Abstract Background Eimeria is a protozoan parasite that affects poultry, particularly chickens, causing a disease known as coccidiosis. This disease imposes substantial significant economic challenges to the poultry sector. Objectives The current study aimed to estimate the global prevalence and associated risk factors of Eimeria in domestic chickens. Methods Multiple databases (Scopus, PubMed, ProQuest, Web of Science and Google Scholar) were searched for articles published until June 2023. The pooled prevalence was estimated using a random‐effects model with a 95% confidence interval. The statistical analysis was conducted using meta packages in R version (3.6.1). Results In total, 41 articles fulfilled the eligibility criteria. The global pooled prevalence was 44.3% (36.9%–51.8%) with Eimeria tenella (38.7%, 30.1%–47.7%) as the most prevalent species. The highest pooled prevalence was related to the Western Pacific Region (80.5%, 72.6%–87.3%) and urban areas (44.4%, 36.5%–52.6%). Moreover, areas with humid subtropical climates represent the highest overall prevalence (75.8%, 46.6%–95.9%). Conclusion The necessity for robust and innovative strategies for preventing and managing this disease cannot be overstated. Addressing Eimeria impact is crucial not only for safeguarding poultry health but also for sustaining the economic viability of the poultry industry.
Abstract Background and Aim Escherichia coli pathobionts and particularly the adherent‐invasive E. coli (AIEC) may play a putative role in initiating and maintaining the inflammatory process in the intestinal tissues of inflammatory bowel disease (IBD) patients, by providing stimulatory factors that trigger gut immune system activation. The aim of this study is to conduct a systematic review and meta‐analysis to determine the prevalence of AIEC among patients with Crohn's disease (CD) and ulcerative colitis (UC). Methods Electronic databases were searched up to February 2020 for relevant publications reporting the prevalence of AIEC in IBD patients. The prevalence rate of AIEC among CD and UC patients, the odds ratio (OR) and 95% confidence interval (CI) were calculated compared to non‐IBD controls. Results The final dataset included 12 studies, all investigating AIEC isolates from ileal/colonic specimens. The OR for prevalence of AIEC in CD patients was 3.27 (95% CI 1.79–5.9) compared with non‐IBD controls. The overall pooled prevalence of AIEC among CD patients was 29% (95% CI 0.17–0.45), whereas this prevalence was calculated to be 9% (95% CI 0.03–0.19) in controls. Moreover, the prevalence of AIEC in UC subjects was calculated 12% (95% CI 0.01–0.34), while AIEC showed a prevalence of 5% (95% CI 0.0–0.17) among the controls. The OR for prevalence of AIEC in UC patients was 2.82 (95% CI 1.11–7.14) compared with controls. Conclusions There is a substantial increase in the prevalence of AIEC in IBD patients compared with controls. This review supports the growing evidence that AIEC could be involved in both CD and UC pathogenesis.
Although the main cause of appendicitis is unclear, infection with Enterobius vermicularis is suggested as a neglected risk factor. Since, there is no comprehensive analysis to estimate the prevalence of E. vermicularis in appendicitis; therefore, we conducted a global-scale systematic review and meta-analysis study to estimate the prevalence of E. vermicularis infection in appendicitis cases. PubMed, Scopus, Web of Science and Google Scholar databases were systematically searched for relevant studies published until 15 August 2019. Pooled prevalence of E. vermicularis infection was estimated using the random effects model. Data were classified based on the continents and countries. Moreover, subgroup analyses regarding the gender, the human development index (HDI), and income level of countries were also performed. Fifty-nine studies involving 103195 appendix tissue samples belonging to the individuals of appendicitis were included. The pooled prevalence of E. vermicularis infection was (4%, 95%CI, 2–6%), with the highest prevalence (8%, 95% CI: 0–36%) and lowest prevalence (2%, 95% CI: 1–4%) in Africa and Americas continents, respectively. With respect to countries, the lowest and highest prevalence rates were reported from Venezuela (<1%, 95% CI: 0–1%) and Nigeria (33%, 95% CI: 17–52%), respectively. Indeed, a higher prevalence was observed in females, as well as in countries with lower levels of income and HDI. Our findings indicate the relatively high burden of E. vermicularis infection in appendicitis cases. However, our findings suggest the great need for more epidemiological studies to depth understand overlaps between E. vermicularis infection and appendicitis in countries with lower HDI and income levels.
The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD).To accomplish this, we established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches.In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high-income Asia-Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively.Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data.
Strongyloides stercoralis, a soil-transmitted helminth, occurs in humans, non-human primates, dogs, cats and wild canids. The zoonotic potential between these hosts is not well understood with data available on prevalence primarily focused on humans. To increase knowledge on prevalence, this review and meta-analysis was performed to estimate the global status of S. stercoralis infections in dogs. Following the PRISMA guidelines, online literature published prior to November 2020 was obtained from multiple databases (Science Direct, Web of Science, PubMed, Scopus and Google Scholar). Prevalence was calculated on a global and country level, by country income and climate, and in stray/animal shelter dogs versus owned dogs. Statistical analyses were conducted using R-software (version 3.6.1). From 9428 articles, 61 met the inclusion criteria. The estimated pooled global prevalence of S. stercoralis in dogs was 6% (95% CI 3-9%). Infection was found to be the most prevalent in low-income countries with pooled prevalence of 22% (95% CI 10-36%). The highest pooled prevalence of S. stercoralis in dogs was related to regions with average temperature of 10-20 °C (6%; 95% CI 3-11%), an annual rainfall of 1001-1500 mm (9%; 95% CI 4-15%) and humidity of 40-75% (8%; 95% CI 4-13%). Prevalence was higher in stray and shelter dogs (11%; 95% CI 1-26%) than in owned dogs (3%; 95% CI 1-7%). As with S. stercoralis in humans, higher prevalence in dogs is found in subtropical and tropical regions and lower-income countries, locations which also can have high dog populations. While this study presents the first estimated global prevalence of S. stercoralis in dogs, it is potentially an underestimation with 15 of 61 studies relying on diagnostic methods of lower sensitivity and a paucity of data from most locations. Standardized protocols (e.g. quantity of feces and number of samples for a Baermann) in future studies could improve reliability of results. More prevalence studies and raising veterinary awareness of S. stercoralis are needed for a One Health approach to protect humans and dogs from the impact of the infection.
Among the potential animal reservoirs of the zoonotic parasite T. gondii, birds have received relatively little attention. This systematic review and meta-analysis aimed to assess the global status and to provide an overview of the epidemiology of T. gondii infection in birds. The standard protocol of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Scopus, PubMed, Web of Science, Science Direct, ProQuest, and Google Scholar were searched for relevant publications from January 1990, to March 2024. All peer-reviewed original research articles describing the prevalence of T. gondii in birds were included. Inclusion and exclusion criteria were applied, and both direct and indirect detection were considered. The point estimates and 95% confidence intervals were calculated using the meta-package in R (version 3.6.1). The variance between studies (heterogeneity) was quantified by the I2 index. Finally, 258 articles (including 380 datasets) were eligible for inclusion in the systematic review and meta-analysis. The global pooled prevalence was 24% (21 - 26%). The highest prevalence of T. gondii was observed in buzzards (52%, 34 - 70%), turkeys (31%, 17 - 46%), and chickens (30%, 26 - 34%). The present study provides a comprehensive view of the global prevalence of T. gondii in birds.
Abstract Purpose Intestinal protozoan parasites among Asian schoolchildren are a subject of concern due to their prevalence and potential health impact. Understanding and addressing this issue is crucial for public health in the region. Methods We conducted a comprehensive search for articles published up to December 2023 across four databases, including Scopus, PubMed, ProQuest, and Web of Science. To estimate the combined prevalence, a random-effects model with a 95% confidence interval (CI) was applied, and the statistical analysis was performed using meta-analysis packages in R version (3.6.1). This study is registered with PROSPERO (CRD42023481146). Results Among 131 eligible articles, the prevalence of intestinal protozoan parasites was 0.208 (95% CI = 0.180–0.238). Lebanon and Tajikistan had the highest country-level prevalence at 0.851 and 0.836, respectively, with Giardia duodenalis being the most prevalent species at 0.082. Conclusion In summary, our study highlights the urgent public health issue of protozoan parasites among Asian schoolchildren due to poor sanitation and water quality. Immediate interventions are essential, considering climate and socioeconomic factors, to combat these infections and improve overall health.
Abstract Background Patients with mental disorders have a high risk of intestinal parasitic infection due to poor hygiene practices. Hence, to better clarify this overlooked phenomenon, the current study is conducted to determine the global prevalence of protozoan parasite infections in patients with mental disorders and investigate the associated risk factors. Methods Several databases (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched for papers published until December 2022. The fixed effect meta-analysis was used to estimate the overall odds ratio (OR) and pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI). Results Totally, 131 articles (91 case–control and 40 cross-sectional studies) met the eligibility criteria. Patients with mental disorders were significantly at higher risk for protozoan parasites than healthy controls (OR: 2.059, 1.830–2.317). The highest pooled OR (2.485, 1.413–4.368) was related to patients with neurodevelopmental disorders, and the highest pooled prevalence was detected in patients with neurodevelopmental disorders (0.341, 0.244–0.446), followed by bipolar and related disorders (0.321, 0.000–0.995). Toxoplasma gondii was the most prevalent protozoan parasite (0.343, 0.228–0.467) in cross-sectional studies and the highest pooled OR was related to Cyclospora cayetanensis (4.719, 1.352–16.474) followed by Cryptosporidium parvum (4.618, 2.877–7.412). Conclusion Our findings demonstrated that individuals afflicted with mental disorders are significantly more susceptible to acquiring protozoan parasites in comparison to healthy individuals. Preventive interventions, regular screening, and treatment approaches for parasitic diseases should be considered for patients with mental disorders.
Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women.We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs).A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]).The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
The role of various parasitic infections in the occurrence of appendicitis is illustrated through cases recorded all over the world. The purpose of the current study was to estimate the global prevalence of parasite infestation (other than E. vermicularis) in appendectomy specimens.
