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Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic methods, geographical distribution and study population. Meta-regression was performed on the year of publication, proportion of patients with diarrhea, and proportion of patients with CD4

Background: Toxoplasmosis is a zoonotic disease caused by the parasite Toxoplasma gondii, a cosmopolitan intracellular parasite. It can be a risk factor for autoimmune diseases, including rheumatoid arthritis (RA). This study was designed to investigate the possible association between serological history of T. gondii infection and defined clinical manifestation of RA in Northeast of Iran. Methods: Overall, serum samples were collected from 50 RA patients and 40 healthy controls, from Qaem Hospital in Mashhad City, northeastern Iran in 2018. Seroprevalence of T. gondii infection was determined by ELISA. Results: The prevalence of anti -T. gondii IgG in RA patients 48% (24.50) was significantly higher than the control group 10% (4.40) (P <0.001). Erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide (anti-CCP) and (rheumatoid factor) RF levels between the RA and control groups (P <0.01). Control group were matched with patients for age, gender and living area. Conclusion: Given that a high correlation has been demonstrated between positivity rate of anti-T. gondii IgG and RA in Northeastern Iran, further studies will be necessary to clarify the pathogenesis of T. gondii among these patients. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to determine the prevalence and intensity of nematode infections in sheep located in northeastern Iran from Apr 2018 to Mar 2019. Methods: Gastrointestinal nematodes of 300 sheep were inspected. The season of slaughter, anatomic location where the parasite was located, the animal’s sex, infection prevalence and intensity were recorded. Seasonal differences in arrested larvae numbers also were assessed using Cochran's Q test. Results: Overall, 4,331 adult nematode specimens were collected. Among the examined sheep, 53% (159/300) were infected with one or more nematode species. Among infected sheep, 42.8% were infected with a single species of nematode, 26.4% were infected with two species of nematodes, and 30.8% were infected with three or more species of nematodes. Marshallagia marshalli (13.3%) was the most common nematode recovered from the abomasums of infected sheep, while Trichostrongylus vitrinus (4.6%) was commonly recovered from the small intestines, and Trichuris ovis (25.6%) was commonly recovered from the large intestines. In total, 463 arrested larvae were found in the abomasums of 7.5% of infected sheep and 104 arrested larvae were found in the small intestines of 8.8% of infected sheep. A significantly higher numbers of arrested larvae were found in summer compared to autumn (P<0.001). Conclusion: Intestinal parasites continue to be a problem for sheep in northeastern Iran and additional control measures need to be explored. [ABSTRACT FROM AUTHOR]

Strongyloidiasis is caused by nematode infections of the genus Strongyloides, mainly Strongyloides stercoralis, and affects tens of millions of people around the world. S. stercoralis hyperinfection and disseminated strongyloidiasis are unusual but potentially fatal conditions mostly due to Gram‐negative bacteremia and sepsis, primarily affecting immunocompromised patients. Infections with immunosuppressive viruses such as human immunodeficiency virus (HIV) and Human T‐cell leucemia virus type 1 (HTLV‐1) have been reported as risk factors for strongyloidiasis. Hyperinfection syndrome has been described in HIV‐positive patients following the use of corticosteroids or during immune reconstitution inflammatory syndrome (IRIS). In this research, we conducted a global systematic review and meta‐analysis to assess the seroprevalence and odds ratios (ORs) of S. stercoralis infections in HIV‐infected patients. A total of 3,649 records were screened, 164 studies were selected and evaluated in more detail, and 94 studies were included in the meta‐analysis. The overall pooled prevalence of S. stercoralis infection in HIV positive patients was 5.1% (CI95%: 4%–6.3%), and a meta‐analysis on six studies showed that with a pooled OR of 1.79 (CI95%: 1.18%–2.69%) HIV‐positive men are at a higher risk of S. stercoralis infections (p < .0052) compared to HIV positive women. [ABSTRACT FROM AUTHOR]

Two known types of cutaneous leishmaniasis (CL) including zoonotic CL due to Leishmania major and anthroponotic CL due to Leishmania tropica are prevalent in 14 of 22 countries located in the Eastern Mediterranean region including Iran. According to existing data, CL is endemic in Sabzevar City (northeast of Iran) and, because of the climatic conditions in this semi-desert region, is suitable for living vector/reservoir hosts of infection. The aim of our study was to identify the recent status of CL causative species in rural areas of Sabzevar County. Suspected patients of CL who were referred to health centers in suburban areas of Sabzevar and confirmed via microscopic observation of amastigotes were included in the study. Molecular identification of Leishmania species was done via nested PCR assay, based on amplification of kinetoplast minicircle fragments of L. major and L. tropica. In total, 153 patients including 89 males and 64 females were enrolled in this study. A high infection rate was reported in the autumn season (with a peak in October). Our findings revealed that L. major is responsible for 100% of infections. In addition, there was no association between CL and risk factors after statistical analysis. It seems that the infection pattern of CL is changing predominantly to L. major in most regions of Iran, which may be due to environmental changes, or ecological amendment and their effects on (vector/reservoir) host distribution in rural parts. Finally, controlling programs as well as promotion in public health systems should be considered in this area. [ABSTRACT FROM AUTHOR]

