Laboratory Cross-Contamination of Mycobacterium tuberculosis: A Systematic Review and Meta-analysis.

BACKGROUND: Microbiological cultures are the mainstay of the diagnosis of tuberculosis (TB). False-positive TB results lead to significant unnecessary therapeutic and economic burden and are frequently caused by laboratory cross-contamination. The aim of this meta-analysis was to quantify the prevalence of laboratory cross-contamination. METHODS: Through a systematic review of five electronic databases, we identified studies reporting rates of laboratory cross-contamination, confirmed by molecular techniques in TB cultures. We evaluated the quality of the identified studies using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and conducted a meta-analysis using standard methodology recommended by the Cochrane Collaboration. RESULTS: Based on 31 eligible studies evaluating 29,839 TB cultures, we found that 2% (95% confidence intervals [CI] 1-2%) of all positive TB cultures represent false-positive results secondary to laboratory cross-contamination. More importantly, we evaluated the rate of laboratory cross-contamination in cases where a single-positive TB culture was available in addition to at least one negative TB culture, and we found a rate of 15% (95% CI 6-33%). Moreover, 9.2% (91/990) of all patients with a preliminary diagnosis of TB had false-positive results and received unnecessary and potentially harmful treatments. CONCLUSIONS: Our results highlight a remarkably high prevalence of false-positive TB results as a result of laboratory cross-contamination, especially in single-positive TB cultures, leading to the administration of unnecessary, harmful treatments. The need for the adoption of strict technical standards for mycobacterial cultures cannot be overstated.

Genotyping determination of Acanthamoeba strains: an original study and a systematic review in Iran.

This study aimed to detect the presence of Acanthamoeba spp. in different water resources of Zahedan, southeast of Iran, and also systematically reviewed all publications regarding Acanthamoeba in Iran (2005-2018). Fifty water samples were collected from different water resources in Zahedan. The positive samples were identified morphologically and subjected to polymerase chain reaction (PCR) using fragments of 18S rRNA. In the systematic review, data collection using particular terms was carried out using the following electronic databases including Science Direct, ISI Web of Science, MEDLINE, EBSCO, Scopus, and Google Scholar. A total of 17 (34%) samples were positive for Acanthamoeba spp., and nucleotide sequencing indicated that 15 samples (88.23%) belonged to the T4 genotype and the rest belonged to the T5 genotype. A total of 39 studies reported genotyping of Acanthamoeba spp. from various geographical areas of Iran and revealed that T4 (35 studies), T5 (19 studies), T3 (11 studies), T11 (8 studies), and T2 (6 studies) genotypes were the most prevalent in Iran. The T4 genotype of Acanthamoeba is a prevalent free-living amoeba and widely distributed not only in Zahedan but also in other provinces of Iran. Phylogenetic analysis reveals that A. castellanii and A. griffini predominantly colocalize with the T4 genotype.

Nanobiotechnology as an emerging approach to combat malaria: A systematic review.

Mosquitoes (Diptera; Culicidae) present a major threat to millions of people and animals worldwide, as they act as vectors for various pathogens, especially parasites and viruses. Resistance to insecticides, such as organophosphates and microbial control agents, and insufficient adherence to application guidelines are common reasons for insecticide treatment failure. Therefore, there is an urgent need for exploration of safer, cheaper, and more effective agents, with novel modes of action, to improve mosquito control. Biosynthesized nanoparticles (NPs) have recently been considered as a potential approach for combating vectors of malaria and also as a treatment for malaria. Here, we present current knowledge about the characterization and effectiveness of biogenic NPs against major vectors of malaria, including avian malaria (which may also provide useful insights on vectors of human malaria). This article is the first systematic review of the effects of biosynthesized nanoparticles on both malaria parasites (Plasmodium spp.) and relevant vectors.

Effects of Aloe vera and Eucalyptus methanolic extracts on experimental toxoplasmosis in vitro and in vivo.

