Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Prevalence of Infertility among Iranian Women: An Overview of Systematic Reviews and Meta- Analyses 1 8 193681 10.22034/hp.2024.451486.1043 EN Shima Imannezhad Pediatric Neurologist, Department of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-5537-2763 Maryam Mirzaei Department of Obstetrics and Gynecology, Jiroft University of Medical Sciences, Jiroft, Iran. 0000-0003-2758-853X Behnaz Khodadadi Department of Nursing, Mashhad Branch, Islamic Azad University, Mashhad, Iran. 0000-0002-9714-5825 Omolbanin Heydari Student of Midwifery Counseling, Kerman Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran. Neda Dehghani Department of Midwifery, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran. 0000-0002-3294-0561 Journal Article 2024 01 12 Background: Understanding the magnitude of infertility is critical for monitoring, assessing, and improving equitable access to fertility care services, as well as for addressing the risk factors associated with infertility. This study aims to estimate the prevalence of infertility and its associated factors among Iranian women. Materials and Methods: In this overview, the online databases Medline, EMBASE, Web of Science, Scopus, Cochrane Library, CINAHL, CIVILICA, and Google Search Engine were searched for relevant systematic reviews and meta-analyses published up to January 2024. Two independent scholars conducted the screening, selection, and quality assessment of the selected studies using the AMSTAR tool. Results: A total of five systematic reviews, comprising 95 studies with a total of 279,717 women, were included. The results indicated that the current prevalence of infertility in Iran is 10.5% (ranging from 7.8% to 13.2%). The prevalence of primary infertility is 10.6% (ranging from 3.09% to 18.3%), while secondary infertility is 2.6% (ranging from 2% to 3.2%). Additionally, the prevalence of current infertility is 2.9% (ranging from 2.2% to 3.7%). The rates of primary and secondary infertility were significantly higher in women than in men (6% and 3%, respectively; p < 0.05). Primary infertility was more common in women under the age of 35 (p < 0.05). Subgroup analysis revealed significant differences in the prevalence of current infertility based on the year (p < 0.05). The prevalence of causes related to ovulation, uterine tubes, and endometriosis among infertile women was estimated at 54.0%. Conclusion: The prevalence of infertility among women from 1990 to 2019 has decreased over time. Primary infertility is more common than secondary infertility and is particularly prevalent in women under the age of 35. However, for both women and men, lifestyle factors such as smoking, excessive alcohol intake and obesity are associated with an increased risk of infertility.

https://www.health-providers.ir/article_193681_09bb607c2260f4c9a20c7d2ca1c4830b.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Pap Smear Test: A Neglected Necessity among Iranian Women 9 10 207897 10.22034/hp.2024.483907.1045 EN Fatemeh Shoaee Gynecologist, Fellowship in Minimally Invasive Gynecologic Surgery, Kowsar Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. 0009-0008-2704-8668 Journal Article 2024 10 16 Dear Editor-in-chief, Pap smear test, also known as the Papanicolaou test, is an essential screening tool for cervical cancer. This non-invasive method collects cells from the cervix to identify precancerous and cancerous changes. Early detection through Pap smear can significantly reduce the morbidity and mortality associated with cervical cancer (1-4). The sensitivity of Pap smears ranges from 70% to 89.79%, while specificity can be as high as 95.34%, indicating that the test is effective in diagnosing cervical lesions (2, 4). Recent studies show that while many Iranian women have undergone a Pap smear test at least once, the rate of regular screening is significantly low. The prevalence of Pap smear tests among Iranian women shows significant differences, especially in the regular screening rate (5, 6). The results of a meta-analysis showed that while 46.52% of women had undergone a Pap smear test at least once, only 17.80% participated in regular screening, indicating a low rate of screening and potential underdiagnosis (7). Socioeconomic factors strongly influence these statistics, with wealthier women showing higher uptake rates for screening. It is reported that 86% of women have been screened at least once, but most of them live in urban areas and belong to the affluent classes of society (8). Another study shows that 52.4% of women in Tehran had done a Pap smear test. However, the level of knowledge was low, with only 16% having appropriate knowledge about Pap smear testing. This highlights the importance of raising awareness and education to increase screening rates (9, 10). A study in Jiroft found that only 1.4% of women had abnormal Pap smears, highlighting the need for increased screening efforts (11).

