Introduction of Azar Cohort Project
Prospective Cohort is one of fundamental projects of epidemiologic studies in which the possibility of the study of combined effects of the life style, genetic background and other risk factors exists. Comparing with the other studies, it includes a wide scope of research subjects which can be generalized to a society or even to a wider population than a society. According to the scientific position of the cohort, the existence of such a study is very worthy in every university. In this regard, Tabriz University of Medical Sciences in 1393 announced its readiness to implement the cohort of the part of the prospective epidemiological research studies in Iran (Persian).
Persian Cohort has been implemented in 1393 to develop and encourage research and also to empower medical universities of the country in medical sciences, epidemiology, health and nutrition. The main purpose of this project is to find risk factors and prevent from common non-communicable diseases (NCDs). The results and findings of this study had been important in the country health system in order to make necessary changes. These information can provide more suitable methods to prevent and treat these diseases which finally result in the promotion of the health of the Iranian society and the development of medical sciences in Iran and in the world.Considering the expertise of Tabriz university of Medical sciences, and proven track record of Prof. Somi, Tabriz university of medical sciences was selected for the cohort study.
Choosing the place of the study
Azar Cohort project chose Shabestar County as the place for the implementation of Azar Cohort. This process took place after holding various sessions with professors of Tabriz University of Medical Sciences and health authorities as well as studying the conditions of the study and possible facilities in Shabestar County.
The purpose of the study
The most important purposes of Azar Cohort have been mentioned as follows:
1. The study of the prevalence of non-communicable diseases (such as cardiovascular diseases, cancer, respiratory diseases and so on) and according to the World Health Organization, they are the main cause of mortality and disability in the world. Approximately, three quarters of deaths in low and middle income countries are due to NCDs (28 million deaths). According to the country reports, the prevalence of cardiovascular diseases, cancer and diabetes is increasing. Cardiovascular diseases, cancer and diabetes ranked second and third in Iran, respectively after incidents and road accidents.
2. Evaluation of the best methods to determine the prevalence, causes of the prevalence of NCDs, prevention, intervention and treatment NCDs which cardiovascular diseases, cancer, respiratory, digestive, kidney and liver and other diseases are the most important ones.
3. Empower health care systems to provide the best prevention and treatment services
4. Offering and presenting the most practical solutions and programs to increase life expectancy
5. Providing the possibility of exchanging scientific information with the international universities
The expected results
1. To determine the causes of death
2. To determine the prevalence of NCDs
3. To determine changes of the risk pattern of effective factors such as anthropometric and physiologic factors, life style, environment and diet in the prevalence of NCDs
Purpose population
Generally, the population of 35 to 70 year old inhabitants in the central district of Shabestar County is about 33 thousand people which according to the country protocol in all the conducting cohorts, 10 thousand people should participate in every study. But in Azar Cohort based on the held scientific sessions, it was decided to participate 15 thousand people in this study. Enrollment phase of Azar Cohort is already implementing.
It should be mentioned that regarding to the deployment of the cohort staff in Khameneh city, the random selection of households has not been made; in other words, the invitation of the qualified individuals was made in all of their households. Now 100 percent of the eligible individuals in Khameneh city are participated in this study. In other regions under investigation with the cohort, 30 to 40 percent of the eligible population has been participated in this study.
The method of data collection
The method of data collection is a face-to-face interview done by the trained interviewers. Questionnaires are in an electronic form and include 55 questions and 482 items. According to the questionnaires, this information has been gathered: economic-social situation, life style, occupation, medical history, the used drugs, the family history of diseases, the history of fertility, oral and dental health, anthropometric information, blood pressure, food habits, the use of mobile set and pesticides.
Biologic samples
After obtaining the consent informed from all of the participants, blood, urine, hair and nail samples are taken from them. First, fasting blood sugar, lipid profile, CBC (complete blood count ), liver enzymes, urea, creatinine were studied. Urinalysis was also done on urine samples. Then plasma, serum, buffy coat and whole blood are stored at -80 C freezer and one urine sample are kept at -20 freezer.
The phases of the study
1. Pilot Phase: The pilot phase of Azar Cohort study started on 7 October 2014 and completed on 28 December 2014 and totally 952 people were studied.
2. Enrollment Phase: The Enrollment Phase started on 7 May 2015 and completed on 18 February 2017 and in this phase 15 thousand people were studied.
3. Follow-up Phase: This phase starts in 2018 and now it is running.
Every year, follow-ups will perform for all the participants.
Execution of process:
1 week ago Phone call with eligible people and explaination of the conditions of the study
Presence of the people in the center of the cohort
Send patients to the cohort laboratory, obtain 25 cc of blood, hair and nail sample
Obtain blood sample and make ready breakfast for the participants
Physical questionnaire
Questionnaire (information about economic, social and other situations)
Anthropometry
Food frequency questionnaire and food habits
Blood pressure and pulse
Reference of the individuals to other sections
Enrollment of people based on the identification information
Phone call or recall one day sooner