A systematic review and meta-analysis on prevalence of gastrointestinal helminthic infections in rodents of Iran: An emphasis on zoonotic aspects.

Rodents are the largest group of mammals that adapt to different ecosystems and may act as the potential reservoirs of significant pathogens including gastrointestinal (GI) helminths. Rodent-borne parasitic pathogens have been and remain a great concern for animal and human health. The aim of this systematic review and meta-analysis is thus to clarify and better understand the pooled prevalence of GI helminthic infections and the associated risk factors in rodents in Iran. Multiple databases (PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran and Irandoc) were searched for relevant literature published up to March 2022. A random-effects meta-analysis model was applied to estimate the pooled prevalence with 95 % confidence interval. Moreover, heterogeneity among studies was evaluated using the Cochran's Q test and the I 2-statistic. Out of the 5438 publications searched, 28 articles (30 datasets) were ultimately eligible for inclusion in the study. Thus, 3649 captured rodents belonging to 6 families, 20 genera, and 35 species were examined for GI helminths in Iran. Then, 54 helminth species were identified in the present research, including 33 nematodes, 16 cestodes, 4 trematods, and 1 acanthocephalan. The prevalence rate of GI parasitic infections was 56 % (95 % CI: 50-63 %). Hymenolepis diminuta, Syphacia obvelata and Rodentolepis nana were the most common helminthic infections (13 %, 9 %, and 8 %, respectively). Moreover, 11 potential zoonotic helminths were found. There was no significant difference in pooled prevalence between male and female rodents (P = 0.40). Considering geographical areas, northern and eastern provinces had the highest prevalence of GI helminthic infections among rodents. The prevalence of GI worms in Iranian rodents was as high as 56 % with 11 zoonotic helminths. Therefore, it is suggested to observe the health of the environment, destroy the biological nests of rodents, avoid half-finished constructions, repair and improve streams and sidewalks, organize and collect garbage, and carry out biological and chemical control to handle the population of rodents. Increasing the awareness of local people about the harmful effects of rodents and the ways of transmission and prevention of rodent-borne intestinal worms transmitted to humans should be prioritized in health decisions.

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features.

Introduction: Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis. Objective: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis. Methods: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis. Results: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis (p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy (p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis (p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis (p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant (p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm3, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively. Conclusion: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.

Traumatic fracture of central venous catheter.

Central venous catheter (CVC) placement is frequently essential for the management of critically ill patients. This report describes a case involving the surgical retrieval of an embolized fragment of a CVC, originally intended for dialysis, following an unsuccessful removal attempt by a nurse due to catheter malfunction. The decision to remove and replace the malfunctioning catheter was made by the patient's physician. However, during the removal process, both the retaining suture and the catheter were inadvertently severed. This report also discusses the complications and management strategies associated with the embolization of a central line.

Presence of CRISPR CAS-Like Sequences as a Proposed Mechanism for Horizontal Genetic Exchanges between Trichomonas vaginalis and Its Associated Virus: A Comparative Genomic Analysis with the First Report of a Putative CRISPR CAS Structures in Eukaryotic Cells.

Introduction: Trichomonas vaginalis genome is among the largest genome size and coding capacities. Combinations of gene duplications, transposon, repeated sequences, and lateral gene transfers (LGTs) have contributed to the unexpected large genomic size and diversity. This study is aimed at investigating genomic exchange and seeking for presence of the CRISPR CAS system as one of the possible mechanisms for some level of genetic exchange. Material and Methods. In this comparative analysis, 398 publicly available Trichomonas vaginalis complete genomes were investigated for the presence of CRISPR CAS. Spacer sequences were also analyzed for their origin using BLAST. Results: We identified a CRISPR CAS (Cas3). CRISPR spacers are highly similar to transposable genetic elements such as viruses of protozoan parasites, especially megavirals, some transposons, and, interestingly, papillomavirus and HIV-1 in a few cases. Discussion. There is a striking similarity between the prokaryotes/Archaean CRISPR and what we find as eukaryotic CRISPR. About 5-10% of the 398 T. vaginalis possess a CRISPR structure. Conclusion: According to sequences and their organization, we assume that these repeated sequences and spacer, along with their mentioned features, could be the eukaryotic homolog of prokaryotes and Archaean CRISPR systems and may involve in a process similar to the CRISPR function.

