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Rahimitabar P, Kraemer A, Bozorgmehr K, Ebrahimi F, Takian A. Health condition of Afghan refugees residing in Iran in comparison to Germany: a systematic review of empirical studies. Int J Equity Health 2023; 22:16. [PMID: 36681845 PMCID: PMC9862781 DOI: 10.1186/s12939-023-01832-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The re-emerging dominance of the Taliban in Afghanistan in 2021 caused a new wave of Afghan refugees heading Iran and neighboring countries. Iran in the Middle East and Germany in Europe are two major host countries to the largest populations of Afghan refugees. In both countries, several studies have been done to assess the health condition of refugees. OBJECTIVES To systematically review the existing literature to identify similarities and differences of health conditions of Afghan refugees living in the two countries, and to synthesize evidence on the health status and health care access of these populations. METHODS Related electronic databases and grey literature of Iran and Germany on the health of Afghan refugees were scanned and searched up for the period 2000-2020. Key terms were formed by combining "Afghan refugees or immigrants or populations or asylum seekers", "Physical or mental health", "Healthcare service or access or use", "Iran or Germany". Empirical studies were considered if they contained samples of Afghan refugees with particular outcomes for Afghans. Results were categorized for both countries in the three main areas of physical health, mental health, and access/use of healthcare services. RESULTS Nine hundred twenty-two documents were extracted, of which 75 full-texts were finally reviewed. 60 documents belonged to the health condition of Afghan refugees residing in Iran including 43 in physical health, 6 in mental health, 8 in healthcare access and use, and 3 in multiple aspects of health, and 15 belonged to Germany including 7 in physical health, 4 in mental health, 2 in healthcare access and use, and 2 in multiple aspects of health. A less explicit evaluation of the overall health condition of Afghan refugees was observable, particularly for Germany. While matches on the study subject exist for both countries, in comparison to Germany, we extracted more quantitative and qualitative health studies on Afghan refugees of the mentioned areas from Iran. German health studies were rare, less qualitative, and more on the health condition of diverse refugee groups in general. CONCLUSIONS Wide gaps and unanswered questions related to mental health and overall health status of the Afghan refugee population are observable, especially in Germany. Our systematic review identified the gap in evidence, which we would recommend to bridge using a wider lens to comprehensively assess the overall condition of refugees considering associations between health and socio-economic and cultural determinants instead of a one-dimensional approach. Further, within health studies on refugee populations, we recommend stratification of results by the country of origin to capture the within-group diversity among refugees with different countries of origin.
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Affiliation(s)
- Parisa Rahimitabar
- grid.7491.b0000 0001 0944 9128FlüGe Research Project (Refugee Health), School of Public Health, Bielefeld University, P.O. Box 100131, 33501 Bielefeld, Germany
| | - Alexander Kraemer
- grid.7491.b0000 0001 0944 9128FlüGe Research Project, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Kayvan Bozorgmehr
- grid.7491.b0000 0001 0944 9128Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.O. Box 100131, 33501 Bielefeld, Germany ,grid.5253.10000 0001 0328 4908Section for Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
| | - Fatemeh Ebrahimi
- grid.7491.b0000 0001 0944 9128School of Public Health, Bielefeld University, P.O. Box 100131, 33501 Bielefeld, Germany
| | - Amirhossein Takian
- grid.411705.60000 0001 0166 0922Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), P.O. Box 1417613151, Tehran, Iran ,grid.411705.60000 0001 0166 0922Department of Health Management, Policy & Economics, School of Public Health, TUMS, Tehran, Iran ,grid.411705.60000 0001 0166 0922Heath Equity Research Center (HERC), TUMS, Tehran, Iran
