Erfan Ghasemi

Tehran University of Medical Sciences | TUMS · Non-communicable Disease Research Center

Objective To examine trends in intake of key food groups among Iranian adults between 2005 and 2016, overall, and according to socio-demographic characteristics. Design Repeat cross-sectional data from the Iran-STEPwise approach to risk factor surveillance (Iran-WHO STEPS) 2005-2016 were analyzed. Regression analyses were used to evaluate trends i...

Background The aim of this study was to examine the quality of care by age and gender in oesophageal cancer using Global Burden of Disease (GBD) database. Methods Patients aged 20 and over with oesophageal cancer were included in this longitudinal study using GBD 1990–2019 data. We used the Socio-Demographic Index (SDI) to classify the regions. We...

Background The updated epidemiology of injuries at the national and sub-national levels are required for policymakers to effectively handle the burden of injuries. This paper aimed to assess the incidence and risk factors of different injuries in Iran based on a recent national survey. Methods We used data from Iran Stepwise approach to surveillan...

Objective To report the efficacy, safety, and exploratory immunogenicity findings of two 5 µg doses of the BIV1-CovIran vaccine. Design Randomised, placebo controlled, double blind, multicentre, phase 3 clinical trial. Setting In six cities of Iran, including Bushehr, Isfahan, Karaj, Mashhad, Shiraz, and Tehran. The first vaccine or placebo injec...

Background: Multiple sclerosis (MS) is a common neurologic autoimmune disorder. We have used a newly introduced measure, Quality of Care Index (QCI), which is associated with the efficacy of care given to patients suffering from MS. Objective: To report and compare the quality of care given to MS patients in different regions and country. Metho...

Abstract The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged ov...

Background: . Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups. Methods: . This study used GBD data from 1990 to 2017 from the Institute for Health Met...

Polycyclic aromatic hydrocarbons (PAHs) are one of the most important environmental pollutants. Urinary concentrations of 1-hydropyren metabolites of PAHs have been used as biomarkers of these chemicals’ exposure in humans. This cross-sectional study was conducted on 468 healthy Iranian adults over 25 years old and non-smokers in six provinces who...

This study aimed to investigate the diabetes mellitus (DM) and prediabetes epidemiology, care cascade, and compliance with global coverage targets. We recruited the results of the nationally representative Iran STEPS Survey 2021. Diabetes and prediabetes were two main outcomes. Diabetes awareness, treatment coverage, and glycemic control were calcu...

Background and objectives: Chronic kidney disease (CKD) imposes a heavy obscure burden on individuals and health systems. Besides its burden, the quality of care of CKD is less investigated. In this study, we aimed to explore the global, regional, and national trends of CKD burden and quality of care. Design, setting, participants, and measuremen...

PCR tests for COVID-19 have relatively low sensitivity and only symptomatic cases have been tested. Thus, a population-based seroprevalence study was necessary to determine the extent of missed cases. The objective of this study was to achieve a realistic infection rate in Iran and probe into some explanations behind being infected or not. In this...

Scarcity of ventilators during COVID-19 pandemic has urged public health authorities to develop prioritization recommendations and guidelines with the real-time decision-making process based on the resources and contexts. Nevertheless, patients with COVID-19 who will benefit the most from ventilation therapy have not been well-defined yet. Thus, th...

Smoking is recognised as a critical public health priority due to its enormous health and economic consequences. Constant monitoring of the effectiveness of tobacco control programs calls for timely population-based data. This study reports the national and sub-national patterns in tobacco consumption among Iranian adults based on the results from...

Background: Hypertension (HTN) and diabetes mellitus (DM) as part of non-communicable diseases are among the most common causes of death worldwide, especially in the WHO's Eastern Mediterranean Region (EMR). The family physician program (FPP) proposed by WHO is a health strategy to provide primary health care and improve the community's awareness...

PurposeWhile many studies have reported hypertension (HTN) and pre-hypertension (PHTN) in large geographic locations of Iran, information regarding district levels is missing. We aimed to examine inequalities in the prevalence of hypertension, prehypertension, anti-hypertensive coverage, awareness, and effective treatment of adults in districts of...

