Bioclimatic analysis and spatial distribution of fascioliasis causative agents by assessment of Lymnaeidae snails in northwestern provinces of Iran.

BACKGROUND: Snails of the Lymnaeidae family are the intermediate hosts of Fasciola species, the causative agents of fascioliasis. The purpose of this study was to determine the prevalence of Fasciola species in lymnaeid snails and to investigate the association of geoclimatic factors and Fasciola species distribution in northwestern provinces of Iran using geographical information system (GIS) data. METHODS: A total of 2000 lymnaeid snails were collected from 33 permanent and seasonal habitats in northwestern Iran during the period from June to November 2021. After identification by standard morphological keys, they were subjected to shedding and crushing methods. Different stages of Fasciola obtained from these snails were subjected to the ITS1 polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for species identification. The associations of weather temperature, rainfall, humidity, evaporation, air pressure, wind speed, elevation, and land cover with the distribution of Fasciola species were investigated. Geographical and statistical analysis was performed using ArcMap and SPSS software, respectively, to determine factors related to Fasciola species distribution. RESULTS: Of the 2000 snails collected, 19 were infected with Fasciola hepatica (0.09%), six with F. gigantica (0.03%), and 13 with other trematodes. Among geoclimatic and environmental factors, mean humidity, maximum humidity, and wind speed were significantly higher in areas where F. hepatica was more common than F. gigantica. The altitude of F. hepatica-prevalent areas was generally lower than F. gigantica areas. No significant relationship was observed between other investigated geoclimatic factors and the distribution of infected snails. CONCLUSIONS: The present study showed the relationship of humidity and wind speed with the distribution of snails infected with F. hepatica or F. gigantica in the northwestern regions of Iran. In contrast to F. gigantica, F. hepatica was more prevalent in low-altitude areas. Further research is recommended to elucidate the relationship between geoclimatic factors and the presence of intermediate hosts of the two Fasciola species.

Geographical and climatic risk factors of cutaneous leishmaniasis in the hyper-endemic focus of Bam County in southeast Iran.

Introduction: Cutaneous leishmaniasis (CL) is a prevalent debilitating disease in many countries, particularly in Iran, the Middle East, North Africa, and South America. Bam County is the most important highly endemic focus of anthropometric CL in Iran and has been under consideration by WHO. This study investigated the environmental and geographic factors affecting the occurrence and distribution of CL in this focus. Methods: Demographic data and the home addresses of CL patients diagnosed from 2015 to 2020 were retrieved from the Leishmaniasis Center of Bam in southeast Iran. The effects of mean annual rainfall (MAR), mean annual humidity (MAH), mean annual temperature (MAT), maximum annual temperature (MaxMAT), minimum annual temperature (MinMAT), mean annual humidity (MAH), mean annual evaporation (MAE), mean annual frosty days (MAFD), mean annual snowy hours (MASH), elevation, and land cover on the distribution of CL were analyzed using geographical information systems (GIS) and univariate and multivariate regression models. Results: Of 847 patients studied, 50.9% (n = 431) were female and 49.1% (n = 416) were male. The age classes 0-10 (n = 246) and 11-20 (n = 145) showed the highest frequency of patients, respectively. Leishmaniasis patients were reported from 66 villages/cities (11.8%) out of 561 residential areas in Bam County. Univariate analysis showed that urban settings (OR = 21.66), agriculture (OR = 5.73), orchards (OR = 5), salty land (OR = 1.05), and temperatures (OR = 2.37, 2.79 and 3.47) had positive effects on CL occurrence (p < 0.05), while altitude, precipitation, humidity, evaporation, and the number of frozen days had negative effects. Multivariate analysis identified urban settings (OR = 13.6), orchards (OR = 6.29), agriculture (OR = 5.82), and minimum temperature (OR = 2.38) as the most significant determinants of CL occurrence in this region. Conclusion: Environmental and ecological factors play an important role in the distribution of CL in Bam County. The high-risk zones for CL are cities/large villages, agricultural and orchard areas in lower altitudes and with warmer climates and lower rainfall and humidity. This model can guide researchers and health managers to properly conduct CL control programs and allocate budgets.

