HIV and Other Sexually Transmitted Infections Among Female Sex Workers in Iran: A Systematic Review and Meta-Analysis.

Given the high burden of HIV and other sexually transmitted infections (STIs) among female sex workers (FSW) and their potential role in bridging HIV/STIs into the general population, estimating the prevalence of HIV/STIs among FSW is essential for future research and policy developments. This systematic review and meta-analysis synthesize the available HIV/STIs data among FSW in Iran. We searched MEDLINE, PsycINFO, CINAHL, Embase, Web of Science, Google Scholar, and Iranian databases from inception through to January 2018. Inclusion criteria were original quantitative studies that measured HIV/STIs prevalence among FSW. Pooled prevalence estimates were calculated using random-effects meta-analyses. Out of a total of 299 screened studies, 12 were included with total study participants of 4328 FSW. Heterogeneity was present but meta-regression analyses revealed no significant association between HIV prevalence and year of publication, city, and age. Pooled HIV prevalence was 2.23% (95% confidence interval [CI] 0.82, 3.64). We estimated the prevalence of other STIs as 0.77% (95% CI 0.01, 1.53) for hepatitis B, 6.18% (95% CI 1.32, 11.04) for hepatitis C, 0.33% (95% CI 0.00, 0.66) for syphilis, 1.47% (95% CI 0.22, 2.71) for gonorrhea, 9.80% (95% CI 4.70, 14.91) for chlamydia, and 6.18% (95% CI 4.92, 7.43) for trichomonas vaginalis. Based on the existing evidence, HIV and STIs prevalence among FSW are relatively low in Iran. Strategies for timely diagnosis and treatment of HIV and other STIs among FSW and their sexual and injecting partners are needed to reduce the burden of HIV/STIs among these vulnerable populations in Iran.

A Nationwide Study on the Seroprevalence of Measles, Mumps, and Rubella in Iranian Children and Adolescents.

Background: Assessing the prevalence of infections, which are preventable by vaccination, is crucial to monitor the vaccination program efficacy, and it can demonstrate the gaps in population immunity. The current study attempted to assess the specific Immunoglobulin (IgG) antibody against measles, mumps, and rubella (MMR) in Iranian children and adolescents, years after their vaccination. Methods: This cross-sectional study was conducted in Iran. Serum samples of 2100 students, aged 7-18 years, included in a national health survey, were tested for MMR antibodies by ELISA assay. Multistage random cluster sampling was used to select subjects from 30 provinces in Iran. Results: Overall, 1871, 1718, and 1678 serums were tested for measles, mumps, and rubella antibodies, respectively. The prevalence of positive test was 1231 (65.8%) for measles, 1327 (77.2%) for mumps and 1344 (80.1%) for rubella. Conclusion: Despite high vaccination coverage in Iran, IgG antibody against measles, mumps, and rubella was not detected in a considerable proportion of children and adolescents aged 7-18 years. In case of contacts with residents of other countries, where measles or rubella have not yet been eliminated, it may create problems for Iranian children.

Comparison of the Prevalence and Risk Factors of Hepatitis A in 10 to 18-Year-Old Adolescents of Sixteen Iranian Provinces: The CASPIAN-III Study.

BACKGROUND: Hepatitis A is a common health concern both in developing and developed countries. Hygienic and socioeconomic parameters deeply impact the prevalence and transmission of this disease. Evaluating the epidemiological distribution and risk factors for Hepatitis A virus (HAV) is necessary for policy makers to improve local and national preventive measures. OBJECTIVES: The aim of this study was to compare the prevalence of hepatitis A infection in a sample of Iranian adolescents living in different provinces of Iran and to assess its family- and community-related risk factors. METHODS: In this cross-sectional study, serum samples of 10 to 18-year-old adolescents, who were studied in a national health survey, were examined for anti-HAV antibodies. A total of 2,494 subjects were included from 16 provinces by multistage random cluster sampling. Demographic and socioeconomic factors related to HAV transmission were extracted by valid questionnaires. A multilevel analysis using mixed-effects logistic regression (melogit) was used to evaluate the association of risk factors with HAV infection. RESULTS: The weighted prevalence of HAV varied significantly across the studied provinces (P = 0.001), ranging from 50.43% in the Fars province to 78.81% in Markazi province. HAV was significantly more prevalent in children whose mothers worked outside of the home (OR, 1.73; 95% CI, 1.14-2.62; P = 0.009). CONCLUSIONS: The risk of symptomatic HAV infection is considerable in adolescents of all studied provinces; thus, universal HAV vaccination is recommended for all adolescents, regardless of their socioeconomic level. However, the risk is higher in some provinces, which seem to be transitioning from intermediate to low endemicity.