In vitro and in vivo evaluation of kojic acid against Toxoplasma gondii in experimental models of acute toxoplasmosis.

As current toxoplasmosis chemotherapies have many side effects along with toxicity on patients, we examined the anti-Toxoplasma effect of a biologically important natural antibiotic, kojic acid, in vitro and in vivo. Vero cells were incubated with different concentrations of kojic acid or pyrimethamine (positive control), and the cellular viability was determined. Next, Vero cells were infected with T. gondii (RH strain) and treated with drugs. Then, we calculated the infection index, T. gondii intracellular proliferation and the number and measure of plaque. Moreover, the effect of kojic acid on survival times, serum levels of IFN-γ and TNF-α and histopathological changes in the liver and spleen of Balb/c mice infected with T. gondii were determined. Kojic acid reduced the infection index, intracellular proliferation, the number and measure of plaque in vitro when compared to untreated infected cells. Kojic acid (100 mg/kg/day) also showed a better survival rate than infected untreated control mice (P < 0.05). IFN-γ and TNF-α secretions were significantly increased by kojic acid treatment in comparison to untreated groups (P < 0.05). In addition, its inhibitory effects on inflammatory alterations, apoptosis, and necrosis have been shown in sections of liver and spleen. We conclude that kojic acid exhibit potent anti-Toxoplasma activity with direct and indirect effects on the parasite, although further studies are needed before consideration of clinical trials.

The potential risk of toxoplasmosis for traffic accidents: A systematic review and meta-analysis.

Toxoplasmosis is a prevalent infectious disease. Although most people infected by Toxoplasma gondii are asymptomatic, evidence has suggested that this disease might affect some aspects of a host's behavior and associate with schizophrenia, suicide attempt, changes in various aspects of personality, and poor neurocognitive performance. These associations may play roles in increasing the risk of a number of incidents, such as traffic accidents, among infected people. In this regard, this study aimed to provide summary estimates for the available data on the potential risk of toxoplasmosis for traffic accidents. To this end, using a number of search terms, i.e. toxoplasmosis, Toxoplasma gondii, traffic accident, road accident, car accident, crash, and prevalence, literature searches (up to October 1, 2017) were carried out via 6 databases. The meta-analysis was conducted using the StatsDirect statistical software and a P-value less than 0.05 was regarded as significant in all statistical analyses. Out of 1841 identified studies, 9 studies were finally considered eligible for carrying out this systematic review. Reviewing results of these studies indicated that 5 out of 9 studies reported a significant relationship between Toxoplasma gondii and traffic accidents. Additionally, data related to gender showed significant differences between infected and control men and women. Considering age, reviewing the results of these studies revealed a significant difference between the infected people and the Toxoplasma-negative subjects under 45 years of age. However, no significant difference was found between the two groups aged 45 or older. Given these results, it can be concluded that Toxoplasma gondii significantly increases the risk of having traffic accidents.

Milk as a Non-Invasive and Alternative Sample for Serum in the Diagnosis of Animal Toxoplasmosis: A Systematic Review.

Background: Toxoplasmosis is one of the most important zoonotic parasitic diseases worldwide with a high impact on human and animal health. Body fluids such as milk are used to diagnose many parasitic diseases, including toxoplasmosis. Therefore, this study aimed to investigate the role of milk as a non-invasive and alternative sample for serum in the diagnosis of animal toxoplasmosis. Methods: Five English-language databases (ScienceDirect, PubMed, ProQuest, Scopus, and Web of Science) were explored for published articles before Dec 2020. Results: In total, 42 out of 2256 published articles were included in this systematic review. In 21 articles, serum and milk samples were evaluated simultaneously with serological or molecular tests, and the results were compared. The results of descriptive studies and a review of nine experimental studies showed that milk could be used as a non-invasive and alternative sample for the serum in the diagnosis of toxoplasmosis. Conclusion: Due to the relatively high prevalence of Toxoplasma gondii (T. gondii) infection in milk, consumption of raw milk from infected animals can be a potential source of human infection and a significant threat to public health. On the other hand, due to the ease and cheapness of collecting milk samples, the use of milk is recommended for the diagnosis of toxoplasmosis.