Geo-climatic risk factors for chronic rhinosinusitis in southwest Iran.

Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease associated with some environmental factors. In this study, we evaluated the effect of geo-climatic factors on CRS in a region of southwest Iran. The study mapped the residency addresses of 232 patients with CRS who lived in Kohgiluyeh and Boyer-Ahmad province and had undergone sinus surgery from 2014 to 2019. The effects of Mean Annual Humidity (MAH), Mean Annual Rainfall (MAR), Mean Annual Temperature (MAT), maximum MAT (maxMAT), minimum MAT (minMAT), Mean Annual Evaporation (MAE), wind, elevation, slope, and land cover were assessed on the occurrence of CRS using Geographical Information System (GIS). Statistical analysis was performed using univariate and multivariate binary logistic regression. Patients came from 55 points including villages, towns, and cities. In univariate analysis, climatic factors including MAT (OR = 0.537), minMAT (OR = 0.764), maxMAT (OR = 0.63), MAR (OR = 0.994), and MAH (OR = 0.626) were significantly related to CRS occurrence. Elevation (OR = 0.999), slope (OR = 0.9), and urban setting (OR = 24.667) were the significant determinants among geographical factors when analyzed independently. The multivariate analysis found maxMAT (OR = 0.5), MAR (OR = 0.994), elevation (OR = 0.998), and urban (OR = 16.8) as significant factors affecting CRS occurrence. The urban setting is the most critical factor affecting CRS disease. Cold and dry areas and low attitude are the other risk factors for CRS in Kohgiluyeh and Boyer-Ahmad province, southwest Iran.

Geospatial Analysis and Molecular Epidemiologic Study of Emerging Pulmonary Lophomoniasis in Iran: A National Registry-Based Study.

Introduction: Bronchopulmonary lophomoniasis (BPL) is a protozoan pulmonary disease that has been reported sporadically, but its incidence has been increasing. However, the epidemiology and risk factors of the disease have not been clearly identified. The current study aims to identify BPL cases molecularly and assess the demographic and some environmental factors for the first time on the prevalence of BPL as a national registry-based study in Iran. Methodology. The study tested 960 patients with lower respiratory tract symptoms whose bronchoalveolar lavage samples were submitted from seven provinces of Iran to the Iranian National Registry Center for Lophomoniasis. They were tested for BPL by a newly developed polymerase chain reaction test. The study assessed the association of Normalized difference vegetation index (NDVI), digital elevation model (DEM), and geographic latitude as environmental factors and sex and age as demographic factors on the prevalence of BPL. Geospatial information systems methods and chi-squared and Pearson's correlation tests were used for the assessment of geographical and environmental factor effects and statistical analysis, respectively. Results: Of the 960 patients, 218 (22.7%) tested positive for BPL; the highest and lowest prevalence rates were reported from the south and northeast of Iran, respectively. The study found a correlation between geographic latitude and age with BPL prevalence, but no association was found for gender, NDVI, or DEM. Most patients were over 40 years old, and the rate of disease was higher in southern latitudes. Conclusion: Age and geographical latitude were found to be risk factors for BPL. More exposure to dust and/or chronic pulmonary problems may explain the higher prevalence of the disease in older adults. Higher rates of BPL in lower latitudes may be due to warmer weather and longer days, which can confine individual activities indoors and result in more contact with domestic insects and infected dust.

Three cases of brain hydatidosis in North Khorasan, Iran.

Cystic hydatidosis is a serious public health problem in Iran. Although cysts can develop in almost all organs and the brain cysts are very rare. Here, we present 3 confirmed cases of brain hydatidosis and the patients who underwent successful surgery. Pathological examinations demonstrated the presence of cystic hydatidosis.

A family cluster of cutaneous Leishmania major infection unresponsive to intralesional meglumine antimonial: Case reports.

We describe a family cluster of L. major that became infected by traveling to an endemic focus of CL, which did not respond to intralesional meglumine antimonial treatment whilst two were hospitalized due to the progressive disease that responded to 4 weeks of oral ketoconazole. Parasite genotyping of the internal transcribed spacer 1 gene revealed the same infecting parasite strain in all family members and was the same strain in GenBank that caused mucosal L. major in a tourist who visited several North African countries. We hypothesise a reduced host immune response in the two hospitalized patients.

