Review of trichomonas vaginalis in Iran, based on epidemiological situation

Trichomoniasis, which is caused by Trichomonas vaginalis, is the most common non-viral sexually transmitted infection [STI] in the world including Iran. There were roughly 250 million new cases all over the world in a year. T. vaginalis as an important disease has been associated with HIV [in terms of exposure to sexually transmitted infection, STI] which increases the number of high-risk members, and thus it is an important public health problem. Additionally, this pathogen has been associated with serious health consequences. For instance, it may cause a woman to deliver a low-birth-weight or premature infant, and increase chances of cervical can-cer. Because little information is available about the prevalence of T. vaginalis infec-tion in Iranian population, this review was carried out to determine the prevalence of T. vaginalis among Iranian population. For this systematic review, data about epi-demiology of T. vaginalis in different parts of Iran with different populations were systematically collected from 1992 to 2017 through the international databases such as PubMed, Scirus, ISI Web of Science, Scopus, EMBASE, Science Direct and Google Scholar and Islamic World Science Citation Center [ISC]. National database searching included Iran Medex, Iran Doc, Magiran and Scientific Information Data-base [SID]. A total of 39 clinical and laboratory investigations about the prevalence of Trichomoniasis from different regions of Iran were analyzed. The overall preva-lence rate of T. vaginalis infection in Iranian population was estimated to be mini-mally 0.4% and maximally 42%. The present review showed that T. vaginalis infec-tion rate is relatively high among the Iranian population. The control strategies, in-cluding personal hygienic education, simultaneous couple treatment, the sensitivity of diagnostic methods, appropriate preventive tool [condom] in sexual contacts could lead to the disruption of transmission

Therapeutic effects of Iranian herbal extracts against Trichomonas vaginalis

Trichomonas vaginalis is a flagellated parasite affecting about 276 million people annually worldwide. Tricomoniasis is associated with different complications in pregnant women and infants. S'-nitroimidazole derivatives [metronidazole, ornidazole, and tinidazole] are FDA approved drugs recommended for trichomoniasis treatment. Treatment with metronidazole S'-nitroimidazole derivatives is associated with many side effects, and drug resistance to metronidazole has been reported in some cases. Recently, many attempts have been made to evaluate the effects of plants on causative agents of vaginal infections. In our research, the national and international databases were searched and the effects of various herbal extracts on T. vaginalis in Iran were reviewed from 2006 to 2016. In articles investigated, some plants had favorable antitrichomonal effects and needed to be further investigated. All the plant extracts have only been evaluated in vitro. Surveys of different articles in this review show that the active ingredients present in different parts of plants, including aerial parts, leaves, flowers, stems, and root can be suitable sources for introducing and developing new antitrichomonal compounds

Ginger [Zingiber officinale] induces apoptosis in Trichomonas vaginalis in vitro

Background: Trichomoniasis is the most common sexually transmitted protozoan diseases in the worldwide. Metronidazole is the choice drug for trichomomasis treatment, however, metronidazole resistant Trichomonas vaginalis [T. vaginalis] has been reported. Natural products are the source of most new drugs, and Zingiber officinale [Ginger] is widely used ingredient in the traditional medicine

Objective: The aim of the present study was to determine the effect of different concentrations of the ginger ethanol extract on the growth of T.vaginalis trophozoites in vitro

Materials and Methods: In this experimental study, 970 women who were attend in Kashan health centers were examined for T. vaginalis. Of them, 23 samples were infected with T.vaginalis, Three T. vaginalis isolates were cultured in a TYI-S-33 medium. The effect of ginger ethanol extracts and its toxicity in different concentrations [25, 50, 100, 200, 400, 800 microg/ml] on mouse macrophages were measured in triplicate exam by MTT [3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide] assay. The effect of ginger on apoptosis induction was determined by Flow cytometry

Results: The IC50 of ginger and metronidazole were 93.8 and 0.0326 yg/ml, respectively. 12, 24 and 48 hr after adding different concentrations of extract on mouse macrophages, fatality rates in maximum dose [800 fig/ml] were 0.19, 0.26 and 0.31 respectively. Flow cytometry results showed the apoptosis rate following treatment with different concentrations of the extract after 48 hr were 17, 28.5, 42.1, 58.8, 76.3 and 100% respectively, while in the control group was 2.9%

Conclusion: Ginger ethanol extract induces programmed death itv T. vagincrfis. It is recommended that due to the known teratogenic effect of metronidazole, ginger can be considered as an alternative drug for metronidazole

Developing a climate-based risk map of fascioliasis outbreaks in Iran

The strong relationship between climate and fascioliasis outbreaks enables the development of climate-based models to estimate the potential risk of fascioliasis outbreaks. This work aims to develop a climate-based risk map of fascioliasis outbreaks in Iran using Ollerenshaw's fascioliasis risk index incorporating geographical information system [GIS]. Using this index, a risk map of fascioliasis outbreaks for the entire country was developed. We determined that the country can be divided into 4 fascioliasis outbreak risk categories. Class 1, in which the Mt value is less than 100, includes more than 0.91 of the country's area. The climate in this class is not conducive to fascioliasis outbreaks in any month. Dryness and low temperature in the wet season [December to April] are the key barriers against fascioliasis outbreaks in this class. The risk map developed based on climatic factors indicated that only 0.03 of the country's area, including Gilan province in the northern region of Iran, is highly suitable to fascioliasis outbreaks during September to January. The Mt value is greater than 500 in this class. Heavy rainfall in the summer and fall, especially in Rasht, Astara and Bandar Anzaly [>/=1000 mm/year], creates more suitable breeding places for snail intermediate hosts

