The protocol of a population-based prospective cohort study in southwest of Iran to analyze common non-communicable diseases: Shahrekord cohort study

Investigation of the levels of essential and non-essential metals in women with and without abortion history: A study based on the Persian population of the Shahrekord cohort

Spontaneous abortion is a serious threat to the mothers' physical and mental well-being. The cause of spontaneous abortion is multifactorial disease. Prenatal non-essential metal exposure, particularly heavy metals, has been suggested to be associated with adverse pregnancy and birth outcomes. The purpose of this study was to investigate the relationship between the concentration of essential and non-essential metals including Pb, As, Zn, and Se and the risk of spontaneous abortion. In this case-control study the levels of Pb, As, Zn, and Se in the whole blood of 60 women with spontaneous abortion (case group) and also 60 women without spontaneous abortion (control group) were measured by atomic absorption spectrophotometry. Results revealed statistically significant reductions (P < 0.001) in whole blood levels of Zn and Se as well as the levels of As and Pb had a substantial elevation (P < 0.001) in cases compared to controls. According to the findings, repeated spontaneous abortion may be influenced by increasing whole blood levels of heavy metals such as As (OR = 17.53, P = 0.001) and Pb (OR = 15.58, P = 0.001) as well as decreasing levels of vital micronutrients Zn (OR = 0.20, P = 0.001) and Se (OR = 0.14, P = 0.001). The results of this study support the idea that limiting intake of non-essential metals during pregnancy can decrease the risk of spontaneous abortion. Overall, the information presented is expected to help plan future fundamental and applied investigations on the spontaneous abortion.

Dietary antioxidants and liver enzymes in Rafsanjan, a Region in Southeast Iran

Oxidative stress has been considered the main contributor to liver injury. Dietary antioxidants would be expected to improve liver function. The hepatoprotective effects of antioxidants are controversial. In the present study, the associations of some dietary antioxidants and the levels of serum liver enzymes were examined. This cross-sectional study was conducted using the Rafsanjan Cohort Study (RCS) data as a population-based prospective cohort which is a part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). A total of 9942 participants aged 35-70 years old were included in this study. Among this population, 4631 (46.59%) were male, and 5311 (53.42%) were female. Dietary intakes were collected by a validated food frequency questionnaire (FFQ) with 128 items. Aspartate transaminase (AST), Alanine transaminase (ALT), γ-glutamyl transferase (GGT), and Alkaline phosphatase (ALP) were measured by a biotecnica analyzer. Dichotomous logistics regression models were used to investigate the association between the elevated liver enzymes and intake of dietary antioxidants using crude and adjusted models. In the adjusted model, in subjects with higher consumption of Se, Vit A, Vit E, β-carotene, α-carotene, and β-cryptoxanthin, the odds ratios of elevated ALP were decreased compared to the reference group (ORs 0.79 (0.64-0.96), 0.80 (0.66-0.98), 0.73 (0.60-0.89), 0.79 (0.64-0.96), 0.78 (0.64-0.95), 0.80 (0.66-0.98), and 0.79 (0.64-0.98), respectively). Subjects with higher consumption of Se, Vit A, Vit E, and provitamin A carotenoids (β-carotene, α-carotene, β-cryptoxanthin) showed decreased odds of elevated ALP. These findings support the hypothesis that Se, Vit A, Vit E, and provitamin A carotenoids may be associated with improvements in ALP and act as suppressors against the development of liver injury.

Sleep characteristics of middle-aged adults with non-alcoholic fatty liver disease: findings from the Shahrekord PERSIAN cohort study

BACKGROUND

Several studies have reported short sleep duration in people with non-alcoholic fatty liver disease (NAFLD) but other sleep characteristics have been less studied. We aimed to assess the cross-sectional association of NAFLD with sleep duration and quality in an Iranian population sample.

METHODS

We used data from 9,151 participants in the Shahrekord Prospective Epidemiological Research Studies in Iran (PERSIAN) Cohort Study, including 1,320 that were diagnosed with NAFLD. Log-binomial regression models sequentially adjusted for sociodemographic, lifestyle, clinical and biological variables were used to estimate relative risks (RR) and 95% confidence intervals (95% CI) for the association between NAFLD and sleep characteristics.

