Asymptomatic Leishmania Infected Children: A Seroprevalence and Molecular Survey in a Rural Area of Fars Province, Southern Iran.

The current study aimed to evaluate the seroprevalence of visceral leishmaniasis in asymptomatic healthy children in a rural area of Fars province, Southern Iran. Blood samples were taken from 617 asymptomatic healthy children and serum samples along with buffy coat were separated from the blood. The serum samples were assessed for antibodies against Leishmania infantum by an indirect ELISA and the buffy coats were tested for the presence of L. infantum DNA by molecular method. Of the 617 recruited children, 297 (48.1%) were female and 317 (51.4%) were male. Anti-Leishmania antibodies were detected in 17 (2.8%) of the children. From those 17 seropositive cases, 5 (29.4%) were male and 12 (70.6%) cases were female. Children aged 5-8 years had the highest seroprevalence rate; however, no associations were found between seropositivity to Leishmania and gender or age of the children. Moreover, L. infantum DNA was detected in buffy coat of 8 (1.3%) of 617 children. Three of the PCR-positive cases were seropositive whereas 14 of seropositive subjects (82.3%) were PCR-negative. Findings of the current study revealed a considerable subclinical leishmanial infection in children in the studied rural area in the south of Iran. Results of the current study could be used for surveillance, prevention, and control of VL in the area.

Increased IL-17 and TGF-ß serum levels in peripheral blood of patients with ß-thalassemia major: implication for continual transfusions role in T helper17-mediated proinflammatory responses.

BACKGROUND/AIM: Recent studies have shown that IL-17-producing CD4+ T helper (Th17) cells play an important role in proinflammatory processes. In this report we analyzed IL-17, IL-21, and TGF-ß serum levels in the peripheral blood of Iranian beta-thalassemia major patients that clinically exhibited splenectomy and iron overload. MATERIALS AND METHODS: Blood samples were collected from 43 beta-thalassemia patients and 43 healthy individuals with no history of malignancies or autoimmune disorders. Then serum levels of IL-17, IL-21, and TGF-ß were measured by enzyme linked immunosorbent assay (ELISA). RESULTS: The levels of IL-17 (P = 0.005) and TGF-ß (P < 0.001) were significantly higher in the thalassemia patients compared to the healthy control. No significant differences in the level of serum IL-21 was observed between the patients and controls. There were no significant differences in serum levels of IL-17, IL-21, and TGF-ß between patients with high or low serum levels of ferritin. CONCLUSION: Multiple blood transfusions cause constant immune stimulation, as a result of repeated exposure to new alloantigens. This might have significant effects on the stimulation of cytokine producing cells in those patients and cytokine profile can be used as a related marker for assessing disease severity and consequently therapeutic intervention.

Visceral Leishmaniasis in Southwestern Iran: A Retrospective Clinico-Hematological Analysis of 380 Consecutive Hospitalized Cases (1999-2014).

Visceral Leishmaniasis (VL) is an endemic parasitic disease and remains as a major health concern in southwestern Iran. The current study describes clinico-hematological, epidemiological and therapeutic features of VL cases, admitted to university-affiliated hospitals, during 1999-2014 in Fars province, southwestern Iran. A total of 380 VL cases were recorded during a 16 years period, giving an average annual admission of 23.75 cases/year in which 217 (57.1%) were male and 163 (42.9%) were female. Mean age of the patients was 3.7 years. The majority of the cases (91.5%) were ≤ 5 years old. Bone-marrow aspiration detected Leishmania amastigotes only in 26.6% of cases. Fever (98.1%), abdominal protrusion (65.1%) and hepatosplenomegaly (63.7%) were the most common clinical presentations of the patients. Pancytopenia was noted in 43.1, anemia in 87.3 and thrombocytopenia in 64% of cases. Increase in the level of AST (aspartate aminotransferase), ALT (alanine aminotransferase), alkaline phosphatase, LDH (lactate dehydrogenase) and CRP (C-Reactive Proteins) were seen in 84.9, 53.6, 44.4, 72.5 and 83.1% of cases, respectively. Mortality was noted in 5.3% of cases. Deranged haemato-biochemical parameters including total and direct bilirubin, PLT (platelet) and pancytopenia were significantly contributed to mortality from VL. Moreover, clinical features such as severe splenomegaly as well as bacterial infections were meaningfully contributed to death from VL. The majority of patients (74.9%) were treated with meglumine antimoniate. Amphotericin B was administrated in 59 of cases, 11 of them were initially treated with meglumine antimoniate with a shift to amphotericin B, because of treatment failure. Findings of the current study demonstrated that VL is present in southwest of Iran with a fairly continual rate during the last 16 years period. Deranged haemato-biochemical parameters along with severe splenomegaly contributed to mortality from VL.

