Comparing spatio-temporal distribution of the most common human parasitic infections in Iran over two periods 2007 to 2012 and 2013 to 2018: A systematic quantitative literature review

Retrospective Evaluation of Toxoplasma gondii Test Results in Patients Applying to A Research Hospital

Objective

This study retrospectively evaluates our laboratory Toxoplasma gondii immunoglobulin (Ig)M, IgG antibody and avidity test results to determine the distribution of the pathogen according to sex, age, clinics and years.

Methods

The serum samples sent to Pamukkale University Healthcare Research and Practice Hospital's Medical Microbiology laboratory between January 2016 and December 2023 were evaluated for T. gondii seropositivity. Toxoplasma antibodies and avidity testing were studied using chemiluminescent microparticle immunological testing method (Abbott Architect i2000SR, Weisbaden, Germany).

Results

The study evaluated 42,817 tests ordered from patients with suspected toxoplasmosis. Five hundred-three (2.1%) were found to be anti-T. gondii-IgM positive and 4.406 (24.7%) to be anti-T. gondii-IgG positive. Anti-T. gondii-IgM and anti-T. gondii-IgG positivity were significantly higher in women than in men (p=0.0001; p=0.0001, respectively). Anti-T. gondii-IgM positivity was found to be high between the ages of 19 and 49 (p=0.0001). The anti-T. gondii-IgG positivity rate increased with age (p=0.0001). Anti-T. gondii-IgM and anti-T. gondii-IgG positivity rates have decreased significantly over the last four years (2020-2023) compared to the first four years (2016-2019) (p=0.0001; p=0.0001, respectively). When the results of 582 patients with T. gondii-avidity requests were evaluated, 38.1% of the anti-T. gondii-IgM positive patients and 7.8% of the anti-T. gondii-IgM negative patients had low avidity.

Conclusion

T. gondii seroprevalence was found to be similar to the global average, with female sex, age and nationality among the risk factors. It has also been observed that seroprevalence has significantly decreased in recent years.

Molecular epidemiology and multilocus genotyping of Giardia duodenalis in individuals attending major public hospitals in Shiraz, southwestern Iran: A public health concern

Giardia duodenalis is one of the most common causes of waterborne disease worldwide, and is often associated with outbreaks of diarrhea in areas with poor sanitation and hygiene. This study aimed to assess the prevalence and genetic diversity of G. duodenalis assemblages in individuals attending major public hospitals in Shiraz, southwestern Iran. From August 2022 to May 2023, a total of 614 stool samples from individuals were collected and initially examined for G. duodenalis cysts using parasitological techniques, sucrose flotation, and microscopy. Microscopy-positive samples were validated by SSU-PCR amplification of the parasite DNA. A multilocus genotyping (MLG) scheme, which focused on the triose phosphate isomerase (tpi) and the glutamate dehydrogenase (gdh) genes, was employed for genotyping purposes. G. duodenalis cysts were found in 7.5% (46/614) and 8.5% (52/614) of samples through microscopy and SSU-PCR, respectively. Successful amplification and sequencing results were obtained for 77.3% (17/22) and 45.5% (10/22) of the infected samples at the tpi and gdh loci, respectively. MLG data for the two loci were available for only five samples. Out of the 22 samples genotyped at any loci, 54.5% (12/22) were identified as assemblage A, while 45.5% (10/22) were identified as assemblage B. AII was the most predominant sub-assemblage identified [54.5% (12/22)], followed by BIII [27% (6/22)], discordant BIII/BIV [13.6% (3/22)], and BIV [4.5% (1/22)]. In the present study, no assemblages suited for non-human animal hosts (e.g., C-F) were detected. This suggests that the transmission of human giardiasis in Shiraz is primarily anthroponotic. Further molecular-based analyses are necessary to confirm and expand upon these findings. These analyses will also help determine the presence and public health importance of the parasite in environmental samples, such as drinking water.

