Effects of geographical and climatic factors on cystic echinococcosis in south-western Iran.

Cystic echinococcosis (CE) is caused by the larval form of Echinococcus granulosus that can cause serious health and economic problems in the endemic foci. CE is globally distributed in various climatic conditions from circumpolar to tropical latitudes. Iran is an important endemic area with a spectrum of weather conditions. The aim of this study was to determine the effects of geo-climatic factors on the distribution of livestock CE in south-western Iran (SWI) in 2016 to 2018. Data of livestock CE were retrieved from veterinary organizations of four provinces of SWI. The geo-climatic factors, including mean annual temperature (MAT), minimum MAT (MinMAT), maximum MAT (MaxMAT), mean annual rainfall (MAR), elevation, mean annual evaporation (MAE), sunny hours, wind speed, mean annual humidity (MAH), slope, frost days and land cover, were analysed using geographical information systems (GIS) approaches. The statistical analysis showed that MAR, frost days, elevation, slope and semi-condensed forest land cover were positively and MAE, MAT, MaxMAT, MinMAT and salt and salinity land cover were negatively correlated with CE occurrence. MAE was shown to be a predictive factor in the stepwise linear logistic regression model. In short, the current GIS-based study found that areas with lower evaporation were the main CE risk zones, though those with lower temperature and higher rainfall, altitude and slope, especially where covered with or in close proximity of semi-condensed forest, should be prioritized for consideration by health professionals and veterinarians for conducting control programmes in SWI.

Association of -607 C/A polymorphism of IL-18 gene (rs1946518) with breast cancer risk in Zahedan, Southeast Iran.

It is known that interleukin-18 (IL-18) is a proinflammatory cytokine with dual effects on tumor development and progression. It can increase the immune defense against tumor cells. Polymorphisms in the IL-18 genes are known to influence both expression levels and may be associated with outcome of cancers. This study was aimed to find out the possible association of IL-18 polymorphism at position -607 C/A (rs1946518) with breast cancer in a sample of Iranian population. We investigated IL-18 rs1946518 polymorphism on 72 breast cancer patients and 93 cancer free women. Genotyping was done using amplification refractory mutation system-PCR (ARMS-PCR). We found no significant differences between breast cancer patients and control subjects regarding IL-18 rs1946518 polymorphism (χ2=1.78, p=0.411). In conclusion, our finding showed that IL-18 rs1946518 polymorphism was not associated with breast cancer in a sample of Iranian population.

Topical treatment modalities for old world cutaneous leishmaniasis: a review.

Diagnosis and therapy of cutaneous leishmaniasis (CL) can be difficult due to the variability of the clinical pictures and resistance to therapy. There is no vaccine currently available for CL. The aim of the present review is to describe different topical treatment modalities for old world CL. The mainstays of treatment for old world CL are pentavalent antimony compounds which are administered parenterally or intralesionally. New topical treatment alternatives have been available within the past few years. Amongst several treatments used topically, physical therapies including cryotherapy, heat therapy and CO2 laser are promising for the treatment of old world CL. Along with that, other randomized placebo controlled trials should be designed to find new effective therapeutic regimens.

The L55M polymorphism of paraoxonase-1 is a risk factor for rheumatoid arthritis.

Paraoxonase-1 (PON1) is a high-density lipoprotein-associated enzyme that exhibits antioxidant and antiatherogenic activities. We examined a possible association between T172A (L55M) and T(-107)C polymorphisms and rheumatoid arthritis. These polymorphisms were determined in 88 rheumatoid arthritis patients and 78 healthy subjects, using the tetra-amplification refractory mutation system-PCR method. The prevalence of the PON1 55MM genotype was significantly greater among rheumatoid arthritis patients (17%) when compared to control subjects (5.2%) (odds ratio (OR) = 3.75; 95% confidence interval (CI) = 1.87-11.8, P = 0.025). In addition, the M allele was more frequent in rheumatoid arthritis patients (40%) than in healthy subjects (24.7%) (OR = 1.997; 95%CI = 1.243-3.210, P = 0.005). There were no significant differences in the -107C/T polymorphism in the promoter sequence of PON1 between rheumatoid arthritis and normal subjects (chi(2) = 0.861, P = 0.650). In conclusion, the PON1 55MM genotype is a risk factor for rheumatoid arthritis.

Lack of association between paraoxonase-1 Q192R polymorphism and rheumatoid arthritis in southeast Iran.

