The prevalence of aflatoxin M1 in milk of Middle East region: A systematic review, meta-analysis and probabilistic health risk assessment.

The current investigation was undertaken to take a review of the performed studies regarding the concentration and prevalence of aflatoxin M1 (AFM1) of the consumed cow milk in the Middle East. In this context, all available studies published in databases include Science Direct, PubMed, Scopus, and Web of Science among 1995 to December 2017; were screened accordingly. Also, the carcinogenic risk was estimated by calculating hazard index (HI) using the Monte Carlo simulation (MCS). The result of conducted meta-analysis for 49 articles containing 7484 data indicated that the rank order of type of milk based on the concentration of aflatoxin M1 was Ultra-high temperature processing (UHT) milk (82.57 ng/kg) > raw milk (60.37 ng/kg) > pasteurized milk (PAS) (45.81 ng/kg). The pooled concentration of aflatoxin M1 in raw and UHT milk was higher than EC (European Committee, 50 ng/kg) standard limit. The rank order of countries based on the concentration of aflatoxin M1 in raw milk was Syria > Turkey > Iran > Egypt > Lebanon > Palestine; pasteurized milk, Turkey > Iran > Lebanon; and UHT milk, Iran > Turkey > Saudi Arabia. The overall prevalence of aflatoxin M1 in the raw milk of Iran, Turkey, Lebanon, Palestine, Egypt, and Syria was identified as 76%, 12%, 67%, 85%, 38%, and 14%; pasteurized milk, in the Iran, Lebanon, and Turkey was 77%, 36%, and 11%; and finally UHT milk in Iran, Saudi Arabia, and Turkey was 81%, 82%, and 62%, respectively. HI in the adult's consumer's raw milk in the Iran, Turkey, Syria, Palestine, Lebanon, and Egypt were calculated as 0.26, 0.47, 0.52, 0.34, 0.23 and 0.18; However, the HI for adult consumers of pasteurized milk in the Iran, Turkey, and Lebanon were 0.28, 0.31 and 0.11. Also, the measured HI for adult consumers of UHT milk in the Saudi Arabia, Turkey, and Iran was 0.20, 0.33 and 0.50, respectively. The obtained HI for consumers of raw milk in the children age group of the Iran, Turkey, Syria, Palestine, Lebanon, and Egypt were 1.03,2.20, 2.42, 1.59, 1.05, and 0.84. The calculated HI for consumers of pasteurized milk in the children age group of the pasteurized milk in of Iran, Turkey, and Lebanon were 1.30, 1.56, and 0.50. Finally, in term of UHT milk in Saudi Arabia, Turkey, and Iran were 0.94, 1.44 and 2.35, respectively. Unlike Adults, children consumers in the several Middle East countries are at considerable cancer risk due to consumption of raw, pasteurized and UHT milk contain AFM1(HI > 1).

Metal concentrations in fillet and gill of parrotfish (Scarus ghobban) from the Persian Gulf and implications for human health.

Despite the benefits of seafood's consumption, the bioaccumulation of metals in fish can endanger consumers' health. This study analyzed lead (Pb), mercury (Hg), Arsenic (As), and Cadmium (Cd) concentrations in fillet and gill of parrotfish (Scarus ghobban) using flame atomic adsorption spectroscopy (FAAS). The potential non-carcinogenic and carcinogenic health risks due to consumption of Scarus ghobban fillet were assessed by estimating average target hazard quotient (THQ) and total target hazard quotient (TTHQ) and Incremental Lifetime Cancer Risk cancer risk (ILCR) of the analyzed metals. This study indicated that Cd, Pb, As and Hg concentrations were significantly (p < 0.05) lower than Food and Agriculture Organization (FAO) and national standard limits. The meal concentrations (µg/kg dry weight) in both fillet and gill were ranked as follows Pb > Cd > As > Hg. THQ and TTHQ were lower than 1 for adults and children, indicating that consumers were not at considerable non-carcinogenic risk. However, ILCR value for As was greater than 10-4, indicating that consumers are at carcinogenic risk. Overall, this research highlighted that although the consumption of parrotfish from the Persian Gulf does not pose non-carcinogenic health risks, carcinogenic risks derived from toxic As can be detrimental for local consumers.

Do needle and syringe programs reduce risky behaviours among people who inject drugs in Kermanshah City, Iran? A coarsened exact matching approach.

INTRODUCTION AND AIMS: In this study, we used a 'coarsened exact matching' method to evaluate the relationship between two levels of needle and syringe program (NSP) utilisation and HIV-related risk behaviours among people who inject drugs (PWID). DESIGN AND METHODS: Using snowball sampling, we recruited 500 PWID (all male) in Kermanshah City, Iran between September and December 2014 in a cross-sectional survey. We categorised participants into two groups, including high (i.e. receiving 60% or more of their syringes from an NSP) and low (i.e. receiving less than 60% of their syringes from NSP) NSP users. Then, we applied coarsened exact matching to match the two groups based on confounding covariates (age, place of residence, income, receiving methadone maintenance treatment) and made statistically equivalent comparison groups to estimate the effect of the NSP on injection risk behaviours. RESULTS: Participants with low NSP use were more likely to report borrowing syringes in past 2 months (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.30, 1.86; P < 0.04), in comparison with participants with high NSP use. Regarding recent syringe lending, low NSP use was also significantly and positively associated with this outcome (OR 3.34; 95% CI 1.70, 5.20; P < 0.02). Reusing one's own syringe was reported more frequently in low NSP use group (OR 1.40; 95% CI 1.22, 3.97; P < 0.03). DISCUSSION AND CONCLUSIONS: NSPs are a promising approach to reduce injection-related risk behaviours among PWID in Kermanshah, Iran. Expanded coverage of high-quality NSPs is recommended.

The global seroprevalence of Toxoplasma gondii among wild boars: A systematic review and meta-analysis.

This systematic review and meta-analysis study was performed to evaluate the worldwide seroprevalence of Toxoplasma gondii among wild boar. We searched PubMed, Science Direct, Web of Science, Cochrane, Scopus, EBSCOhost and Google Scholar databases for studies reporting T. gondii seroprevalence in wild boars between January 1995 and March 2017. Inclusion and exclusion criteria were applied. We estimated the pooled seroprevalence of T. gondii in wild boars using a random-effects model, and evaluated overall seroprevalence in different geographical areas. A total of 43 articles that included 16788 wild boar from 23 countries fulfilled our eligibility criteria. Of these, 4759 wild boar had been defined T. gondii seropositive and we estimated the pooled worldwide seroprevalence of toxoplasmosis in wild boars to be 23% (95% CI: 19-27%). The pooled seroprevalence in North America (32%, 20-45%; odds ratio [OR] 2.09) and Europe (26%, 21-30%; OR 1.72), was higher than Asia (13%, 5-23%). The lowest seroprevalence was estimated in South America (5%, 3-8%). An increased seropositivity was observed with elevation in geographical latitude. In subgroup analyses, the pooled seroprevalence of T. gondii was higher in wild boar older than 12 months of age (28%, 22-35%; OR 1.57) compared to those up to 12 months of age (20%, 16-25%). Our findings suggest that wild boar have an important role in human infection and the epidemiological cycle of T. gondii infection.