Remdesivir-Related Cardiac Adverse Effects in COVID-19 Patients: A Case-Control Study.

BACKGROUND: There have been reports of serious side effects of Remdesivir, including cardiovascular complications. The present study aimed to determine the adverse cardiovascular effects of Remdesivir and the factors affecting them in COVID-19 patients. METHODS: The patients were classified into two groups: those receiving Remdesivir without cardiac complications and those receiving Remdesivir with cardiovascular complications. After reviewing the patient's medical records, the relationship of some factors with the incidence of adverse cardiovascular effects was measured. RESULTS: Chi-square test showed that the distribution of complications in men was significantly higher than in women (P=0.001). The independent t-test revealed that the mean age in the group with complications was significantly higher than the group without complications (P=0.013). Fisher's exact test demonstrated a significant relationship between smoking and cardiovascular complications (P=0.05). According to the Mann-Whitney test, a significant difference was found in the mean changes of Bilirubin (P=0.02) and ALKP (P=0.01) before and after treatment in the groups with and without heart complications. CONCLUSION: Our findings indicated that most of the COVID-19 patients suffered from sinus bradycardia, and the distribution of complications was more pronounced in men than in women. The mean age in the group with complications was higher than the group without complications. Smoking was found to be associated with the occurrence of cardiovascular complications and the mean changes of Bilirubin and ALKP before and after treatment were significantly different in the groups with and without cardiovascular complications.

Healthy eating index 2015 might be associated with migraine headaches: Results from a Case-Control study.

Migraine headaches are the most prevalent disabling primary headaches, affecting individuals at an active age. Dietary interventions are considered low-cost and practical approaches to migraine prophylaxis. Hence, the present study aimed to assess the association between adherence to the Healthy Eating Index 2015 (HEI-2015) and migraine headaches. The present case-control study was conducted on 476 newly diagnosed adults with migraine headaches, based on the International Classification of Headache Disorders 3rd edition (ICHDIII criteria(, and 512 healthy controls. Participants' dietary intakes were collected using a validated, 168-item semi-quantitative food frequency questionnaire (FFQ). The association between HEI-2015 and migraine headaches was assessed using logistic regression models. Although the trend was not statistically significant, being in the 4th quantile of the HEI-2015 was associated with about 50% lower odds of migraine headaches in both primary (adjusted for age and gender) (odds ratios (OR): 0.51, 95% confidence intervals (CI): 0.33, 0.78) and fully adjusted models (additionally adjusted for body mass index (BMI) and total calories) (adjusted OR: 0.50, 95%CI: 0.32, 0.77). Intriguingly, the odds of migraine headaches were significantly higher in those in the last quantile of "Total Fruits," which is equal to more than 237 g per 1000 kcal (aOR: 2.96, 95%CI: 1.99, 4.41) and "Whole Fruits," which is equal to more than 233 g per 1000 kcal (aOR: 2.90, 95%CI: 1.94, 4.31). Similarly, higher intakes of "Dairy," which is equal to more than 138 g per 1000 kcal (aOR: 2.66, 95%CI: 1.71, 4.14), and "Total Protein Foods," which is equal to more than 259 g per 1000 kcal (aOR: 2.41, 95%CI: 1.58, 3.70), were associated with higher odds of migraine headaches. The current study revealed an indirect association between HEI-2015 and its components, including "Greens and Beans," "Whole Grains," "Refined Grains," and "Added Sugars" and lower odds of migraine headaches.

Prevalence of dyslipidemias in the Middle East region: A systematic review & meta-analysis study.