Toxoplasmosis is a worldwide disease caused by the protozoan parasite Toxoplasma gondii (T. gondii), which is most commonly treated by pyrimethamine and sulfadiazine. However, this treatment presents several adverse side effects; Thus, new drugs with lower toxicities are urgently needed. In this study the anti-T. gondii activity of A. vera and Eucalyptus extracts were evaluated in vitro using a MTT (3-(4, 5-dimethylthiazol-2-yl) 2, 5-diphenyltetrazolium bromide) assay and in vivo by measuring the survival rates of mice infected with 2 × 103 tachyzoites of RH strain of T. gondii and then injected intraperitoneally by different concentrations of extracts for 4 days. Biochemical parameters such as Ferric Reducing Antioxidant Potential (FRAP) and malondialdehyde (MDA) assay were also evaluated. As results, in the in vitro assay, the IC50 values were 13.2, 24.7, 2.63 µg/ml, and the selectivity indexes were 3.3, 2.4, 3.03 for the A. vera, Eucalyptus and pyrimethamine, respectively. The mice treated with Eucalyptus showed a better survival rate than others (P < 0.05). The increased weight of liver and spleen, due to infection, was reduced by treatments. In FRAP assay Eucalyptus showed a better antioxidant activity than the other extracts. MDA levels in both liver and spleen were reduced by treatment. The results show that A. Vera and Eucalyptus possess anti-T. gondii activities in vitro and in vivo, in addition, Eucalyptus shows antioxidant activity with a higher survival rate. Therefore, Eucalyptus may be a useful candidate for treating Toxoplasma infection. Moreover, further studies are required to investigate the fractionations of this plant against T. gondii.

Immunological evaluation of a DNA cocktail vaccine with co-delivery of calcium phosphate nanoparticles (CaPNs) against the Toxoplasma gondii RH strain in BALB/c mice.

Many recent studies have been conducted to evaluate protective immunity mediated by DNA vaccines against toxoplasmosis. Cocktail DNA vaccines showed better immune responses compared to single vaccines. The objective of the current study was to evaluate the protective efficacy of rhomboid 4 (ROM4) and cocktail DNA vaccines (ROM4 + GRA14) of the Toxoplasma gondii RH strain with or without coated calcium phosphate nanoparticles (CaPNs) as the adjuvant to improve the immunogenicity against the T. gondii RH strain in BALB/c mice. Cocktail DNA vaccines of pcROM4 + pcGRA14 of the T. gondii RH strain were constructed. CaPNs were synthesized and the cocktail DNA vaccine was coated with the adjuvant of CaPNs. Immunogenicity and the protective effects of cocktail DNA vaccines with or without CaPNs against lethal challenge were evaluated in BALB/c mice. pcROM4 and cocktail DNA vaccine coated with CaPNs significantly enhanced cellular and humoral immune responses against Toxoplasma compared to pcROM4 and cocktail DNA vaccine without CaPNs (p < 0.05). These findings indicate that the survival time of immunized mice after challenge with the RH strain of T. gondii was increased compared to that of controls and the DNA vaccine provided significant protection in mice (p < 0.05). The CaPN-based cocktail DNA vaccine of pcROM4 + pcGRA14 showed the longest survival time compared to the other groups. Co-immunization with CaPN-based cocktail DNA vaccine (pcROM4 + pcGRA14) boosted immune responses and increased the protective efficacy against acute toxoplasmosis in BALB/c mice compared to both single gene and bivalent DNA vaccine without nano-adjuvants.

The efficacy of herbal medicines against Toxoplasma gondii during the last 3 decades: a systematic review.

The objective of the current study was to systematically review papers discussing the efficacy of medicinal herbs against Toxoplasma gondii. Data were systematically collected from published papers about the efficacy of herbs used against T. gondii globally from 1988 to 2015, from PubMed, Google Scholar, ISI Web of Science, EBSCO, Science Direct, and Scopus. Forty-nine papers were included in the current systematic review reporting the evaluation of medicinal plants against T. gondii globally, both in vitro and in vivo. Sixty-one plants were evaluated. Most of the studies were carried out on Artemisia annua. The second highest number of studies were carried out on Glycyrrhiza glabra extracts. RH and ME49 were the predominant parasite strains used. Additionally, Swiss-Webster and BALB/c mice were the major animal models used. Alcoholic and aqueous extracts were used more than other types of extracts. Natural compounds mentioned here may be developed as novel and more effective therapeutic agents that improve the treatment of toxoplasmosis due to their lower side effects, higher availability, and better cultural acceptance compared with those of the chemical drugs that are currently being used.

Mucormycosis in Iran: a systematic review.

