This study aimed to estimate the direct economic burden and years of life lost (YLL) attributable to smoking in NCDs in Mashhad, 2015-2016. METHODS: Hospital-based data were utilized to calculate the economic burden of four selected diseases related to smoking. An epidemiological population-attributable risk method was used to determine the smoking-attributable fraction (SAF). Moreover, the study was conducted by data related to disease-specific expenditures and patients' information on cost and the number of mortality for estimating the YLL for each disease, population and life expectancy data, the prevalence of smoking, and the relative risk of smoking. Data analysis was performed with STATA software, version 12. RESULTS: The total costs attributable to smoking for stroke, myocardial infarction, chronic obstructive pulmonary disease (COPD), and lung cancer were 94148, 151272, 1191396, and 574784 US Dollars, respectively (per 100000). In 2015, the YLL per deaths due to COPD were 4217 and 3522 among males and females, respectively. Furthermore, in 2016, the YLL per deaths due to the stroke in males and females were 8317 and 7563, respectively. In the same year, the highest proportion of years of potential life lost per 100000 smoking-attributable deaths belonged to COPD. CONCLUSIONS: The results of this study can be used to inform policy-makers about smoking-attributable diseases in Iran. To decrease the smoking-attributable costs, which have resulted in the spread of NCDs, policy-makers should adopt and implement effective policies regarding smoking prevention and control.

HIV testing and its associated factors among street-based female sex workers in Iran: results of a national rapid assessment and response survey.

BACKGROUND: Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. METHOD: A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). RESULT: Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). CONCLUSION: Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

Income-Related Inequality in Traffic Accident Health Outcomes (Injury, Disability and Mortality): Evidence from the Nationwide Survey in Iran.

BACKGROUND: Despite many efforts, Iran continues to have a high rate of traffic accidents and poor health outcomes. This study aimed to measure income-related inequality for traffic accident health outcomes in Iran, a country with one of the highest rates of traffic accidents and related health problems. METHODS: The source of data was a national representative survey named the Iranian Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010). Monthly household income is obtained through self-report in different quarters. Disparity rate ratio (DRR), slop index of inequality (SII) and the population attributable risk percentage measure (PAR%) were calculated. The concentration index (CI) of RTIs was used as our measure of socioeconomic inequality and decomposed into its determining factors. RESULTS: Using the DRR index, in the lowest income group, the risk of death from an accident was 2.3 times, greater and the risk of accidental disability was 11.7 times greater than for the third income quartet. The slope index also shows that the rate of road traffic deaths, disability and injury per 100,000 individuals decreased by 28, 82, and 392 moving from lower to higher incomes. This decrease in injury was about 581 for motorcyclists. CI was -0.04078643 (SE=.01424828, P-value 0.004). Male sex (68.9%), 15-29 yr old age (9.4%), employed activity status (20.8%) has a positive contribution in the RTIs concentration index. CONCLUSION: In addition to intervention related to the road safety and vehicles and reducing human errors, prevention of the road traffic ill health outcomes requires attention to reduction of inequality in society.

Prevalence of smoking and its association with health-related behaviours among Iranian university students: a large-scale study.

BACKGROUND: The prevalence of smoking and contributing factors among Iranian university students has been paid little attention. AIMS: The aim of this study was to assess the prevalence of smoking in Iranian university students and its association with health-related behaviours. METHODS: This cross-sectional study was carried out on a sample of 82 806 Iranian university students admitted in 2012-2013. Information on demographic characteristics and health-related behaviours, including physical activity, sleep pattern, use of electronic devices and dietary habits, were collected using a standardized questionnaire. Weight and height were measured using a standard protocol and body mass index calculated. Smokers were defined as students who smoked ≥ 1 cigarette per week. RESULTS: Smoking was prevalent among 6.0% of university students (males 6.6%, females 5.6%). Moderate physical activity was inversely associated with odds of smoking. A significant positive association was also found between obesity and odds of being a smoker. Higher intake of fruits and dairy products were associated with lower odds of smoking. However, intake of vegetables, fast foods and carbonated beverages was positively associated with smoking. Breakfast consumption was also associated with greater odds of being a smoker. CONCLUSIONS: Demographic characteristics and health-related behaviours, including marital status, occupation, economic status, sleep pattern, physical activity, use of electronic devices and dietary intake, were significantly associated with smoking.

Implementing Prevention against Tobacco Dependence (PAD) "Toward the Tobacco-Free Schools, Neighborhoods, and Cities": Study Protocol.