BACKGROUND AND AIMS: Dyslipidemia is a known main risk factor for cardiovascular diseases, and it can be controlled to reduce the incidence of cardiovascular diseases. This meta-analysis aimed to estimate the prevalence of dyslipidemias in the Middle East. METHODS: The relevant published articles between 2000 and 2021 that investigated the prevalence of dyslipidaemias in the Middle East were found through international data sources such as Medline, PubMed, and Google Scholar. The random-effects model was used to estimate the pooled prevalence with 95% confidence intervals. RESULTS: The pooled prevalence of dyslipidemias, hypertriglyceridemia, hypercholesterolemia, high levels of low-density lipoprotein cholesterol and low levels of high-density lipoprotein cholesterol in the Middle East were 54.08% (95% CI: 43.83-66.71), 32.51% (95% CI: 28.59-36.43), 29.44% (95% CI: 18.74-40.13), 32.09% (95% CI: 22.17-42.01), 44.71% (95% CI: 37.86-51.57), respectively. During the last two decades, an increasing trend in the prevalence of dyslipidemias was observed overall and in both sexes. Also, the age groups over 30 significantly had the highest prevalence of hypercholesterolemia, high levels of low-density lipoprotein cholesterol, and low levels of high-density lipoprotein cholesterol (p < 0.05). CONCLUSIONS: The increasing trend in the prevalence of dyslipidemias during the last two decades is an alarming and significant concern in the Middle East. Therefore, special measures are needed to deal with dyslipidemias as a health priority in the Middle East.

The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis.

BACKGROUND: Seat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers. METHODS: The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis. RESULTS: Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis. CONCLUSIONS: In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.

Bariatric Surgery in Migraine patients: CGRP Level and Weight Loss.

BACKGROUND: Obesity makes migraine more prevalent and severe. Serum level of calcitonin gene-related peptide (CGRP) is associated with the severity of migraine attacks. Although the effect of weight and bariatric surgery has been studied on migraine, the role of CGRP in migraine remission after weight loss surgery needs more investigation. METHODS: Patients with severe obesity who were bariatric surgery candidates and had been diagnosed with chronic migraine were included in this study. Weight, BMI, number of days with headache in the past 3 months, and severity of headaches in 10-point Likert VAS, Migraine Disability Assessment Scale (MIDAS) and Migraine Specific Quality of life (MSQ) questionnaire scores, and serum CGRP levels were evaluated before and within 6-10 months after surgery. RESULT: Sixty patients with chronic migraine with severe obesity were included. Ninety-five percent of patients reported a significantly lower number of attacks (21 to 8, p < 0.001) and severity of headaches within 90-day (7.7 to 4.8, p < 0.001); MIDAS (64.4 to 25.5, p < 0.001) and MSQ scores (44.6 to 26.8, p < 0.001) and CGRP level (252.7 to 130.1, p < 0.001) were significantly reduced after surgery with a mean follow-up of 7.5 months. Changes in MIDAS, MSQ, and CGRP were significantly associated with weight-related variables. CONCLUSION: Bariatric surgery decreases the frequency of migraine attacks, lessens the severity of headaches, and improves the quality of life and disability as well as CGRP plasma levels, suggesting CGRP as a possible etiology in the migraine-obesity link.

Adverse events following COVID-19 vaccination: A systematic review and meta-analysis.

BACKGROUND: High speed of COVID-19 vaccination has raised some concerns about the safety of the new vaccines. It is of a great importance to perform a review of the safety and efficacy of the COVID-19 vaccines. METHODS: Two International electronic databases (PubMed, ISI) were searched for clinical trials reporting efficacy and safety of COVID-19 vaccines compared to control group. Pooled risk ratio (RR) for total, systemic and local adverse events following immunization was calculated for different vaccine modalities. RESULTS: The pooled RRs of total adverse reactions for Inactivated, mRNA, and vector vaccines were 1.46 (95% CI: 1.19-1.78), 2.01 (95% CI: 1.82 - 2.23), and 1.65 (95% CI: 1.31 - 2.32) respectively. The pooled RR for occurrence of systemic adverse reactions following immunization for different vaccine modalities was 1.13 (95% CI: 0.79 - 1.61), 1.53 (95% CI 1.08 - 2.16), 1.58 (95% CI: 1.13 - 1.90), 0.72 (95% CI: 0.34 - 1.55), and 1.62 (95% CI: 1.39 - 1.89) for inactivated vaccine, mRNA, vector, DNA, and protein subunit vaccines respectively. The pooled RR of local adverse event following immunization with inactivated vaccine, mRNA vaccine, vector vaccine, DNA vaccine, and protein subunit vaccine was 2.18 (95% CI: 1.32 - 3.59), 4.96 (95% CI: 4.02 - 6.11), 1.48 (95% CI: 0.88-2.50) 1.04 (95% CI: 0.12-8.75), and 4.09 (95% CI: 2.63-6.35) respectively. CONCLUSION: mRNA vaccines are associated with greater risk of adverse events following immunization. However, at the present moment the benefits of all types of vaccines approved by WHO, still outweigh the risks of them and vaccination if available, is highly recommended.