Geoclimatic risk factors for childhood asthma hospitalization in southwest of Iran.

BACKGROUND: Asthma is a chronic respiratory disease resulting from a complex interaction between genetic and environmental factors. Among environmental factors, climatic and geographical variations have an important role in increasing asthma hospitalization. The current study aimed to investigate the effect of geoclimatic factors on the occurrence of childhood asthma hospitalization in Fars province, southwest Iran. METHOD: We mapped the addresses of 211 hospitalized patients with childhood asthma (2016-2019) and investigated the effects of different temperature models, mean annual rainfall and humidity, number of frosty and rainy days, evaporation, slope, and land covers on the occurrence of childhood asthma hospitalization using a geographical information system. The Kriging and Spline methods have been used for generating interpolated models. Data were analyzed using logistic regression. RESULTS: In the multivariate model, urban setting was recognized as the most important childhood asthma hospitalization predictor (p < 0.001, odds ration [OR] = 35.044, confidence interval [CI] = 9.096-135.018). The slope was considered the determinant of childhood asthma hospitalization when analyzed independently and its increase was associated with decreased childhood asthma hospitalization (p = 0.01, OR = 0.914, CI = 0.849-0.984). CONCLUSION: In the current study, the urban setting was the most important risk factor associated with increased childhood asthma hospitalization.

Effects of an Iranian traditional fermented food consumption on blood glucose, blood pressure, and lipid profile in type 2 diabetes: a randomized controlled clinical trial.

BACKGROUND: Ash-Kardeh is one of the few fermented foods without a dairy base in Iran, which is traditionally prepared from cereals and plants in the presence of microorganisms (mainly lactic acid bacteria). PURPOSE: This study aimed to assess the effects of Ash-Kardeh consumption on blood glucose, lipid profile, and blood pressure in type 2 diabetic patients. METHODS: Forty-six patients with type 2 diabetes were studied in this randomized controlled clinical trial. Subjects were randomly allocated into intervention (n = 23) and control (n = 23) groups. Individuals of both groups received the usual treatment of diabetic patients, while those in the intervention group, in addition to the usual treatment, received 250 g of Ash-Kardeh daily for 6 weeks. Fasting blood glucose, blood pressure, and lipid profiles were measured before and after the intervention. RESULTS: Compared to the control group, Ash-Kardeh consumption led to a significant decrease in fasting blood glucose (P = 0.003), total cholesterol (P = 0.025), triglyceride (P = 0.003), systolic (P < 0.001), and diastolic blood pressure (P = 0.014) in the intervention group. Also, a significant increase in the concentrations of high-density lipoprotein cholesterol (P = 0.048) was observed after Ash-Kardeh consumption. CONCLUSION: It seems that Ash-Kardeh consumption could improve high blood glucose, lipid profile, and hypertension in type 2 diabetic patients but does not affect low-density lipoprotein cholesterol concentrations. This study was registered on 2019-09-15 in the Iranian Registry of Clinical Trials ( www.irct.ir ) with the code number IRCT20170202032367N3.

A comparative study of the proximity to nomadic travel routes and environmental factors on the occurrence of cutaneous leishmaniasis in Kohgiluyeh and Boyer-Ahmad province, southwestern Iran.