Abstract This systematic review and meta-analysis study was conducted to estimate the pooled prevalence of CD in low and high risk groups in this region. Following keywords were searched in the Medline, PubMed, Scopus, Web of Science and Cochrane database according to the MeSH terms; celiac disease, prevalence, high risk population and Asian-Pacific region. Prevalence studies published from January 1991 to March 2018 were selected. Prevalence of CD with 95% confidence interval (CI) was calculated using STATA software, version 14. The pooled sero-prevalence of CD among low risk group in Asia–Pacific region was 1.2% (95% CI 0.8–1.7%) in 96,099 individuals based on positive anti-tissue transglutaminase (anti-t-TG Ab) and/or anti-endomysial antibodies (EMA). The pooled prevalence of biopsy proven CD in Asia–Pacific among high and low risk groups was 4.3% (95% CI 3.3–5.5%) and 0.61% (95% CI 0.4–0.8%) in 10,719 and 70,344 subjects, respectively. In addition, the pooled sero-prevalence and prevalence of CD in general population was significantly higher in children compared with adults and it was significantly greater in female vs. male ( P < 0.05). Our results suggest high risk individuals of CD are key group that should be specifically targeted for prevention and control measures, and screening may prove to have an optimal cost–benefit ratio.
Gluten proteins are known as immunological triggers for inflammation resulting in mucosal lesions in patients with coeliac disease (CD). Adherence to a strict gluten-free diet (GFD) is currently known as the only effective treatment for CD. In this study, we performed a systematic review and dose-response meta-analysis on data from previous studies to investigate the association between different gluten doses administered and the risk of CD relapse. Electronic databases were systematically searched to retrieve studies that investigated the response of CD patients to different amounts of gluten intake and evaluated the clinical, serologic, and/or histologic evidence to recognize disease relapse. Study-specific relative risks (RRs) were combined using a random effects model. A total of 440 identified published papers were screened, of which 7 records were selected following full-text reviewing and eligibility assessment for dose-response meta-analysis. According to our analysis, the risk of CD relapse is estimated to be 0.2% (RR: 1.002; 95% CI: 1.001 to 1.004) following the consumption of 6 mg gluten/day, which was increased to 7% (RR: 1.07; 95% CI: 1.03 to 1.10), 50% (RR: 1.50; 95% CI: 1.23 to 1.82), 80% (RR: 1.80; 95% CI: 1.36 to 2.38), and 100% (RR: 2.00; 95% CI: 1.43 to 2.78) by the daily intake of 150, 881, 1276, and 1505 mg gluten, respectively. Although good adherence to a GFD can adequately control CD-related symptoms, disease relapse might happen even with a very low dose of gluten, and the duration of exposure to gluten is also an important matter. The current literature has substantial limitations, such as relying on the data from just a few countries that were different in terms of the amount of gluten administered, the duration of the challenge, etc. Therefore, more randomized clinical trials using a standardized gluten challenge protocol are needed to confirm the findings of the present study.
Cockroaches are significant health hazards as they can carry and transmit various pathogens, leading to serious illnesses in humans. This study investigates the global prevalence of intestinal protozoan parasites (IPPs) in cockroaches through a systematic review and meta-analysis. Several databases, including (PubMed, Scopus, Web of Science, and Google Scholar), were searched for publications covering 2003 to 2024. Following PRISMA guidelines, we identified 5,955 records, resulting in 36 eligible studies. The pooled global prevalence of contaminated cockroaches was estimated at 0.26 (95% CI = 0.16-0.37). Further analysis indicated that the highest pooled prevalence based on sample source was found in zoo samples (0.82, 95% CI = 0.75-0.88). Polymerase Chain Reaction (PCR) detection methods yielded the highest prevalence (0.42, 95% CI = 0-1.00), while Blatta orientalis showed a pooled prevalence of 0.57 (95% CI = 0.49-0.65). Geographically, Asia exhibited the highest prevalence rate (0.35, 95% CI = 0.16-0.57), particularly in low-income countries (0.56, 95% CI = 0.00-1.00). These findings underscore significant public health concerns regarding the contamination of cockroaches with IPPs and highlight the necessity for effective monitoring and control measures.
Abstract Background and objective Recently, dietary restriction of fermentable carbohydrates (a low-FODMAP diet) in combination with a gluten-free diet (GFD) has been proposed to reduce the symptoms in irritable bowel syndrome (IBS) patients. Different studies reported that IBS has been associated with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in the gastrointestinal (GI) system of adults with IBS. In this study, we aimed to investigate the effects of low FODMAP-gluten free diet (LF-GFD) on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS. Design In this clinical trial study, 42 patients with IBS (Rome IV criteria) underwent LF-GFD intervention for 6 weeks. Symptoms were assessed using the IBS symptom severity scoring (IBS-SSS), and fecal samples were collected at baseline and after intervention and analyzed by quantitative 16 S rRNA PCR assay. The diversity of gut microbiota compared before and after 6 weeks of dietary intervention. FC was also analyzed by the ELISA method. Results Thirty patients (mean age 37.8 ± 10.7 years) completed the 6-week diet. The IBS-SSS was significantly ( P = 0.001) reduced after LF-GFD intervention compared to the baseline. Significant microbial differences before and after intervention were noticed in fecal samples. A significant increase was found in Bacteroidetes , and the Firmicutes to Bacteroidetes (F/B) ratio was significantly ( P = 0.001) decreased after the dietary intervention. The value of FC was significantly decreased after 6 weeks of dietary intervention ( P = 0.001). Conclusions Our study suggests that patients with IBS under an LF-GFD had a significant improvement in IBS symptoms severity, with reduced FC level following normalization of their gut microbiota composition. Further rigorous trials are needed to establish a long-term efficacy and safety of this dietary intervention for personalized nutrition in IBS. Clinical Trial Registry Number: IRCT20100524004010N26.
Clostridioides difficile infection (CDI) remains a major healthcare problem worldwide, however, little is known about CDI epidemiology in Iran. Between December 2004 and November 2018, 3649 stool samples were collected from patients in 69 hospitals and medical centres in Tehran and were cultured for the presence of C. difficile; isolates were characterized by PCR ribotyping and toxin genes detection. A total of 582 C. difficile isolates were obtained and the overall CDI prevalence was 15.9%; 290 (49.8%) cases were healthcare-associated (HA) and 292 (50.2%) cases were community-associated (CA). Of these, DNA of 513 isolates submitted for ribotyping. The ribotype and/or WEBRIBO type could be assessed in 366 (62.9%) isolates. The most frequent RTs were 001 (n = 75, 12.9%), 126 (n = 65, 11.2%) and 084 (n = 19, 3.3%); the toxin gene profile tcdA+B+/cdtA+B+ (n = 112, 19.2%) was the most common. Fifteen C. difficile isolates (2.6%) did not carry any toxin genes. There was no difference between frequently found RTs in HA-CDI and CA-CDI, except for RT 029 which was more likely to be associated with healthcare origin (12/15, p-value = 0.02). No isolate of RTs 027 or 078 was identified. Importantly, RTs 031, 038, 039, 084, 085 reported previously as RTs with an absence of toxin genes, revealed the presence of toxin genes in our study. Using Simpson's reciprocal index of diversity, we found that RT diversity decreased as the prevalence of the RT 084 increased (R = −0.78, p-value = 0.041). Different patterns in CDI epidemiology underscore the importance of local surveillance and infection control measures in Tehran healthcare settings.
Toxoplasmosis is a zoonotic and cosmopolitan infection. Although a few studies have evaluated the prevalence of Toxoplasma oocysts in the soil of public places, the present study was conducted to provide insights into environmental contamination levels and its potential transmission to humans on a global scale. A systematic search was conducted using bibliographic databases through 30 August 2020. A random effects model was utilized to estimate pooled prevalence with 95% confidence intervals (CIs). Subgroup analysis and meta-regressions were also performed on the geographical and environmental parameters. Finally, 22 articles, wherein 15 420 soil samples were examined, met the systematic review and meta-analysis requirements. The mean pooled prevalence of Toxoplasma oocysts was estimated at 16% (95% CI 10 to 26) in public places. The estimated prevalences in Europe, South America, Asia and North America were 23% (95% CI 4 to 65), 22% (95% CI 18 to 26), 15% (95% CI 0.06 to 33) and 8% (95% CI 0.00 to 97), respectively. An increasing trend was observed in the prevalence of Toxoplasma oocysts with increasing latitude (41-56°), decreasing longitude (0-40°) and increasing relative humidity (≥76%). Loop-mediated isothermal amplification and polymerase chain reaction methods revealed the highest and lowest prevalence rates, respectively, in the detection of Toxoplasma oocysts. Awareness of the health authorities and people about Toxoplasma prevalence in the soil of public places and its risk factors is of great importance to developing effective strategies to prevent infection.
Background Co-infection of intestinal helminthic infections (IHIs) and tuberculosis (TB) has appeared as a public health issue, especially in developing countries. Some recent studies have been carried out on the possible relevance of IHIs to TB. The current systematic review and meta-analysis was conducted to assess the prevalence and odds ratio (OR) of IHIs among TB patients and clarify the relationship between IHIs and TB disease. Methods For the purpose of the study, five English databases including PubMed, Science Direct, Scopus, Web of Science (ISI), and Google scholar were searched (up to January 30, 2019) in order to find the related studies. Random-effects meta-analysis model was used to estimate the pooled prevalence, odds ratio (OR), and 95% confidence interval (CI). Inclusion and exclusion criteria were applied. Results A total of 20 studies including 10 studies with case-control design (2217 patients and 2520 controls) and 10 studies with cross-sectional design (a total of 2415 participants) met the eligibility criteria. As shown by the random-effects model, the pooled prevalence of IHIs in TB patients was estimated to be 26% (95% CI, 17–35%; 1249/4632). The risk of IHI was higher in TB patients compared to controls but this was not statistically significant. However, according to genus/species, the pooled OR of Strongyloides stercoralis (S. stercoralis) (OR, 2.68; 95% CI, 1.59–4.54) had a significantly higher risk in TB patients compared to controls. Nevertheless, the results of random effects model showed no statistically significant association between overall pooled OR of IHIs in TB patients compared to controls in case-control studies (OR, 1; 95% CI, 0–1). Conclusions It is highly recommended that more precise studies should be carried out by researchers in order to better understand this association. Also, it is of great importance to include the periodic screenings for IHIs in the routine clinical care of these patients.
Purpose Ocular toxocariasis (OT) is a zoonotic infection caused by larval stages of Toxocara canis and T. cati. The current review and meta-analysis aimed to evaluate the global prevalence of OT.
