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Epidemiologic Investigation
How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time
Meysam Olfatifar, Seyed Mehdi Hosseini, Payam Shokri, Soheila Khodakarim, Naghmeh Khadembashi, Sajjad Rahimi Pordanjani
Epidemiol Health. 2020;42:e2020058.   Published online August 10, 2020
DOI: https://doi.org/10.4178/epih.e2020058
  • 10,027 View
  • 178 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis.
METHODS
An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas.
RESULTS
The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables.
CONCLUSIONS
The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.
Summary

Citations

Citations to this article as recorded by  
  • Asymmetric Effects of Weather-Integrated Human Brucellosis Forecasting System Using a New Nonlinear Autoregressive Distributed Lag Model
    Yongbin Wang, Chenlu Xue, Bingjie Zhang, Yuchun Li, Chunjie Xu, Daniel Diaz
    Transboundary and Emerging Diseases.2024; 2024: 1.     CrossRef
  • Spatio-temporal Analysis of COVID-19: A Global Study
    Sajjad Rahimi Pordanjani, Maryam Mohammadian, Somayeh Derakhshan, Fatemeh Hadavandsiri, Seyed Saeed Hashemi Nazari, Mohammad Hossein Panahi
    Middle East Journal of Rehabilitation and Health Studies.2023;[Epub]     CrossRef
  • Factors Associated With Diagnostic Delays in Human Brucellosis in Tongliao City, Inner Mongolia Autonomous Region, China
    Jingbo Zhai, Ruihao Peng, Ying Wang, Yuying Lu, Huaimin Yi, Jinling Liu, Jiahai Lu, Zeliang Chen
    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Clinical Effect of Doxycycline Combined with Compound Sulfamethoxazole and Rifampicin in the Treatment of Brucellosis Spondylitis
    Xin-Ming Yang, Yong-Li Jia, Ying Zhang, Pei-Nan Zhang, Yao Yao, Yan-Lin Yin, Ye Tian
    Drug Design, Development and Therapy.2021; Volume 15: 4733.     CrossRef
Original Articles
Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran
Sohrab Iranpour, Soheila Khodakarim, Abbas Shahsavani, Ardeshir Khosravi, Koorosh Etemad
Epidemiol Health. 2020;42:e2020053.   Published online July 18, 2020
DOI: https://doi.org/10.4178/epih.e2020053
  • 10,379 View
  • 221 Download
  • 6 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide).
METHODS
Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value.
RESULTS
We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality.
CONCLUSIONS
A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
Summary

Citations

Citations to this article as recorded by  
  • Associations between ambient temperature and suicide: а systematic review
    Andrej М. Grjibovski, Ivan М. Kobelev, Natalia N. Kukalevskaya, Yulia A. Popova, Alexander V. Baranov
    Ekologiya cheloveka (Human Ecology).2023; 30(6): 399.     CrossRef
  • Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States
    Richard V. Remigio, Hao He, Jochen G. Raimann, Peter Kotanko, Frank W. Maddux, Amy Rebecca Sapkota, Xin-Zhong Liang, Robin Puett, Xin He, Amir Sapkota
    Science of The Total Environment.2022; 812: 152481.     CrossRef
Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study
Masoumeh Sadeghi, Maryam S. Daneshpour, Soheila Khodakarim, Amir Abbas Momenan, Mahdi Akbarzadeh, Hamid Soori
Epidemiol Health. 2020;42:e2020009.   Published online March 8, 2020
DOI: https://doi.org/10.4178/epih.e2020009
  • 13,026 View
  • 154 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers).
METHODS
In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders.
RESULTS
The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern.
CONCLUSIONS
The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.
Summary