Decreased paraoxonase-1 (PON1) activity has been associated with rheumatoid arthritis. There are two polymorphisms in serum PON1; one differs in the amino acid at position 192 (Q192R) and the other one differs at position 55 (L55M). We looked for a possible association between Q192R polymorphism and rheumatoid arthritis. The Q192R polymorphism in 88 rheumatoid arthritis patients and 78 healthy subjects was determined using tetra amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and PCR-restriction fragment length polymorphism (RFLP) methods. We found no significant differences between rheumatoid arthritis patients and control subjects regarding PON1 Q192R polymorphism. PON1 Q192R polymorphism was not found to be correlated with increased risk for rheumatoid arthritis in this Iranian population.

Factors associated with breastfeeding patterns in women who recourse to health centres in Zahedan, Iran.

INTRODUCTION: The practice of breastfeeding, an important need for infants, can be affected by several factors that need to be investigated. This study was designed to survey the patterns and period of breastfeeding and its associated factors in women. METHODS: The study was performed in Zahedan, southeast Iran, in 2004-2005, with a sample of 450 mothers via a questionnaire to collect information about the period of breastfeeding and some important factors concerning both mothers and children. RESULTS: The exclusive breastfeeding ratio obtained from this study was 98 percent. The proportion of breastfeeding in months 1, 3, 6, 12 and 24 after birth were 92 percent, 85 percent, 69 percent, 56 percent and 8 percent, respectively. The median breastfeeding period was 15 months, with a standard error of 1.17. The period of breastfeeding showed a significant relationship with the age of the children and mothers, the mothers' education level, night breastfeeding, breastfeeding to an ill child, breastfeeding during a mother's illness and the frequency of breastfeeding per 24 hours. The Cox regression also confirmed a significant relationship between the period of breastfeeding and the above-mentioned variables, except for mother's education level and breastfeeding to an ill child. CONCLUSION: Young pregnant women need to be aware of the importance of breastfeeding and of avoiding the reduction or interruption of the breastfeeding period. It is recommended that the health authorities incorporate training and education programmes as well as healthcare measures to their family health programmes in order to overcome the problems of insufficient breastfeeding.

Emergence of cutaneous leishmaniasis in a border area at south-east of Iran: an epidemiological survey.

BACKGROUND & OBJECTIVES: Cutaneous leishmaniasis (CL) has been recently emerged in new foci, posing a public health problem. Increasing cases of CL have been reported during recent years from a border area between Iran and Pakistan, a previously non-endemic area. The present study was designed for epidemiological and parasitological characterization of the disease for the first time in this area. METHODS: A total of 3100 individuals from the city of Mirjaveh and its four rural districts were randomly selected and surveyed from March 2005 to February 2006. Microscopic examination, in vitro culture, mouse inoculations and species-specific kDNA-PCR assay were carried out for Leishmania detection and species identification. RESULTS: CL was endemic in an important rural district of Mirjaveh, presenting active lesions and scars in 6.6 and 9.5%, respectively. The highest rates of both active lesions and scars were found in the age group of 10 years or under with significant differences (p < 0.05) comparing to the older age groups. No association between genders and the rate of leishmaniasis was observed (p > 0.05). The most affected location was upper limb, 39.2% of ulcers and 41.7% of scars. Inoculation of the clinical isolates on Balb/c mice, led to the development of ulcers in the animals, implying that the causative parasite is Leishmania major. The PCR amplification also generated amplicons specific to L. major. CONCLUSION: It can be concluded that Mirjaveh is an endemic region of cutaneous leishmaniasis as a new focus due to the recent emergence in this border area of south-east of Iran with a major contribution of L. major, as the causative parasite species.

Isolation and molecular characterization of Toxoplasma gondii strains from different hosts in Iran.

Toxoplasma gondii is one of the most prevalent protozoan parasites in Iran. This study was aimed to isolate T. gondii from a variety of hosts and to genetically analyze the parasite isolates. The prevalence of T. gondii in different animal hosts was assessed in two provinces of Iran, Tehran and Mazandaran in the central and northern parts, respectively. The latex agglutination (LA) test was carried out, and antibodies were found in 24 out of 105 sheep, 5 out of 35 goats, 23 out of 45 free-ranging chickens (Gallus domesticus), 2 out of 13 ducks (Anas spp.), and two of four stray cats (Felis domesticus). T. gondii was isolated by bioassay in mice from four sheep, six chickens, one duck, two cats, and three human samples. Genotyping of these 16 isolates was performed using Multiplex PCR for five microsatellite markers and GRA6 gene sequence analysis. The results indicated that the studied isolates consisted of only two genotypes, II and III, with no evidence of type 1 or mixed genotypes.

A new perspective on and re-assessment of SAG2 locus as the tool for genetic analysis of Toxoplasma gondii isolates.