Objective: The present investigation aims to evaluate the prevalence of IgM and IgG anti-7, gondii antibodies and the associated risk factors among healthy blood donors in Mashhad city, Razavi Khorasan province, Iran. Methods: We screened a total of 500 serum samples by census method from apparently healthy blood donors of the Mashhad Blood Transfusion Organization (MBTO) for IgG and IgM anti-T gondii antibodies by enzyme linked immunosorbent assay (ELISA). Results: We found that 29.6%, 25%, 1.4%, and 3.2% of tested donors were positive for anti-T gondii antibodies, only IgG antibody, both IgM and IgG, and IgM antibody alone, respectively. Several risk factors which were significantly related to T gondii seropositivity in the univariate analysis at P < 0.05 included female gender (OR = 3.222, P < 0.001), age more than 40 years (P = 0.026), and sausage/hot dog consumption (OR = 4.472, P < 0.001). Conclusions: The results of this study can be a warning for blood transfusion organizations to pay special attention to toxoplasmosis among blood donors and also design screening programs for prevention of transfusion-transmitted toxoplasmosis. sis [ABSTRACT FROM AUTHOR]

Background: In this study, two-dimensional gel electrophoresis (2-DE) method was applied to determine and compare the protein spots expressed in the two field isolates of Leishmania major and recovered from the patients who were clinically sensitive and resistant to Glucantime® treatment. Methods: Leishmania parasites were isolated from the cutaneous lesions of two CL infected patients in Shiraz, south of Iran. The species of the two isolates were identified as L. major using Nested-PCR. Sensitivity (Sh-214S) and resistance (Sh-120R) of the two isolates to meglumine antimonite were checked by the standard in vitro assays. Both sensitive and resistant L. major isolates were harvested in RPMI 1640 medium. Protein extractions were performed using TCA/Acetone method and the protein spots were determined by a two-dimensional gel electrophoresis (2-DE). The gels were stained with silver nitrate and analyzed by Image Master 2D Melanie-6 software. Results: About 2967 protein spots were detected. Overall, 89 protein spots represented considerable changes of expression in the resistant isolate of L. major compared to the sensitive isolate. Of these, 60 and 29 protein spots were up-and down regulated, respectively. In addition, 11 protein spots present in the resistant isolate were noticed to be absent in the sensitive isolate. Conclusion: A number of proteins showed significant changes of expression in the drug-resistant L. major; moreover, the roles of these proteins probably enhanced the parasite resistance to the drug and increased parasite survival in the cells. [ABSTRACT FROM AUTHOR]

Leishmania infantum is the most frequent cause of visceral leishmaniasis and L. tropica has been rarely linked to the disease in Iran. In this study, bone marrow aspirates were collected from 10 child patients, suspected with visceral leishmaniasis referred to the Pediatric Wards of Kerman Medical Hospitals, Kerman, Iran during 2002-2011. Leishmania species were identified by using nested PCR in all slides. The PCR samples from nine patients indicated L. infantum as principal causative agent of visceral leishmaniasis and one L. tropica as a minor species. [ABSTRACT FROM AUTHOR]

Background Malaria transmission through blood transfusion is an accidental but preventable cause of malaria infection and is increasingly becoming a matter of concern for blood transfusion services. This systematic review was conducted to provide a summary of evidence about the prevalence of Plasmodium infection in asymptomatic blood donors and the effectiveness of screening methods used based on the available literature. Methods PRISMA guidelines were followed. Scopus, PubMed, Science Direct, and EMBASE were searched from 1982 to October 10, 2017. All peer-reviewed original research articles describing the prevalence of malaria parasitemia in blood donors with different diagnostic methods were included. The random-effects model was applied to assess the effects of heterogeneity among the selected studies. Incoherence and heterogeneity between studies were quantified by I 2 index and Cochran's Q test. Publication and population bias was assessed with funnel plots and Egger's regression asymmetry test. All statistical analyses were performed using Stata (version 2.7.2). Results Seventy-one studies from 21 countries, 5 continents, were included in the present systematic review. The median prevalence of malaria parasitemia among 984 975 asymptomatic healthy blood donors was 10.54%, 5.36%, and 0.38% by microscopy, molecular methods (polymerase chain reaction), and rapid diagnostic tests, respectively. The most commonly detected Plasmodium species was P. falciparum. Conclusions This systematic review demonstrates that compared with other transfusion-linked infections, that is, HIV, HCV, and HBV, transfusion-transmitted malaria is one of the most significant transfusion-associated infections especially in Sub-Saharan Africa. Future work must aim to understand the clinical significance of transfusion-transmitted malaria in malaria-endemic settings. [ABSTRACT FROM AUTHOR]