INTRODUCTION: Although tobacco consumption in Iran has decreased in recent years, in 2010, the exposure to cigarette smoke was the fifth leading risk factor for death in Iran. This article is presenting the protocol for the prevention against tobacco dependence (PAD) project, an initiative planned and implemented by the Iranian Anti-Tobacco Association (IATA) of Iran in the city of Varamin. STUDY DESIGN: A prospective cohort study. METHODS: This project is carried out based on a participatory community-oriented approach and an action research method. It includes four inter-related, prospective studies phases; pilot, tobacco-free school (TFS), tobacco-free neighborhood (TFN), and tobacco-free city (TFS). The measuring tools for each phase were designed primarily using CDC and WHO guidelines and preliminary details were identified. Each phase is a combination of different methods (including systematic observation, questionnaire, heuristic interview, and structured interview). The studies will examine twelve goals and meet 9 project objectives in a comprehensive evaluation of ongoing progress with TFS, TFN, and TFC. DISCUSSION: This project seeks to achieve indicators of tobacco-free schools, neighborhoods, and cities through direct and indirect education of all the target groups in the community. Participation of stakeholders and supporters in problem-solving can increase the effectiveness and influence of the project. The outcomes of the first two phases will be expanded to the wider settings.

Prevalence and Socio-Economic Determinants of Disabilities Caused by Road Traffic Accidents in Iran; A National Survey.

OBJECTIVE: To determine the prevalence and socio-economic disparity among victims with disabilities caused by RTAs in Iran as country with a high rate of accidents. METHOD: The source of data was the Iranian Multiple Indicator Demographic and Health Survey, a nationwide cross-sectional study. The sampling framework was based on the population and housing census for Iran in 2006. Provincial samples ranged from 400 to 6,400 households. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural clusters. In the present study, all but a few indicators are reported at provincial levels. Mortality indicators, accident and disability rates, low birth weight rate and young age at marriage rates are presented at the national level only. Logistic regression was performed to investigate the individual and family factors influencing RTAs that lead to disability in Iran. RESULTS: The period prevalence (12 months) of road traffic accident disabilities (RTADs) in the total population of 111415 was 30.52 (95% CI: 21.13.41.64) per 100,000 individuals. Among those who had been injured during the year leading up to the study, the proportion of disabilities caused by RTAs was 31.67 (95% CI; 8.51.54.97) per 1000 pedestrians, 20.99 (95% CI: 13.37.30.75) per 1000 motorcyclists, 18.64 (95% CI: 7.71.29.57) per 1000 vehicle drivers. Multivariate logistic regression analysis showed that the risk of RTADs differed significantly in relation to age (AOR 50-59 vs. 0-9=10. 78, p-value:0.05); activity status (AOR unemployed vs. employed=4.72, p-value:0.001) and family income (AOR q2 vs. q1=0.37, p-value:0.048) of the victim. CONCLUSION: In addition to the risks associated with socio-economic groups, particularly vulnerable groups, RTADs have consequences which can lead to further marginalization of individuals, can affect their quality of life and damage the community as a whole.

Social Differences in the Prevalence of Road Traffic Injuries among Pedestrians, and Vehicle and Motorcycle Users in Iran: Results of a National Multiple Indicator Demographic and Health Survey (IrMIDHS, 2010).

BACKGROUND: Traffic injuries are considered as the most important health issues for different countries in the world, especially developing countries that are experiencing rapid social changes. The purpose of this study was to investigate the prevalence of road traffic injuries (RTIs) and its socioeconomic differences among road users in Iran as it is one of the countries with high rates of accidents in the world. The study population included all people in Iran. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural households. METHODS: Source of the raw data was the Iran's Multiple Indicator Demographic and Health Survey (IrMIDHS) 2010, which is a multi-stage stratified cluster-random cross-sectional study. The logistic regression has been performed for investigating the socioeconomic determinants which influence the RTIs among pedestrian, vehicle, and motorcycle users. RESULTS: The prevalence of RTIs is 13.8 (95% CI: 13.1, 14.5) per 1,000 people in the year leading up to the study. The injured groups included pedestrians (14.37%), vehicles (38.36%), motorcyclists (43.37%), and 3.9% of users injured with other vehicles. A total of 78.3% of the injured people underwent outpatient treatment or were hospitalized. The mean age in these three groups was significantly increased (27.9, 32.5, 33.4, respectively), and the proportion of men decreased (89.2, 75.2, and 60.6). CONCLUSIONS: RTIs in Iran are higher than previous estimates due to consideration of non-hospitalized cases. Considering the high contribution of human factors in developing countries, these measures should prioritize vulnerable groups.