Fungi in the order Mucorales cause acute, invasive and frequently fatal infections in susceptible patients. This study aimed to perform a systematic review of all reported mucormycosis cases during the last 25 years in Iran. After a comprehensive literature search, we identified 98 cases in Iran from 1990-2015. The mean patient age was 39.8 ± 19.2 years. Diabetes was the most common underlying condition (47.9%), and 22.4% of the patients underwent solid organ or bone marrow transplantation. The most common clinical forms of mucormycosis were rhinocerebral (48.9%), pulmonary (9.2%) and cutaneous (9.2%). Eight cases of disseminated disease were identified. Overall mortality in the identified cases was 40.8%, with the highest mortality rate in patients diagnosed with disseminated infection (75%). The mortality rate in rhinocerebral infection patients was significantly lower (45.8%). Rhinocerebral infection was the most common clinical manifestation in diabetes patients (72.9%). Patients were diagnosed using various methods including histopathology (85.7%), microscopy (12.3%) and culture (2.0%). Rhizopus species were the most prevalent (51.7%), followed by Mucor species (17.2%). Sixty-nine patients were treated with a combination of surgery and antifungal therapy (resulting survival rate, 66.7%). Owing to the high mortality rate of advanced mucormycosis, early diagnosis and treatment may significantly improve survival rates. Therefore, increased monitoring and awareness of this life-threatening disease is critical.

Prevalence of Ecto and Gastrointestinal Parasites of Rattus rattus in Mazandaran Province, North of Iran

Objective: Rodents act as reservoir hosts and are an important potential source for many zoonotic pathogens such as parasites, which pose a public health risk to humans. Therefore, it is necessary to investigate the prevalence of parasites among rodents. Methods: A total of 118 Rattus rattus were captured in Mazandaran province, north of Iran, using snap live traps. Various samples were collected from feces and each rat was combed with a fine-tooth comb to extricate any ectoparasite. Fecal specimens were examined by direct wet mounting, formalin-ether concentration, modified acid-fast, and trichrome staining methods. Results: The overall prevalence of gastrointestinal parasites in the examined rats was 75.4%. Cryptosporidium spp. (30.5%) were the most prevalent protozoan, followed by Giardia spp. (20.3%), Entamoeba muris (13.5%), Trichomonas muris (10.1%), and Spironucleus muris (3.3%). Regarding helminths' eggs, Syphacia obvelata (24.5%), Hymenolepis diminuta (10.1%), and Trichuris muris (9.3%) had the highest prevalence, respectively. Furthermore, 3060 ectoparasites collected from 102 rodents were infested with lice (40% Polyplax spp.), mites (33.3%), and flea (16.1% Xenopsylla cheopis and 10.6% Xenopsylla astia). Conclusion: According to the results of this study, the prevalence of ecto and gastrointestinal parasites in the collected rats in the area being studied was remarkably high. Additionally, Rattus rattus can be considered a potential risk to human health.

Global Burden of Cyclospora cayetanensis Infection and Associated Risk Factors in People Living with HIV and/or AIDS.

Cyclospora cayetanensis infections remain one of the most common protozoan opportunistic causes of gastrointestinal diseases and diarrhea among people living with HIV and/or AIDS (PLWHA). This study was conducted to provide a summary of the evidence on the global burden of C. cayetanensis infection and associated risk factors among PLWHA. Scopus, PubMed, Science Direct, and EMBASE were searched up to February 2022. All original peer-reviewed original research articles were considered, including descriptive and cross-sectional studies describing C. cayetanensis in PLWHA. Incoherence and heterogeneity between studies were quantified by I index and Cochran's Q test. Publication and population bias were assessed with funnel plots and Egger's asymmetry regression test. All statistical analyses were performed using StatsDirect. The pooled prevalence of C. cayetanensis infection among PLWHA was 3.89% (95% CI, 2.62-5.40). The highest prevalence found in South America was 7.87% and the lowest in Asia 2.77%. In addition, the prevalence of C. cayetanensis was higher in PLWHA compared to healthy individuals. There was a relationship between a higher C. cayetanensis prevalence in PLWHA with a CD4 cell count below 200 cells/mL and people with diarrhea. The results show that PLWHA are more vulnerable to C. cayetanensis infection and emphasizes the need to implement the screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite, an early identification of seropositivity is recommended to initiate prophylaxis between PLWHA with a CD4 count ≤200 cells/mL and PLWHA who do not receive antiviral therapy.