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Okati-Aliabad H, Ansari-Moghaddam A, Mohammadi M, Nejati J, Ranjbar M, Raeisi A, Kolifarhood G, Shahraki-Sanavi F, Khorram A. Access, utilization, and barriers to using malaria protection tools in migrants to Iran. BMC Public Health 2022; 22:1615. [PMID: 36008787 PMCID: PMC9404647 DOI: 10.1186/s12889-022-13913-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Imported malaria cases could be considered one of the threats to malaria elimination. Therefore, increasing migrants’ access to malaria preventive measures can play an essential role in maintaining appropriate conditions and preventing malaria outbreaks. This study aimed to provide detailed information about access, utilization, and barriers to using malaria protection tools in migrants to Iran. Methods This study was conducted in a vast region consisting of 4 provinces and 38 cities located in the south and southeast of the country. Study participants were migrants who moved to the study area in the past three months. A sample of 4163 migrants participated in the study. They were selected through a multi-stage sampling method to obtain a representative community sample. Data were collected through interviewer-administered questionnaires about participants’ socio-demographic specification, commuting characteristics, travel aim, access, ways of preparing, and reasons to use or not to use malaria protection tools. Quantitative and qualitative variables were described and analyzed finally. Results The mean age of individuals was 28.6 ± 10.8, with a range of 3–88 years old. Migrants’ country of origin was Afghanistan (56.6%), Pakistan (38.4%), and Iran (5%). Most migrants (69.2%) did not have malaria protection tools while staying in Iran. Among those who procured the protection tools, 74% used long-lasting insecticidal nets (LLINs), 13.4% used mosquito repellent sticks and coil, and 12.7% did not use any tools. Respectively, lack of knowledge about where they can get LLINs, followed by being expensive, unavailability in the market, not cooperation of health officer, and no need to use were expressed as the causes for having no access. The main reasons for non-using the tools were lack of knowledge about their application, followed by a defect in protection tools, ineffectiveness, and being harmful, respectively. Migrants who were supported by an employer accessed more to LLINs. Conclusions This study reveals significant shortcomings in knowledge, access, and utilization of malaria protection tools among migrants in Iran. Inequitable access to public health services is predictable during migration; however, access to sustainable protection tools is recommended.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Jalil Nejati
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mansour Ranjbar
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ahmad Raeisi
- National Program for Malaria Control, Center of Disease Control & Prevention, Ministry of Health and Medical Education, Tehran, Iran
| | - Goodarz Kolifarhood
- National Program for Malaria Control, Center of Disease Control & Prevention, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Alireza Khorram
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Setto JM, Libonati RMF, Ventura AMRDS, Chaves TDSS, Sequeira CG, Martins Filho AJ, Machado RLD, Franceschin SDCC, Barreto JTT. Association between vitamin D serum levels and clinical, laboratory, and parasitological parameters in patients with malaria from an endemic area of the Amazon. Rev Soc Bras Med Trop 2022; 55:e00772021. [PMID: 35416868 PMCID: PMC9009878 DOI: 10.1590/0037-8682-0077-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Some studies have suggested the importance of vitamin D [25(OH)D] in malaria clinical practice. The prevalence of 25(OH)D deficiency in the Amazon population is not well known, and there are few studies in patients with malaria. This study aimed to evaluate 25(OH)D serum levels in patients with malaria and determine their relationships with epidemiological, clinical, laboratory, and parasitemia data. Methods: An analytical cross-sectional study of 123 patients with malaria and 122 individuals without malaria was performed in Itaituba, Pará, Brazil, from January 2018 to October 2019, by evaluating sociodemographic, clinical-epidemiological, parasitological, and laboratory data and adopting a 5% significance level. Parametric tests (Student's t-test), non-parametric tests (Mann-Whitney U), and Spearman’s correlation ([rs], for non-parametric variables) were used according to the nature of the distribution of the variables. For the qualitative variables, Pearson's chi-square test, Fisher's exact test, and the G test were used. Spearman's correlation was used to compare the results of the 25(OH)D levels and blood counts performed among patients and the control group. Results: Malaria patients residing in a mining area had 25(OH)D serum levels that were significantly lower than those in the control group residing in the mining area, though both were within normal levels. Red blood cell counts had an inverse correlation with parasitemia (Plasmodium falciparum), and platelet levels had an inverse correlation with parasitemia (Plasmodium vivax). 25(OH)D deficiency was evidenced in Itaituba, in the state of Pará, which is an endemic area of malaria in the Amazon region.