Cutaneous leishmaniasis (CL) is one of the most important health challenges in hyperendemic countries like Iran. Geospatial information systems-based studies have shown that factors, including land cover, altitude, slope temperature, rainfall and animal livestock, affect CL distribution in Kohgyloyeh and Boyerahmad province, southwestern Iran. However, the question of the influence of nomadic tribes, who travel with their goats and sheep, on CL is unanswered. We, therefore, investigated their role in CL epidemiology from 2008 to 2017 and compare them with geoclimatic factors. CL patient demographic data and their village/city addresses were retrieved from Provincial Health Center and mapped on the geographic information system (GIS) layer of the province's political divisions. Nomadic travel routes (NTRs) with a 2 km buffer were generated and their effect on CL was investigated together with the interpolated layers of rainfall, temperatures, humidity, slope, elevation, land covers, by binary regression. CL was significantly more common in villages/cities in the 2 km NTR zone (p value < .001; OR = 1.96; 95% CI = 1.4-2.745). Geoclimatic factors, including slope, elevation, rainfall, temperatures, humidity and most of the landcovers, were not significantly different inside and outside the NTR. Areas of irrigated farm were the only effective landcover on CL (p value = .049; OR = 2.717; 95% CI = 1.003-7.361) within the NTR versus non-NTR. Living within NTRs almost doubled the risk of acquiring CL. Several factors for this include passage through areas of high sand fly activity, increased contact between sandflies and humans, sheep and goats, and feeding on their blood and faeces, and low availability of health facilities that should be more investigated and considered in the future control programs.

PPARγ activation by pioglitazone enhances the anti-proliferative effects of doxorubicin on pro-monocytic THP-1 leukemia cells via inducing apoptosis and G2/M cell cycle arrest.

PURPOSE: Doxorubicin (DOX) is a common chemotherapeutic agent, with toxic side effects, and chemoresistance. Combination chemotherapy is a successful approach to overcome these limitations. Here, we investigated the effects of pioglitazone (PGZ), a PPARγ agonist, and/or DOX on the viability, cell cycle, apoptosis on THP-1 cells and normal human monocytes (NHMs). METHODS: MTT assay was used to evaluate the cytotoxicity of DOX and/or PGZ. Cell cycle progression and apoptosis induction were examined by PI or Annexin V-PI double staining, and analyzed by flow cytometry. Quantitative RT-PCR was used to evaluate the changes in the mRNA expression of cell cycle progression or apoptosis-associated genes including P27, P21, CDK2, P53, BCL2 and FasR. RESULTS: DOX, PGZ and DOX + PGZ exerted their cytotoxic effects in a dose- and time-dependent manner with low toxicity on NHMs. The cell growth inhibitory effects of DOX were in association with G2/M arrest, while PGZ executed S phase arrest. PGZ treatment enhanced G2/M among DOX-treated combinations with moderate elevation in the S phase. DOX, PGZ and combined treatments induced apoptosis (mostly late phase) in a dose-dependent manner. All treatments resulted in the significant overexpression of p21, p27, p53 and FasR genes and downregulation of CDK2. DOX + PGZ combined treatments exhibited the most significant changes in mRNA expression. CONCLUSION: We demonstrated that the antiproliferative, cell cycle regulation and apoptosis-inducing capacity of DOX was enhanced by PGZ in THP-1 leukemia cells in a dose-dependent manner. Therefore, the combination of DOX + PGZ could be used as a novel combination to target AML.

Sequence analysis, intra-genotyping variation, and phylogenetic study of nad1 gene in Echinococcus granulosus sensu lato genotypes from intermediate hosts in southwestern Iran.

Cystic echinococcosis (CE) is caused by the larval stage of Echinococcus granulosus sensu lato (s. l.). The disease is cosmopolitan, and Iran is a highly endemic area for CE. This parasite exhibits high genetic diversity, which can be related to its life cycle, transmission, and pathogenesis. This study was aimed at determining the phylogenetic relationship and intra-genotyping variation of E. granulosus s.l. in a vast area in the southwest of Iran (SWI). Eighty hydatid cyst isolates of intermediate hosts (i.e., cattle, sheep, goat, buffalo, camel, and human) were collected. The sequence analysis of the nad1 gene exhibited the three genotypes of G1 (n = 70, 87.5%), G3 (n = 8, 10%), and G6/G7 (n = 2, 2.5%). Also, 16, 2, and 1 unique haplotypes were identified for the G1, G3, and G6/G7 genotypes, respectively. According to the phylogenetic tree topology, the nad1 gene similarities were found for some G1 isolates in some vast areas, and the G1 genotype showed a heterogeneous population worldwide. The only SWI G6/G7 haplotype was at a distant position in E. canadensis clade, indicating the notable difference of this haplotype from other isolates from Iran and other countries. The presence of the G6/G7 genotype in the SWI may be due to the transmission of the genotype from other regions or the role of camel/wild boar or other possible hosts in the expansion of this genotype in SWI. The results of the present study can be used in CE control programs, molecular epidemiology, and phylogenetic studies in Iran and other countries for future goals.

