Seroprevalence of Brucellosis in Human Immunodeficiency Virus Infected Patients in Hamadan, Iran

OBJECTIVES: Brucellosis is a systemic disease with a wide spectrum of clinical manifestations. This study aimed to determine the seroprevalence of brucellosis in human immunodeficiency virus (HIV) infected patients in Hamadan Province in the west of Iran. METHODS: A total of 157 HIV-infected patients were screened through standard serological tests, including Wright’s test, Coombs’ Wright test, and 2-mercaptoethanol Brucella agglutination test (2ME test), blood cultures in Castaneda media, and CD4 counting. Data were analyzed using Stata version 11. RESULTS: Wright and Coombs’ Wright tests were carried out, and only 5 (3.2%) patients had positive serological results. However, all patients had negative 2ME results, and blood cultures were negative for Brucella spp. Moreover, patients with positive serology and a mean CD4 count of 355.8 ± 203.11 cells/μL had no clinical manifestations of brucellosis, and, and the other patients had a mean CD4 count of 335.55 ± 261.71 cells/μL. CONCLUSION: Results of this study showed that HIV infection is not a predisposing factor of acquiring brucellosis.

Assessment of health-related quality of life among patients with tuberculosis in Hamadan, western Iran

Tuberculosis is one of the oldest infections known to affect humans. The aim of the study was to assess the quality of life including physiological, general health perception and social role functioning among patients with tuberculosis in Hamadan, Western Iran. A cross sectional analytical study was conducted between December 2009 and March 2011, the quality of life scores of 64 tuberculosis cases were measured by SF-36 questionnaire before treatment, after the initial phase and at the end of treatment and were compared with those of 120 controls. The association of the quality of life with age, type of tuberculosis, sputum smear, duration of disease, and the stage of treatment were assessed among the patients. Before treatment, all scores of tuberculosis patients were lower than those of the controls [p<0.05]. The patients' score increased signififificantly after two months of treatment [p=0.01], but the difference was not significant between two and six months after treatment [p=0.07]. The lowest score in tuberculosis patients was related to physical functioning and energy [45 +/- 42, 44 +/- 24, respectively]. According to the results, tuberculosis patients still have a low quality of life in spite of receiving new care strategies. Therefore, enhancement in quality of life may improve adherence to anti-tuberculosis treatment, functioning and well-being of patients with tuberculosis.

Ocular involvement of brucellosis

A 29-year-old male diagnosed with brucellosis a week earlier was referred to the ophthalmology clinic with visual complaints. On examination, visual acuity was 20/25, he had conjunctival injection on slit lamp examination. There was also bilateral optic disk swelling plus retinal hyperemia [optic disc hyperemia and vascular tortuosity] and intraretinal hemorrhage on funduscopy. The patient was admitted and treated with cotrimoxazole, rifampin, doxycycline and prednisolone for 2 months. Ocular manifestations subsided gradually within 6 months after treatment. Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas

Epidemiologic, clinical and laboratory findings of patients with brucellosis in Hamadan, west of Iran

Brucellosis is one of the most common infectious diseases in some areas of Iran. Brucellosis has various clinical manifestations and should be considered in the differential diagnosis of many infectious and non-infectious diseases. The aims of this study were to determine the epidemiological, clinical and laboratory findings of the disease in patients with brucellosis in Hamadan, west of Iran. In this cross- sectional study, 230 brucellosis patients admitted in Farshchian Hospital in Hamadan from March 2005 to March 2010 were studied for epidemiological, clinical and laboratory characteristics of brucellosis. The patients who had manifestations compatible with brucellosis and standard tube agglutination test or Coombs test >/= 1/80 plus 2ME >/= 1/40 were enrolled. Data were analyzed using SPSS statistical package, version 15. About 43.5% of patients were female with mean age of 40.84 yr old. 27.8% of cases were living in urban and 72.2% in rural areas. The most contagious seasons were spring and summer. The most common transmission way was consuming of contaminated dairy products [60.3%]; however, 39.7% of patients had a history of animal contacts. The most common symptoms were fever [77.4%], arthralgia [70%], sweating [47%], malaise and fatigue [46.5%]. The most common clinical signs were fever and peripheral arthritis. Leukocytosis and elevated ESR [>20 mm/h] were reported in 20.8% and 59.5% of cases, respectively. Elevated CRP was detected in 52.9% of patients. Brucellosis should be considered in the differential diagnosis of patients with prolonged fever, spondylitis or peripheral arthritis in endemic areas.

Screening for tuberculosis among patients with chronic psychiatric disorders in Hamedan

Tubercle bacilli most often are transmitted from one person by the airborne route. The aim of the present study was to determine the frequency of latent tuberculosis infection and active pulmonary tuberculosis among patients with chronic psychiatric disorders in Hamedan. In a cross sectional study, 215 patients with chronic psychiatric disorders were investigated for tuberculin skin test. Those with an induration of >/= 10 mm were introduced for further evaluation, including a chest-x-ray and examination of the sputum for acid-fast bacilli for those with radiographic abnormalities. Of 215 patients, 62 [28.8%] had positive tuberculin skin test reaction. Age and duration of psychiatric disorders were significantly associated with test positivity. Of 62 tuberculin-positive patients, 25 [40.3%] had radiographic evidences of inactive pulmonary tuberculosis. None of them had positive sputum smear for tuberculosis. Chronic psychiatric patients are more susceptible to tuberculosis infection. Screening tests should be applied for these patients

Electiveness of hepatitis B vaccination in children of chronic hepatitis B mothers

Although all newborns in Iran have been vaccinated against hepatitis B since March 1993, routine screening of pregnant women has not been conducted in prenatal care programs, yet transmission of hepatitis B via the maternal-fetal route is still a viable likelihood, which must be entertained. The subjects were divided into 2 groups. The exposed group comprised 97 vaccinated children whose mothers were seropositive for hepatitis B surface antigen [HBsAg] and had not received hepatitis immunoglobulin at birth. The unexposed group consisted of 87 vaccinated children whose mothers were seronegative for hepatitis B surface antigen. We compared these 2 groups to determine the efficacy of vaccine alone in high-risk children. This study was conducted in Tehran, Iran, from June 2002 to December 2002. All children were born after 1993. Chronic infection [HBsAg positivity] was detected in 14.3% of children in the exposed group. There were no instances of chronic infection in the unexposed group [relative risk [RR]=13.48, 95% confidence intervals [CI] 1.8-100.02]. Previous infection of hepatitis B [HBcAb positivity] was found in 29 [29.9%] children in the exposed group, but only one [1.2%] in the unexposed group [RR=26.01, 95% CI: 3.61-186.95]. Immunity [HBsAb positivity] in the exposed group measured 48 [49.5%] and unexposed group measured 56 [64.4%] [R.R=0.76, 95% CI: 0.59-0.99]. Vaccination alone did not induce immunity against hepatitis B in high-risk children; it seems that routine screening of pregnant women is necessary for determining whether neonates need hepatitis B immunoglobulin after birth