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Affiliation(s)
- Janaina Maria Setto
- Marinha do Brasil, Centro de Instrução Almirante Braz de Aguiar, Belém, PA, Brasil.,Universidade Federal do Pará, Núcleo de Medicina Tropical, Programa de Pós-Graduação em Doenças Tropicais, Belém, PA, Brasil
| | - Rosana Maria Feio Libonati
- Universidade Federal do Pará, Núcleo de Medicina Tropical, Programa de Pós-Graduação em Doenças Tropicais, Belém, PA, Brasil
| | - Ana Maria Revoredo da Silva Ventura
- Instituto Evandro Chagas, Laboratório de Ensaios Clínicos em Malária, Ananindeua, PA, Brasil.,Universidade Estadual do Pará, Centro de Ciências Biológicas e da Saúde, Belém, PA, Brasil
| | - Tânia do Socorro Souza Chaves
- Instituto Evandro Chagas, Laboratório de Ensaios Clínicos em Malária, Ananindeua, PA, Brasil.,Universidade Federal do Pará, Centro Universitário do Estado do Pará, Belém, PA, Brasil
| | - Carina Guilhon Sequeira
- Universidade Estadual do Pará, Centro de Ciências Biológicas e da Saúde, Departamento de Saúde Integrada, Belém, PA, Brasil
| | | | - Ricardo Luiz Dantas Machado
- Universidade Federal Fluminense, Programa de Pós-Graduação em Microbiologia e Parasitologia, Rio de Janeiro, RJ, Brasil
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Mirahmadi H, Rahmati-Balaghaleh M, Afzalaghaee M, Zarean M, Shamsian SA, Mehravaran A, Raissi V, Etemadi S. Detection of malaria using blood smear by light microscopy, RDT and nested-PCR for suspected patients in south-eastern Iran. Gene Reports 2021. [DOI: 10.1016/j.genrep.2021.101339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zare M, Farshidi H, Soleimani-Ahmadi M, Jaberhashemi SA, Sanei-Dehkordi A. Significant decline of malaria incidence in a low socioeconomic area in the southeast of Iran: 10 years field assessment during malaria elimination programme. J Parasit Dis 2021; 45:986-994. [PMID: 34789982 DOI: 10.1007/s12639-021-01391-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/07/2021] [Indexed: 11/26/2022] Open
Abstract
Although malaria burden and its active foci have sharply declined after the implementation of elimination programme since 2010, it is still considered as a major public health problem in southeast Iran. This descriptive-analytical study aimed to determine 10-years of malaria epidemiological trends in Bashagard County. Data were collected from 7 selected malarious region of the county based on active and passive surveillance of clinical cases. For diagnosis of malaria, the examination of microscopic slides and rapid diagnostic test, were used. In total, 237 malaria cases were found from 2009 to 2018. Plasmodium vivax was the dominant parasite species and identified in 232 (97.9%) individuals. Males were infected more than females and the majority of malaria cases (67.4%) were recorded from rural areas. Although about 98% of malaria cases were indigenous, they have decreased form 200 cases in 2009 to zero indigenous transmission in 2018. During the study period, malaria cases had decreased significantly by about 99% and the incidence rate had declined from 5.47/1000 cases in 2009 to 0.002/1000 in 2018. The incidence of malaria, especially indigenous cases, in Bashagard County has decreased dramatically in the past 10 years. However, there is still probability of malaria re-introduction and outbreak in the county due to climatical and geographical conditions. Therefore, it is necessary to implement an active surveillance system to detect and treat malaria cases quickly, during the elimination phase in this county.
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Affiliation(s)
- Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hossein Farshidi
- Department of Surgery, Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Moussa Soleimani-Ahmadi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, P.O. Box: 79145-3838, Bandar Abbas, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Seyed Aghil Jaberhashemi
- Infectious and Tropical Disease Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Alireza Sanei-Dehkordi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, P.O. Box: 79145-3838, Bandar Abbas, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Soltan-Alinejad P, Soltani A. Vector-borne diseases and tourism in Iran: Current issues and recommendations. Travel Med Infect Dis 2021; 43:102108. [PMID: 34111565 DOI: 10.1016/j.tmaid.2021.102108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/14/2021] [Accepted: 06/04/2021] [Indexed: 12/24/2022]
Abstract
Iran is one of the largest countries in the Middle East with lots of historical and natural attractions. This country has always been considered to be one of the most important tourist destinations in the world. Several important vector-borne diseases have been reported from different parts of the country. Thus, having comprehensive and adequate knowledge about the main vector-borne diseases in Iran and their high-risk areas are really important. In this review, different provinces of Iran have been studied in terms of arthropod-borne diseases reported in the last decades. Reports indicated that some vector-borne diseases such as Leishmaniasis and CCHF had the highest incidence rate and they need serious attention. However, some diseases reported from Iran are not endemic, and all cases were imported such as Dengue fever. A group of arthropod-borne diseases was reported only from animals, and the health of travelers is not threatened such as Eyeworm infection.