Domestic dogs carriers of Leishmania infantum, Leishmania tropica and Crithidia fasciculata as potential reservoirs for human visceral leishmaniasis in northeastern Iran.

BACKGROUND: In recent years, cases of human visceral leishmaniasis (HVL) have been reported in some districts of Golestan Province, northeastern Iran, particularly in rural areas. Recent epidemiological evidence in Leishmania infantum endemic regions of in Iran indicates approximately 50%-80% of seropositive dogs are asymptomatic for Leishmania infection. OBJECTIVES: The goal in this study was to determine Leishmania species infecting domestic dogs in Golestan Province, Iran. METHODS: Between 2015 and 2016, blood samples were obtained from 100 domestic dogs in rural regions of Golestan Province, northeastern Iran. All samples were tested for anti-Leishmania antibodies using a direct agglutination test (DAT), and for Leishmania spp. kinetoplast DNA (kDNA) using PCR. RESULTS: Seven (7%) dogs were antibody positive and 25 dogs (25%) were Leishmania spp. DNA positives by PCR positive for leishmaniasis. Four of the seven (71%) antibody-positive dogs and 19 of the 25 (76%) PCR-positive dogs were asymptomatic. The rate of infection detected by PCR was significantly higher in male dogs (21/75, 28%) than that in female dogs (4/25, 16%). The ITS1 PCR-RFLP assay identified the presence of L. infantum, L. tropica or Crithidia spp. in the 25 PCR-positive samples. CONCLUSIONS: The high proportion of asymptomatic dogs in the study areas represent they act as potential reservoirs in the transmission cycle of Leishmania spp. and also Crithidia fasciculata as an emerging agent for the first time. Moreover, our data showed that PCR is a more reliable assay than DAT for detecting Leishmania spp. infection among asymptomatic dogs.

Is there any association between Toxoplasma gondii infection and depression? A systematic review and meta-analysis.

BACKGROUND: Toxoplasma gondii (T. gondii) is an obligate intracellular opportunistic parasite that is the causative agent of toxoplasmosis. This parasite accounts for mental disorders; however, the relationship between T. gondii infection and depressive disorder is unclear. Regarding this, the present systematic review and meta-analysis was conducted to investigate the scientific evidence regarding the potential association between major depression disorder (MDD) and Toxoplasma infection. METHODS: For the purpose of the study, the articles related to the subject of interest were systematically searched in seven electronic databases. Special attention was given to the studies examining T. gondii seropositivity level in depressed patients and controls. RESULTS: The search process resulted in the identification of a total of 30 publications meeting the inclusion criteria and published up to April 2018 for the systematic review. Furthermore, 29 studies met the inclusion criteria to be entered into meta-analysis. Our meta-analysis involved the review of cross-sectional studies including 1657 depressed patients and 19565 individuals as controls and case-control studies entailing 1311 depressed cases and 6015 controls without depression. 1582 depressed people participated in cross-sectional studies whose results were reported as odds ratio (OR). In addition, the total number of participants was 15068 in this type of studies. Statistical analysis indicated that the pooled OR of the risk of anti-T. gondii IgG antibody in depressed individuals in case-control and cross-sectional studies was 1.15 (95% confidence interval (CI): 0.95-1.39). CONCLUSIONS: As the findings of the reviewed articles indicated, toxoplasmosis is not a risk factor for MDD. However, it is necessary to perform further research to clarify the detailed association between T. gondii and dysthymia or mild and moderate depression. Furthermore, it is recommended to better investigate the effect of antibody titers on the relationship between depression and T. gondii infection.

Congenital toxoplasmosis among Iranian neonates: a systematic review and meta-analysis.

Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.