Abstract Background Malaria is still a major public health problem in subtropical and tropical regions. The rapid and accurate diagnosis of malaria remains a challenge in most of the endemic areas. The primary objective of the present study was to evaluate the performance of multiplex/nested PCR in detecting Plasmodium falciparum at low parasite densities and mixed infection. Methods The study was performed in the Sistan-Baluchestan province of the southeastern Iran, from May 2015 to July 2016. A total of 105 patients suspected to malaria infection were enrolled in the study. The obtained DNA products, extracted from the thick/thin films, were analyzed by multiplex/nested PCR using genus-specific primers and compared with light microscopy. Results 43 samples were confirmed to be infected by microscopic examination. Among 43 microscopically diagnosed P. falciparum cases, 11.4% (12/105) were confirmed by multiplex/nested PCR, 36.2% (38/105) were confirmed as P. vivax , 1.9% (2/105) had mixed infections with P. falciparum and P. vivax. Among microscopy-negative samples, 10 samples turned malaria-positive in nPCR. In multiplex/nested PCR, the rate of mixed infections was 8.6% (9/105). When compared to LM, the sensitivity, specificity, positive predictive value and negative predictive value of multiplex/nested PCR were calculated to be 82.8, 91.5, 92.3 and 81.1%, respectively. Conclusion In this study, we showed that microscopic examination of blood smears does not reliably distinguish Plasmodium species in the case of mixed infections. Therefore, it seems that multiplex/nested PCR is a good candidate for examining the presence of malaria parasites in clinically suspected but microscopically negative cases. Highlights • 1-This research was done in order to Implementation of Malaria Elimination Program in Iran. • 2-The use of Multiplex/nested PCR test was able to detect all microscopy-positive samples as well as single or mixed infections and submicroscopic infections that were missed by Light Microscopy. • 3-DNA extraction was attempted from Giemsa-stained blood smears on glass slides from all patients with suspected malaria. [ABSTRACT FROM AUTHOR]

• Gene expression in AH and PBMC in active ocular toxoplasmosis and controls. • While the expression for IL-10 and IL-17 in the AH was increased, TGF-β was decreased. • Expression for IL-10, IL-17 and TGF-β in AH followed an opposite pattern compared to PBMC. • The expression levels for IL-17 in PBMC was not upregulated. • Our results strongly indicate an underlying local rather than a systemic immune regulation. To compare mRNA expression of interleukin 10 (IL-10), interleukin 17 (IL-17) and Transforming Growth Factor-β (TGF-β) in aqueous humor (AH) and peripheral blood mononuclear cells (PBMCs) in human ocular toxoplasmosis (OT) and controls. RNA isolation, cDNA synthesis and real-time polymerase chain reaction were performed on AH sediments and PBMCs of 16 patients with active OT and 21 controls at the Khatam-al-Anbia Eye Hospital, Iran. For comparison, Mann Whitney U test was used at a discrimination level of p < 0.05. Pearson and Spearman rank correlation test were applied for correlation with clinical parameters. The expression for IL-10 and IL-17 in the AH was 3.7- and 88.0-fold higher in OT than in controls (P = 0.04 and P = 0.03, respectively) whereas that of TGF-β was 7.7-fold lower (P < 0.001). The expression levels for these cytokines in PBMC followed a similar pattern (IL-10 13.8-fold down-regulated (P = 0.001), IL-17 with 1.9-fold insignificantly upregulated (p = 0.43), TGF-β 452.8-fold down-regulated (P = 0.002). Compared to PBMC, IL-10 coding mRNA was 1876-fold higher in the almost cell-free AH in OT (39.2-fold in controls), IL-17 coding mRNA was 9.4-fold higher (17.7-fold down-regulated in controls), and that coding for TGF-β 207-fold higher in OT (7x105-fold in controls). The expression for IL-10, IL-17 and TGF-β in AH thus followed an opposite pattern compared to that in PBMC. OT induces a highly-specific local immunoregulatory process as evidenced by an intraocular up-regulation of IL-10 and down-regulation of TGF-β mRNA. This could indicate an attempt to prevent unnecessary tissue damage which is in line with a moderate local mRNA up-regulation for IL-17 which seems sufficient to control parasite proliferation. That this regulation is opposite to that in PBMC may be linked to intraocular immune deviation in the course of disease. [ABSTRACT FROM AUTHOR]

