Showing papers by "Mohsen Naghavi published in 2008"
TL;DR: A significant proportion of deaths in the Iranian death registration system are being classified to cause groups of little relevance to epidemiological research or health policy, resulting in substantial changes to procedures for diagnosing causes of death.
Abstract: Objective To assess the extent and pattern of misclassification of death from non-specific diagnoses emanating from the Iranian death registration system, and to correct the data for health policy and planning. Methods Detailed medical records for 1426 hospital deaths classified to seven ill-defined or vague causes of death were reviewed by trained physicians, who then completed standard death certificates. Underlying causes of death from the review were compared with the cause assigned in registration data. Findings The probable underlying pattern of causes of death in the Islamic Republic of Iran is substantially different to that suggested by the death registration system. About 88% of 582 cases with non-specific diagnoses at ages 15–69 years were reassigned to various specific causes including ischaemic heart disease (33%), stroke (13%) and injuries (10%). A similar pattern of misclassification is apparent for 738 deaths at older ages (70 years and over), with 46% being reassigned to ischaemic heart disease and stroke. Conclusion A significant proportion of deaths in the Iranian death registration system are being classified to cause groups of little relevance to epidemiological research or health policy. Reassignment of these deaths would increase the proportion of deaths from ischaemic heart disease and cerebrovascular diseases each by 32%, diabetes mellitus by 68% and chronic lower respiratory diseases by 73%. Substantial changes to procedures for diagnosing causes of death are urgently required if registration data are to effectively guide health policies and programmes in the Islamic Republic of Iran.
75 citations
Journal Article•
43 citations
TL;DR: This mid-term evaluation found that the iron fortification programme in Iran has only had a beneficial effect on the prevalence of low ferritin levels.
38 citations
TL;DR: Bicyclists in Iran, particularly males and young children, are vulnerable to severe injury and death when struck by moving vehicles on highways.
30 citations
TL;DR: Not only domestic injuries but also those in traffic are an important cause of severe and fatal injury among rural people and health workers may play an important role in injury surveillance and in identifying context-relevant means of prevention that they or other actors may then implement.
Abstract: Knowledge is sparse concerning injuries affecting rural populations in low and middle-income countries in general and in Iran in particular This study documents the incidence and characteristics of severe injuries affecting rural people in the Iranian district of Twiserkan and it investigates these people's suggestions for injury prevention and control An interview-based investigation was undertaken that comprised all unintentional injuries leading to hospitalization (more than 6 hours) or death that had occurred within a twelve month period and that were identified in the files of the 62 "health houses" of the Twiserkan district For each case, semi-structured interviews were conducted at the households of the injured people (134 injuries affecting 117 households were identified) The incidence rates of fatal and non-fatal injuries were respectively 41 and 172 per 10 000 person-years and, as expected, men were more affected than women (776% of all injury cases) Traffic injuries (in particular among motorcyclists) were as common as home-related injuries but they were far more fatal Among common suggestions for prevention, people mentioned that the authorities could work on the design and engineering of the infrastructure in and around the village, that the rural health workers could contribute more with local information and education and that the people themselves could consider behaving in a safer manner Not only domestic injuries but also those in traffic are an important cause of severe and fatal injury among rural people Health workers may play an important role in injury surveillance and in identifying context-relevant means of prevention that they or other actors may then implement
30 citations
TL;DR: The Bayesian method was found to be a significant improvement for generating estimates of incidence for many external causes and performed poorly in distinguishing between falls and road traffic injuries, both of which are characterized by similar injury codes in the authors' datasets.
19 citations
Journal Article•
TL;DR: Death registration in the Islamic Republic of Iran was initiated by the National Organization for Civil Registration in 1918 and has evolved over the past few decades into a new comprehensive death registration system operated by the Ministry of Health and Medical Education (MOH&ME).
