Leishmania major Infection in Synanthropic Rodents: Evidence for the Urbanization of Zoonotic Cutaneous Leishmaniasis (ZCL) in Southern Iran

Cutaneous leishmaniasis is of particular importance in southern Iran. This study aimed to investigate the infection of rodents with Leishmania major in an urban area of Fars Province, located in southern Iran. Rodents were trapped and samples from the liver, spleen, and skin were collected. Impression smears were prepared from these tissues and any skin lesions and were examined microscopically. In addition, a portion of the samples were preserved for subsequent DNA extraction. A total of 41 rodents belonging to three species were caught from 10 trapping stations in gardens or houses within the area. The caught rodent species were Rattus rattus (n = 25, 60.97%), Mus musculus (n = 15, 36.58%), and Meriones persicus (n = 1, 2.5%). Leishmania amastigotes were seen in the spleen tissue smear of 6 (2.43%) of the rodents, including 4 of R. rattus and 2 of M. musculus. Skin lesions were observed on the muzzles of two R. rattus and one M. musculus. Samples taken from these lesions tested positive for Leishmania infection. Leishmania DNA was detected in 18 (43.9%) rodents, including 11 R. rattus, 6 M. musculus, and one M. persicus, based on DNA sequencing of the ITS2 gene and PCR of the kDNA. Phylogenetic reconstruction revealed that the parasite infecting the rodents was L. major. The detection of Leishmania infection in these rodents in urban areas raises concerns about the urbanization of cutaneous leishmaniasis caused by L. major. This urbanization poses unique challenges for control and prevention efforts.

Protective effect of Melissa officinalis against acetic acid-induced ulcerative colitis in rat models: an experimental study

Background

Inflammation and oxidative activities within the gut play major roles in the pathogenesis of ulcerative colitis (UC). We aimed to determine the effect of Melissa officinalis, an antioxidant and anti-inflammatory agent, on the colon histological characteristics in acetic acid (AA)-induced UC in rat models.

Methods

Thirty-six male rats with AA-induced colitis were divided into 5 groups: no treatment (AA); daily treatment with 300 mg/kg Melissa officinalis orally (MO) and rectally (MR); and 100 mg/kg mesalamine orally (AO) and rectally (AR). Macroscopic and histopathological evaluation of the colon, along with a biochemical laboratory evaluation, were performed 10 days after UC induction.

Results

All treatment groups demonstrated lower macroscopic grading scores compared to the AA group. After treatment with MO, 42.9% of cases demonstrated no macroscopic changes, while 14.3% demonstrated only mucosal erythema. In the MR group 28.6% of rats had no changes in their mucosal lining and 28.6% had only mucosal erythema. Following histopathological evaluation, the AO group had lower scores regarding the severity of ulcer, inflammation, destruction, crypt abscess, and disorganization compared to the MO group. (P=0.02) The MR group demonstrated lower microscopic scores compared to the MO group, and also lower macroscopic scores compared to the AR group, although not significantly (P>0.05).

Conclusions

Both oral and topical administration of Melissa officinalis have satisfactory healing properties compared to mesalamine, with topical route having better results. Therefore, further studies are needed to establish the benefit of Melissa officinalis administration (both orally and topically) within a UC treatment protocol.

Evaluation of the features of cystic echinococcosis with concurrent super-infection: a retrospective study in Southern Iran

OBJECTIVE

Superinfection of cystic echinococcosis (CE) is a life-threatening complication with significant morbidities, which can be prevented with early diagnosis and treatment. This study aims to examine the clinical characteristics, diagnostic methods, and treatment options for superinfected CE, as there is currently limited information available on the differences between superinfected and non-infected CE in terms of clinical features, serological and radiologic findings.

METHODS

This cross-sectional study was conducted on hospital records of patients who were diagnosed with hydatid cysts in a 15-year period (2004 to 2018) in two main university-affiliated referral centers in Fars province, southern Iran. Patients' information regarding the demographical and clinical features related to CE, age, sex, previous history of CE or recurrence, size and location of CE, and length of hospital stay were collected. Moreover, the characteristics of concurrent infections with hydatid cysts were recorded.

RESULTS

A total of 586 surgeries due to CE were performed on 501 patients, of which 67 (11.43%) had reoperations due to the recurrence of the disease. A total of 30 (5.99%) incidences of superinfection were observed. There were no statistically significant differences in terms of laboratory and imaging findings between CE patients with concurrent infections and other CE patients (p-value > 0.05). Among the patients with super-infection, four had fungal infections of the lungs. Aspergillus fumigatus was the causative pathogen in all four patients that were diagnosed with fungal superinfection. All patients underwent surgical excision with favorable long-term outcomes.

CONCLUSION

Our study revealed a 5.99% incident rate of CE superinfection. Regarding the concurrent fungal infections in hydatid cysts, the patient's symptoms and laboratory and imaging findings are inconclusive and histopathological evaluation seems to be the most reliable option. Surgical resection is the gold-standard treatment option with favorable outcomes and potentially can be curative.

Deglycosylation of Excretory-Secretory Antigens of the Second-Stage Larvae of Toxocara cati Improves Its Efficacy in the Diagnosis of Human Toxocariasis

Background

Toxocariasis is an important zoonotic infection, especially in tropical areas. One of the significant challenges in the serodiagnosis of human toxocariasis is the cross-reaction of Toxocara antigens with other parasites due to their relatively similar glycan structures. Removing the glycan structure from Toxocara excretory-secretory (TES) antigens may increase the efficacy of these antigens in the diagnosis of toxocariasis. The current study aimed to assess the efficacy of deglycosylated Toxocara cati excretory-secretory (dTES) antigens for the serodiagnosis of human toxocariasis.

Methods

Toxocara ES antigens were prepared from T. cati second-stage larvae and deglycosylated using sodium hydroxide (NaOH). The TES antigens, along with the dTES antigens, were used in an ELISA as well as a western blotting system for the detection of anti-Toxocara antibodies. Sera samples collected from 30 confirmed cases of toxocariasis, 30 patients with other diseases, and 30 healthy subjects were evaluated by both systems.

Results

The sensitivity of TES and dTES ELISA for the diagnosis of human toxocariasis was 96.67% (95% CI = 82.78-99.92) and 93.33% (95% CI = 77.93-99.18), respectively, while the specificity of dTES (88.33%; 95% CI = 77.43-95.18) increased significantly compared to the TES (80.00%; 95% CI = 67.67-89.22). The sensitivity of both antigens was 100% (95% CI = 88.43-100) by the western blotting system. Moreover, the specificity of TES and dTES antigens was 95% (95% CI = 86.08-98.96) and 98.33% (95% CI = 91.06-99.96), respectively, when using the western blotting system.

Conclusion

Results of the current study indicate that the chemical removal of the glycan epitopes of T. cati ES antigens significantly reduces cross-reactivity rates with other parasitic infections. Considering the findings of the present study, the dTES antigens seem to be suitable antigens for the serodiagnosis of human toxocariasis.

Hospital-based retrospective analysis of 224 surgical cases of lung hydatid cyst from southern Iran

BACKGROUND

The lungs are considered the second-most frequent location for hydatid cyst in human. The current retrospective hospital-based study aimed to assess the epidemiological data, clinical presentation, and treatment outcomes of lung hydatid cyst in patients who underwent surgery for this disease in Fars province, southern Iran.

METHODS

In this retrospective study, hospital records of 224 pulmonary hydatid cyst patients were assessed in two main university-affiliated hospitals in Fars Province, southern Iran. Clinical features of patients, epidemiological data, cyst features, surgical interventions, and treatment outcomes were reviewed and analyzed.

RESULTS

A total of 224 hydatid cyst cases of the lung were reviewed. Male patients accounted for the majority of cases (60.4%). The average age of the patients was 31.13 (± 19.6), ranging from 2 to 94 years old. Of the 224 patients, 145 (75.9%) cases had only one single cyst and mostly 110 (53.9%) located in the right lung. Also, 6 (2.9%) cases had cysts in both lungs. The lower lobe of the lungs was the most common location of the hydatid cyst. The average size of lung hydatid cyst was 7.37 cm (SD = 3.86; rang: 2-24) while for the cyst areas was 42.87cm² (SD = 52.76; range: 2-488). Regarding the surgical method, 86 (38.6%) cases were operated by lung resection surgery while 137 (61.4%) cases had lung preserving one. The chief complaints of the patients were cough (55.4%) and dyspnea (32.6%). Relapse was documented in 25 (11.16%) of cases.

