Background: Visceral leishmaniasis (VL) has strong links with poverty, substantial medical and veterinary impacts. This review aimed to focus in studies published during 1994-2016 on VL in southeastern Iran.

Methods: The present review is based on expert knowledge and historical studies published during the past 23 yr (1994-2016) on VL in southeastern Iran. In addition, related literature found in PubMed by using the keywords such as visceral leishmaniasis, kala-azar, and Leishmania infantum are included.

Results: Overall, 118 children aged 4.2 yr were detected as infected with human VL (HVL). The majority of the cases were from Orzoieh district (37.1%) in southwest of Kerman Province, followed by Sirjan (15.7%), Jiroft (14.8%), Kahnuj (9.3%) and to lesser extent from other areas. The male to female ratio was 1.7. The three most frequent clinical features were represented by fever (100.0%), anemia (95.0%) and splenomegaly (91.5%). Altogether, 42.0% of the VL cases developed secondary bacterial infections, the overall case-fatality rate was 3.4%, and majorities (88.0%) of the VL patients were undernourished. Overall, 733 dogs and wild canines were examined by different techniques with various seroprevalence ranges.

Conclusion: In southeastern Iran, VL is endemic in Orzoieh district in Kerman Province. While the dogs are implicated as the main domestic reservoir of VL, wide range of wild canines can serve as a secondary potential reservoir host.

Background: Demodex is a genus of mites living predominantly in mammalian pilosebaceous units. They are commonly detected in the skin of face, with increasing numbers in inflammatory lesions. Causation between Demodex mites and inflammatory diseases, such as rosacea, blepharitis, perioral and seborrhoeic dermatitis or chalazion, is controversially discussed. Clinical observations indicate a primary form of human Demodex infection. The aim of this review was to highlight the biological aspects of Demodex infestation and point out directions for the future research.

Methods: We conducted a broad review based on the electronic database sources such as MEDLINE, PubMed and Scopus with regard to the characteristics of the Demodex species, methods of examination and worldwide epidemiology, molecular studies and its role in the complex human ecosystem.

Results: Demodex mites are organisms with a worldwide importance as they act in indicating several dermatoses, under certain conditions. However, correlations between Demodex and other parasites or microorganisms occupying one host, as well as interactions between these arachnids and its symbiotic bacteria should be considered. There are few methods of human mites' examination depending on purpose of the study. Nevertheless, paying attention must be needed as polymorphism of Demodex species has been reported.

Conclusion: Overall, the present review will focus on different aspects of Demodex mites’ biology and significance of these arachnids in human’s health.

Background: Fascioliasis is a zoonotic disease caused by the liver fluke Fasciola hepatica. Drug resistance, high costs of treatment and economic losses in meat production have emerged the need of alternative control measures into consideration. The aim of this study was to evaluate the in vitro ovicidal activity of Paecilomyces lilacinus fungus on F. hepatica eggs.

Methods: P. lilacinus isolated from the soil of natural environment was challenged on F. hepatica eggs to observe the bio control effect of nematophagous fungi on trematode helminth eggs. The study was conducted in Tehran University of Medical Sciences, in 2015. Within 21 d of experiment, destructive effects exhibited on the eggshells were investigated using optical and Scanning Electron Microscopy.

Results: The effective role of P. lilacinus on damaging the eggs of F. hepatica was noticed.

Background: In spite of sufficient knowledge about phenotypic variation of Trichomonas vaginalis, its genetic characteristics are poorly understood. We carried out a molecular epidemiology study in which in vitro metronidazole susceptibility of T. vaginalis isolates was considered.

Methods: This study was conducted on 862 women admitted to Gynecology Clinics in Hamadan, west of Iran, during 2014-2015. After recording the socio-demographic and clinical characteristics of participants, vaginal swab samples were taken and subjected to microscopic examination, culture, in vitro sensitivity testing and PCR-restriction fragment length polymorphism (RFLP) analysis.

Results: T. vaginalis was detected in 1.9% (16/862) of the samples using two parasitological methods. The all T. vaginalis isolates that subjected to drug susceptibility analysis were sensitive to metronidazole with MICs ranged from 0.4 to 12.8 µg/ml. T. vaginalis genotyping by using actin gene and PCR-RFLP analysis identified three actin type; A (9, 56%), I (6, 38%) and E (1, 6%). No significant correlation was observed between actin genotypes and their clinical manifestation (P>0.05). 