Prevalence of ruminants fascioliasis and their economic effects in Kashan, center of Iran

Objective: To determine the prevalence and economic losses of Fasciola spp. isolates and costs incurred due to liver condemnation from ruminants in Kashan region, center of Iran from 2012 to 2013. Methods: In this cross-sectional study, a total number of 251 325 slaughtered sheep, goats and cattle (88 939 sheep, 151 924 goats and 10 462 cattle) were examined via necropsy for fasciolasis in industrial Kashan abattoirs located in center of Iran. The average weight was calculated as 1 000 g for sheep, 900 g for goat and 5 000 g for cattle in this study region. Based on market value, the average price of a kilo gram of normal liver at Kashan city during the study period was 8 USD.The amount of main nutrients and vitamins elimination in liver contaminated to fascioliasis was determined. Results: Overall 3.28% of the livers were found to be infected. For total number of sheep, goats and cattle slaughtered annually in region study, it was estimated that 7 505 livers were infected and total annual economic losses of fascioliasis of studied animals was 41 784 USD (based on market prices in study period). Of this, 23 360 USD, 30 240 USD and 15 400 USD were associated with the fascioliasis of sheep, goats and cattle, respectively. Conclusions: This study indicated that the Fasciola sp. clearly remains prevalent and causes considerable economic losses in study region in sheep, goats and cattle and presumably, other areas and hosts of Iran, providing baseline data for the future monitoring of this potentially important parasitic infection in the country.

Prevalence of Trichomonas vaginalis infection in Kashan city, Iran [2012-2013]

Trichomonas vaginalis infection is one of the most common sexually transmitted diseases in humans. T.vaginalis is a parasitic protozoan with a predilection for human urogenital tract and causative agent for vaginitis, cervicitis and urethritis in females. T.vaginalis infection is associated with risk of Human Immunodeficiency Virus infectivity and pregnancy complication. In this study, the prevalence of T.vaginalis in individuals who referred to public health units in Kashan city, Iran was investigated. This study was conducted on 970 women and 235 men who referred to 5 government health centers in Kashan, Iran during October 2012 to August 2013. Demographic information was collected as per the study protocol. Vaginal discharges and urine samples were obtained and examined by Trypticase-Yeast Extract Maltose [TYM] culture medium and wet-mount methods. The prevalence of T. vaginalis was determined using culture based method and wet-mount examinations. The overall prevalence of trichomonal infection was 2% [95% CI, 2 +/- 0.08]. The age of infected individual was 33.7 +/- 9.4 years. All of those infected, were married housewives and 58.3% of them had primary school education. No statistical correlation was observed between clinical manifestations and parasitological results [p=0.8]. This study showed a relatively low prevalence of T.vaginalis infection in the study population. Since the clinical signs of trichomoniasis are the same of other Sexually Transmitted Diseases [STDs], confirmatory laboratory tests are necessary. Due to adverse outcomes of disease, there is a great need for public education regarding implementation of personal hygienic measures and prevention of inappropriate sexual contacts

Investigation the relationship between chemotherapy and intestinal parasitic infections in cancer patients undergoing chemotherapy

Cancer or neoplasia is recognized as abnormal, uncontrolled growth of cells. New cases of cancer reported everyday. Development of medical science led to diagnostic and treatment methods for cancer. Many drugs are used in cancer chemotherapy and can treat a wide range of cancers. These drugs work in different ways and can lead to deficiency of immune cells and humoral responses. So it is expected that people treating with these drugs show higher rates of parasitic infections. This study was done to compare intestinal parasitic infections in cancer patients undergoing chemotherapy with healthy ones and with cancer patients that were not undergoing chemotherapy. In this case-control study three groups of people were selected. First group were 250 cancer patients undergoing chemotherapy for at least 1 month. Second group were 250 healthy people with immunocompetency. Third group were 100 cancer patients not that undergoing chemotherapy and radiotherapy. We take a stool specimen from each person. Specimens examined by direct [for diarrheal ones] and formalin-ether [for all]. In order to investigate the presence of Cryptosporidium parvum, we take a thin smear from each specimen and stained it by Zeil Nelson method. Frequency of intestinal parasitic infections in first, second and third group were 24.8%, 33.6% and 28%; respectively; but differences were not statistically significant [P=0.09%]. In another investigation of intestinal parasites in three groups, infection rate of E.hartmani in second group and G.lamblia in first group was significantly higher. Infection rates of other parasites were not significantly different. Overally in three groups, most frequent parasites were B.hominis 12.8%, E.coli 11.7% and G.lamblia 4.3%, Cryptosporidium infection was not seen. Despite our hypothesis, prevalence of intestinal parasitic infections in three groups were not significantly different. Drugs used in cancer chemotherapy may have suppressive effects on parasites or kill them. In another hand, cancer patients despite their depressed immunity may show parasitic infection less than expected because of less exposure to parasites due to special medical care