Seroepidemiology of human hydatidosis in Golestan province, Iran

Hydatidosis is one of the most prevalent zoonotic diseases worldwide. So far no survey was conducted to determine the rate of human hydatidosis in Golestan Province, so using IFA and ELISA tests the prevalence of this disease was detected in patients referred to health centers in this province. Totally 1024 serum samples were collected from patients referred to different health centers in 4 cities of Gloestan Province including Gorgan, Gonbad kawoos, Aliabad Katool and Kordkoy. All the sera were examined using IFA and ELISA tests. Twenty four cases [2.34%] were positive for hydatidosis in Golestan Province using IFA, whereas 22 cases [2.15%] showed positivity using ELISA. Gorgan, Gonbadkaoos, Aliabad Katool and Kordkoy demonstrated the rate of positivity as 1.41%, 2.40%, 5.36% and 2.30%, respectively, but no significant difference was seen. As to positivity, there was no significant difference between age groups, sex, different cities and rural or urban life, but a significant different was seen according to job and literacy [P< 0.001]. According to Job and literacy, housewives and illiterates had the highest rate of infection as 3.67% and 3.72%, respectively. As regards residency, urban life showed no significant difference with rural life [2.47% vs. 2.45%]. Age group of 40-49 years old had the highest rate of positivity [3.95%]. Females were more infected than males [3.16% vs. 1.93%]. The rate of prevalence in this province shows somehow a resemblance with the other cities in Iran. Considering the lifestyle in this province a complementary study is suggested in all related cities

Nuclear ribosomal DNA ITS-2 sequence characterization of Fasciola Hepatica and Galba truncatula

Human fascioliasis is an important health problem in the province of Gilan, at the Caspian Sea, Iran. There is the overlapping of both fasciolid species, Fasciola hepatica and F. gigantica. Recent studies on both domestic animal and lymnaeid infection furnished evidence suggesting that F. gigantica and Radix gedrosiana may be the main fasciolid and lymnaeid involved in the disease in that province, controversy still being there concerning the presence and importance of F. hepatica and other lymnaeid species. The present paper includes the results of studies on Galba truncatula and the first finding of natural infection by F. hepatica in Gilan proved by molecular studies. Snail collections were carried out in summer, when their populations present the highest densities. Surveys on lymnaeids furnished the finding of a lymnaeid snail infected by trematode rediae and cercariae in the mountains of Talesh, in the Asalem district, western Gilan. Nuclear ribosomal DNA ITS-2 sequences proved that they were F. hepatica and G. truncatula. The liver fluke ITS-2 sequence was identical to that of F. hepatica from Spain and the Northern Bolivian Altiplano and that of G. truncatula to the haplotype H-2 known in Portugal, Spain, France and The Netherlands. This genetic characterization suggests that both may be also involved in human fascioliasis infection in Gilan

Evaluation of Dot-ELISA method using excretory-secretary antigens of fasciola hepatica in laboratory diagnosis of human fasciolosis

Fasciolosis diagnosis, due to low sensitivity of coprological diagnostic method has been challenging for a long period. In this study, Dot-ELISA, one of the simplest and the most sensitive tests in this regard, was evaluated using excretory-secretory antigens of Fasciola hepatica to diagnose human fasciolosis Three groups consisting of patients infected with fasciolosis [n= 95], patients with other parasitic diseases [n= 37] and healthy individuals [n= 40], were implicated in the test. All collected sera were tested by Dot-ELISA using excretory-secretory antigens. Optimal criteria were detected as 1.5 micro g of antigen per dot, serum dilution of 1:320, and anti human IgG conjugate dilution of 1:500. The sensitivity, specificity, positive and negative predictive values were 96.8%, 96.1%, 96.8% and 96.1%, respectively. In conclusion, Dot-ELISA using excretory-secretory antigens could be regarded as a cheap, rapid, antigen and serum conservative diagnostic method in diagnosing fasciolosis

Comparative evaluation of fast enzyme linked immunosorbent assay [fast-ELISA] and standard-ELISA for the diagnosis of human hydatidosis

