Genotypic characterization of two novel avian orthoreoviruses isolated in Iran from broilers with viral arthritis and malabsorption syndrome.

Background: Avian reovirus (ARV) is a major poultry pathogen associated with arthritis, malabsorption, and enteric diseases in chickens. In recent years, emerging ARV strains have become a growing concern causing significant economic losses in broiler chickens around the world. This report focuses on the isolation of ARV from the clinical occurrence of ARV-associated diseases in commercial broiler chickens in Iran and the genotypic characterization of the selected isolates. Case description: In 2018, two distinct clinical diseases, suggestive of malabsorption syndrome (MAS) and viral arthritis, were noticed in commercial broiler chickens in the north of Iran. Laboratory investigations were carried out following necropsy, documentation of the gross lesions, and sampling of the affected tissues for histopathology and virology. Molecular diagnosis and characterization of ARV were performed targeting Sigma C (σC) gene sequences of the virus. Findings/treatment and outcome: Two variant ARV strains were isolated from tendon and gizzard of broilers with clinical viral arthritis and MAS, respectively. Phylogenetic analysis of the ARV σC gene sequences revealed that field isolates were clustered in genotypes 2 and 4 (which were distinct from previous Iranian field ARV strains) with relatively low sequence identity (59.2% and 49.1%) to the classical vaccine strains (S1133 and 1733) in genotype 1. Conclusion: This report, for the first time, represents new emerging ARV variants associated with clinical events in Iran, providing insights on the diversity of endemic ARV field isolates, and urges the need for national-wide surveillance of ARV.

Sex out of marriage and condom use among homeless youth in Iran.

OBJECTIVES: Sexual behaviors of homeless youth in Iran have not been well studied. This study aimed to measure the frequency and associated factors of sex out of marriage and condom use among homeless youth in Kerman, Iran. STUDY DESIGN: In this cross-sectional study, we recruited 202 homeless youth (age: 15-29 years who experienced 30 or more days of homelessness in the last 12 months) from 11 street locations between September to December 2017. METHODS: Of 202 participants, 169 (83.7%) reported sex in the last 12 months and were include in this analysis. We assessed the prevalence of sex out of marriage in the last 12 months, condom use in last sex, and then evaluated their covariates in multivariable logistic regression analysis. RESULTS: The prevalence of sex out of marriage was 19.6% (95% confidence intervals [CIs]: 13.8%, 26.3%) and the prevalence of condom use was 43.8% (95% CI: 36.2%, 51.6%). Sex out of marriage was significantly correlated with male gender (adjusted odds ratio [AOR]: 24.38; 95% CI: 3.1-192.1) and being unmarried (AOR: 5.94; 95% CI: 2.3-15.5). Condom use was significantly correlated with male gender (AOR: 2.16; 95% CI: 1.1-4.2) and higher educational status (AOR: 4.30; 95% CI: 2.1-8.8). CONCLUSION: Our findings indicate that one in five homeless youth had sex out of marriage, and less than half did no use condom. These should be addressed by adapting education and harm reduction programs targeting this specific population in Iran.

Gender difference in all-cause mortality of people living with HIV in Iran: findings from a 20-year cohort study.

OBJECTIVES: Gender differences in the efficacy of treatment and the mortality of HIV-infected patients have not yet been fully elucidated. For the first time, we used data from a 20-year cohort of people living with HIV (PLWH) in four provinces (Fars, Bushehr, Bandar Abbas, and Kohgiluyeh and Boyer-Ahmad) in the southern part of Iran to assess the gender difference in all-cause mortality in PLWH in Iran. METHODS: We analysed data for 1216 patients aged ≥ 15 years who were diagnosed with HIV/AIDS between 1997 and 2017. Three hundred and fourteen (25.8%) were women. RESULTS: The death rate from all causes among women was 13.7% vs. 43.8% among men (P < 0.001). All-cause mortality was significantly associated with gender [the adjusted hazard ratio (aHR) for men compared with women was 3.20], not being on antiretroviral therapy (ART) compared with being on ART at the last visit (aHR 5.42), older age (aHR 1.03), delayed HIV diagnosis compared with early diagnosis (aHR 1.72), history of incarceration (aHR 1.57), higher log CD4 count at diagnosis (aHR 0.54), and prophylaxis for Pneumocystis pneumonia (aHR 0.09). CONCLUSIONS: The results of this 20-year cohort study suggest that gender is an important predictor of survival among HIV-infected patients. Improving early HIV diagnosis and early ART initiation in men, as well as increased access to hepatitis C virus treatment are needed to increase the survival rate of HIV-infected patients in Iran.

Clinical display, diagnostics and genetic implication of novel Coronavirus (COVID-19) epidemic.