Parasite-based interventions in systemic lupus erythematosus (SLE): A systematic review.

BACKGROUND: The hygiene hypothesis proposed in 1989 expresses that allergic and infectious diseases are inversely related. Accordingly, it has been demonstrated that infection with some microorganisms such as parasites and helminths can provide a potential immunity and prevent the onset of some life-threatening autoimmune diseases like systemic lupus erythematosus (SLE). Therefore, in this comprehensive study, we systematically reviewed and discussed the use of live parasites or parasitic products in the treatment of mouse models of SLE. METHODS: The present systematic review was performed using the following search terms: ("systemic lupus erythematosus" OR "SLE" OR "lupus") AND ("parasite" OR "protozoa" OR "helminths" OR "worms" OR "helminth" OR "worm") in PubMed, Scopus, and Web of Science online databases. We included studies reporting the effect of any intervention using parasites or parasitic-based products on animal models of SLE, which were published until January 20th, 2021 without any language or date restrictions. For each included study, we extracted the authors' names, publication year, type of animal, number of groups, types of intervention, sample size, changes in immunologic cells, auto-Abs, cytokines, and blood cells count, urine analysis, histological analysis of kidney/spleen/liver, outcome and survival. (PROSPERO CRD42020160460). RESULTS: A total of 17 eligible articles were included in this systematic review. Sixteen out of the 17 studies reported immunomodulating changes in immunologic cells, cytokines, and/or auto-Abs in mouse models of SLE after using parasitic interventions compared to not-infected or control groups. Moreover, 14 studies reported decreased level of proteinuria and/or favorable kidney, liver, or spleen histological changes. CONCLUSION: In conclusion, we have demonstrated that parasites like Hymenolepis microstoma, TPC and ES-62 from Acanthocheilonema viteae, Plasmodium chabaudi, Schistosoma mansoni, and Toxoplasma gondii have favorable immunomodulating effects on SLE outcomes in lupus-prone mice.

Toxoplasma gondii infection in domestic and wild felids as public health concerns: a systematic review and meta-analysis.

Felidae as definitive hosts for Toxoplasma gondii play a major role in transmission to all warm-blooded animals trough oocysts dissemination. Therefore the current comprehensive study was performed to determine the global status of T. gondii infection in domestic and wild felids aiming to provide comprehensive data of interest for further intervention approaching the One Health perspective. Different databases were searched by utilizing particular key words for publications related to T. gondii infecting domestic and wild feline host species, worldwide, from 1970 to 2020. The review of 337 reports showed that the seroprevalence of T. gondii in domestic cats and wild felids was estimated in 37.5% (95% CI 34.7-40.3) (I2 = 98.3%, P < 0.001) and 64% (95% CI 60-67.9) (I2 = 88%, P < 0.0001), respectively. The global pooled prevalence of oocysts in the fecal examined specimens from domestic cats was estimated in 2.6% (95% CI 1.9-3.3) (I2 = 96.1%, P < 0.0001), and that in fecal samples from wild felids was estimated in 2.4% (95% CI 1.1-4.2) (I2 = 86.4%, P < 0.0001). In addition, from 13,252 examined soil samples in 14 reviewed studies, the pooled occurrence of T. gondii oocysts was determined in 16.2% (95% CI 7.66-27.03%). The observed high rates of anti-T. gondii antibodies seroprevalence levels and oocyst excretion frequency in the felids, along with soil (environmental) contamination with oocysts may constitute a potential threat to animal and public health, and data will result of interest in further prophylaxis programs.

Cyanocobalamin improves memory impairment via inhibition of necrosis and apoptosis of hippocampal cell death after transient global ischemia/reperfusion.