Molecular Survey on Detection of Leishmania Infection in Rodent Reservoirs in Jahrom District, Southern Iran.

BACKGROUND: Zoonotic Cutaneous Leishmaniasis (ZCL) is endemic in many parts of Iran. Recently its incidence is considerable in different parts of Jahrom district, in Fars Province, southern Iran. The aims of our study were to investigate the prevalence of leishmania infection, and identify and characterize the Leishmania species present, among the rodents by molecular methods in a new endemic focus of ZCL, in an urban and rural area of the Jahrom district, Fars Province, southern Iran. METHODS: From May to November 2010), 55 rodents in four regions of Jahrom focus were caught and checked for leishmania infection by the microscopical examination of liver, spleen, ears, and footpads' smears. RESULTS: Overall 18 Meriones persicus, 15 Tatera indica, 14 Mus musculus, and 8 Rattus rattus were caught. Totally, four (16.5%) and two (13.3%) of the Me. persicus and Ta. indica, but only one of Mu. musculus and Ra. rattus were found smear-positive for leishmania amastigotes, respectively. In the nested-PCR assay 8 (14.6%) smears were found positive for Leishmania major, none was found positive for any other Leishmania species. Sequencing based detection of Leishmania confirmed the microscopic and PCR findings. All positive specimens were shown 95-96% similarity with L. major Friedlin. CONCLUSION: Tatera indica and Me. persicus are incriminated as the main 'reservoir' hosts of L. major in the rural area of Jahrom, moreover, Mu. musculus and Ra. rattus have the minor but remarkable role in the maintenance of the disease in the urban regions of Jahrom focus.

Evaluation of anti-varicella antibody in young women before their marriage: A sero-epidemiologic study in Iran.

BACKGROUND: Chickenpox during pregnancy can cause severe complications in both the mother and her baby. However, no complications will occur in a mother with proper immunity. Therefore, physicians and health systems can make better decisions when they know the immunologic status of the women in a community. OBJECTIVES: We conducted this study to clarify the Varicella zoster virus (VZV) immune status of engaged women in Iran. STUDY DESIGN: This cross-sectional descriptive study was carried out on 334 young women who intended to marry between 2006 and 2008. The subjects' VZV-immunoglobulin G (IgG) and demographic characteristics were evaluated. RESULTS: The mean age of the subjects was 20.5+/-4.9 years and their mean anti-varicella value was 86.22+/-71.05 U ml(-1). Of 333 young women studied, 242 (72.7%) were positive, 89 (26.7%) were negative for anti-varicella antibody and two were equivocal (0.6%). The rate of immunity increased with increasing age; all of the subjects over 35 years of age were immune to varicella. The positive predictive value (PPV) for self-reported history of chickenpox in subjects was estimated to be 79.5% and the negative predictive value (NPV) of a negative or uncertain disease history was 30.5%. A higher immune ratio was seen in women with more siblings. CONCLUSIONS: The difference in the proportion of VZV-immune people in our country versus developed countries may be due to the introduction of varicella vaccine in developed nations. The mean age at first pregnancy in Iran is 25.7 years and the results of our study indicate that more than one-fourth of these women are not immune to varicella. We therefore recommend vaccination in women, especially those who are under 35 years of age. Number of siblings and positive history of varicella infection may be the indicators to determine the immunity level of a pregnant woman who has had contact with a patient with chickenpox.

Hypercalciuria in Jahrom's school-age children: what is normal calcium-creatinine ratio?

INTRODUCTION: The purpose of this study was to determine normal reference values for urine calcium-creatinine (Ca/C) ratio in Iranian children of Jahrom, in south-east of Iran. MATERIALS AND METHODS: A total of 1068 school-age children were included by stratified clustered random sampling from primary schools of Jahrom, Iran, between March 2008 and May 2008. Nonfasting random urine specimens from each subject were analyzed for calcium and creatinine concentrations. RESULTS: The mean ratio of urine Ca/C in all children was 0.123 +/- 0.106 (range, 0.01 to 2.25), and the 95th percentile value was 0.25. Nonfasting Ca/C ratios were not significantly different between the boys and the girls. The Ca/C ratio was highest in 9-year-old children (mean, 0.132 +/- 0.11). Based on the 95 percentile value of urine Ca/C (> 0.25) in the present study, 5.1% of the children in Jahrom were hypercalciuric. The prevalence of hypercalciuria differed with age (P = .06), and the most prevalent rate was observed in 9-year-old group (9.3%). CONCLUSIONS: We provided a reference value for urine Ca/C ratio in south-east Iranian children. A child's age and ethnicity should be taken into consideration when assessing the urinary solute-creatinine ratios.