The effect of geo-climatic determinants on the distribution of cutaneous leishmaniasis in a recently emerging focus in eastern Iran.

BACKGROUND: Cutaneous leishmaniasis (CL) has been reported in recent years in South Khorasan Province, a desert region of eastern Iran, where the main species is Leishmania tropica. Little is known of the influence of geography and climate on its distribution, and so this study was conducted to determine geo-climatic factors by using geographic information system. METHODS: The home addresses of patients with CL patients who were diagnosed and notified from 2009 to 2017 were retrieved from the provincial health center and registered on the village/town/city point layer. The effects of mean annual rainfall (MAR) and mean annual humidity (MAH), mean annual temperature (MAT), maximum annual temperature (MaxMAT), minimum annual temperature (MinMAT), mean annual number of high-velocity wind days (MAWD), mean annual frosty days (MAFD) and snowy days (MASD), elevation, soil type and land cover on CL distribution were examined. The geographical analysis was done using ArcMap software, and univariate and multivariate binary logistic regression were applied to determine the factors associated with CL. RESULTS: A total of 332 CL patients were identified: 197 (59.3%) male and 135 (40.7%) female. Their mean age was 29.3 ± 2.1 years, with age ranging from 10 months to 98 years. CL patients came from a total of 86 villages/towns/cities. By multivariate analysis, the independent factors associated with increased CL were urban setting (OR = 52.102), agricultural land cover (OR = 3.048), and MAWD (OR = 1.004). Elevation was a protective factor only in the univariate analysis (OR = 0.999). Soil type, MAH, MAT, MinMAT, MaxMAT, and MAFD did not influence CL distribution in eastern Iran. CONCLUSIONS: The major risk zones for CL in eastern Iran were urban and agricultural areas with a higher number of windy days at lower altitudes. Control strategies to reduce human vector contact should be focused in these settings.

Hospital discharge on the first compared with the second day after a planned cesarean delivery had equivalent maternal postpartum outcomes: a randomized single-blind controlled clinical trial.

OBJECTIVE: Determining the effect of discharge time after elective cesarean section on maternal outcomes. METHODS: This study is a randomized clinical trial that performed on 294 women who undergo elective cesarean section. The patients were randomized in two groups by simple randomization method: Group A (discharge 24 h after cesarean) and group B (discharge for 48 h after cesarean). In both groups, during the first 24 h, they received intravenous antibiotic (cefazolin as routine order) and pethidine at the time of pain. The patients were discharged with the hematinic and mefenamic acid. The main outcome variables were satisfaction of the patient, surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage and pain of the patient on discharge day, one and six weeks after cesarean. RESULTS: Satisfaction scores and pain score at discharge day, one and six weeks after discharge were not significant different in the study groups (P > 0.05). Another key finding of this paper was no significant difference in the incidence of surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage at one and six weeks after discharge in the study groups(P > 0.05). CONCLUSION: The time of discharge can be reduced to 24 h after surgery if the mother to be at good general condition, the vital signs are stable, the patient has no underlying problem and disease, and it is financed for the patient and the health system.

Relationship between Bacillus Calmette Guerin Vaccination Policy and Coronavirus Disease-2019 (COVID-19) Incidence.

Bacillus Calmette Guerin (BCG) was designed for protecting children against tuberculosis. Also, it can protect against other infectious diseases through the induction of trained immunity. Due to its heterologous protective effects, the BCG vaccine has been proposed as atreatment option for coronavirus disease-2019 (COVID-19). Epidemiological studies have found that countries without BCG vaccination policy have experienced higher mortality rates related toCOVID-19 infection than those with BCG vaccination policy. However, there are some confounding factors such as age, population intensity, immigration, the pandemic phase, and data accuracy that may affect these results. Therefore, this hypothesis should be evaluated by clinical trial studies. Large-scale clinical trials are in progress to investigate ifthe BCG vaccine could be used as a useful tool for protection against COVID-19 infection.