https://www.health-providers.ir/article_207897_f8eb0c63ce68919b99ef0f2a044669ca.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Prevalence of Vitamin D Deficiency and Associated Factors in Healthy Iranian Children and Adolescents: A Systematic Review 11 27 207794 10.22034/hp.2024.483526.1044 EN Maryam Naseri Fellowship of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran. 0000-0002-8420-0485 Mohammad Hasan Mohammadi Department of Pediatrics, Zabol University of Mediacl Sciences, Zabol, Iran. 0000-0003-0533-5320 Najmeh Soltani Nejad Kerman University of Medical Sciences, Kerman, Iran . 0000-0002-3149-5945 Hashem Lashgari Kalat Department of Pediatrics, Clinical Research Development Center of Children's Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Neda Dehghani Department of Midwifery, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran. 0000-0002-3294-0561 Journal Article 2024 10 14 Background: Vitamin D deficiency can have significant health implications for children and adolescents, affecting bone development, immune function, and overall well-being. We aimed to investigate the prevalence of vitamin D deficiency and its associated factors in Iranian children and adolescents. Materials and Methods: In this systematic review, a search of online databases (Medline, Scopus, Web of Science, WHO, CIVILICA, and Google Scholar) was conducted with no time limit up to March 2024. The quality of the information was evaluated using the STROBE checklist. Results: Finally, 33 related studies were included. The prevalence of vitamin D deficiency in children and adolescents was estimated to be 47.35% (3-91.7%), with a mean value ranging from 7.26 ± 2.81 to 23.46 ± 9.30 ng/dL. The prevalence of vitamin D insufficiency in children and adolescents was estimated to be 55.6% (11.3-100%). The prevalence of vitamin D deficiency in infants was estimated to be 51% (2.8-93.3%), with a mean value ranging from 28.3 ± 19.4 to 61.3 ± 31.4 ng/dL. The prevalence of severe vitamin D deficiency was significantly higher among girls than boys. The concentration of 25(OH)D was associated with BMI (p = 0.000, r = -0.13), pubertal status (r = -0.08, p= 0.04), weight (p = 0.000, r = -0.12), waist circumference (r = -0.112, p = 0.047), age (p = 0.000, r= -0.13), height (p < 0.05), pubertal status (r=− 0·08, p=0·04), sunlight exposure (r = 0.10, p = 0.04), gender (p = 0.01), maternal vitamin D deficiency (p < 0.01), daily intake of vitamin D (p < 0.05), and the areas (p < 0.05). Conclusion: The prevalence of vitamin D deficiency among Iranian children and adolescents is alarmingly high, with various studies indicating significant rates across different age groups, genders, and regions. This deficiency poses serious health risks, necessitating urgent public health interventions.

https://www.health-providers.ir/article_207794_379104722a179eb9664c9a5fbbbf0964.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Overview of Iron Deficiency Anemia in Iranian Children and Adolescents 29 39 208003 10.22034/hp.2024.484213.1046 EN Maryam Naseri Fellowship of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran. 0000-0002-8420-0485 Hashem Lashgari Kalat Department of Pediatrics, Clinical Research Development Center of Children's Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Maryam Mirzaei Department of Obstetrics and Gynecology, Faculty of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran. 0000-0003-2758-853X Najmeh Soltani Nejad Kerman University of Medical Sciences, Kerman, Iran . 0000-0002-3149-5945 Mohammad Hasan Mohammadi Department of Pediatrics, Zabol University of Mediacl Sciences, Zabol, Iran. 0000-0003-0533-5320 Journal Article 2024 10 18 Background: Iron deficiency anemia (IDA) is a significant global health issue, particularly affecting children and adolescents. The present study aims to review the existing research on the prevalence of IDA and iron deficiency (ID) in Iranian children and adolescents. Materials and Methods: Online databases such as PubMed, Scopus, Web of Science, EMBASE, CIVILICA, and the Google Scholar were searched for related reviews and systematic reviews up to February 2024. Two reviewers evaluated the quality of eligible studies and conducted the selection procedure. Results: Five systematic reviews and two additional reviews, involving a total of 159 studies, were selected. The results indicated that the overall prevalence of ID and IDA among Iranian children and adolescents was 24.18% (ranging from 17.95% to 27.7%) and 16.73% (ranging from 10.6% to 21.4%), respectively. The prevalence of IDA was 7.9% (95% CI: 4.1–11.7) in males and 8.5% (95% CI: 6.1–10.8) in females under 18 years of age. In children under 6 years, the prevalence of ID and IDA was 27.7% and 18.2%, respectively. Notably, boys exhibited a higher prevalence of IDA at 17.7% compared to girls at 14.4%. Recent data highlights the differences in prevalence rates among genders, age groups, and geographical locations. Additionally, several factors contribute to the risk of developing IDA, including age (specifically in children under 2 years), family size (larger families), maternal factors (such as children born to anemic mothers or those with low birth weight), and dietary habits (notably a lack of iron-fortified milk consumption). Conclusion: The overall prevalence of IDA varies widely among children and adolescents. By promoting awareness of dietary needs and implementing effective screening programs, healthcare providers can significantly reduce the incidence of IDA in younger populations.

