Search

Background: This study's major aim is to investigate the situation of visceral leishmaniasis vectors, with a focus on their distribution and relationships to the disease in Iran and some other old-world nations. Methods: The terms Iran and the Old World, along with the keywords sand flies, vectors, visceral leishmaniasis, distribution, and Phlebotomus, were searched in electronic databases from 1930 to 2018, including Pub-Med, Web of Science, Google Scholar, and MEDLINE. Results: According to the findings, Phlebotomus tobbi was a mountain species, but it was also found in the plains, rodent nests, and rock crevices. This species was considered to be one of the vectors of visceral leishmaniasis in Iran. Phlebotomus kandelakii has been caught in Afghanistan, Iran, Lebanon, Turkey and Georgia. In Iran, the first infection of Phlebotomus kandelakii and Ph. perfiliewi transcaucasicus with Leishmania infantum were reported in northwest of Iran. Phlebotomus major was one of the complex sand flies, and its members include Ph. major (India, Nepal, and Pakistan), Ph. neglectus (Southern Europe, Crimea and Iran), Ph. syriacus (Southwest Asia, Caucasus), Ph. notus (Afghanistan and Iran), Ph. wenyoni (Iran and Iraq), and Ph. wui (China). The first natural infection of Ph. alexandri with Leishmania infantum was reported in 2006 in endemic foci of visceral leishmaniasis in Fars Province, southern Iran. Conclusion: The findings of this project suggest that sand fly species of the subgenus Larrousisus play a key role in the transmission of all types of visceral leishmaniasis in Iran. [ABSTRACT FROM AUTHOR]

Background: Iran is a country with a high prevalence of visceral leishmaniasis (VL) and seven endemic provinces. In this study, we tried to identify unobserved classes of knowledge among Iranians toward VL and assess the predictors of each latent class. Methods: This cross-sectional study was conducted among randomly selected participants from endemic and non-endemic areas of VL in Iran in 2020 and 2021. The collected data included demographic characteristics and questions about knowledge, attitude, and practice toward VL. We performed latent class analysis using a procedure for latent class analysis (PROC LCA) in SAS to identify the class membership of knowledge of participants toward VL. Results: Five latent classes were identified: very low (38.9%), low (15.5%), moderate (6.2%), high (14.1%), and very high (25.2%) knowledge about VL. Living in endemic areas significantly increased the odds of belonging to the low (adjusted OR (AOR = 7.23; 95% confidence interval (CI):4.52–11.58), high (AOR = 2.71; 95%CI: 1.73–4.23), and very high (AOR = 8.47; 95%CI: 5.78–12.41) classes compared to the very low class. Also, having academic education increased the odds of membership in the very high class (AOR = 2.36; 95%CI: 1.61–3.47) compared to the very low class. Conclusion: This study revealed that more than 50% of the participants fell into the latent classes of very low and low knowledge toward VL. Some educational workshops in the endemic areas could be effective in enhancing knowledge about VL. [ABSTRACT FROM AUTHOR]

Objective: Phlebotomine sand flies are the primary vectors of leishmaniasis; visceral form of disease is transmitted mainly by species belonging to Larroussius and Adlerius subgenus. Species identification of some females in Larroussius subgenus is not easy due to the high similarity. Accurate species identification enables control operations to target only main vectors and increase understanding of ecological needs, bionomic characteristics, and behavioral traits. The purpose of current study was to use two approaches based on internal and external morphological characters to identify the wild caught of female specimens belonged to Larroussius subgenus and investigate Leishmania infection. Methods: Totally, 128 specimens belonging to Larroussius' subgenus were collected from a VL focus in northwestern Iran, species differentiation was done by two approaches proposed in literature: (1) characters of pharyngeal armature, number of Spermathecal segment, length of spermathecal neck, palpal and ascoid formulae; (2) blindly on the basis of the shape of the base of spermathecal duct. Their potential infection to Leishmania was investigated by kDNA-Nested-PCR. Results: The results of species identification were consistent based on two methods. Among three identified species, Phlebotomus perfiliewi was found to be the dominant species, followed by Ph. neglectus and Ph. tobbi. Two specimens of Ph. perfiliewi were found to be infected by Leishmania infantum, which emphasizes the role of this species in VL transmission in study area. Conclusion: It is suggested that combination of the characters used here be considered for species identification of female of Larroussius subgenus to take advantage of maximum characters, especially where species present sympatrically. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is a rare infectious disease observed in subtropical and tropical areas. This disease that demonstrates different clinical characteristics is caused by intracellular Leishmania protozoan. One of the important countries facing the incidence of this infectious disease is Iran. Recently, human immunodeficiency virus–Leishmania coinfection has been indicated in Iran. Case presentation: In the present case report, we show an atypical case of severe visceral leishmaniasis in a 52-year-old Iranian-Arab male with positive human immunodeficiency virus status. Leishmaniasis was detected by node biopsy and subsequently histopathology evaluations and confirmed by molecular methods. Conclusions: The current study was the first report of an atypical case of a patient with Leishmania–human immunodeficiency virus coinfection in southwestern Iran, which was not responsive to the treatment. Therefore, the health authorities should be aware of these reports, which require permanent clinical follow-up of the patients as well as effective treatments. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) is one of the most important neglected tropical diseases. The zoonotic form of VL is endemic in some areas of Iran. We aimed to determine the status of VL identified in humans and canines in different parts of Iran from 2013 to 2022. Method: A national representative cross-sectional study was conducted in 10 provinces of Iran, including the national leishmaniasis reference lab. We employed the direct agglutination test (DAT) as a reliable serological method to detect anti-Leishmania infantum antibodies in humans and animal reservoir hosts. Additionally, a narrative literature review was conducted to identify relevant studies on VL seroprevalence in Iran from 2013 to 2023. Results: The results of 21281 human and 5610 canine serum samples from 2013 to 2022 are reported. Altogether, 448 (2.1%, 95%CI: 2.0-2.3) human serum samples showed anti-L. infantum antibody levels of ≥1:3200. Of these samples, 13716 (64.5%) were collected actively, which showed a seroprevalence of 0.6% (95% CI: 0.5-0.8) and 7565 (35.5%) were collected passively, which showed a seroprevalence of 4.8% (95%CI: 4.3-5.3). Overall, 1035 (20.1%, 95%CI: 19.0-21.2) of 5160 domestic dogs (Canis familiaris) samples showed anti-L. infantum antibody levels of ≥1:320. Northwest (...,^%) and northeast (0.96%) regions had the highest human VL seroprevalence, while northwest (21.5%) and south (14.4%) regions had the highest canine VL seroprevalence. Conclusion: Zoonotic VL, an endemic parasitic disease, is still present in several different distinct areas across Iran. While human VL cases have shown a declining trend over the last decade, the prevalence of canine VL remains significant. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (Kala-azar) is an inherently dangerous and progressive disease that can be seen in many parts of the world, including Iran. Therefore, we decided to conduct this study on children with Kala-azar in Rasht-Iran. Methods: In this descriptive study, the hospital records of all children with Kala-azar disease admitted to 17 Shahrivar Hospital, Rasht-Iran from 2009 to 2021 were reviewed. Required information were collected from patients' records and descriptive statistical analysis was done using SPSS version 24 statistical software. Results: A total of 22 children with visceral leishmaniasis were admitted to 17 Shahrivar Hospital during the study period. The average age of the children was 2.93 ± 3.32 years. Most of them (59.1%) were boys and lived in the foothills (59.1%). The most common season for children to get the disease was spring (45.5%), and the average duration of the disease until hospitalization was 16.5 ± 13.54 days. In this study, the most common clinical manifestations included fever (90.9%), splenomegaly (77.3%), hepatomegaly (50%), weakness and restlessness (27.3%), and vomiting (18.2%). The most common laboratory findings were anemia (90.9%), leukopenia (59.1%), increased erythrocyte sedimentation rate (ESR) (75%), and increased C-reactive protein (CRP) (75%). 72.7% of the children were treated with liposomal amphotericin and others with glucantime, which were all successful. Conclusion: The results of our studies were consistent with most studies in Iran and other countries. These findings can help in the diagnosis and management of children with Kalaazar and better control of the disease in the province. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is currently considered a re-emerging or emerging infection based on the geographic region. The outcome of leishmaniasis vastly depends on Leishmaniahost interaction. This preliminary study aimed to show the association of human leukocyte antigen (HLA) class I and II genes with healed and non-healed cutaneous leishmaniasis (CL), and symptomatic and asymptomatic visceral leishmaniasis (VL) compared with control groups in Iran. Methods: Ninety-five people, including 31 patients versus 64 individuals in the control group, were enrolled. Among them, 20 patients had confirmed CL based on amastigote observation, 10 had improved CL and 10 non-healed CL. Eleven patients were suffering from confirmed VL based on direct agglutination test (Five asymptomatic and six symptomatic VL cases). Besides, they were residents in an endemic area of VL in the northwest of Iran. To select a control group, it was ensured that they had no history of leishmaniasis. Peripheral blood samples were collected from each patient. After DNA extraction, HLA typing was conducted using polymerase chain reaction - sequence-specific priming (PCR-SSP). Subsequently, data were statistically analyzed by SPSS. Results: There was a statistical relationship between the presence of HLA-A26 and CL, healed CL and the existence of the B38 allele, C1 allele and symptomatic VL, as well as B1.4 allele and asymptomatic VL (P<0.05). Conclusion: This primary finding indicates that several HLA genes have a potential role in the susceptibility of Iranian people to CL and VL. [ABSTRACT FROM AUTHOR]