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Affiliation(s)
- Parisa Soltan-Alinejad
- Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Aboozar Soltani
- Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Asali S, Raz A, Turki H, Mafakher L, Razmjou E, Solaymani-Mohammadi S. Restricted genetic heterogeneity of the Plasmodium vivax transmission-blocking vaccine (TBV) candidate Pvs48/45 in a low transmission setting: Implications for the Plasmodium vivax malaria vaccine development. Infect Genet Evol 2021; 89:104710. [PMID: 33421653 DOI: 10.1016/j.meegid.2021.104710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/28/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022]
Abstract
Plasmodium vivax is the most widespread malaria species parasitizing humans outside Africa, with approximately 100 million cases reported per year. Most human cases of P. vivax are asymptomatic with low parasitemia, making active case detection-based elimination programme challenging and less effective. Despite the widespread distribution of P. vivax, no effective vaccines are currently available. Transmission blocking vaccines have recently emerged as potential vaccine candidates to reduce transmission rates to below the essential levels required for the maintenance of the parasite life cycle. Here, we demonstrated that P. vivax was the predominant species found in a malaria-endemic area, although P. vivax/P. falciparum co-infections were also common. Through genomic sequence analysis and neighbor-joining algorithms, we demonstrated limited genetic heterogeneity in the P. vivax transmission-blocking vaccine candidate Pvs48/45 among clinical isolates of P. vivax. Restricted genetic polymorphism occurred at both nucleotide and amino acid levels. The most frequent mutation was A → G at nucleotide position 77 (46.7%), whereas the least frequent was C → T at nucleotide position 1230 (3.3%). The occurrence of single nucleotide polymorphisms (SNPs) distribution at 6/8 positions (75%) led to changes in amino acid sequences in the Pvs48/45 loci, whereas 2/8 (25%) of SNPs resulted in no amino acid sequence variations. Consistently, the nucleotide diversity in the Pvs48/45 locus among the P. vivax population studied was extremely low (π = 0.000525). Changes in amino acid sequences in the Pvs48/45 protein did not result in substantial conformational modifications in the tertiary structures of these proteins. Unveiling the population genetic structure and genetic heterogeneity of vaccine target antigens are necessary for rational design of transmission-blocking antibody vaccines and to monitor the vaccine efficacy in clinical trials in endemic areas for malaria.
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Affiliation(s)
- Soheila Asali
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbasali Raz
- Malaria and Vector Research Group, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Habibollah Turki
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ladan Mafakher
- Medicinal Plant Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Razmjou
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Microbial Biotechnology Research Center (MBiRC), Iran University of Medical Sciences, Tehran, Iran.
| | - Shahram Solaymani-Mohammadi
- Laboratory of Mucosal Immunology, Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States.
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Delam H, Shokrpour N, Nikbakht HA, Hassanipour S, Safari K, Bazrafshan MR. Changing Patterns in Epidemiology of Malaria Between 2006 and 2018 in the South of Fars Province, Southern Iran: The Fall and Rise of Malaria. Ann Glob Health 2020; 86:80. [PMID: 32704485 DOI: 10.5334/aogh.2850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Malaria is one of the major human health problems that have become increasingly important in recent decades. Objective The present study aimed to identify the epidemiological status of malaria in the years 2006-2018 in the southern region of Fars province in southern Iran. Methods This is a cross-sectional descriptive-analytical study. The study population consisted of all persons with malaria referred to the Center for Disease Control in the four cities of Larestan, Gerash, Evaz and Khonj in the south of Fars province, Southern Iran, between 2006 and 2018. Frequency (%) was used to report descriptive statistics and mean and standard deviation for quantitative variables. The trend of malaria incidence during these years was analyzed using the Cochran Armitage Test. The significance level was considered 5%. Findings A total of 190 cases of malaria in the period of 2006 to 2018 occurred in the southern region of Fars province; 77.9% were men, more than 95% were Afghans, and most of them were workers. The incidence of malaria in one hundred thousand people per month showed that most of the new malaria cases were in the months of July to October. The peak incidence was in August, with 19.88 cases per 100,000 people. Cochran-Armitage test results showed that this trend was not statistically significant (P = 0.399), despite an almost upward trend in malaria incidence in the south of Fars province. Conclusion The results of this study showed that the trend of malaria in the south of Fars province was ascending; therefore, increasing surveillance activities to prevent and control malaria in such area is of utmost importance.
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Azizi H, Davtalab-Esmaeili E, Farahbakhsh M, Zeinolabedini M, Mirzaei Y, Mirzapour M. Malaria situation in a clear area of Iran: an approach for the better understanding of the health service providers' readiness and challenges for malaria elimination in clear areas. Malar J 2020; 19:114. [PMID: 32188469 PMCID: PMC7079540 DOI: 10.1186/s12936-020-03188-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 03/11/2020] [Indexed: 12/07/2022] Open
Abstract
Background Malaria mortality and morbidity have decreased in recent years. Malaria elimination (ME) and effective efforts to achieve ME is one of the most important priorities for health systems in countries in the elimination phase. In very low transmission areas, the ME programme is faced with serious challenges. This study aimed to assess the trend while getting a better understanding of Health Service Providers’ (HSPs) readiness and challenges for ME in a clear area of Iran. Methods This study was performed in two phases. At first, the malaria trend in East Azerbaijan Province, was surveyed from 2001 to 2018; afterward, it was compared with the national situation for a better understanding of the second phase of the study. Data were collected from the Ministry of Health’s protocol and the health centre of the province. In the second phase, malaria control programme experts, health system researchers, and health managers’ opinions were collected via in-depth interviews. They were asked regarding HSPs readiness and appropriate Malaria Case Management (MCM) in a clear area and possible challenges. Results A total of 135 and 154,560 cases were reported in the last 18 years in East Azerbaijan Province and Iran, respectively. The incidence rate decreased in East Azerbaijan Province from 0.4/10,000 in 2001 to zero in 2018. Furthermore, no indigenous transmission was reported for 14 years. Also, for the first time, there was no indigenous transmission in Iran in 2018. The main elicited themes of HSPs readiness through in-depth interviews were: appropriate MCM, holistic and role-playing studies for assessment of HSPs performance, system mobilization, improving identification and diagnosis of suspected cases in the first line. Similarly, the main possible challenges were found to be decreasing health system sensitivity, malaria re-introduction, and withdrawing febrile suspected cases from the surveillance chain. Conclusion Health systems in eliminating phase should be aware that the absence of malaria cases reported does not necessarily mean that malaria is eliminated; in order to obtain valid data and to determine whether it is eliminated, holistic and role-playing studies are required. Increasing system sensitivity and mobilization are deemed important to achieve ME.
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Affiliation(s)
- Hosein Azizi
- Department of Epidemiology and Biostatistics, School of Health, Tehran University of Medical Sciences, Tehran, Iran. .,Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Elham Davtalab-Esmaeili
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Zeinolabedini
- Basic Sciences Department, School of Allied Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yagoub Mirzaei
- Province Heath Center for Disease Control, Department of Communicable Diseases, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Mirzapour
- Health Network Manager, Tabriz University of Medical Sciences, Tabriz, Iran
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Mardani A. Prevention strategies of transfusion-transmitted parasitic infections (TTPIs): Strengths and challenges of current approaches, and evaluation of the strategies implemented in Iran. Parasite Epidemiol Control 2020; 9:e00141. [PMID: 32149193 PMCID: PMC7052507 DOI: 10.1016/j.parepi.2020.e00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 01/27/2020] [Accepted: 02/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Several strategies are being implemented in blood transfusion centers of the world to prevent the transfusion-transmitted parasitic infections (TTPIs). The objective of this study was to determine and describe the strategies to minimize the transmission risk of parasitic agents via blood transfusion in Iran. Methods This study was conducted in the Iranian blood transfusion organization (IBTO). The data were extracted from the latest version of the “medical interview” standard operating procedure (SOP). Results The donor selection is the first and only step to reduce the risk of TTPIs in endemic and non-endemic areas of Iran. In all blood transfusion centers of the IBTO, the blood donation volunteers with a previous history of malaria, Chagas disease, visceral leishmaniasis (VL), muco-cutaneous leishmaniasis and babesiosis, as well as those with clinical toxoplasmosis, cutaneous leishmaniasis (CL) and with a history of residence in, or travel to, malaria-endemic areas are permanently or temporarily deferred from the blood donation. Conclusions Since malaria, toxoplasmosis and VL are endemic in parts of Iran, as well as the increasing travels to endemic areas and immigrations from endemic to non-endemic areas of parasitic infections, the extensive use of blood and blood components and the asymptomatic occurrence of most parasitic infections in blood donors, the donor selection strategy is not sufficient to prevent the TTPIs. Therefore, the changing of donor selection process and the use of other common preventive strategies are recommended to reduce the risk of TTPIs, especially for high-risk groups of toxoplasmosis and VL.