Involving Mothers in Child Development Assessment in a Community-based Participatory Study Using Ages and Stages Questionnaires.

BACKGROUND: Child-friendly environment project (MAZDAK) is a community-based project for monitoring the development of children in Iran that was implemented as a pilot study in one of the neighborhoods of Tehran (Eyvanak-e Gharb). This study attempted to engage mothers in monitoring of their children's development and assesses the status of children's development by a community-based participatory approach using the ages and stages questionnaires (ASQ). METHODS: This study was a community-based participatory research. Two hundred households residing in Eyvanak-e Gharb with children under 5-year-old were selected as a convenient sample and completed the ASQ. Descriptive measures were used to describe the overall status of children, in each domain. Furthermore, we compared the current sample with other populations, using independent t-test. RESULTS: This study engaged mothers, trained volunteers from the community, and some local institutions in screening and monitoring children development and addressing any poor developmental growth. The mean scores of the different domains (communication, gross motor, fine motor, problem solving, and social-personal) in sampled children in MAZDAK project were higher than corresponding mean scores of the children in a project conducted in Tehran in 2006. CONCLUSIONS: Involving mothers and community in monitoring children development based on ASQ was an effective strategy to monitor and foster children development.

Iranian university students lifestyle and health status survey: study profile.

BACKGROUND: The physical health assessment of university students in Iran is a national large scale assessment examining health behaviors among tertiary education students. Understanding risky health behaviors which are the major sources of global mortality and morbidity in adulthood is the key objective of this assessment. METHODS: In academic year of 2012-2013, newly admitted students (N = 151,671) at 74 governmental eligible universities that had health center from 28 provinces were invited to participate in the health assessment program. The physical health behaviors of the students were evaluated by using questionnaire. The test-retest reliability method was applied to estimate the reliability of physical health questionnaire. After filling out the questionnaires, students were led to the examination room for the measurement of height, weight and blood pressure. RESULTS: From the total study population, 84,298 student's ages between 18 and 29 years old, were participated in the health assessment. The mean response proportion was 63%. The mean age of students was 21.5 ± 4.01, with 49.20% percent being <20 years old. 32.31% were between 20 and 24 years, 13.44% between 25 and 29 years, 69% of the participants were undergraduate 34.9% were master's students, and 2.9% were Ph.D. students. The mean BMI for total students was 22.5 ± 4.0 and regarding to gender, the mean BMI for male and female were 23.0 ± 4.1 and 22.2 ± 3.8 respectively. CONCLUSION: Analysis of student's findings will generate multiple studies which report different aspects of physical health of Iranian university students who constitute a large proportion of young adult aged 18-29 years in the country. This assessment also provides opportunity to compare Iranian student's behavioral patterns with the behavioral pattern of students worldwide.

Drug Use and Sex Work Among At-risk Women: A Qualitative Study of Initial Factors.

BACKGROUND: In recent years, there has been an increasing interest in performing research on drug use and sex work among at-risk women. Although there is a well-documented literature of the initial reasons associated with drug use and sex work among women, there is, however, a paucity of information in this area in Iran. OBJECTIVES: This study aimed to explore the initial reasons associated with drug use and sex work in a group of female treatment seekers, who presented health-related risk behaviors, in Tehran, Iran. PATIENTS AND METHODS: This qualitative study enrolled a total of 65 at-risk women, from five women-specific drug clinics, who participated in the study in 2011. Individual in-depth interviews were conducted. Focus group interviews were conducted with 10 key informants. All interviews were audio-taped and thematically written. The recorded data were analyzed using ATLASti qualitative research software version 10. RESULTS: The median age of the sample was 34 years. In addition, 44.6% of subjects were opiate users, and 55.4% were users of opiates and methamphetamine. Sex work was the main source of income for almost half of the sample. The most frequently reported reasons, associated with initial drug use, were extrinsic motivations, including the drug-using family, friends or social networks. Intrinsic motivations, including curiosity and individual willingness to use drugs, were other initial reasons. The most frequently reported reasons, associated with initial sex work, included the need to purchase drugs and financial problems. CONCLUSIONS: The study findings demonstrated a number of reasons associated with initial drug use and sex work. The role of sex work in providing drugs necessitates education and prevention. Special treatment programs should be implemented to prevent sex work among at-risk women in Iran.