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Kiani B, Tabari P, Mohammadi A, Mostafavi SM, Moghadami M, Amini M, Rezaianzadeh A. Spatial epidemiology of skin cancer in Iran: separating sun-exposed and non-sun-exposed parts of the body. Arch Public Health 2022; 80:35. [PMID: 35057858 PMCID: PMC8772111 DOI: 10.1186/s13690-022-00798-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Skin cancer is among the most common cancer types with an increasing global trend of incidence rate. This study explores the spatial distribution of skin cancer, considering body sites exposed and not exposed to sunshine separately. Methods We used 4302 skin cancer cases recorded by Fars Cancer Registry in south-western Iran for over 6 years (2011–2017). The variables included in the study were patients’ residence address, gender, age, report date, and final topographical code. The patients’ addresses were geocoded to the counties of the study area. Skin cancer sites were categorized based on sun exposure in male and female cases. We used the empirical Bayesian smoothing approach to smooth the skin cancer incidence rate at the county level to remove any potential population size bias. Finally, Anselin’s Local Moran’s Index and Getis Ord G* were used to identify the clustered and high-risk skin cancer geographical areas. Results The incidence rates had an increasing trend from 14.28 per 100,000 people in 2011 to 17.87 per 100,000 people in 2016, however, it was decreased to 13.05 per 100,000 people in 2017. Out of 4302 patients with skin cancer, 2602 cases (60%) were male. The cancer cumulative incidence rate in males and females who were not exposed to sunshine was 7.80 and 14.18 per 100,000, respectively. The rates increased to 86.22 and 48.20 in males and females who were exposed to the sun. There were some high-risk spatial clusters of skin cancer in the study area. Further investigations are required to identify the underlying cause of the formation of these clusters. Conclusions Patients exposed to sunshine, especially among the male group, experienced much higher rates of cancer occurrence as compared to unexposed individuals. With a heterogeneous spatial pattern, hotspots were identified in non-sun-exposed and sun-exposed categories in the study area. Researchers and policymakers can significantly benefit from the spatial analyses of skin cancer incidence. These analyses can provide useful and timely prevention policies as well as tailored monitoring techniques in high-risk regions. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00798-2.
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Firouraghi N, Mohammadi A, Hamer DH, Bergquist R, Mostafavi SM, Shamsoddini A, Raouf-Rahmati A, Fakhar M, Moghaddas E, Kiani B. Spatio-temporal visualisation of cutaneous leishmaniasis in an endemic, urban area in Iran. Acta Trop 2022; 225:106181. [PMID: 34678259 DOI: 10.1016/j.actatropica.2021.106181] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/29/2021] [Accepted: 10/02/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Cutaneous Leishmaniasis (CL) is a significant public health concern worldwide. Iran is among the most CL-affected countries, being one of the six most endemic countries in the world. This study aimed to provide a spatio-temporal visualisation of CL cases in an endemic urban area in north-eastern Iran identifying high-risk and low-risk areas during the period 2016-2019. METHODS This ecological study was conducted in the city of Mashhad, north-eastern Iran. All cases (n=2425) were diagnosed based on clinical findings and parasitological tests. The patient data were aggregated at the census tract level (the highest resolution available). CL incidence rates were subjected to Empirical Bayesian smoothing across the census tracts followed by spatial autocorrelation analysis to identify clusters and outliers. Spatial scan statistic was used to explore the purely temporal, purely spatial and spatio-temporal trend of the disease. In all instances, the null hypothesis of no clusters was rejected at p ≤0.05. RESULTS The overall crude incidence rate decreased from 34.6 per 100,000 individuals in 2016 to 19.9 per 100,000 in 2019. Cluster analysis identified high-risk areas in south-western Mashhad and low-risk areas in the north-eastern areas. Purely time scan statistics identified March to July as the time period with highest risk for CL occurrence. One most likely purely high-risk spatial cluster and six secondary purely high-risk spatial clusters were identified. Further, two spatio-temporal high-risk clusters, one in the north of the city from April to August and a second in the south-western part from March to September were observed. CONCLUSIONS Significant spatial, temporal and spatio-temporal patterns of CL distribution were observed in the study area, which should be considered when designing tailored interventions, such as effective resource allocation models, informed control plans and implementation of efficient surveillance systems. Furthermore, this study generated new hypotheses to test potential relationships between socio-economic and environmental risk factors and incidence of CL in high-risk areas.
