Capture - recapture based study on the completeness of smear positive pulmonary tuberculosis reporting in southwest Iran during 2016.

BACKGROUND: Tuberculosis (TB) is one of the ten leading causes of death in infectious diseases and one of the ten leading causes of death in the world. For any TB control program, a valid surveillance is essential. In order to assess the status of the assessment, the quality of the record and the completeness of reporting should be assessed. The purpose of this study was to investigate the completeness of smear positive pulmonary tuberculosis reporting in Ahvaz, south west of Iran. METHODS: This cross-sectional study was conducted in 2016 in Ahvaz, southwest Iran. The study was conducted through a three-source Capture recapture method by collecting laboratory, hospital, physician prescription data; including patient referral to the health care center, prescriptions of patients receiving anti-tuberculosis drugs and prescriptions of medical TB diagnostic laboratories, and laboratory prescriptions. Percentage, mean and standard deviation were used to describe the variables. Data analysis was performed using log-linear model in Rcapture package R software. RESULTS: Generally, 134 new cases of smear-positive pulmonary tuberculosis patients were reported through three sources from urban and rural regions during 2016. Pulmonary tuberculosis was reported through three sources from urban and rural regions during 2016. The most common age group was 25 to 44 years and 79.1% of the patient were man. The overall prevalence of new cases of smear-positive pulmonary tuberculosis was in persons that lived urban areas (97.8%). The completeness of reporting the disease estimated by log-linear model was 87.5% and the incidence rate was estimated to be 11.8 disease per 100,000 persons. Completeness of reporting of laboratory, hospital and physician resources were 79%, 30% and 16.3%, respectively. CONCLUSIONS: The present study shows the necessity of evaluating the quality, completeness and linkage between data. Linking between data sources can improve the accuracy and completeness of TB surveillance.

Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran.

The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with an acute respiratory infection (ARI). During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients. Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003).  In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-COV-2 with a real-time PCR method is the first line of choice.

Association between cancer risk and polycyclic aromatic hydrocarbons' exposure in the ambient air of Ahvaz, southwest of Iran.

Nowadays, a large number of health endpoints such as disease rates, treatment costs, and death, by air pollutants, have been a serious health problem for humans. One of the most hazardous air pollutants, which is highly dangerous for human health, is polycyclic aromatic hydrocarbons (PAHs). The existence of the emission of industries' pollutants and seasonal variations are the primary agents affecting PAHs' concentration. The purposes of this study were to calculate the cancer risk and measure PAHs' exposure in the ambient air of Ahvaz, southwest of Iran, during 2017. Three distinct areas ((S1) industrial, (S2) high traffic, and (S3) residential) of Ahvaz metropolitan were selected. Omni sampler equipped with polytetrafluoroethylene (PTFE) filters were used for active sampling of PAHs. To detect the level of PAHs, gas chromatography with mass spectrometry (GC/MS) was used. Incremental lifetime cancer risk (ILCR) and lifetime average daily dose (LADD) were used to estimate the health risk caused by PAHs. The results showed that the residential and industrial areas had the lowest and highest level of PAHs. Moreover, the average levels of PAHs in industrial, high traffic, and residential areas were 8.44 ± 3.37, 7.11 ± 2.64, and 5.52 ± 1.63 ng m-3, respectively. Furthermore, ILCR in autumn and winter was higher than EPA standard, 0.06307 and 0.04718, respectively. In addition, ILCR in different areas was significantly higher than standard. Research findings imply that the levels of exposure to PAHs can increase ILCR and risk of health endpoint. The cancer risk attributed to PAHs should be further investigated from the perspective of the public health in metropolitans.

Correction to: Prevalence of HIV-1 transmitted drug resistance in recently infected, treatment-naïve persons in the Southwest of Iran, 2014-2015.

The author would like to correct the error in the online published article. The correct details are given below for your reading.

Infection after open heart surgery in Golestan teaching hospital of Ahvaz, Iran.

The present study surveyed demographic and infection data which were obtained after open heart surgery (OHS) through patient's admission in Golestan teaching hospital, Ahvaz metropolitan city of Iran, taking into account the confirmed location of the infection, microorganism and antibiotic susceptibility. The occurrence of infection among patients during 48 to 72 h after surgery and hospital admission is the definition of Nosocomial infections (NIs) (Salmanzadeh et al., 2015) [1]. All of them after OHS were chosen for this study. In this paper, type of catheter, fever, type of microorganism, antibiotic susceptibility, location of the infection and outcome (live or death) were studied (Juhl et al., 2017; Salsano et al., 2017) [2], [3]. After the completion of the observations and recording patients' medical records, the coded data were fed into EXCELL. Data analysis was performed using SPSS 16.