Socio-Environmental Determinants and Human Health Exposures in Arid and Semi-Arid Zones of Iran-Narrative Review

Lifestyle is different in arid and semi-arid zones. However, where people are born and live have a lasting influence on their social and environmental exposure. This review focuses on the, various dimensions of environmental health imbalance inequality especially in significant environmental sources such as (ie, air, water, soil) among provinces that creates a big health gap in the center, East and the Southeast of Iran. Thus, the population of the arid and semi-arid zones of Iran is facing respiratory, cardiovascular, cancer and infection diseases linked to environmental problems such as chemical and microbial pollution due to air pollution and unsafe water sources, respectively. The prevalence of certain types of cancer such as skin, stomach, bladder, prostate and colorectal cancer together with some respiratory and cardiovascular diseases in arid and semiarid zones such as Kerman, Yazd, etc., has been reported in comparison with other provinces frequently. These impacts have effects on multiple levels of health security in those zones. Based on these concerns, we propose key questions that should guide research in the context of the socio environmental science to support science-based management actions in Iran and other similar semi-arid areas worldwide.

Spatio-temporal visualisation of cutaneous leishmaniasis in an endemic, urban area in Iran

INTRODUCTION

Cutaneous Leishmaniasis (CL) is a significant public health concern worldwide. Iran is among the most CL-affected countries, being one of the six most endemic countries in the world. This study aimed to provide a spatio-temporal visualisation of CL cases in an endemic urban area in north-eastern Iran identifying high-risk and low-risk areas during the period 2016-2019.

METHODS

This ecological study was conducted in the city of Mashhad, north-eastern Iran. All cases (n=2425) were diagnosed based on clinical findings and parasitological tests. The patient data were aggregated at the census tract level (the highest resolution available). CL incidence rates were subjected to Empirical Bayesian smoothing across the census tracts followed by spatial autocorrelation analysis to identify clusters and outliers. Spatial scan statistic was used to explore the purely temporal, purely spatial and spatio-temporal trend of the disease. In all instances, the null hypothesis of no clusters was rejected at p ≤0.05.

RESULTS

The overall crude incidence rate decreased from 34.6 per 100,000 individuals in 2016 to 19.9 per 100,000 in 2019. Cluster analysis identified high-risk areas in south-western Mashhad and low-risk areas in the north-eastern areas. Purely time scan statistics identified March to July as the time period with highest risk for CL occurrence. One most likely purely high-risk spatial cluster and six secondary purely high-risk spatial clusters were identified. Further, two spatio-temporal high-risk clusters, one in the north of the city from April to August and a second in the south-western part from March to September were observed.

CONCLUSIONS

Significant spatial, temporal and spatio-temporal patterns of CL distribution were observed in the study area, which should be considered when designing tailored interventions, such as effective resource allocation models, informed control plans and implementation of efficient surveillance systems. Furthermore, this study generated new hypotheses to test potential relationships between socio-economic and environmental risk factors and incidence of CL in high-risk areas.

A geodatabase of blood pressure level and the associated factors including lifestyle, nutritional, air pollution, and urban greenspace

Objectives

Hypertension is a prevalent chronic disease globally. A multifaceted combination of risk factors is associated with hypertension. Scientific literature has shown the association among individual and environmental factors with hypertension, however, a comprehensive database including demographic, environmental, individual attributes and nutritional status has been rarely studied. Moreover, an integrated spatial-epidemiological approach has been scarcely researched. Therefore, this study aims to provide and describe a geodatabase including individual-based and socio-environmental data related to people living in the city of Mashhad, Iran in 2018.

Data description

The database has been extracted from the PERSIAN Organizational Cohort study in Mashhad University of Medical Sciences. The data note includes three shapefiles and a help file. The shapefile format is a digital vector storage format for storing geometric location and associated attribute information. The first shapefile includes the data of population, air pollutants and amount of available green space for each census block of the city. The second shapefile consists of aggregated blood pressure data to the census blocks of the city. The third shapefile comprises the individual characteristics data (i.e., demographic, clinical, and lifestyle). Finally, the fourth file is a guide to the previous data files for users.

Epidemiological characteristics and initial spatiotemporal visualisation of COVID-19 in a major city in the Middle East

BACKGROUND

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged initially in China in December 2019 causing the COVID-19 disease, which quickly spread worldwide. Iran was one of the first countries outside China to be affected in a major way and is now under the spell of a fourth wave. This study aims to investigate the epidemiological characteristics of COVID-19 cases in north-eastern Iran through mapping the spatiotemporal trend of the disease.

