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Objective: To determine the effect of climatic and environmental factors on the incidence of cutaneous leishmaniasis in Qom province in 2018. Methods: In this cross-sectional study, the data on cutaneous leishmaniasis incidence were collected from the Disease Control and Prevention Center in Qom province. Climatic and environmental data including Normalized Difference Vegetation Index (NDVI), Land Surface Temperature (LST), and soil moisture were extracted using satellite images. Data of altitude and sunny hours were provided based on shuttle radar topography mission digital elevation model and hemispherical viewshed algorithm, respectively. The associations of climatic and environmental variables with the incidence of the disease were analyzed by Pearson correlation method. The ArcGIS 10.3 software was used to determine the geographical distribution of these factors. Results: There were positive correlations between cutaneous leishmaniasis incidence and the two climatic factors: LST and sunny hours per day (P=0.041, P=0.016), and it had weak negative correlations with the digital elevation model (P=0.27), soil moisture (P=0.54), and NDVI (P=0.62). The time delay analysis showed that in one-, two-, and three month periods, the correlations increased with a 95% confidence interval. Accordingly, the correlation with the three-month time delay was positive and relatively strong between the cutaneous leishmaniasis incidence and LST and sunny hours (P=0.027, P=0.02); nevertheless, there were negative correlations between the cutaneous leishmaniasis incidence and the soil moisture (P=0.27) and NDVI (P=0.62). Conclusions: As Qom is located in one of the semi-arid climate zones, topography and solar energy are important factors affecting the incidence of cutaneous leishmaniasis in autumn. Therefore, appropriate disease control programs are recommended.
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Objective: To determine the effect of climatic and environmental factors on the incidence of cutaneous leishmaniasis in Qom province in 2018. Methods: In this cross-sectional study, the data on cutaneous leishmaniasis incidence were collected from the Disease Control and Prevention Center in Qom province. Climatic and environmental data including Normalized Difference Vegetation Index (NDVI), Land Surface Temperature (LST), and soil moisture were extracted using satellite images. Data of altitude and sunny hours were provided based on shuttle radar topography mission digital elevation model and hemispherical viewshed algorithm, respectively. The associations of climatic and environmental variables with the incidence of the disease were analyzed by Pearson correlation method. The ArcGIS 10.3 software was used to determine the geographical distribution of these factors. Results: There were positive correlations between cutaneous leishmaniasis incidence and the two climatic factors: LST and sunny hours per day (P=0.041, P=0.016), and it had weak negative correlations with the digital elevation model (P=0.27), soil moisture (P=0.54), and NDVI (P=0.62). The time delay analysis showed that in one-, two-, and three month periods, the correlations increased with a 95% confidence interval. Accordingly, the correlation with the three-month time delay was positive and relatively strong between the cutaneous leishmaniasis incidence and LST and sunny hours (P=0.027, P=0.02); nevertheless, there were negative correlations between the cutaneous leishmaniasis incidence and the soil moisture (P=0.27) and NDVI (P=0.62). Conclusions: As Qom is located in one of the semi-arid climate zones, topography and solar energy are important factors affecting the incidence of cutaneous leishmaniasis in autumn. Therefore, appropriate disease control programs are recommended.