Background: After the earthquake in 2017 a few new cases of visceral leishmaniasis (VL) were reported from SarPol-e-Zahab district of Kermanshah Province, western part of Iran. This study was conducted to determine the seroprevalence in Kermanshah Province. Methods: This descriptive cross-sectional study was conducted on children up to 12 years of age from SarPol-e-Zahab County, Kermanshah Province, western part of Iran in 2021. For each individual, a questionnaire including age, sex, clinical features, history of the disease, and contact with canines as reservoir hosts of VL were completed, separately. To determine VL seroprevalence, blood samples were collected from the children and after centrifugation, the sera samples were separated and tested using Direct Agglutination Test (DAT) for detection of anti-L. infantum antibodies. Statistical analyses were performed using SPSS16. Results: Totally, 13 persons were seropositive; 7 samples with titer 1:800, 3 samples had 1:1600, 2 samples had 1:3200 and 1 sample had 1:6400. None of the seropositive cases had a history of kala-azar. There was no significant difference between males and females at titers of anti-Leishmania specific antibodies. Conclusion: L. infantum infection is being circulated with low prevalence in children up to 12 years old from SarPol-e-Zahab County but it is necessary that the surveillance system is regularly monitored among physicians and public health managers in the studied areas. [ABSTRACT FROM AUTHOR]

Background: In recent years, cases of human visceral leishmaniasis (HVL) have been reported in some districts of Golestan Province, northeastern Iran, particularly in rural areas. Recent epidemiological evidence in Leishmania infantum endemic regions of in Iran indicates approximately 50%–80% of seropositive dogs are asymptomatic for Leishmania infection. Objectives: The goal in this study was to determine Leishmania species infecting domestic dogs in Golestan Province, Iran. Methods: Between 2015 and 2016, blood samples were obtained from 100 domestic dogs in rural regions of Golestan Province, northeastern Iran. All samples were tested for anti‐Leishmania antibodies using a direct agglutination test (DAT), and for Leishmania spp. kinetoplast DNA (kDNA) using PCR. Results: Seven (7%) dogs were antibody positive and 25 dogs (25%) were Leishmania spp. DNA positives by PCR positive for leishmaniasis. Four of the seven (71%) antibody‐positive dogs and 19 of the 25 (76%) PCR‐positive dogs were asymptomatic. The rate of infection detected by PCR was significantly higher in male dogs (21/75, 28%) than that in female dogs (4/25, 16%). The ITS1 PCR‐RFLP assay identified the presence of L. infantum, L. tropica or Crithidia spp. in the 25 PCR‐positive samples. Conclusions: The high proportion of asymptomatic dogs in the study areas represent they act as potential reservoirs in the transmission cycle of Leishmania spp. and also Crithidia fasciculata as an emerging agent for the first time. Moreover, our data showed that PCR is a more reliable assay than DAT for detecting Leishmania spp. infection among asymptomatic dogs. [ABSTRACT FROM AUTHOR]

Ticks play an important role in the transmission of parasitic diseases, especially pathogenic protozoa in canine hosts, and it is very important to determine the role and extent of their infection with these pathogens in order to determine important control strategies. This study assessed the molecular prevalence of three protozoan pathogens including Hepatozoon canis , Leishmania spp. and Babesia spp., in ticks using PCR. A total 300 stray dogs were investigated and 691 ticks (171 male, 377 female and 143 nymph) were detected directly from 45 infested dogs. Species, stage of growth, and gender were determined for each tick. DNA extracted from 224 ticks (26 male, 165 female and 33 nymph). The molecular presence of three protozoan pathogens including Hepatozoon spp. (18S rRNA gene), Leishmania infantum (kinetoplastid minicircle DNA) and Babesia spp. (ssrRNA gene) were investigated using PCR method. One species of ticks, Rhipicephalus sanguineus was identified. Two of the target pathogens, Hepatozoon spp. (7/83; 8.43 %) and Babesia spp. (1/83; 1.2 %), were detected by PCR method. Sequence analysis of the ssrRNA gene of detected Babesia spp. showed a close relationship to the deposited strains of Babesia vulpis in the gene bank. To the best of our knowledge, this is the first study to undertake a phylogenetic analysis of H. canis and Babesia spp. in stray dogs in Alborz province, Iran and the first report about molecular detection of Babesia vulpis from tick infesting dogs in Iran. According to the above results, it seems necessary to implement tick control programs in dogs. [Display omitted] • This study is the first report about molecular detection of Babesia vulpis from tick infesting dogs in Iran. • This is the first investigation of the possible role of ticks in the transmission of visceral leishmaniasis in dogs in Alborz province, Iran. • This is the first study to undertake a phylogenetic analysis of H. canis and Babesia spp. in stray dogs in Alborz province, Iran [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) also known as Kala-azar is considered as one of the zoonotic infections in Mediterranean countries. The disease reservoir and vectors are dogs and sandflies respectively. Due to reported sporadic cases of Kala-azar in the past five years in Shahroud County, Semnan Province, Iran, this study aimed to investigate the status of this infection in this area and to determine its seroepidemiology to take required measurements for infection control and treatment. Methods: This study was conducted on 504 subjects residing in seven villages in Shahroud County. Blood samples were randomly selected using the cluster sampling method and were collected from subjects aged up to 13 years old (90%) and adults over 13 years old (10%) from September to May 2019. After separating sera from whole blood, samples were subjected to direct agglutination test (DAT) to detect anti-Leishmania infantum antibodies. A range of 1:10 to 1:800 dilutions were prepared from the samples. Results: Results of 1:800 titration indicated that no sample was positive for antibodies against L. infantum. After the secondary screening, 10 cases (1.98%) showed the antibody titer of 1:100, while four cases (0.79%) showed the antibody titer of 1:400. Of 14 cases with the L. infantum antibodies, all were detected from the children <13 years old. According to clinical findings, no patient was suffering from fever, weight loss, splenomegaly, hepatomegaly, and cachexia and therefore did not show the Kala-azar symptoms. Conclusion: The results of the current study indicate that Kala-azar is not prevalent in Shahroud County. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) caused by the Leishmania donovani complex that is transmitted by the bites of female sandflies. Mediterranean type of VL caused by L. infantum. While, Roudbar County of Guilan Province has been introduced as a suspected cutaneous leishmaniasis focus; there are no published data on the seroprevalence of VL in Guilan Province. We aimed to investigate the seroprevalence of this disease in Roudbar County. Methods: This descriptive cross-sectional study was carried out in 2019-2020 among children less than 12 years of age to determine the seroprevalence of VL by direct agglutination test (DAT). Blood samples were randomly collected from 918 children under 12 years of age refers to the public health center in the clusters. Results: Out of 918 children, 14 (1.52%) showed anti-Leishmania antibodies, with 4 (0.43%), 2 (0.21%), 8 (0.87%) anti-L. infantum antibodies at titers 1:800, 1:1600 and =1: 3200 respectively. All children with anti-Leishmania antibody titers of =1:800 were evaluated by a physician. Clinical manifestation of VL including fever, anemia and hepatosplenomegaly observed in a 6-year-old boy from Defraz village with anti-Leishmania antibody of titers =102400.This patient was admitted to the pediatric hospital in Rasht, capital of Guilan province, Iran and was successfully treated. Conclusion: VL is being circulated with low prevalence in children up to 12 years old in Roudbar, northern part of Iran. Accordingly, it is critical to improve the awareness of physicians and public health supervisors about the importance of this fatal disease in Guilan province and especially in Roudbar area. [ABSTRACT FROM AUTHOR]