Phylogenetic analysis of Trichostrongylus vitrinus isolates from southwest Iran.

BACKGROUND: Trichostrongylus is one of the most important zoonotic trichostrongylid nematodes, infecting mostly livestock. Data on its genetic characteristics are lacking in Iran. METHODS: We determined the phylogenetic relationships of Trichostrongylus species in three counties of Kohgiloyeh and Boyerahmad (K-B) province, southwest Iran. Small intestine and abomasum of 70 sheep and goats were investigated. RESULTS: A total of 35 isolates of Trichostrongylus worms were detected and all were genetically identified as Trichostrongylus vitrinus. Analysis of 321 bp of the internal transcribed spacer 2 (ITS2) of ribosomal DNA revealed 16 genotypes. All genotypes were single nucleotide polymorphisms, including some hypervariable points. All sequences were trimmed to 170 bp, compared with sequences on GenBank including short sequences from other endemic foci of Iran and other countries and all isolates were used to generate a maximum likelihood phylogenetic tree, which consisted of two clades A and B. Clade A included isolates from Iran, Russia, New Zealand, Australia and the UK; clade B only contained South African isolates. Most clade A isolates (north, southwest and west Iran, Russia, New Zealand, Australia and UK) were in a similar phylogenetic position. One subclade was detected in clade A (isolates from Southwest Iran, New Zealand and UK). CONCLUSIONS: We hypothesize that drug resistant T. vitrinus may account for its exclusive detection in our samples. The high similarity of genotypes from Iran, New Zealand and UK may be due to their close political relationships during the colonial era. More research is needed to understand better the phylogeny of T. vitrinus and its relationship with drug resistance and human transmission.

Environmental, climatic and host population risk factors of human cystic echinococcosis in southwest of Iran.

BACKGROUND: Cystic echinococcosis (CE), a worldwide zoonotic disease, is affected by various biological and environmental factors. We investigated dog/livestock populations, climatic and environmental factors influencing the distribution of human CE cases in Fars province, southwest Iran. METHODS: We mapped the addresses of 266 hospitalised CE patients (2004-2014) and studied the effects of different temperature models, mean annual rainfall and humidity, number of frosty days, slope, latitude, land covers, close proximity to nomads travel routes, livestock and dog densities on the occurrence of CE using geographical information systems approach. Data were analyzed by logistic regression. RESULTS: In the multivariate model predicting CE, living in an urban setting and densities of cattle and dogs were the most important CE predictors, sequentially. Dry (rained) farm, density of camel and sheep, close proximity to nomads travel routes, humidity, and slope also were considered as the determinants of CE distribution, when analyzed independently. Slope had a negative correlation with CE while temperature, frost days and latitude were not associated with CE. CONCLUSIONS: In our study, an urban setting was the most important risk factor and likely due to a combination of the high density of key life cycle hosts, dogs and livestock, a large human susceptible population and the high number of abattoirs. Farmland and humidity were highly suggestive risk factors and these conditions support the increased survival of Echinococcus granulosus eggs in the soil. These findings support the development of strategies for control of disease. More research is needed test optimal interventions.

The Geographical Distribution of Cutaneous Leishmaniasis Causative Agents in Iran and Its Neighboring Countries, A Review.

Leishmania tropica and Leishmania major are both the main cause of anthroponotic (ACL) and zoonotic cutaneous leishmaniasis (ZCL), respectively, in the Old World. Leishmania infantum and Leishmania donovani, which are important causes of visceral leishmaniasis, have also occasionally been reported in CL patients. The present study investigates the current distribution of causative species of CL in Iran and neighboring countries in the Middle East. There has been expansion of L. tropica into new urban and rural foci in Iran, with well-documented cases of visceralization, a substantial increase of CL in Syria, and the emergence of new foci and outbreaks in Turkey and Iraq, especially due to L. major. Civil war in Syria and Iraq, population movement, poverty, and climatic change play important roles in the changing CL distribution in this region. Control programs should adopt a multidisciplinary approach based on active surveillance and case finding, especially in vulnerable refugee populations, determination of hazard maps for CL hot points using GIS and other advanced technology, the free distribution of drugs, rodent control, and greater community engagement in poor and marginalized populations. Comprehensive molecular studies that could show the species and strains of Leishmania in different areas of each country can give a better view from the distribution of CL in this region.