RESULTS

Participants with NAFLD had shorter sleep duration, later wake-up time and bedtime, worse sleep efficiency, and more frequent daytime napping and use of sleeping pills, in age- and sex-adjusted models. After controlling for sociodemographic, lifestyle, clinical, and biological variables the associations remained strong for sleep efficiency (per 10%, RR = 0.92, 95%CI: 0.88-0.96) and use of sleeping pills (RR = 1.48, 95%CI: 1.17-1.88). The association between NAFLD and sleep efficiency was stronger in participants aged > 60 years (RR = 0.81, 0.70-0.93) and 40-60 years (RR = 0.87, 0.82-0.94), compared with those aged < 40 years (P-heterogeneity < 0.001). More frequent daytime napping in participants with NAFLD, compared with non-NAFLD, was observed in males but not females (P-heterogeneity = 0.007), and in those with body mass index (BMI) < 30 but not in obese participants (P-heterogeneity < 0.001).

CONCLUSIONS

Diagnosis of NAFLD is associated with several poor sleep characteristics in middle-aged Iranians. Although longitudinal studies would help to clarify the direction of causality, our study shows that poor sleep is an important aspect of NAFLD.

The Prevalence of Metabolic Syndrome, Scoring, and Comparison in People With and Without COPD: Evidence from Shahrekord PERSIAN Cohort Study

Background: Comorbidities are common in patients with chronic obstructive pulmonary diseases (COPDs), including metabolic syndrome (MetS). This study aimed to determine the prevalence of MetS and its components in people with and without COPD. Methods: This population-based study was performed on 6961 adults in the Shahrekord Prospective Epidemiological Research Studies in Iran. Data collection, spirometry, and COPD diagnosis were performed according to the cohort protocol from 2015 to 2019. The data were analyzed by two independent sample t-tests, analysis of covariance, chi-square, and odds ratio (OR) with 95% confidence interval (95% CI) in logistic regression models. P value <0.05 was considered statistically significant. All analyses were conducted using Stata Statistical Software Release 16 (Stata Corp., College Station, TX). Results: The prevalence of MetS in patients with and without COPD was 28.4% and 31%, respectively. The most common components of MetS in people with COPD were low high-density lipoprotein cholesterol (47.4%), waist circumference (43.9%), and high fasting plasma glucose (39.3%). There was a statistically significant difference in the frequency of respiratory dysfunction between people with and without MetS. Being older than 60 (OR = 2.20, 95% CI: 1.72-2.80), female (OR = 1.36, 95% CI: 1.49-1.97), obese (OR = 11.17, 95% CI: 9.02-13.62), and uneducated (OR = 1.80, 95% CI: 1.49-2.17), and living in urban areas (OR = 1.96, 95% CI: 1.64-2.35) are stronger predictors of MetS in this population. Conclusion: There was no significant difference in the prevalence of MetS between patients with and without COPD. Spirometry parameters and respiratory problems were significant in subjects with and without MetS.

Alarm of non-communicable disease in Iran: Kavar cohort profile, baseline and 18-month follow up results from a prospective population-based study in urban area

The PERSIAN Kavar cohort study (PKCS) aims to investigate the prevalence, trends, and relevant prognostic risk factors of non-communicable diseases in participants aged 35-70 years living in the urban area of Kavar County. Kavar County is located at the center of Fars province in the southwest of Iran. Overall, 5236 adults aged 35-70 years old were invited to participate in the PKCS. From whom, 4997 people comprising 2419 men and 2578 women met the inclusion criteria and were recruited in the study (participation rate: 95.4%). This study is aimed to follow participants for at least 10 years; it is designed to perform all procedures similar to the primary phase including biological sampling, laboratory tests, physical examinations, and collecting general, nutritional, and medical data at the 5th and 10th years of follow-up. In addition, participants are annually followed-up by phone to acquire data on the history of hospitalization, any major diagnosis or death. At the enrollment phase, trained interviewers were responsible for obtaining general, nutritional, and medical data utilizing a 482-item questionnaire. The results of the baseline phase of this study show that the overweight category was the most prevalent BMI category among the registered participants (n = 2005, 40.14%). Also, almost one-third of Kavar adult population suffered from metabolic syndrome at the baseline phase (n = 1664, 33.30%). The rate of eighteen-month follow-up response was 100% in the PKCS. Hypertension (n = 116, 2.32%), cardiovascular outcomes (n = 33, 0.66%), and diabetes (n = 32, 0.64%) were the most prevalent new-onset NCDs during eighteen months of follow-up in the participants.

Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study

Background

Critical inter-provincial differences within Iran in the pattern of non-communicable diseases (NCDs) and difficulties inherent to identifying prevention methods to reduce mortality from NCDs have challenged the implementation of the provincial health system plan. The Shahrekord Cohort Study (SCS) was designed to address these gaps in Chaharmahal and Bakhtiari, a province of high altitude in the southwest of Iran, characterized by its large Bakhtiari population, along with Fars and Turk ethnicity groups.

Methods

This ongoing cohort, a prospective, large-scale longitudinal study, includes a unique, rich biobank and was conducted for the first time in Chaharmahal and Bakhtiari Province in Iran. SCS is a part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort. The study began in 2015, recruited 10075 participants (52.8% female, 47.2% male) from both urban (n=7034) and rural (n=3041) areas, and participants will be annually followed up for at least 15 years. A cross-sectional analysis was conducted using baseline data from the SCS, using descriptive statistics and logistic regression. Data analysis was performed using Stata software.

Results

The prevalence of NCDs was 9.8% for type 2 diabetes, 17.1% for hypertension, 11.6% for thyroid disease, 0.2% for multiple sclerosis and 5.7, 0.9 and 1.3% for ischemic heart disease, stroke and myocardial infarction, respectively. The prevalence of multimorbidity (≥2 NCDs) was higher in women (39.1%) than men (24.9%). The means (standard deviations) of age, BMI, systolic blood pressure and fasting blood glucose were 49.5 (9) years, 27.6 (4.6) kg/m², 115.4 (17.3) mmHg and 96.7 (27.3) mg/dL, respectively. Logistic regression models showed that older age, female gender, living in an urban area, non-native ethnicity, high wealth index, unemployment, obesity, low physical activity, hypertriglyceridemia, high fasting blood sugar, alkaline urine pH and high systolic and diastolic blood pressure were associated with increased prevalence of NCDs.

Conclusions

The SCS provides a platform for epidemiological studies that will be useful to better control NCDs in the southwest of Iran and to foster research collaboration. The SCS will be an essential resource for identifying NCD risk factors in this region and designing relevant public health interventions.

Profile and preliminary results of Iranian sub cohort chronic obstructive pulmonary disease (COPD) in Shahrekord PERSIAN cohort in southwest Iran

Background

Chronic obstructive pulmonary disease (COPD) is a chronic and complex respiratory disorder associated with airflow limitation and increased inflammatory response of the lungs to harmful particles. The purpose of this original study was to describe the results and profile of the Shahrekord Prospective Epidemiological Research Studies in IrAN (PERSIAN) regarding COPD in southwestern Iran.

Methods

This study of asthma and respiratory diseases is a subcohort of the more extensive cohort study, i.e., Shahrekord PERSIAN cohort, a population-based prospective study on people aged 35–70 years in southwestern Iran (n = 10,075). The sample size of the subcohort was 8500 people. Annual follow-ups (person-year) of the cohort were designed to be conducted up to 2036. The instruments to collect data on various exposures were derived from the questionnaires previously developed in extensive multinational studies (occupational exposures, smoking, housing status, and fuel consumption, history of respiratory and chronic diseases, comorbidity, etc.). The Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the lower limit of normal (LLN) spirometric criteria were used to confirm COPD diagnosis.

Results

The response rate was 93.85%. The mean age of the participants was 49.48 ± 9.32; 47.9% were male, and 52.9% were female; nearly 16% of the population was current smokers; the fuel used by most of the participants for heating the house and cooking was gas. The most common comorbidity among participants was dyslipidemia; 30% of people have three or more comorbidities. According to GOLD and LLN criteria, the Prevalence of COPD was 3.6% and 8.4%, respectively. 4.3% of the participants had a history of chronic lung disease. The group of subjects with COPD had higher mean age, fewer years of schooling, a higher percentage of smokers with a smoking history of 10 or more pack years. 4.6% of patients had a history of chronic lung disease, 17.6% had a history of asthma in childhood, and 5.2% had a family history of respiratory and pulmonary diseases.

Conclusion

Epidemiological research is necessary to create an appropriate framework to fight COPD. This framework requires a better description of men and women at risk of developing COPD and describing people with early-stage illnesses.