Becoming armed with an appropriate strategy to isolate the minimum number of human papillomaviruses (HPV), regardless of DNA extraction method, can be a huge step in preventing false negative; it has a significant effect on the management and control of HPV infection among women's population. This study was conducted in Qom province, considering the risk factors associated with HPV. It was able to analyze genetic evolution in its genotypes and evaluated the limit of detection by a new diagnostic approach. Totally, 486 Pap smear samples were tested; then, the HPV DNA was developed by a semi-nested quantification PCR. Positive samples were sequenced and submitted to the GenBank (MG825048–MG825061). After alignment, phylogenetic and polymorphism analyses were performed on the sequenced samples with a number of GenBank sequences. The overall HPV prevalence among all women in Qom was 11.7%. HPV6 (43.24%) and HPV16 (6.75%) were the most frequent LR and HR genotypes, respectively. Although the Tajima's D of all genotypes was positive, it was negative individually. The position of genotypes 6, 11, and 73 was controversial on phylogenetic trees. Limit of detection (LOD) was obtained as about 10–100 copies per reaction in various genotypes of HPV by semi-nested qPCR. The nature of HPV could be preserved during natural selection. This research, through innovative usage of the primers, could detect different genotypes of the HPV, and inform the women society of the probable risk through its prevalence determination. • Determination of HPV prevalence in different area is important for management of infection. • Nested-qPCR method can be effective in determine limit of detection of HPV. • The phylogenic trees can be used for identification of HPVs genotypes. • Tajima's D index is helpful in examining the evolution of the HPVs. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori is a universal pathogen that causes gastric diseases and cancers in humans. In recent years, several virulence genes have been detected in this microorganism. Thus, we aimed to investigate the frequency of Helicobacter pylori strainswith cytotoxin-associated gene A ( cagA ) and outer membrane inflammatory protein A ( oipA ) genotypes among children and adult patients in Tehran, Iran, and evaluatetheir relation to themanifestations of different clinical symptoms., Methods: In this cross-sectional study, biopsy specimens were obtained from patients with gastrointestinal symptomsand evaluated for Helicobacter pylori infection and its genotypes ( cagA / oipA) througha polymerase chain reaction PCR assay. Clinical findings and demographic data of patients were documented and analyzed., Results: A total of 80 patients with Helicobacter pylori infectionwere included in the study (34 children and 46 adults). The cagA and oipA genotypes of Helicobacter pylori wereidentified in 22 (64.7%) and 24 (70.5%) children and in 31 (67.3%) and 34 (73.9%) adults, respectively. These differences were not statistically significant between the 2 studied groups. In addition, the frequency of cagA -positive strains of Helicobacter pylori wasfound more among patients with gastric ulcers rather than other clinical outcomes., Conclusion: Our findings demonstrate a highfrequency of Helicobacter pylori strains with oipA and cagA genotypes among children and adults in this region. Although we could not find a significant relationship between virulence genes and clinical outcomes in the patients, further studies are suggested to evaluate these factors in patients and assess their potential roles in the presence of antibiotic-resistant strains., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Background: Visceral leishmaniasis (VL), so-called Kala-azar is a life threating parasitic infectious disease caused by Leishmania spp. L. infantum is the main causative agent for Mediterranean form of Kala-azar which is endemic in northeastern Iran. This study attempted to investigate existence of canine visceral leishmaniasis (CVL) in Khorasan Razavi., Methods: Between 2014 and 2016, tissue samples collected from spleen and liver of 192 stray dogs were examined to investigate existence of L. infantum . Kinetoplast DNA (k-DNA) PCR was performed to identify the species of parasites. The positive PCR products were sequenced in both directions to confirm the kDNA PCR results., Results: Among samples obtained from 192 dogs, kinetoplast DNA of L. infantum was detected in two female dogs. L. infantum was confirmed by sequence analysis of PCR products., Conclusion: Our data confirm stray dogs play as potential reservoirs for VL in this province. Further investigation will be necessary to clear role of stray dogs in the transmission of L. infantum to human and domestic dogs., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests.