Clinical and haematological characteristics of human trichostrongyliasis.

Trichostrongylus spp. are primarily parasites of ruminants, but humans can become infected as accidental hosts. Information about the clinical aspects of human trichostrongyliasis is limited. This study investigated the clinical and haematological characteristics of a large number of trichostrongyliasis patients. In the Fouman district of Guilan Province in northern Iran, during 2015-2016, 60 patients were identified as positive for Trichostrongylus spp., using stool examination methods. The clinical manifestations and demographic data of all patients were recorded and further analysed. Twenty-three patients (38.3%) were male and 37 (61.7%) were female. Among the individuals infected only with Trichostrongylus, only nine patients (16.4%) were asymptomatic. Forty-six patients (83.6%) presented with gastrointestinal (76.3%), pulmonary (30.9%) and cutaneous (12.7%) symptoms. No statistically significant relationship was found between clinical manifestations and sex or age groups. Ten patients (18.1%) revealed eosinophilia and five (9.1%) presented with hypochromic microcytic anaemia. The relationship between eosinophilia and age group, sex and clinical manifestations showed no statistical significance. Our study indicated that trichostrongyliasis may be a major parasitic aetiology for gastrointestinal symptoms and eosinophilia in rural residents of endemic areas.

Fatal Strongyloides hyper-infection in a patient with myasthenia gravis.

PURPOSE: We report a fatal case of Strongyloides hyper-infection as the result of corticosteroid therapy of a patient with myasthenia gravis. CASE PRESENTATION: Our patient was a farmer with a past history of living in an endemic area for Strongyloides stercoralis in Iran. Hyper-infection was diagnosed during the advanced-stage disease by demonstration of enormous number of larvae in the direct smears prepared from both the stool and tracheal secretions. Unfortunately, despite appropriate anti-parasite therapy, the patient died due to respiratory failure. CONCLUSION: We recommend the provision of more awareness in high-risk people prior to immunosuppressive therapy, through screening for S. stercoralis, even in non-endemic regions.

Seroprevalence of Toxoplasma gondii in unmarried women in Qazvin, Islamic Republic of Iran.

In a cross-sectional study, we evaluated the seroprevalence of Toxoplasma gondii among 400 women referred to Qazvin community health centre laboratory for pre-marriage examinations. Indirect immunofluorescent antibody test was used to detect IgG anti-toxoplasma. Titres > or = 1: 20 were considered positive. The overall seropositivity was 34%. Mean age was significantly higher in seropositive women (P < 0.05). Seropositivity was highest among unemployed women (38.3%) and lowest among students (22.6%), and was significantly higher in women with less than high-school education (P < 0.05). With two-thirds of these unmarried women seronegative, they represent a high-risk group in pregnancy. Such women need to be educated to prevent congenital toxoplasmosis.

Evaluation of confounders in toxoplasmosis indirect fluorescent antibody assay.

BACKGROUND: The IFA test is one of the most usual methods for detecting anti-Toxoplasma antibodies, although it has not any unique standardization. It seems that the microscopic judgment of results is an important confounder in IFA test. Therefore, we conducted the present study to clarify the role of microscopic observer, and other confounders on the test. METHODS: Eighty sera were collected from patients suspicious to toxoplasmosis for detection IgG anti-T. gondii by this test. Samples were examined against different series of antigens, IgG anti-human conjugates, and observers. RESULTS: There were no significant differences between the two series of antigens and conjugates. For the observers groups the kappa coefficient of the test results in the experts group (0.97, 0.94-1.00) were significantly higher than the less experienced observers (0.77, 0.68-0.87). CONCLUSION: We recommend the IFA test to be performed only in reference laboratories and by laboratory technicians that have enough experience for this test. Otherwise, we suggest the substitution of this test with other tests like ELISA for the diagnosis and epidemiological studies.

Seroprevalence of Toxoplasma gondii in unmarried women in Qazvin, Islamic Republic of Iran

In a cross-sectional study, we evaluated the seroprevalence of Toxoplasma gondii among 400 women referred to Qazvin community health centre laboratory for pre-marriage examinations. Indirect immunofluorescent antibody test was used to detect IgG anti-toxoplasma. Titres >/= 1: 20 were considered positive. The overall seropositivity was 34%. Mean age was significantly higher in seropositive women [P < 0.05]. Seropositivity was highest among unemployed women [38.3%] and lowest among students [22.6%], and was significantly higher in women with less than high-school education [P < 0.05]. With two-thirds of these unmarried women seronegative, they represent a high-risk group in pregnancy. Such women need to be educated to prevent congenital toxoplasmosis