Background: The magnitude of the health problems caused by leishmaniasis has been a major driving factor behind the development and implementation of leishmaniasis control programs by the national authorities in Iran, with a priority for health and environmental management. Such programs are not achievable unless all of the factors leading to the infection, including the parasite's life-cycle, vectors and reservoirs, are recognized. So far in Iran, humans and rodents have been considered the principal reservoirs of Leishmania tropica and Leishmania major, respectively, both associated with cutaneous leishmaniasis (CL), with domestic dogs considered to be the main reservoir for Leishmania infantum, associated with visceral leishmaniasis (VL). The role of other mammals in maintaining the Leishmania parasite has remained unclear. This study aimed to investigate Leishmania infection among livestock in endemic areas of VL and CL in Fars province, southern Iran, using serological and molecular methods. Methods: Blood samples from 181 clinically healthy livestock, including 49 sheep, 114 goats, 16 cattle and two donkeys, were screened to detect Leishmania DNA and anti-Leishmania antibodies using qPCR (quantitative PCR) and the direct agglutination test (DAT), respectively. Four qPCR-positive samples were amplified using the internal transcribed spacer one (ITS1) primers in conventional PCR and sent for directional sequencing. Results: Of the 181 livestock tested, 51 (28.2%) were infected with Leishmania, using serological and molecular methods. Anti-Leishmania antibodies were detected in 70 (38.7%) (95% confidence interval [CI]: 31.5–46.2) and Leishmania DNA in 93 (51.4%) (95% CI: 43.9–58.9) livestock. The identified Leishmania spp. were L. infantum and L. major. Conclusions: The findings of the present study show a relatively high prevalence of Leishmania infection among livestock in endemic areas of the disease, in Fars province, southern Iran. Given the large population of this group of animals and the fact that they live in the vicinity of the main reservoirs of the disease and vectors, it seems that sand flies regularly bite these animals. Further studies are needed to determine the role of livestock in the parasite's life-cycle and the epidemiology of Leishmania infection. [ABSTRACT FROM AUTHOR]

Background: Despite the broad distribution of leishmaniasis in Iran, there is a little genetic information about the causative agents and epidemiological status of the disease. Genetic diversity of the parasite is suggested to be one of the factors, which influences the clinical manifestations of the disease. In this study, we investigated the genetic variations, population structure, and evolutionary history of Leishmania species from endemic foci of Iran. Methods: Fifty-two isolates from humans, canines, and rodents from different endemic foci of Iran were used to sequence the N-acetyl glucosamine-1-phosphate transferase (Nagt) gene. Phylogenetic and structure analyses were performed to investigate inter- and intra-species diversity of the Leishmania isolates. Results: In total, 10 haplotypes including L. major (n = 6), L. tropica (n = 2), L. infantum (n = 1) and L. turanica (n = 1) were identified across 52 isolates. Haplotype diversity (Hd) ranged from zero for L. infantum and L. turanica to 0.78 ± 0.136 for L. major. This study identified population structure of Leishmania isolates from different geographical regions of Iran. The results of the phylogenetic tree showed 4 distinct clades for each species of Leishmania. In addition, the highest intraspecies diversity was observed among L. major isolates. No correlation was observed between species and geographic distribution of haplotypes. Conclusions: Leishmania isolates were identified at the species level using the Nagt gene, low variation within species indicates conservation of this gene in Leishmania. The results provide knowledge into the evolutionary history of Iranian Leishmania isolates. [ABSTRACT FROM AUTHOR]

Chronic granulomatous disease (CGD) described as an essential immunodeficiency problem of phagocytic cells resulting in a phagocyte dysfunction and inability to kill a spectrum of bacteria and fungi. Despite the fact that CGD patients are more susceptible to intracellular infections, visceral leishmaniasis has been reported rarely in these cases. Here, we report an uncommon case of visceral leishmaniasis in a child with CGD. An 8-yr old boy with CGD presented to the infectious disease ward, Children's Medical Center, Tehran University of Medical Sciences, Iran after the onset of 20 days fever with chronic crusted ulcer approximately 3 cm x 3cm on the left upper limb and a small ulcer measuring 0.5 cm x 0.5 cm on the right knee with moderate secretion. Bone Marrow Aspiration (BMA) and Bone Marrow Biopsies (BMB) of fragmented samples were performed and polymorphic population of hematopoietic cells, Megakaryocytes and Leishman bodies were seen. The patient was treated with meglumine antimoniate (Glucantime®) 20 mg/kg for 28 days and after partial improvement patient discharged and continue the treatment at home. Amphotericin B lipid complex (Ambisome®) (3-5 mg/kg per dose once) was administered every 3-4 weeks for 18 months as secondary prophylaxis that was well tolerated and effective. [ABSTRACT FROM AUTHOR]

Background: Iran is one of the endemic areas of Mediterranean Visceral Leishmaniasis, a disease caused by Leishmania infantum. In this work, we examined whether Proteína quimérica 10 (PQ10) recombinant protein is suitable for immunological diagnosis of human visceral leishmaniasis. Methods: The study was carried out in Tarbiat Modares University during 2016-2018. The coding sequence of PQ10 recombinant protein was sub-cloned in pET28 expression vector and was commercially synthesized by GENERAY Biotechnology, China. Sequencing with proper primers was done, the expression, optimization of expression and protein purification were performed, and the purified recombinant protein was confirmed by western blot. The efficacy of PQ10 for serodiagnosis was evaluated with 50 positive and 50 negative serum samples, which confirmed by the direct agglutination test and collected from individuals living in the visceral leishmaniasis endemic areas of Iran. ELISA was performed with the PQ10 recombinant protein. Results: The 95% CI sensitivity of ELISA that was evaluated with sera from naturally infected individuals was 84%. The 95% CI specificity value of the ELISA determined with sera from healthy individuals (50 serum samples) and from individuals with other infectious diseases was 82%. The 95% CI positive predictive value (PPV) and negative predictive value (NPV) were exterminated 82.35% and 83.67%, respectively. Conclusion: We have used a recombinant synthetic protein to improve serodiagnosis of human visceral leishmaniasis. PQ10 could be useful for diagnosis of asymptomatic cases, as well as in the early phase of infections. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis in human (VLH) also known as kala-azar is a neglected disease of humans that mainly occurs in more than 50 countries mostly located in the Eastern Mediterranean and the Northern America. Objective: The purpose of this study was to determine the temporal patterns and predict of occurrence of VL in Ardabil Province, in northwestern Iran using autoregressive integrated moving average (ARIMA) models. Methods: This descriptive study employed yearly and monthly data of 602 cases of VLH in the province between January 2000 to December 2019, which was provided by the leishmaniasis national surveillance system. The monthly occurrences case constructed the ARIMA model of time-series model. The insignificance of the correlation in the lags of 12, 24 and 36 months, and Chi-square test showed the occurrence of VLH does not have a seasonal pattern. Eleven potential ARIMA models were examined for VLH cases. Finally, the best model was selected with the lower Akaike Information Criteria (AIC) and Bayesian information criterion (BIC) value. Then, the selected model was used to forecast frequency of monthly occurrences case. The forecasting precision was estimated by mean absolute percentage error (MAPE). Data analysis was performed using Stata14 and its package time series analysis. Results: ARIMA (5, 0, 1) model with AIC (25.7) and BIC (43.35) was selected. The MAPE value was 26.89% and the portmanteau test for white noise was (Q = 23.02, P = 0.98) for the residuals of the selected model showed that the data were fully modelled. The total cumulative VLH cases in the next 24 months' in Ardabil province predicted 14 cases (95% CI: 4-54 case). Conclusion: The ARIMA (5, 0, 1) model can be a useful tool to predict VLH cases as early warning system and the results are helpful for policy makers and primary care physicians in the readiness of public health problems before the outbreak of the disease. [ABSTRACT FROM AUTHOR]