Abstract Patients with diabetes are at an increased risk of intestinal parasitic infections (IPIs). We evaluated the pooled prevalence and OR of IPIs in patients with diabetes through a systematic review and meta-analysis. A systematic search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for studies reporting IPIs in patients with diabetes through 1 August 2022. The collected data were analyzed using comprehensive meta-analysis software version 2. Thirteen case-control studies and nine cross-sectional studies were included in this study. The overall prevalence of IPIs in patients with diabetes was calculated to be 24.4% (95% CI 18.8 to 31%). Considering the case-control design, the prevalence of IPIs in case (25.7%; 95% CI 18.4 to 34.5%) was higher than controls (15.5%; 95% CI 8.4 to 26.9%) and a significant correlation was observed (OR, 1.80; 95% CI 1.08 to 2.97%). Moreover, a significant correlation was seen in the prevalence of Cryptosporidium spp. (OR, 3.30%; 95% CI 1.86 to 5.86%), Blastocystis sp. (OR, 1.57%; 95% CI 1.11 to 2.22%) and hookworm (OR, 6.09%; 95% CI 1.11 to 33.41%) in the cases group. The present results revealed a higher prevalence of IPIs in patients with diabetes than in controls. Therefore, the results of this study suggest a proper health education program to preventing measures for the acquisition of IPIs in patients with diabetes.
ABSTRACT Background Despite remarkable progress in contemporary medical technology and enhanced survival outcomes for various cancer types, pancreatic cancer (PC) continues to stand out as a particularly deadly gastrointestinal malignancy. Given a persistent rise in both incidence and the corresponding mortality rates of PC globally, evaluations of PC burden by sex are of great importance. Here, we used the illness‐death multi‐state model (IDM) to forecast the prevalence of PC through the year 2040. Methods IDM was established based on obtainable data to predict the future prevalence of PC on global, regional, and national scales from 2019 to 2040. Analyses were also performed regarding sex and 95% confidence intervals (CIs) are presented for all estimates. Results The projected prevalence rate for 2040 is anticipated to be 6.093 ([95% CI 5.47–6.786] per 100,000) worldwide, indicating a significant increase of 31.45% since 1990, and a 12.29% increase since 2019. The estimated average annual increase since 2020 was 0.5%. Considering sex differences, females are expected to have a steeper slope in prevalence rate than males. Intriguingly, when considering the percentage changes between the periods of 2019–2040 and 1990–2019 for both sexes, females exhibited 29% and 11% increase relative to males (2.6‐fold greater increase). Conclusions By 2040, it is predicted that the prevalence of PC will increase globally, with women being at higher risk of developing the disease. Considering the percentage changes, regions with lower socioeconomic status are anticipated to face a greater risk of experiencing PC compared to other geographical areas.
The associations between oral bacterial pathogens and the risk of pancreatic cancer (PC) have been reported in several epidemiological studies. In this study, we evaluated the diagnostic potential of periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in combination with circulating oncomiRNAs, including miR-21 and miR-155. A total of 41 PC patients and 40 age- and sex-matched controls were recruited for the study. The salivary bacterial load of P. gingivalis and A. actinomycetemcomitans, along with the copy number of miR-21 and miR-155 in blood, were measured using quantitative real-time PCR. Subsequently, the predictive power of the selected biomarkers in PC diagnosis was determined. Elevated load of the periodontal pathogens P. gingivalis in females (OR=2.31; 95% CI 0.98-5.47) and A. actinomycetemcomitans in diabetic individuals (OR=3.66; 95% CI 0.47-6.68) were associated with a higher risk of PC. Moreover, the diagnostic model incorporating two salivary species and two circulating miRNAs demonstrated an AUC of 0.878 (95% CI 0.802-0.955). This study offers compelling new evidence supporting the idea that the combined analysis of salivary microbiota and circulating miRNAs serves as an informative avenue for the discovery of non-invasive biomarkers for PC.
Helminthic parasites are a significant concern for the food industry because of their detrimental effects on livestock health and food safety. This study aimed to provide data on the prevalence of helminthic parasites in 2250 slaughtered small ruminants in Qazvin Province, Iran. The overall infection rate was 56.6%, with sheep (64.9%) exhibiting a higher prevalence compared with goats (41.9%). Cystic echinococcosis (CE) was the most frequently detected parasite, followed by Moniezia expansa and Cysticercus tenuicollis. This study revealed higher susceptibility to infections in male animals and younger sheep, with infections occurring year-round, peaking in spring and summer. These findings highlight the need for targeted interventions, such as improved pasture management and deworming strategies, to mitigate economic losses and zoonotic risks. This research contributes significantly to livestock health and food safety efforts in Iran, advocating for integrated control measures within a One Health framework.
To investigate the presence of intestinal parasites in tuberculosis patients who suffered from immunodeficiency disorders.Tuberculosis is an important infectious disease that is endemic in some regions of Iran. However, there is a coverage in the endemicity areas of this infection with intestinal parasites.Stool samples were collected from 50 immunocompromised tuberculosis patients. Direct smear using the normal saline (0.85% NaCl solution) and Lugol's iodine staining were performed to detect trophozoite of parasites. Moreover, stool samples were concentrated using routine formalin-ether to detect protozoan cysts and helminth's ova/larvae. Specific staining techniques including Trichrome, Modified Ziehl-Neelsen and chromotrope 2R were employed to detect amoeba, Giardia spp., coccidian parasites and microsporidia.From 50 participants, 42 (84%) and 8 (16%) were male and female, respectively. The mean age + SD of patients was 47.88 + 10.88 years. Among the participated patients, HIV positive, cancer, organ transplant and receiving corticosteroids were seen in 13, 10, 15 and 12 subjects, respectively. The prevalence of Intestinal parasites was 34 %( 17/50). Blastocystis (18%; 9/50), and intestinal helminth (Enterobius vermicularis) (2%; 1/50) were the most prevalent and less prevalent parasites, respectively. Statistical significance difference was not seen between presence of intestinal parasites and type of immunodeficiency.Our findings showed the high prevalence of intestinal parasites with majority of Blastocystis. Indeed, this study suggested that due to complicated immune conditions of TB patients with immunodeficiency disorders, this group of patients are at higher risk of infection by intestinal parasites.
Prevalence of Chronic Complications and Related Risk Factors of Diabetes in Patients Referred to the Diabetes Center of Hamedan Province
Abstract Intestinal parasitic infection (IPI) is the main cause of gastrointestinal complications in hemodialysis patients due to their impaired immune systems. We conducted a systematic review and meta‐analysis to evaluate the prevalence and odds ratio (OR) of IPIs in this population. Relevant eligible studies were identified by searching the PubMed, Science Direct, Scopus, Web of Science, and Google scholar databases up to January 30, 2019. A random‐effects meta‐analysis model was used to estimate the pooled prevalence, OR, and 95% confidence intervals (CI). Twenty‐two studies, from Turkey, Iran, Brazil, Egypt, Saudi Arabia, Pakistan, and Malaysia met eligibility criteria for analysis, and included 11 using a case–control design (980 patients and 893 controls) and 11 studies using a cross‐sectional design (a total of 1455 participants). Cross‐sectional studies suggested that the pooled prevalence of IPIs in hemodialysis patients was 24% (95% CI, 14–36%; 307/1455). In studies using a case–control design, the pooled prevalence of IPIs in hemodialysis patients (30%, 330/980) was found to be significantly higher than controls (10%, 115/893) (OR, 3.40; 95%CI, 2.37–4.87). With respect to the parasites, Cryptosporidium spp. (OR, 4.49; 95%CI, 2.64–7.64) and Blastocystis sp. (OR, 4.03; 95%CI, 1.20–13.51) were significantly higher in hemodialysis patients compared to the controls. The current study revealed a high prevalence of IPIs in hemodialysis patients from countries in which the baseline prevalence of parasitic infection is high. We recommend that periodic screenings for IPIs in such countries should be incorporated into the routine clinical care of hemodialysis patients.
Investigating the global epidemiological patterns of Trichinella in pigs is required for accurate recognition and to establishing proper control programmes and preventive measures, as well as to decrease human exposure.To obtain a better understanding of the global prevalence of Trichinella in domestic pigs and factors that might influence the prevalence, a systematic review and meta-analysis was performed.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Multiple databases were used to identify literature published between January 2000 and December 2021, representing studies from 1985 to 2021, on Trichinella prevalence in domestic pigs. Prevalence was calculated on a global and country level, by country Human Development Index (HDI), climate, pig management system, and diagnostic test.The global pooled prevalence based on 60 manuscripts representing 32 countries and 65 pig populations was 2.02% (95% confidence interval [CI]: 0.88-3.62) and the estimated pooled prevalence in different continents ranged from 0.00% to 11.8%. Trichinella was highest in low HDI countries (21.6%; 95% CI: 4.3-47.2), tropical wet climates (20.9%; 95% CI: 10.3-34.1), and non-intensive pig farming systems (6.1%; 95% CI: 1.0-15.5).While there were regional differences in Trichinella prevalence in domestic pigs, these were likely driven by country HDI and pig farming systems versus climatic factors. Increased biosecurity in outdoor pig production systems, focused meat inspections and promoting awareness could potentially decrease risk of infection.
Abstract Background Spirometra infection is aneglected food‐ and waterborne disease with worldwide distribution. Objectives The present study aims to estimate the global prevalence of Spirometra species in snakes, frogs, dogs and cats. Methods Multiple databases (PubMed, Scopus, ProQuest, Web of Science and Google Scholar) were searched for relevant literatures published up to March 2022. Results Among 131 data sets (including 113 articles) that met the inclusion, 15 investigations reported Spirometra infection in snakes, 23 in frogs, 41 in dogs and 52 in cats. The pooled prevalence (95% confidence interval) in intermediate hosts and definitive hosts was found to be 0.313% and 0.089%, respectively. Based on continent, the infection was most prevalent in Asia for studies on snakes (0.696%) and frogs (0.181%), while Africa (0.224%) and Oceania (0.203%) were the regions with the highest pooled prevalence rates of the infection in dogs and cats, respectively. Among different diagnostic methods, the highest pooled prevalence was related to morphological method for studies on snakes, frog and cats with rate of 0.665%, 0.189% and 0.104%, respectively. Regarding studies on dogs, the highest pooled prevalence was observed for molecular technique (0.101%). Conclusions The results presented here revealed the importance of establishing a prevention and control measure focused on protection of aquaculture systems from being contaminated with faeces of dogs and cats, and raising awareness of parasitic zoonotic diseases to decrease the transmission risk.