Background: To calm non-cooperative children needing dental treatment, sedatives are used. Vital parameters must be monitored during sedation. This study aimed to evaluate the effects of Ketamine-Midazolam (KM) and Ketamine-Propofol (KP) combinations on the heart rate (HR) and oxygen saturation (SPO2) of uncooperative children. The model parameters...

Background: We aimed to estimate the prevalence of physical inactivity in all districts of Iran and the disparities between subgroups defined by various measures. Methods: Small area estimation method was employed to estimate the prevalence of physical inactivity in districts based on the remaining districts in which data on the level of physica...

This study aimed to investigate the diabetes mellitus (DM) and prediabetes epidemiology, care cascade, and compliance with global coverage targets. We recruited the results of the nationally representative Iran STEPS Survey 2021. Diabetes and prediabetes were two main outcomes. Diabetes awareness, treatment coverage, and glycemic control were calcu...

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6 . Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural an...

Purpose The prevalence of metabolic syndrome is 4.8% in adults worldwide. In the treatment process, Polypharmacy which is defined as concomitant use of ≥ 5 medications in a prescription is common and it may lead to untoward Drug-drug interactions. Methods A population-based, cross sectional study was conducted following joining the data from Irani...

Introduction Data on the distribution of the burden of diseases is vital for policymakers for the appropriate allocation of resources. In this study, we report the geographical and time trends of chronic respiratory diseases (CRDs) in Iran from 1990 to 2019 based on the Global burden of the Disease (GBD) study 2019. Methods Data were extracted fro...

The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged higher than...

Background and objective: Cervical cancer is the most preventable and ovarian cancer is the most lethal gynecological cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health-system quality of care and inequities fo...

Objective: Hypertension is one of the major modifiable risk factors in developing cardiovascular diseases (CVD). Hence, we aimed to ascertain age- and sex-specific population attributable fraction (PAF) for CVD in different blood pressure levels to implement efficient preventive strategies at the population level. Methods: Participants' data wer...

Background Kidney cancer is a prevalent cancer worldwide. The incidence and mortality rates of Kidney Cancer (KC) have risen in recent decades. The quality of care provided to KC patients is a concern for public health. Considering the importance of KC, in this study, we aim to assess the burden of the disease, gender and age disparities globally,...

Background: Evidence, albeit with conflicting results, has suggested that cardiometabolic risk factors, including obesity, type 2 diabetes (T2D), dyslipidemia, and hypertension, are highly associated with changes in metabolic signature, especially plasma amino acids and acylcarnitines levels. Here, we aimed to evaluate the association of circulati...

Objective This study aims to assess geographic inequalities in the prevalence, awareness of diagnosis, treatment coverage and effective control of diabetes in 429 districts of Iran. Methods A modelling study by the small area estimation method, based on a nationwide cross-sectional survey, Iran STEPwise approach to surveillance (STEPS) 2016, was p...

Background Insufficient physical activity (IPA) is a significant risk factor for various non-communicable diseases. The Iran action plan is a 20% reduction in IPA. Therefore, we aimed to describe the age and sex pattern of physical activity domains, IPA, the intensity of physical activity, sedentary behavior, and their associates at Iran's national...

Background Obesity and its increasing burden have become an urgent health problem all over the world. Benefiting from a national representative sample, the present study aimed to estimate the distribution of body mass index (BMI) levels and its association with metabolic and lifestyle risk factors in an Iranian adult population by sex, age, and geo...

Background: This study presents estimates of central nervous system (CNS) cancers' prevalence, incidence and its contributors, death, years-of-life-lost (YLLs), years-lived-with-disability (YLDs), and disability-adjusted-life years (DALYs) from 1990 to 2019 in North Africa and the Middle East. Methods: Primary measures were retrieved from Global...

Background: Cancer is a major public health problem and comorbidity associated with COVID-19 infection. According to previous studies, a higher mortality rate of COVID-19 in cancer patients has been reported. Aims: This study was undertaken to determine associated risk factors and epidemiological characteristics of hospitalized COVID-19 patients...

PurposeNon-communicable diseases (NCDs) have become a global health priority with a great need for prompt evidence-based preventing and managing interventions. Here, we describe the development of a comprehensive cohort study that provides the most accurate results for NCDs’ risk factors, named the Iran Cohort Study (ICS) to estimate the effect siz...