Comment on Islam et al. Helminth Parasites among Rodents in the Middle East Countries: A Systematic Review and Meta-Analysis. Animals 2020, 10, 2342.

I read with great interest the article by Islam et al. entitled "Helminth parasites among rodents in the Middle East countries: a systematic review and meta-analysis" published in Animals in December 2020 [...].

Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran.

Background and Aims: Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits. Aim: This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran. Methods: Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic. Results: Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions. Conclusion: It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.

Phylogenetic analysis of avian schistosome Trichobilharzia regenti (Schistosomatidae, Digenea) from naturally infected hosts in northern Iran.

BACKGROUND: Trichobilharzia regenti (T. regenti) is an avian schistosomatid fluke species that causes human cercarial dermatitis (HCD) in areas of aquaculture in northern Iran. Understanding the phylogenetic relationships and genetic diversity of this thread-like fluke will deepen our thoughtful of avian schistosomiasis epidemiology and lead to more effective HCD control in the region. OBJECTIVES: To determine the life cycle of nasal Trichobilharzia in aquatic birds as well as aquatic snails and also identify the haplotype diversity of the isolates in Mazandaran Province, northern Iran. METHODS: In the present study, adult or egg of Trichobilharzia isolated from aquatic birds as well as schistosomes cercariae isolated from aquatic snails in Mazandaran Province, northern Iran, belonged to the authors' previous research, were examined. Molecular studies and phylogenetic analysis were carried out on these schistosomes samples. RESULTS: The phylogenetic analysis of the ITS1 and COX1 genes in isolated schistosomes revealed that all samples belong to the T. regenti clade. Remarkably, based on phylogenetic results, these schistosomes samples from Anas platyrhynchos domesticus, A. platyrhynchos, Spatula clypeata and Lymnaea stagnalis grouped together with previously sequenced samples from Iran (Trichobilharzia cf. regenti). Unlike the phylogenetic tree and haplotype network of COX1 gene, ITS1 did not show distinct clusters. CONCLUSION: This study completed the puzzle of the disease in Mazandaran Province by isolating and genotyping furkocercariae from L. stagnalis that was consistent with the isolated new genotype from ducks. For the first time in Iran, this confirmed the potential role of L. stagnalis snails in the transmission of the disease.

Global prevalence of Neospora caninum in rodents: A systematic review and meta-analysis.

BACKGROUND: Neosporosis has been considered a cause of abortion in dairy and beef cattle worldwide. Rodents are reservoir hosts for several infectious diseases. It is necessary to determine the prevalence of Neospora caninum in rodents to improve the current understanding of the transmission dynamics of Neospora as well as its life cycle and risk of transmission to livestock. Therefore, the objective of the present study was to estimate the pooled global prevalence of N. caninum in different rodent species. METHODS: Published studies on the prevalence of N. caninum in different rodent species were searched in the MEDLINE/PubMed, ScienceDirect, Web of Science, Scopus and Google Scholar and the reference lists of the retrieved articles until July 30, 2022. The eligible studies were selected using inclusion and exclusion criteria. The extracted data were verified and analysed using the random-effect meta-analysis. RESULT: For this meta-analysis, a total of 4372 rodents from 26 eligible studies were included. The global prevalence of N. caninum in rodents was estimated at 5% (95% CI 2%-9%), with the highest prevalence in Asia (12%; 95% CI 6%-24%) and lowest prevalence in America (3%; 95% CI 1%-14%) and Europe (3%; 95% CI 1%-6%). N. caninum was more prevalent in females (4%; 95% CI 2%-9%) than in males (3%; 95% CI 1%-11%). The most common diagnostic test was polymerase chain reaction (PCR) (21 studies). The pooled prevalence of N. caninum in rodents based on the diagnostic method was as follows: immunohistochemistry: 11% (95% CI 6%-20%), NAT: 5% (95% CI 4%-7%), IFAT: 5% (95% CI 2%-13%) and PCR: 3% (95% CI 1%-9%). CONCLUSION: The results of this study showed a relatively low but widespread prevalence of N. caninum infection in rodents.