https://www.health-providers.ir/article_208003_b97375314ef18c253deaba1dfbaba0ad.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Evaluating the Role of Anti-Paternal Cytotoxic Antibodies (APCA) in Recurrent Miscarriage: A Critical Review 41 51 209354 10.22034/hp.2024.488089.1049 EN Parsila Taheri Obstetrics and Gynecology Specialist, Infertility Fellowship, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0001-8094-7066 Journal Article 2024 11 10 Background: Recurrent miscarriage (RM), or recurrent pregnancy loss (RPL), is a significant reproductive health issue that affects approximately 2% to 5% of women attempting to conceive. The anti-paternal cytotoxic antibody (APCA) test can serve as an important diagnostic tool for investigating RM. This study aims to review the existing literature on the prevalence and diagnostic utility of APCA testing in women experiencing RM. Materials and Methods: The search was conducted across online databases, including PubMed, Scopus, Web of Science, CIVILICA, and Google Scholar until March 2024. This review integrates findings from various studies to determine the prevalence and diagnostic effectiveness of APCA in women with RM. Results: The incidence of positive APCA was detected in 32% of successful pregnancies. However, the detection of APCA was rare before 28 weeks of gestation, which limits its utility as an early diagnostic tool for recurrent miscarriage. For women diagnosed with RM and positive APCA, immunotherapy may serve as a promising treatment option that can significantly enhance live birth rates, increasing from 18.5% to 53.7% post-treatment. While APCA testing can provide insights into miscarriage risk, its reliability is constrained by methodological inconsistencies and demographic variability. To enhance the accuracy and relevance of APCA testing in clinical practice, it is essential to consider individual patient factors such as age, medical history, and genetic background when developing treatment strategies. Conclusion: While, APCA testing provides valuable insights into immunological factors related to recurrent pregnancy loss (RPL), but its limitations necessitate a cautious approach. Clinicians should integrate APCA results with genetic assessments and environmental considerations to develop a comprehensive diagnostic strategy for better management of RPL.

https://www.health-providers.ir/article_209354_6f7e52dca0fa98be9e09fcd03dff83c7.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Tobacco Use among Iranian Students: A Public Health Challenge 53 56 210210 10.22034/hp.2024.490859.1051 EN Shima Imannezhad Pediatric Neurologist, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-5537-2763 Journal Article 2024 11 26 The prevalence of smoking among Iranian students is a significant public health concern, with an overall rate of approximately 13.56% among college and high school students. College students exhibit a higher smoking rate of 15.62% compared to high school students, who have a rate of 9.77% (1). Specific groups, such as medical students, report even higher rates at 19.2% (2), while approximately 7.8% of university students engage in non-daily smoking (3) (Table 1). This variation highlights the need for targeted public health initiatives to address the rising tobacco use among Iranian youth and to understand the underlying factors contributing to this trend. The issue of smoking among students is a complex public health concern influenced by multiple factors. Understanding how demographics, social influences, and behavioral factors interact is crucial for effectively addressing this challenge. Research indicates that these elements significantly impact students’ smoking behaviors, influencing their decisions to start or continue smoking. Demographic factors significantly influence smoking behavior among Iranian students, highlighting the need for targeted public health interventions. Research indicates that variables such as gender, age, and socioeconomic status play critical roles (2-4). For instance, the prevalence of smoking is notably higher among male students (33%) compared to female students (11%), with urban areas exhibiting greater rates than rural ones (5). Social influences, particularly peer pressure and a family history of smoking, also contribute significantly to smoking behavior. A study revealed that 51% of high school students had tried smoking, with friends being the primary influence (6). Geographic location is another critical factor affecting smoking prevalence; urban areas typically show higher rates than their rural communities. For example, students in northern Iran have significantly higher smoking rates compared to those in other regions (4).

https://www.health-providers.ir/article_210210_d60349506d45922f37a7377d2a93ff49.pdf

Masumeh Saeidi Health Providers 2820-9192 4 1 2024 06 01 Understanding Malnutrition in Iraqi Children: Key Insights on Prevalence, Causes, and Solutions 57 62 213889 10.22034/hp.2025.501344.1056 EN Zahid Jasim Mohammed Basic Science Department, College of Nursing, University of Baghdad, Baghdad, Iraq. 0000-0002-7510-5144 Alaa Jasim Alsadaji MSN, Technical Affairs Department, Baghdad Medical City, Baghdad, Iraq. 0000-0001-9042-973X Sadeq Al-Fayyadh Associate Professor, Chair of Adult Nursing, School of Nursing and Midwifery, University of Baghdad, Baghdad, Iraq. 0000-0002-1194-1143 Journal Article 2025 01 21 Dear Editor-in-Chief, The prevalence of malnutrition among children aged 0-6 years in Iraq is a significant public health concern, with various studies highlighting different aspects of this issue (1). The prevalence rates vary across regions and are influenced by socio-economic and environmental factors (2). In Baghdad, the prevalence of malnutrition among preschool children was found to be 18.2%, with environmental factors such as unstable security situations playing a significant role (3). A national survey indicated that 27% of children under five in Iraq suffer from chronic malnutrition, despite extensive food aid efforts (4). Recent data indicates that Iraq is making significant strides in addressing malnutrition. The prevalence of stunting among children under five years is reported at 12.6%, which is notably lower than the regional average of 21.8% (5). Additionally, the prevalence of wasting has decreased to 3%, also below the regional average (6). However, challenges persist, particularly in southern Iraq, where stunting affects 21% of children and wasting is reported at 10.8% (7). At present, malnutrition among children in Iraq remains a significant public health concern, shaped by socio-economic, environmental, and political factors (8). The following presents a brief analysis based on the latest data:

https://www.health-providers.ir/article_213889_223e3102c2627d3326ae42892631cde0.pdf