CONCLUSIONS

Lung hydatid cyst is a common infection in southern Iran. Lung preserving surgery is the method of choice for the management of hydatid cyst. Relapse, which was not uncommon in our study, is a challenging feature of hydatid cyst management.

Management of Liver Hydatid Cysts: A Retrospective Analysis of 293 Surgical Cases from Southern Iran

Background

The current study aimed to evaluate the therapeutic features and complications of liver hydatid cyst in patients who underwent surgery for cystic echinococcosis (CE) in Fars province, southern Iran.

Methods

A total of 293 patients who underwent surgery for liver hydatid cyst from 2004 to 2018 in Fars province, southern Iran, were retrospectively evaluated. The clinical records of patients were reviewed, and the demographic and clinical characteristics of each patient were assessed.

Results

Of the total of 293 cases, 178 (60.9%) were females and 115 (39.1%) were males. The mean age of the subjects was 37.22 (±20.55) years. The mean size of the liver hydatid cyst was 9.18 (±4.365) cm. Of the 293 patients studied, 227 (77.4%) had hydatid cysts only in the liver, while 55 (9.4%) had both liver and lung cysts. More than half of the liver cysts (65.9%) were located in the right portion of the liver (segment 5 to 8). Of the 293 cases, 52 (17.7%) underwent radical surgery, while 241 (82.3%) underwent conservative surgery. Recurrence of hydatid cyst was recorded in 46 (15%) of cases. Patients who were treated with radical surgery in comparison with those who had conservative surgery had a lower recurrence rate but a longer duration of hospital stay (P < 0.05).

Conclusion

Recurrence remains as one of the major challenges in the management of hydatid cyst. Radical surgery reduces the chance of recurrence, although this procedure increases the length of hospital stay.

Seroprevalence of toxoplasmosis among individuals with intellectual disability in Hormozgan Province, southern Iran

BACKGROUND

People with mental defects are more likely to get the infection due to their low levels of health care and personal hygiene. The current study aimed to determine the seroprevalence of Toxoplasma infection among individuals with intellectual disabilities in Hormozgan province, southern Iran.

METHODS

The study population was 117 individuals with intellectual disabilities. Venous blood (3 mL) was taken from each subject. A commercial ELISA kit was used to determine anti-Toxoplasma IgG antibodies.

RESULTS

Of 117 recruited subjects, 55 (47.0%) were men and 62 (53.0%) were women. The mean age of participants was 27.6 (±12.31) years. Out of 117 studied subjects, 76 had severe and 41 had profound intellectual disabilities. Anti-Toxoplasma IgG antibodies were detected in the sera of 35 out of 117 (29.9%) individuals. Seropositivity to toxoplasmosis was significantly higher in severe than in individuals with profound intellectual disabilities (P < 0.05). There was no statistically significant association between Toxoplasma infection and age, sex and duration of residency in the rehabilitation centre.

CONCLUSIONS

The findings of this study indicate that the prevalence of Toxoplasma in people with intellectual disabilities is not much different from other groups of the community.

Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis

Background

We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis.

Methods

All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were "Giardia", "Giardia lamblia", "Giardia intestinalis", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis. The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results

The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world.

Conclusion

The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis. The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection.

Seroprevalence of Toxocariasis and Its Associated Risk Factors among Adult Population in Kavar District, Fars Province, South of Iran: A Cross-Sectional Community-Based Seroepidemiological Survey

Toxocariasis as a common neglected disease is the culprit of infecting all age groups. The current cross-sectional study was designed to assess the seroprevalence of toxocariasis and risk factors associated with seropositivity of Toxocara infection among the general population of adults in the Kavar district, south of Iran. A total of 1060 participants with an age range of 35 to 70 years from the Kavar region entered the study. Manual ELISA was utilized to detect anti-Toxocara-specific antibodies in their serum samples. In addition, demographic information as well as risk factors related to toxocariasis was collected from individuals who participated in the survey. The mean age of the participants was 48.9 (±7.9) years old. Out of 1060 subjects, 532 (50.2%) were men, and 528 (49.8%) were women. The overall Toxocara seroprevalence was 5.8% (61/1060). The prevalence of Toxocara seropositive cases was significantly different between males and females (p = 0.023). The seropositive rate for Toxocara infection was also significantly higher in housewives (p = 0.003) and subjects with learning disabilities (p = 0.008). Multivariable logistic regression revealed that housewives (OR = 2.04, 95% CI: 1.18-3.51, p = 0.010) and subjects with learning disability (OR = 3.32, 95% CI: 1.29-8.52, p = 0.013) were at increased risk of Toxocara infection. The findings of the current study depicted a noticeable seroprevalence of Toxocara infection in the general population in the Kavar district, southern Iran. An increased risk of toxocariasis has been associated with learning disabilities and being a housewife. All of the toxocariasis-positive cases had contact with animals, at some point in their life. In perspective, it is necessary to raise awareness of this infection among the population while surveilling Toxocara infection in high-risk groups.

Occurrence, genetic characterization, and zoonotic importance of Giardia duodenalis in various species of rodents (Mus musculus, Rattus norvegicus, and Rattus rattus)

Giardia duodenalis is a well-known flagellated parasite and the causative agent of protozoal diarrhea in animals and humans worldwide. Current study was aimed at determination of G. duodenalis prevalence, genetic variation and zoonotic significance in various species of rodents in Shiraz, southwestern Iran. In brief, 120 fecal specimens were collected from rodents (Rattus rattus, Rattus norvegicus, and Mus musculus) during May up to November 2021 and microscopically examined for Giardia cysts. Further molecular characterization of positive samples was done by nested-PCR, followed by nucleotide sequencing of the triose phosphate isomerase (tpi) gene. A total prevalence of 3.3% (4/120) was observed in rodents, with highest rate in black rats [5% (2/40)]. Regarding brown rats and house mice, only one sample was found to be positive, showing 2.5% and 2.5% prevalence, respectively. It is noteworthy that Giardia B and G assemblages were found in black rats (one case/genotype), whereas the only positive samples from brown rats and house mice were characterized as assemblage G. The major findings of the present study were the presence of both zoonotic and non-zoonotic Giardia assemblages in examined rats in Shiraz and the potential of black rats to harbor Giardia infection to humans. These concerns should be taken seriously in terms of public health. Nevertheless, the true epidemiology and assemblage distribution of Giardia is still open to question.

Designing a Multi-Epitope Antigen for Serodiagnosis of Strongyloides stercoralis Based on L3Nie.01 and IgG Immunoreactive Epitopes

Background

Serological diagnosis of Strongyloides stercoralis (S. stercoralis) is fre-quently challenging because of cross-reactivity with other parasitic nematodes. Therefore, it is necessary to introduce novel serological tests with high performance to properly diagnose this neglected parasitic infection. The purpose of the current study was to design a multi-epitope construct for the diagnosis of S. stercoralis.

Methods

For the purpose of this study, first, highly antigenic segments and potential immunodominant epitopes of S. stercoralis were identified from two antigenic proteins, and then all of the selected parts were linked by an appropriate linker. Next, the physicochemical features of the designed construct were analyzed. Then, tertiary structures of the construct were built and evaluated to find out the best one. Lastly, the amino acid sequence was reverse-translated and optimized for over-expression in Escherchia coli (E. coli).

Results

The bioinformatic evaluation indicated that the designed protein construct could be hydrophilic, thermostable, and acidic and the estimated half-life was more than 10 hr in E. coli.

Conclusion

According to the results of the study, the designed construct could be used as an efficient antigen in the ELISA system for serological diagnosis of human strong-yloidiasis.

Development of a recombinant nucleocapsid protein-based ELISA for the detection of IgM and IgG antibodies to SARS-CoV-2

Coronavirus 2019 (COVID-19) is a global concern for public health. Thus, early and accurate diagnosis is a critical step in management of this infectious disease. Currently, RT-PCR is routine diagnosis test for COVID-19, but it has some limitations and false negative results. enzyme-linked immunosorbent assay (ELISA) against SARS-CoV-2 antigens seems to be an appropriate approach for serodiagnosis of COVID-19. In the current study, an ELISA system, using a recombinant nucleocapsid (N) protein, was developed for the detection of IgM and IgG antibodies to SARS-CoV-2. The related protein was expressed, purified, and used in an ELISA system. Sera samples (67) for COVID-19 patients, as well as sera samples from healthy volunteers (112), along with sera samples from non-COVID-19 patients were examined by the ELISA system. The expression and purity of the recombinant N protein were approved by SDS-PAGE and Western blotting. The sensitivity of ELISA system was 91.04 and 92.53% for the detection of IgG and IgM antibodies, respectively. Moreover, the specificity of the developed ELISA system for IgG and IgM were 98.21 and 97.32%, respectively. Our developed ELISA system showed satisfactory sensitivity and specificity for the detection of antiSARS-CoV-2 IgM and IgG antibodies and could be used as a complementary approach for proper diagnosis of COVID-19.

Stereological analysis of liver, spleen and bone of Leishmania infantum-experimentally infected hamsters

Leishmaniasis is remaining as one of the important health problems of many countries around the world. The histopathology of the disease and the effects of the parasite on various tissues have not yet been fully elucidated. The current study aimed to evaluate the stereological features of the liver, spleen, and bone of hamsters infected with Leishmania infantum. In this experimental study, the L. infantum parasite was mass cultivated in a culture medium. Then, 15 golden hamsters were selected, of which 5 animals were considered as controls and another 10 animals were injected intravenously, with 1 × 10⁸ promastigotes of L. infantum. Four months later, the hamsters were euthanized and impression smears were prepared from the liver and spleen. Moreover, pathology slides were prepared from the spleen, liver, and femur. The orientated method was used to obtain isotropic uniform random (IUR) sections. For stereological evaluation, the tissues were fixed with formalin buffer, and sections (4 and 25 μm thick) were prepared and stained with Heidenhain's AZAN trichrome and hematoxylin-eosin, respectively. The tissue samples were examined by stereological methods and all changes in the samples of the infected hamsters were compared with the control group. The number of hepatocyte and their nuclei volumes were significantly decreased in the Leishmania-infected group, compared to the control group. The number of Kupffer cells and their volume in the liver of the Leishmania-infected group was higher than that of the control group, and the differences were statistically significant. The volume of trabeculae and central arteries in the spleen of the Leishmania-infected group was lower than that of the control group and the number of lymphocytes and macrophages in the spleen of the Leishmania-infected group was increased compared to the control group. The trabecular volume and the number of osteoblasts and osteoclasts of the femur in Leishmania-infected animals decreased, whereas the volume of bone marrow was significantly raised. Leishmaniasis leads to changes in tissue structure and their function in the host by the involvement of various organs of the immune system including the liver, spleen, and bone. Understanding these changes are important in identifying the effective mechanisms of the parasite and host interaction.

Echinococcus granulosus sensu stricto G1 is the predominant genotype in human and livestock isolates from Turkey and Iran, based on mitochondrial nad5 gene differentiation

Background

Different genotypes of Echinococcus granulosus sensu stricto (s.s.) isolated from livestock and humans have been identified based on cox1 and nad1 genomic fragments. The present study was performed to differentiate the G1/G3 genotypes of Echinococcus granulosus (s.s.) isolated from humans and livestock (sheep and cattle) from Azerbaijan in northwestern Iran, Fars Province in southern Iran, and Van province in Eastern Turkey, using the nad5 gene fragment as a suitable marker to distinguish these two genotypes.

Methods

A total of 60 pathologically confirmed human hydatid cysts and 90 hydatid cyst samples from livestock were collected from Turkey and Iran. PCR was performed on all of the samples, targeting the nad5 gene. Based on PCR product quality, host type, and the geographical area where the samples were obtained, 36 of the samples were sequenced and were used in the phylogenetic analysis.

Results

Out of 36 evaluated samples, 26 (72.2%) samples belonged to G1, and 10 (27.8%) samples belonged to the G3 genotype. Out of 21 samples from Turkey, 16 (76.2%) were G1 and 5 (23.8%) were G3, while out of 15 samples from Iran, 10 (66.7%) were G1 and 5 (33.3%) were the G3 genotype. None of the samples isolated from humans in Iran or from sheep in Turkey were G3. Overall, between the two countries, 18.18% of E. granulosus isolates in cattle, 41.66% of isolates in sheep, and 23.07% of human samples were identified as G3, and the others as the G1 genotype. The G3 genotype was not detected in human samples from Iran or sheep samples from Turkey.

Conclusion

The findings of the study revealed that the G1 genotype of E. granulosus s.s. is the predominant genotype in humans and livestock, both in Turkey and Iran. The ratio of the E. granulosus s.s. G1 to G3 genotype was 3.2 in Turkey and 2 in Iran. The study also further confirmed that the nad5 gene properly differentiated the G1/G3 isolates of E. granulosus from both humans and livestock.

Graphical Abstract

Dissolvable carboxymethyl cellulose/polyvinylpyrrolidone microneedle arrays for transdermal delivery of Amphotericin B to treat cutaneous leishmaniasis

Cutaneous leishmaniasis (CL) is a significant public health problem caused by different species of Leishmania parasites. Due to low skin permeability, the development of an effective system for delivery of Amphotericin B (AMB), the common effective drug for leishmaniasis treatment, is required to replace the unpleasant and problematic injections. To overcome this problem, a dissolvable microneedle (MN) patch was developed, using biodegradable polymers (a mixture of polyvinylpyrrolidone and carboxymethyl cellulose) for AMB's transdermal delivery. Scanning electron microscopy and fluorescent images showed successful fabrication of the MNs and homogeneous dispersion of the drug into the needles. MNs showed good mechanical properties with the ability to penetrate the rat skin and reach the lower layers. After insertion to the skin, the MNs were rapidly dissolved to release the encapsulated drug, and the resulted micropores in the skin were quickly resealed within 30 min. MN patches showed non-toxicity as exposed to HT-29 cell line. Flow cytometry results showed a potent in vitro leishmanicidal activity of AMB-loaded MN patches against the Leishmania parasites (up to 86% of the parasites' death). Taken together, MN patches might represent a new, efficient and clinically translational approach for transdermal AMB delivery to treat CL.

Seroprevalence and associated risk factors of toxocariasis among nomads in Boyer-Ahmad County, southwest Iran

BACKGROUND

Human toxocariasis is caused by the larval stage of Toxocara canis and Toxocara cati. This cross-sectional study was conducted to evaluate the seroprevalence and the risk factors associated with Toxocara infection in nomads of Boyer-Ahmad County in the southwest of Iran.

METHODS

A total of 968 blood samples were collected from nomads. A structured questionnaire, containing sociodemographic data, was completed for each participant. Sera were evaluated for anti-Toxocara antibodies, using the T. canis excretory-secretory antigens prepared from the second stage larvae, in an ELISA system.

RESULTS

Among the 968 participants, 220 (22.7%) were males and 748 (77.3%) were females; the mean age was 40.71 y. Anti-Toxocara IgG antibodies were detected in 14 (1.4%) of the 968 nomads. The association between Toxocara infection and gender, age, contact with dogs, residential area and level of education were not statistically significant (p>0.05).

CONCLUSIONS

The findings of the study revealed a low prevalence rate of toxocariasis in nomadic communities in southwest Iran. Geographic location and climatic conditions as well as the lifestyle and sociodemographic features of the participants may contribute to the low prevalence rate of Toxocara infection.

Effects of topical gel formulation of Ficus carica latex on cutaneous leishmaniasis induced by Leishmania major in BALB/c mice

Objectives

The current study aimed to evaluate the effects of Ficus carica latex on the treatment of cutaneous leishmaniasis (CL), induced by Leishmania major. A 5% topical gel with F. carica latex was prepared. BALB/c mice were infected by inoculation of amastigotes form of L. major. Thirty BALB/c mice were divided into five groups, where the first group was treated daily, the second group twice per day, and the third group every other day with the 5% topical gel, for 3 weeks. The sizes of the lesions were measured before and during the course of treatment.

Results

Although the mean size of lesions in the mice group treated with the 5% F. carica gel, especially in the group receiving daily treatment, was less than the mean size of the lesions in the control group, yet, the differences was not statistically significant (p > 0.05). The findings of the current study demonstrated that the 5% F. carica latex with a 3-week course of treatment had no considerable effect in recovery or control of CL induced by L. major in the murine model. Using higher concentration of F. carica latex and with longer treatment lengths may increase its efficacy in the treatment of CL.

Molecular and serological evaluation of zoonotic visceral leishmaniasis in dogs in a rural area of Fars province, southern Iran, as a source of Leishmania infantum infection

Canine visceral leishmaniasis (CVL) is endemic in the southern parts of Iran. The current study aimed at molecular and serological evaluation of zoonotic visceral leishmaniasis in dogs in Fars province, southern Iran. Blood samples were collected from 60 dogs in the three villages in Fars Province. Serum samples were tested for antibodies against L. infantum by direct agglutination test (DAT). DNA was extracted from each dog's buffy coat and tested by PCR, targeting the Leishmania ITS‐2 region. From a total of 60 studied dogs, 25 (41.7%) were female, and 35 (58.3%) were male. Dogs' age ranged from 1 to 7 years, with a mean age of 2.97 (±1.4) years. Anti‐Leishmania antibodies were detected in sera samples of 28 (46.7%) dogs, (titre ≥ 1:320). Out of 28 seropositive cases, 13 (46.4%) were female, and 15 (53.6%) were male. Association between seropositivity and dogs’ clinical signs was statistically significant (p < .05). Leishmania DNA was detected in the buffy coat of 3 of 60 studied dogs which were all seropositive by DAT. The PCR products were sequenced and molecular analysis showed that two of the isolates were Leishmania infantum, and one was L. tropica. The high proportion of seropositive dogs indicates the important role of these animals in the epidemiology of the disease in the region. Infected dogs with or without signs, especially those that are molecularly positive, can act as an active reservoir of the disease in the area.

Seroprevalence of Cystic Echinococcosis Using Recombinant Antigen B-ELISA in North Khorasan Province, Northeast of Iran

Background

Cystic echinococcosis (CE) is one of the most important helminthic parasitic diseases in Iran. The current study aimed to assess the seroprevalence of CE in North Khorasan Province, Northeast of Iran in 2018.

Methods

The study was carried out in seven cities of North Khorasan Province. Venous blood samples were collected from 932 individuals referring to health centers of those seven cities. A questionnaire was used to obtain the data regarding the subject's gender, age, residence and risk factors linked to the hydatid cyst. Sera samples were evaluated for anti-hydatid cyst antibodies in an ELISA system, using a recombinant B8/1 antigen of E. granulosus.

Results

Of the 932 recruited subjects, 496 (53.2%) were male and 436 (46.8%) were female. The range of participants' age was between 11 to 83 yr old and the mean age of the subjects was 35.4 (±12.7) years. Anti-hydatid cyst antibodies were detected in the sera of 37 out of 932 subjects, corresponding to a seroprevalence rate of 3.96%. From these, 20 (54.05%) were male and 17 (45.95%) were female. There were no associations between seropositivity to hydatid cyst and age, the gender of the participants, residential areas and having contact with dogs (P>0.05).

Conclusion

CE is relatively prevalent throughout the North Khorasan Province in the Northeast of Iran. Rate of CE infection in this Province is somewhat similar to the rate of infection in other parts of the country.

The Prevalence of Hepatitis B Virus Markers among Students of Shiraz University of Medical Sciences

Background

Protection against hepatitis B virus (HBV) is based on the presence of antibodies against hepatitis B surface antigen (HBsAg). Vaccination of newborns is the most effective means of prevention. This study aimed to evaluate the frequency of anti-HBs antibody (anti-HBsAb), anti-HB core Ab (anti-HBcAb), HBsAg, and HBV DNA among university students in Fars province, Southern Iran.

Materials and Methods

In this cross-sectional study, 272 students of Shiraz University of Medical Sciences, were enrolled. Venous blood (5 mL) was collected from each participant and centrifuged; the sera were stored at -20°C until use. Anti-HBsAb, Anti-HBcAb, and HBsAg were measured using a commercial enzyme-linked immunosorbent assay kit. HBV DNA load was also measured by a real-time polymerase chain reaction.

Results

The mean age of the participants was 19 ± 1 years. There were 171 (62.9%) females and 101 (37.1%) males. Anti-HBsAb at a protective level (>10 mIU/mL) were detected in the sera of 104 (38.5%) of the cases. Of the anti-HBsAb seropositive participants, 82 were female and 22 were male; the difference between the gender and seropositivity to anti-HBsAb was statistically significant (P = 0.001, odds ratio: 3.3, 95% confidence interval = 1.89-5.79). Anti-HBcAb was detected in only one participant that was negative for both HBsAg and HBV DNA.

Conclusion

Findings of the current study show that more than half of the students do not have a protective level of anti-HBsAb and might be susceptible to HBV infection, indicating the necessity of checking the level of anti-HBsAb as well as a booster dose in high-risk groups.

Molecular and Serological Evaluation of Neospora caninum Infection in Dogs from a Rural Setting in Fars Province, Southern Iran

Background:

Dogs, as the definitive host of Neospora caninum, are important in the epidemiology of this parasitic infection. We aimed to determine the prevalence of N. caninum infection in a dog population from a rural setting in Fars Province, Southern Iran, using a combination of molecular and serological techniques.

Methods:

This cross-sectional study was carried out in Nov 2018 in three rural districts, Sar Mashhad, HosseinAbad, and Tolesaman located in Kazeroun Township in Fars province, southern Iran. Blood samples were taken from 60 stray and household dogs. Dogs’ sera were tested for antibodies against N. caninum, using a Neospora-Modified Agglutination Test. Moreover, dogs’ buffy coats were tested for Neospora DNA, using a molecular method.

Results:

Anti-Neospora antibodies were detected in sera of 4 out of 60 dogs, corresponding to a seroprevalence rate of 6.7%. Out of 25 female dogs, 1 was seropositive and of 35 males, 3 were seropositive, yet the differences were not statistically significant. The infection was more prevalent in adult dogs (> 12 months), nevertheless, the differences between age and Neospora seropositivity was not statistically significant. N. caninum DNA was not detected in the buffy coat of any of the studied dogs.

Conclusion:

Findings of the study indicate that N. caninum is a common infection in dogs in rural areas of Fars province in southern Iran. The infected dogs might be a potentially important source of N. caninum infection to livestock in the area.

Toxoplasmosis in Nomadic Communities: A Seroepidemiological Study in Southwestern Iran

BACKGROUND

Toxoplasma gondii is the agent of a zoonotic protozoan infection with worldwide distribution. The rates of infection in different areas are depending on climatic conditions and also social and cultural habits of the people. This cross-sectional study aimed to find out the seroprevalence of toxoplasmosis in nomadic people in Boyer-Ahmad County, in the southwest of Iran.

METHODS

Blood samples (5 mL) were collected from 1005 individuals of nomadic tribes of Boyer-Ahmad County in Kohgiluyeh and Boyer-Ahmad Province in 2016. A predesigned questionnaire, containing basic epidemiological information was filled out for each subject during the sampling. Sera were evaluated for anti-T. gondii antibodies (both IgG and IgM), using a commercial ELISA kit. Collected data were analyzed by SPSS, using descriptive statistics and Chi-square test.

RESULTS

Out of the 1005 studied subjects, 227 (22.6%) were male and 778 (77.4%) were female. The mean age of participants was 41 years (SD: ±17). The most represented (24.4%) age class was 21-30 years and the least (1.9%) 1-10 years. Anti-T. gondii antibodies were detected in 174 (17.3%) of the cases. No statistically significant associations were found between seropositivity to T. gondii and area of residence, age, gender and educational levels of the participants.

CONCLUSIONS

Findings of this study show that the seroprevalence of toxoplasmosis among the nomads of Kohgiluyeh and Boyer-Ahmad province is alike to other communities in our country. Further study is required to elucidate the genotype of T. gondii in this community.

Serosurvey of HBV surface antigen and anti-HBV surface antibody among HIV-infected patients in Fars province, southern Iran

HBV infection is a major public health issue that can lead to liver cirrhosis and hepatocellular carcinoma. The current study evaluated the prevalence of HBsAg and anti-HBsAb among HIV/AIDS patients in Shiraz, southern Iran. The subjects in this study comprised 251 participants previously confirmed for HIV infection registered at the Shiraz HIV/AIDS center in southern Iran. Peripheral whole blood (5 ml) was obtained from each participant and evaluated for HBsAg and anti-HBs antibodies, utilizing commercial ELISA kits. The 251 participants consisted of 158 (63.5%) males and 91 (36.5%) females. HBsAg and anti-HBsAb were detected in 16 (6.4%) and 117 (46.6%) cases, respectively, while five cases (2%) were positive for both viral markers. No statistically significant association was observed between patients' age, sex, or CD4+ cell count and seropositivity to HBsAg or anti-HBsAb. The findings of the study revealed a relatively high seroprevalence of HBsAg and anti-HBsAb among HIV patients, highlighting the importance of preventive and therapeutic programs in such patients.