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Rationale: Rabies, as an acute viral disease of the mammal's central nervous system (CNS), with a high mortality rate, is transmitted to humans through the bite of a rabid animals, especially canine and feline. Patient concerns: An Afghan man, aged 50 years was bitten by a fox in a farm around the Qom-Tehran road, Central Iran in 2018. The patient visited the doctor after the bite, however the period between incidence and hospital visit was not established and no indication was given whether the bite site injury was thoroughly washed. The patient was neither referred to the health center for vaccination (post-exposure prophylaxis) nor an effective therapeutic measures was applied. Forty-five days post-exposure, the patient presented with symptoms such as headache, fever, tingling and burning sensation and was referred to the Centers for Disease Control and Prevention (CDC) unit of Qom Provincial Health Center. Diagnosis: Rabies infection. Interventions: Forty-five days after the animal bite, in CDC of Qom Health Center, he received rabies post-exposure prophylaxis treatment was referred to an infectious diseases physician. Based on the history of animal bites, the patient was classified as probable case of rabies. The clinical symptoms of rabies appeared in patient after hospitalization. Outcomes: Ultimately the patient died in hospital 4 days after hospitalization (50 days after the occurrence of animal bite). After referring the patient to the CDC, the patient's saliva (0.5-1 mL) was sampled three times every 3-6 hours and tested by PCR. Human rabies was confirmed by Department of Virology in the Pasteur Institute of Iran. Lessons: Physicians and clinicians have responsibilities to be critical in observations and take prompt actions in case of animal bites, as rabies usually develops within 7 to 14 days, and delayed intervention after the onset of symptoms, vaccine and serum injections cannot lead to the survival of the patient.
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To determine the spatial distribution and infection rate of sand flies as vectors of Leishmania parasite in Ardabil province, northwest of Iran. Methods: This was a descriptive cross-sectional study. The sand flies were collected from 30 areas in all 10 districts of Ardabil province during 2017. The specimens were caught using the sticky traps. The head and genitalia of sand flies were separated and mounted in Berlese solution for microscopic identification. The Geographical Information System ArcMap10.4.1 software was used to provide the spatial maps. Results: A total of 2 794 sand flies specimens were collected and 22 species of sand flies were identified from the two genera: Phlebotomus and Sergentomyia from Ardabil province. The highest frequency was found in Phlebotomus papatasi (23.7%) followed by Phlebotomus kandelakii (13.0%). The promastigote form of Leishmania infantum parasite has been reported from the three main vectors of visceral leishmaniasis (Phlebotomus kandelakii, Phlebotomus perfiliewi and Phlebotomus tobbi) from Ardabil province, where the spatial distribution map of these visceral leishmaniasis vectors was prepared. Some important species of sand flies such as Phlebotomus kandelakii, Phlebotomus perfiliewi and Phlebotomus tobbi were reported and identified as main and probable vectors of visceral leishmaniasis in Ardabil. Conclusions: According to the Geographic Information System based maps, the frequency of the sand flies as leishmaniasis vectors, the leishmania parasite infection rate and the prevalence of the disease in the central areas of Ardabil province are higher than in other areas in Ardabil province.
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Objective: To represent a new geographical record, Phlebotomus (Adlerius) kabulensis (P. kabulensis), which is suspected to be a potential vector of visceral leishmaniasis. Methods: For the first time, P. kabulensis specimens were collected using the sticky paper traps method in outdoor places in mountainous areas with vegetation coverage of three provinces in Iran. Identification of males was based on ecological, morphological, morphometric and molecular (mtDNA cytochrome b gene sequences) criteria. Generally, males have two ascoids on the 8
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Objective:To represent a new geographical record, Phlebotomus (Adlerius) kabulensis (P. kabulensis), which is suspected to be a potential vector of visceral leishmaniasis.Methods:For the first time, P. kabulensis specimens were collected using the sticky paper traps method in outdoor places in mountainous areas with vegetation coverage of three provinces in Iran. Identification of males was based on ecological, morphological, morphometric and molecular (mtDNA cytochrome b gene sequences) criteria. Generally, males have two ascoids on the 8Results:Morphometric measurement revealed that P. kabulensis specimens were the same as compared with seven other morphological characters in three provinces of the country but lengths of the coxite were significantly different. The PCR result of the cytochrome b (Cyt b)-mtDNA fragment shows 550-bp length, with its special nucleotide arrangement. The male and female of P. kabulensis were newly discovered members of the subgenus Adlerius from Iran. Initial DNA analysis indicated how distinct this species is.Conclusions:The results show that the P. kabulensis female will be identified by comparing with other Adlerius female groups regarding its morphometric characters and molecular sequencing.
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Objective: To determine spatial distribution of sand flies (Diptera: Psychodidae; Larroussius group), the vectors of visceral leishmaniasis in Ardabil province, Northwest of Iran. Methods: Sand flies were collected using sticky traps from the 30 selected points in Ardabil province, during May-November 2017. The MaxEnt model in GIS software was used for modeling. Results: A total of 2 794 specimens of sand flies were collected, of which 33% were Larroussius subgenus sand flies. Phlebotomus kandelakii and Phlebotomus wenyoni were the highest and lowest collected species respectively. Based on the modeling, four areas in the province were identified with more than 70% probability of the presence of Larroussius group vectors which were at risk of visceral leishmaniasis disease transmission. Conclusions: The distribution of Larroussius subgenus sand flies was observed in all parts of Ardabil. But the northern parts of the province (Germi and Bilesavar counties) as well as central part (Ardabil and Meshkinshahr counties) were of great importance in terms of the presence of Larroussius subgenus sand flies and the possibility of transmission of the visceral leishmaniasis.
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Objective: To identify the scorpion fauna and classify the epidemiological aspects of scorpionism in an endemic region, Southeast Iran. Methods: Scorpionism data were collected from health centers and hospitals in Sistan-Baluchestan Province during 2010-2011. Specimens were collected at night, using UV light, between May and October 2012.Results:Five species including Odontobuthus odonturus, Hottentotta (Buthotus) jayakari, Compsobuthus matthiesseni, Scorpio maurus and Orthochirus scrobiculosus are reported for the first time from this area. Androctonus crassicauda was the dominant species. In total, 3638 scorpion sting cases were recorded by health system, the majority of which were females. Stings mostly occurred in July and the age group of 15-24 years presented the highest frequency. Scorpionism decreased during 2011 compared with that in 2010 (68.2%). In total, 246 scorpions were collected from two families (Buthidae and Scorpionidae). Conclusions: Based on the results, scorpionism is a serious health problem in this area and increasing knowledge of residents regarding the prevention methods of scorpion stings is recommended. Additional research on the scorpion fauna, their ecological and molecular variety in this part of the country is needed as well as the correlation between scorpions’ species and the clinical signs and symptoms.
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Hydatid cyst is one of the parasitic zoonotic diseases in Iran and the world, and a significant percentage of hospital beds are annually allocated to these patients. This study aimed to determine the epidemiological status of hydatid cyst in hospitals affiliated to Qom University of Medical Sciences during a 12-year period. In this descriptive-analytic study, the medical records of all patients with hydatid cyst who underwent surgery in hospitals of Qom University of Medical Sciences from 2002 to 2013, were investigated. The demographical and clinical data were extracted from patients' records. Data analysis was performed using chi square test. The number of patients during this period was 82. The mean age of patients was 38.80 +/- 17.20 [min=8 and max=69]. 57.3% of the patients were female and 42.7% were male. The highest percentage of hydatid cyst was seen in menin the age group of 31-40 years [37.15%], and in women, in the age group of 21-31 [25.53%] were in the age group 21-30 years old. Frequency of the disease among housewives [51.3%] was higher than other occupational groups. Most of the patients [90%] lived in urban areas. Liver infection was seen in 74.3% of the patients. Considering that the highest frequency of the disease was reported in economically active age group and that housewives are more at risk for this disease, therefore training programs for the prevention and control of the disease appears to be essential for target groups
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Background: Although vegetables have important role to our diets but in case of infection with microbes they can act as a source of infection for variety of intestinal diseases namely cholera. Present study aimed to figure out the status of vegetable disinfection behavior and its modifiable determinants during cholera outbreak in Qom province in 2011.
Material and Methods: In a descriptive-analytic study on 554 women [who were household-keeper], vegetable disinfection behavior and its determinants were investigated. In this study, the multistage sampling method was used. A researcher-tailored questionnaire was used to gather data. The valid and reliable questionnaire was comprised of 85 questions and was completed by subjects. Then, the collected data was analyzed by SPSS software [version 19] and using Pearson correlation coefficient [CI=95%].
Results: The mean and standard error [SE] of age of subjects were about 31.24+-8.45 Women's knowledge score on use of vegetable disinfectants had a mean and SE of 71.5+-11.65. Altogether, only 15.99% of women [87 persons] reported a complete disinfection of vegetables. The strongest relationship was found between Vegetable disinfection behavior and the perceived barriers that based on Pearson correlation coefficient was a significant but reverse relationship. [r=-0.567, p=0.019].
Conclusion: Our findings showed that house-keeping women had a poor behavior regarding vegetable disinfection. Consequently, poorly-disinfected vegetables are still a prominent health problem respecting spread of intestinal diseases especially cholera.
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Animal bite is considered as a public health problem. Increasing cases of animal bite is of high importance because of causing rabies losses in livestock and economic damages. This study was conducted to determine the epidemiology of animal bite in Qom province. This descriptive-retrospective study was done on medical records of subjects with animal bite in Qom province during 2007-2012. The collected data were analyzed using chi-square. The significance level was considered to be p<0.05. During these 6 years, 7246 cases had been bitten by animals. Bites were significantly higher in men [89.6%] compared to women [p<0.01]. The mean age of injured population was 29.6 +/- 15.7. The overall incidence rate of animal bite was 109.4 cases per 100000 people. The highest frequencies of bites were in spring season [27.3%] compared to other seasons. Most cases were bitten by dogs [61.7%]. In most of the cases, the bitten body sites were hand and leg [93.8%]. In 81.5% of cases, vaccination history was in three times. A significant relationship was observed between resident place and species of biting animal [p<0.05]. Based on the results of this study, the incidence of animal bites in Qom province was higher than other provinces. Hence, implementation of basic measures, such as training at-risk groups, establishing a committee for dissipation of stray dogs, strengthening care system, and vaccination program, seem to be necessary
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<p><b>OBJECTIVE</b>To identify the scorpion fauna and classify the epidemiological aspects of scorpionism in an endemic region, Southeast Iran.</p><p><b>METHODS</b>Scorpionism data were collected from health centers and hospitals in Sistan-Baluchestan Province during 2010-2011. Specimens were collected at night, using UV light, between May and October 2012.</p><p><b>RESULTS</b>In total, 246 scorpions were collected from two families (Buthidae and Scorpionidae). Five species including Odontobuthus odonturus, Hottentotta (Buthotus) jayakari, Compsobuthus matthiesseni, Scorpio maurus and Orthochirus scrobiculosus are reported for the first time from this area. Androctonus crassicauda was the dominant species. In total, 3 638 scorpion sting cases were recorded by health system, the majority of which were females. Stings mostly occurred in July and the age group of 15-24 years presented the highest frequency. Scorpionism decreased during 2011 compared with that in 2010 (68.2%).</p><p><b>CONCLUSIONS</b>Based on the results, scorpionism is a serious health problem in this area and increasing knowledge of residents regarding the prevention methods of scorpion stings is recommended. Additional research on the scorpion fauna, their ecological and molecular variety in this part of the country is needed as well as the correlation between scorpions' species and the clinical signs and symptoms.</p>
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Leishmaniasis is one of the most important health problems in many areas of Iran. This study aimed to identify leishmania species in patients with cutaneous leishmaniasis using PCR teqnique based on sequencing ITS1 primers in villages of the central county of Qom province. This descriptive cross-sectional study was done on 169 patients who with leishmaniosis, based on clinical and laboratory confirmation treated and were followed in health center of Qomrood in 2010. This data was recorded in epidemiologic data forms. The DNA was extracted by KIAGEN kits. The extracted DNA was exploited to identify the parasite by PCR technique. The data were analyzed by SPSS-17 software. Chi square and Fisher's exact test were used for the evaluation of the hypothesis. The PCR result confirmed the parasite positive slides and obtained bands from these slides were seen in the range of 350 bp which are expected band for the leishmania major parasite. The most frequent age group was above 15 years old [71.5%]. Hands and feet were the most common sites of ulcer [78.8%]. 19.5 of patients had 3 ulcers and more. Highest disease prevalence was observed in months October, December and November. The PCR results illustrated that the prevalent CL in the central county of Qom province is Zoonotic type [ZCL], and the agent of disease is leishmania major parasite. In conclusion, identification of the disease and parasite type can help the health officials to make appropriate strategies for its prevention and control