PurposeGiven the high prevalence of non-alcoholic fatty liver disease (NAFLD) and the role of Alanine aminotransferase (ALT) in diagnosing liver injury along with the increasing prevalence of lifestyle risk factors, we aimed to evaluate the association between serum ALT level and lifestyle risk factors in a population-based survey.Methods This was...

PurposeDiabetes care is one of the major healthcare problems. This study aimed to introduce a recently-developed Quality of Care Index (QCI) for type 2 diabetes and utilized it to compare different genders, age groups, and Iranian provinces.Methods From the Global Burden of Disease 1990–2019 database, we obtained primary epidemiologic measures and...

Background and aim: Cirrhosis and other chronic liver diseases are complex disorders with a known burden. Currently health systems have different approaches to dealing with this issue. The objective of this study is to describe the burden attributed to and quality of care for cirrhosis and other chronic liver diseases. Methods: Data of cirrhosis...

Background The increasing burden of hypertension in low- to middle-income countries necessitates the assessment of care coverage to monitor progress and guide future policies. This study uses an ensemble learning approach to evaluate hypertension care coverage in a nationally representative Iranian survey. Methods The data source was the cross-sec...

Purpose: The present study is aimed at predicting the physician's specialty based on the most frequent two medications prescribed simultaneously. The results of this study could be utilized in the imputation of the missing data in similar databases. Patients and Methods. The research is done through the KAy-means for MIxed LArge datasets (KAMILA)...

Background: Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present. Methods: In addi...

Background The adherence to speed limits can reduce deaths associated with road traffic injuries (RTIs) by more than a quarter. This study aimed to evaluate the effective factors on the speeding behavior of Iranian taxi drivers around fixed speed cameras. Method Telematics devices used in this study collected the location and speed of the vehicles...

Objectives To determine the prevalence and frequency of using any tobacco product and each of a detailed set of tobacco products, how tobacco use and use frequency vary across countries, world regions, and World Bank country income groups, and the socioeconomic and demographic gradients of tobacco use and use frequency within countries. Design Sec...

Background Insulin resistance (IR) evolved from excessive energy intake and poor energy expenditure, affecting the patient's quality of life. Amino acid and acylcarnitine metabolomic profiles have identified consistent patterns associated with metabolic disease and insulin sensitivity. Here, we have measured a wide array of metabolites (30 acylcarn...

Objective To investigate the benefit of ventilation therapy among various patient groups with COVID-19 admitted to hospitals, based on the real-world data of hospitalized adult patients. Methods Data used in the longitudinal study included 599,340 records of hospitalized patients. All participants were categorized based on demographics and their d...

Background: Breast cancer (BC), as the top neoplasm in prevalence and mortality in females, imposes a heavy burden on health systems. Evaluation of quality of care and management of patients with BC and its responsible risk factors was the aim of this study. Methods: We retrieved epidemiologic data of BC from the Global Burden of Disease (GBD) 1...

Background: Lung cancer is one of the leading cancers, with a high burden worldwide. As a developing country, Iran is facing with population growth, widespread tobacco use, demographic and epidemiologic changes, and environmental exposures, which lead to cancers becoming a severe concern of public health in Iran. We aimed to examine the burden of...

Purpose To express a global view of care quality in major causes of mortality and morbidity in children and adolescences Methods We used primary epidemiologic indicators from the Global Burden of Disease 1990–2017 database. We have created four secondary indices from six primary indices in order to assess the care quality parameters. We conducted...

Background: Data on the burden of stroke and changing trends at national and subnational levels are necessary for policymakers to allocate recourses appropriately. This study presents estimates of the stroke burden from 1990 to 2019 using the results of the Global Burden of Disease (GBD) 2019 study. Methods: For the GBD 2019, verbal autopsy and...

Background Atherosclerotic Cardiovascular Disease (CVD) is the leading cause of death globally and dyslipidemia plays a critical role in the development of this condition. This study aimed to analyze the potential impact of socioeconomic factors on the prevalence of dyslipidemia at district level in Iran. Understanding these factors is important fo...