OBJECTIVES: Brain ischemia/reperfusion (I/R) causes irreversible damage, particularly in the hippocampus. Cyanocobalamin (CNCbl) is known to be crucial for the proper operation of the nervous system. Vitamin B12 has been demonstrated to exert antioxidant effects via direct and indirect mechanisms. It can also protect cortical neurons against glutamate cytotoxicity. This research was conducted to examine CNCbl protection against neuronal cell death in the rat hippocampal region following transient cerebral ischemia. MATERIALS AND METHODS: In this experiment, 48 male Wistar rats were selected, which were randomly divided into four groups (n=12 in each group): sham, ischemia/reperfusion, ischemia/reperfusion + CNCbl 200 and 400 (µg/kg). By occlusion of both common carotids, ischemia induction was performed within 20 min. CNCbl at the doses of 200 and 400 µg/kg was injected (IP) at the start of the reperfusion, 24 and 48 hr following reperfusion. The spatial memory was assessed 7 days following ischemia through the Morris water maze test. Antioxidant enzymes, apoptosis, and necrosis were measured after behavioral tests. RESULTS: CNCbl significantly improved spatial memory impairments (P<0.05), also CNCbl therapy significantly increased both glutathione (P<0.01) and superoxide dismutase (P<0.05) and reduced malondialdehyde (P<0.01) and TNF-α (P<0.05) in comparison with the ischemia group. In addition, CNCbl significantly decreased both apoptosis and necrosis in the hippocampus CA1 (P<0.01). CONCLUSION: CNCbl improves memory impairment following ischemia injury by decreasing neuronal cell death via its antioxidant properties.

High Parasitic Contamination of Soil Samples in the North of Iran: A Potential Risk of Parasitic Infection for Tourists.

BACKGROUND: Soil-transmitted parasites (STPs) are significant intestinal parasites that infect humans and animals and impose considerable burdens on human society and animal husbandry industries. Therefore, the present study aimed to determine the prevalence of parasitic elements of soil samples collected from the north of Iran. METHODS: A total of 256 soil samples were collected from public parks, public places, vegetable gardens, sand heaps, and shadow areas near houses in the north of Iran and examined using the sucrose flotation method. RESULTS: Out of 256 examined samples, 131 (51.2%) showed parasitic contamination, including larvae (43%), oocysts (14.1%), and different eggs (6.6%). According to the results, the most and least common parasites observed in the samples were larvae (43%), as well as Toxascaris leonina, and Trichuris trichiura (0.4%), respectively. Moreover, the most and least contaminated locations were sand heaps (62.5%) and shadow areas near houses (45.6%), respectively. Regarding cities, Behshahr (68.3%) and Sari (67.5%) had the highest contaminated soil samples, whereas Chalus (37.5%) showed the lowest contamination. On the other hand, rural samples showed more contamination compared to urban areas (P< 0.05). CONCLUSION: The findings of the present study indicate that the overall prevalence of STPs in examined areas and highly contaminated soil samples can be considered as a potential source of human contamination particularly tourists with STPs.

Copro-molecular diagnosis of the Toxoplasmatinae subfamily in dog and cat populations in northern Iran.

OBJECTIVES: The oocysts of the Toxoplasmatinae subfamily (Neospora caninum, Hammondia hammondi and H. heydorni, and Besnoitia besnoiti) are morphologically similar to Toxoplasma gondii, and indistinguishable from each other. This study investigated the prevalence of the Toxoplasmatinae subfamily in dog and cat fecal samples using a nested polymerase chain reaction method. METHODS: Overall, 200 fecal samples from domestic dogs (n=120) and cats (n=80) were collected from 15 farms in northern Iran. The samples were homogenized in 2.5% potassium dichromate solution and subsequently concentrated with sucrose solution. DNA was extracted from samples using a genomic DNA kit. Specific primers and the 18S rDNA gene were used to screen and detect all Toxoplasmatinae oocysts. RESULTS: Overall, 2.5% (3 of 120) and 22.5% (18 of 80) of the fecal samples collected from dogs and cats were infected with Toxoplasmatinae. In dogs, 2 samples were positive for N. caninum and 1 sample was positive for T. gondii. In cats, all 18 positive samples belonged to T. gondii. No contamination with H. heydorni was observed in dog fecal samples or H. hammondi and B. besnoiti in cat fecal samples. A phylogenetic analysis revealed that the T. gondii (cat) and N. caninum (dog) found had similarities with parasites reported from other regions of the world. CONCLUSIONS: This is the first study to provide data on the epidemiology of Toxoplasmatinae oocysts in Iran. The findings suggest that public-health monitoring for the effective control of feces from cats and dogs and improved pet hygiene habits are needed.

Cryptosporidiosis in HIV-positive patients and related risk factors: A systematic review and meta-analysis.

Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic methods, geographical distribution and study population. Meta-regression was performed on the year of publication, proportion of patients with diarrhea, and proportion of patients with CD4 < 200 cells/mL. One hundred and sixty-one studies and 51,123 HIV-positive participants were included. The overall pooled prevalence of Cryptosporidium infection in HIV-positive patients was 11.2% (CI95%: 9.4%-13.0%). The pooled prevalence was estimated to be 10.0% (CI95%: 8.4%-11.8%) using staining methods, 13.5% (CI95%: 8.9%-19.8%) using molecular methods, and 26.3% (CI95%: 15.0%-42.0%) using antigen detection methods. The prevalence of Cryptosporidium in HIV patients was significantly associated with the country of study. Also, there were statistical differences between the diarrhea, CD4 < 200 cells/mL, and antiretroviral therapy risk factors with Cryptosporidiosis. Thus, Cryptosporidium is a common infection in HIV-positive patients, and safe water and hand-hygiene should be implemented to prevent cryptosporidiosis occurrence in these patients.

TITLE: Cryptosporidiose chez les patients VIH-séropositifs et facteurs de risque associés : revue systématique et méta-analyse. ABSTRACT: Cryptosporidium est l'une des principales causes de diarrhée chez les patients séropositifs pour le VIH. Le but de cette étude est de revoir et méta-analyser systématiquement la prévalence de Cryptosporidium chez ces patients. Les bases de données PubMed, Science Direct, Google Scholar, Web of Science, Cochrane et Ovid ont été recherchées pour des études pertinentes datant du 1er janvier 2000 au 31 décembre 2017. L'extraction des données pour les études incluses a été réalisée indépendamment par deux auteurs. La prévalence globale combinée a été calculée et une analyse en sous-groupes a été effectuée sur les méthodes de diagnostic, la répartition géographique et la population étudiée. Une méta-régression a été réalisée pour l'année de publication, la proportion de patients atteints de diarrhée et la proportion de patients avec CD4 < 200 cellules/mL. Cent soixante et une études et 51,123 participants séropositifs ont été inclus. La prévalence globale combinée de l'infection à Cryptosporidium chez les patients VIH-séropositifs était de 11,2 % (IC95 % : 9,4 %­13,0 %). La prévalence regroupée a été estimée à 10,0 % (IC95 % : 8,4 %­11,8 %) en utilisant des méthodes de coloration, 13,5 % (IC95 % : 8,9 %­19,8 %) en utilisant des méthodes moléculaires et 26,3 % (IC95 % : 15,0 %­42,0 %) en utilisant des méthodes de détection d'antigènes. La prévalence de Cryptosporidium chez les patients infectés par le VIH était significativement associée au pays d'étude. En outre, il existe des différences statistiques entre la diarrhée, les CD4 < 200 cellules/mL et les facteurs de risque du traitement antirétroviral avec la cryptosporidiose. Ainsi, Cryptosporidium est une infection courante chez les patients séropositifs, et une eau salubre et une hygiène des mains doivent être mises en œuvre pour prévenir la survenue de cryptosporidiose chez ces patients.

Corrigendum to: Transfusion-Transmitted Malaria: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.1093/ofid/ofz283.].

Nosocomial Myiasis in an Intensive Care Unit (ICU): A Case Report.

Myiasis is a parasitic infestation of human and animal tissues caused by larva of several fly species. Nosocomial myiasis is a type of myiasis that patient acquires infestation after admission to hospital and prevention of this infestation should be one of hospital authorities concerns. Therefore, we report a case of nosocomial oral myiasis caused by Lucilia sericata in a woman aged 78-yr-old hospitalized in a Heart Center in north of Iran Aug 2015. The significance of fly extermination in hospital was highlighted and emphasized. Besides, the etiology and different aspects of infestation were discussed elaborately.

Transfusion-Transmitted Malaria: A Systematic Review and Meta-analysis.

