What do we need to eradicate rubella in the Islamic Republic of Iran?

To evaluate the need for congenital rubella syndrome prevention in our national health programme we aimed to determine the rate of anti-rubella positivity in umbilical cord blood samples 8 years after measles–rubella mass vaccination in the Islamic Republic of Iran. In a cross-sectional study we tested umbilical cord blood samples for anti-rubella IgG and IgM by ELISA in 154 deliveries at a university hospital in Tehran. Overall 72.7% of umbilical cord blood samples were positive for anti-rubella IgG and 27.3% were negative. All of the samples were negative for anti-rubella IgM. In the samples with a history of mothers' rubella vaccination, only 87.5% were positive for anti-rubella IgG. The results suggest the need for another mass vaccination for rubella in women of child-bearing age and continuation of routine vaccination of infants, plus consideration of obligatory anti-rubella IgG testing before pregnancy in women who were not vaccinated and vaccination of women before marriage.

Immunoasssay chromatographic antigen test for rapid diagnosis of Group A beta hemolytic Streptococcus pharyngitis in children: a cross/ sectional study

Group A beta-hemolytic streptococcus [GABHS] is an important pharyngotonsillitis etiologic agent in children. The objective of this study was diagnosis of streptococcal pharyngitis based on rapid antigen detection test and conventional pharyngeal culture. The rapid GABHS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent. Streptococcal antigen was detected in pharyngeal specimens of 34.5% of cases by rapid strip test. We detected group A Streptococcus in 17.2% of pharyngeal culture. There was no agreement between two methods [PV < 0.1]. The negative pharyngeal culture results are probably due to antibiotic usage in 43.2% of patients. Positive rapid test results in pharyngeal swab was age dependent [P < 0.05]. There was good correlation between observing the [petechia in pharynx of patients] and positive rapid test in pharyngeal swab [P < 0.004]. Throat culture results were relatated to previous antibiotic usage [P < 0.03]. The rapid test in pharyngeal swab is helpful for rapid diagnosis and treatment of GABHS pharyngitis. Diagnosis of GABHS pharyngitis based on soley clinical findings is misleading in the majority of cases. Petechia observed in pharynx of the cases was highly predictive of streptococcal pharyngitis

Evaluation of an interferon-gamma release assay in young contacts of active tuberculosis cases

In a cross-sectional study in a hospital in Tehran in 2006-08 the QuantiFERON[Registered]-TB interferon-gamma release assay [QTB] was compared with the tuberculin skin test [TST] in 59 young people [aged<20 years] with close contact with immunocompetent cases of proven pulmonary tuberculosis. After 1 year follow-up 10 subjects had progressed to tuberculosis disease and received treatment; TST was positive in 30% and QTB in 100%. Of the 49 non-progressive subjects, TST was positive in 10.4% and QTB in 16.3%. The agreement between TST and QTB assay in non-progressive subjects was poor [Kappa=0.43]. False positive and false negative rates for TST were 40.0% and 9.3% respectively; positive and predictive values were 60.0% and 90.7%. We suggest adding the interferon assay to the skin test in the decision to perform chest X-ray or to start chemoprophylaxis at least in younger subjects [aged<20 years]

Viral infections detected by serology and PCR of perilymphatic fluid in children with idiopathic sensorineural hearing loss

The etiology of sensorineural hearing loss [SNHL] in children may be viral. This cross-sectional study aimed to determine the role of viral infectious agents in children with idiopathic SNHL Of 119 children with SNHL aged 3-168 months undergoing cochlear implant surgery at a hospital in Tehran, no cause could be established in 18 cases [15.1%]. Cytomegalovirus [CMV] and herpes simplex virus [HSV] active infections [detected by DNA-PCR, confirmed by serology] were found in the perilymphatic fluid of 16.7% [3/18] cases of idiopathic SNHL Serology was performed on blood samples from 11 of these cases: specific antibodies against CMV, Toxoplasmo spp., HSV and rubella were determined in all cases; acute T. gondii infection was detected in 7 cases and rubella IgG was found in only 1 case. Neonatal screening for CMV, HSV and T. gondii may be helpful in the Islamic Republic of Iran

Study of antibiotics resistance in pediatric acute bacterial meningitis with E test method

Appropriate treatment of bacterial meningitis especially in children is a important problem due to multiple drug resistance. The determination MIC of conventional antibiotics for bacterial meningitis with quantitative E. test is exactly practical and essential. We studied MIC of conventional antibiotics in pediatric acute bacterial meningitis older than two months, center children hospital, 1382-1384. In this prospective and cross sectional process research we measured MIC of antibiotics in 30 positive bacterial culture in CSF or blood with quantitative E. test and compared with qualitative disk diffusion test. Antibiotic resistance of 10 Haemophilus influenzae type b patient was: ampicillin resistance in 90%, co- Amoxiclave R. in 10%, chlorampheicol R. in 40%, third gerenation cephlosporins R.[ceftriaxone and cefotaxime] in 0% and cotrimoxazole R. in 100% and antibiotic resistance of 20 streptococcous pneumoniae patient was: penicillin R. in 35%, chloramphenical R. in 10%, third generation cephalosporins R. in 5%,rifampin R. in 10% and cotrimoxazole R. in 60% .In comparison of two methods E-Test and Disk Diffusion we found insignificant difference. Antibiotic Resistance of our study is compatible with other studies. Therefore it seems that composition of ampicillin and chloramphenicol as empiric therapy for bacterial meningitis for many years ago,aren't appropriate today and third generation cephalosporins alone or with vancomycin is a suitable therapy