Prevalence of HIV-1 transmitted drug resistance in recently infected, treatment-naïve persons in the Southwest of Iran, 2014-2015.

The emergence and transmission of drug resistant HIV mutants is a major concern, especially in resource-limited countries with expanding antiretroviral therapy. Studies have recently reported the prevalence of HIV-1 transmitted drug resistance (TDR) mutations in certain Iranian cities; however, no information is currently available about the level of TDR, as well as the nature of the circulating HIV-1 subtypes, in the Southwestern bordering province of Iran, Khuzestan. Herein, we used a WHO-recommended TDR survey method to classify the prevalence of TDR in indigenous people of Khuzestan province. For this purpose, between March 2014 and February 2015, blood samples were collected from 52 newly diagnosed, antiretroviral treatment-naïve, HIV-1 infected persons aged from 18 to 30 years. TDR mutations were determined by sequencing the protease (PR) and reverse transcriptase (RT) genes and interpreted using the WHO drug resistance mutations surveillance list. HIV-1 subtypes were characterized by sequencing the PR-RT, C2-V5, and p17 regions of the pol, env and gag genes, respectively. Two participants had non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations, specifically K103N in one individual and K101EK/K103KN/G190AG in the other. No nucleoside reverse transcriptase inhibitor (NRTI) or major protease inhibitor (PI) mutations were identified. HIV-1 subtyping revealed that all participants were infected with HIV-1 CRF35_AD. According to the WHO sequential sampling method, the prevalence of HIV-1 TDR in the sampling area (Khuzestan province) was classified as moderate for NNRTIs and low for NRTIs and PIs. This is the first HIV-1 drug resistance threshold survey in the Khuzestan province of Iran and shows a predominance of NNRTI TDR mutations in this area.

Post-vaccination Immunity Against Hepatitis B Virus and Predictors for Non-responders Among Medical Staff.

BACKGROUND: Hepatitis B virus (HBV) is a major cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). HB vaccination is an essential step in the prevention of the disease and its consequent complications. OBJECTIVES: Immune status of medical personnel in teaching hospitals of Khuzestan is not well known. Since these personnel are usually at risk of needle stick and other high-risk events, some challenges exist in infection control committee with regard to managing these events. This study was conducted to assess post-vaccination immunity status and non-response to HBV vaccine as well as its predictors among medical staff in a teaching hospital affiliated to Ahvaz Jundishapur University of Medical Sciences (AJUMS) in Ahvaz, southwest Iran. PATIENTS AND METHODS: In this retrospective cross-sectional study, the medical staff of a teaching hospital was evaluated for their immune response against HBV and factors affecting it. The study conducted in Razi Hospital, Ahvaz City, southwest of Iran, in 2013. Demographical, clinical, and laboratory data registered in medical files of hospital staff were analyzed by SPSS software version 16 using chi-square and Fisher exact tests. Differences with P value < 0.05 were considered significant. To identify predictors for non-responders, we used odds ratio (OR) with 95% confidence interval (CI). RESULTS: Out of 239 participants, 43 (18 %) were men and 196 (82%) were women. Their mean age was 31.9 ± 18.1 years (range of 20 - 55 years). Fourteen (5.9%) participants were non-responders, 37 (15.5%) were poor responders, and 188 (78.6%) were good responders. The non-responders were older (> 50 years) than the responders (P = 0.0001), while the body mass index (BMI) was not significantly different (P = 0.37) between them. Diabetes mellitus (DM) (OR: 7.3, 95% CI, 1.3 - 41.7, P = 0.05), and using immunosuppressive drugs (ISD) (OR: 3.2, 95% CI, 1.1 - 11.5, P = 0.03) were two variables in association with non-response to HB vaccine. CONCLUSIONS: Non-response rate to HB vaccine in our study was approximately 6%. Age over 50 years, DM, and receiving immunosuppressive drugs may be considered as predictors for non-response to HB vaccine in medical staff.

Comparison of epidemiological, clinical, laboratory and radiological features of hospitalized diabetic and non-diabetic patients with pulmonary tuberculosis at razi hospital in ahvaz.