Prevalence of different comorbidities in chronic obstructive pulmonary disease among Shahrekord PERSIAN cohort study in southwest Iran

Comorbidities are common in chronic obstructive pulmonary disease (COPD) patients. This study was conducted to determine the prevalence of common comorbidities in patients with COPD compared with people without COPD. This cross-sectional, population-based study was performed on 6961 adults aged 35-70 years enrolled in the Shahrekord PERSIAN cohort study. Data (demographic and clinical characteristics, comorbidities, anthropometric and blood pressure measurements, laboratory, and spirometry tests) collection was performed according to the cohort protocol from 2015 to 2019. In the present study, 215 (3.1%) patients were diagnosed with COPD and 1753 (25.18%) ones with restrictive lung patterns. The mean age of COPD patients was 52.5 ± 9.76 years. 55.8% of patients were male, 17.7% were current smokers and 12.1% had a history of smoking or were former smokers. 5.6% of patients had no comorbidity and 94.5% had at least one comorbidity. The most common comorbidities in COPD patients were dyslipidemia (70.2%), hypertension (30.2%), metabolic syndrome (22.8%), and diabetes (16.7%). The most common comorbidities in individuals with a restrictive spirometry pattern were dyslipidemia (68.9%), metabolic syndrome (27.2%), hypertension (26.1%), depression (17.6%), and fatty liver (15.5%). The logistic regression analysis with 95% confidence interval (95%CI) of odds ratio (OR) showed that comorbidities of chronic lung diseases (OR = 2.12, 95% CI 1.30-3.44), diabetes (OR = 1.54, 95%CI 1.03-2.29), cardiovascular disease (OR = 1.52, 95%CI 1.17-2.43), and hypertension (OR = 1.4, 95%CI 1.02-1.99) were more likely to occur in COPD patients than in healthy individuals. Knowing these prevalence rates and related information provides new insights on comorbidities to reduce disease burden and develop preventive interventions and to regulate health care resources to meet the needs of patients in primary health care.

The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study

INTRODUCTION

The SARS-CoV-2, virus that caused the COVID-19 global pandemic, possesses a neuroinvasive potential. Patients with COVID-19 infection present with neurological signs and symptoms aside from the usual respiratory affectation. Moreover, COVID-19 is associated with several neurological diseases and complications, which may eventually affect clinical outcomes.

OBJECTIVES

The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA) study investigators will conduct a nationwide, multicentre study involving 37 institutions that aims to determine the neurological manifestations and factors associated with clinical outcomes in COVID-19 infection.

METHODOLOGY AND ANALYSIS

This is a retrospective cohort study (comparative between patients with and without neurological manifestations) via medical chart review involving adult patients with COVID-19 infection. Sample size was determined at 1342 patients. Demographic, clinical and neurological profiles will be obtained and summarised using descriptive statistics. Student's t-test for two independent samples and χ² test will be used to determine differences between distributions. HRs and 95% CI will be used as an outcome measure. Kaplan-Meier curves will be constructed to plot the time to onset of mortality (survival), respiratory failure, intensive care unit (ICU) admission, duration of ventilator dependence, length of ICU stay and length of hospital stay. The log-rank test will be employed to compare the Kaplan-Meier curves. Stratified analysis will be performed to identify confounders and effects modifiers. To compute for adjusted HR with 95% CI, crude HR of outcomes will be adjusted according to the prespecified possible confounders. Cox proportional regression models will be used to determine significant factors of outcomes. Testing for goodness of fit will also be done using Hosmer-Lemeshow test. Subgroup analysis will be performed for proven prespecified effect modifiers. The effects of missing data and outliers will also be evaluated in this study.

ETHICS AND DISSEMINATION

This protocol was approved by the Single Joint Research Ethics Board of the Philippine Department of Health (SJREB-2020-24) and the institutional review board of the different study sites. The dissemination of results will be conducted through scientific/medical conferences and through journal publication. The lay versions of the results may be provided on request.

TRIAL REGISTRATION NUMBER

NCT04386083.

The burden and predisposing factors of non-communicable diseases in Mashhad University of Medical Sciences personnel: a prospective 15-year organizational cohort study protocol and baseline assessment

Background

The rising burden of premature mortality for Non-Communicable Diseases (NCDs) in developing countries necessitates the institutionalization of a comprehensive surveillance framework to track trends and provide evidence to design, implement, and evaluate preventive strategies. This study aims to conduct an organization-based prospective cohort study on the NCDs and NCD-related secondary outcomes in adult personnel of the Mashhad University of Medical Sciences (MUMS) as main target population.