Individuals with celiac disease (CD), non-celiac wheat sensitivity (NCWS), and irritable bowel syndrome (IBS), show overlapping clinical symptoms and experience gut dysbiosis. A limited number of studies so far compared the gut microbiota among these intestinal conditions. This study aimed to investigate the similarities in the gut microbiota among patients with CD, NCWS, and IBS in comparison to healthy controls (HC).In this prospective study, in total 72 adult subjects, including CD (n = 15), NCWS (n = 12), IBS (n = 30), and HC (n = 15) were recruited. Fecal samples were collected from each individual. A quantitative real-time PCR (qPCR) test using 16S ribosomal RNA was conducted on stool samples to assess the relative abundance of Firmicutes, Bacteroidetes, Bifidobacterium spp., and Lactobacillus spp.In all groups, Firmicutes and Lactobacillus spp. had the highest and lowest relative abundance respectively. The phylum Firmicutes had a higher relative abundance in CD patients than other groups. On the other hand, the phylum Bacteroidetes had the highest relative abundance among healthy subjects but the lowest in patients with NCWS. The relative abundance of Bifidobacterium spp. was lower in subjects with CD (P = 0.035) and IBS (P = 0.001) compared to the HCs. Also, the alteration of Firmicutes to Bacteroidetes ratio (F/B ratio) was statistically significant in NCWS and CD patients compared to the HCs (P = 0.05).The principal coordinate analysis (PCoA), as a powerful multivariate analysis, suggested that the investigated gut microbial profile of patients with IBS and NCWS share more similarities to the HCs. In contrast, patients with CD had the most dissimilarity compared to the other groups in the context of the studied gut microbiota.
Abstract Background Canine babesiosis is a clinically significant tick‐transmitted disease caused by several species of the intraerythrocytic protozoan parasite Babesia , which result in a wide range of clinical manifestations, from mild, transient infection to serious disease and even death. Objectives The current study aimed to estimate the global prevalence and associated risk factors of Babesia in dogs. Methods Multiple databases (PubMed, Scopus, ProQuest, Web of Science and Google Scholar) were searched for relevant literature published from January 2000 up to December 2022. The statistical analyses were performed based on the R software (version 3.6) meta‐package. Results Out of 23,864 publications, 229 studies met the inclusion criteria. The pooled prevalence of canine babesiosis was 0.120 (95% CI; 0.097–0.146). The highest pooled prevalence was found in Europe (0.207, 95% CI; 0.097–0.344). Among several species, Babesia canis was the most prevalent parasite (0.216, 95% CI; 0.056–0.441). The highest pooled prevalence of Babesia in dogs was observed in the summer season (0.097, 95% CI; 0.040–0.174). Conclusions Regular screening and appropriate control strategies are recommended for the prevention of transmission of tick‐borne disease transmission among dogs.
Strongyloidiasis is a neglected tropical disease mostly distributed in tropical and subtropical regions. The current study evaluated the prevalence of Strongyloides stercoralis in immunocompetent and immunodeficient patients in Iran. The available online literature published from June 1994 to October 2020 was obtained from multiple English databases (PubMed, Science Direct, Scopus, Web of Science and Google Scholar) and four Persian databases (Magiran, Iran Medex, Iran Doc and SID). All statistical analyses were performed using R software (version 3.6) meta-package and p-values <0.05 were considered significant. From 1051 articles, 74 studies (248 656 individuals) met the inclusion criteria. The pooled prevalence of S. stercoralis was 2% (95% confidence interval [CI] 1 to 3) and 4% (95% CI 1 to 8) in immunocompetent and immunodeficient patients, respectively. In immunodeficient cases, the pooled prevalence of studies utilizing serology, culture and microscopic methods was 10% (95% CI 2 to 23), 1% (95% CI 0 to 6) and 1% (95% CI 0 to 1), respectively. In immunocompetent cases, the pooled prevalence of studies utilizing microscopic, culture and molecular methods was 2% (95% CI 1 to 3), 2% (95% CI 1 to 4) and 2% (95% CI 0 to 6), respectively. We propose an appropriate screening and control program along with comprehensive research regarding the frequency of strongyloidiasis in the country.
ABSTRACT Background and Aims Emerging evidence suggests that ciprofloxacin and other quinolones can be effectively used as adjuncts to immunosuppressive therapy in managing inflammatory bowel disease (IBD). Clinical isolates of Enterobacterales frequently exhibit quinolone resistance. Additionally, increased IBD severity has been linked to the proliferation of Enterobacterales in the gut. This study aimed to explore the frequency of fluoroquinolone resistance and the presence of associated resistance genes in Escherichia coli isolates obtained from intestinal biopsies of patients with IBD in Iran. Methods In this research, we conducted a study that involved the isolation and examination of E. coli bacteria from inflamed ileal and/or colonic tissues of patients diagnosed with IBD, specifically ulcerative colitis (UC) and Crohn's disease (CD), during colonoscopy procedures. We collected demographic and clinical information from the patients. To identify E. coli strains that were resistant to quinolone antibiotics, we performed both phenotypic and molecular analyses. Results From the colonic and ileal biopsies of 121 patients with IBD, we isolated 107 unique strains of E. coli . Among these strains, 18 (16.8%) were derived from patients with CD, and 89 (83.2%) came from those with UC. Antimicrobial susceptibility tests revealed that 61 out of 107 isolates (57%) of the isolates showed phenotypic resistance to at least one type of quinolone. Additionally, plasmid‐mediated quinolone resistance (PMQR) genes, specifically oqxA , oqxB , and qnrS were detected in the E. coli strains linked to both UC and CD. Notably, there was a significant positive correlation observed between intestinal colonization by ciprofloxacin‐resistant E. coli and the patients' history of extended ciprofloxacin antibiotic therapy. Conclusion Our results reveal that a significant number of patients with IBD carry quinolone‐resistant E. coli . This colonization may pose a risk factor that could affect disease progression and contribute to potential complications.
Background: Coronavirus disease 2019 (abbreviated as COVID-19) is a mysterious respiratory syndrome symptomatically spanning from healthy carriers to patients with life-threatening complications, in some cases, leading to a mournful death For the time being, the contributory role of hematologists is much more recognized in the management of COVID-19, since the emergence of coagulopathy has recently been the focus of many studies in SARS-CoV-2 infection Methods: To provide a well-conceptualized viewpoint demonstrating the prognostic value of coagulation-related laboratory tests, we planned to perform a meta-analysis of pertinent literature representing information on PT, aPTT, and D-dimer tests in patients with COVID-19 Results: Albeit the estimated pooled means of PT and aPTT were higher in severe cases, their mean values were not significantly higher as compared with patients in a non-severe condition On the other hand, the mean value of D-dimer in severe patients was significantly higher than non-severe cases (X2=6 34, P=0 01), highlighting that the elevation of this parameter may be associated with the progression of the disease toward an unfavorable clinical outcome Conclusion: Even though at the time of writing this article the lack of adequate and appropriate studies denotes a major limitation to the current study, planning for the future research to determine the prognostic value of laboratory tests reflecting SARS-CoV-2-induced coagulopathy, mainly D-dimer, will definitively cast a flash of light on the significance of therapeutic anticoagulation at least for those with no absolute contraindication
ABSTRACT Anaplasma phagocytophilum is an emerging tick‐borne zoonotic bacterium, which is considered a significant risk to the health and industry of cattle in tropical and sub‐tropical regions worldwide. This research focuses on examining the worldwide occurrence of A. phagocytophilum in cattle. Several databases, including Scopus, PubMed, ProQuest, Web of Science, ScienceDirect, and Google Scholar, were searched for publications spanning October 2004 to November 2024. The pooled prevalence was calculated with a 95% confidence interval (CI) using a random‐effects model based on the Freeman‐Tukey double arcsine transformation. A total of 72 studies satisfied the inclusion criteria, revealing a global prevalence of A. phagocytophilum in cattle estimated at 8.5% (5.9%–11.5%). Mongolia (51.9%, 45.9%–56.2%) and Guatemala (51%, 41.2%–60.7%) were countries that accounted for the highest prevalence. Moreover, the infection was most prevalent in African region with prevalence of 11.3% (3.9%–21.5%). The highest prevalence rate was observed in hot‐summer Mediterranean climate (13.7%, 4.7%–26.2%). The analysis indicated that immunological techniques were associated with the highest prevalence rate (14.2%, 6.5%–24.3%). The findings of the present research highlighted important geographical and environmental factors that affect the prevalence of disease. In the fields of veterinary medicine and public health, these findings enhance disease management plans and preventative initiatives.
Background and Aims Primary sclerosing cholangitis (PSC) exhibits varying incidence and prevalence rates across different regions; however, comprehensive global studies examining its geographic distribution and future trends are scarce. This study presents an updated meta-analysis through 2024 and projects the global and regional prevalence of PSC from 2024 to 2040 using an illness-death multi-state model. Methods We conducted a thorough systematic search across multiple databases to identify all primary studies published until 2024 that reported on the incidence, prevalence, and mortality rates of PSC in various regions. Using the gathered data, we developed an illness-death model to forecast the future prevalence of PSC, covering the years 2024–2040. Results Our meta-analysis revealed that the global pooled incidence and prevalence rates of PSC are 0.65 and 7.52 per 100,000 persons, respectively. Projections indicate that the global prevalence of PSC will rise to 22.98 cases per 100,000 (95% CI: 21.0–24.95), corresponding to an overall increase of 28.3%. Specifically, North America is forecasted to experience a 5.45% increase in PSC cases, reaching 24.76 cases per 100,000 (95% CI: 19.63–29.88), while Western Europe is anticipated to see a more pronounced rise of 28.79%, resulting in a prevalence of 21.48 cases per 100,000 (95% CI: 18.3–24.65) by 2040. Conclusions Our findings indicate a substantial rise in the number of individuals affected by PSC in recent years and estimate a significant future burden of the disease.
