Iranian Journal of Epidemiology

Investigating the Factors Related to the Migration of Patients from Iranshahr to Other Regions of Iran for Hospital Care in 2023–2024

2026-01-04T11:35:32+00:00

Background and Objectives: This study was conducted to determine the rate and examine factors associated with the migration of patients from Iranshahr to other regions of Iran for hospital care during 2023–2024.

Methods: This cross-sectional study employed an indirect approach. First, patients registered in the SIB system were asked about the size of their close family network. If the patient or their first-degree relatives had traveled outside Iranshahr to receive medical services, they were interviewed. Ultimately, 159 individuals were included. Factors and challenges associated with patient migration were scored on a scale from 0 to 20.

Results: The proportion of individuals who migrated from Iranshahr for hospital services in the past year was 5.9% (95% CI: 5.0, 6.7), equivalent to 6,785 people. The leading factor for migration was the type of illness, with a score of 19.1 (95% CI: 18.5, 19.5). Most patients traveled for gastrointestinal, cancer, and cardiac diseases, with referrals mainly to Kerman and Yazd provinces. Satisfaction with services received, with a score of 17.1 (95% CI: 16, 17.5), was the main reason for repeat referrals. The principal challenges were transportation costs (score 16.6) and accommodation costs (score 16.3).

Conclusion: Poor quality, limited effectiveness, and lack of diagnostic infrastructure were the main drivers of patient migration. To promote access and social equity, strengthening the healthcare infrastructure in this region must be prioritized.

Association of Infertility with Socioeconomic Indicators in Iran: An Ecological Study

2026-01-04T11:35:37+00:00

Background and Objectives: Infertility, as one of the most critical public health and reproductive issues globally, has extensive impacts on the physical, psychological, and social well-being of couples. Previous studies have shown that socioeconomic components, alongside biological variables, influence the occurrence and aggravation of infertility. We aimed to evaluate the relationship between some socioeconomic variables and prevalence of infertility at the province level.

Methods: This ecological study examined the relationship between infertility (dependent variable) and key socioeconomic indicators (independent variables) at the provincial level in Iran. Primary and secondary infertility defined using lifetime clinical, current clinical, and epidemiological definitions served as dependent variables. Statistical analysis employed univariate and multiple linear regression using the stepwise method, with a significance level of 0.05.

Results: Although numerous variables showed significant associations with infertility in simple regression models, only illiteracy and unemployment rates in the multiple regression model retained significant relationships with infertility. Furthermore, unemployment retained its significance only in epidemiological definition of primary infertility at the multiple model. Other variables lost their significance.

Conclusion: Provincial illiteracy rates emerged as the strongest predictor of infertility prevalence. Illiteracy is directly associated with infertility and also represents an important indicator of broader socioeconomic conditions. However, due to its ecological design, this study cannot distinguish between these two pathways.

Evaluating the Effectiveness of a Cognitive Therapy-Based Strategic Program for Reducing Suicidal Thoughts and Depression in Adolescents: A Randomized Controlled Trial

2026-01-04T11:36:02+00:00

Background and Objectives: Suicidal thoughts and depression during adolescence present significant challenges that have major negative consequences for public health. The current study aimed to assess the effectiveness of a cognitive-behavioral therapy-based strategic program for preventing suicide and depression in adolescents.

Methods: This randomized controlled trial was conducted in the winter of 2025 on 36 adolescents with suicidal thoughts and depression in Qazvin province, Iran. Participants were randomly assigned to either an intervention or a control group. The intervention group received cognitive-behavioral therapy for 6 weeks, while the control group received the standard treatment protocol designed by the Ministry of Health for 4 weeks. Comparisons between groups were made before, immediately after, and three months following the intervention. The Beck Scale for Suicidal Ideation and the Beck Depression Inventory-II were used to assess suicidal thoughts and depression.

Results: The mean difference in suicidal ideation and depression scores (with 95% confidence intervals) in the intervention group compared to the control group was 2.96 (1.19, 4.74) and 5.84 (0.86, 10.81), respectively, immediately after the intervention, and 6.06 (4.51, 7.61) and 11.62 (7.24, 15.99), respectively, at the three-month follow-up. Cognitive therapy had a significant effect only on reducing depression (p = 0.022). Furthermore, the pattern of change in suicidal thoughts over time differed significantly between the two groups (p = 0.021).

Conclusion: The cognitive-based strategic program significantly reduced depression levels among adolescents. These findings highlight the importance of incorporating cognitive therapy into depression treatment programs in health and medical centers. Additionally, intervention programs aiming to reduce suicidal thoughts should be designed with consideration of changing patterns of suicidal ideation over time.

The Quality of Iranian and Foreign Patient Package Inserts: What do Pharmacists Say?

2026-01-04T11:36:15+00:00

Background and Objectives: Patient package inserts (PPIs) are the accessible source of drug information which is expcted to contribute with the safe and efficient use of medicines. The aim of this study was to evaluate the satisfaction of pharmacists in Tabriz with the quality of Iranian and foreign PPIs.

Methods: The present study is a descriptive cross-sectional study. The study sample consisted of 170 pharmacists working in community pharmacies in Tabriz, who completed a validated questionnaire with confirmed reliability and validity. The questionnaire included items regarding the scientific quality of Iranian and foreign PPIs. The study data were presented and analyzed using means, percentages, and frequencies.

