Epidemiology of Gastroesophageal Reflux Disease in Iran: A Systematic Review and Meta-analysis

Abstract

Introduction : Gastroesophageal reflux disease (GERD), which leads to acid reflux into the esophagus, is a common gastrointestinal disorder. Several studies have shown the prevalence of GERD in Iranian population, but their evidence is contradictory. Therefore, the present study was conducted to investigate the epidemiology of GERD in Iran. Methods: The entire steps of this systematic review and meta-analysis were based on the MOOSE protocol, and the results were accordance with the PRISMA guideline. To find potentially relevant published articles, comprehensive search was done on international online databases Scopus, Science Direct, EMBASE, PubMed/Medline, CINAHL, EBSCO, Cochrane Library (Cochrane Database of Systematic Reviews - CDSR), Web of Science (ISI) and Iranian online databases IranDoc, (SID), Magiran, RICST, Iranian National Library, and Barakat Knowledge Network System and the Google Scholar search engine in June 2019. Cochran test and I 2 index were used to assess the heterogeneity of the studies. Data were analyzed using Comprehensive Meta-Analysis (CMA) software. Results: The daily, weekly, monthly, and overall prevalence of GERD symptoms in Iranian population was 5.64% (95%CI [confidence interval]: 3.77%-8.35%; N=66,398), 12.50% (95%CI: 9.63%-16.08%; N=110,388), 18.62% (95%CI: 12.90%-26.12%; N= 70,749) and 43.07% (95%CI: 35.00%-51.53%; N=73,189), respectively. The daily, weekly, monthly, and overall prevalence of heartburn in Iranian population was 2.46% (95%CI: 0.93%-6.39%; N=18,774), 9.52% (95%CI: 6.16%-14.41%; N=54,125), 8.19% (95%CI: 2.42%-24.30%; N=19,363) and 23.20% (95%CI: 13.56%-36.79%; N=26,543), respectively. The daily, weekly, monthly, and overall prevalence of regurgitation in Iranian population was 4.00% (95%CI: 1.88%-8.32%; N=18,774), 9.79% (95%CI: 5.99%-15.60%; N=41,140), 13.76% (95%CI: 6.18%-44.31%; N=19,363) and 36.53% (95%CI: 19.30%-58.08%; N=21,174), respectively. Conclusion: The present meta-analysis provides comprehensive and useful information on the epidemiology of GERD in Iran for policy-makers and health care providers. This study showed a high prevalence of GERD in Iran. Therefore, effective measures on GERD-related factors such as lifestyle can be among the health policies of Iran.

The Relationship of Basic and Instrumental Activities of Daily Living With the Risk of Developing Pressure Ulcer

“…In this study, there were significant correlations between the risk of pressure ulcer development and variables of age, underlying diseases, disability, and specific drug use (P<0.001). The results of review and metaanalysis study of Karimian et al Entitled "The incidence of pressure ulcer in Iran: A systematic review study and meta-analysis" in 2014 indicate that the prevalence of pressure ulcer increases with the increase of age (Karimian et al 2016). Raju et al (2015) In their study entitled "Investigating factors associated with pressure ulcer development: An analytical method" found out that age had a statistically significant and positive correlation with pressure ulcer development (P<0.001).…”

“…About 10% of hospitalized patients and 5% of communityliving patients have varying degrees of PUs. In a review study of Karimian et al On 5973 patients in Iran during 1998, the incidence of PUs among hospitalized patients was reported as 19% (Karimian et al 2016).…”