ABSTRACT Leptospirosis, a global zoonotic disease caused by pathogenic Leptospira spp., poses significant health risks to both animals and humans. This study aimed to assess the seroprevalence of antibodies against Leptospira interrogans serovars in stabled horses in Qazvin province, Northwest Iran. From January 2023 to April 2024, a total of 83 blood samples were collected from asymptomatic horses using the microscopic agglutination test (MAT). Results indicated a seroprevalence of 40.96% (95% CI: 31–52), with notable variations among regions: 38.89% (95% CI: 27–52) in Qazvin, 38.46% (95% CI: 18–64) in Alborz and 50% (95% CI: 28–72) in Takestan. The Hardjo serovar was most prevalent (21.68%, 95% CI: 14–32), followed by Icterohaemorrhagiae (13.25%, 95% CI: 7–22) and Canicola (7.22%, 95% CI: 3–15). Statistical analysis revealed significant associations between seropositivity and factors such as the presence of domestic animals and housing conditions. Notably, adult horses exhibited higher seropositivity compared to younger ones. This study highlights the potential role of horses as reservoirs for Leptospira , particularly the Hardjo serovar, suggesting a zoonotic risk to humans and underscoring the need for effective surveillance and control measures in equine populations.
Neglected tropical diseases (NTDs) are responsible for substantial illness and death worldwide. Helminthic infections among school-aged children pose a serious public health challenge due to their detrimental effects on health and development. A wide-ranging search conducted across five databases, including Scopus, EMBASE, PubMed, Web of Science, and Google Scholar to retrieve papers published between 1998 and 2024. To evaluate the combined prevalence, a random-effects model with a 95% confidence interval (CI) was applied, and the statistical analysis was performed using meta-analysis packages in R version (3.6.1). There were 190 eligible studies documented in 42 countries, and 199,988 schoolchildren included in this review. The global prevalence of helminthic parasites was 20.6% (17.2– 24.3%). Among the countries studied, Tanzania and Vietnam showed the highest levels of prevalence at 67.41% and 65.04%, respectively, with Toxocara spp. and Ascaris lumbricoides being the most prevalent helminthic parasites at 10.36% and 9.47%, respectively. In conclusion, this study underscores the pressing public health concern of helminthic infections among schoolchildren, largely driven by inadequate sanitation and poor water quality. Prompt action, such as improving sanitation, expanding school-based deworming programs, and enhancing access to safe water, is crucial to control these infections and enhance overall health outcomes.
ABSTRACT Background and Aims The gut microbiota is a diverse ecosystem with the potential to significantly enhance athletic metabolic capacity. Emerging research indicates that the gut microbiota plays a crucial role in modulating energy metabolism, immune function, oxidative stress, skeletal muscle dynamics, and neuroendocrine regulation, all of which are essential for optimizing athletic performance. This study investigates the composition of a selection of gut microbiota among Iranian professional and semi‐professional runners from three different disciplines including endurance, middle‐distance, and speed runners, and examines their association with performance levels. Methods Fresh stool samples of 60 runners were collected and the relative abundance of a selection of intestinal microbiota at various taxonomic levels was assessed by RT‐qPCR. The relative abundance of the selected microbiota revealed distinct patterns across different types of runners. Results Predominant taxa in professional groups were Bacteroidetes, Firmicutes, and Prevotella spp., while semi‐professional groups had a higher abundance of Firmicutes, Bacteroidetes, Actinobacteria, Clostridia, and Prevotella spp. Akkermansia muciniphila was mostly abundant among speed runners (40.95%), followed by endurance (27.025%) and middle‐distance runners (23.525%). Fusobacterium nucleatum was more abundant in middle‐distance (34.9%) and endurance runners (34.3%) compared to speed runners (22.3%). A negative correlation was found between performance levels and the abundance of Actinobacteria, Enterobacteriaceae, E‐proteobacteria, Bifidobacterium spp., and Faecalibacterium prausnitzii , while a positive correlation was observed with Methanobrevibacter smithii . Conclusion This study illuminates the distinct microbial taxa detected in professional and semi‐professional runners, which corroborates the relationship between running disciplines and the gut microbiota composition, as well as their impact on performance levels.
This study investigates the global prevalence of helminthic parasites in contaminated cockroaches, with a particular focus on identifying patterns based on climatic variable, geographic location, sample sources, detection methods, and cockroach species. From 2,884 articles, 39 articles had the eligibility to be included in the current study. The analysis revealed that the highest prevalence was found in household samples (0.399, 95% CI: 0.252–0.556). Specific species, such as Blatta orientalis, showed an exceptionally high prevalence of 0.885 (95% CI: 0.822 – 0.928). Regionally, Cameroon had the highest prevalence at 0.898 (95% CI: 0.856 – 0.934). Furthermore, environmental factors significantly influenced prevalence, with regions having annual precipitation over 1000 mm and humidity above 75% showing prevalence rates of 0.387 (95% CI: 0.164 – 0.638) and 0.590 (95% CI: 0.283 – 0.863), respectively. The findings indicate a significant global challenge posed by helminthic parasites associated with cockroaches, particularly in Africa and low-income settings. Higher prevalence rates correlate with factors such as household environments and specific detection methods, notably in regions characterized by warm and humid climates. These results underscore the necessity for targeted public health interventions and the implementation of effective pest management strategies to mitigate the risks associated with cockroach-related helminthiases.
Abstract Trichomonas vaginalis is a protozoan parasite and probably one of the main causes of adverse birth outcomes. Still, there is a paucity of information regarding the burden of T. vaginalis infection in Iranian women. To address this gap, we conducted a systematic review and meta-analysis of studies on trichomoniasis among females in Iran from January 2000 to January 2023. We searched multiple electronic databases (PubMed, Science Direct, Scopus, ProQuest, Web of Science, Google Scholar, Scientific Information Database, Iran Medex, Magiran and Iran Doc) and identified 108 articles with a total of 200 728 women. Using a random effects model, we found a pooled prevalence of 4.30% (95% CI 3.23 to 5.52%). Subgroup analysis, also, demonstrated a statistically significant association between the T. vaginalis prevalence in Iranian women, and the age range, city, sample type, being in prison, sex working and symptomatic infections. Our findings provide important information for healthcare authorities and can inform prevention strategies against trichomoniasis in Iran.
Background: Breast cancer is the most common cancer among women in Iran. The aim of this study was to explore the spatial autocorrelation and the estimation incidence rates variance among Iranian provinces. Methods: In this cross-sectional exploratory study, age-standardized incidence rates from 2004 to 2010 were analyzed in order to detect hot and cold spots map and estimate the rates using ordinary kriging Results: Mapping of clusters showed that hot and cold spots located in the East and North East regions of Iran. Maps of estimated values for 2004 were between 0.06 - 101.15 and for 2010 between 20.85 - 329.68, which indicate increase in incidence rates, especially in some areas. Conclusions: There are relatively large differences between the geographic distribution of the breast cancer clusters in the East and North East regions of the country in comparison to other areas. Policy makers are advised to consider such provincial diversity for better understanding of factors affecting the incidence of breast cancer.
This study aimed at building a prognostic signature based on a candidate gene panel whose expression may be associated with lymph node metastasis (LNM), thus potentially able to predict colorectal cancer (CRC) progression and patient survival. The mRNA expression levels of 20 candidate genes were evaluated by RT-qPCR in cancer and normal mucosa formalin-fixed paraffin-embedded (FFPE) tissues of CRC patients. Receiver operating characteristic curves were used to evaluate the prognosis performance of our model by calculating the area under the curve (AUC) values corresponding to stage and metastasis. A total of 100 FFPE primary tumor tissues from stage I–IV CRC patients were collected and analyzed. Among the 20 candidate genes we studied, only the expression levels of VANGL1 significantly varied between patients with and without LNMs (p = 0.02). Additionally, the AUC value of the 20-gene panel was found to have the highest predictive performance (i.e., AUC = 79.84%) for LNMs compared with that of two subpanels including 5 and 10 genes. According to our results, VANGL1 gene expression levels are able to estimate LNMs in different stages of CRC. After a proper validation in a wider case series, the evaluation of VANGL1 gene expression and that of the 20-gene panel signature could help in the future in the prediction of CRC progression.
Bowel preparation affects the quality of colonoscopy. Reaching the optimal preparation has been a challenge for years. Polyethylene glycol (PEG) is the sole FDA-approved substance for this purpose. However, patients find it unpleasant and often complain about its adverse effects. In this study, we aimed to reduce these complaints by lowering the amount of PEG and adding senna which is an herbal stimulant laxative.
Background The precise impact of sex difference on in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients are unclear, and the studies are no longer consistent. Therefore, we sought to evaluate the impact of sex differences in a cohort of STEMI patients. Methods We analyzed the data of 2647 STEMI patients enrolled in the Kermanshah STEMI Cohort from July 2017 to May 2020. To accurately clarify the relationship between sex and hospital mortality, propensity score matching (PSM) and causal mediation analysis was applied to the selected confounder and identified intermediate variables, respectively. Results Before matching, the two groups differed on almost every baseline variable and in-hospital death. After matching with 30 selected variables, 574 male and female matched pairs were significantly different only for five baseline variables and women were no longer at greater risk of in-hospital mortality (10.63% vs. 9.76%, p = 0.626). Among the suspected mediating variables, creatinine clearance (CLCR) alone accounts for 74% (0.665/0.895) of the total effect equal to 0.895(95% CI: 0.464–1.332). In this milieu, the relationship between sex and in-hospital death was no longer significant and reversed -0.233(95% CI: -0.623–0.068), which shows the full mediating role of CLCR. Conclusion Our research could help address sex disparities in STEMI mortality and provide a consequence. Moreover, CLCR alone can fully explain this relationship, which can highlight the importance of CLCR in predicting the short-term outcomes of STEMI patients and provide a useful indicator for clinicians.
Background and aims: One of the most common approach to understanding spatial and temporal trends of event data is to break it up into a series of time snapshots. Therefore space-time cube method applied in order to portray the likely trend in occurrence of the pulmonary tuberculosis (TB) cases.Methods: In this study, information of all patients with pulmonary TB recorded in surveillance system of Hamadan University of Medical Sciences from 2005 to 2013 years were studied. After geocoding the residence location address of pulmonary TB cases and converted to point layer, the space-time cube was used to detect likely trends in occurrence of tuberculosis. Then, based on the space-time cube results the Emerging Hot Spot Analysis was run to clustering hot and cold spots.Results: There was significant increasing trend in occurrence of pulmonary TB cases. The statistic trend was 2.1871 and P-value was 0.0287, as well as 36 hot spots locations was detected that have been form approximately in central areas of province.Conclusion: Significantly increasing trend in occurrence of TB cases and existence of hot spot, especially intensifying hot spots in central areas of province can represent pay more attention to this disease in mentioned areas in order to detect the change in epidemiological face and to implement suitable prevention programs.