Results: Pharmacists were satisfied with the size of the PPIs, font size and font type of the Iranian PPIs (42.4%) and the foreign PPIs (72.3%). With respect to the amount and method of drug use information in PPIs, satisfaction was higher for foreign PPIs than for Iranian PPIs (P=0.017). Satisfaction with the expression of side effects, contraindications, how to adjust the dose of the drug in the underlying diseases and the necessary warnings for children and the elderly in the PPIs of Iranian medicines was significantly less than foreign medicines (P<0.001). Most of the pharmacists agreed to design specific brochures for medical staff and patients.

Conclusion: The results of the present study demonstrated pharmacists’ dissatisfaction with the scientific quality and the availability of sufficient, up-to-date information in domestic drug brochures for the safe use of medicines. Therefore, standardizing the structure of brochures by utilizing the experiences of other countries, using digital innovations and visual tools, implementing user-friendly tests, and continuous monitoring by Iranian Food and Drug Administration are essential.

Consumption of Fast food, Fruits, and Vegetables; and Physical Activity in Relation to Cancer in Tonkabon County, Iran

2026-01-04T11:36:47+00:00

Background and Objectives: Considering the importance of prevention and effective community-based interventions in reducing the psychological and economic burdens of cancers, and focusing on modifiable risk factors, the present study was designed and conducted with regard to several of these factors.

Methods: This case-control study included 211 patients with various types of cancer and 322 controls selected from the PARSA health system. Primary exposures of interest included fast food consumption, fruit and vegetable intake, and physical activity. The International Physical Activity Questionnaire (IPAQ) was used to assess physical activity levels, while the Food Frequency Questionnaire (FFQ) was used to measure fast food and fruit and vegetable consumption. Descriptive statistics and Chi-square tests, independent t-tests, and logistic regression were used for analysis.

Results: Logistic regression analysis indicated that inadequate fruit and vegetable consumption compared to adequate intake was associated with odds ratios of 4.49 and 4.042, respectively, for increased cancer risk. In addition, lower fast food consumption (OR = 0.466)] was associated with a 53% reduction in cancer risk. Physical activity [at the walking level] was statistically significant, although the effect size was very weak. Occupation, gender, education level, family history, and age showed statistically significant relationships with cancer, while other demographic variables showed no significant association.

Conclusion: Based on the findings of the current study and other evidence, as well as the fact that dietary patterns and physical activity are modifiable risk factors, appropriate interventions can play a preventive role in reducing the incidence of chronic diseases. This requires improving community awareness and designing and implementing effective interventions.

Pandemics: Lessons from the Past for the Future

2026-01-04T11:36:53+00:00

Background and Objectives: Over the past century, multiple pandemics have caused the deaths of millions and inflicted serious harm upon the global economy, and humanity is still concerned about the emergence of future pandemics. This paper aims to provide an overview of the upcoming challenges in public health by reviewing previous pandemics and threats, examining past experiences, and analyzing current conditions.

Methods: In this non-systematic review, the Google Scholar search engine was searched using suitable keywords, and studies relevant to the subject were selected.

Results: With increasing population and closer human interactions, the risk of outbreaks of infectious diseases is felt more than in the past. The existence of thousands of pathogens in wildlife, along with the impacts of climate change, globalization, lifestyle, hunting, and environmental destruction, raises the probability of human exposure to these agents. If these encounters lead to genetic changes in pathogens and create new species, the risk of emerging and transmissible diseases to humans will increase. In addition to natural factors, human-related factors including bioterrorism and drug resistance (while not considered direct human actions, they result from human misconduct) must also be considered.

Conclusion: Among various pathogenic microorganisms, viruses are highlighted as the principal agents of future pandemics due to their ability for rapid mutation, persistence in wildlife reservoirs, and the lack of effective preventive and therapeutic tools. What is crucial for countries is to utilize the lessons learned from previous pandemics to increase preparedness through strengthening health systems, employing the one health strategy, and mobilizing all capacities for future pandemics

A Guide to Identifying Knowledge Needs for the Prevention and Control of Non-Communicable Diseases in Iran

2026-01-04T11:37:16+00:00

The World Health Organization has extended the roadmap for prevention and control of the Non-Communicable Diseases (NCDs) program, 2013–2020 until 2030. In the political declaration of the fourth meeting of the United Nations General Assembly held on September 25, 2025, the promotion of mental health and well-being has also been added to the agenda. The overarching goal of the program is to reduce premature mortality from non-communicable diseases by one-third by 2030 through prevention and control, as well as by promoting mental health and well-being. The program emphasizes the need to accelerate progress toward these goals through the implementation of a set of evidence-based, cost-effective, and affordable interventions. The role of national research systems is to generate the necessary evidence to identify best interventions, implement them, and monitor and evaluate their outcomes. This article identifies knowledge needs based on an evidence-informed policymaking approach. Within this framework, specific questions are defined for each stage of the policymaking cycle, which must be answered using evidence. Furthermore, the results of the mid-point evaluation of WHO’s 2013–2020 roadmap have been analyzed, and the identified research questions have been incorporated into those arising from the evidence-informed policymaking approach.