title: A retrospective study of demographic parameters and major health referrals among Afghan refugees in Iran.
abstract: BACKGROUND
  For nearly three decades, the two neighboring countries of Iran and Pakistan hosted millions of Afghans. Today, Afghans still represent the largest group of refugees in the world. This feature has greatly influenced provision of health care for this population. Due to a paucity of research on the health status of Afghan refugees in Iran, this study aim to make a vista on the pattern of different common diseases among Afghan refugees in Iran and use it as an index for performance evaluation of future health services to them.
  
  
  METHODS
  This is a retrospective cross sectional study, in which we collected the demographic and medical data between 2005 and 2010 from referrals to the United Nations High Commissioner for Refugees (UNHCR) offices in Iran. We also considered a comparative review of the burden of disease estimates by the World Health Organization (WHO) for Afghanistan and Iran.
  
  
  RESULTS
  Total numbers of referrals were 23,152 with 52.6% Female and 47.66% male. 29% were 0-14 years of age, 54% were 15-59, and 17% were 60+. The most common health referral for females and males (0-14) was perinatal diseases (15.16%, 15.2%, respectively). In the females (15-59) it was ophthalmic diseases (13.65%), and for males it was nephropathies (21.4%), and in both sexes (60+) age range it was ophthalmic diseases (21.3%, 19.9%, respectively). The largest ethnic group of afghan refugees in this study was Hazara (55%) followed by Tajik (14%), Fars (12%), Sadat (9%), and 10% others. Ophthalmic diseases were the major cause of referrals by Hazara, Tajik, Fars, and Sadat groups with 26%, 20%, 26%, and 27% respectively. Referrals by pashtun group were mostly for neoplasms (17%), among Uzbek group it was nephropathies (26%), and in Baluch group Hematopoietic disorders (25%).
  
  
  CONCLUSIONS
  These data indicate higher referral rate for women 15-59 years of old and people in 60+ with ophthalmic diseases, neoplasms, and nephropathies. Even given certain intrinsic limitations of such a study, we believe these unique findings are worth further explanation. This implies the need for public health researchers to pursue prospective studies in these areas.
authors.affiliation: Department of Research, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA. salmanotoukesh@cdrewu.edu
authors.forename: Salman
authors.initials: S
authors.lastname: Otoukesh
authors.forename: Mona
authors.initials: M
authors.lastname: Mojtahedzadeh
authors.forename: Dean
authors.initials: D
authors.lastname: Sherzai
authors.forename: Arash
authors.initials: A
authors.lastname: Behazin
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Bazargan
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000208:ethnology; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult