Burden of Vaccine-Preventable Diseases-Measles, Tetanus, Diphtheria and Whooping Cough-in Iran: Findings from the GBD study 2010.

Background: Vaccination has been one of the most successful and cost-effective public health interventions in the last century and hassaved millions of lives. In 1984, the Expanded Program on Immunization (EPI) was launched in Iran as one of the main components ofPrimary Health Care (PHC).Objectives: We aimed to investigate the burden of four vaccine-preventable diseases from 1990 to 2010 in Iran.Methods: GBD study 2010 includes death rates, Years of Life Lost (YLLs), Years Lived with Disability (YLDs) and Disability Adjusted LifeYears (DALYs). YLLs is calculated through multiplying the number of deaths in each age group by a reference life expectancy for the sameage group, while YLDs can be obtained from the prevalence of a disease multiplied by the disability weight (DW) for the same disease.The sum of these two indices yields DALYs. In the present study, we tried to produce new graphs and explain more about Iran results. Wealso describe the GBD study limitations.Results: Regardless of gender differences, DALYs rates for measles at all ages were 86.1220 and 5.5703 per 100 000 in 1990 and 2010,respectively, indicating approximately 94% decrease in this disease. The maximum and minimum rates of deaths from whooping coughfor males aged under 5 was 4.0674 and 0.2713 per 100 000 in 1990 and 2000, respectively, which shows 93% decline in whooping coughfrom in this period.Conclusion: This study demonstrated that vaccination has had a positive impact on the control of communicable diseases. But the resultsof this study have some limitations similar to GBD study which may pave the way for decision makers about other public health interventions.Moreover, since measuring the impact of various diseases on health plays an important role in public health, it can be an importantstep toward prioritization in health.Keywords: Diphtheria, Iran, measles, tetanus, vaccine, whooping cough