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Crimean-Congo Hemorrhagic fever [CCHF] is an acute viral febrile hemorrhagic disease that is common between human and animal. This study was performed with the aim of determining epidemiological status of CCHF in Qom province. This descriptive study was done on patients with clinical signs or with an epidemiological history of CCHF, who were referred to hospitals, health centers, and private clinics during 2011. Then, based on guideline of the National Technical Committee of the Ministry of Health, patients were classified into three groups of suspected, probable and confirmed. The data were analyzed by frequency table, chi-square test, and Fisher's exact test. p<0.05 considered as significant. Twelve out of 38 patients, after diagnosis were placed in the suspected to CCHF group, went under follow-up and treatment. Among them, 5 cases [41.67%] were confirmed, 2 cases [16.67%] were probable, and 5 cases [41.67%] were suspected [only had some symptoms]. The majority of patients were male [91.76%] with the age range of 15-30 [83.34%], and resident in urban areas [75%]. 58.34% of the whole patients were farmers, students, or butchers. 83.34% of patients reported a history of contact with animals, and the mortality rate of confirmed cases was 20%. According to the results of this study, training of people at risk, and doing safety measures, such as keeping fresh meat in the refrigerator for 24 hours and using gloves while household cleaning fresh meat are necessary
Subject(s)
Humans , Male , Female , Hemorrhagic Fever Virus, Crimean-Congo , MeatABSTRACT
Cutaneous leishmaniasis is a major health problem in many parts of Iran and its main foci are in various parts of the country. This study was carried out with the intention of examining the species composition of the possible disease reservoirs in the cutaneous leishmaniasis focus in the selected villages of central county of Qom province. Study was done as a descriptive, cross-sectional study on rodents [possible leishmaniasis reservoirs] in the selected rural areas of Qomrood and Ghanavat located in central parts of Qom province in 2010. In this research, a total of 46 small rodents were hunted by live traps from 5 selected villages. A Smear prepared from auricle or suspicious lesions on skin, and after Giemsa staining, the smears were examined for the presence of leishman's bodies. After extracting DNA from positive smears, PCR technique was exploited to determine the parasite species. A total 46 small mammals were hunted and identified by the authentic keys. They included 31 rodents [67.4%] were Meriones libycus, 8 [17.4%] Allactaga elater, 4 [8.7%] Mus musculus, 2 [4.3%] Nesokia indica and one [2.7%] Hemiechinus auritus. The results of PCR demonstrated that 3.7% of M. libycus rodents were infected by Leishmania major. The results of this study showed that epidemic cutaneous leishmaniasis in the central county of Qom province was zoonotic and its reservoir was species of rodents. Therefore, determining disease type and its reservoir can help health care authorities to adopt appropriate strategies for prevention and control of the disease in this area
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Animals , Polymerase Chain Reaction , Disease Reservoirs , Cross-Sectional Studies , RodentiaABSTRACT
Malaria is still one of the most serious health problems all across the world. This study aimed at investigating the epidemiological features of malaria in Qom province form 2001 to 2011. It was a descriptive-analytic cross-sectional study conducted on the malaria cases in Qom province from 2001 to 2011. The data analyzed by SPSS software and t-test and chisquare test. During those 10 years, 553 cases of malaria were reported. Most of those cases were Iranian men of 15 years old and over. In most of the cases, Plasmodium vivax was the main cause of the disease. Considering the huge number of pilgrims entering Qom city and also the existence of Mosquito vectors, programs to combat malaria should continue.