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Affiliation(s)
- Ahmad Mardani
- Department of Microbiology, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
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Taghdiri A, Nejad Almani PG, Sharifi I, Mohammadi MA, Salari S. Detection of malaria with light microscopy and Nested polymerase chain reaction (Nested PCR) methods in peripheral blood expansions and investigation of the genetic diversity of Plasmodium species by 18S rRNA gene in Southeast of Iran. Microb Pathog 2019; 137:103782. [PMID: 31600540 DOI: 10.1016/j.micpath.2019.103782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/07/2019] [Accepted: 10/05/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Malaria is a public health concern that leads to about a million deaths worldwide every year. Malaria is caused by the genus Plasmodium, which includes P. falciparum, P. vivax, P. malariae, and P. ovale. Molecular phylogeny is essential to better recognition the evolution of the genus Plasmodium genus and detection of the relative degree of Plasmodium species in humans. The aim of this study was to detect malaria with Light Microscopy (LM) and Nested polymerase chain reaction (Nested PCR) methods in peripheral blood expansions and to investigate the genetic diversity of Plasmodium species by 18S rRNA gene in the southeast of Iran. METHODS A total of 97 blood smears were collected from patients suspected to malaria in a 6-year period in the southeast of Iran including Hormozgan, Kerman, and Sistan and Baluchestan provinces. Diagnosis of Plasmodium species on blood smears was performed using LM and Nested PCR methods. In addition, 16 Plasmodium-positive samples were chosen for the determination of genetic diversity. RESULTS Overall, 97 of 97 (100%) studied cases were positive by LM while 94 of 97 (96.8%) of them were detected as malaria by Nested PCR. Except for seven cases, Nested PCR confirmed the LM results. These samples involved two P. vivax and five P. falciparum in the LM method. Meanwhile, the Nested PCR was detected in all of the cases as a mixed infection with P. vivax and P. falciparum. The results of the phylogenetic analysis revealed two main clades and five different subclades. About 87.5% of the isolates were located in clade I and contained P. vivax. In addition, 12.5% of the studied isolates involved P. falciparum that was in clade II. CONCLUSION According to our results, Nested PCR method had higher sensitivity than LM and is suggested as a good approach for malaria detection. Consideration the wide diversity of tested isolates and the importance of vaccine development, which is affected by this diversity, further studies are needed in this regard.
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Salehi M, Masoumi-Asl H, Assarian M, Khoshnam-Rad N, Haghi AM, Nikbakht M, Khalili H. Delayed Hemolytic Anemia after Treatment with Artesunate: Case Report and Literature Review. Curr Drug Saf 2019; 14:60-66. [PMID: 30411691 DOI: 10.2174/1574886313666181109150157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/20/2018] [Accepted: 11/06/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND In recent years, few cases of post-artemisinin delayed hemolysis have been reported. OBJECTIVE All cases of post-artemisinin delayed hemolysis were reported from non-middle east areas. No case of post-artemisinin delayed hemolysis has yet been reported from this region. In this paper, we describe a case of post-artemisinin delayed hemolysis in an Iranian female. Moreover, previous reports have been reviewed. METHODS Patient's data including demographic characteristics, past medical, drug and travelling history, present illness, vital signs, laboratory data, clinical course of current illness and follow-up findings were considered. RESULTS A 27-year-old female with a recent travel history to Ghana admitted with severe falciparum malaria. She was successfully treated with parenteral artesunate. However after 12 days of post artesunate treatment, she returned with dark urine, malaise and fatigue. CONCLUSION Considering the clinical course and base on a reliable causality assessment scale, post artesunate delay hemolytic anemia was possible.