Background: Toxoplasma gondii, the obligate, intracellular parasite afflicts human in diverse ways such as ingestion of tissue cysts in undercooked meat. The aim of this study was to assess the prevalence and genotyping of Toxoplasma isolated from meat samples being consumed in East Azerbaijan, Northwest of Iran.

Methods: Overall, 150 samples including chicken, beef and lamb meat were collected from retailers in different regions of Tabriz, northwestern Iran during April to September 2014. Molecular detection was done by amplifying B1 gene and T. gondii surface antigen 2 (SAG2) loci. For genotyping of T. gondii, restriction fragment length polymorphism (RFLP) was performed using Sau3AI and HhaI restriction enzymes. Finally, three positive isolate from each host was sequenced to evaluate and phylogenetic analysis.

Results: Overall, 26 (17.33%) samples were positive for T. gondii including 4 (8%) isolate from chicken, 8 (16%) isolates from cattle and 14 (28%) isolates from sheep. According to the RFLP patterns, sequencing and phylogenetic results, all of the samples were identified as genotype I.

Background: The aim of this study was to investigate the role of oxidative stress in the pathology of ovine dicrocoeliasis.

Methods: During Dec 2013 - Oct 2014, seventy-two sheep (1-3 years) with liver dicrocoeliasis along with 47 healthy sheep were selected from animals admitted for slaughtering at slaughterhouse located in Neyshabour, Razavi Khorasan Province, Iran.

Results: In comparison to healthy control, the malondialdehyde (MDA) level and serum total antioxidant capacity were significantly higher in the parasitized group (P<0.05). A significant increase in liver MDA concentration (P<0.05) of parasitized group was also observed. Packed cell volume (PCV), zinc, iron, total bilirubin and albumin sera levels were significantly lower in the parasitized group (P<0.05). In parasitized sheep, a significant positive correlation was seen between serum MDA concentration and the activity of aspartate aminotransferase (AST). On the other hand, the concentration of serum MDA was inversely correlated with the value of PCV. No significant differences were observed for MDA concentration and total antioxidant capacity between normal and abnormal hepatic lobes in the parasitized animals. Oxidative stress markers (MDA and total antioxidant capacity in serum and liver samples) showed no significant correlations with the extent of pathological lesions and serum variables of liver injury in the parasitized sheep. No significant correlation was observed between oxidative stress markers and the fluke’s number in the parasitized animals.

Background: The diagnosis of ocular toxoplasmosis is mainly based on clinical features. However, ocular fluid testing by PCR may be very helpful for approval or rejection of this etiology. In this study, we utilized a nested-PCR technique, targeting the B1 partial sequence to analyze the aqueous and vitreous samples for evaluating the presence of the Toxoplasma DNA.

Methods: Fifty aqueous or vitreous humor samples were obtained from patients with clinical features of ocular toxoplasmosis admitted to ophthalmology hospitals and clinics in Iran, within 2014. The samples were subsequently subjected to DNA extraction and purification. For nested amplification of the Toxoplasma B1 gene, two primer pairs were used. The outer and inner primers are expected to produce a 193 bp and a 96 bp fragments, respectively.

Results: The first-round PCR resulted in the detection of T. gondii in 58% of samples by amplification of the expected 193bp DNA fragment. The nested-PCR using the inner primers, detected 15 additional samples from those with negative amplicons in the first round PCR (overall positivity of 88%). In addition, vitreous samples showed relatively more positive cases than aqueous humor in detection of the infection.

Background: Blastocystis is one of the most common parasites, reported from both human and animals. This parasite is more prevalent in regions with low levels of hygiene, close contact with animal and unsuitable disposal systems. The aim of the study was to subtype Blastocystis sp., isolated from diarrheic and non-diarrheic patients using sequencing of 18S ribosomal DNA.

Methods: Totally, 300 stool samples were collected from diarrheic and non-diarrheic patients referred to Imam Reza Hospital, Tehran from Apr to Aug 2015. All samples were concentrated using conventional Formalin – ether technique and recognized under light microscope. The fresh stool samples were also cultivated in clotted fetal bovine medium and examined for growing of Blastocystis every 48 h with direct smear slides for 10 d.DNA extraction was performed on all positive samples. Amplified DNA fragment of 18S rDNA was sequenced and compared with reference genes, previously deposited in Genbank database.