Citations

Citations to this article as recorded by  
  • Health effects associated with exposure to secondhand smoke: a Burden of Proof study
    Luisa S. Flor, Jason A. Anderson, Noah Ahmad, Aleksandr Aravkin, Sinclair Carr, Xiaochen Dai, Gabriela F. Gil, Simon I. Hay, Matthew J. Malloy, Susan A. McLaughlin, Erin C. Mullany, Christopher J. L. Murray, Erin M. O’Connell, Chukwuma Okereke, Reed J. D.
    Nature Medicine.2024; 30(1): 149.     CrossRef
  • Association of secondhand smoke exposure with all-cause mortality and cardiovascular death in patients with hypertension: Insights from NHANES
    Dikang Pan, Julong Guo, Sensen Wu, Hui Wang, Jingyu Wang, Cong Wang, Yongquan Gu
    Nutrition, Metabolism and Cardiovascular Diseases.2024;[Epub]     CrossRef
  • Predictive Value of Cardiovascular Health Score for Health Outcomes in Patients with PCI: Comparison between Life’s Simple 7 and Life’s Essential 8
    Xueqin Gao, Xinrui Ma, Ping Lin, Yini Wang, Zhenjuan Zhao, Rui Zhang, Bo Yu, Yanhua Hao
    International Journal of Environmental Research and Public Health.2023; 20(4): 3084.     CrossRef
  • A gender specific risk assessment of coronary heart disease based on physical examination data
    Hui Yang, Ya-Mei Luo, Cai-Yi Ma, Tian-Yu Zhang, Tao Zhou, Xiao-Lei Ren, Xiao-Lin He, Ke-Jun Deng, Dan Yan, Hua Tang, Hao Lin
    npj Digital Medicine.2023;[Epub]     CrossRef
  • The predictive accuracy of coronary heart disease risk prediction models in rural Northwestern China
    Jiangwei Qiu, Zhenqi Chang, Kai Wang, Kexin Chen, Qingan Wang, Jiaxing Zhang, Juan Li, Chan Yang, Yi Zhao, Yuhong Zhang
    Preventive Medicine Reports.2023; 36: 102503.     CrossRef
  • Risk factors for incident cardiovascular events among adults in low- and middle-income countries: A systematic review and meta-analysis of prospective cohort studies
    Mulugeta Molla Birhanu, Sojib Bin Zaman, Amanda G. Thrift, Roger G. Evans, Ayse Zengin
    Preventive Medicine.2022; 158: 107036.     CrossRef
  • Burden of current and past smoking across 28 European countries in 2017: A cross-sectional analysis
    Ayaka Teshima, Anthony Laverty, Filippos Filippidis
    Tobacco Induced Diseases.2022; 20(June): 1.     CrossRef
  • Role of Air Pollution and rs10830963 Polymorphism on the Incidence of Type 2 Diabetes: Tehran Cardiometabolic Genetic Study
    Fatemeh Jabbari, Anoushiravan Mohseni Bandpei, Maryam S. Daneshpour, Abbas Shahsavani, Seyed Saeed Hashemi Nazari, Hassanali Faraji Sabokbar, Amir abbas Momenan, Fereidoun Azizi
    Journal of Diabetes Research.2020; 2020: 1.     CrossRef
Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis
Seyed Saeed Hashemi Nazari, Yaser Mokhayeri, Mohammad Ali Mansournia, Soheila Khodakarim, Hamid Soori
Epidemiol Health. 2018;40:e2018021.   Published online May 21, 2018
DOI: https://doi.org/10.4178/epih.e2018021
  • 12,986 View
  • 264 Download
  • 11 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.
METHODS
Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.
RESULTS
The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).
CONCLUSIONS
Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.
Summary

Citations

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  • Comparison of data-driven identified hypertension-protective dietary patterns among Chinese adults: based on a nationwide study
    Yuxiang Yang, Wei Piao, Shuya Cai, Kun Huang, Changzheng Yuan, Xue Cheng, Ling Zhang, Yuge Li, Liyun Zhao, Dongmei Yu
    European Journal of Nutrition.2023; 62(7): 2805.     CrossRef
  • Associations between dietary patterns and cardiovascular disease risk in Canadian adults: a comparison of partial least squares, reduced rank regression, and the simplified dietary pattern technique
    Svilena V Lazarova, Mahsa Jessri
    The American Journal of Clinical Nutrition.2022; 116(2): 362.     CrossRef
  • Association Between Dietary Quality Indices and Atherosclerosis Risk: A Case-Control Study
    Mahsa Samadani, Anahita Mansoori, Habib Haybar, Fatemeh Haidari, Majid Mohammadshahi
    Nutrition and Metabolic Insights.2022; 15: 117863882211119.     CrossRef
  • Visceral adiposity-related dietary patterns and the risk of cardiovascular disease in Iranian adults: A population-based cohort study
    Nazanin Moslehi, Fatemeh Rahimi Sakak, Maryam Mahdavi, Parvin Mirmiran, Fereidoun Azizi
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Dietary patterns derived by reduced rank regression and non-communicable disease risk
    Carmen Piernas, Min Gao, Susan A. Jebb
    Proceedings of the Nutrition Society.2022; : 1.     CrossRef
  • Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort
    Hye Ah Lee, Hyoin An, EunJin Lee
    The American Journal of Clinical Nutrition.2020; 111(6): 1159.     CrossRef
  • Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population
    Jing Song, Xia Jiang, Yaying Cao, Juan Juan, Tao Wu, Yonghua Hu
    Journal of Atherosclerosis and Thrombosis.2019; 26(9): 835.     CrossRef
The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis
Yaser Mokhayeri, Seyed Saeed Hashemi-Nazari, Mohammad Ali Mansournia, Hamid Soori, Soheila Khodakarim
Epidemiol Health. 2017;39:e2017024.   Published online June 18, 2017
DOI: https://doi.org/10.4178/epih.e2017024
  • 12,887 View
  • 202 Download
  • 4 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.
METHODS
Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of followup was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.
RESULTS
During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.
CONCLUSIONS
These results suggest that PA is inversely associated with AF in women.
Summary

Citations

Citations to this article as recorded by  
  • Weekly physical activity and incident atrial fibrillation in females – A dose-response meta-analysis
    Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Eleni Lakka, Dimitrios Vrachatis, Spyridon Deftereos, Vassilios P. Vassilikos, Georgios Giannopoulos
    International Journal of Cardiology.2023; 370: 191.     CrossRef
  • Self-Reported Walking Pace and Risk of Cardiovascular Diseases: A Two-Sample Mendelian Randomization Study
    Lu Chen, Xingang Sun, Yuxian He, Liangrong Zheng
    Frontiers in Genetics.2022;[Epub]     CrossRef
  • Sex-Specific Exposure–Effect Relationship Between Physical Activity and Incident Atrial Fibrillation in the General Population: A Dose–Response Meta-Analysis of 16 Prospective Studies
    Qin Wan, Yue Zhou, Wengen Zhu, Xiao Liu
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
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