Epidemiological and clinical risk factors related to severe COVID-19 in Iran: a multi-center study.

BACKGROUND: Iran was one of the first countries to be affected by COVID-19. Identifying factors associated with the severity of COVID-19 is effective in disease management. This study investigated the epidemiological and clinical features and factors related to the severity of COVID-19 in one of the less privileged areas in Iran. METHODS: In a multi-center study, all patients admitted to Zahedan University of Medical Sciences hospitals in southeastern Iran were investigated from February 29 to April 31, 2020. Demographic, epidemiological, and clinical data of patients were extracted from medical records. Bivariate and multivariate logistic regression models were used to explore the risk factors associated with the severity of COVID-19. RESULTS: Among the 413 patients, 55.5% were male, and 145 (35.10%) were in a severe condition at admission time. Multivariate analysis showed that the adjusted odds of the disease severity increased in patients with older age (OR 2.27; 95% CI 1.41-3.65), substance abuse (OR 2.49; 95% CI 1.14-5.43), having one underlying disease (OR 1.52; 95% CI 0.90-2.55), having two underlying disease (OR 2.31; 95% CI 1.19-4.50), and having three or more underlying disease (OR 2.60; 95% CI 1.19-5.66). CONCLUSIONS: COVID-19 was more severe in older patients, patients with a history of substance abuse, and patients with the underlying disease. Understanding the factors affecting the disease severity can help the clinical management of COVID-19, especially in less privileged areas where fewer resources are available.

HIV infection and increased risk of COVID-19 mortality: A Meta-Analysis.

There are some concerns on the effect of infection with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) on the outcome and mortality of COVID-19. In this meta-analysis, we aimed to address this issue and assess the risk of mortality in COVID-19 patients who are co-infected with HIV. Two International electronic databases (PubMed, Scopus) were searched from the first time available to 12 August 2021. The targeted outcome was the pooled odds ratio to examine the effect of HIV infection on COVID-19 mortality. The crude odds ratio (OR) for all studies and the pooled OR were calculated with 95% confidence interval. The forest plot was used to graphically represent the result of conducted meta-analysis and calculated OR for individual studies. The I2 statistic was used to examine the Heterogeneity in the included studies. Eleven studies were included in our study consisting of 19,642,775 COVID-19 infected cases, 59,980 HIV-positive, and 4,373 deaths due to COVID-19 in HIV positive patients. The overall pooled odds ratio was 1.21 (CI: 1.02; 1.43) and P-value < 0.0277. The I^2 value was 89% (P-value < 0.0001), which shows that included studies are heterogeneous. In this study, the funnel plot analysis showed symmetry among the included studies. HIV-positive patients are 21% more likely to die because of COVID-19 infection than people without HIV. Special attention should be considered for the prevention and treatment of COVID-19 and consistent treatment for HIV infection, in HIV-positive patients.

Systematic review and meta-analysis of hospital acquired infections rate in a middle east country (1995-2020).