Fast enzyme linked immunosorbent assay [Fast-ELISA] was compared with the standard ELISA for the diagnosis of human hydatidosis. Seventy serum samples including 30 from hydatidosis patients [surgically confirmed], healthy control individuals not infected with any parasitic diseases [n=/20] and from others with different parasitic infections including, toxocariosis [n=5], fasciolosis [n=5], trichostrongylosis [n=5], and strongyloidosis [n=5] were analysed for anti-hydatid IgG antibodies using sheep hydatid cyst fluid antigen. The sensitivity, specificity, positive and negative predictive values, as well as validity of the test were found as 96.7%, 95.2%, 93.7%, 97.5% and 96% for conventional ELISA, while these paramters for fast-ELISA were respectively as follows: 100%, 97.5%, 96.7%, 100% and 98.8%. Regarding standard-ELISA 3microg/ml of antigen, serum dilution of 1:500, conjugate dilution of 1:3000 and 30 min incubation were found optimal, while for fast-ELISA 3microg/ml of antigen, serum dilution of 1:125, conjugate dilution of 1:1000 and 5 min incubation were utilized. The present study indicates that fast ELISA can easily be performed in place of the standard ELISA for the serodiagnosis of human hydatidosis with the advantage of minimising consumed time and manpower hours. Moreover, this test can be utilized in screening tests to diagnos human hydatidosis

Evaluation and comparison of antigen B-Elisa and antigen B-iimunoblotting in immunodiagnosis of cystic hydatid disease

Evaluation and comparison of the diagnostic value of ELISA using partial purified antigen B [AgB-ELISA] and antigen B subunits immunoblotting in immunodiagnosis of cystic hydatid disease [CHD]. Antigen B was obtained and partially purified from sheep hydatid cyst fluid. Serum samples were collected from surgically confirmed CHD patients, other parasitic disease, patients with malignancies and normal individuals. Sera were analyzed by ELISA using antigen B and immunoblotting based on antigen B subunits. School of Public Health serum blood bank, Tehran University of Medical Sciences, volunteers and selected CHD patients from different local hospitals. Subject: Serum samples were obtained from 64 surgically confirmed CHD patients, 55 from individuals infected with toxocariasis or fascioliasis, 50 from patients with malignancies and 73 from normal individuals. The sensitivity, specificity and cross-reaction of comparative tests evaluated. The sensitivity of AgB-ELISA was 89%, while that of 8/12-, 16-kDa immunoblot was 80%. Specificity of AgB-ELISA was 98% and that of 8/12-, 16-kDa immunoblot was 100%. The sensitivity and specificity of ELISA using crude hydatid fluid antigen [CHFAg-ELISA] were 94% and 83%, respectively. AgB-ELISA as well as 8/12-, 16-kDa immunoblot can be convenient in specific and confirmatory diagnosis of CHD

Observation of hydatid cyst infection in kordestan province [West of Iran] using epidemiological and seroepidemiological criteria

Echinococcosis is the major helminthic parasitic infection in Iran. The health hazard and economic loss in man and livestock is significant. In this study 3 major topics as the prevalence of hydatid cyst in human population, in livestock and echinococcosis in stray dogs, were studied. Total of 1114 serum samples in different age groups in Sanandaj and Divandareh area of Kurdestan province in west of Iran were examined by indirect immunoflurecent test [IFA]. In Sanandaj area 3.3% and in Divandareh 9.5% of serum samples were positive for hydatidosis. In livestock using abattoir inspection the rate of infection was 51.9% and 28.02% for sheep and cattle, respectively. Nine stray dogs [44%] autopsied in Sanandaj were positive for Echinococcosis

Relationship between serum IgE and intestinal parasites

Intestinal parasitosis has been a major public health problem in Iran. It is necessary to evaluate an up-date data in this regard to be used by local authorities. Serum IgE determinations and coproparasitological analyses were conducted on 1200 individuals in city of Ghaemshahr, Mazandaran province, northern Iran. A total of 1200 subjects were taken stool samples for three days consecutively. Two hundred and ninety seven cases [24.7%0] were positive for parasitic diseases. The age group of 8-15 years old encompassed the highest rate of infection which showed a significant difference with the other groups [P< 0.01]. No significant difference was detected between males and females as to the rate of infection based on the Chi-squared test [14.2% vs. 10.6%], but a significant difference was seen between infection rate and cases education [P<0.01]. An about 5-fold elevation in serum IgE level was demonstrated. Intervention programs including health education and environmental sanitation are recommended

Evidence suggesting that fasciola gigantica might be the most prevalent causal agent of fascioliasis in northern Iran