METHODS

The study comprises data of 4000 patients diagnosed by laboratory assays or clinical investigation from the beginning of the disease on Feb 14, 2020, until May 11, 2020. Epidemiological features and spatiotemporal trends of the disease in the study area were explored by classical statistical approaches and Geographic Information Systems.

RESULTS

Most common symptoms were dyspnoea (69.4%), cough (59.4%), fever (54.4%) and weakness (19.5%). Approximately 82% of those who did not survive suffered from dyspnoea. The highest Case Fatality Rate (CFR) was related to those with cardiovascular disease (27.9%) and/or diabetes (18.1%). Old age (≥60 years) was associated with an almost five-fold increased CFR. Odds Ratio (OR) showed malignancy (3.8), nervous diseases (2.2), and respiratory diseases (2.2) to be significantly associated with increased CFR with developments, such as hospitalization at the ICU (2.9) and LOS (1.1) also having high correlations. Furthermore, spatial analyses revealed a geographical pattern in terms of both incidence and mortality rates, with COVID-19 first being observed in suburban areas from where the disease swiftly spread into downtown reaching a peak between 25 February to 06 March (4 incidences per km2). Mortality peaked 3 weeks later after which the infection gradually decreased. Out of patients investigated by the spatiotemporal approach (n = 727), 205 (28.2%) did not survive and 66.8% of them were men.

CONCLUSIONS

Older adults and people with severe co-morbidities were at higher risk for developing serious complications due to COVID-19. Applying spatiotemporal methods to identify the transmission trends and high-risk areas can rapidly be documented, thereby assisting policymakers in designing and implementing tailored interventions to control and prevent not only COVID-19 but also other rapidly spreading epidemics/pandemics.

Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018

BACKGROUND

Effective reduction of tuberculosis (TB) requires information on the distribution of TB incidence rate across time and location. This study aims to identify the spatio-temporal pattern of TB incidence rate in Iran between 2008 and 2018.

METHODS

This cross-sectional study was conducted on aggregated TB data (50,500 patients) at the provincial level provided by the Ministry of Health in Iran between 2008 and 2018. The Anselin Local Moran's I and Getis-Ord Gi* were performed to identify the spatial variations of the disease. Furthermore, spatial scan statistic was employed for purely temporal and spatio-temporal analyses. In all instances, the null hypothesis of no clusters was rejected at p ≤ 0.05.

RESULTS

The overall incidence rate of TB decreased from 13.46 per 100,000 (95% CI: 13.19-13.73) in 2008 to 10.88 per 100,000 (95% CI: 10.65-11.11) in 2018. The highest incidence rate of TB was observed in southeast and northeast of Iran for the whole study period. Additionally, spatial cluster analysis discovered Khuzestan Province, in the West of the country, having significantly higher rates than neighbouring provinces in terms of both total TB and smear-positive pulmonary TB (SPPTB). Purely temporal analysis showed that high-rate and low-rate clusters were predominantly distributed in the time periods 2010-2014 and 2017-2018. Spatio-temporal results showed that the statistically significant clusters were mainly distributed from centre to the east during the study period. Some high-trend TB and SPPTB statistically significant clusters were found.

CONCLUSION

The results provided an overview of the latest TB spatio-temporal status In Iran and identified decreasing trends of TB in the 2008-2018 period. Despite the decreasing incidence rate, there is still need for screening, and targeting of preventive interventions, especially in high-risk areas. Knowledge of the spatio-temporal pattern of TB can be useful for policy development as the information regarding the high-risk areas would contribute to the selection of areas needed to be targeted for the expansion of health facilities.

The Role of Social Media in the Advent of COVID-19 Pandemic: Crisis Management, Mental Health Challenges and Implications

BACKGROUND

This study focuses on how educating people through social media platforms can help reduce the mental health consequences of the COVID-19 to manage the global health crisis. The pandemic has posed a global mental health crisis, and correct information is indispensable to dispel uncertainty, fear, and mental stress to unify global communities in collective combat against COVID-19 disease worldwide. Mounting studies specified that manifestly endless coronavirus-related newsfeeds and death numbers considerably increased the risk of global mental health issues. Social media provided positive and negative data, and the COVID-19 has resulted in a worldwide infodemic. It has eroded public trust and impeded virus restraint, which outlived the coronavirus pandemic itself.