Cancer is a problem of both global and local concern. We determined the geo-epidemiological and spatial distribution of the 10 most common cancers in Iran. We used the data of the Iranian Cancer Registry for the year 2014 analysing the prevalence of 112,131 registered cancer cases with the aim of detecting potential geographical underlying causes. The geographic distribution of cancers is reported as standardized incidence rates at the provincial level considering risk with respect to sex and age. A geographical information systems (GIS) approach based on Anselin Local Moran’s index method was used to map clusters and spatial autocorrelation patterns. The mean age of the patients was 55.6 (±17.8) and 61.7 (±18.2) for females and males, respectively, in the database which showed 46.1% (n=51,665) of all cases to be female. Analysis of the spatial distribution of cancers showed significant differences among the different provinces. Stomach and breast cancers were the most prevalent cancers in men and females, respectively. The highest incidence rates of stomach cancer were found in Ardabil and Zanjan provinces, with 48.38 and 48.08 per 100,000 population, respectively, while Tehran and Yazd provinces had the highest incidences of breast cancer, 51.0 and 47.5 per 100,000 population, respectively. Strong clustering patterns for stomach and breast cancers were identified in the north-western provinces and in Semnan Province, respectively. These patterns indicate a diversity of geo-epidemiological contributing factors to cancer incidence in Iran.
We conducted this study to estimate the direct medical cost of Iranian IBD patients.
This study was conducted to detect clusters of pulmonary TB cases in Hamadan Province, west of Iran.All patients with pulmonary tuberculosis recorded in the surveillance system from 2005 to 2013 were studied. The spatial scan statistic was used to detect significant clusters in status of unadjusted and adjusted for age, sex and location residence variables.Clusters with high rate for both purely spatial and space-time analyses were seen in the same geographical areas composed of four city of Asadabad, Bahar, Toyserkan and Nahavand. Adjustment for mentioned variables did not change location of detected clusters with high rates.Findings revealed evidence of significant clusters in Hamadan Province. Study results may help the health system to develop effective public health interventions and extend preventive interventions. However more study are needed to better explain of detected clusters due to limited access to effecting factors.
Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis.An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas.The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables.The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.
Suicide behaviors are complex and multifactorial problems that in the most of the societies are considered as the public health challenge. However, its underlying reasons and spatial pattern remain unclear in Hamadan Province, western Iran.Secondary analysis of existing data.We assessed the spatial pattern pre-city regarding some influencing factors by scan-statistics and logistic regression to detect clusters areas and its comparison with other areas for the period of 2016-2017. All of the registered cases of attempted suicide in a quality registry system of suicide in Sina (Farshchian) Hospital affiliated to Hamadan University of Medical Sciences, Hamadan, Iran were enrolled.Two significant clusters were detected in study areas, formed with relative risk at 5.28 (P=0.001) and 6.33 (P=0.017), and with the centrality of Asadabad and Razan, respectively. Clusters and non-clusters areas were differed in terms of location (OR=0.15, 95%, CI: 0.07, 0.31), self-harms methods (OR=0.28, 95%, CI: 0.9, 0.88) and education. Residents of rural areas, illiterate people and non-drug user cases have more likely to be in a cluster.Clusters were not formed equally among cities of Hamadan Province. Accordingly, we suggest the implementation of appropriate, long-term and evidence-based educations for high-risk and vulnerable groups through the intersectoral interventions in different parts of Hamadan Province (considering the cluster and non-clusters areas) to avert deaths and related injuries from attempted suicide.
Aim: The prognostic and predictive value of Elevated Microsatellite Alterations at Selected Tetranucleotide (EMAST) has been reported in colorectal cancer (CRC). The prevalence of EMAST in CRC varied across the literature. We conducted a meta-analysis to determine the prevalence of EMAST in CRC. Materials & methods: Three international databases including PubMed, ISI and Scopus were searched to identify related articles that described the frequency of EMAST. Results: Analysis was performed on 16 eligible studies including 4922 patients. The overall EMAST prevalence among CRCs patients was 33% (95% CI: 23-43%, I2 = 98%). Conclusion: This study indicated that approximately a third of the CRC patients are diagnosed with EMAST, hereupon EMAST as a prognostic and predictive biomarker should be more studied clinically.
This systematic review and meta-analysis evaluated the subtyped Blastocystis sp. isolated from humans in Iran.Blastocystis sp. is an anaerobic intestinal protozoan that infects humans as well as domestic and wild animals, i.e. mammals, amphibians, reptiles, and arthropods.A comprehensive search for papers published before April 2022 was undertaken utilizing English and Persian databases. The following MeSH keywords were used in the electronic search: (Blastocystis sp.) AND (molecular OR subtype) AND (prevalence OR epidemiology) AND Iran. The quality of the included studies was evaluated. Thereafter, a random-effects meta-analysis was conducted to estimate the pooled prevalence and odds ratios regarding the included studies.A total of 32 studies comprised of five case-control studies and 27 cross-sectional studies met the eligibility criteria. The overall pooled prevalence of subtyped Blastocystis sp. in Iran was estimated to be 10% (95% confidence interval: 6 to 15%). Eight subtypes of Blastocystis sp. (ST1- ST7 and ST9) were identified in our study, of which ST3 was the most common subtype (0.04); 0.02-0.07). The difference in subtypes between two case and control groups in reported studies was not significant, but the odds ratio of infection by ST3 (0.98; 95% CI, 0.30 to 3.20) was higher in cases.The current systematic review showed that with the exception of ST8 and ST12, all human Blastocystis sp. subtypes reported in the world are found in different parts of Iran.
The present study aims to evaluate the prognostic value of liver-related laboratory parameters in COVID-19.This is not the first nor will it be the last time that a member of the β-coronaviruses wages a full-scale war against human health. Notwithstanding atypical pneumonia being the primary symptom, the emergence of severe disease mainly resulting from the injury of non-pulmonary organs leaves no alternative, in some cases, other than a dreadful death.To provide a well-conceptualized viewpoint representing the prognostic values of liver-related laboratory parameters in COVID-19, a meta-analysis was performed with the calculation of mean difference and 95% confidence intervals of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Bili), and albumin (Alb) in severe and non-severe COVID-19 patients.While severe COVID-19 cases displayed higher values of ALT, AST, and Bili compared to non-severe patients (mean differences of 7.48, 12.07, and 3.07, respectively), the value of Alb was significantly lower in severe cases (mean differences of -6.15). There was also a correlation between alterations in all of the parameters; however, only correlations between ALT and Bili (R=0.98, p=0.0031), and Bili and Alb (R=-1, p=0.0012) were significant.Abnormal values of liver-related examinations outwardly contribute to reflect the progression of the disease toward an unfavorable outcome. Therefore, careful scrutiny of these parameters will provide clinicians with invaluable information regarding SARS-CoV-2 infection, at least in terms of liver injury.
Clostridioides difficile infection (CDI) is a major cause of morbidity among patients with inflammatory bowel disease (IBD). Diagnostic biomarkers for early detection of CDI are needed in clinical practice. The relationship between serum procalcitonin and CDI in IBD patients has not been investigated so far. Therefore, we aimed to evaluate the usefulness of measuring serum procalcitonin level to detect CDI in patients with the flare of IBD.One hundred twenty patients with IBD were enrolled in this study. Bacterial identification was performed using standard microbiological and molecular methods. The serum procalcitonin levels were measured in all patients. Receiver operating characteristic (ROC) curve analysis was applied to assess the value of procalcitonin for the prediction of CDI among IBD patients.The median serum procalcitonin level was significantly increased in IBD patients with CDI compared to non-CDI IBD patients (0.69 ng/mL vs 0.32 ng/mL). In univariate analysis, log10 procalcitonin was associated with CDI (OR 2.81, 95% CI 1.54-4.09, P-value < 0.001). Procalcitonin 1.1 ng/mL was 85% sensitive and 88% specific for the prediction of CDI. In the multivariable model including the covariates log10 procalcitonin, age, hospitalization, type of IBD, duration of the disease, and antibiotic usage, procalcitonin showed a robust association with CDI (OR 4.59, 95% CI 2.49-6.70, P-value < 0.001). An elevated procalcitonin level was associated with the presence of CDI among IBD patients.Our results indicate that procalcitonin level can be a good candidate biomarker for assessing the CDI in IBD patients. Further studies are required to decipher whether procalcitonin can predict CDI therapy or its recurrence.
Abstract Purpose Entamoeba gingivalis (E . gingivalis ) is one of the members of the wide range of oral resident pathogens in humans, particularly found in dental plaques, surfaces of gingiva or teeth, interdental spaces and carious lesions. The purpose of the current review and meta-analysis was to determine the global prevalence of E. gingivalis infection and its association with oral diseases based on published literatures. Methods Multiple English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored for papers published until August 2020. A total of 52 studies (including 7596 participants) met the inclusion criteria. Results The overall prevalence of E. gingivalis was estimated to be 37% (95% CI: 29% - 46%). With regard to different countries, the highest and lowest pooled prevalence of E. gingivalis infection were related to Jordan with 87% (95% CI: 81% - 92%) and Portugal with 3% (95% CI: 0% - 10%), respectively. Based on WHO regions, the highest prevalence was related to the region of the Americas with 56% (95% CI: 31%-79%). The infection was most prevalent in 46-55 mean age groups [61% (95% CI: 21% - 94%)]. Among different diagnostic methods, the highest rate of the pooled prevalence was related to the molecular [53% (95% CI: 24% - 81%)] and the direct methods [36% (95% CI: 25% - 47%)], respectively. Our analyses revealed that E. gingivalis infection was associated with 4.34-fold increased risk of oral diseases ( P < 0.05). Conclusion Our findings revealed a high prevalence rate of the infection among periodontal disease patients with 37% (95% CI: 20% - 57%). To conclude, it must be considered that E. gingivalis can be a risk factor associated with oral diseases and a wide range of research is needed to specify its role in the pathogenesis of these disorders.
: The ongoing devastating epidemic of coronavirus disease 2019 (COVID-19) in Iran and the evolving public health situation is very concerning. We have developed a deterministic epidemiological SEIR (Susceptible, Exposed, Infectious, Recovered) model to quantify the required time and efficacy to bring the COVID-19 outbreak under control in Iran. Our results showed that the efficacy of COVID-19 confronting strategies on Feb 29th and March 9th were at 0.5 and 0.7, respectively owing to the relative equivalence number of infected cases estimated by the model and national officially reported cases. Therefore, to control the COVID-19 outbreak in Iran we strongly recommend maintaining the effectiveness of interventions at 0.7 or more at least for the next 4 - 6 weeks. Because the COVID-19 declining statistics over the next few days or weeks do not mean the definitive control of the outbreak.