COVID-19 pandemic can cause irreparable damage to the involved society. This study aimed to provide a summary of the up-to-dated clinical display, diagnostics, molecular and genetic implications for COVID-19 infected patients. In this review, 73 research articles published before 25 March 2020 were analyzed to better understand the clinical characteristics of patients and to introduce the available serological, hematology and molecular diagnostic methods. Apart from articles extracted from PubMed and Google Scholar, WHO (https://www.who.int/), NHC (National Health Commission of the People's Republic of China (http://www.nhc.gov.cn/), NICE (National Institute for Health and Clinical Excellence, https://www.nice.org.uk/), CDC (Centers for Disease Control and Prevention, https://www.cdc.gov/), and National Administration of Traditional Chinese Medicine (http://www.satcm.gov.cn/) were also accessed to search for eligible studies. Papers published between January 1, 2020, and 25 March 2020 were searched in English and the terms "2019-nCoV, Covid-19, Clinical Characteristics OR manifestation, method of detection, COVID-19 Genome and molecular test" were used. As the pandemic continues to evolve, there have been reports about the possibility of asymptomatic transmission of this newly emerged pneumonia virus. We highlighted the role of HLA haplotype in virus infection as HLA typing will provide susceptibility information for personalized prevention, diagnosis, and treatment in future studies. All the data in this article will assist researchers and clinicians to develop their clinical views regarding infected patients and to emphasize the origin of SARS-CoV-2 for diagnostics.

A primary occurrence of inclusion body hepatitis in absence of predisposing agents in commercial broilers in Iran: a case report.

BACKGROUND: Fowl adenoviruses (FAdVs) associated with certain clinical diseases including inclusion body hepatitis (IBH) have become of considerable importance in the poultry industry. Currently, an increasing number of IBH outbreaks in different parts of Iranian poultry industries is a growing concern. Infectious bursal disease virus (IBDV) or chicken infectious anemia virus (CIAV) have historically been incriminated as predisposing factors for FAdVs to cause IBH. Furthermore, some have speculated whether IBDV vaccine strains impact on IBH clinical manifestation. The present report assesses the potential predisposing role of IBDV, CIAV, and infectious bursal disease) IBD( vaccine strains for FAdVs in the course of an IBH occurrence in the field. CASE DESCRIPTION: 90000 day-old broiler chickens with the same parent source were housed, at 4 day-interval, in two commercial farms in Shiraz, Iran. Increased mortality with lesions of hepatitis, suggestive of IBH, started in the primitive farm right after blind prescription of IBD vaccine at the age of 12-days-old. Consequently, IBD vaccination was postponed for the apparently healthy chickens of the other farm in which chickens were monitored for the occurrence of IBH afterwards. Laboratory examination was followed by histopathology and polymerase chain reaction (PCR) on liver, cloacal bursa, and thymus samples to determine the involvement of FAdV, IBDV, and CIAV in the occurrence of the disease. FINDINGS/TREATMENT AND OUTCOME: No evidence was found to support the predisposing role of neither IBD vaccination nor IBDV/CIAV infection in this IBH occurrence. The results also demonstrated a primary role of the FAdV-11 as a causal agent of the IBH occurrence. CONCLUSION: The findings suggest that certain FAdVs are pathogenic enough to primarily induce IBH in young broilers.

Higher incidence of HCV in females compared to males who inject drugs: A systematic review and meta-analysis.

Women who inject drugs have been shown to have higher incidence of HIV and risk behaviours than men, but there are conflicting reports about hepatitis C virus (HCV) incidence. We systematically reviewed the literature to examine the female-to-male (F:M) HCV incidence in female and male persons who inject drugs (PWID), and also to explore the heterogeneity (i.e. methodological diversity) in these differences. We searched PubMed and EMBASE for studies published between 1989 and March 2015 for research that reported incidence of HCV infection by sex or HCV incidence F:M rate ratio. A total of 28 studies, which enrolled 9325 PWID, were included. The overall pooled HCV incidence rate (per 100 person-years observation) was 20.36 (95% CI: 13.86, 29.90) and 15.20 (95% CI: 10.52, 21.97) in females and males, respectively. F:M ratio was 1.36:1 (95% CI: 1.13, 1.64) with substantial heterogeneity (I-squared=71.6%). The F:M ratio varied by geographic location from 4.0 (95% CI: 1.80, 8.89) in China to 1.17 (95% CI: 0.95, 1.43) in the U.S. In studies which recruited participants from community settings, the F:M ratio was 1.24 (95% CI: 1.03, 1.48), which was lower than that reported in the clinical settings (1.72, 95% CI: 0.86, 3.45). The number of studies included provided sufficient statistical power to detect sex differences in this analysis. Our findings raise questions and concerns regarding sex differences with respect to the risk of HCV. Both behavioural and biological studies are needed to investigate causes and potential mechanisms as well as sex-specific prevention approaches to HCV infection.

