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Cohort Profile: the Hoveyzeh Cohort Study (HCS): a Prospective Population-Based Study on Non-Communicable Diseases in an Arab Community of Southwest Iran

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Cohort Profile: the Hoveyzeh Cohort Study (HCS): a Prospective Population-Based Study on Non-Communicable Diseases in an Arab Community of Southwest Iran Original Article http://mjiri.iums.ac.ir Medical Journal of the Islamic Republic of Iran (MJIRI) Med J Islam Repub Iran. 2020(21 Oct);34.141. https://doi.org/10.34171/mjiri.34.141 Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran Bahman Cheraghian1, Seyed Jalal Hashemi2, Seyed Ahmad Hosseini3, Hossein Poustchi4, Zahra Rahimi5, Sara Sarvandian5, Amal Saki Malehi5, Meysam Alipour6, Sareh Eghtesad4, Jafar Fatahiasl7, Arash Bayat8, Hanieh Raji9, Nader Saki*10 Received: 15 Aug 2020 Published: 21 Oct 2020 Abstract Background: The Hoveyzeh cohort study (HCS) is a population-based cohort study that conducted in Hoveyzeh County (South-west Iran). HCS focus on common chronic diseases, disorders and risk factors of NCDs in the Arab ethnicity. Methods: A total number of 10009 participants (35-70 years old) were recruited in this prospective cohort study from May 2016 to August 2018. The HCS data were gathered by trained interviewer through interviewer-administered questionnaires. Also anthropometric measurements, physical examinations, clinical assessments, ophthalmology evaluation, auditory examinations, respiratory and cardiovascular assessments was conducted by means of standard instruments. Biological samples including blood, urine, hair, and nail collected and stored in the biobank. Results: The overall participation rate was 82.7%. The prevalence of obesity was 27.4% in males and 47% in females. Cigarette smoking prevalence was 20.9% (40.6 % in men and 7.6 % in women). Prevalence of major non communicable diseases such as diabetes, hypertension, metabolic syndrome, cardiac ischemic, myocardial infarction and stroke was 22.2%, 26.4% 31.9 %, 13.6%, 1.85% and 1.6% respectively. Conclusion: Considering the high prevalence of obesity and smoking in the population of Hoveyzeh and since the important role of these risk factors in development of common non communicable diseases, this issue should be taken into consideration and the necessary interventions in this context must be considered to modify lifestyle. The HCS is the only comprehensive cohort in the region, enabling it to provide valuable evidence about NCDs for a wide geographical area covering millions of people in both Iran and Iraq. Keywords: The Hoveyzeh cohort study, HSC, Non-communicable diseases, Cohort profile, Prospective population-based study, Southwestern Iran, PERSIAN Conflicts of Interest: None declared Funding: The Iranian Ministry of Health and Medical Education has contributed to the funding used in the PERSIAN Cohort through Grant no. 700/534. Ahvaz Jundishapur University of Medical Sciences has also substantially contributed to the funding. *This work has been published under CC BY-NC-SA 1.0 license. Copyright© Iran University of Medical Sciences Cite this article as: Cheraghian B, Hashemi SJ, Hosseini SA, Poustchi H, Rahimi Z, Sarvandian S, Saki Malehi A, Alipour M, Eghtesad S, Fatahiasl J, Bayat A, Raji H, Saki N. Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran. Med J Islam Repub Iran. 2020 (21 Oct);34:141. https://doi.org/10.34171/mjiri.34.141 ______________________________ Corresponding author: Dr Nader Saki, [email protected] 1. Alimentary Tract Research Center, Department of Biostatistics & Epidemiology, ↑What is “already known” in this topic: School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Although, the STEPS program about NCDs risk factors has Iran already been performed on a small sample size of the Hoveyzeh 2. Alimentary Tract Research Center, School of Medicine, Ahvaz Jundishapur population, but no comprehensive health screening program University of Medical Sciences, Ahvaz, Iran has been conducted in this area so far. Downloaded from mjiri.iums.ac.ir at 15:45 IRST on Saturday November 7th 2020 [ DOI: 10.34171/mjiri.34.141 ] 3. Nutrition and Metabolic Diseases Research Center, Department of Nutrition, School of Allied Medical Sciences , Ahvaz Jundishapur University of Medical Sciences, →What this article adds: Ahvaz, Iran This study is the first and only comprehensive health research 4. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research on total adult's residents (35-70 years old) in this county. The Institute, Tehran University of Medical Sciences, Tehran, Iran prevalence of common NCDs like Hypertension, Diabetes and 5. Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Metabolic Syndrome were identified. Also, the prevalence of Jundishapur University of Medical Sciences, Ahvaz, Iran major risk factors for NCDs such as obesity cigarette smoking 6. Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of were determined. Medical Sciences, Ahvaz, Iran 7. Department of Radiology Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 8. Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 9. Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 10. Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Hoveyzeh cohort study on NCDs 1. Why was Hoveyzeh cohort set up? socioeconomic, genetic, nutritional, and environmental and Non-communicable diseases (NCDs) cause 41 million lifestyle factors of the common chronic diseases or disor- annual deaths worldwide (1). NCDs account for 72.3% of ders as well as their interactions. The objectives of our total deaths in 2016 (2). It is estimated that 82% of all study are to estimate the prevalence and incidence of deaths in Iran are caused by NCDs, including cardiovascu- NCDs, to determine crude death rate and cause-specific lar diseases (43%), cancers (16%), chronic respiratory dis- mortality rates for the main causes of mortality, to define eases (4%), diabetes (4%), accidents (10%), and other the natural history of NCDs accurately, to discover the risk NCDs (15%) (3). In 2017, low back pain, headache, and and protective factors of NCDs in the Arab community, to depression were reported as 3 major causes of YLD (Years establish a population-based research context for health re- Lived with Disability) (4). In developed and developing searchers, and to provide a Biobank for assessing the role countries, NCDs impose a heavy burden on health systems of biomarkers and genes in disease and death (7). and the economy of communities. It is estimated that NCDs Khuzestan province is located in Southwest Iran, border- will cost more than $ 30 trillion in the next 2 decades, which ing Iraq in the west and the Persian Gulf in the south. Hov- is equivalent to 48% of GDP in 2010 pushing millions into eyzeh county is located on the west side of Khuzestan prov- poverty (5). The transition from infectious diseases to ince with a total area of 5330 km2 (Fig. 1). The county is NCDs in developing countries is the outcome of some risk located about 80 kilometers from Ahvaz, the capital of factors often caused by economic progress. The 4 major Khuzestan. The climate is generally very hot and occasion- risk factors in 2017 were hypertension, smoking, high ally humid so that the temperature varies from 55°C in the blood sugar, and high body mass index (BMI) (2). Tobacco summer to 10°C in the cold seasons. Most of the residents use, insufficient physical activity, alcohol abuse, and inad- are from the Arab ethnicity. The county is divided into 2 equate nutrition increase the risk of death from NCDs (1, districts: the Central District and Neysan District. The larg- 6). Numerous cohort studies have been conducted on large est wetland in Khuzestan, called Houralazim or Houralhov- populations to explore the association between non-com- eyzeh, is located in this area. Agricultural and pastoral oc- municable disease risk factors in developed countries, but cupations are very common jobs in the county. Hoveyzeh such studies have been implemented only in a few develop- suffered very heavy damages during the Iran–Iraq war, re- ing countries. No population-based cohort study has been sulting in the complete destruction of the city. Due to envi- conducted to date on non-communicable diseases in the ronmental changes such as drought, the wetland has be- southwest region of Iran (Khuzestan) and in the Arab eth- come a source of dust; also, climatic changes led to wild- nicity. Moreover, the mechanisms of disease development fires in the wetland that might be one of the major risk fac- may vary based on geographical, cultural, and social con- tors threatening the health of its inhabitants, especially the ditions, so this comprehensive and prospective study seems incidence of respiratory diseases. Moreover, the presence necessary in the region. The Hoveyzeh cohort study (HCS) of numerous oil and gas fields may cause health-related will focus on common chronic diseases or disorders, such ecological changes in this region. Moreover, there are many as cardiovascular, respiratory, digestive, hepatic, renal, sunshine days in Hoveyzeh each year, so high levels of ex- metabolic, psychiatrics, visual, hearing and cancers, in posure to sunlight can increase the risk of skin and eye dis- adults. Moreover, it will assess the effects of demographic, eases, especially among outdoor workers. The grant of this Downloaded from mjiri.iums.ac.ir at 15:45 IRST on Saturday November 7th 2020 [ DOI: 10.34171/mjiri.34.141 ] Fig. 1. Location of Hoveyzeh County http://mjiri.iums.ac.ir 2 Med J Islam Repub Iran. 2020 (21 Oct); 34:141. Hoveyzeh cohort study on NCDs study was partially provided by the Vice President of Re- the referral day. A phone call was made to remind the in- search and Technology at the Ministry of Health and Med- vitees the day before the visit. Participants were transported ical Education and partially by Ahvaz Jundishapur Univer- daily to the cohort site by a minibus.
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