Methods

This study was designed to recruit 12,000 adults aged between 30 and 70 years for 15 years. Baseline assessment includes a wide range of established NCD risk factors obtaining by face-to-face interview or examination. The questionnaires consist of demographic and socioeconomic characteristics, lifestyle pattern, fuel consumption and pesticide exposures, occupational history and hazards, personal and familial medical history, medication profile, oral hygiene, reproduction history, dietary intake, and psychological conditions. Examinations include body size and composition test, abdominopelvic and thyroid ultrasonography, orthopedic evaluation, pulse wave velocity test, electrocardiography, blood pressure measurement, smell-taste evaluation, spirometry, mammography, and preferred tea temperature assessment. Routine biochemical, cell count, and fecal occult blood tests are also performed, and the biological samples (i.e., blood, urine, hair, and nail) are stored in preserving temperature. Annual telephone interviews and repeated examinations at 5-year intervals are planned to update information on health status and its determinants.

Results

A total of 5287 individuals (mean age of 43.9 ± 7.6 and 45.9% male) were included in the study thus far. About 18.5% were nurses and midwives and 44.2% had at least bachelor’s degree. Fatty liver (15.4%), thyroid disorders (11.2%), hypertension (8.8%), and diabetes (4.9%) were the most prevalent NCDs. A large proportion of the population had some degree of anxiety (64.2%). Low physical activity (13 ± 22.4 min per day), high calorie intake (3079 ± 1252), and poor pulse-wave velocity (7.2 ± 1.6 m/s) highlight the need for strategies to improve lifestyle behaviors.

Conclusion

The PERSIAN Organizational Cohort study in Mashhad University of Medical Sciences is the first organizational cohort study in a metropolitan city of Iran aiming to provide a large data repository on the prevalence and risk factors of the NCDs in a developing country for future national and international research cooperation.

Estimation of the 10-Year Risk of Cardiovascular Diseases: Using the SCORE, WHO/ISH, and Framingham Models in the Shahrekord Cohort Study in Southwestern Iran

Background: Predicting the risk of cardiovascular diseases (CVDs) helps the management of high-risk individuals by the health system. We sought to determine the 10-year risk of CVDs in the Shahrekord Cohort Study (SCS).

Methods: In this cross-sectional study based on the SCS in the southwest of Iran, the demographic, anthropometric, clinical, and laboratory data of 5152 persons recruited in the SCS by census method from 2016 to 2017 were used. R software was utilized to calculate the 10-year risk of CVDs according to the World Health Organization/International Society of Hypertension (WHO/ISH) chart, the Framingham Risk Score (FRS) model, and the Systematic Coronary Risk Evaluation (SCORE) model.

Results: The mean age of the participants was 49.49±9.40 years, and 50.3% of them were female. According to the WHO/ISH chart, 94.1% of the participants were in the low-risk class, 4.1% in the moderate-risk class, and 0.4% in the high-risk class. Based on the FRS model, 72.2% of the participants were in the low-risk class, 18% in the middle-risk class, and 9.8% in the high-risk class. On the basis of the SCORE model for low-risk areas, 55.3% of the participants were in the low-risk class, 39.6% in the moderate-risk class, and 5.1% in the high-risk class. The agreement concerning risk estimation between the models was approximately 70%.

Conclusion: The risk estimated in this study was higher than that in other similar studies. For monitoring risk trends over time, it is essential to nativize a valid risk function, including ethnicity and geographical characteristics, for the Iranian population.

The Investigation of Psychometric Properties (Validity and Reliability Reassessment) of WHO QOL-BREF Questionnaire in Shahrekord Cohort Study

Background and aims: The purpose of this study was to revalidate the Persian version of the WHO quality of life (WHOQOL-BREF) instrument to determine the quality of life status in the Shahrekord Cohort Study (SCS) in the southwest of Iran. This study was designed to serve as one of the sources of the Prospective Epidemiological Research Studies in Iran. Materials and Methods: In this cross-sectional study, 2000 people were randomly selected from the study population of the SCS. The reliability and internal consistency of the WHOQOL-BREF were measured using Cronbach alpha coefficient and Pearson’s correlation. construct validity and factors measured using Pearson’s correlation matrices with each of its domains. To measure the face, content, and construct validities, the views of the panel of experts and exploratory factor analysis were used. In addition, the validity of the questionnaire was evaluated using linear regression. Results: All domains of the questionnaire met the minimum reliability standards (Cronbach alpha and intra-class correlation >0.7), except for social relationships. The results of comparison analysis indicated that the questionnaire discriminated well between subgroups of the study samples differing in their health status. Regarding validity, the Kaiser-Meyer-Olkin (KMO) value was 0.94 and the value of Bartlett’s test was 1699.01 (P≤0.001). Conclusion: The findings suggested that WHOQOL-BREF is a reliable and valid measure of healthrelated quality of life among SCS population.