Geo-climatic factors in a newly emerging focus of zoonotic visceral leishmaniasis in rural areas of north-eastern Iran.

Visceral leishmaniasis (VL) is the fatal form of leishmaniasis. A newly emerging focus of zoonotic VL (ZVL) including 13 villages has been reported from Maraveh Tappeh County, Golestan province, north-eastern Iran. We investigated the effect of climatic and environmental factors on the occurrence of disease in this focus by geographical information systems (GIS) approaches and logistic regression models. The incidence rate of ZVL in human and dog population was estimated 1.2% and 27.3%, respectively, in the studied areas. Rock soil type (OR = 11.7), rainfall (OR = 1.04) and elevation (OR = 0.99) were found as determinants of ZVL. Also, almost all infected villages were in close proximity of rivers. Cavities of rock soil around rivers are assumed as suitable areas for sandfly resting and growth by providing shadow and moisture. Rainfall also provides appropriate moisture in semi-arid regions for survival of sandflies. The negative effect of higher altitude can be explained by some sandfly life-limiting conditions like freezing weather. Accordingly, regions with lower altitude and higher rainfall, covered by rock and in close proximity of rivers, are the hazard zones for ZVL in the Maraveh Tappeh. Air humidity, temperature, land cover type and slope were not predictors of disease in the current study. Further investigations on human population movement, probable reservoirs and vectors of disease can provide valuable data for modelling the future distribution of ZVL in the Iranian province.

Population structures of Leishmania infantum and Leishmania tropica the causative agents of kala-azar in Southwest Iran.

Visceral leishmaniasis (VL) is endemic in Iran and is caused predominantly by Leishmania infantum, but L. tropica is emerging as an important cause. We studied the intra-species population structure of Leishmania spp. causing VL in southwest Iran by sequence analysis of the internal transcribed spacer (ITS) 1 of DNA samples from 29 bone marrow aspiration smears. L. infantum (n = 25) and L. tropica (n = 4) were identified, consisting of 10 and three ITS1 sequence types (STs), respectively. Compared to GenBank ITS1 STs, our L. infantum parasites displayed high heterogeneity but less heterogeneity compared than northwest Iranian isolates. VL affects mostly nomadic populations in southwest Iran, and their mobility may explain partly the L. infantum heterogeneity. The VL causing L. tropica was also genetically heterogeneous but genetically indistinguishable from L. tropica strains causing anthroponotic cutaneous leishmaniasis from southwest Iran.

Population Structure of Leishmania tropica Causing Anthroponotic Cutaneous Leishmaniasis in Southern Iran by PCR-RFLP of Kinetoplastid DNA.

Iran is one of the six countries with the most cutaneous leishmaniasis (CL) patients. Understanding better the genotypes of the parasite population in relation to geography and climate is critical to achieving better CL control. We aimed to characterise the population structure of Leishmania tropica, the cause of anthroponotic cutaneous leishmaniasis (ACL), from important foci in southeast (Bam and Kerman) and southwest (Shiraz) Iran. A total of 39 L. tropica isolates from ACL patients from southeast (Bam 14, Kerman 12) and southwest (Shiraz 13) Iran were analysed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) of the kinetoplast DNA (kDNA) using restriction enzymes MspI (HpaII) and ClaI. 37 genotypes were identified among south Iran L. tropica isolates. The unweighted pair group method with arithmetic mean (UPGMA) tree obtained from the banding patterns of ClaI digested kDNA RFLP distinguished southeast from and southwest L. tropica isolates with some subclustering but the MspI derived tree showed greater discrimination with greater subclustering and divergence of the two foci of southeast region but with some overlapping. Although a monophyletic structure has been defined for southeast L. tropica, isolates from two foci of southeast Iran were partly discriminated in the current study.