The burden of disease and injury in Iran 2003

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Abstract

Background

The objective of this study was to estimate the burden of disease and injury in Iran for the year 2003, using Disability-Adjusted Life Years (DALYs) at the national level and for six selected provinces.

Methods

Methods developed by the World Health Organization for National Burden of Disease (NBD) studies were applied to estimate disease and injury incidence for the calculation of Years of Life Lost due to premature mortality (YLL), Years Lived with Disability (YLD), and DALYs. The following adjustments of the NBD methodology were made in this study: a revised list with 213 disease and injury causes, development of new and more specific disease modeling templates for cancers and injuries, and adjustment for dependent comorbidity. We compared the results with World Health Organization (WHO) estimates for Eastern Mediterranean Region, sub-region B in 2002.

Results

We estimated that in the year 2003, there were 21,572 DALYs due to all diseases and injuries per 100,000 Iranian people of all ages and both sexes. From this total number of DALYs, 62% were due to disability premature deaths (YLD) and 38% were due to premature deaths (YLL); 58% were due to noncommunicable diseases, 28% – to injuries, and 14% – to communicable, maternal, perinatal, and nutritional conditions. Fifty-three percent of the total number of 14.349 million DALYs in Iran were in males, with 36.5% of the total due to intentional and unintentional injuries, 15% due to mental and behavioral disorders, and 10% due to circulatory system diseases; and 47% of DALYs were in females, with 18% of the total due to mental and behavioral disorders, 18% due to intentional and unintentional injuries, and 12% due to circulatory system diseases. The disease and injury causes leading to the highest number of DALYs in males were road traffic accidents (1.071 million), natural disasters (548 thousand), opioid use (510 thousand), and ischemic heart disease (434 thousand). The leading causes of DALYs in females were ischemic heart disease (438 thousand), major depressive disorder (420 thousand), natural disasters (419 thousand), and road traffic accidents (235 thousand). The burden of disease at the province level showed marked variability. DALY estimates by Iran's NBD study were higher than those for EMR-B by WHO.

Conclusion

The health and disease profile in Iran has made the transition from the dominance of communicable diseases to that of noncommunicable diseases and road traffic injuries. NBD results are to be used in health program planning, research, and resource allocation and generation policies and practices.

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Most cited references 22

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A generic model for the assessment of disease epidemiology: the computational basis of DisMod II

Jan J Barendregt, Gerrit van Oortmarssen, Theo Vos … (2003)

Epidemiology as an empirical science has developed sophisticated methods to measure the causes and patterns of disease in populations. Nevertheless, for many diseases in many countries only partial data are available. When the partial data are insufficient, but data collection is not an option, it is possible to supplement the data by exploiting the causal relations between the various variables that describe a disease process. We present a simple generic disease model with incidence, one prevalent state, and case fatality and remission. We derive a set of equations that describes this disease process and allows calculation of the complete epidemiology of a disease given a minimum of three input variables. We give the example of asthma with age-specific prevalence, remission, and mortality as inputs. Outputs are incidence and case fatality, among others. The set of equations is embedded in a software package called 'DisMod II', which is made available to the public domain by the World Health Organization.

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Decomposing socioeconomic inequality in infant mortality in Iran.

Eddy van Roon, Bahram DELAVAR, Jeanette Vega … (2006)

Although measuring socioeconomic inequality in population health indicators like infant mortality is important, more interesting for policy purposes is to try to explain infant mortality inequality. The objective of this paper is to quantify for the first time the determinants' contributions of socioeconomic inequality in infant mortality in Iran. A nationally representative sample of 108 875 live births from October 1990 to September 1999 was selected. The data were taken from the Iranian Demographic and Health Survey (DHS) conducted in 2000. Households' socioeconomic status was measured using principal component analysis. The concentration index of infant mortality was used as our measure of socioeconomic inequality and decomposed into its determining factors. The largest contributions to inequality in infant mortality were owing to household economic status (36.2%) and mother's education (20.9%). Residency in rural/urban areas (13.9%), birth interval (13.0%), and hygienic status of toilet (11.9%) also proved important contributors to the measured inequality. The findings indicate that socioeconomic inequality in infant mortality in Iran is determined not only by health system functions but also by factors beyond the scope of health authorities and care delivery system. This implies that in addition to reducing inequalities in wealth and education, investments in water and sanitation infrastructure and programmes (especially in rural areas) are necessary to realize improvements of inequality in infant mortality across society. These findings can be instrumental for the recent 5 year Economic, Social and Cultural Development Plan of Iran, which identified the reduction of inequalities in social determinants of health.