Prevalence and risk factors of non-alcoholic fatty liver disease in southwest Iran: a population-based case-control study

Aim of the study

Few population-based studies have been conducted to report the prevalence of non-alcoholic fatty liver disease (NAFLD) and determine its risk factors in Iran, particularly in Shahrekord, southwest Iran. The main aim of this population-based, case-control study was to determine the prevalence of NAFLD and its potential risk factors in an Iranian population-based cohort study in Shahrekord, Iran.

Material and methods

We compared 1153 cases with NAFLD at 35 to 70 years to 1153 frequency-matched NAFLD-free controls from a population-based Shahrekord cohort study. Data collection and assessed risk factors (demographics, anthropometrics, clinical and biochemical factors, and laboratory tests) were performed based on the Shahrekord cohort study protocol. Chi-square test, stepwise selection with backward likelihood ratio, logistic regression and log-binomial regression model with 95% confidence interval were performed to determine risk factors with significant effects on NAFLD.

Results

In this study, the mean (± standard deviation) age of the participants was 50.23 (±8.70) years. The prevalence of NAFLD and metabolic syndrome with 95% confidence interval were 16.47% (15.61-17.36%) and 32.74% (30.83-34.70%), respectively. There was a significant difference in the frequency of waist circumstance, triglycerides, body mass index, blood pressure, and alanine aminotransferase between cases and controls (p < 0.001). According to log-binomial model results, socioeconomic status, hypertension, diabetes, and physical activity were significantly associated with NAFLD.

Conclusions

Our findings have important clinical and public health implications in southwest Iran for monitoring the prevalence of NAFLD and important risk factors to manage, screen, prevent, and reduce NAFLD and related factors.

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Background

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. We aimed to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

Methods

We conducted a scoping review to map the extent of current NCDs research in SSA by identifying studies published after the year 2000 using prospectively collected cohort data on any of the six NCDs (cardiovascular diseases, diabetes, obesity, chronic kidney disease, chronic respiratory diseases, and cancers), ≥1 major risk factor (other than age and sex), set only within SSA, enrolled ≥500 participants, and ≥12 months of follow-up with ≥2 data collection points (or with plans to). We performed a systematic search of databases, a manual search of references lists from included articles and the INDEPTH network website, and study investigators from SSA were contacted for further articles.

Results

We identified 30 cohort studies from the 101 included articles. Eighteen countries distributed in West, Central, East and Southern Africa, were represented. The majority (27%) set in South Africa. There were three studies including children, twenty with adults, and seven with both. 53% of cohorts were sampled in general populations, 47% in clinical populations, and 1 occupational cohort study. Hypertension (n = 23) was most commonly reported, followed by obesity (n = 16), diabetes (n = 15), CKD (n = 6), COPD (n = 2), cervical cancer (n = 3), and breast cancer (n = 1). The majority (n = 22) reported data on at least one demographic/environmental, lifestyle, or physiological risk factor but these data varied greatly.

Conclusions

Most studies collected data on a combination of hypertension, diabetes, and obesity and few studies collected data on respiratory diseases and cancer. Although most collected data on different risk factors the methodologies varied greatly. Several methodological limitations were found including low recruitment rate, low retention rate, and lack of validated and standardized data collection. Our results could guide potential collaborations and maximize impact to improve our global understanding of NCDs (and their risk factors) in SSA and also to inform future research, as well as policies.

Study of correlation between chronic stressor, biochemical markers and hematologic indices in Shahrekord Cohort Study: A population-based cross-sectional study

AIM

Stress is one of the most common and controllable risk factors for non-communicable diseases. The purpose of this study was to determine the relationship between stress and biochemical factors and hematologic indices.

METHODS

The data to conduct this cross-sectional study were obtained from Shahrekord Cohort Study (SCS). The sample size included 1000 people who were randomly selected from 7000 people enrolled in the SCS conducted in 2017-2018. To measure stress as well as blood biochemical factors and hematologic indices, the Questionnaire of Stressful Life Events and Glucose and Lipid profile were used, respectively.

RESULTS

Among stress dimensions, job security was significantly associated with most biochemical factors and hematologic indices. Linear regression model showed that there was a significant correlation between stress and blood urea, liver enzymes (ALT and AST), education, marital status, and occupation.

CONCLUSION

This study reported that the level of exposure to stressors was higher than that of other studies, and the results of this study are recommended to be used for screening and early detection of the consequences of exposure to chronic stressors, especially for the prevention of cardiovascular diseases.