BACKGROUND: Malaria transmission through blood transfusion is an accidental but preventable cause of malaria infection and is increasingly becoming a matter of concern for blood transfusion services. This systematic review was conducted to provide a summary of evidence about the prevalence of Plasmodium infection in asymptomatic blood donors and the effectiveness of screening methods used based on the available literature. METHODS: PRISMA guidelines were followed. Scopus, PubMed, Science Direct, and EMBASE were searched from 1982 to October 10, 2017. All peer-reviewed original research articles describing the prevalence of malaria parasitemia in blood donors with different diagnostic methods were included. The random-effects model was applied to assess the effects of heterogeneity among the selected studies. Incoherence and heterogeneity between studies were quantified by I 2 index and Cochran's Q test. Publication and population bias was assessed with funnel plots and Egger's regression asymmetry test. All statistical analyses were performed using Stata (version 2.7.2). RESULTS: Seventy-one studies from 21 countries, 5 continents, were included in the present systematic review. The median prevalence of malaria parasitemia among 984 975 asymptomatic healthy blood donors was 10.54%, 5.36%, and 0.38% by microscopy, molecular methods (polymerase chain reaction), and rapid diagnostic tests, respectively. The most commonly detected Plasmodium species was P. falciparum. CONCLUSIONS: This systematic review demonstrates that compared with other transfusion-linked infections, that is, HIV, HCV, and HBV, transfusion-transmitted malaria is one of the most significant transfusion-associated infections especially in Sub-Saharan Africa. Future work must aim to understand the clinical significance of transfusion-transmitted malaria in malaria-endemic settings.

Anti-Toxoplasma Activities of Zea Mays and Eryngium Caucasicum Extracts, In Vitro and In Vivo.

OBJECTIVES: Toxoplasmosis is a worldwide health problem that caused by intracellular apicomplexan parasite, Toxoplasma gondii (T. gondii). Considering that the available drugs for toxoplasmosis have serious host toxicity, the aim of the current study was to survey the in vitro and in vivo anti-Toxoplasma activity of Zea mays (Z. mays) and Eryngium caucasicum (E. caucasicum) extracts. METHODS: Four concentrations (5, 10, 25, and 50 mg mL-1) of Z. mays and E. caucasicum methanolic extracts for 30, 60, 120, and 180 min were incubated with infected macrophages and then the viability of RH strain of T. gondii tachyzoites was evaluated by trypan blue staining method. Also, we evaluated the survival rate of acutely infected mice with the extracts (100 and 200 mg kg-1 day-1) intraperitoneally for 5 days after infection with 2× 104 tachyzoites of T. gondii. RESULTS: The anti-Toxoplasma effect of the methanolic extracts were extremely significant compared to the negative control group in all exposure times (P < 0.05). The Z. mays (10, 25 and 50 mg mL-1) killed 100% of the parasites after 180 and 120 min exposure, respectively. Also, high toxoplasmacidal activity was observed with E. caucasicum extract. Furthermore, treatment of experimentally infected mice with the Z. mays (100, 200 mg kg-1 day-1) and E. caucasicum (100 mg kg-1 day-1) significantly increased their survival rate compared to untreated infected control (P < 0.05). CONCLUSION: These extracts are promising candidates for further medicine development on toxoplasmosis. However, further investigations are necessary to clarify effective fractions of the Z. mays and E. caucasicum extracts and the mechanisms of action.

The Prevalence of Intestinal Helminths in Free-Ranging Canids of Mazandaran, Northern Iran.

BACKGROUND: The purpose of this study was to investigate the current knowledge on the epidemiology of importance zoonotic parasitic diseases in free-ranging canids of Mazandaran, north of Iran. METHODS: Overall, 63 small intestinal samples of animals (20 stray dogs and 43 golden jackals) were collected from April 2017 to May 2018. The intestine contents were studied to detect and identify helminth infections. Additionally, 274 fecal samples (130 dogs, 35 fox, 90 golden jackal and 19 wolf) were examined by Sheather's flotation method for detection of Taenia eggs. RESULTS: Sixty (95.2%) animals were infected with at least one species of intestinal helminth. the intestinal helminths were found in dogs and golden jackals included: Dipylidium caninum (25.3%), Uncinaria stenocephala (52.3%), Ancylostoma caninum (41.2%), Mesocestoides spp. (33.3%) and Toxocara canis (14.2%). In fecal examination, 2.5% of samples contained Taenia eggs, and through a species-specific PCR, 1.09% of these samples were confirmed positive for Echinococcus granulosus. CONCLUSION: There is a high prevalence and clear risks of zoonotic helminths in free-ranging carnivores in Mazandaran province, north of Iran. Therefore, understanding the epidemiology of zoonotic parasite infection is useful for health care access both domestic animals and humans health.