Acceptability of Global Positioning System technology to survey injecting drug users' movements and social interactions: a pilot study from San Francisco, USA.

BACKGROUND: Despite potential applications for improving health services using GPS technology, little is known about ethical concerns, acceptability, and logistical barriers for their use, particularly among marginalized groups. OBJECTIVES: We garnered the insights of people who inject drug (PWID) in San Francisco on these topics. METHODS: PWID were enrolled through street-outreach (n=20) and an ongoing study (n=4) for 4 focus group discussions. Participants also completed a self-administered questionnaire on demographic characteristics and their numbers and types of interactions with other PWID. RESULTS: Median age was 30.5 years, majorities were male (83.3%) and white (68.2%). Most interacted with other PWID for eating meals and purchasing drugs over the last week; fewer reported interactions such as sexual contact, drug treatment, or work. Participants identified several concerns about carrying GPS devices, including what authorities might do with the data, that other PWID and dealers may suspect them as informants, and adherence to carrying and use. Most felt concerns were surmountable with detailed informed consent on the purpose of the study and practical ways to carry, charge, and hide devices. CONCLUSIONS: PWID felt data collection on their movements and social interactions with other PWID using GPS can be acceptable with addressing specific concerns. The technology is now in hand to greatly expand the ability to monitor health conditions with respect to the environment and improve the location of prevention, care, and treatment facilities to serve hard to reach, mobile, and hidden populations.

Coronary Artery Disease Risk Factors in an Urban and Peri-urban Setting, Kerman, Southeastern Iran (KERCADR Study): Methodology and Preliminary Report.

BACKGROUND: This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study (first round) in an urban and peri-urban setting, Kerman, southeastern Iran 2009-11. METHOD: 5900 (3238 female) people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package. RESULTS: The participation rate was more than 95% in all subgroups. Cigarette smoking (18.4% vs. 1.2%), opium use (17.8% vs. 3.0%) and triglyceridemia (16.1% vs. 12.0%) were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety (29.1% vs. 16.7%), obesity (16.8% vs. 9.2%), low-physical activity (45.1% vs. 39.2%) and uncontrolled diabetes (60.2% vs. 31.0%). More than 68% of all subjects have presented with moderate to severe gingival index scores. CONCLUSION: The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort.

Malaria Status in Economic Cooperation Countries; Achievement and Gaps toward United Nations Millennium Development Goals.

BACKGROUND: Evaluating the malaria status of the Economic Cooperation Organization (ECO) member countries relation to goal 6 of 3rd Millennium Development Goals (MDGs) which includes have halted by 2015 and begun to reverse the incidence of malaria. METHODS: By 2009, we reviewed the MDGs reports, extracted the data from surveillance system, published, and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process. RESULTS: The malaria incidence is very heterogeneous among ECO countries, which differ less than 200 cases in total country in Kazakhstan, Kyrgyzstan, Turkey, Turkmenistan, Uzbekistan, and Azerbaijan to 82,564 cases (2,428/100,000) in Afghanistan and 59,284 cases (881/100,000) in Pakistan and about 18/100,000 in Iran in 2008. Malaria has been a major public health problem in Pakistan and Afghanistan and will continue to pose serious threat to millions of people due to poor environmental and socioeconomic conditions conducive to the spread of disease. The main malaria endemic areas of Iran are in southeastern part of the country; consist of less developed provinces that are bordered in the east by Afghanistan and Pakistan. There are little valid information about proportion of population in malaria-risk areas using effective malaria prevention and treatment measures indicators. CONCLUSION: All ECO countries could achieve MDGs malaria indicators by 2015 except Pakistan and Afghanistan, unless preparing urgent intervention programs to fulfill the goals.

HIV, HSV2 and Syphilis Prevalence in Female Sex Workers in Kerman, South-East Iran; Using Respondent-Driven Sampling.

BACKGROUND: We estimated the prevalence of HIV, sexually transmitted infections (STIs), and risky behaviors among female sex workers (FSW) in Kerman City, Iran. METHODS: Women, 18 years or older, who reported selling sex for at least 6 months during their lifetime and had at least one sexual contact with a client in the recent 12 months were sampled using Responding Driven Sampling (RDS). Participants were interviewed about their sexual behaviors and provided whole blood for HIV, syphilis, and Herpes simplex type 2 (HSV2) testing. Data were analyzed using RDSAT Version 6.0 software. RESULTS: Among samples of 177 FSW, we did not find any HIV positive cases. The weighted prevalence of syphilis and HSV2 were 7.2% and 18.0%, respectively. The reported STI syndromes for the proceeding year of the survey were 36%. Unprotected sexual contact was about 17-22% and link to injecting drug users through injection was about 18%. CONCLUSION: While this survey found no HIV, there were findings of risky sexual behaviors and STI, markers for potential infection for HIV. The prevalence of STI and sexual risk behaviors for HIV is considerably high in this subpopulation that alarming for an urgent public health preventive measures and national control-plan to be developed and implemented.