Objective Assessing safety and immunogenicity of an inactivated whole virus particle vaccine. Design Single-centre, double-blind, randomised, placebo-controlled, phase I (stage I: 18–50, stage II: 51–75 years), phase II (18–75 years) clinical trials. Setting 29 December 2020 to 22 April 2021. Participants Stage I-phase I: 56 participants; stage...

Background: Many of the variables which are investigated in survival research are time-invariant, i.e. their values do not change over time. But their effects, may yet vary over time. Thus, the change in behavior that occurs over time needs to be included in the analysis. This can be done by adding time-interaction terms to the model. Method: In th...

Background Development of surveillance systems based on big data sources with spatial information is necessitated more than ever during this pandemic. Here, we present our pilot results of a new technique for the incorporation of spatial information of transactions and a vital registry of COVID-19 to evaluate the disease spread. Methods We merged...

Introduction COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. Methods This cross-sectional study evaluated different aspect of COVID-19 infection in hospitalized COVID-19 positive children (≺18 years oldwith...

Background To measure the quality of care for lip and oral cavity cancer worldwide using the data from the Global Burden of Disease (GBD) Study 2017. Methods After devising four main indices of quality of care for lip and oral cavity cancer using GBD 2017 study’s measures, including prevalence, incidence, years of life lost, years lived with disab...

Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor...

PurposeDiabetes is one of the major comorbidities associated with COVID-19. We aimed to determine the clinical and epidemiological factors associated with the mortality of COVID-19 in diabetic patients in Iran, and also the impact of prescribed antiviral and antibiotics on patients’ status.Methods In this study, we used the national registry of hos...

PurposeThe novel coronavirus disease 2019 (COVID-19) has imposed a great global burden on public health. As one of the most affected countries, Iran has tackled emerging challenges in the path to overcoming the epidemic, with three peaks of the disease propagation as of February 19, 2020. To flatten the curve of the COVID-19 pandemic, most countrie...

Brain and other CNS cancers are major burdens. About 330,000 new cases, 227,000 deaths and 7.7 million Disability-Adjusted Life Years (DALYs) globally in 2017. Burden have been decreasing in high, high-middle, and middle socio-demographic index (SDI) quintiles, while it is opposite in low SDIs. Lack of study on burden and quality of care, access, a...

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30...

Objective High salt intake is one of the leading diet-related risk factors for several non-communicable diseases. We aimed to estimate the prevalence of high salt intake in Iran. Design A modeling study by the small area estimation method, based on a nationwide cross-sectional survey, Iran STEPs 2016. The modeling estimated the prevalence of high...

Background: The knowledge of Emergency Medical Technicians (EMTs) plays a crucial role in the outcomes of traumatic patients. This study aimed to assess the knowledge of EMTs about the prehospital care intensity index of spinal cord trauma in Ilam Province, Iran. Materials and Methods: This cross-sectional study was conducted on 98 EMTs chosen by t...

Breast cancer is the most common cancer among women, causing considerable burden and mortality. Demographic and lifestyle transitions in low and low-middle income countries have given rise to its increased incidence. The successful management of cancer relies on evidence-based policies taking into account national epidemiologic settings. We aimed t...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...

Background Thyroid cancer (TC) is the most prevalent malignancy of the endocrine system. Over the past decades, TC incidence rates have been increasing. TC quality of care (QOC) has yet to be well understood. We aimed to assess the quality of TC care and its disparities. Methods We retrieved primary epidemiologic indices from the Global Burden of...

Primary brain and other central nervous system (CNS) cancers cause major burdens. In this study, we introduced a measure named the Quality of Care Index (QCI), which indirectly evaluates the quality of care given to patients with this group of cancers. Here we aimed to compare different geographic and socioeconomic patterns of CNS cancer care accor...

Non-Communicable Diseases (NCDs) are the major cause of premature death and disability due to diseased globally, imposing a heavy burden on the health systems. Four main categories of NCDs are cardiovascular diseases, neoplasms, diabetes, and chronic respiratory diseases. Iran, the second greatest country in the Middle East Region, has been through...

Over 80% of deaths due to non-communicable diseases (NCDs) occur in low and middle-income countries, indicating an inequality in the health care system around the world. Conducted studies at provincial level in developed countries have shown that mortality rates due to this group of diseases are higher in the populations with lower education, incom...