Effectiveness of oral levamisole as an adjuvant to hepatitis B vaccination in healthcare workers non-responsive to previous vaccination: A randomized controlled trial.

Background: Healthcare workers are at risk for HBV infection through percutaneous or mucosal contact with infected blood, body secretions, or blood products or via sharps injury. Hepatitis B vaccination, despite immunogenicity, may not induce a proper immune response in 5-10% of the general adult population. Increased immune response in healthcare providers that do not respond properly to conventional hepatitis B vaccination is an important health challenge. Therefore, the aim of the present study was to evaluate the effectiveness of hepatitis B vaccination plus oral levamisole as adjuvant in healthcare providers non-responsive to routine vaccination. Materials and methods: The healthcare workers that were non-responsive to previous hepatitis B vaccination were enrolled in a double-blind randomized placebo-controlled clinical trial. The participants were then randomized to two groups including hepatitis B vaccination (as a three-dose series on a 0, 1, and 2-month schedule in the deltoid muscle) plus levamisole (levamisole group) and hepatitis B vaccination plus placebo (placebo group) at a 1:1 ratio. The outcome measure was the HBs antibody titer one month after receiving each dose as well as the seroprotection ratio. The side effects were also evaluated in all participants. Results: In total, 22 subjects finished the trial (11 individual in per group). The median antibody titer one month after receiving the first and third doses increased more in the levamisole group compared to the placebo group but the difference was not significant (p â€‹= â€‹0.34, p â€‹= â€‹0.66, respectively).The seroprotection ratio after three doses was similarly high in both groups (90.9% in per group). Furthermore, the seroprotection ratio and median antibody titer had no significant correlation with age, sex, BMI, and history of smoking in intervention and control groups (p>0.05). No serious side effects were noted in both groups. Conclusions: Re-vaccination can boost the immune response in healthcare professionals that were non-responsive to previous vaccination although the mean antibody titer was higher in the levamisole group.

Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave.

COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The characteristics of this infectious disease vary from a country to another and from one peak to the next. The aim of the present study was to describe the COVID-19 patients hospitalized in Kermanshah, a city in the west of Iran, in the third peak of the disease and to identify in-hospital mortality determinants in this disease. Methods: In this retrospective study, the clinical and demographic characteristics, laboratory findings, prescribed treatments and outcome of all COVID-19 patients (definitive, suspected, and probable) were collected from the medical records department of Farabi Hospital affiliated with Kermanshah University of Medical Sciences, Kermanshah, Iran from 22 October to 20 November 2020. Results: In total, 665 COVID-19 patients (265 females and 400 males, mean age: 58.7 years) were enrolled, including 479 confirmed, 15 probable, and 30 suspected cases. About 84% of the patients presented with low oxygen saturation levels. The most common comorbidities were hypertension (15%), diabetes (10%), and cardiovascular disease (3%). The median (IQR) length of hospital stay was 6 (Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021 (4., 5., 6., 7., 8.)) and 7 (Javadi Mamaghani et al., 2021; Abdolahnejad et al., 2022; Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021; Sayad et al., 2021; Hesni et al., 2022; Buttenschøn et al., 2022; Smits et al., 2022; Rosenberger et al., 2021; Shi et al., 2022 (2., 3., 4., 5., 6., 7., 8., 9., 10., 11., 12., 13., 14.)) day in discharged and deceased patients, respectively. Eighty-two out of 655 patients admitted to the hospital and 39of the 60 patients admitted to the ICU died. In total, in-hospital mortality rate was 12.33%. Regarding lab variables, in the adjusted model, no significant difference was observed between discharged and deceased patients.The results of multivariable logistic regression showed that each one-unit increase in oxygen saturation (SPO2) increased the odds of survival by 0.88 times (aOR 0.88, 95% CI 0.78-0.99, p = 0.043). Moreover, each one-day increase in the length of ICU stay reduced the odds of mortality by 0.49 times (aOR 0.82, 95% CI 0.26-0.95, p = 0.035). Conclusion: Hospitalized COVID-19 patients were generally more ill during the third peak so that about 85% of the patients had SPO2 ≤ 93%. The in-hospital mortality rate was also high. Demographic and paraclinical variables (except SPO2 level) were not suitable predictors of mortality.