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Affiliation(s)
- Mohammadreza Salehi
- Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Masoumi-Asl
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mehrdad Assarian
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Khoshnam-Rad
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Motevalli Haghi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Nikbakht
- Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Ghahremani L, Azizi M, Moemenbellah-Fard MD, Ghaem H. Malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, south of Iran: interventional design based on PRECEDE model. Pathog Glob Health 2019; 113:32-38. [PMID: 30784362 DOI: 10.1080/20477724.2019.1583847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Suburban areas suffer from unfavorable conditions as a result of poor health standards, low income, illness, and slight levels of education. One of the most important components in malaria elimination programs is health education. Bandar-Abbas is a malaria endemic city. Therefore, this study aimed to promote malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, Iran, through a PRECEDE model-based intervention program. This quasi-experimental study was carried out on 172 housewives under the coverage of four healthcare centers in Bandar-Abbas in 2016. The participants were randomly divided into two experimental and control groups, based on the inclusion criteria. The data collection tools included ademographic questionnaire, aresearcher-made questionnaire based on the educational phase of the PRECEDE model and achecklist for assessing malaria preventive behaviors. After the pre-test, the educational intervention was implemented on the intervention group at the first stage and the same questionnaire was administered as the post-test for both groups two months after the intervention. In this study, after implementing the intervention using the PRECEDE educational program, asignificant difference was found between the intervention and control groups in the mean scores for predisposing factors (knowledge and attitude) (P< 0.001), enabling factors (P< 0.001) and reinforcing factors (P< 0.001), which contributed to the improvement of preventive behaviors (P< 0.001). The PRECEDE model-based health education was effective in increasing knowledge and attitude, enabling and reinforcing factors, and promoting malaria preventive behaviors in the studied endemic areas.
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Affiliation(s)
- Leila Ghahremani
- a Department of Health Education and Promotion , School of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mojdeh Azizi
- a Department of Health Education and Promotion , School of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mohammad Djaefar Moemenbellah-Fard
- b Research Center for Health Sciences, Institute of Health, Department of Medical Entomology , School of Health, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Haleh Ghaem
- c Department of Epidemiology , School of Health, Shiraz University of Medical Sciences , Shiraz , Iran
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Firooziyan S, Dinparast Djadid N, Gholizadeh S. Speculation on the possibility for introducing Anopheles stephensi as a species complex: preliminary evidence based on odorant binding protein 1 intron I sequence. Malar J 2018; 17:366. [PMID: 30326917 PMCID: PMC6191895 DOI: 10.1186/s12936-018-2523-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anopheles stephensi is considered an important malaria vector in Iran, Asia, and recently in the Horn of Africa. Recently, Ansteobp1 intron I sequence has been introduced a new molecular marker for identification of its biological forms including, mysorensis, intermediate and type, using insectary colony specimens. METHODS In the current study, new marker ability in molecular identification of biological forms has been evaluated with An. stephensi specimens collected from Iran and Afghanistan malarious provinces. Following DNA extraction and PCR amplification, sequence analysis and constructed phylogenetic tree revealed that type and intermediate forms are distributed in Iran. RESULTS The specimens collected from Afghanistan identified as intermediate and mysorensis forms. Therefore, intermediate form is sympatric species in both countries. Based on the results of Ansteobp1 intron I sequences, An. stephensi could be suggested as new Anopheles complex species including An. stephensi sibling A (type form), An. stephensi sibling B (intermediate form) and An. stephensi sibling C (mysorensis form). This is the first report on the presence of An. stephensi biological forms in Afghanistan. CONCLUSIONS Iran is going to eliminate malaria transmission from the country, precise species identification, especially in complex species will be helpful in the prevention of malaria resurgence in the country, mainly because of common fauna of Anopheles species and through border malaria and population movement within Afghanistan, Pakistan, and Iran.
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Affiliation(s)
- Samira Firooziyan
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, P.O. Box: 5756115198, Iran.,Medical Entomology Department, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Dinparast Djadid
- Malaria and Vector Research Group, National Insectarium, Pasteur Institute of Iran, Tehran, Iran
| | - Saber Gholizadeh
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, P.O. Box: 5756115198, Iran. .,Medical Entomology Department, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
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Sheikhzadeh K, Haghdoost AA, Bahrampour A, Raeisi A, Zolala F, Farzadfar F, Kasaeian A, Parsaeian M. Predicting Malaria Transmission Risk in Endemic Areas of Iran: A Multilevel Modeling Using Climate and Socioeconomic Indicators. Iran Red Crescent Med J 2017; 19. [DOI: 10.5812/ircmj.45132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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