The prevalence of honorary and ghost authorships in Iranian bio-medical journals and its associated factors.

BACKGROUND: The purpose of this study was to detect the prevalence of ghost and honorary authors and its determinant factors in bio-medical journals of Iran. METHODS: The study was done in 2009-10 in Tehran, Kerman, and Iran Medical Universities, Iran. We contacted the first or corresponding authors of the papers had published papers in the recent two issues of Iranian Journal of Public Health, Journal of Kerman University of Medical Sciences, and Tehran University Medical Journal. They explored the role of each coauthor and others who had done mouthing for the paper. Then, according to ICMJE criteria, we counted how many of them are real, honorary or ghost author. For the analysis, we utilized two databases. One included articles as the records and the other included authors as the records. RESULTS: From 124 articles, with 536 authors, 301 (56.1%) were honorary authors. Each article had 4.35 authors on average, while 2.4 of them were honorary authors. The percentage of honorary author in basic science articles was about 6% more than the articles of clinical sciences. Moreover, 89% of articles had at least one honorary author. About 20% of all articles had more than three honorary authors. Besides, 25 (21.43%) authors confessed they had colleague(s) omitted from the authors list, while only one (0.81%) of them met the authorship criteria. The percentage of agreement between the corresponding and the remaining authors on the number of honorary of the authors was about 47.4% (Kappa= 0.27, P= 0.01). CONCLUSION: It seems that the present data might assist the authorities to make a decisive decision on amending the process of authorship in Iran.

Housewives' obesity determinant factors in iran; national survey - stepwise approach to surveillance.

BACKGROUND: Women suffer more from obesity than men in Iran do. In this study, we compared obesity risk and its contributors regarding the job categories as housewives (HWs) or employees to deeply explore the risk of obesity in housewives in Iran. METHODS: Based on WHO stepwise approach, in 2005, 33472 women aged 15 to 65 years old (excluding all men) were examined for the major risk factors for non-communicable diseases. Obesity was determined by Body Mass Index>30kgm(-2) in adults (>20 years) and by girl BMI percentiles according to WHO 2007 Growth Reference 5-19 years in adolescents. We modeled obesity by logistic regression and entered all the known/potential predictors, including job categories. RESULTS: The participation rate was more than 99%. The weighted prevalence of overweight and obesity in HWs were 34.5% and 24.5% respectively. Employed women were about 4% and 10% less overweight and obese than the HWs, respectively (P< 0.01). HWs vs. employed women had the adjusted OR 1.39 (CI95%, 1.18-1.63) for obesity. Older women, with higher educational level and socioeconomic status, lower physical activities and those living in urban areas were at risk of obesity. In comparison to HWs, working as an Official Clerk (OR=0.66) associated with a decrease in odds of obesity significantly, while others did not. CONCLUSION: Being as HW is an independent significant factor for obesity in women. Preventive health care programs to reduce risk of obesity in women should be applied, considering their occupation for achieving more effectiveness.

Patients' preferences for receiving clinical information and participating in decision-making in Iran.

INTRODUCTION: This study, the first of its kind in Iran, was to assess Iranian patients' preferences for receiving information and participating in decision-making and to evaluate their satisfaction with how medical information is given to them and with their participation in decision-making at present. METHOD AND MATERIALS: 299 of 312 eligible patients admitted to general internal medicine or surgery wards from May to December 2006 were interviewed according to a structured questionnaire. The questionnaire contained questions about patients' preferences regarding four domains of information and their participation in decision-making. Patients' responses were measured on a visual analogue scale graded from 1 to 10. RESULTS: The mean (SD) score for desire to receive information was 8.88 out of 10 (1.5) and for participation in medical decision-making was 7.75 out of 10 (3). The desire to receive information was greater in women than men (9.0 (1.5) vs 7.8 (1.4), p = 0.025). It was also correlated with their education (r = 0.2, p = 0.001) and their estimation of the severity of their own disease (r = 0.13, p = 0.027). The score for preference to participate in decision-making was higher in women than in men (7.95 (2.8) and 7.0 (3.2), respectively; beta = 0.8, p = 0.022) and was negatively correlated with education (r = -0.14, p = 0.015). DISCUSSION: This study shows that Iranian patients are highly interested in receiving information about their condition and participating in clinical decision-making. No predictive variable for such attitudes was found; therefore, the only way for the physician to recognise patients' desire is to ask them explicitly.