Introducción: COVID-19 es una enfermedad causada por el síndrome respiratorio agudo severo coronavirus 2 (SARS CoV 2). Las características de esta enfermedad infecciosa varían de un país a otro y de un pico a otro. El objetivo del presente estudio fue describir a los pacientes con COVID-19 hospitalizados en Kermanshah, una ciudad al oeste de Irán, durante la tercera ola pandémica e identificar los determinantes de mortalidad hospitalaria de esta enfermedad.Métodos: en este estudio retrospectivo, las características clínicas y demográficas, los hallazgos de laboratorio, los tratamientos prescritos y el resultado de todos los pacientes ingresados por COVID-19 (definitivo, sospechoso y probable) se recopilaron a partir de los registros médicos del Hospital Farabi afiliado a la Universidad de Medicina de Kermanshah. Sciences, Kermanshah, Irán, del 22 de octubre al 20 de noviembre de 2020.Resultados: En total, se registraron 665 pacientes ingresados por COVID-19 (265 mujeres y 400 hombres), de los cuales 479 casosfueron confirmados, 15 probables y 30 sospechosos. La edad promedio del total de casos fue de 58,7 años. Alrededor del 84% de los pacientes presentaron niveles bajos de saturación de oxígeno. Las comorbilidades más comunes fueron hipertensión (15%), diabetes (10%) y enfermedad cardiovascular (3%). La mediana (RIC) de estancia hospitalaria fue de 6 (Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021 (4., 5., 6., 7., 8.)) y 7 (Javadi Mamaghani et al., 2021; Abdolahnejad et al., 2022; Nojomi et al., 2021; Flores-Vega et al., 2022; Fattahi et al., 2021; Cusinato et al., 2022; Avatef Fazeli et al., 2021; Sayad et al., 2021; Hesni et al., 2022; Buttenschøn et al., 2022; Smits et al., 2022; Rosenberger et al., 2021; Shi et al., 2022 (2., 3., 4., 5., 6., 7., 8., 9., 10., 11., 12., 13., 14.)) días en pacientes dados de alta y fallecidos, respectivamente. El 82 de los 655 pacientes ingresados en el hospital y el 39 de los 60 pacientes ingresados en UCI fallecieron. En total, la tasa de mortalidad hospitalaria fue del 12,33%. En cuanto a las variables de laboratorio, en el modelo ajustado no se observaron diferencias significativas entre los pacientes dados de alta y los fallecidos. Los resultados de la regresión logística multivariable mostraron que cada aumento de una unidad en la saturación de oxígeno (SPO2) aumentó las probabilidades de supervivencia en 0,88 veces (ORa 0,88, IC del 95% 0,78-0,99, p = 0,043). Además, cada aumento de un día en la duración de la estancia en la UCI redujo las probabilidades de mortalidad en 0,49 veces (ORa 0,82, IC del 95%: 0,26-0,95, p = 0,035).Conclusión: los pacientes hospitalizados con COVID-19 generalmente estaban más enfermos durante el tercer pico, de modo que aproximadamente el 85% de los pacientes tenían SPO2 ≤ 93%. La tasa de mortalidad hospitalaria también fue alta. Las variables demográficas y paraclínicas (excepto el nivel de SPO2) no fueron predictores adecuados de mortalidad.

Systematic Review and Meta-analysis of Role of Felids as Intermediate Hosts in the Life Cycle of Neospora caninum Based on Serological Data.