Leishmaniasis is a rare complication in adult cases even in endemic areas. Here, the first report of visceral leishmaniasis in a young woman in northeast of Iran has been described. [ABSTRACT FROM AUTHOR]

Background: Over the last decade, a few cases of visceral leishmaniasis (VL) have been reported in some provinces of northeastern Iran. We aimed to investigate clinical and laboratory findings of VL among children who admitted to the pediatric ward in a referral hospital in Mashhad, northeastern Iran. Methods: A retrospective study, between 1997 and 2017, was performed on the data sheet registered for children with confirmed VL at the referral Emam Reza Hospital in Mashhad. Hematological and biochemical profiles of the patients were analyzed. Results: Thirty-five children with VL, confirmed by the presence of amastigotes of Leishmania in Giemsa stained smears of the bone marrow, had been recorded through 20 yr. The mean age of patients was 3.7±4 yr. The majority of the patients suffered from hepatosplenomegaly (100%, n=35/35), followed by prolonged fever and pallor (91%, n=32/35), weight loss (85%, n=30/35). The main laboratory findings were anemia (94.1%), leukopenia (52.9%) and thrombocytopenia (70.5%). Almost one-third (37.1%; 13/35) of VL patients inhabited in rural areas of the Bojnoord district as a known VL endemic focus in northeastern Iran. Conclusion: Our preliminary data showed that the origin of VL is still in some districts other than Mashhad, where VL just will be diagnosed. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Razi Institute is the property of Institut Razi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Visceral leishmaniasis is a common parasitic disease between humans and animals, transmitted by sandflies (Phlebotomus) in the Mediterranean countries, including Iran. The statistics have been reported less than real due to errors in the diagnosis and reporting of affected cases. In this report, we will present the symptoms and manifestations of this disease to reduce late detection and exacerbating factors. The patient was a three-year-old girl from Tehran, Iran who had ascites and hepatomegaly. When she was 9 month-old, she was diagnosed as autoimmune hepatitis after liver biopsy and she was treated with immunosuppressive drugs (Azathioprine, prednisolone, and cyclosporine) for 22 months, but later she suffered from fever, pancytopenia, and hepatosplenomegaly. Then a bone marrow biopsy was done for her. There was a large amount of Leishman body in her bone marrow and treatment for Kala-azar was started for her. In patients with prolonged fever and splenomegaly, especially association with pancytopenia, consider leishmaniasis. Immunosuppressive drugs can disseminate parasitic diseases, including visceral leishmaniasis. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis diseases are known to be one of the most important public health problems in World and Iran. Visceral leishmaniasis is considered to be the most serious form and transmitted by sand flies species. The aim of this study was to investigate the dynamic activities of sandflies in northwestern Iran. Methods: This crass-sectional study was conducted from April to December 2018 in Meshkinshahr County, Ardabil Province. Sticky traps have been used to collect sand flies. They are stored in 70% alcohol and finally identified using valid keys. The aspects of the synoptic information were inquired from the Meshkin Shahr weather department and results analyzed for SPSS24. Results: Totally 259 sandflies were collected during study period. From collected samples 78.7% were male and 21.3% female. There were 8 different species. Phlebotomus kandelakii was the most prevalent one (30.8%). The average temperature, relative humidity, and average wind speed was 13.5 °C, 84%, and 2 meters per hour on the onset of sandflies' activity, respectively. These values were 18.3 °C, 85% and 1.5 meters per hour at the peak of their activity and 16 °C, 62% and 5 meters per hour at the final stage of their activity. Sand flies had one peak in July which is strongly influenced by temperature and humidity conditions. Two species of Ph. kandelakii and Phlebotomus perfilewi transcaucasicus, had the highest activity in this endemic area. Conclusion: The results of current study will provide a guideline for control of diseases in the country. [ABSTRACT FROM AUTHOR]

Background: Mediterranean form of visceral leishmaniasis (VL) is endemic among some provinces of Iran. The present study was designed to determine the prevalence of canine visceral leishmaniasis (CVL) in the owned dogs of the rural areas of Alborz Province near Tehran as the capital of Iran. Methods: This study conducted on 303 owned dogs that selected using a stratified random sampling method. The direct agglutination test (DAT) was used to determine the frequency of Vl. The spleen biopsy was taken from the serologypositive dogs for the confirmation of CVL in the suspected dogs. Nested PCR and sequencing methods were used to determine the type of Leishmania species in the dogs which were parasitological positive. Results: Overall, the DAT results of 9 dogs (2.97%, CI: 1.57-5.55) showed anti Leishmania antibodies at titers ≥ 1:320 indicating VL infection. One dog (0.33%, CI 95%: 0.06-1.85) showed clinical signs and symptoms of VL. There was a significant correlation between the positive cases of CVL and rural area (p< 0.001). The Leishmania was observed in the impression smears that were prepared from spleen biopsy of five the studied dogs. Leishmania infantum were confirmed in all them using nested-PCR assay. The sequence analysis of all five isolates was 95% similar to L. infantum. Conclusion: This study shows that domestic cycle of L. infantum has been established in rural areas of Alborz province where located near Tehran as capital city of Iran. It is necessary to increase the awareness and monitoring of the disease periodically. [ABSTRACT FROM AUTHOR]

Background: Visceral and cutaneous leishmaniasis are common in some areas of Iran and consider as health problems. Phlebotomus alexandri has been incriminated as a suspected vector for the both form of leishmaniasis. Methods: This study was carried out in 4 western provinces of Iran. Sand flies were collected using sticky traps and light traps from indoor and outdoor resting places. Nested PCR was employed to detect Leishmania parasites among collected sand flies. Results: Seven hundred and twenty two P. alexandri females were collected and pooled in 179 batches. Results of nested PCR showed, out of 9 samples from East Azerbaijan Province, only one sample was infected by Leishmania infantum. Of 34 individual and pooled samples from Kermanshah Province, only one pooled sample was infected with Leishmania major and among 30 individual and pooled samples in Fars Province, five specimens were infected by L. major, L. infantum, Leishmania donovani and Leishmania tropica. Furthermore, out of 108 individual and pooled samples from Khuzestan Province, 10 samples showed infection with L. major and L. infantum. Conclusion: The results of this study showed that P. alexandri is more active in hot zones than in moderate zones and this species may be considered as a permissive species. [ABSTRACT FROM AUTHOR]