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Affiliation(s)
- Neda Firouraghi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Mohammadi
- Department of Geography and Urban Planning, Faculty of Social Sciences, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Robert Bergquist
- Swiss Tropical and Public Health Institute. Ingerod, Brastad, SE-454 94, Sweden (Formerly UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization), Geneva, Switzerland
| | - Sayyed Mostafa Mostafavi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Shamsoddini
- Department of Human Geography, Faculty of Humanities, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
| | - Amene Raouf-Rahmati
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Fakhar
- Department of Health and Health Promotion, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Moghaddas
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behzad Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Reeves N, Cuff S, Boyce K, Harries R, Roberts C, Harrison W, Torkington J. Diagnosis of colorectal and emergency surgical site infections in the era of enhanced recovery: an all-Wales prospective study. Colorectal Dis 2021; 23:1239-1247. [PMID: 33544977 DOI: 10.1111/codi.15569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/26/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
AIM Surgical site infections (SSIs) are associated with increased morbidity, hospital stay and cost. The literature reports that 25% of patients who undergo colorectal surgical procedures develop a SSI. Due to the enhanced recovery programme, patients are being discharged earlier with some SSIs presenting in primary care, making accurate recording of SSIs difficult. The aim of this study was to accurately record the 30-day SSI rate after surgery performed by colorectal surgeons nationally within Wales. METHOD During March 2019, a national prospective snapshot study of all patients undergoing elective or emergency colorectal and general surgical procedures under the care of a colorectal consultant at 12 Welsh hospitals was completed. There was a multimodal 30-day follow-up using electronic records, clinic visits and/or telephone calls. Diagnosis of SSI was based on Centers for Disease Control and Prevention diagnostic criteria. RESULTS Within Wales, of the 545 patients included, 13% developed a SSI within 30 days, with SSI rates of 14.3% for elective surgery and 11.7% for emergency surgery. Of these SSIs, 49.3% were diagnosed in primary care, with 28.2% of patients being managed exclusively in the community. There were two peaks of diagnosis at days 5-7 and days 22-28. SSI rates between laparoscopic (8.6%) and open (16.2%) surgeries were significantly different (p = 0.028), and there was also a significantly different rate of SSI between procedure groups (p = 0.001), with high SSI rates for colon (22%) and rectal (18.9%) surgery compared with general surgical procedures. CONCLUSION This first all-Wales prospective study demonstrated an overall SSI rate of 13%. By incorporating accurate primary care follow-up it was found that 49.3% of these SSIs were diagnosed in primary care.
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Affiliation(s)
- Nicola Reeves
- Colorectal Surgery, University Hospital of Wales, Cardiff, UK
| | - Simone Cuff
- Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Kathryn Boyce
- Colorectal Surgery, University Hospital of Wales, Cardiff, UK
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Montazeri M, Hoseini B, Firouraghi N, Kiani F, Raouf-Mobini H, Biabangard A, Dadashi A, Zolfaghari V, Ahmadian L, Eslami S, Bergquist R, Bagheri N, Kiani B. Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014 to 2017. BMC Cancer 2020; 20:1170. [PMID: 33256668 PMCID: PMC7708260 DOI: 10.1186/s12885-020-07674-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background The most common gender-specific malignancies are cancers of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores incidence patterns of potential high-risk clusters of breast and prostate cancers in southern Iran. Methods This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels calculating the incidence rate per 100,000 people both for cancers of the breast and the prostate. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017. Results There were 1350 breast cancer patients (including, 42 male cases) and 478 prostate cancer patients in the province of Kerman, Iran during the study period. After 45 years of age, the number of men with diagnosed prostate cancer increased similarly to that of breast cancer for women after 25 years of age. The age-standardised incidence rate of breast cancer for women showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014–2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the north-western part of the province for all years studied, but the analysis at the district level showed high-high clusters for only two of the years. With regard to prostate cancer, cluster analysis at the county and district levels identified high-high clusters in this area of the province for two of the study years. Conclusions North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer than the average, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses regarding the potential relationship between increased incidence of cancers in certain geographical areas and environmental risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-020-07674-8.
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Affiliation(s)
- Mahdieh Montazeri
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Health Information Technology, School of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Benyamin Hoseini
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Neda Firouraghi
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Raouf-Mobini
- Department of Health Information Technology, Faculty of Paramedicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Adele Biabangard
- Department of Health Information Technology, Faculty of Paramedicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ali Dadashi
- Medical Records Department, Vali-e-asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Vahideh Zolfaghari
- Department of Medical Educational Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Ahmadian
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeid Eslami
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robert Bergquist
- Ingerod, SE-454 94 Brastad, Sweden. Formerly UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Nasser Bagheri
- Visualisation and Decision Analytics (VIDEA) Lab, Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Behzad Kiani
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Kiani B, Raouf Rahmati A, Bergquist R, Moghaddas E. Comparing spatio-temporal distribution of the most common human parasitic infections in Iran over two periods 2007 to 2012 and 2013 to 2018: A systematic quantitative literature review. Int J Health Plann Manage 2020; 35:1023-1040. [PMID: 32567736 DOI: 10.1002/hpm.3010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/01/2023] Open
Abstract
This study analyses the spatio-temporal trend of the prevalence of the four most prevalent parasitic diseases in Iran over two periods, 2007 to 2012 and 2013 to 2018, indicating high-risk and low-risk areas. Out of 19 126 articles, we selected 220 articles for data extraction and calculated the pooled prevalence for cutaneous leishmaniasis, human toxoplasmosis, giardiasis and blastocystosis for all 31 provinces in the country. Anselin local Moran's I was used to identify clusters and outliers in the prevalence rates. The mean prevalence of cutaneous leishmaniasis patients was found 35.12 per 100 000 in 2007 to 2012 but fell to 19.12 per 100 000 in the 2013 to 2018 period. The mean prevalence of acute and chronic toxoplasmosis was 2.36% and 32.5%, respectively, in 2007 to 2012, which changed to 2.28% and 31.14% in 2013 to 2018. The total prevalence of giardiasis declined from 9.8% in 2007 to 2012 to 4.8% in 2013 to 2018, while the mean prevalence of blastocystosis declined from 8.9% in 2007 to 2012 to 6.76% in the 2013 to 2018 period. There was only one high-high cluster in 2007 to 2012 and that was due to giardiasis, while there were two in 2013 to 2018, one for blastocystosis and one for chronic toxoplasmosis. The total prevalence of blastocystosis, giardiasis and cutaneous leishmaniasis in Iran has continually declined since 2007. In contrast, the prevalence of toxoplasmosis in pregnant Iranian women has not been changed. Iran's Midwest has more parasitic infections compared to the Mideast, which may be explained by the existence of vast deserts and consequently dry and hot climate in the latter part of the country.
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Affiliation(s)
- Behzad Kiani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amene Raouf Rahmati
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robert Bergquist
- Ingerod, Brastad, Sweden. Formerly UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Elham Moghaddas
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Shabanikiya H, Hashtarkhani S, Bergquist R, Bagheri N, VafaeiNejad R, Amiri-Gholanlou M, Akbari T, Kiani B. Multiple-scale spatial analysis of paediatric, pedestrian road traffic injuries in a major city in North-Eastern Iran 2015-2019. BMC Public Health 2020; 20:722. [PMID: 32430028 PMCID: PMC7236119 DOI: 10.1186/s12889-020-08911-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background Paediatric, pedestrian road traffic injuries (PPRTIs) constitute a major cause of premature death in Iran. Identification of high-risk areas would be the primary step in designing policy intervention for PPRTI reduction because environmental factors play a significant role in these events. The present study aims to determine high-risk areas for PPRTIs at three different geographical scales, including the grid network, the urban neighbourhood and the street levels in Mashhad, Iran during the period 2015–2019. Methods This cross-sectional retrospective study was based on all pedestrian accidents with motor vehicles involving children (less than 18 years of age) between March 2015 and March 2019 in the city of Mashhad, which is the second-most populous city in Iran. The Anselin Local Moran’s I statistic and Getis-Ord Gi* were performed to measure spatial autocorrelation and hotspots of PPRTIs at the geographical grid network and neighbourhood level. Furthermore, a spatial buffer analysis was used to classify the streets according to their PPRTI rate. Results A total of 7390 PPRTIs (2364 females and 4974 males) were noted during the study period. The children’s mean age was 9.7 ± 5.1 years. Out of the total PPRTIs, 43% occurred on or at the sides of the streets, 25 of which labelled high-risk streets. A high-high cluster of PPRTI was discovered in the eastern part of the city, while there was a low-low such cluster in the West. Additionally, in the western part of the city, older children were more likely to become injured, while in the north-eastern and south-eastern parts, younger children were more often the victims. Conclusions Spatial analysis of PPRTIs in an urban area was carried out at three different geographical scales: the grid network, the neighbourhood and the street level. The resulting documentation contributes reliable support for the implementation and prioritization of preventive strategies, such as improvement of the high-risk streets and neighbourhoods of the city that should lead to decreasing numbers of PPRTIs.
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Affiliation(s)
- Hamidreza Shabanikiya
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheil Hashtarkhani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robert Bergquist
- Ingerod, Brastad, Sweden (formerly with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization), Geneva, Switzerland
| | - Nasser Bagheri
- Visualization and Decision Analytics (VIDEA) lab, Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Reza VafaeiNejad
- Center for Accident and Emergency Medicine Management, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Amiri-Gholanlou
- Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Akbari
- Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behzad Kiani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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