METHODS

The study incorporated the narrative review analysis based on the existing literature related to mental health problems using the non-pharmaceutical interventions (NPIs) approach to minimize the COVID-19 adverse consequences on global mental health. The study performed a search of the electronic databases available at PsycINFO, PubMed, and LISTA. This research incorporates the statistical data related to the COVID-19 provided by the WHO, John Hopkins University, and Pakistani Ministry of Health.

RESULTS

Pakistan reported the second-highest COVID-19 cases within South Asia, the fifth-highest number of cases in Asia after Iran, India, Russia, Saudi Arabia, and the 14th highest recorded cases, as of October 14, 2020. Pakistan effectively managed the COVID-19 pandemic in the second wave. It stands at the eighth-highest number of confirmed cases in Asia, the 3rd-highest in South Asia, and the 28th-highest number of established patients globally, as of February20, 2021.

CONCLUSION

The COVID-19 has resulted in over 108.16 million confirmed cases, deaths over 2.374 million, and a recovery of 80.16 million people worldwide, as of February 12, 2021. This study focused on exploring the COVID-19 pandemic's adverse effects on global public health and the indispensable role of social media to provide the correct information in the COVID-19 health crisis. The findings' generalizability offers helpful insight for crisis management and contributes to the scientific literature. The results might provide a stepping-stone for conduct future empirical studies by including other factors to conclude exciting developments.

A spatio-temporal geodatabase of mortalities due to respiratory tract diseases in Tehran, Iran between 2008 and 2018: a data note

Objectives

Respiratory tract diseases (RTDs) are among the top five leading causes of death worldwide. Mortality rates due to respiratory tract diseases (MRRTDs) follow a spatial pattern and this may suggest a potential link between environmental risk factors and MRRTDs. Spatial analysis of RTDs mortality data in an urban setting can provide new knowledge on spatial variation of potential risk factors for RTDs. This will enable health professionals and urban planners to design tailored interventions. We aim to release the datasets of MRRTDs in the city of Tehran, Iran, between 2008 and 2018.

Data description

The Research data include four datasets; (a) mortality dataset which includes records of deaths and their attributes (age, gender, date of death and district name where death occurred), (b) population data for 22 districts (age groups with 5 years interval and gender by each district). Furthermore, two spatial datasets about the city are introduced; (c) the digital boundaries of districts and (d) urban suburbs of Tehran.

Mortality rates due to respiratory tract diseases in Tehran, Iran during 2008-2018: a spatiotemporal, cross-sectional study

BACKGROUND

Tehran, the 22nd most populous city in the world, has the highest mortality rate due to respiratory system diseases (RSDs) in Iran. This study aimed to investigate spatiotemporal patterns of mortality due to these diseases in Tehran between 2008 and 2018.

METHODS

We used a dataset available from Tehran Municipality including all cases deceased due RSDs in this city between 2008 and 2018. Global Moran's I was performed to test whether the age-adjusted mortality rates were randomly distributed or had a spatial pattern. Furthermore, Anselin Local Moran's I was conducted to identify potential clusters and outliers.

RESULTS

During the 10-year study, 519,312 people died in Tehran, 43,177 because of RSDs, which corresponds to 831.1 per 10,000 deaths and 5.0 per 10,000 population. The death rate was much higher in men (56.8%) than in women (43.2%) and the highest occurred in the > 65 age group (71.2%). Overall, three diseases dominated the mortality data: respiratory failure (44.2%), pneumonia (15.9%) and lung cancer (10.2%). The rates were significantly higher in the central and southeastern parts of the city and lower in the western areas. It increased during the period 2008-2018 and showed a clustered spatial pattern between 2008 and 2013 but presented a random geographical pattern afterwards.

CONCLUSIONS

This study provides a first report of the spatial distribution of mortality due to RSDs in Tehran and shows a significant increase in respiratory disease mortality in the last ten years. Effective control of the excess fatality rates would warrant a combination of urban prevention and treatment strategies including environmental health plans.