PURPOSE: Neosporosis is an important widespread parasitic infection caused by N. caninum. It infects a wide range of warm-blooded animals as intermediate hosts and dogs as the definitive host. Nevertheless, there are a number of questions regarding the life cycle and epidemiological aspects of N. caninum. Also, the role of felids (domestic and non-domestic) in the life cycle of N. caninum has been little described. Therefore, this study was conducted to evaluate the global prevalence of N. caninum in domestic and wild felids. METHODS: PubMed, Scopus, Google Scholar, Web of Science, and ScienceDirect databases were searched for articles published on the prevalence of N. caninum in felids until Aprill 2, 2022 and the reference lists of retrieved articles were screened. A random-effects meta-analysis model was used to estimate the pooled prevalence and 95% confidence interval. Heterogeneity among studies was evaluated using Cochran's Q and the I2 statistic. RESULTS: After exclusion of irrelevant articles and duplication removal, 30 studies were eligible for quantitative analysis including 20 studies on domestic cats and 10 studies on wild felids. The overall prevalence of neosporosis infection in cats was 15% (95% CI 10-21%) that was significantly higher in wild felids (26%, 95% CI 13-38%) than in domestic cats (11%, 95% CI 6-16%) (P = 0.03). There was no significant difference in pooled prevalence between male and female domestic cats (P = 0.75). Regarding continent, the lowest prevalence of neosporosis infection was in Asia (9%, 95% CI 1-20%) and the highest was in North America (43.6%, 95% CI 33.9-53.2%) and Africa (18%, 95% CI 9-46%). Higher prevalence was obtained when using the NAT with 22% (95% CI 7-37%), compared to the IFAT (17%, 95% CI 9-24%) and ELISA (6%, 95% CI 2-9%) (P = 0.01). CONCLUSION: The findings highlighted the importance of felids as potential intermediate hosts of neosporosis despite the fact that the source of the parasite for these animals was unknown. Further studies should be performed to investigate the role of this top predator (felids) in maintaining both domestic and sylvatic cycles of Neospora caninum.

Prevention of mother-to-child transmission of HIV in Kermanshah, west of Iran from 2014 to 2021.

BACKGROUND: This study aimed to evaluate the implementation of the prevention of mother-to-child transmission (PMTCT) of the HIV-PMTCT program in Kermanshah, west of Iran, from 2014 to 2021. METHODS: The data of all HIV-infected mothers and their infants who were monitored by the Kermanshah behavioral diseases counseling center was extracted and recorded in a checklist. RESULTS: Out of 95 included infant, 45 (47.4%) were girls and 50 (52.6%) were boys. The mothers were mostly infected with HIV via their infected spouse. The pregnancies of 77 cases (82.1%) were in accordance with the national guideline. The average length of treatment for this group was 185 days. Of the 18 mothers who did not receive treatment, nine were diagnosed during childbirth and nine had no available information. All infants born from infected mothers underwent after-birth-antiretroviral prophylaxis, and all remained healthy. There was no statistically significant relationship between the birth weight and height of neonates with maternal age, maternal last viral load, disease stage, education, and maternal CD4 levels. Only a statistically significant relationship was observed between the duration of treatment and the infants' weight. CONCLUSION: The results suggest the feasibility and effectiveness of the PMTCT program for HIV-positive mothers in Kermanshah. It seems that if pregnant HIV-positive women are diagnosed early and covered by a good prevention program on time, the risk of HIV to their babies will be reduced, significantly.

Toxoplasma gondii vaccine candidates: a concise review.

Toxoplasma gondii is an obligate intracellular parasite that causes toxoplasmosis. It has been shown that the severity of symptoms depends on the functioning of the host immune system. Although T. gondii infection typically does not lead to severe disease in healthy people and after infection, it induces a stable immunity, but it can contribute to severe and even lethal Toxoplasmosis in immunocompromised individuals (AIDS, bone marrow transplant and neoplasia). The antigens that have been proposed to be used in vaccine candidate in various studies include surface antigens and secretory excretions that have been synthesized and evaluated in different studies. In some studies, secretory antigens play an important role in stimulating the host immune response. Various antigens such as SAG, GRA, ROP, ROM, and MAG have been from different strains of T. gondii have been synthesized and their protective effects have been evaluated in animal models in different vaccine platforms including recombinant antigens, nanoparticles, and DNA vaccine. Four bibliographic databases including Science Direct, PubMed Central (PMC), Scopus, and Google Scholar were searched for articles published up to 2020.The current review article focuses on recent studies on the use and usefulness of recombinant antigens, nanoparticles, and DNA vaccines.

Molecular and phylogenetic analysis of E. vermicularis in appendectomy specimens from Iran.