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An epidemiological survey of psychiatric disorders in Iran

Mohammad Reza Mohammadi, Haratoon Davidian, Ahmad Ali Noorbala … (2005)

Background The nation-wide epidemiological survey of psychiatric disorders in term of lifetime prevalence is not adequately known in Iran. The prevalence of lifetime psychiatric disorders was estimated among the population of aged 18 and over on gender, age group, educational level, occupational status, marital status, and residential area. Methods The subjects were 25,180 individuals selected through a clustered random sampling method. The psychiatric disorders were diagnosed on the bases of Diagnostic and Statistical Manual of Mental Disorders-IV criteria. It is the first study in which the structured psychiatric interview administered to a representative sample of the Iranian population age 18 and over by the 250 trained clinical psychologist interviewers. The data was entered through EPI-Info software twice in an attempt to prevent any errors and SPSS-11 statistical software was also used for analyses. The odds ratios and their confidence intervals estimated by using logistic regression. Results and Discussion The prevalence of psychiatric disorders was 10.81%. It was more common among females than males (14.34% vs. 7.34%, P < 0.001). The prevalence of anxiety and mood disorders were 8.35% and 4.29% respectively. The prevalence of psychotic disorders was 0.89%; neuro-cognitive disorders, 2.78% and dissociative disorders, 0.77%. Among mood disorders, major depressive disorder (2.98%) and among anxiety disorders, phobic disorder (2.05%) had the higher prevalence. The prevalence of psychiatric disorders among divorced and separated 22.31%; residents of urban areas 11.77%; illiterates 13.80%; householders 15.48%; unemployed 12.33% that were more than other groups. Conclusion The mental health pattern in Iran is similar to the western countries, but it seems that the prevalence of psychiatric disorders in Iran may be lower than these countries. It is estimated that at least about 7 millions of Iranian population suffer from one or more of the psychiatric disorders. It shows the importance of the role of the psychiatric disorders in providing preventive and management programs in Iran.

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Author and article information

Journal

Journal ID (nlm-ta): Popul Health Metr

Title: Population Health Metrics

Publisher: BioMed Central

ISSN (Electronic): 1478-7954

Publication date Collection: 2009

Publication date (Electronic): 15 June 2009

Volume: 7

Page: 9

Affiliations

[1 ]Health Programs Management Bureau, Health Network Development Center, Health Deputy, Ministry of Health and Medical Education, Hafez Jomhouri Crossroad, Tehran, Iran

[2 ]Currently Associate Professor of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA

[3 ]Internal Diseases Department, Faculty of Medicine, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran

[4 ]Epidemiology and Biostatistics Department, Faculty of Health, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran

[5 ] Currently Post-Graduate Fellow in Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA

[6 ]Community Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Hemmat Expressway, Tehran, Iran

[7 ]Psychosocial Health Bureau, Mental Health Department, Health Deputy, Ministry of Health and Medical Education, Hafez Jomhouri Crossroad, Tehran, Iran

[8 ]Shaheed Beheshti University of Medical Sciences, Tehran, Iran

Article

Publisher ID: 1478-7954-7-9

DOI: 10.1186/1478-7954-7-9

PMC ID: 2711041

PubMed ID: 19527516

SO-VID: a2d59e4f-aded-45b3-98ec-b8c6c0640676

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The burden of disease and injury in Iran 2003

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Most cited references 22

A generic model for the assessment of disease epidemiology: the computational basis of DisMod II

Decomposing socioeconomic inequality in infant mortality in Iran.

An epidemiological survey of psychiatric disorders in Iran

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