FML-ELISA a novel diagnostic method for detection of feline leishmaniasis in two endemic areas of Iran

Although canids are regarded as major reservoir hosts for Leishmania infantum, feline leishmaniasis are reported sporadically from different endemic foci of Mediterranean visceral leishmaniasis (VL). Despite the risk of parasite transmission between human and other animals, most of the studies are limited to dogs and few studies are focused to investigate Leishmania sp. among other mammals. This project was aimed to detect L. infantum antibodies of cats in two VL endemic regions of Iran by Fucose Mannose Ligand (FML) and soluble L. infantum antigen (SLA) ELISA. Forty nine stray cats of different age and sex, from Fars and Ardabil provinces (two VL endemic loci of Iran) were sampled, then tested for L. infantum by FML and SLA-ELISA. Sixteen percent (8/49) of cat sera were reported positive by FML-ELISA. SLA-ELISA showed 18.3% (9/48) positive cases in cats. Sensitivity of FML-ELISA was calculated 57% and SLA ELISA 25%. Specificity of FML and SLA ELISA were assessed 78% and 68% respectively. Kappa coefficient of agreement between FML and SLA-ELISA was detected on 0.45. As feline leishmaniasis could be a potential risk in endemic areas, FML-ELISA could be considered as an appropriate examination to detect leishmaniasis in cats.

Molecular Genotyping of Toxoplasma gondii in Sheep Aborted Fetuses Reveals Predominance of Type I Infection in Southwest of Iran

Background

We aimed to detect Toxoplasma gondii in ovine aborted fetuses and evaluate its genetic variations in the southwest of Iran.

Methods

This cross-sectional study was performed on 100 aborted ovine fetuses collected from the different region of Kohgiluyeh and Boyer-Ahmad Province, Iran, in lambing season during 2017 and 2018. DNA was extracted from the brain samples of all of the aborted fetuses and PCR amplified, targeting a 529 bp repetitive element gene of T. gondii. Moreover, to find out the heterogeneity of the positive samples, PCR-DNA amplification of the two main genetic markers, B1 and GRA6, of T. gondii were performed. Nucleotide sequencing and phylogenetic analysis were performed, using the BLAST program and MEGA-X software.

Results

The 529 bp gene of T. gondii was detected in 2 out of 100 (2%) of the ovine aborted samples. The sequences analysis of GRA6 and B1 genes revealed that both isolates from the aborted fetuses of sheep belonged to type I of T. gondii. Intra-divergence was more seen in GRA6 gene whereas less divergence was observed in B1 gene.

Conclusion

Congenital infection with Type I of T. gondii during the neonatal period is associated with abortion in ovine. Evaluation of more aborted samples from broader geographical areas is needed to elucidate the molecular epidemiology and also the genotypes of T. gondii associated with abortion.

Serodiagnosis of human cystic echinococcosis based on recombinant antigens B8/1 and B8/2 of Echinococcus granulosus

BACKGROUND

Cystic echinococcosis (CE) is a widespread parasitic disease caused by the larval stage of Echinococcus granulosus. Since current methods for the diagnosis of CE are not efficient enough, rapid, and reliable tests are required for the acceleration of CE diagnosis. The present study aimed to produce recombinant B8/1 and B8/2 antigens of E. granulosus and evaluate their sensitivities and specificities separately and simultaneously for the diagnosis of CE.

METHODS

The recombinant B8/1 and B8/2 antigens were produced and used in an ELISA system for the diagnosis of CE. The sera specimens including 30 sera from pathologically confirmed CE patients, 30 from other non-CE patients, and 30 from healthy controls, were evaluated by the ELISA, using AgB8/1 and AgB8/2.

RESULTS

The results showed a sensitivity of 93.33%, 90%, and 96.7% for AgB8/1, AgB8/2, and their combination, respectively. The specificities were 91.7%, 93.33%, and 93.33% for AgB8/1, AgB8/2, and their combination, respectively.

CONCLUSION

Simultaneous usage of AgB8/1 and AgB8/2 increased the test sensitivity for the diagnosis of CE. Furthermore, the specificity of AgB8/1 and AgB8/2 combination was more than AgB8/1 and equal to AgB8/2 alone. The findings revealed that the simultaneous usage of AgB8/1 and AgB8/2 could be a suitable approach for the diagnosis of CE.

Comparative genotyping of Blastocystis infecting cattle and human in the south of Iran

BACKGROUND

Blastocystis is a unicellular protozoan and one of the most common parasites found in humans and many animals' intestinal tract. The present study aimed to compare the genotypes of Blastocystis infecting cattle and humans in the south of Iran.

METHODS

A total of 100 human stool samples and 75 cattle stool samples were microscopically examined for Blastocystis infection. DNA was extracted from thirty-eight microscopically positive samples (13 humans and 25 cattle). PCR was performed on positive samples targeting the Blastocystis-specific SSU rDNA gene. PCR products of eight humans and eleven cattle samples were sequenced and compared with available reference sequences in GenBank by BLAST queries. Genetic diversity was measured for Blastocystis subtypes in human and cattle, based on haplotype and nucleotide diversities.

RESULTS

The PCR detected Blastocystis in ten humans and twenty-four cattle samples. Blastocystis subtypes 1, 2, and 6 were found in humans whereas subtypes 5 and 10 were found in cattle. Subtype (ST) 2 was the most predominant subtypes in humans whereas, in cattle specimens, the ST5 was the most dominant subtype. Based on the Blastocystis sequences of SSU rDNA, 68 sites were polymorphic and 49 sites were parsimony informative, resulting in the identification of 15 haplotypes, 10 haplotypes in the cattle and 5 in humans. No haplotype was shared between cattle and human parasites.

CONCLUSION

Human-derived Blastocystis subtypes were different from cattle subtypes in southern Iran. Nevertheless, subtype 5 in cattle can be a risk factor for human infection.

Seroprevalence of anti-hepatitis E antibodies and antigens among HIV-infected patients in Fars Province, southern Iran

Objective

HIV-infected patients have immunological and clinical features that might affect the pathogenesis, as well as the outcome of the HIV/HEV co-infection. The current study aimed to determine the seroprevalence of anti-HEV antibodies and HEV antigens among HIV-infected patients in Fars Province, Southwest Iran.

Methods

Blood samples (5 mL) were collected from 251 HIV-confirmed patients. Respective data, including patients’ demographic information, were obtained for each patient. The presence of HEV antigens and anti-HEV antibodies (IgG) were assessed by commercial ELISA kits, based on the manufacturers’ instructions.

Results

Out of 251 cases, 158 (62.9%) were male and 91 (36.3%) were female. Patients’ age varied from 14 to 83 (mean: 40 ± 9.7) years. Out of 251 HIV positive cases, 26 (10.4%) were positive for anti-HEV IgG antibodies and 6 (2.4%) were positive for HEV-antigens. Also, 2 (0.8%) of the patients were positive for both anti-HEV IgG antibodies and antigens. Statistical analysis revealed no significant association between sex and seropositivity to either HEV antigen or antibodies. Moreover, no significant association was seen between age and seropositivity to HEV antigen or antibody (P = 0.622 and 0.945, respectively).

Conclusion

Our results showed a relatively low prevalence of HEV-antibodies in HIV-infected patients, indicating that HIV positive patients may not be at greater risk of HEV infection than the general population. Moreover, HEV-antigen was detected in a few cases of HIV-infected individuals which indicate an acute or chronic HEV infection in these patients.

Human cystic echinococcosis in southwest Iran: a 15-year retrospective epidemiological study of hospitalized cases

Background

Cystic echinococcosis (CE) is considered as a neglected disease with significant mortality and morbidity in most of the developing countries. The current study aimed to retrospectively assess the demographic and epidemiologic features of human CE surgical cases in a 15-year period in Fars province, southwestern Iran.

Methods

A 15-year (2004–2018) retrospective study was conducted to find out the epidemiological and clinical picture of CE in patients who undergone surgeries for CE in two main hospitals in Fars Province, southwestern Iran. Hospital records were reviewed, and data were retrieved from each CE patient’s record.

Results

A total of 501 CE surgical cases were recorded during a 15-year period, corresponding to an average annual incidence of 33.4 and a surgical incidence rate of 0.74/100,000 population. Of these, 242 (48.6%) were male, and 256 (52.4%) were female. Patients’ age ranged from 2 to 96 years, with a mean age of 34.92 (± 19.87) years. A significantly higher rate of CE cases was noted in subject’s ≥ 50 years of age. The highest frequency of cases (62:12.5%) was recorded in the year 2017. The most commonly involved organs were liver (339 cases; 57.8%) and lung (279 cases; 47.6%). Concurrent involvement of two organs was seen in 58 (9.9%) cases of both lung and liver, 10 (1.6%) cases of lung and other locations (but not liver), and 23 (3.9%) cases of liver and other locations (but not lung). Reoperation was noted in 67 (13.4%) of the cases. The size of the lung hydatid cyst varied, ranging between 2 and 24 cm (mean = 7.33, SD = 3.737). The size of liver hydatid cysts ranged from 1 to 26 cm (mean 9.04, SD = 4.275).

Conclusion

The findings of the current study demonstrated a nearly constant prevalence of CE during the last 15 years in southern Iran. Further studies are needed to find out the reasons behind the recurrence of the disease, which is substantial, in surgically-treated patients.

Diagnostic performance of Echinococcus granulosus protoscolices antigens in the serodiagnosis of human cystic echinococcosis

The development of suitable serological tests for the diagnosis of CE is still necessary. This study aimed to evaluate the efficacy of ELISA in the diagnosis of human cystic echinococcosis (CE), using parasite protoscolices antigens. Liver hydatid cysts were isolated from sheep infected with hydatid cysts and the protoscolices were isolated from the hydatid cyst fluid. Protoscolices crude antigen was prepared by mechanical disruption, plus freeze-thawing and sonication methods. Thirty sera samples of confirmed hydatid cyst patients, 30 samples of healthy individuals, and 30 samples of people with other infections were collected and the samples were evaluated in an ELISA system, using the crude protoscolices antigen. The sera samples were also simultaneously evaluated by antigen B-ELISA. The estimated value of sensitivity and specificity for the ELISA, using the crude protoscolices antigens, was 93.3% (95% CI: 76.4-98.8%) and 90% (95% CI: 78.8-95.8%), respectively. These values were 86.6 (95% CI: 68.3-95.6) and 91 (95% CI: 80.81-96.9) for the antigen-B based ELISA. Antigens prepared from protoscolices of hydatid cyst are suitable candidates for the serologic diagnosis of human CE. Further studies are needed to identify a single specific antigen among the protoscolices antigens to improve the diagnostic performance of these antigens.

Synthesis and Biological Activity of Some Aminothiazole Derivatives as Antileishmanial Agents

Background:

Leishmaniasis is a major health problem which is caused by the protozoan parasite of the genus Leishmania. Cutaneous leishmaniasis is one type of leishmaniasis and selflimited in most of the cases. However, when the lesions come with scars, they make a deep lifelong stigma. Despite being WHO's research priority, the optimum treatment for this disease has not been found yet. The current study aimed to synthesize and assess the activity of some new aminothiazole compounds against Leishmania major-induced cutaneous leishmaniasis in BALB/c mice.

Methods:

Eight new aminothiazole derivatives were synthesized and their chemical structures were characterized by spectral data 1H-NMR spectroscopy, Mass spectrophotometry and elemental analysis. L. major parasites were inoculated into the tail base of BALB/c mice and the induced lesions were treated every other day with three different doses of the synthesized compounds against meglumine antimoniate as the drug reference for two weeks. Size of the lesions was observed for three weeks and the collected data were analyzed by SPSS software. Also, these compounds are docked into the active site of 14- α-demethylase as the targets in the treatment of leishmaniasis.

Results:

Among the synthesized aminothiazole derivatives, compounds 1, 2, 3, 4, and 7 had good leishmanicidal effects. Docking binding energies showed that the synthesized compounds could act as inhibitors for 14- α-demethylase.

Conclusions:

Among the synthesized compounds, compound 3, (N-((4-chlorophenyl)(phenyl) methyl)thiazol-2-amine) was the most promising one which deserves future studies for the treatment of leishmaniasis.

Parasitic infections in irritable bowel syndrome patients: evidence to propose a possible link, based on a case-control study in the south of Iran

OBJECTIVES

The current study aimed to evaluate the prevalence of parasitic infections and their possible association with irritable bowel syndrome (IBS), through a case-control study. Stool samples were collected from patients with IBS and healthy subjects and were examined microscopically to detect intestinal parasites.

RESULTS

A total of 200 subjects were enrolled in the study including 100 patients with IBS and 100 healthy controls. The patients were selected based on the Rome III criteria. Of the 100 patients with IBS, 65 (65%) were female and 35 (35%) were male, with a mean age of 42.57 (± 4.07) years. Of these, 30 (30%) were infected with at least one intestinal parasite; the most common ones were Blastocystis hominis and Giardia lamblia. Of the control cases, 64 (64%) were female and 36 (36%) were male, with a mean age of 41.82 (± 11.75) years. Of these, 16 (16%) were infected with at least one intestinal parasite; the most common were B. hominis and Endolimax. There was a significant difference between the rate of parasitic infections between the patients with IBS and the control in particular, B. hominis and G. lamblia. The findings of the study support a possible link between parasitic infections and IBS.

Importance of L. Infantum H2B Recombinant Antigen for Serodiagnosis of Visceral Leishmaniasis

BACKGROUND

Visceral leishmaniasis (VL) can lead to death in more than 95% of cases if left untreated. Accurate and early diagnosis has an important role in reducing mortality rate of this disease.

OBJECTIVE

To express recombinant H2B antigen from an Iranian isolate of Leishmania Infantum and evaluate its efficacy in the diagnosis of VL.

METHODS

The recombinant H2B antigen was produced in a prokaryotic system, and its efficacy for VL diagnosis was evaluated by ELISA. The serum samples from 80 VL patients, 100 individuals from endemic and non-endemic regions of VL, and 58 non-VL patients were collected. VL cases were confirmed based on the clinical sign, positive IFAT (>64), real time PCR, and response to treatment.

RESULTS

The H2B gene sequence of the Iranian L. infantum isolate had about 4% diversity in comparison with the H2B gene of the L. infantum counterpart. ELISA, using the produced H2B recombinant antigen, showed sensitivity of 71.25% (95% CI: 60.05%-80.82%) and specificity of 69.62% (95% CI: 61.81%-76.68%) regarding VL diagnosis.

CONCLUSION

Recombinant H2B antigen expressed in the prokaryotic system had suboptimal performance for the serological diagnosis of VL. It seems that the production and expression of recombinant H2B antigen in a eukaryotic system may enhance the performance of this antigen in the diagnosis of VL in Iran.

Genetic Diversity of Echinococcus granulosus Isolated from Humans: A Comparative Study in Two Cystic Echinococcosis Endemic Areas, Turkey and Iran

Cystic echinococcosis (CE) is one of the most important zoonotic parasitic diseases caused by the larval stage of Echinococcus granulosus. Based on molecular studies and DNA sequencing, E. granulosus has been classified into 10 different genotypes (G1 to G10). Two neighboring countries, Turkey and Iran, are considered the two main foci of CE in the Middle East. The current study is aimed at examining the genotype diversity of E. granulosus isolated from human clinical samples in Turkey and Iran. Surgically removed human hydatid cysts were collected from East Azerbaijan and Fars provinces in Iran and Van province in Turkey. After extracting DNA, performing PCR, targeting the cox1 gene, the PCR products were purified from the gel and were sequenced from both directions. The sequences were aligned and compared, using BioEdit and also the BLAST program of GenBank. The maximum likelihood tree was constructed based on the Tamura-Nei model, using the MEGAX software. Phylogenetic analysis showed that the human isolated samples were classified into two major clades: G1 (from Iran and Turkey) and G3 (5 samples from northwestern Iran and one sample from Turkey). The mean and degree of genetic divergence (K2P) between the two major clades, G1 and G3, were 0.2% and 0.7 ± 0.4%, respectively. The findings of the current study revealed that the sheep strain (G1) and the less important strain G3 have major roles in the transmission cycle of CE in two neighboring countries, Iran and Turkey. Therefore, it is necessary to interpose the life cycle of this parasite and reduce the disease burden in livestock and humans by adopting common regional preventive and control policies.

Coinfection of Strongyloides stercoralis and Aspergillus sp

BACKGROUND

Strongyloides stercoralis has the ability to proliferate in its hosts for a long time. In most patients with a competent immune system, the infection remains asymptomatic.

OBJECTIVES

Herein, we report a case of concomitant infection of Strongyloides and Aspergillus. Similar cases reported previously were reviewed in the literature and discussed in terms of diagnosis, clinical presentation, and treatment.

METHODS

The patient was a 55-year-old man who had a medical history of two masses in his lung and was treated with corticosteroids six months before the presentation.

RESULTS

Using the parasitological methods, massive actively motile larvae of S. stercoralis were seen in the patient's faecal sample. Aspergillus infection was isolated from his fresh bronchoalveolar lavage (BAL) sample and confirmed by observing the septate, dichotomously branched hyphae in direct microscopic examination and also the isolation of the fungus from the culture medium. Molecular analysis revealed that the fungal species isolated from the patient are A. flavus and A. niger. Conclusion. The case highlights the features of concomitant infection of S. stercoralis and Aspergillus in immunocompromised patients and the importance of screening patients for strongyloidiasis before initiation of immunosuppressive therapy.

Expression of a rK39 homologue from an Iranian Leishmania infantum isolate in Leishmania tarentolae for serodiagnosis of visceral leishmaniasis

BACKGROUND

Kinesin-related gene diversity among strains and species of Leishmania may impact the sensitivity and specificity of serodiagnostic tests for visceral leishmaniasis (VL).

METHODS

In this study, we report on the recombinant expression of this novel Iranian Leishmania infantum (MCAN14/47) homologue of rK39 (Li-rK39), in L. tarentolae. The diagnostic potential of the Li-rK39 antigen was evaluated in an ELISA, using sera from 100 VL patients, 190 healthy endemic controls, 46 non-endemic healthy controls and 47 patients with other infections.

RESULTS

The results showed a sensitivity of 96% and a specificity of 93.8%. A commercial rK39 immunochromatographic test (ICT) was 90% sensitive and 100% specific on the same cohort.

CONCLUSIONS

Here, we show that the K39 gene from an Iranian L. infantum isolate is heterozygous as compared to the sequence of the Brazilian L. infantum (former L. chagasi), whose antigen is incorporated in most rK39-based immunochromatographic tests. Therefore, Li-rK39 has the potential to be used as an alternative for VL diagnosis in Iran.

Comparative Genotyping of Echinococcus granulosus Infecting Livestock in Turkey and Iran

Objective

Echinococcus granulosus contains a complex of different strains that represent diversity in the pattern of the life cycle and also their host types. So far 10 genotypes of this parasite have been identified, using molecular methods. The current study aimed to evaluate and compare the genotypic diversity of E. granulosus metacestodes from livestock of Turkey and Iran.

Methods

A total of 90 livestock liver and lung organs infected with hydatid cyst from industrial slaughterhouses of Bonab Province in the East Azerbaijan Province in Iran (60 samples, including 30 sheep and 30 cattle) and Van Province in Turkey (30 samples, including 15 sheep and 15 cattle) were collected. DNA was extracted from the protoscolices or germinal layers and polymerase chain reaction (PCR) were utilized, targeting the partial mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase 1 (nad1) genes. PCR products were isolated from the electrophoresis gels and sequenced. The sequences were compared with each other, as well as with those related available sequences in the GenBank, using the BioEdit software and the BLAST algorithm. Finally, the phylogenetic trees were constructed by comparing sequences of cox1 and nad1 fragments, using the MEGA7 software and the maximum likelihood method.

Results

All samples sequenced from Iran corresponded to the genotype G1 (100%). Among the samples from Turkey, 15 samples (78.9%) were identified as G1 while only one sample (5.3%) corresponded to the genotype G3 and 3 isolates (15.8%) were defined as genotypes G1/G3. Five distinct haplotypes were determined within the examined isolates from sheep and cattle in both countries and all isolates clustered in one group. Phylogenetic analysis revealed that the intra-species genetic variations were 0.0-0.6% and 0.0-1.4% for cox1 and nad1, respectively.

Conclusion

The dominant genotype of E. granulosus sensu stricto of livestock in both countries was the G1 (sheep strain) genotype. Our findings indicate that the sheep-dog cycle is the leading cycle of E. granulosus in these two areas. Hence, adopting regional common policies and bilateral cooperation helps to control the disease in livestock as well as in human in these two regions. Further study is required to compare the genetic diversity of human isolates of E. granulosus in these two countries.

Neobalantidium coli: First molecular identification from the Eurasian wild boar, Sus Scrofa in Bushehr Province, Southwestern Iran

Balantidium coli is a common parasite of pig and wild boars (Sus scrofa) which can infect humans and several species of mammals. This study aimed to determine the genotype of Balantidium isolated from Eurasian wild boars in Bushehr province, Southwestern Iran. Twenty-five faecal samples, originating from 25 wild boars captivated in our previous study, were processed. DNA was extracted from the faecal samples and PCR-amplified, targeting an ITS1-5.8s-rRNA-ITS2 region of Balantidium genome. PCR product was purified from the gel, and sequenced. BLAST analysis was performed in order to compare our isolates with other previously reported ones. A phylogenetic tree was constructed, using MegaX software, to find out the phylogenetic diversity of the isolates. With PCR it was possible to detect Balantidium DNA in the faecal samples of 13 out of 25 (52%) of the wild boars. BLAST analysis of seven isolates revealed that the isolates belong to the newly introduced genus Neobalantidium coli. Sequences of three isolates were deposited in the GenBank. Moreover, molecular analysis revealed six areas of nucleotide differences within the isolates and nine areas of difference between the sequences obtained in this study and those available in the GenBank. Phylogenetic analysis revealed that the sequences of isolates of this study have up to 2.2% dissimilarity from those published in the GenBank. The findings of this study, for the first time, revealed that some of the isolates of Balantidium originating from wild boars in Southwestern Iran belonged to the N. coli.

Serum levels of anti-hepatitis B surface antibodies among vaccinated children aged 1 to 12 years in a rural community in Fars Province, southern Iran

The present study aimed to find out the levels of anti-HBsAb among vaccinated children in a rural community in Fars Province, Southern Iran. Blood samples were taken from 550 children, aged 1-12 years (mean 6.4 ± 3.5), in 2017 from three villages in the area. A structured questionnaire was used to get the sociodemographic data of the subjects along with determinants concerning the Hepatitis B. Sera samples were examined for anti-HBsAb, using an ELISA commercial kit. Anti-HBsAb were detected in 468 (85.1%) of the subjects. Of the seropositive subjects, 37 (45.1%) were female and 45 (54.9%) were male. In the age group of 0-5 years, 88.7% of the subjects were seropositive. This rate was 84.3% and 78.1% in the age group of 6-10 years old and older than 10 years, respectively. There was a significant association (p < .05) between the anti-HBsAb and age. Findings of the current study revealed that children living in a rural community in southern Iran have appropriate protection against HBV even more than 10 years after being vaccinated. The decline in seropositivity rate of anti-HBsAb with age may further point out the need for a booster dose of HBV vaccine.

Prevalence of bovine fascioliasis in a new-emerging focus of human fascioliasis in BoyerAhmad district, southwest of Iran

BACKGROUND

The prevalence of fascioliasis in a population of cattle in a new-emerging focus of human fascioliasis in Boyer-Ahmad District, in the southwest of Iran, was investigated, using an ELISA system and coprological methods.

METHODS

Blood, as well as stool samples, were collected from 150 dairy cattle consisted of 82 (54.7%) males and 68 (45.3%) females, aged from 1 to 8 years, selected from different pastures. The stool samples were evaluated by direct wet mount microscopic examination as well as sedimentation methods. Moreover, modified Telemann was used for detecting of Fasciola eggs. Anti-Fasciola antibodies in the cattle sera samples were determined, using a Fasciola excretory-secretory antigen-specific ELISA.

RESULTS

Anti-Fasciola antibodies were detected in 64 (42.4%) of the subjects by ELISA. Out of 64 seropositive cases, 29 (45.3%) were female and 35 (54.6%) were male. No significant association was found between sex and seropositivity to fascioliasis. Considering the age of the cattle, the highest prevalence of fascioliasis (23%) was found in the 5-year old age group. However, the difference between the age of the cattle and seropositivity to fascioliasis was not statistically significant (P > 0.05). Fasciola eggs were not detected in fecal samples of any of the studied cattle, while Paramphistomide, as well as Dicrocoelium dendriticum eggs, were detected in 6 (4%) and 17 (11.3%) of the subjects, respectively.

CONCLUSION

Findings of the current study provide basic information about bovine fascioliasis in a new focus of human fascioliasis in Iran, which is needed for effective control of this parasitic infection in such areas.