Results: The number of diarrheic and non-diarrheic patients participated in the study was 134 (44.66%) and 166 (55.34%), respectively. Three subtypes 1, 2, 3 were identified from positive samples. Subtype 2 was the most prevalent (36.5%) followed by subtype 1 (33.3%) and subtype 3 (30.2%). There were no mixed subtypes. Furthermore, the most prevalent subtypes in diarrheic and non-diarrheic patients were subtype 2 (39.28%) and subtype 1 (37.14%), respectively.

Background: Toxocariasis is a prevalent zoonosis disease caused by the closely related nematode species Toxocara canis and Toxocara cati which parasitise Canidae and Felidae respectively. In paratenic hosts, larvae of these worms cause multiple organ damage. However, how these paratenic hosts response to these worms and whether any common biomarker can be applied for diagnosis are still unclear.

Methods: Excreted/secreted (E/S) antigens were prepared by culture of T. canis larvae in vitro. Using a western blot (WB) assay the humoral IgG responses, induced by Toxocara spp. larvae to the worm’s E/S antigens in different infected hosts including mice, rabbits and human, were examined.

Results: In a mouse model of toxocariasis, intraperitoneal injection of T. canis larvae induces inflammatory leukocyte accumulation in the liver and the lungs but not in the brain, although a remarkable number of larvae were detected in this organ. Mice and rabbits responded differently to Toxocara spp. resulting in distinct heterogenous WB band patterns. Mice and rabbits both responded to a 33.1 kDa E/S constituent that turned out to be the most sensitive protein for serodiagnosis. Sera from human toxocariasis patients showed heterogenous WB band patterns similar to those observed in rabbits and all responded to the 33.1 kDa band.

Conclusion: 33.1 kDa E/S protein can be considered as a critical common biomarker for toxocariasis immuno-diagnosis in both paratenic animals and human and its specificity requires further investigation.

Background: Based on genotyping study of human isolates of Giardia lamblia; humans are mainly infected by two assemblages A and B. The present study was carried out to determine the sub-assemblages of G. lamblia isolated from food handlers referred to Kashan health centers, central Iran, 2015.

Methods: In this cross-sectional study, 3653 stool samples collected from food-handlers that annually refer to health center for getting a health certification and examined microscopically for G. lamblia cyst. Totally, 44 isolates were selected from 47 Giardia positive samples. Cysts were partially purified by the sucrose density gradient method. After freeze-thaw cycles, genomic DNA was extracted using QIAamp Stool Mini kit. A single step PCR-RFLP method was used to amplify a 458bp fragment at the glutamate dehydrogenase (gdh) locus, restriction enzymes BspLI and RsaI were used for distinguish between genotypes A and B and their subgroups.

Results: Of 44 isolates, 24(54.5%) were sub-assemblage AII, 9(20.5%) group B including 7(15.9%) BIII and 2(4.6%) BIV sub-assemblage and 11(25%) isolates showed a mixed pattern of AII and B. Sub-assemblage AI was not detected in this study.

Background: Asymptomatic malaria infection provides a reservoir of parasites, causing the persistence of malaria transmission. It accounts an important challenge for successful management of the control, elimination, and eradication programmes in any malaria-endemic region. This investigation was designed to assess the presence and the prevalence of asymptomatic carriers in Iranshahr district of Sistan and Baluchistan Province (2013-2014), with a considerable population movement, during the malaria elimination phase in Iran.

Methods: Finger-prick blood samples were collected from symptomless (n=250) and febrile (n=50) individuals residing in Iranshahr district, easthern Iran (Hoodian, Mand, Chah-e Giji, Jolgehashem, Esfand, Dalgan and Chahshour) during Jan 2013 to Dec 2014, and Plasmodium infections were detected using light microscopic and highly sensitive nested-PCR techniques.

Results: Thick and thin Giemsa-stained blood smears were negative for Plasmodium parasites. In addition, based on nested-PCR analysis, no P. vivax, P. falciparum, and P. malariae parasites were detected among the studied individuals.

Conclusion: Investigation the absence of asymptomatic carriers in Iranshahr district was illustrated and achieving malaria elimination in this area is feasible in a near future.

Background: The purpose of this study was seroepidemiological and parasitological assessment of Toxocara canis infection in children and dogs in Zabol and Chabahar, Iran.