Abstract: Introduction Measures of mortality, such as age-specific death rates, life expectancy, cause-specific death rates and years of life lost, are commonly used to measure the health status of a population and are essential for epidemiological research and priority setting for health development (1-4) In general, countries can be classified into two broad groups on the basis of availability of data on causes of death(3) One group comprises countries that typically have complete vital registration with medical certification of the cause of death assigned by attending physicians The other group includes countries that have death registration systems ranging from incomplete to virtually non-existent, where causes of deaths are often recorded inaccurately at registration, resulting in large proportions of deaths assigned to ill-defined causes (1,3) In some countries a history obtained from relatives or associates, known as "verbal autopsy" or "lay death recording", (5) is available for some segments of the population In China and India, for example, sample vital registration areas that collect information via the use of verbal autopsy provide useful and representative information on causes of death (6) Despite international efforts to facilitate and standardize processes for the collection and coding of data on causes of death, the quality of data from many countries remains poor (1-3) Several factors influence cause of death ascertainment, such as the nature of the disease or circumstances of death, the qualifications and skills of the certifier, and the availability of diagnostic aids and medical evidence Variations in these factors probably contribute to significant misclassification of cause of death in many countries (7,8) Studies to assess the accuracy of data on causes of death from routine death registration systems have been implemented in several countries (4,7) In general, these studies compare causes of death reported on death certificates with diagnoses from clinical records or autopsies These studies can only be conducted in populations for which detailed clinical records (or autopsies) and data from death registration systems are available and useable, as in the Islamic Republic of Iran Death registration in the Islamic Republic of Iran was initiated by the National Organization for Civil Registration in 1918, and has evolved over the past few decades into a new comprehensive death registration system operated by the Ministry of Health and Medical Education (MOH&ME) (9-14) Starting in one province (Bushehr) as a pilot study in 1997, the new system was progressively implemented to cover 29 out of 30 Iranian provinces by 2006 (10,15-17) In urban areas, attending physicians complete a medical certificate of cause of death in accordance with the principles of the International Classification of Diseases (ICD) In rural areas, causes of death are determined by physicians from the local rural health centre, based on "verbal autopsy" interviews conducted by health-centre staff (15) Each month, urban and rural health facilities submit summary information on age, sex and up to three causes for each death to the district health centre, where the data are matched against other sources (eg cemetery, hospital or medico-legal records) to improve the level and quality of death registration, and to remove duplication Next, trained personnel select and code the underlying cause for each death according to ICD rules These data are then computerized and submitted to the provincial health department, where data are cross-checked with information from the National Organization for Civil Registration to further reconcile missed deaths or duplications A final dataset is submitted to the MOH&ME where deaths are tabulated according to an abbreviated list of 321 causes based on ICD-10, but adapted to represent the epidemiological profile of the Islamic Republic of Iran …
2 citations
Journal Article•
TL;DR: Estimating the burden of central nervous system malignancies in Iran will enable the health policy makers to share the community sources, as appropriate, and observe the equity and equality on it.
Abstract: Objective : The policy makers and social managers need some criteria for building up the appropriate health status of the community and observe the equity and equality on it. They have to know the burden of diseases as a main determining factor for decision making, planning and programming. Disability adjusted life years (DALYs) is a criteria which shows the wasted life time due to early death and also wasted time due to disease morbidity and disability. Central nervous system malignancies are important especially in children and estimating the burden of these malignancies in Iran will enable the health policy makers to share the community sources, as appropriate. Material and Methods : The estimation of burden of disease and risk factors was a national study that began on 2003 by the ministry of Health and Medical education (MOHM 1(1): 6-11. References: 1. World Health Organization, How Is Public Interest Protected, in World Health Report 2000; Health System: Improving Performance, 2000 2. Murray CJL, Acharya AK. Understanding DALYs. J Health Economics. 1997 3. Murray CJL, Lopez, AD, eds. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Global Burden of disease and Injury Series, Vol. 1. Cambridge: Harvard University Press; 1996. 4. Naghavi M, Abolhassani F, Moradi Lake M, etc. Guideline for estimation the burden of disease, MOHM 8th edition, October 14, 2004 6. KasperDL, Braunwald E, Fauci A, HauserS, Longo D, Jameson JL, Harrison's Principles of Internal Medicine, 16th edition, McGraw-Hill Professional, July 23, 2004 7. Goldman L, Ausiello D, Cecil Textbook of Medicine, 22th edition, W.B. Saunders Company; 22th edition , December 2003 8. Mathers C, Lopez A, Cancer incidence, mortality and survival site for 14 regions of the world, WHO, 2001. 9. Naghavi M, Death Registry in 23 Province in Iran, forth Book, MOH&ME, Tehran, 2005. 10. SEER Cancer Statistics Review 1975-2002, Central Nervous System Cancers (Table XIV-5), (The National Cancer Institute of U.S.), http:// seer.cancer.gov /csr/ 1975_2003/sections.html 11. Department of Human Services of Australia, Burden of Disease http:// www.health.vic.gov.au /healthstatus/ bod/ daly.htm 12. Incidence, Prevalence, Mortality, YLL, YLD and DALYs by sex, cause and WHO region, estimates for 2002 as reported in the
1 citations