Copyright of Acta Facultatis Medicae Naissensis is the property of Nis University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the spatial distribution and infection rate of sand flies as vectors of Leishmania parasite in Ardabil province, northwest of Iran. Methods: This was a descriptive cross-sectional study. The sand flies were collected from 30 areas in all 10 districts of Ardabil province during 2017. The specimens were caught using the sticky traps. The head and genitalia of sand flies were separated and mounted in Berlese solution for microscopic identification. The Geographical Information System ArcMap10.4.1 software was used to provide the spatial maps. Results: A total of 2 794 sand flies specimens were collected and 22 species of sand flies were identified from the two genera: Phlebotomus and Sergentomyia from Ardabil province. The highest frequency was found in Phlebotomus papatasi (23.7%) followed by Phlebotomus kandelakii (13.0%). The promastigote form of Leishmania infantum parasite has been reported from the three main vectors of visceral leishmaniasis (Phlebotomus kandelakii, Phlebotomus perfiliewi and Phlebotomus tobbi) from Ardabil province, where the spatial distribution map of these visceral leishmaniasis vectors was prepared. Some important species of sand flies such as Phlebotomus kandelakii, Phlebotomus perfiliewi and Phlebotomus tobbi were reported and identified as main and probable vectors of visceral leishmaniasis in Ardabil. Conclusions: According to the Geographic Information System based maps, the frequency of the sand flies as leishmaniasis vectors, the leishmania parasite infection rate and the prevalence of the disease in the central areas of Ardabil province are higher than in other areas in Ardabil province. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of community-wide deployment of insecticide–impregnated collars for dogs- the reservoir of Leishmania infantum–to reduce infantile clinical visceral leishmaniasis (VL). Methods: A pair matched–cluster randomised controlled trial involving 40 collared and 40 uncollared control villages (161 [95% C.L.s: 136, 187] children per cluster), was designed to detect a 55% reduction in 48 month confirmed VL case incidence. The intervention study was designed by the authors, but implemented by the Leishmaniasis Control Program in NW Iran, from 2002 to 2006. Results: The collars provided 50% (95% C.I. 17·8%–70·0%) protection against infantile VL incidence (0·95/1000/yr compared to 1·75/1000/yr). Reductions in incidence were observed across 76% (22/29) of collared villages compared to pair–matched control villages, with 31 fewer cases by the end of the trial period. In 11 paired villages, no further cases were recorded post–intervention, whereas in 7 collared villages there were 9 new clinical cases relative to controls. Over the trial period, 6,835 collars were fitted at the beginning of the 4 month sand fly season, of which 6.9% (95% C.I. 6.25%, 7.56%) were lost but rapidly replaced. Collar coverage (percent dogs collared) per village varied between 66% and 100%, with a mean annual coverage of 87% (95% C.I. 84·2, 89·0%). The variation in post-intervention clinical VL incidence was not associated with collar coverage, dog population size, implementation logistics, dog owner compliance, or other demographic variables tested. Larger reductions and greater persistence in incident case numbers (indicative of transmission) were observed in villages with higher pre-existing VL case incidence. Conclusion: Community–wide deployment of collars can provide a significant level of protection against infantile clinical VL, achieved in this study by the local VL Control Program, demonstrating attributes desirable of a sustainable public health program. The effectiveness is not dissimilar to the community-level protection provided against human and canine infection with L. infantum. [ABSTRACT FROM AUTHOR]

Objective: There exist various diagnostic tests to detect visceral leishmaniasis, but the most efficient ones have not been demonstrated yet. Herein, we evaluated the accuracy of these diagnostic tests in Iran. Methodology: English and Persian database searching was done from 1993 to 2016. According to heterogeneity of the studies, estimations of the study were pooled by random-effects model. Totally, twenty investigations were eligible for current review with 2115 patients as pooled sample size. Results: The overall pooled estimate of sensitivity and specificity for all diagnostic tests were 0.92 ([95% CI = 0.90-0.95]) and 0.92 ([95% CI = 0.89-0.94]), respectively. Also, the separate sensitivity and specificity of each test were as follow: PCR: 1.00 ([95% CI = 0.99-1.01]) and 0.37 ([95% CI = 0.25-0.49]); DAT: 0.93 ([95% CI = 0.89-0.96]) and 0.92 ([95% CI = 0.89-0.94]); ELISA: 0.78 ([95% CI = 0.47-1.09]) and 1.00 ([95% CI = 0.99-1.01]) as well as IFA: 0.50 ([95% CI = 0.29-0.72]) and 0.96 ([95% CI = 0.95-0.97]). Conclusions: The specificity and sensitivity of PCR and DAT as molecular and serological tests, respectively, are remarkable to detect visceral leishmaniasis; hence, it is highly recommended to simultaneously employ these diagnostic tests for this widespread infection. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) is endemic in Iran and is caused predominantly by Leishmania infantum, but L. tropica is emerging as an important cause. We studied the intra-species population structure of Leishmania spp. causing VL in southwest Iran by sequence analysis of the internal transcribed spacer (ITS) 1 of DNA samples from 29 bone marrow aspiration smears. L. infantum (n = 25) and L. tropica (n = 4) were identified, consisting of 10 and three ITS1 sequence types (STs), respectively. Compared to GenBank ITS1 STs, our L. infantum parasites displayed high heterogeneity but less heterogeneity compared than northwest Iranian isolates. VL affects mostly nomadic populations in southwest Iran, and their mobility may explain partly the L. infantum heterogeneity. The VL causing L. tropica was also genetically heterogeneous but genetically indistinguishable from L. tropica strains causing anthroponotic cutaneous leishmaniasis from southwest Iran. [ABSTRACT FROM AUTHOR]

Background: The fatal form of leishmaniasis is visceral form (VL), found in some of the countries in the world. Visceral leishmaniasis has been reported sporadically from all provinces in Iran, including Lorestan. This study aimed to characterize parasite species in DAT positive and some of the DAT negative human blood samples of Delfan district, Lorestan Province, central Iran. Methods: Blood samples were collected from different geographical areas of Delfan. Serum was used for DAT test and remained part of molecular study. DNA was extracted by using DNG-plus extracted kit (Cinagen, Iran). Polymerase chain reaction amplification of Leishmania kDNA and PCR-RFLP of ITS1 was done to identify Leishmania species. Some amplicons were sequenced, submitted to GenBank and analyzed by BLASTn. Results: Expected band of kDNA for L. infantum (720bp) was amplified in 16 out of 186 (8.6%) samples which showed previously anti-Leishmania antibody at different titers or were negative serologically. Using BLASTn, 93% similarity with L. infantum has been shown. The rDNA-ITS1 was amplified only in 9 samples (4.7%). RFLP pattern was similar to what expected for L. infantum. Conclusion: A new emerging hypo-endemic focus, caused by L. infantum, is going to be established in Delphan District, Lorestan Province. Further studies on vector and reservoirs are necessary for the region and other parts of Lorestan Province. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) or kala-azar is a parasitic disease caused by the species of Leishmania donovani complex. Mediterranean type of the disease is endemic in some parts of Iran and more than 95% of cases were reported in children up to 12 years of age. This study was performed to determine the seroprevalence of VL in the rural areas of the Dashti district from Bushehr province. Materials and Methods: In this cross-sectional study, a randomized cluster sampling method was used for the collection of blood samples from children up to 12 years old from rural areas of Dashti district. Before sampling; a questionnaire was filled out for each case. All the collected blood samples were examined after the serum separating by Direct Agglutination Test (DAT) for detection of anti-Leishmania infantum antibodies. The cutoff titers of ≥1: 3200 with specific clinical features were supposed to be considered as VL. Results: Altogether, 24 out of 1221 (1.96%) blood samples showed titers between 1:800 and 1:1600 which considered as suspicious cases. None of the suspicious cases had a history of kala-azar. None of 1221 collected blood samples showed anti Leishmania infantum (L. infantum) at titer ≥1:3200. Conclusion: This study confirms the circulation of L. infantum in Dashti district and highlights the sporadic pattern of VL in the studied areas which necessitates the surveillance system to be monitored by health authorities. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL), caused by Leishmania infantum (L. infantum), is a life-threatening vector-borne parasitic disease is distributed in some parts of the world. The disease is endemic in some parts of Iran. This study was aimed to determine the seroprevalence of VL among children and domestic dogs (as a reservoir of the parasite) in Dehloran, west of Iran. Materials and Methods: This cross-sectional study was carried out in Dehloran County. The blood samples of 872 children up to 12 years old and 52 dogs were collected from 10 villages of Dehloran using randomlyclustered sampling method. Sera were separated from all peripheral blood samples and tested by direct agglutination test (DAT). Anti-Leishmania infantum antibodies at titers of ≥1:800 and ≥1:80 were considered as Leishmania infantum infection in human and dog, respectively. Results: In general, among 872 human samples, 1.03% of samples had anti-Leishmania antibody with 1:1600 titers and 1.26% had 1:800 titers. In addition, from 52 dog samples, 21.15% of dogs had a titer of ≥1:320 and 25% had 1:80 and 1:160 titers. Conclusion: Our findings indicate that the seropositive dogs in the studied areas are considerable and L. infantum may be circulated between human and domestic dog in the studied area. Further study of isolation and molecular identification of Leishmania spp. is recommended. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis is considered an endemic zoonosis in some parts of Iran and dogs are main reservoirs, which play role in the transmission cycle of human leishmaniasis. This systematic review and meta-analysis was performed to determine the prevalence of canine visceral leishmaniasis (CVL) in Iran. Data were systematically collected from 1982 to 2015 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iran medex and Scientific Information Database (SID). A total of 39 articles concerning dogs, 6 articles on jackals, 4 articles on wolves and 4 articles on foxes, reporting the prevalence of CVL from different regions of Iran fulfilled our eligibility criteria. Totally, 19903 dogs, 151 jackals, 42 wolves and 44 foxes were examined and the overall prevalence rate of CVL in Iran was estimated to be as following: in dogs 16% (95% CI: 13–19%), in jackals 10% (95% CI: 5–15%), in wolves 10% (95% CI: 5–15%) and in foxes 10% (95% CI: 1k19%), respectively. There was a significant difference in infection rate between male and female dogs, the infection in males 9% (95% CI: 8.8–10.5%) was more than females 7% (95% CI: 5.5–7.5%) (p = 0.024). Also, the rate of infection was significantly higher in older dogs than younger ones (p < 0.047) while in dogs younger than 1 year was 12% (95% CI: 6–18%), in 1–2 years 10% (95% CI: 6–14%), in 3–5 years 16% (95% CI: 9–22%) and in those which were over 7 years 31% (95% CI: 19–44%), respectively. Our meta- regression analysis revealed the significant correlation between stray and owned dogs: the infection rate in stray 10% (95% CI: 5–4%) was higher than those owned 6% (95% CI: 3- 8%) (p = 0.037). Also, the prevalence of infection in rural dogs 36% (95% CI: -1–72%) is significantly higher than urban dogs, 19% (95% CI:-1–40%) (p = 0.013). Although most (81%) of infected dogs had no clinical signs (asymptomatic), meta-regression analysis showed that the infection rate in asymptomatic dogs was 14% (95% CI: 11–18%) and in those with clinical signs 3% (95%CI: 2–4%), and the correlation is statistically significant (p = 0.001). The present systematic review and meta-analysis indicates that CVL is common at least in some districts of more than half of provinces of Iran. Further investigation and monitoring will be required to improve the surveillance and control strategies to reduce the incidence of CVL in Iran. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) has strong links with poverty, substantial medical and veterinary impacts. This review aimed to focus in studies published during 1994-2016 on VL in southeastern Iran. Methods: The present review is based on expert knowledge and historical studies published during the past 23 yr (1994-2016) on VL in southeastern Iran. In addition, related literature found in PubMed by using the keywords such as visceral leishmaniasis, kala-azar, and Leishmania infantum are included. Results: Overall, 118 children aged 4.2 yr were detected as infected with human VL (HVL). The majority of the cases were from Orzoieh district (37.1%) in southwest of Kerman Province, followed by Sirjan (15.7%), Jiroft (14.8%), Kahnuj (9.3%) and to lesser extent from other areas. The male to female ratio was 1.7. The three most frequent clinical features were represented by fever (100.0%), anemia (95.0%) and splenomegaly (91.5%). Altogether, 42.0% of the VL cases developed secondary bacterial infections, the overall case-fatality rate was 3.4%, and majorities (88.0%) of the VL patients were undernourished. Overall, 733 dogs and wild canines were examined by different techniques with various seroprevalence ranges. Conclusion: In southeastern Iran, VL is endemic in Orzoieh district in Kerman Province. While the dogs are implicated as the main domestic reservoir of VL, wide range of wild canines can serve as a secondary potential reservoir host. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) is a neglected disease. Our retrospective study describes 38 clinical and epidemiological characteristics of VL in patients admitted to a paediatric hospital in Tehran, Iran, who came from different geographical regions, indicating that the disease has spread to most parts of the country. Some 76.3% of the children documented suffered with symptoms of the disease for two months before admission. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of =1:800. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of =1:3,200 indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran. [ABSTRACT FROM AUTHOR]

Background and Objectives: Two clinical forms of leishmaniasis exist in Iran: cutaneous and visceral. According to the sporadic reports of new cases of Visceral Leishmaniasis (VL) in Lorestan province, real status of VL is not clear, so this study aimed to describe the seroprevalence of VL in Delphan city. Materials and Methods: In this descriptive analytic study, blood samples were collected from children ≤ 12 years and 10% of adults by a multi-stage randomized cluster sampling from January 2012 to September 2012. The sero-prevalence evaluation was done by Direct Agglutination Test (DAT). Based on different studies in Iran, the 1/800 and 1/1600 titers were considered as the infection with L. infantum and the of titers ≥ 1/3200 accompanied with clinical symptoms was considered as VL disease. Results: 800 collected serum samples, 21(2.62%) showed anti-Leishmania antibodies at titers of 1/800 and 1/1600, whereas 5(0.62%) showed anti-Leishmania antibodies at titers of ≥1/3200. But just one of them showed clinical symptoms (anemia and large abdominal) which is under treatment with miltefosine. Conclusion: A new focus of VL with low endemicity is going to be formed in our region, which showed that further studies on vector and reservoirs is necessary in the region and other parts of Lorestan province. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) as one of the most important human parasitic disease is endemic in some parts of Iran. Several cases of VL have been reported recently in the Ilam Province. The current study aimed to assess the present status of human VL in the region. Methods: A random cluster sampling method was used to collect 456 serums samples from the children up to 12 years of age and 10% of adults living in urban and rural areas of the province. All the collected serum samples were tested by direct agglutination test (DAT) to detect anti- Leishmania infantum antibodies. Results: Of the examined 456 serum samples with direct agglutination test (DAT), only 21 (0.43%) sera showed anti- Leishmania antibodies at titers 1:400 and higher. Distribution of anti- Leishmania antibodies titers were: 1:400(n=4), 1:800(n=11), 1:1600(n=3), 1:3200(n=1), and 1:6400(n=1). Individuals with titers ⩾1:3200 showed clinical signs and symptoms such as fever and splenomegaly. The highest and lowest seropositivity were observed in the age groups of 5-9 and >15 years old, respectively. There were no significant difference between the rate of seropositivity in males and females. Conclusion: VL with a low prevalence circulates in some parts of Ilam province, particularly in the southern parts. Complementary studies should be needed to find animal reservoir hosts and vectors. Furthermore, health systems and physicians should pay particular attention to the disease. [ABSTRACT FROM AUTHOR]