Brucellosis is one of the most prevalent bacterial zoonotic diseases considered as a public health problem in Golestan province (north-east of Iran), but its spatial pattern remains unclear. Hence we evaluated the spatial analysis of brucellosis disease in Golestan province during 2015-2017. In this study, we explored the Spatial and Spatiotemporal clusters by using scan-statistic to consider influencing factors. In addition, logistic regression and Pearson’s chi-square tests were used to analyze the clusters' zones and compare them with others. We used GIS to determine unites' (Golestan cities) coordinate centers and visualize the location of the clusters. Results revealed that the geographical distribution of brucellosis in Golestan province was affected by several spatial and spatiotemporal clusters. Constituent units of both spatial and spatiotemporal clusters were the same, but the identified time period of spatiotemporal clusters was from January 2015 to June 2016. The main influencing factors were in contact with livestock and dairy hygiene. This study can assist health authorities to plan more effectively to control diseases by highlighting the high-risk areas and behaviors.
Background: Although by comparing the number of deaths to the total number of cases one may conclude that most of the infected cases are recovering, taking a look at the increasing statistics of deaths shows that SARS-CoV-2 continues to take its toll Since lymphocytes are the main immune cells battling with rapidly evolving viruses, it comes as no surprise to assume that a decreased number of these propitious soldiers may contribute to poor prognosis of the wide range of viral infections, including COVID-19 Methods: To provide a better prospect representing the prognostic value of lymphopenia in COVID-19, we searched the national library of medicine Medline/PubMed and performed a meta-analysis of pertinent literature representing information on the lymphocyte count in COVID-19 patients Results: The results of our meta-analysis revealed that the number of lymphocytes retains a specific clinical and biological significance in this infection and lymphopenia is seemingly an important hematological abnormality that contributes to mirror the evolution toward an unfavorable outcome Conclusion: The rapidly evolving nature of COVID-19 together with relentless disclosure of novel findings denotes a major limitation to the current study, and further investigations in the field of prognostic biomarkers will definitively pave the way to better manage patients with severe COVID-19
Spatial scan statistic has been shown as a useful tool to investigate spatial patterns and detecting the spatial clusters of cancer. This study conducted to study spatial analysis of breast cancer and its late-stage cases, one of the most common women cancers in Iran and the world.We used space-time and purely spatial scan statistic implemented in SaTScan software to detect clusters of breast cancer and late-stage cases, at city level by applying Poisson and Bernoulli distribution. Data on 40017 of breast cancer cases that reported to the Ministry of Health and Medical Education (MOHME) during 2005 to 2010 were included.Purely spatial and spatiotemporal high rates significant clusters of breast cancer and its late-stage cases with Poisson distribution were in the same geographical area including southwest, north, and northeast.Significant clusters areas have probably differences with other areas in terms of delay in diagnosis and access to appropriate health services because late-stage breast cancer cases had the greatest impact on formation of clusters. However, more studies are essential to be conducted in different areas of country to explain more precisely clusters detected areas and detecting reasonable justification for existence of significant clusters.
Abstract Background There is often a fear of social stigma experienced by people with multiple sclerosis (pwMS), which negatively impacts the quality of their lives (QoL). Currently, no Persian-validated questionnaire is available to assess this issue in pwMS. This study aimed to assess the validaty and reliability of the Persian version of Reece Stigma Scale Multiple Sclerosis (RSS-MS) questionnaire for pwMS. Method This cross-sectional was conducted between January and February 2023 in Isfahan, Iran. The demographic and clinical information and the RSS-MS and Multiple Sclerosis Impact Scale-29 (MSIS-29) questionnaires were recorded from pwMS. The content validity index (CVI) and content validity ratio (CVR) have been used to evaluate validity. To identify the factors supporting the MS-related stigma, an exploratory factor analysis (EFA) was conducted. Results The present study recruited 194 pwMS. Based on factor analysis, only two factors had eigenvalues ≥ 1.0 and exhibited high internal consistency. The Cronbach’s α coefficient for internal consistency of the RSS-MS scale was 0.822. More evidence for the construct validity suggested that having higher levels of stigma is significantly correlated with psychological (r = 0.468, p-value < 0.001) and physical dimensions (r = 0.585, p-value < 0.001) of MSIS-29. Expanded Disability Status Scale, disease duration, and treatment duration did not show a significant correlation with stigma ( p-value > 0.05). Conclusion This study indicated that the modified version of the RSS-MS scale in the Persian language showed acceptable validity and reliability for evaluating the stigma among Persian pwMS. Furthermore, this study emphasizes the cruciality of monitoring and addressing stigma among pwMS, as it can potentially enhance medical, psychological, physical, and QoL outcomes.
To estimate the epidemiological parameters related to the Covid-19 outbreak in Iran.Estimating the epidemiological parameters of new public health threat (COVID-19) is essential to support and inform public health decision-making in different communities including Iran.We established a mathematical model to estimate the epidemiological parameters from 19 Feb to 15 March based on daily COVID-19 confirmed cases in Iran. Then, we estimated the effect of early traffic restriction on our estimation.We estimated the R0 at 2.11 (95% CI, 1.87-2.50) and the infected number at 92,260 (95% CI: 59,263 -152,212) by 15 March. Our estimate for the ascertainment rate was about 1.2% (95% CI: 1.1-1.4). The latent period estimation was 4.24 (95% CI: 2.84-6.65). We observed a decline in our estimate after considering the traffic restriction.Our results suggest that health authorities in Iran must take impactful strategies to control the COVID-19 outbreak to reach R0<1. Therefore, the establishment of complementary, multilateral, and cost-effective measures for the treatment of symptomatic and early diagnosis and isolation of asymptomatic cases/contacts are strongly recommended because of low ascertainment rate and large number of infected cases. We additionally recommend that traffic restriction be combined with other controlling measures.
Background: Noroviruses are the most common known causes of non-bacterial acute gastroenteritis worldwide. Norovirus gastroenteritis usually presents with vomiting and diarrhea in the winter. Methods: This cross-sectional study was conducted to evaluate the outbreak of gastroenteritis in one of the villages of Kurdistan Province, Iran, from February 1 to 12, 2019. In this period, 149 people developed joint illness and symptoms of diarrhea, vomiting, and abdominal cramps, whose information was recorded. Data analysis was done with Stata7 software. Results: The attack rate of the total population in the village was 31.17% (26.5% in men and 36.24% in women). The median age of the patients was 26.5 years. The mean patients’ age on the first days of the outbreak was less than on the other days, and this relationship was statistically significant (P=0.003). The most common symptoms were non-bloody diarrhea (57.71%), vomiting (52.34%), abdominal cramps (26.17%), and nausea (24.83%). According to the shape of the epidemic curve, the outbreak was a community-wide outbreak caused by the norovirus. Conclusion: Based on clinical evidence, epidemiological examination, and human and water samples analyses, outbreaks occurred due to the consumption of drinking water contaminated with norovirus. To prevent similar outbreaks, it is recommended to fix the bugs observed in the water supply system and implement the water safety program.
Background: Fish tapeworms of the genus Diphyllobothrium are pseudophyllidean cestodes transmitted through the consumption of raw or inadequately cooked fish. Objective: The current systematic review and meta-analysis aim to estimate the global prevalence of Diphyllobothrium in dogs and cats based on published literature. Methods: Multiple English databases (PubMed, Scopus, ProQuest, Web of Science, and Google Scholar) were explored for relevant papers published until December 2021. Findings: Among the 37 studies that were included, 32 documented Diphyllobothrium infection in dogs and five in cats. The pooled prevalence (95% confidence interval) was 0.060% (0.030%-0.100%). The analysis based on country showed that the highest pooled prevalence in dogs and cats was observed in Bangladesh (0.250%, 0.149%-0.366%) and Indonesia (0.254%, 0.182%-0.333%), respectively. Based on the continent, Africa (0.109%, 0.017%-0.264%) and Asia (0.060%, 0%-0.345%) were the most common regions for infection in dogs and cats, respectively. Among different diagnostic methods, the highest pooled prevalence was related to molecular (0.661%, 0.573%-0.743%) and parasitological techniques (0.041%, 0%-0.217%) for dogs and cats’ studies, respectively. Conclusion: The findings show the importance of establishing a prevention and control measure focused on improving regular deworming and enhancing awareness of parasitic zoonotic diseases to minimize the transmission risk.
Abstract Background and aims: Some chronic intestinal disorders, including irritable bowel syndrome (IBS), coeliac disease (CD), and non-coeliac gluten sensitivity (NCGS), can make some changes to the gut microbiota composition and cause dysbiosis. This study aimed to determine the gut microbiota alterations in CD, NCGS, and IBS patients among the Iranian population compared to healthy controls. Materials and Methods: In this prospective study, 72 patients, including 15 healthy controls (HC), 30 IBS, 12 NCGS, and 15 CD patients were included. IBS, CD, and NCGS were diagnosed based on the Rome IV diagnostic criteria, Modified Marsh classification, and gluten challenge test. Stool samples were collected from patients, and after DNA extraction, quantitative real-time PCR (qPCR) was performed for assessing the relative abundance of Firmicutes , Bacteroidetes , Bifidobacterium spp. , and Lactobacillus spp. Results: Firmicutes and Lactobacillus spp . were the most and the least abundant phylum in all samples, respectively. In CD patients, Firmicutes phylum was the most significant relative abundance. Bacteroidetes phylum had a significant relative abundance in CD (P<0.01) and NCGS (P<0.05) patients. The relative abundance of Bifidobacterium spp . was statistically lower in CD (P<0.05) and IBS patients (P<0.001) compared to the HCs. The Firmicutes to Bacteroidetes ratio was statistically significant in NCGS and CD patients compared to the HCs (P = 0.05). Conclusion: Chronic intestinal diseases, including IBS, CD, and NCGS, can alter the gut microbiota composition.