Following the occurrence of two large outbreaks in Gilan province, northern Iran, the public health importance of human fascioliasis has increased significantly. The mixed infections of Fasciola gigantica and F. hepatica within a given domestic animal individual suggest a very complicate picture of possible circulation ways of the parasite and the possibility for humans to be infected with both species. Elucidating these circulation ways is very critical for underst and ing the epidemiology and transmission of the disease and being ascertain how animals and humans enter the different liver fluke circulations in this endemic zone. The main objective of the present study was to investigate the distribution and natural infections of local lymnaeids, environmental characteristics related to the disease transmission and determining the most prevalent fasciolids and definitive hosts in human endemic areas of Gilan province. B and ar-Anzali and Rasht are the most important endemic areas with most of the cases of human disease during the epidemics and inter-epidemic periods. Sheep raising is not normal in these regions, while cattle is the most common definitive host. According to the data obtained from slaughterhouse observations in B and ar-Anzali and Rasht, the main fasciolid in local cattle is F. gigantica. Of 928 adult liver flukes collected from 13 infected livers of cattle, in Rasht and B and ar-Anzali slaughterhouses, 91.1% were diagnosed as F. gigantica and 8.9% as F. hepatica. L. gedrosiana and L. palustris were the most prevalent lymnaeid snails in this endemic zone. It appears that L. truncatula is not prevalent in B and ar-Anzali and Rasht and surroundings of these endemic cities. Of 4830 different snails studied, only seven L. gedrosiana were found to be infected with larval stages [rediae and cercariae] of Fasciola sp. Experimental infections of 15 common laboratory mice by metacercariae, obtained from those naturally infected snails, were carried out and all trematodes recovered at necropsy, 8 weeks post-exposure, appeared to be F. gigantica based on morphology. The high temperature, moisture and rainfall during the year, especially in B and ar-Anzali, support the establishment and transmission of the disease in the zone. Although the species involved in human infections in endemic areas of Gilan has been usually referred to as F. hepatica, the results of this study as well as some interesting epidemiological evidences related to the disease, support that Fasciola gigantica might be the main causal agent of fascioliasis in this important endemic zone

Enterobius vermicularis: a Controversial Cause of Appendicitis

Enterobiasis is undoubtedly one of the most common human helminths infections through the world, with an estimate of 1000 million cases worldwide. Although adult worms and their eggs are frequently found in inflamed appendices, but the role of the parasite in producing appendicitis in humans still remains controversial. Although acute appendicitis may occur at any age, but it is relatively rare at the extremes of age. A histopathological study of infested appendices with Enterobius vermicularis was performed in Khuzestan province, south western Iran, during 2001 to 2003. All 40 samples had surgically been removed during the emergency operations and histopathological process with [H and E] staining has been performed for each. One of the main objects of this work was to collect more data about the possible role of this highly prevalent human round worm as a causative agent of appendicitis in humans, leading to different types of appendicitis in this part of the country. In this occasion over the slide examinations of the tissue sections, fewer cases than expected, with worm infested appendices were seen exclusively affected with this parasite

Clinical trial of triclabendazole on human fascioliasis: long term follow-up

Following an outbreak of human fascioliasis in Gilan province of Iran in 1989, the benzimidazole derivative triclabendazole [TCBZ] was suggested as the drug of choice after finding out that routine drugs were not effective. Two studies were performed: a clinical trial [before/after type] in 1989 and a historical cohort [1989 - 1995] to examine the efficacy of the drug. TCBZ was administered to 94 patients in four groups [A, B, C and D] according to the drug's instructions [time, size and frequency of dose]. The patients were followed up clinically and paraclinically for 60 days. The highest cure rate, i.e., omission of eggs and improvement of clinical symptoms [86.6%] was observed in Group A [5 mg/kg-NPO, 3 days]. Minor epigastric pain and vomiting and some urticaria was reported a few days after administration of the drug. Just a few developed cholangitis and one toxic hepatitis who were all treated satisfactorily. The second study was a 6-year follow-up survey of 50 of the 94 patients. Five cases had epigastric pain, and eggs were detected in the stool exams of two of them. Thus, by demonstrating up to 94% efficacy in the treatment of human fascioliasis in Iran [p<0.002], TCBZ is recommended as the drug of choice

Study on the latent iron deficiency in patients with trichuriasis

Trichuriasis is an intestinal parasitic disease which is caused by Trichuris trichiura, a soil transmitted helminth. In order to evaluate the iron status of trichuriasis in patients a total of 120 [49 males and 71 females] cases with Trichuris trichiura as well as 54 healthy individuals were evaluated. Blood samples were analyzed for serum iron, transferrin saturation%, haemoglobin and other haematological indices. Anaemia based on haemoglobin level less than 13 mg/dI in males and less than 12 mg/dI in females were found in 10 [7 males and 3 females] patients. Of remaining 110 non anaemic patients 11% [14.3% of males and 8.8% in females] would be classified as iron deficient by serum iron and 6% by transferrin saturation%. These findings suggest that serum iron and% transferrin saturation are valid and sensitive tests for detecting iron deficiency in these patients; and T.trichiura infection is associated with high incidence of iron deficiency

