Association between PPD and quanti FERON gold TB test in TB infection and disease among HIV-individuals in southern Iran

Tuberculosis is one of the most common diseases among HIV-infected patients. A person with a positive tuberculin skin test [TST] acquiring HIV infection has a 3-13% annual risk of developing active tuberculosis. The diagnosis of TB in HIV infected patients may be difficult. QuantiFERON-TB Gold [QFT-G] test is a novel method as an aid for diagnosis of Mycobacterium tuberculosis infection. We evaluated the association between TST and QFT-G test in latent TB infection [LTBI] and TB in HIV-infected patients. One hundred and seventy six HIV-infected subjects from Shiraz Consultation and Behavioral Modification Center [SCBMC] entered our study. The individuals were screened for TST, using 5TU purified protein derivative [PPD]. Also, blood sample was provided for QFT, measuring INF-gamma response to M. tuberculosis antigen. Of 176 participants, 98.3% returned for evaluation of TST results. Among them, 63% and 37% were negative and positive for TST, respectively. All the participants returned for QFT-G sampling. Of them, 64.8% and 27.8% were respectively negative and positive for the test and 7.4% showed undetermined results. The agreement between PPD and QFT-G in their negative results was 39.9% and 8.1% in their positive results and the overall agreement was 50%. Disagreement of TST-/QFT[+] was noticed in 19.7% of the subjects and TST[+]/QFT- disagreement in 24.9%. CD4[+] count <100 mm[3] was seen in 5.9%, >/= 100 and < 200 mm[3] in 17.1% and CD4[+] T cell count >/= 200 mm[3] in 76.9% of subjects. As the agreement rate between QFT-G and TST in HIV-infected patients was fair, a strategy of simultaneous TST and QFT-G testing would maximize the potential for LTBI diagnosis in HIV-infected subjects

prevalence of Pediculus capitis among school children in Fars province, southern Iran

Pediculus capitis or head louse infestation affects millions of children worldwide, especially those in the 5-11 years age group. This study aimed to determine the prevalence of head pediculosis among school children in urban and rural areas of Fars Province, southern Iran. All school children of age 6-11 yr from both genders in all urban and rural areas of the province were screened for head louse infestation by examination of their hair and scalps. Parents of all infested children were also examined. The study was repeated in different seasons in the same areas. Moreover, infested children were treated with 5% permethrin shampoo and re-examined one week later for any relapse. The general prevalence of head louse infestation in primary school students was 0.49% in autumn, 0.37% in winter and 0.20% in spring. In the mentioned seasons, the prevalence of P. capitis was higher among females and in rural areas [P=0.001]. Although treatment with permethrin shampoo failed in females, it was successful in all infected males from both regions in autumn and spring and in males from urban areas in winter. Head louse infestation is uncommon among Fars Province school children in rural and urban areas and should not be considered a public health priority. However, due to the higher prevalence of pediculosis in low socioeconomic group and rural area in our region, it seems that health promotion, particularly early detection and effective management strategies should target this group in the province

Toxoplasmosis in HIV/AIDS patients in Shiraz, southern Iran

Toxoplasma gondii is an intracellular protozoan parasite, and causes zoonotic infection. Human latent toxoplasmosis occurs in about half the world's population though most cases are asymptomatic. Toxoplasma encephalitis [TE] has become one of the more frequent opportunistic infection in HIV infected patients. This retrospective and descriptive study was carried out at the Referral Behavioral Counseling and Modification Center in Shiraz, Iran. We were able to review the medical records of 208 HIV infected patients. They were examined and their records were screened via the standardized data collection sheet for demographic characteristics. Diagnoses of TE based on the presence of at least two of the following findings: a history of neurological symptoms, neurological signs, suggestive CT, clinical and radiological response to antitoxoplasmosis medication. The seroprevalence of toxoplasmosis among 208 HIV/AIDS patients was [18.2%] [38 patients] while 4 [10.4%] and 34 [89.6%] subjects showed Toxoplasma seropositivity with and without TE respectively. The majority of these patients were in the 25-34 age group, male, unemployed, single and residence in Shiraz, southern Iran. Toxoplasmosis is a silent disease, which poses many diagnostic and therapeutic challenges. Based on findings of this study, we support a screening program of Toxoplasma infection. Primary chemoprophylaxis should be routinely given to all HIV infected with Toxoplasma seropositive status. Also HIV infected individuals with Toxoplasma seronegative status may be advised about preventive behavioral practice