Human infection with Enterobius vermicularis occurs worldwide, particularly in children. The role of E. vermicularis in appendicitis is neglected. This study was designed to investigate genotypes of E. vermicularis detected from appendectomy specimens in the human population from Iran and clarify the intra-species variation of the parasite. Seventy appendectomies for acute clinical appendicitis isolates from Azerbaijan and North Khorasan of Iran were used in the present study. The genetic information of Tehran and Hamedan regions was also obtained from GenBank for comparison and analysis. The nucleotide sequence of cytochrome c oxidase subunit 1 (cox1) gene was analyzed to perform genetic differentiation, haplotype network analysis, and population structure. Phylogenetic analysis of all the isolates were included in type B haplogroup. The number of haplotypes in all geographical locations of Iran is not much. Network analysis of sequences for regions such as Thailand, Iran, Denmark, and Poland show three classified subtypes B1, B2, and B3 in the B haplogroup. It seems that the haplotypes of E. vermicularis detected from appendectomy are B type, and divided into three subtypes. Further research using another genetic marker is required to elucidate the genetic variation of the parasites in detail.

Assessment of genetic markers for multilocus sequence typing (MLST) of Fasciola isolates from Iran.

BACKGROUND: Several markers have been described to characterise the population structure and genetic diversity of Fasciola species (Fasciola hepatica (F. hepatica) and Fasciola gigantica (F. gigantica). However, sequence analysis of a single genomic locus cannot provide sufficient resolution for the genetic diversity of the Fasciola parasite whose genomes are ∼1.3 GB in size. OBJECTIVES: To gain a better understanding of the gene diversity of Fasciola isolates from western Iran and to identify the most informative markers as candidates for epidemiological studies, five housekeeping genes were evaluated using a multilocus sequence typing (MLST) approach. METHODS: MLST analysis was developed based on five genes (ND1, Pepck, Pold, Cyt b and HSP70) after genomic DNA extraction, amplification and sequencing. Nucleotide diversity and phylogeny analysis were conducted on both concatenated MLST loci and each individual locus. A median joining haplotype network was created to examine the haplotypes relationship among Fasciola isolates. RESULTS: Thirty-three Fasciola isolates (19 F. hepatica and 14 F. gigantica) were included in the study. A total of 2971 bp was analysed for each isolate and 31 sequence types (STs) were identified among the 33 isolates (19 for F. hepatica and 14 for F. gigantica isolates). The STs produced 44 and 42 polymorphic sites and 17 and 14 haplotypes for F. hepatica and F. gigantica, respectively. Haplotype diversity was 0.982 ± 0.026 and 1.000 ± 0.027 and nucleotide diversity was 0.00200 and 0.00353 ± 0.00088 for F. hepatica and F. gigantica, respectively. There was a high degree of genetic diversity with a Simpson's index of diversity of 0.98 and 1 for F. hepatica and F. gigantica, respectively. While HSP70 and Pold haplotypes from Fasciola species were separated by one to three mutational steps, the haplotype networks of ND1 and Cyt b were more complex and numerous mutational steps were found, likely due to recombination. CONCLUSIONS: Although HSP70 and Pold genes from F. gigantica were invariant over the entire region of sequence coverage, MLST was useful for investigating the phylogenetic relationship of Fasciola species. The present study also provided insight into markers more suitable for phylogenetic studies and the genetic structure of Fasciola parasites.

Identification and differentiation of Fasciola hepatica and F. gigantica using multiplex PCR technique.

We aimed to present an alternate method instead of PCR-RFLP and also develop an optimized method for rapid, time-saving and affordable molecular-based approach to discriminate species of liver fluke, Fasciola hepatica and F. gigantica. Seventy-six samples of F. hepatica and 28 F. gigantica were collected from the slaughterhouses of endemic regions in Iran. Following a comprehensive analysis of the mitochondrial complete sequences of both F. hepatica and F. gigantica, the extracted DNAs from all samples were used as templates in multiplex PCR reactions containing two sets of primers specific for cytochrome c oxidase I (cox I) gene of both species. In a parallel experiment, PCR-RFLP was performed for each sample using internal transcribed spacer (ITS1) sequence. Furthermore, following a PCR amplification for cox I gene, the amplicons were purified for sequencing. To assess the validity of the multiplex PCR approach, the obtained data from the multiplex PCR and PCR-RFLP experiments were compared with each other. By sequence analysis of 104 samples, 76 and 28 samples were identified as F. hepatica and F. gigantica, respectively. Results revealed 100% and 92% of accuracy as for multiplex PCR and PCR-RFLP. The designed multiplex PCR strategy offers a valid alternative approach to the conventional methods with distinctive features including convenience, cost-effectiveness, time-saving (3 hours from sampling to obtain final results) and high efficacy.