SAG2 locus, the coding gene of the P22 protein, has been widely used for the molecular epidemiology of Toxoplasma gondii and characterization of the parasite isolates with two separate polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) processes. To re-assess the resolution power and suitability of this genetic marker for molecular characterization of the parasite isolates, a number of 27 Toxoplasma strains from different zymodeme patterns were used in the present study. Both codon and non-codon regions of the SAG2 locus of all 27 strains were amplified and subjected to sequencing and nucleotide alignment. Nucleotide variations clustered the three major genotypes (I, II and III). Some minor genotypes, unidentifiable by SAG2-RFLP, could be identified by sequence comparison. However, there were other genotypes that could not be differentiated from the major types due to having identical sequences. This suggests that a remarkable number of field isolates representing several minor types will be miss-clustered with the major types by using the traditional SAG2-PCR-RFLP method. It was concluded that this technique seems not to be suitable for Toxoplasma population study. Thus, the utilization of more variable markers and other discriminatory methods are also recommended.

High rate of detection of mixed infections of Plasmodium vivax and Plasmodium falciparum in South-East of Iran, using nested PCR.

Sistan and Baluchestan province, South-East of Iran, has been reported as an endemic area of malaria [Sadrizadeh B. Malaria in the world, in the eastern Mediterranean region and in Iran: Review article. WHO/EMRO Report 2001: 1-13.]. The main objective of this research was to perform rapid and correct diagnoses of malaria infection. Blood specimens were collected from 140 suspected volunteers. The Giemsa-stained slides examination and nested PCR for amplification of the Plasmodium small subunit ribosomal genes (ssrRNA) were utilized. The results demonstrated 118 out of 140 cases (84.3%) positive for malaria parasites, including 60.7%, 20.7% and 2.9% as having Plasmodium vivax (P.v), Plasmodium falciparum (P.f) and mixed infections (P.v+P.f), respectively by microscopy. The nested PCR detected malaria parasites in 134 samples (94.3%), consisting of 51.4% P.v, 12.6% P.f and 29.3% mixed infections. The PCR analysis detected 37 cases of mixed infections more than that of the routine microscopy. These results suggested that there are a considerable number of cases with mixed infections in the study area that mainly remain undiagnosed by microscopy. It is also concluded that the nested PCR is a suitable complement to microscopy for accurate specific diagnosis of malaria species in field.

Intergenic spacer (IGS) polymorphism: a new genetic marker for differentiation of Toxoplasma gondii strains and Neospora caninum.

The region between the 28S and 18S rRNA genes, including the intergenic spacer (IGS) region and the 5S rRNA gene, from 32 strains of Toxoplasma gondii and the NC1 strain of Neospora caninum was amplified and used for DNA sequencing and/or restriction fragment length polymorphism (RFLP) analysis. The 5S rDNA sequences from 20 strains of T. gondii were identical. The IGS region between the 5S and 18S rRNA genes (nontranscribed spacer 2 or NTS 2) showed 10 nucleotide variations. Six of the 10 variant positions correlated with the murine virulence of the strains. Intraspecific polymorphisms distinguished the virulent strains of zymodemes 5, 6, and 8 from other virulent strains (in zymodeme 1). RFLP methods (IGS-RFLP) were developed and used to characterize the virulent and avirulent patterns among 29 T. gondii strains. Sequence diversity of 19.8% was found between T. gondii and N. caninum when comparing a region of 919 bp at the 3' end of NTS 2. The sequence variation in ribosomal IGS could therefore be a useful marker for Toxoplasma strain identification and for distinguishing N. caninum from T. gondii.

Molecular typing of Toxoplasma gondii strains by GRA6 gene sequence analysis.

The utility of sequence polymorphisms in the dense granule antigen GRA6 gene as typing markers for Toxoplasma gondii was investigated. The coding region of GRA6 was amplified, sequenced and compared for 30 Toxoplasma strains from eight different zymodemes (Z1-Z8). Sequence alignment identified nucleotide polymorphisms at 24 positions out of 690 bp, which correlated with murine-virulence. Types I, II, and III could be distinguished from each other on the basis of three, 10, and six variable positions, respectively. Two deletions of 15 bp and 3 bp existed in the avirulent (type II) strains. With one exception, all polymorphic positions resulted in amino acid substitutions, and the two gaps of 15 bp and 3 bp caused the deletion of six amino acids in type II strains. Intra-specific polymorphisms were also found in the virulent group. A high degree of sequence polymorphism correlating with the phenotypes of T. gondii strains points to the GRA6 gene being a good marker for strain characterisation and typing of the isolates of this apicomplexan. The large variety of amino acid changes supports the view that the GRA6 protein plays an important role in the antigenicity and pathogenicity of T. gondii. The existence of polymorphic restriction sites for endonuclease MseI was used to develop a PCR-RFLP method which could simply differentiate the three different groups (types I, II, III) of T. gondii.