Methods: This study was a descriptive-analytic study with a simple random sampling of children under 14 yr old, referring to urban, rural, and tribal laboratories of Zabol and Chabahar, Sistan and Baluchestan Province, Iran in 2016. Demographic data, clinical, and laboratory conditions of patients were collected through interviews, questionnaires, and blood count measuring. The prevalence of IgG antibodies against T. canis was assessed by ELISA. T. canis eggs in dogs (as the original host) were also assessed by examining animal feces. Then the data were analyzed using SPSS 19 software and descriptive statistics, chi-square and ANOVA statistical tests.

Results: Totally, 364 patients were enrolled, of which 51.6% were female and mean±SD age of participants was 7.2 (±3.7) yr. IgG antibodies against T. canis was observed in 3.8% of cases. A significant association was found between the seroprevalence of T. canis and eosinophil (P=0.003) and red blood cell count (P=0.04). We also found a significant association between serological prevalence of T. canis and demographic parameters, such as city of residence (P=0.003), gender (P=0.04), consumption of vegetables (P=0.01), and the living place (P=0.04). Mean antibody titration was 2.2 ±1.1, with statistically significant difference among age groups (P=0.001). In addition, T. canis infection was positive in 27.5% of dogs living in the study areas.

Background: Intestinal parasites are still a serious public health problem in the world, especially in developing countries. This study aimed to assess the prevalence of intestinal protozoa infections and associated risk factors among schoolchildren in Sanandaj City, Iran.

Methods: This cross-sectional study involving 400 schoolchildren was carried out in 2015. Each student was selected using systematic random sampling method. Questionnaire and observation were used to identify possible risk factors. Fresh stool samples were observed using formal-ether concentration method.

Results: Five species of intestinal protozoa were identified with an overall prevalence of 42.3%. No cases of helminthes infection were detected. The predominant protozoa were Blastocys hominis (21.3%) and Entamoeba coli (4.5%). Overall, 143 (35.9%) had single infections and 26 (6.4%) were infected with more than one intestinal protozoa, in which 23 (5.9%) had double intestinal protozoa infections and 3 (0.5%) had triple infections. A significant relationship was observed between intestinal protozoa infection with economic status, water resources for drinking uses, and the methods of washing vegetables (P<0.05).

Conclusion: Education programs on students and their families should be implemented for the prevention and control of protozoa infections in the study area. 

Background: Psychiatric patients have an increased risk of some infections like toxoplasmosis. Investigations on Toxoplasma gondii infection among psychiatric patients have been limited in Mashhad, Northeast of Iran. In this case-control study, prevalence of T. gondii was investigated by serological method.

Methods: This case-control study was performed among psychiatric patients admitted to Avicenna Hospital in Mashhad, Northeast of Iran. Three hundred and fifty inpatients and 350 controls were examined in 2012-2013 for detection of IgG and IgM antibodies against T. gondii in their blood sera by ELISA. Socio-demographic and clinical manifestations of the patients were obtained.

Results: Anti-T. gondii IgG antibodies was found in 164 (46.85%) of 350 psychiatric inpatients and 120 (34.28%) of 350 controls. Seventeen (4.85%) of psychiatric individuals and 3 (0.85%) of control group were IgM+/IgG- indicating acute form of toxoplasmosis. There were no statistically significant differences between the case and control groups. In patient group, schizophrenic patients had the highest positive rate (46.28%) and bipolar mood disorder had the second most prevalent rate (20%). Of 162 schizophrenia patients, 65 (40.1%) had latent infection which was higher than that observed in controls.

Conclusion: The prevalence of T. gondii infection among psychiatric patients suffering from schizophrenia was more in Mashhad, compared with control group.

Background: The prevalence and intensity of endo and ectoparasites in shrews inhabiting in the Dasht-e Razan of Hamedan Province, Iran, were determined in this study.

Methods: By live traps, 64 shrews belong to species bicoloured white-toothed shrews (Crocidura leucodon) were trapped during 2010-2012. Captured animals were euthanized and their gender recorded. The blood thick and thin smears were stained with Geimsa and examined for protozoan parasites. Then, ectoparasites were collected and preserved in 70% ethanol and after necropsies; different organs were examined for helminthes.

Results: The prevalence of collected helminthes of Crocidura leucodon were; Capillaria crociduri (18.7%), Vigisolepis secunda (26.5%), Coronacantus sp (15.6%), Capillaria hokkaidensis (45.3%), and its ectoparasites were; Nymphs of three species of ticks; Haemaphysalis sp (32.8%), Ornitodoros sp (23.4%), Hyalomma sp (9.4%), one species of louse, Polyplax reclinata (18.7%) and one species of flea Leptopsylla sp (39.1%). Among the collected parasites, all helminthes and one sucking louse, P. reclinata are reported for the first time in Iran. Statistically analysis with the Chi-square test did not show any significant relation between gender and endoparasites (P>0.05), but the ectoparasites had significant differences with gender (P<0.05). No significant correlation was found between the altitude and the parasite species richness (Spearman's test: P>0.05).

Background: The intraperitoneal injection is a common method for establishing the experimental animal model infected with parasites. The aim of this study was to investigate if the intraperitoneal injection was another route of Trichinella spiralis infection.

Methods: From June to July 2015, twenty BALB/c mice were intraperitoneally injected with 300 T. spiralis muscle larvae in Department of Parasitology, Medical College, Zhengzhou University, China. The larvae per gr (LPG) muscle from the infected mice and the reproductive capacity index (RCI) of T. spiralis were calculated

Results: Sixty percent (12/20) mice injected were successfully infected at 35 day post injection (dpi), but the muscle larval burden (381.53 larvae per gr) and reproductive capacity index (32.33) in infected mice was lower.

Conclusion: A mechanical force indicated as a possible mechanism in successful larval invasion of almost all kind of host tissues. However, the exact migratory route of larvae from peritoneal cavity into small intestine is not clear.

Background: Human toxocariasis is contained in the list of neglected diseases. The infection occurs after ingestion of embryonated eggs in contaminated soil. The present study was carried out to estimate the extent of soil contamination with Toxocara spp. eggs in the public places.

Methods: Soil samples were collected randomly from 41 public places in various parts in and around of Ardabil, Iran, between March 2013 and March 2014. Data were examined by microscopy following sodium nitrate flotation.

Results: Of the 200 collected soil samples, 35 (17.5%) were positive for soil parasites. The eggs of Toxocara spp. were found in 14 (7%) soil samples.

Conclusion: This investigation gives baseline knowledge regarding soil contamination with Toxocara spp. eggs in Ardabil city and provides information for local control of toxocariasis.  

Opportunistic infections due to free-living amoebae such as Granulomatous Amoebic Encephalitis (GAE), cutaneous acanthamoebiasis and disseminated infections could be the causative agent of mortality in people living with HIV/AIDS. In this study, we report the occurrence of the Acanthamoeba belonging to the T4 genotype isolated from nasal and oral swabs of a 15 -yr-old man with HIV infection. HIV was confirmed using ELISA kit and RT-PCR assay. The isolated strain showed pathogenic potential using thermo and osmotolerance assays. This patient might be vulnerable to develop GAE or disseminated infections and depending on the immunologic status of the patient, this could be a health threat. Monitoring of such patients, appropriate diagnostic procedures and improved-HIV related care can alter the outcome of such infections. 

A case of the Budd Chiary Syndrome (BCS) in a 43-yr-old man with hydatid cyst (HC) in the liver is reported from Imam Ali Hospital, Kermanshah, western Iran in 2016. This case was complicated by inferior vena cava (IVC) thrombosis, right atrial clot and pulmonary emboli. Compression of IVC was the likely mechanism. Abdominal ultrasonography revealed a huge HC located in segments near IVC and caused compression of IVC. Transthoracic echocardiography (TTE) revealed IVC and right atrium thrombosis, however pulmonary emboli was not documented in TTE but intra operative exploration showed multiple clot in main and left pulmonary artery branch. The patient recovered after open-heart surgery with removal of right atrial, IVC and pulmonary artery emboli. BCS should be looked for routinely in patients with HC of the liver.

Although Hydatid disease eradicated in many countries, it is still widespread in communities where agriculture is dominant. Cystic hydatidosis is significant public health problem in the regions with endemic echinococcosis. The hydatid cysts tend to form mostly in the liver or lung. Brain involvement is very rare. In the present report, we describe magnetic resonance imaging findings in an 18-yr-old male with cerebral echinococcosis, in Shahid Madani Hospital, Karaj, Iran in 2015. The patient, presented with headache, hemiparesis, impairment of speech, vomiting, and nausea. Computed tomography, magnetic resonance imaging, and surgical exploration proved a cyst in the superior portion of left temporal lobe. Pathological examination showed it to be a solitary primary cerebral hydatid cyst.