Low prevalence of Toxoplasma gondii infection among children in a rural community in Fars province, Southern Iran

The current study aimed to determine the seroprevalence of Toxoplasma gondii infection and associated risk factors in children in a rural community in Fars province in southern Iran. Blood samples were collected from 671 children living in three rural areas, and sera and buffy coats were isolated from each sample. Anti-T. gondii antibodies were detected by ELISA, using a commercial kit. Also, buffy coats of seropositive children were examined by a PCR method, targeting a 529 bp gene of T. gondii. Of 671 children participating in the study, 319 (51.7%) were boys and 298 (48.3%) were girls. The mean age of the children was 9.7 (±10.7) years. Anti-Toxoplasma antibodies were detected in sera of 23 out of 671 children, corresponding to a seroprevalence rate of 3.8%. Gender and level of education had no significant influence on the risk of Toxoplasma infection (p>0.05). Toxoplasma DNA was not detected in buffy coats of any of the seropositive cases. Geographic location, as well as the low age of the participants, may contribute to the low rate of Toxoplasma infection in children of rural areas in southern Iran.

Comparison of the Utility of Recombinant B8/2 Subunit of the Antigen B, Native Antigen, and a Commercial ELISA Kit in the Diagnosis of Human Cystic Echinococcosis

Background

Cystic echinococcosis (CE) is a helminthic disease caused by the larval form of Echinococcus granulosus. In the present study, the B8/2 subunit of antigen B (AgB) of E. granulosus was expressed in E. coli host and then applied in a diagnostic ELISA set up.

Methods

The DNA sequence of AgB8/2 subunit from E. granulosus was extracted from the GenBank and codon-optimized according to E. coli codon usage. The target sequence was cloned in an expression vector (pGEX-4T-1). The produced antigen was used in an ELISA system, and its performance for the diagnosis of human hydatid cyst was evaluated, using sera from CE and non-CE patients, along with the sera from healthy subjects. Moreover, the diagnostic value of the recombinant protein was compared with native AgB, as well as with a commercial kit.

Results

Antibodies to hydatid cyst were detected in 27 out of 30 patients corresponding to a sensitivity of 90% (95% CI: 73-98%). Cross-reaction with sera of non-CE subjects was seen in two cases resulted in a specificity of 93.5% (95% CI: 82-98%) for the test. A sensitivity of 87% and specificity of 90% were found for the native form of the antigen, while the ELISA commercial kit had a sensitivity of 97% and specificity of 95%.

Conclusion

Our data show that rEgAgB8/2 is an appropriate source of antigen for the serological diagnosis of human hydatid cyst. Co-expression of the rEgAgB/2 along with other subunits of AgB may enhance the performances of these antigens for the serodiagnosis of human CE.

Human fascioliasis in nomads: A population-based serosurvey in southwest Iran

Fascioliasis is a human and veterinary concern in Iran. This cross-sectional population-based study was conducted to determine the seroprevalence of human fascioliasis among nomadic people in Kohgiluyeh and Boyer-Ahmad province located in the southwest of Iran. Venous blood samples were collected from 933 nomads in the area. A predesigned questionnaire containing basic epidemiological information was filled out for each subject during the sampling. Sera were evaluated for anti-Fasciola antibodies, using excretory-secretory (ES) antigen of Fasciola hepatica in an ELISA system. Of 933 recruited subjects, 726 (77.8%) were females and 206 (22.1%) were males. The mean age of the participants was 43.1 (±16.7) years old. Most of the subjects (24.6%) were in the age group of 21-30 years old. Anti-Fasciola antibodies were detected in 24 (2.6%) out of 933 cases. Of 24 seropositive cases, 3 (12.5%) were male and 21 (87.5%) were female. The differences between the seropositivity and sex, age, level of education and residence area were not statistically significant (p >0.05). Findings of the current study demonstrated that the seroprevalence of fascioliasis in the studied nomadic population was significant, and that preventive and control measures should be taken to prevent the disease from spreading and causing even greater health and economic problems in this area.

Diagnostic accuracy of urinary latex agglutination test (KAtex) for the diagnosis of visceral leishmaniasis: A meta-analysis

Latex agglutination test (KAtex) has been used in the last two decades for the diagnosis of visceral leishmaniasis (VL) in different VL-endemic areas. Here, we present a meta-analysis of studies which evaluated the KAtex for the diagnosis of VL to find out its overall diagnostic performance. A database search was performed on PubMed, Scopus, ISI Web of Science, Iranmedex and Google Scholar. The search of databases found 57 papers, of which 17 articles fulfilled our eligibility criteria. Meta-analysis of diagnostic accuracy (MADA) and Hierarchical Summary Receiver Operating Curve (HSROC) packages were used to do the meta-analysis and to obtain pooled estimates of sensitivity and specificity. Fixed effect bivariate analysis was conducted, using Mantel-Haenszel estimator, to measure the performance and diagnosis odds ratio (DOR) of the test. Heterogeneity of the test results was assessed by Chi-squared test. The sensitivity of individual studies ranged from 39.8 to 100%, and the specificity ranged from 64 to100%. The combined sensitivity and specificity estimates of KAtex were 77% (95% CI, 70-83%), and 97% (95% CI, 93-97%), respectively. Comparing the performance of the test by region suggests a significant difference where the lowest and highest sensitivities are reported from Nepal/Tunisia and Europe/Middle East respectively (p < 0.05). On the other hand, the lowest and highest rates of specificity were reported from Sudan and America/Middle East respectively. The overall specificity of KAtex is satisfactory. However, KAtex suffers from low sensitivity and this shortcoming should be improved. The test provides a rapid and simple diagnosis of VL and improvement of its sensitivity deserve further studies.

Seroepidemiological study of cystic echinococcosis in nomadic communities in the southwest of Iran: A population-based study

The current study aimed at the seroepidemiological survey of human cystic echinococcosis (CE) in nomadic people in Boyer-Ahmad District in the southwest of Iran. One thousand and five nomads were selected by cross-sectional sample collection in nomadic tribes of Boyer-Ahmad District in the southwest of Iran. Blood samples were taken from each individual, and the sera were tested for detection of anti-hydatid cyst antibodies using antigen B-ELISA. A predesigned questionnaire which contained basic epidemiological and individual information related to hydatid cyst was filled for each subject during sample collecting. Subjects of the study were 227 males (22.6%) and 778 (77.4%) females. The mean age of the participants was 40.4 years old (±16.6). Anti-hydatid cyst antibodies were detected in 81 (8.1%) of the subjects. Seroprevalence rate for CE in females (9%) was more than males (4.8%). Multivariate logistic regression revealed significant associations between CE seropositivity and sex (odds ratio [OR] = 1.88; 95% confidence interval [CI] = 0.93-3.80) and dog ownership (OR = 8.3; 95% CI = 3.94-16.37). The rate of infection with CE in nomadic people in southwest of Iran is considerable. Treatment of dogs and increasing the level of people awareness may contribute a substantial advancement in the control of the disease in the area.

Vaccination with Live Attenuated L. Major and TLR4 Agonist Promotes a Th1 Immune Response and Induces Protection against L. Major Infection in BALB/c Mice

BACKGROUND

Toll like receptors play a major role in immune responses against Leishmania parasites.

OBJECTIVE

To evaluate the efficacy of vaccination with live attenuated L. major and TLR4 agonist in protection against L. major infection.

METHODS

Attenuated L. major was prepared by continuous sub-culturing of the parasite. A total of 90 mice were assigned to 9 groups including 6 groups of BALB/c (G1-6) and 3 groups (G7-9) of C57BL/6 mice. Group 1 was the control groups, group 2 received the wild-type L. major promastigotes, group 3 the attenuated line, group 4 the TLR4 agonist, group 5 the wild-type L. major and TLR4 agonist, and group 6 the attenuated line along with TLR4 agonist. Group 7 was control, group 8 received wild-type L. major and group 9 the wild-type along with TLR4 agonist. Vaccinated mice were then challenged with wild-type of L. major. Lesion size, parasite burden, and the expression levels of IL-4, IFN-γ, IL-2, 1L-17A, IL-10, TGF-β and TLR4 were evaluated before the challenge while parasite burden and lesion size were evaluated.

RESULTS

Vaccinated mice with a TLR4 agonist or attenuated L. major plus TLR4 agonist produced the highest levels of IFN-γ, IL-2, and IL-17A. Post-challenge analysis revealed that mice vaccinated with the attenuated line along with TLR4 agonist displayed the lowest lesion size and parasite load. These mice developed a predominant Th1 immune response.

CONCLUSION

Vaccination with the attenuated L. major along with TLR4 agonist promotes a Th1-mediated immune response which leads to the protection of BALB/c mice against L. major infection.