BACKGROUND: Diabetes mellitus (DM) due to suppressive effect on cellular immunity can impact on progression of tuberculosis (TB). OBJECTIVES: The aim of this study was to investigate the impact of DM on the epidemiological, clinical and para clinical aspects of pulmonary TB. PATIENTS AND METHODS: The information of 148 admitted pulmonary TB patients in infectious ward of Razi hospital in Ahvaz from 2009 to 2010 was extracted from their medical files. The patients were divided into two groups as TB with DM (n = 36) and TB without DM (n = 112). The related data on epidemiology, signs, symptoms, radiology and sputum smear examination in both groups were compared in SPSS 16 by using chi squared test. RESULTS: The mean age of TB with DM patients was higher TB without DM patients (56.6 ± 12.7 vs. 44.8 ± 18.3; respectively, P = 0.006). Whereas cough, night sweating, fever and weigh loss was not statistically different, sputum, hemoptysis and dyspnea was more prominent in TB with DM (69.4%, 33.4%, 44.5% vs. 36.6%, 9.8%, 20.5%; P = 0.005, P = 0.001, P = 0.005, respectively). In chest x-ray, cavitation and reticulonodular pattern was more frequent in TB with DM (55.5%, 22.2% vs. 31.2%, 8% - P = 0.008, P = 0.02, respectively). The rate of sputum smear positivity in TB with DM and TB without DM was 66.6% and 47.3%, respectively (P = 0.03). CONCLUSIONS: According to the results of this study, in approach to every DM cases suffering of respiratory symptoms such as productive cough, hemoptysis and dyspnea in association with cavitation or miliary mottling in chest x-ray, pulmonary TB should be considered at the top of the differential diagnosis list.

A comparative study on the prevalence and risk factors of tuberculosis among the prisoners in khuzestan, South-west iran.

BACKGROUND: High prevalence of Tuberculosis (TB) among prisoners is reported as an alarming public health problem in the world, especially in the developing countries. OBJECTIVES: Since there is almost no information from TB in this population in Khuzestan province, the current study aimed to assess the prevalence and identify risk factors of TB among the prisoners of this region. PATIENTS AND METHODS: In a retrospective study, medical files of patients with Tuberculosis in Khuzestan Health Center (KHC), from 2005 to 2010, were studied. Patients with Pulmonary TB were placed in two groups as the Inmate Prison (IP) and Non-Inmate Prison (NIP) groups. Data extracted from the patients' records in the two groups were compared by SPSS software system using Chi square and Fisher exact tests. P-value was considered less than 0.05. RESULTS: From the reported 4562 patients with Tuberculosis, 363 (7.9%) were prison inmates at the time of TB diagnosis. Prevalence of TB cases among the prison inmates was 403.3 per 100'000.The annual TB case rate in the general population during this period was 16.4 per 100,000. Among the TB risk factors close contact [odds ratio (OR), 95% confidence interval (CI), 19.4, 8.9-41.8, P < 001] especially in the recent 2 years, injection drug use (IDU) [OR, 95% CI, 4.61, 1.7-12.4, P = 006], and Human Immunodeficiency Virus (HIV) infection [OR, 95% CI, 2.4, 1.1-5.0, P = 025] were more frequent in the prisoners than in the general population with TB. CONCLUSIONS: In the region under study the prevalence of TB among the prisoners was higher than the general population. The main risk factors for Pulmonary TB in this population were close contact, IDU and HIV infection.

Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran.

BACKGROUND: Toxoplasmosis is a common parasitic infection in human around the world and can cause life-threatening encephalitis in human immunodeficiency virus (HIV) infected host. The aim of this study was to assess the frequency of toxoplasma infection in illicit drug users (IDUs) with and without HIV infection in Iran. METHODS: This study was carried out on 84 IDUs (42 HIV positive as case group and 42 HIV negative subjects as control group) from 2008 to 2009. Serum samples were tested for T. gondii IgG antibodies by Enzym linked immunosorbant assay (ELISA). Based on the company brochure kit, the test was defined positive if the antibody titer was 3 IU/ml or more. The data from these two groups were collected and analyzed. RESULTS: The mean age of HIV positive cases was 34.4±8.6 and for HIV negative cases was 35.9±9.3 year. The mean age and distribution of sex in both groups were equal. The frequency of toxoplasma-IgG in HIV positive and HIV negative was 73.8% and 81%, respectively (p=0.19). CONCLUSION: The results show that prevalence of toxoplasmosis infection in the illicit drug users with HIV positive or negative is equal.