Molecular Characterization of Animal Fasciola Spp. Isolates from Lorestan Province, Western Iran.

Background: We aimed to detect the genetic diversity of samples identified morphologically as Fasciola spp. from sheep, cattle and goat from Lorestan Province, western Iran using PCR-RFLP method. Besides, we evaluated the genetic diversity indices, sequencing and phylogenetic analysis using mitochondrial gene (ND1 and CO1). Methods: PCR-RFLP analysis of ribosomal ITS1 fragment by RsaI restriction enzyme to investigate the genetic characteristics of Fasciola species obtained from different hosts (18 sheep, 21 cattle, and 17goats) was conducted. The samples were sequenced. Sequences were evaluated using BLAST software and the parasite species were identified with similarity percentage and overlap with the species registered in the gene bank. Then similarity and diversity of intra-species and intra-species diversity of Fasciola species were calculated. Results: In Lorestan, based on RFLP pattern, 93% (52) of the Fasciola spp. isolates had a RFLP pattern related to F. hepatica and 7% (4) were F. gigantica. No hybrid forms were detected. The CO1 gene could clarify 19 haplotypes against ND1 gene that found 22 haplotypes among livestock. Sequencing results of the mtDNA showed intra-species identity 98. 5%-100% and Intra-species-diversity: 0-1.5% compared to the GenBank sequences. Conclusion: Using PCR-RFLP method, two species of F. hepatica and F. gigantica, were present in Lorestan Province, but F. hepatica was more prevalent. Mitochondrial genes could better test variability indices in different hosts than ribosomal genes, consequently among mitochondrial genes, the ND1 gene could better examine differences and similarities than CO1.

Assessment of the Endoparasite Fauna amongst the Rodents in Kurdistan Province, West of Iran.

Background: We aimed to evaluate the rate of infection by endoparasites amongst rodents in the western regions of Iran to enhance the level of knowledge amongst health authorities in this entity. Methods: This study was conducted in the west and southwest of Kurdistan Province, including the cities of Sanandaj, Marivan, and Sarvabad. The field mission of this work was performed in three seasons' spring, summer, and autumn. The rodents were captured alive and their gastrointestinal tracts were evaluated for the worm endoparasites. Results: Herein, 208 rodents from 15 types of seven species, including Apodemus, Meriones, Mus, Sciurus, Cricetulus, Microtus, and Dryomys, were captured. In addition, 67 (32.21%) rodents were infected with endoparasites and 10 types of worms endoparasites, including Syphacia muris, Streptophagus spp., Mastophorus muris, Skrjabinema spp., Trichostrongylus spp., Trichuris muris, Hymenolepis nana, Hymenolepis dimimuta, Heligmosomoide spp., and other oxiuros were isolated from their gastrointestinal tracts. Most of these parasites (60%) were isolated from their small intestine whereas they were least (10%) found in their stomach and cecum. Conclusion: Having compared the results of this study with other studies in different regions of Iran, there is a higher variety of rodents and worm parasites in these regions of Iran.

Molecular and serological evaluation of visceral leishmaniasis in domestic dogs and cats in Maragheh County, north-west of Iran, 2018-2021.

OBJECTIVE: Zoonotic visceral leishmaniasis (VL) is caused by Leishmania infantum, of which dogs are the main reservoir. VL is endemic in the Middle East, also in some parts of Iran. Following reports of new cases of VL in children in Maragheh County, the non-endemic area of the disease, we encouraged to conduct a preliminary study on domestic dogs and cats to identify their potential role as reservoirs for the disease. MATERIALS AND METHODS: This study was conducted during a period of 3 years from 2018 to 2021. Two hundred ownership dogs and 25 cats from Maragheh County, north-west of Iran, were randomly screened. Blood samples were collected. A direct agglutination test (DAT) was used for the detection of anti-L. infantum antibodies. Furthermore, buffy coat samples from the L. infantum seropositive animals were examined to detect parasite presence using polymerase chain reaction. RESULTS: Out of the total of 200 ownership dogs evaluated, 170 (85%) were male and 30 (15%) were female with a mean age of 4.3 years. Anti-L. infantum antibodies (IgG cut-off ≥ 1:320) were observed in 3.5% of dogs (7/200) by the DAT test. All seropositive dogs were identified in the first year of examination. Regarding molecular approaches in seropositive dogs, two samples were positive for a 565 bp kDNA minicircle gene specific for L. infantum. During the study period, no seropositive case was detected in the cats examined. CONCLUSIONS: This study shows that the domestic cycle of L. infantum has been established in the studied region. It is necessary to increase the awareness and monitoring of the disease with the study of wild reservoirs periodically.