Comparison of excretory secretory antigens of ascaris lumbricoides and toxocara cati 2nd stage larvae with biochemical methods

Purification of parasitic antigens is a major activity in immunoparasitology because of its application in immunodiagnosis, vaccination analysis of immunopathology, preparation of monocolomal antibody and finding out the cross reactive antigens versus specific antigens of a parasite. In this survey F2 ultrafiltration excretory secretory antigens of Ascaris lumbricoides and Toxocara cati were separated by gel chromatography on sephacryl S-200 into several antigenic and non antigenic fractions. The E/S antigens of this nematode were analyzed by using soudium dodecyl sulfate polyacryl amide gel electrophoresis [SDS PAGE analysis of Ascaris lumbricoides and Toxocara cati revealed a minimum of 12 KD to 130 KD distinct with brilliant coomassie blue staining bands respectively

effect of variation in miracidial exposure dose on experimental infections of fasciola gigantica in lymnaea gedrosiana

The laboratory infection of Lymnaea gedrosiana with 2,5 and 10 miracidia of Fasciola gigantica resulted in infection rates of 20%, 40% and 69%, respectively, with a prepatent Period of 66-88 days. There was a significant difference in infection rate between the snails infected with 2 and those with 10 miracidia [P<0.05]. At 92 days post- infection there was 25% to 33.3% of live snails still harboring immature stages of F.gigantica larvae. The mortality rate of the infected and non-infected control groups showed no marked differences

Characterization of Northern and Southern isolates of trichinella in Iran

Two isolates of Trichinella were obtained from the jackal, Canis aureus: one from the north Caspian area, the other from the south-west Khuzestan area of Iran. The infectivity of the isolates was tested in laboratory animals, in a wild rodent [Tatera indica] and in wild pigs. The isolate from Khuzestan was of low infectivity to albino rats and it was provisionally identified as Trichinella nelsoni. The Caspian isolate was highly infective for albino rats and wild pigs and was identified as Trichinella spiralis

Field trials of a slow release copper molluscicide in Khuzestan, South-West of Iran

In the field trials of slow-release nollusicide, copper content McCkechnie Chemical Inc. 30 cuso4 5H2o or 7.5 cupellet/sinking material 7 days release life were tested against the common aquatic snails bulinus truncatus, Physa acuta and Lymnaea gedrosiana in stagnant water bodies in Khuzestan province, south-west of Iran. Snail densities before treatment and 7 days after mollucicide application were determined by 10 deep nets per man. The results of the present trials as shown on tables 1, 2, 3 and 4 indicate that the effect of different concentration of copper based slow-relased mollnscicide [7.55 cu] is different for different species of aquatic snails. The maximum concentration to achieve 100 ppm. Mortality rate was 20 ppm for Lymnaea gedrosiana, 100ppm for physaacuta and over 120ppm for Bulinus truncatus. The high susceptibility of lymnaea snails to the chemical is very promising for the control of livestock trematodes infection in this area

Histopathology of liver in cattle spontaneously infected with fasciola hepatica and fasciola gigantica in Iran

A total of 1500 infected liver with F. hepatica and F. gigantica from slaughtered cattle in different parts of Iran were studied. Grossly the livers were usually irregular in shape, with prominent bile ducts on the visceral surface as grayish-white, firm-branching streaks. The atrophy of the left lobe due to fibrosis and ischemia were noticed. On the cut surface the main bile ducts wall consisted of hard fibrotic tissue with pipe-stem appearance and calcium deposition on the inner layer of the ducts in F.hepatica infection. In the livers infected with F.gigantica, grossly seemed to be of a more normal consistency with much less calcium deposition in the ducts. In histopathological changes there was evidence of different stages of parenchymal damages, varying from fresh burrow with young flukes inside to old and healed nodules due to migration of the young flukes. A large number of eosinophils, lymphocytes plasma cells, disintegration of hepatocytes and coagulation necrosis were seen. The thickening of the bile ducts wall and the intense fibrous tissue proliferation in the portal areas compressed the adjacent liver cells, causing pressure atrophy of the liver. In very chronic cases glandular hyperplasia of ducts wall which lined by columnar epithelial cells with vacuolated cytoplasm were marked. In some ducts compact aggregation of fibroblasts which gave a smooth appearance to the bile ducts wall were noticed. The monolobular fibrosis in both F.hepatica and F.gigantica infections were a typical feature