Background: Hospital-acquired infections (HAIs) are a global problem in hospitals and significant causes of mortality and morbidity regardless of advances in supportive care, antimicrobial therapy and prevention. The study aimed to determine a comprehensive estimate of the HAIs prevalence, influential factors, and types of these infections in Iran. Methods: A systematic literature review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the online databases; Medline, EMBASE, Scopus, Cochrane, SID, Magiran, and Medlib from January 1995 to September 2020 using a combination of medical subject heading terms ('Nosocomial infection [Mesh] OR '' Hospital infection [Mesh] OR Hospital Acquired Infection[Mesh] OR Healthcare-associated infection ''AND ('Iran' [Mesh]) among observational and interventional studies. SPSS version 25 and STATA version 11 were used for data analysis. Results: A total of 66 (cross-sectional, cohort, and case-control) observational studies were identified. More of the studies had been done before 2014(43 papers or 65%). Based on the random-effects model, the overall prevalence of HAIs in Iran was 0.111 [95% CI: 0.105 - 0.116] with a high, statistically significant heterogeneity (I2= 99.9%). The infection rate was 0.157 and 0.089 before and after the Iranian Health Transformation Plan (HTP), respectively. HAIs rates reported more in the South and West of Iran rather than other regions (0.231 and 0.164) (p= 0.001). Escherichia coli and klebsiella infections were reported in 53 and 52 papers (0.239 and 0.180, respectively). In addition, respiratory and urinary infections were reported 0.296 and 0.286 in 51 and 38 papers, respectively. Conclusion: The prevalence of HAIs in Iran is relatively high. Preventing and decreasing hospital nosocomial infections can considerably affect reducing mortality and health-related costs. This should be taken into consideration by health policymakers for pathology and revision of some previous programs and standards as well as the development of appropriate and evidence-based control and education programs to reduce this health problem.

DNA vaccine containing Flagellin A gene induces significant immune responses against Helicobacter pylori infection: An in vivo study.

OBJECTIVES: Helicobacter pylori is one of the most prevalent human infectious agents that is directly involved in various upper digestive tract diseases. Although antibiotics-based therapy and proton pump inhibitors eradicate the bacteria mostly, their effectiveness has been declined recently due to emergence of antibiotic-resistant strains. Development of a DNA vaccine is a promising approach against bacterial pathogens. Genes encoding motility factors are promising immunogens to develop a DNA vaccine against H. pylori infection due to critical role of these genes in bacterial attachment and colonization within the gastric lumen. The present study aimed to synthesize a DNA vaccine construct based on the Flagellin A gene (flaA), the predominant flagellin subunit in H. pylori flagella. MATERIALS AND METHODS: The coding sequence of flaA was amplified through PCR and sub-cloned in the pBudCE4.1 vector. The recombinant vector was introduced into the human dermal fibroblast cells, and its potency to express the flaA protein was analyzed using SDS-PAGE. The recombinant construct was intramuscularly (IM) injected into the mice, and the profiles of cytokines and immunoglobulins were measured using ELISA. RESULTS: It has been found that flaA was successfully expressed in cells. Recombinant-vector also increased the serum levels of evaluated cytokines and immunoglobulins in mice. CONCLUSION: These findings showed that the pBudCE4.1-flaA construct was able to activate the immune responses. This study is the first step towards synthesis of recombinant-construct based on the flaA gene. Immunization with such construct may inhibit the H. pylori-associated infection; however, further experiments are urgent.

Enhanced Estimation of Root Zone Soil Moisture at 1 km Resolution Using SMAR Model and MODIS-Based Downscaled AMSR2 Soil Moisture Data.