Demographics, clinical characteristics, and outcomes of 27,256 hospitalized COVID-19 patients in Kermanshah Province, Iran: a retrospective one-year cohort study.

BACKGROUND: Since the first official report of SARS-CoV-2 infection in Iran on 19 February 2020, our country has been one of the worst affected countries by the COVID-19 epidemic in the Middle East. In addition to demographic and clinical characteristics, the number of hospitalized cases and deaths is an important factor for evidence-based decision-making and disease control and preparing the healthcare system to face the future challenges of COVID-19. Therefore, this cohort study was conducted to determine the demographics, clinical characteristics, and outcomes of hospitalized COVID-19 patients in Kermanshah Province, west of Iran. METHODS: This multicenter retrospective cohort study included all suspected, probable, and confirmed cases of COVID-19 hospitalized in Kermanshah Province, Iran during the first year of the COVID-19 pandemic. Demographics, clinical characteristics, outcomes and other additional information of hospitalized patients were collected from the COVID-19 database of the Medical Care Monitoring Center (MCMC) of Kermanshah Province. RESULTS: Kermanshah Province experienced three waves of COVID-19 infection considering the hospitalization and mortality rates between February 20, 2020 and February 19, 2021. A total of 27,256 patients were included in the study: 5203 (19.09%) subjects were suspected, 9136(33.52%) were probable, and 12,917 (47.39%) were confirmed COVID-19 cases. The mean age of the patients was 53.34 ± 22.74 years and 14,648 (53.74%) were male. The median length of hospital stay among COVID-19 survivors and non-survivors patients were 4 (interquartile range [IQR] 1-6) and 4 (IQR 1-8) days, respectively. Among patients with COVID-19, 2646 (9.71%) died during hospitalization. A multivariable logistic regression revealed that odds of death among patients ≥ 85 years was significantly greater than among patients < 15 years (adjusted odds ratio [aOR] 4.79, 95% confidence interval [CI] = 3.43-6.71, p≤ 0.001). Patients with one (aOR 1.38, 95% CI 1.21-1.59, p = 0.04), two (aOR 1.56, 95% CI 1.27-1.92, p = 0.001) or more (aOR 1.50, 95% CI 1.04-2.17, p = 0.03) comorbidities had higher odds of in-hospital death compared to those without comorbidities. The male sex (aOR 1.20, 95% CI 1.07- 1.35, p = 0.002), ICU admission (aOR 4.35, 95% CI 3.80-4.97, p < 0.001), intubation (aOR 11.09, 95% CI 9.58-12.84, p < 0.001), respiratory distress (aOR 1.40, 95% CI 1.22-1.61, p < 0.001), loss of consciousness (aOR 1.81, 95% CI 1.45-2.25, p < 0.001), anorexia (aOR 1.36, 95% CI 1.09-1.70, p = 0.006) and peripheral oxygen saturation (SpO2) < 93(aOR 2.72, 95% CI 2.34-3.16, p < 0.001) on admission were associated with increased risk of death in patients with SARS-CoV-2 infection. Having cough (aOR 0.82, 95% CI 0.72-0.93, p = 0.003) and headache (aOR 0.70, 95% CI 0.50-0.97, p = 0.03) decreased the odds of death. CONCLUSION: The mortality rate of the patients admitted to the general wards and ICU can be a guide for allocating resources and making appropriate plans to provide better medical interventions during the COVID-19 pandemic. Several risk factors are associated with the in-hospital mortality of COVID-19, including advanced age, male sex, ICU admission, intubation, having comorbidity, SpO2 < 93, respiratory distress, loss of consciousness, headache, anorexia, and cough. These risk factors could help clinicians identify patients at high risk for death.