Background: A two year seroepidemiological study was designed to find out the seroprevalence and risk factors of canine visceral leishmaniasis (CVL) among stray and owned dogs in Tehran and Alborz Provinces of Iran. Methods: Blood samples of 602 dogs living in 11 counties of Tehran and Alborz Provinces were taken by venipuncture in 2008-2010. After separation of blood sera, anti-leishmanial antibodies were detected by direct agglutination test (DAT). Results: Overall, of the 408 and 194 serum samples collected randomly from dogs in 11 localities in Tehran and Alborz Provinces, 18/408 (4.41%) and 12/194 (6.18%) respectively were found positive. Among the localities, Shemiran in Tehran Province and Karaj In Alborz Province had the highest prevalence rates. No statistically significant differences were found between sex and living place but there was significant difference between living status (owned or stray) and CVL infection of dogs in Alborz Province (P= 0.018). The highest seroprevalence (7.5%) was found in dogs aged 3 to 5 years old. Only 20% of the seropositive dogs were symptomatic. Conclusion: Concerning possible human infections in Tehran and Alborz Provinces, both symptomatic and asymptomatic seropositive dogs should be considered as a risk. [ABSTRACT FROM AUTHOR]

Background: Parasitological methods for the diagnosis of Visceral leishmaniasis (VL) require invasive procedures, so serological and molecular approaches have been developed but are not generally applicable in the field. We evaluated a loop mediated isothermal amplification (LAMP) assay using blood from VL patients and compared it to nested PCR. Methods: Forty-seven subjects with clinical features (fever, hepatosplenomegaly and anemia) were confirmed positive for VL by the direct agglutination test (DAT) at titers >3200. Forty DAT negative individuals from non-endemic areas with no clinical signs or symptoms of VL served as controls. A LAMP assay was performed using a set of six primers targeting Leishmania infantum kinetoplast DNA (kDNA) minicircle gene under isothermal (64 °C) conditions. For nested PCR we used primers targeting the kDNA minicircle gene. Results: The LAMP assay provided a detection limit of 1 parasite in 1 ml of peripheral blood and detected L. infantum DNA in 44 of 47 DAT-confirmed VL cases, with diagnostic sensitivity of 93.6% (95% CI). No L. infantum DNA was amplified in controls, indicating a specificity of 100%. The nested PCR yielded sensitivity of 96% (95% CI) and a specificity of 100% (95% CI). Conclusion: The LAMP assay gave results similar to those of nested PCR but in a shorter time. The LAMP method is simple; requires no sophisticated equipment; has a short reaction time; and results, indicated by turbidity of the reaction mixture, are observable with the naked eye. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL) is a life-threatening vector-borne parasitic disease is distributed in some parts of the new world and old world. The disease is endemic in different parts of Iran. This review article has been focused on major topics of epidemiological aspects and clinical features of VL in Iran for the period of 2002 through 2012. For the detection of VL in humans as well as animal reservoir hosts, anti-Leishmania antibodies were detected using direct agglutination test (DAT) as a validated serological test. Parasitological examinations were performed on suspected VL patients as well as canines and rodents. Different molecular methods were used for identification of species and genotype/ or strain of Leishmania spp. isolated from infected humans, animal reservoir hosts and vectors. Altogether, 1698 out of 36081 (4.7%) human serum samples collected from 5 distinct geographical zones showed anti-Leishmania antibodies at titers≥1:3200 using DAT. The majority of VL cases in the endemic areas were found among children up to 12 years old. Almost 75% of DAT-positive cases (≥1:3200) in endemic areas showed clinical signs and symptoms. Predominant signs and symptoms in 217 hospitalized patients with DAT positive (≥1:3200) results included paleness (99.5%), fever (96.9%), splenomegaly (91.5%), hepatomegaly (53.6%) and lymphadenopathy (21.1%). Integrated VL surveillance system in primary care using DAT, could decrease mortality and morbidity of the disease in the VL endemic areas of the northwestern Iran. Out of 7204 serum samples collected from domestic dogs in various geographical locations of Iran, 879 (12.2%) were DAT sero-positive at titers≥1:320. L. infantum as the principal causative agent of the disease was isolated from infected humans, domestic and wild canines and rodents. The principal animal reservoir hosts of the infection are domestic and wild canines. Ph. kandelakii, Ph. perfiliewi transcaucasicus, Ph. tobbi in northwestern Iran; Ph. major s.l. (=Ph. neglectus), Ph. keshishiani, and Ph. alexandri in southern parts of Iran were molecularly and/or parasitologically positive for L. infantum infections. The zoonotic form of VL (ZVL) caused by L. infantum occurs sporadically in all geographical zones of Iran but in northwestern and southern parts of the country the disease is endemic. DAT as an appropriate and potential tool has been used for sero-diagnosis and sero- epidemiological of VL among humans as well as domestic and wild canines. [ABSTRACT FROM AUTHOR]

Background: The aim of present study was to determine the seroprevalence of canine visceral leishmaniasis (CVL) among stray and owned dogs in Kouhsar district of Alborz Province, central Iran. Methods: The study was performed from March 2011 to July 2011 using Direct Agglutination Test (DAT). Three hundred and thirty seven dogs including 257 stary and 80 owned dogs were selected by random sampling. The agreement between serological data and sex, age, life style of dogs and clinical signs were assessed by Chi-square. Results: DAT showed that from 337 serum samples collected from owned and stray dogs, 12sera (3.6%) were positive. The seroprevalance was 10% (8/80) among owned dogs and 1.6% (4/257) among stray dogs. A significant difference in seroplevalance was seen between owned and stray dogs (P = 0.01). The highest seroprevalence rate (14%) was observed among the ownership dogs of 5 years old and above. Statistical analysis revealed significant relation between seroprelvalence and age (P= 0.02). There was no statistically significant relation between male (6.3%) and female (2.2%) seroprevalence (P= 0.085). Conclusion:This survey indicates the importance and necessity of serologic screening of visceral leishmaniasis in human and dogs in Kouhsar district. [ABSTRACT FROM AUTHOR]

Abstract: Phlebotomine sandflies of the subgenus Adlerius (Diptera: Psychodidae) includes 20 described species and two unnamed from Afghanistan. The female sandflies of this subgenus are considered as indistinguishable morphologically and their identification is based on the identification of associated males. Some species of Adlerius are suspected vectors of visceral leishmaniasis and at least one species has been implicated as a vector of cutaneous leishmaniasis. Four species of Adlerius have been recorded in Iran in the past: P. brevis Theodor and Mesghali, 1964, P. halepensis Theodor, 1948, P. longiductus Parrot, 1928 and P. balcanicus Theodor, 1948. The present study based on a field work carried out all over Iran reports two new species in the country: Phlebotomus turanicus Artemiev 1974 and Phlebotomus salangensis Artemiev, 1978. They have been caught from the North-East of Iran in provinces bordering Turkmenistan and Afghanistan, respectively. A review of the distribution of the Adlerius species of Iran is proposed. [Copyright &y& Elsevier]

Background: Mediterranean visceral leishmaniasis (MVL) is an infectious disease that affects both human and animals. Domestic dogs (Canis familiaris) are principal reservoir hosts of MVL caused by Leishmania infantum. Dogs are definitive hosts for Neospora caninum and a risk factor for infecting intermediate hosts. The immunosuppression caused by visceral leishmaniasis (VL) can promote the occurrence of co-infections with other agents such as neosporosis. This study aimed to determine the frequency of co-infection of the both protozoan parasites in the endemic areas of VL from Meshkin-Shahr District, north-west of Iran. Methods: Altogether, 171 serum samples were collected from domestic dogs of Meshkin- Shahr District by multistage cluster sampling from October 2008 to August 2009. The collected serum samples were tested for the detection of simultaneous infection of L. infantum and N. caninum using direct agglutination test (DAT) and indirect ELISA, respectively. Results: Of the 171 domestic dogs, 27 (15.8%) and 52 (30.4%) were showed antibodies against L. infantum and N. caninum, respectively. Simultaneous infections of N. caninum and L. infantum was found in 16 (9.4%) of the dogs. In VL-positive and VL-negative dogs, N. caninum infection was found in 59.3% and 25.0%, respectively. A statistically significant difference was found between VL-positive and VL-negative dogs with N. caninum infection (P= 0.001). Conclusion: These findings indicate that Meshkin-Shahr District in northwestern Iran is an active focus of canine visceral leishmaniasis (CVL). Neospora caninum and L. infantum co-infection is prevalent in the area and infection by L. infantum seems to enhance susceptibility to N. caninum infection in domestic dogs. [ABSTRACT FROM AUTHOR]

Background: New cases of visceral leishmaniasis (VL) have been reported recently in some parts of Mazandaran Province, north of Iran where the first human case of VL was reported in 1949. This study aimed to determine the present status of Leishmania infantum infection among humans and domestic dogs using serological and molecular methods in central parts of Mazandaran Province. Methods: In this cross-sectional study, blood samples were randomly collected from 402 humans and fortynine domestic dogs throughout 2009 and 2010 in the central part of Mazandaran Province including Semeskadeh and Kiakola districts where recent cases of human visceral leishmaniasis had been reported there. All the collected samples were tested by direct agglutination test (DAT) for the detection of anti- Leishmania infantum antibodies as well as convenience PCR assay on whole blood samples for detection of leishmanial infection and identification of Leishmania species. Results: None of 402 collected human (402) and dog (49) blood samples showed anti Leishmania infantum antibodies at titers 1:3200 and 1:320 as cut-off values of DAT, respectively but only 2 of domestic dogs (4.1 %) were found PCR-positive corresponding to L .infantum. Conclusion: This study confirms the circulation of L. infantum at least among domestic dogs and highlights the sporadic pattern of VL in the studied areas. Further investigations regarding to sand flies fauna and wild canines as reservoir hosts of the disease, are recommended. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To investigate species composition, density, accumulated degree-day and diversity of sand flies during April to October 2010 in Azarshahr district, a new focus of visceral leishmaniasis in north western Iran. Methods: Sand flies were collected using sticky traps biweekly and were stored in 96% ethanol. All specimens were mounted in Puri''s medium for species identification using valid keys of sandflies. The density was calculated by the formula: number of specimens/m2 of sticky traps and number of specimens/number of traps. Degree-day was calculated as follows: (Maximum temperature + Minimum temperature)/2—Minimum threshold. Diversity indices of the collected sand flies within different villages were estimated by the Shannon-weaver formula (). Results: Totally 5 557 specimens comprising 16 Species (14 Phlebotomus, and 2 Sergentomyia) were indentified. The activity of the species extended from April to October. Common sand-flies in resting places were Phlebotomus papatasi, Phlebotomus sergenti and Phlebotomus mongolensis. The monthly average density was 37.6, 41.1, 40.23, 30.38 and 30.67 for Almalodash, Jaragil, Segaiesh, Amirdizaj and Germezgol villages, respectively. Accumulated degree-day from early January to late May was approximately 289 degree days. The minimum threshold temperature for calculating of accumulated degree-day was 17.32°. According on the Shannon-weaver (H′), diversity of sand flies within area study were estimated as 0.917, 1.867, 1.339, 1.673, and 1.562 in Almalodash, Jaragil, Segaiesh, Amirdizaj and Germezgol villages, respectively. Conclusions: This study is the first detailed research in terms of species composition, density, accumulated degree-day and diversity of sand flies in an endemic focus of visceral leishamaniasis in Azarshahr district. The population dynamics of sand flies in Azarshahr district were greatly affected by climatic factors. According to this study the highest activity of the collected sand fly species occurs at the teritary week of August. It could help health authorities to predicate period of maximum risk of visceral leishamaniasis transmission and implement control program. [Copyright &y& Elsevier]

Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged ≤ 12 years in the primary health system in Meshkin- Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran. Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment. Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000. Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (kala-azar) is an endemic disease in some areas of Iran. A cross- sectional study was conducted for sero-epidemiological survey of visceral leishmaniasis (VL) in Baft district from Kerman Province, southeast of Iran. Methods: Blood samples were collected from children up to 12 years old and 10% of adult population from Baft villages with a multi-stage randomized cluster sampling. In addition, blood samples were collected from 30 domestic dogs from the same areas. All the collected blood samples were tested by direct agglutination test (DAT) for the detection of anti-Leishmania antibodies in both human and dog using the cut-off value of ⩾1:3200 and ⩾ 1:320, respectively. Parasitological, molecular, and pathological were performed on infected dogs. Chi-square and Fisher exact tests were used to compare sero-prevalence values. Results: From 1476 collected human serum samples, 23 (1.55%) showed anti-Leishmania antibodies at titers of 1:800 and 1:1600 whereas 14 (0.95%) showed anti-Leishmania infantum antibodies at titers of ⩾ 1:3200. No statistically significant difference was found between male (1.18 %) and female (0.69%) sero-prevalence (P=0.330). Children of 5-8 years showed the highest sero-prevalence rate (3.22%). Seven out of 30 domestic dogs (23%) showed anti-Leishmania antibodies at titers ⩾1:320. Leishmania infantum was identified in five infected dogs by nested — PCR assay. Conclusion: It seems that visceral leishmaniasis is being endemic in southern villages of Baft district, southeast of Iran. [ABSTRACT FROM AUTHOR]

Abstract: Leishmania infantum is the causative agent of infantile visceral leishmaniasis (IVL) in the Mediterranean Basin and, based on isoenzyme typing of the parasite isolated from dogs; this parasite was considered to predominate in the all foci of IVL in Iran. However, based on PCR detection and sequencing of parasite Cysteine Protease B (CPB), only one out of seven sandfly infections in Phlebotomus perfiliewi transcaucasicus was found to be L. infantum in the current investigation. The six other infections were haplotypes of Leishmania donovani, the causative agent of anthroponotic visceral leishmaniasis (AVL) in West Africa and India. The deduced amino acid of the L. donovani haplotype was found to be novel and the shortest CPB protein reported within the Leishmania spp. Circulation of both L. donovani and L. infantum by P. perfiliewi transcaucasicus, in addition to previous data indicating its ability to circulate L. tropica, suggests that this species, like other vectors of VL, is a permissive vector. Finding L. donovani infecting P. perfiliewi transcaucasicus in the area demands extensive and intensive typing of natural Leishmania infections in epidemiological investigations in Iran and the Mediterranean Basin in general. [Copyright &y& Elsevier]

Summary: Leishmania infantum is the causative agent of infantile visceral leishmaniasis (IVL) in the Mediterranean Basin and, based on isoenzyme typing of a few isolates from patients and domestic dogs, this parasite was considered to predominate in the Kaleybar focus of IVL in northwest Iran. However, in the current investigation only one out of five sandfly infections was found to be L. infantum, based on PCR detection and sequencing of parasite internal transcribed spacer (ITS) rDNA infecting Phlebotomus perfiliewi transcaucasicus. The four other infections were of haplotypes of L. tropica, the causative agent of anthroponotic cutaneous leishmaniasis in the Middle East and a parasite occasionally detected in the viscera of dogs and patients in Iran and elsewhere. The widespread distribution of L. tropica in the Kaleybar focus suggests that this parasite is not a transient introduction. Kaleybar has been used for a deltamethrin dog collar intervention to reduce the biting rates of the vectors of L. infantum and this has significantly reduced the incidence of Leishmania infections both in children and the domestic dog, the usual reservoir host of IVL. The implications of finding L. tropica widespread in the heart of the intervention area are discussed. Extensive and intensive typing of natural Leishmania infections is a characteristic of epidemiological investigations in the Neotropics and the current report indicates that this will also be necessary in some regions of the Old World. [Copyright &y& Elsevier]