Root zone soil moisture (RZSM) is an essential variable for weather and hydrological prediction models. Satellite-based microwave observations have been frequently utilized for the estimation of surface soil moisture (SSM) at various spatio-temporal resolutions. Moreover, previous studies have shown that satellite-based SSM products, coupled with the soil moisture analytical relationship (SMAR) can estimate RZSM variations. However, satellite-based SSM products are of low-resolution, rendering the application of the above-mentioned approach for local and pointwise applications problematic. This study initially attempted to estimate SSM at a finer resolution (1 km) using a downscaling technique based on a linear equation between AMSR2 SM data (25 km) with three MODIS parameters (NDVI, LST, and Albedo); then used the downscaled SSM in the SMAR model to monitor the RZSM for Rafsanjan Plain (RP), Iran. The performance of the proposed method was evaluated by measuring the soil moisture profile at ten stations in RP. The results of this study revealed that the downscaled AMSR2 SM data had a higher accuracy in relation to the ground-based SSM data in terms of MAE (↓0.021), RMSE (↓0.02), and R (↑0.199) metrics. Moreover, the SMAR model was run using three different SSM input data with different spatial resolution: (a) ground-based SSM, (b) conventional AMSR2, and (c) downscaled AMSR2 products. The results showed that while the SMAR model itself was capable of estimating RZSM from the variation of ground-based SSM data, its performance increased when using downscaled SSM data suggesting the potential benefits of proposed method in different hydrological applications.

The pattern of gene copy number alteration (CNAs) in hepatocellular carcinoma: an in silico analysis.

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common type of liver cancer that occurs predominantly in patients with previous liver conditions. In the absence of an ideal screening modality, HCC is usually diagnosed at an advanced stage. Recent studies show that loss or gain of genomic materials can activate the oncogenes or inactivate the tumor suppressor genes to predispose cells toward carcinogenesis. Here, we evaluated both the copy number alteration (CNA) and RNA sequencing data of 361 HCC samples in order to locate the frequently altered chromosomal regions and identify the affected genes. RESULTS: Our data show that the chr1q and chr8p are two hotspot regions for genomic amplifications and deletions respectively. Among the amplified genes, YY1AP1 (chr1q22) possessed the largest correlation between CNA and gene expression. Moreover, it showed a positive correlation between CNA and tumor grade. Regarding deleted genes, CHMP7 (chr8p21.3) possessed the largest correlation between CNA and gene expression. Protein products of both genes interact with other cellular proteins to carry out various functional roles. These include ASH1L, ZNF496, YY1, ZMYM4, CHMP4A, CHMP5, CHMP2A and CHMP3, some of which are well-known cancer-related genes. CONCLUSIONS: Our in-silico analysis demonstrates the importance of copy number alterations in the pathology of HCC. These findings open a door for future studies that evaluate our results by performing additional experiments.

The Promising Effect of Nerve Decompression in Trigeminal Autonomic Cephalalgias: Report of Case Series.

Trigeminal Autonomic Cephalalgias (TAC) are excruciating headaches with limited treatment options. The chronic forms of TACs, including chronic cluster, chronic paroxysmal hemicrania, and hemicrania continua, are disabling conditions. In addition to drug therapy, there are some studies regarding nerve blocking and nerve stimulation with acceptable results. Here we report four cases of decompression nerve surgery with promising results on pain control in these difficult to treat headaches.

Surgical Options for Migraine: An Overview.

OBJECTIVE: The goal of this manuscript was to provide a comprehensive review of the surgical treatment for migraine headaches with a focus on trigger points and their clinical presentations, and to emphasize the importance of appropriate patient selection. BACKGROUND: Migraine is a prevalent neurological disease with headache being a disabling component of it. Surgical treatment for migraine headache became available two decades ago, which is based on proper identification and the deactivation of the specific trigger sites in the head and neck area. DESIGN: This manuscript reviews the discovery and evolution of migraine surgery with changes in patients' selection throughout the years. CONCLUSION: Patients with migraine headaches who do not respond or cannot tolerate the medical treatment might benefit from trigger site deactivation surgery. The success of the surgery is closely related to proper identification of trigger point (s) and close collaboration with a neurologist or a headache specialist. This collaboration would enhance patients' positive outcomes and help to rule out other causes of the headache.

The Association Between Dietary Acid Load and Odds of Migraine: A Case-Control Survey.

INTRODUCTION: It has been shown that a high acid load in the human body can affect inflammatory factors and the nitric oxide pathway. These factors are also thought to play an important role in the initiation of migraine attacks. We have therefore explored the association between dietary acid load and odds of migraine in a case-control study. METHODS: The migraine group (n = 514, diagnosed according to the International Classification of Headache Disorders 3rd edition [ICHDIII] criteria) was recruited from a tertiary headache clinic. The controls consisted of 582 sex-matched healthy volunteers who were randomly selected from the general population. A validated 168-item semiquantitative food frequency questionnaire was used for dietary intake assessments. Estimation of the dietary acid load was performed using three different measures: potential renal acid load (PRAL) score, net endogenous acid production (NEAP) score, and protein/potassium ratio. RESULTS: Multivariable logistic regression analysis showed that, in comparison with the lowest tertile, the highest tertile of dietary acid load measures, including PRAL (odds ratio [OR] 7.208, 95% confidence intervals [CI] 3.33-15.55), and NEAP (OR 4.108, 95% CI 1.924-8.774) scores and the protein/potassium ratio (OR 4.127, 95% CI 1.933-8.814), significantly increased the odds of migraine (P value for trend ≤ 0.001). CONCLUSION: In this study, high dietary acid load was associated with higher odds of migraine. It is therefore possible that restricting dietary acid load could reduce the odds of migraine in susceptible subjects. However, due to the preliminary nature of the current evidence, caution is advised in drawing a definitive conclusion. More well-designed studies are required for a better understanding of this important issue.

The economic burden of tuberculosis in Sistan: a high-risk region in Iran.

INTRODUCTION: To estimate the economic burden of tuberculosis treatment in Sistan, the region with the highest number of tuberculosis cases in Iran. METHODS: All patients with smear-positive pulmonary tuberculosis who had contracted tuberculosis in 2018 and successfully completed their treatment were interviewed. RESULTS: Ninety patients with a mean age of 57 ± 18 years were interviewed. Most of them were women (58%), housewives (57%) and resided in rural areas (84%). The mean cost of treatment for tuberculosis was estimated as 6800 USD per patient. Direct costs were 87% of the total cost. Twenty-two patients lost an average income of 530 USD (8514590 rials) during treatment. The results showed the significant correlation of direct and indirect costs with sex, age, place of residence and education (P < 0.05). CONCLUSION: It appears essential to improve social protection and implement interventions to promote knowledge in rural areas.

Neurological features and outcome in COVID-19: dementia can predict severe disease.

The COVID-19 pandemic has infected more than 22 million people worldwide. Although much has been learned about COVID-19, we do not know much about its neurological features and their outcome. This observational study was conducted on the patients of Imam Hossein Hospital, and 361 adult patients (214 males) with confirmed diagnosis of COVID-19 from March 5, 2020 to April 3, 2020, were enrolled. Data was gathered on age, sex, comorbidities, initial symptoms, symptoms during the disease course, neurological symptoms, and outcome. The mean age of the patients was 61.90 ± 16.76 years. The most common initial symptoms were cough, fever, and dyspnea. In 21 patients (5.8%), the initial symptom was neurological. History of dementia was associated with severe COVID-19 disease (odds ratio = 1.28). During the course of the disease, 186 patients (51.52%) had at least one neurological symptom, the most common being headache (109 [30.2%]), followed by anosmia/ageusia (69, [19.1%]), and dizziness (54, [15%]). Also, 31 patients had neurological complications (8.58%). Anosmia, ageusia, dizziness, and headache were associated with favorable outcome (P < 0.001), while altered mental status and hemiparesis were associated with poor outcome. The mortality rate of patients who had neurological complications was more than twice than that of patients without neurological complication (P = 0.008). Almost half of the patients experienced at least one neurological symptom, which may be the initial presentation of COVID-19. Dementia appears to be associated with severe COVID-19. Mortality was higher in patients with neurological complications, and these patients needed more intensive care.

An investigation of the effects of environmental and ecologic factors on cutaneous leishmaniasis in the old world: a systematic review study.

OBJECTIVES: Leishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World. CONTENT: A systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria. SUMMARY AND OUTLOOK: A total of 827 relevant records in 2015-2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence. CONCLUSIONS: Temperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.