Background: Spatial analysis is one of the required tools of epidemiology and public health sciences. This study intends to detect significant clusters of breast cancer cases in Kurdistan Province, Iran.Methods: We obtained data that pertained to breast cancer cases during 2005-2014 from the Health Deputy at Kurdistan University of Medical Sciences. After application of spatial scan statistics to detect the purely spatial (aggregation of cases in particular locations of space) and space-time (diseases clusters in space that depend on the time period) clusters, we calculated the population attribution risk (%) values to better distinguish the detected clusters.Results: We observed that the second secondary purely spatial cluster (P=0.0051) had the highest population attribution risk (%) of 3.8 and the primary space-time unadjusted cluster (P=0.0019) had the lowest population attribution risk (%) of 0.67 of all the detected clusters. Before we applied the adjustment, both the space-time and purely spatial clusters had similar locations. However, after adjustment for age, the space-time clusters location shifted and population attribution risk (%) values changed (between 0.02 and 0.4).Conclusion: Population attribution risk (%) value differences and clusters’ temporal and spatial variations before and after adjustments can represent disease interventions impact. Additional studies should be conducted to strengthen the registering and reporting system to determine other influencing factors.
This study was conducted to provide a clear epidemiological picture of HCV spatial pattern.Hepatitis C virus (HCV) is one of the major problems of public health, that its spatial and spatiotemporal pattern remain unclear in Hamadan province.We used the scan statistic to identify the spatial and spatiotemporal clusters of HCV in Hamadan province with an emphasis on considering the role of carrier's and injecting drug users (IDUs) cases. We repeated the same analysis to estimate the effect of some influencing factors on the formation of clusters. All HCV cases that had been recorded by deputy health of Hamadan University of Medical Sciences during 2008-2016 were included in this study.The location of the purely spatial cluster for carriers, IDUs and total of cases were similar to each other, a cluster consisting of Toyserkan, Nahavand, Asadabad, Malayer and Bahar cities. However, after adjustment, the location of the identified cluster for both carries and IDUs cases changed to a cluster consisting of Asadabad, Bahar, Toyserkan and Nahavand cities. This cluster also observed for spatiotemporal clusters carriers, IDUs and total of cases even after adjustment.Although further studies in individual level are needed, our results revealed that spatial distribution of HCV in Hamadan province (especially in clusters areas) can strongly dependent on the distribution of IDUs cases. Consequently, the effectiveness of HCV combating programs is subjected to properly controlling these case through various counseling, behavioral and therapeutic programs.
Background: Dutch Musculoskeletal Questionnaire (DMQ) is used to examine physical and environmental risk factors and to identify high-risk groups for exposure to the risk factors of musculoskeletal disorders at workplace. The aim of this study was to develop the Persian version of the DMQ and to assess its psychometric properties. Methods: This study was conducted on 212 employees of Gas Transmission Company. Using a standard forward-backward translation procedure, the English version of the questionnaire was translated into Persian and culturally adapted. Content validity was established by 10 expert opinions. The intraclass correlation coefficient (ICC) was used for the statistical analysis of reproducibility. Kuder-Richardson-20 was used for internal consistency and confirmatory factor analysis for structural validity. Results: This study revealed high internal consistency and good test-retest reliability for the Persian version of the questionnaire. The means of the content validity ratio (CVR) and content validity index (CVI) for the total 35 items of the questionnaire were 0.96 and 0.91, respectively. The internal consistency of the factors was satisfactory, ranging from 0.83 to 0.88. Confirmatory factor analysis confirmed the existence of 7 factors in the questionnaire and an acceptable fit for the Persian version of the DMQ. Conclusion: The Persian version of the DMQ has acceptable psychometric properties. Thus, it can be used as a valid instrument to assess workload and to identify high-risk groups of musculoskeletal disorders at workplace.
<title>Abstract</title> The authors have withdrawn this preprint from Research Square
Co-infection of schistosomiasis and malaria with hepatitis B virus (HBV) and hepatitis C virus (HCV) are common in countries where schistosomiasis and malaria are endemic.The present systematic review and meta-analysis was conducted to assess the prevalence of malaria/hepatitis viruses and Schistosoma/hepatitis viruses' co-infections.Relevant published studies on the co-infection of malaria and Schistosoma spp. with HBV and HCV were retrieved via international databases (PubMed, Scopus, Web of Science, and Google Scholar). Regarding meta-analysis, the random-effect model was employed by forest plot with a 95% of confidence interval (CI).A total of 22 studies, including 15 studies with malaria/hepatitis viruses' co-infection and 7 studies with Schistosoma/hepatitis viruses' co-infection met the eligibility criteria. The co-infection of malaria/HCV and malaria/HBV in different populations were 15% (95% CI, 0-77%) and 5% (95% CI, 1-10%), respectively. Moreover, Schistosoma/HCV and Schistosoma/HBV co infection were detected in 7% (95% CI, 0-54%) and 2% (95% CI, 0-7%), respectively.The overlaps between Schistosoma spp. and malaria with hepatitis B and C viruses in endemic countries with lower income levels were high, which deserve further attention.
Abstract Background & objective: Recently, dietary restriction of fermentable carbohydrates (a low-FODMAP diet) in combination with a gluten-free diet (GFD) has been proposed to reduce the symptoms in irritable bowel syndrome (IBS) patients. Different studies reported that IBS has been associated with dysbiosis in the gut microbiota. Additionally, a few studies have reported inflammation in gastrointestinal (GI) system of adults with IBS. In this study we aim to investigate the effects of GFD and low-FODMAP diet on clinical symptoms, intestinal microbiota diversity, and fecal calprotectin (FC) level in Iranian patients with IBS. Design: In this clinical trial study, 42 patients with IBS (Rome IV criteria) underwent GFD + low-FODMAP dietary intervention for 6 weeks. Symptoms were assessed using the IBS symptom severity scoring (IBS-SSS), and fecal samples were collected at baseline and after intervention and analyzed by quantitative 16S rRNA PCR assay. The diversity of gut microbiota compared before and after 6 weeks of dietary intervention. FC was also analyzed by ELISA method. Results: Thirty patients (mean age 37.8 ± 10.7 years) completed the 6-week diet. The IBS-SSS was significantly ( P = 0.038) reduced after GFD + low-FODMAP dietary intervention compared to the baseline. Significant microbial differences before and after intervention were noticed in fecal samples. A significant increase was found in Bacteroidetes , and the Firmicutes to Bacteroidetes (F/B) ratio was significantly ( P = 0.001) decreased after the dietary intervention. The value of FC was significantly decreased after 6 weeks dietary intervention ( P = 0.001). Conclusions: Our study suggests that patients with IBS under a GFD + low-FODMAP diet had a significant improvement in IBS symptoms severity, with reduced FC level following normalization of their gut microbiota composition. Further rigorous trials are needed to establish long-term efficacy and safety of this dietary intervention for personalized nutrition in IBS.
Description of the inflammatory bowel disease natural history in Tehran province.Inflammatory bowel disease (IBD) is a non-homogeneous disorder with an unpredictable natural history that impairs a patient's quality of life over the course of their life. As a result, providing evidence for efficient patient management is critical.In this case series study, 198 IBD patients who were visited in our clinic at least three times routinely from Oct 2015 to May 2020 were included. Then, two panel-based approaches, the Multi-State Model (MSM) and random-effect ordered logistic, were used to deduce the clinical course of IBD, which included remission, mild, moderate to severe, and surgical states.For ulcerative colitis (UC), women had a slightly poorer condition for remission but better for moderate to severe and a faster transition from moderate to severe to mild (HR=1.490, 95% CI: 1.02-2.16) compared to men. For Crohn's disease (CD), they had a better condition for remission but a slightly poorer condition for the severe state and higher transition from mild to moderate to severe (HR=1.221, 95% CI: 0.471-3.22) than men. Oral 5-ASA had better efficacy in people with remission and/or mild states but not for those with moderate to severe states, especially in CD (mild to moderate to serve, HR=1.526, 95% CI: 0.59-3.89). Immunosuppressive drugs were better for patients with lower disease severity, especially with UC (mild to remission, HR=1.258, 95% CI: 0.75-2.09).Panel approaches have the potential efficacy to tackle the unpredictable clinical course of IBD (UC/CD). Hence, we highly recommend that our findings be included into the Iranian routine clinical environment of IBD and/or that related studies be conducted in Iran and other regions to gain a better understanding of the natural history of IBD.
The role of various parasitic infections in the occurrence of appendicitis is illustrated through cases recorded all over the world. The purpose of the current study was to estimate the global prevalence of parasite infestation (other than <i>E. vermicularis</i>) in appendectomy specimens. In the setting of the PRISMA guidelines, multiple databases (Science Direct, Scopus, Web of Science, PubMed, and Google Scholar) were explored in articles published until 28 September 2020. Totally, 62 studies (106 datasets) with 77, 619 participants were included in the analysis. The pooled prevalence of parasites in appendectomy samples was as follows; 0.012% (95% CI; 0.004–0.025) for <i>Ascaris lumbricoides</i>, 0.004% (95% CI; 0.001–0.009) for <i>Trichuris trichiura</i>, 0.025% (95% CI; 0.007–0.052) for <i>Schistosoma mansoni</i>, 0.002% (95% CI; 0.001–0.005) for <i>Taenia</i> spp., 0.061% (95% CI; 0.020–0.122) for <i>Entamoeba histolytica</i> and 0.034% (95% CI; 0.018–0.056) for <i>Giardia lamblia</i>. Our results demonstrated that the risk of appendicitis may increase in the presence of helminth and protozoan infections. As such, the most cases of parasites in appendectomy specimens were reported in developing countries. Regular screening plans for diagnosis, treatment and prevention are needed for prevention of parasitic infection as well as parasitic associated appendicitis, especially in endemic regions of the world.
Ocular toxocariasis (OT) is a zoonotic infection caused by larval stages of <i>Toxocara canis</i> and <i>T. cati</i>. The current review and meta-analysis aimed to evaluate the global prevalence of OT. Five English (PubMed, Scopus, Science Direct, Web of Science, and Google Scholar) databases were explored and 101 articles met the inclusion criteria. The pooled prevalence (95% confidence interval) of OT was higher in immunological studies (9%. 6–12%) than in studies that applied ophthalmic examination (1%. 1–2%). The lower middle-income level countries had the highest prevalence (6%. 2–12%) as well as the African region (10%. 7–13%). The highest infection rate (4%. 2–7%) was detected in the 1–25 mean age group. Regular anthelminthic treatment of cats and dogs, and removal of animal feces from public places must be considered.
Dear Researchers, Understanding the future burden of Rheumatoid Arthritis is critical for shaping global healthcare policy and resource …