Parasitic Helminths in Wild Boars (Sus scrofa) in Mazandaran Province, Northern Iran.

BACKGROUND: Wild boars (Sus scrofa) are distributed worldwide and found in many parts of Iran. Although S. scrofa is reservoirs for many parasites, there is little data on helminthic prevalence in them. We aimed to survey the status of helminthic infections in S. scrofa in the Mazandaran Province of northern Iran. METHODS: Twenty-one wild boars were captured and examined for helminth infection during Dec 2012-Mar 2014. Adult worms such as Macracanthorhynchus hirudinaceus were identified by helminth size and shape, and the arrangement of the proboscis hooks. The sedimentation and flotation techniques were used to detect parasite eggs and larvae in faecal samples. Muscle samples were also surveyed for Trichinella larvae by artificial digestion method. RESULTS: Of the 21 samples, 13 (61.9%) were infected with one or more helminth species. Seven helminth types were identified in the alimentary track, comprising 5 nematodes, 1 trematode, and 1 acanthocephalan, with prevalence rates of Macracanthorhynchus hirudinaceus (57.14%), Globocephalus spp. (33.33%), Trichuris suis (19.04), Gongylonema pulchrum (14.28%), Fasciola hepatica (14.28%), Dioctophyma renale (4.76%), and Ascaris suum (4.76%). CONCLUSION: Wild boars might be involved in transmitting zoonotic parasites to humans. The abundance of these animals near human habitation creates favorable conditions for infection. So the risk of parasitic helminth diseases increases in other animals and humans.

Toxoplasmosis seroprevalence in rheumatoid arthritis patients: A systematic review and meta-analysis.

BACKGROUND: Toxoplasmosis is a cosmopolitan infection caused by an intracellular obligatory protozoan, Toxoplasma gondii. Infection to this parasite in immunocompetent patients is usually asymptomatic, but today it is believed that the infection can be a risk factor for a variety of diseases, including rheumatoid arthritis (RA). RA is an autoimmune disease and the most common type of inflammatory arthritis that is a major cause of disability. The aim of this systematic review and meta-analysis was to address the association between RA and toxoplasmosis in light of the available research. METHODS: Based on the keywords, a systematic search of eight databases was conducted to retrieve the relevant English-language articles. Then, the studies were screened based on the inclusion and exclusion criteria. The random effect model was used to calculate the odds ratio (OR) using forest plot with 95% confidence interval (CI). RESULTS: Overall, 4168 Individual, extracted from 9 articles were included for systematic review evaluation, with 1369 RA patients (46% positive toxoplasmosis) and 2799 individuals as controls (21% positive toxoplasmosis). Then, eight articles (10 datasets) were used for meta-analysis (1244 rheumatoid arthritis patients and 2799 controls). By random effect model, the combined OR was 3.30 (95% CI: 2.05 to 5.30) with P < 0.0001. CONCLUSION: Although toxoplasmosis could be considered as a potential risk factor for rheumatoid arthritis, more and better quality studies are needed to determine the effect of T. gondii infection on induction or exacerbation of RA. Our study was registered at the International Prospective Register of Systematic Reviews (PROSPERO; code: CRD42017069384).

Phylogenetic analysis of nasal avian schistosomes (Trichobilharzia) from aquatic birds in Mazandaran Province, northern Iran.

Nasal schistosomes are trematodes in the family Schistosomatidae, many members of which are causative agents of human cercarial dermatitis (HCD). Little is known about the species diversity and distribution of nasal dwelling schistosomes of water birds, particularly in countries outside of Europe; even less is known in countries like Iran. Nasal schistosomes are of particular interest since these species migrate via the central nervous system to the nasal cavity once they penetrate their host. Thus, there must be efforts to determine the incidence of HCD due to nasal schistosomes. HCD outbreaks are reported seasonally in Mazandaran Province, northern Iran, an area well known for rice cultivation leading to increased person contact with water and infected snails. Such places include favorable habitat for both domestic ducks year round, and wild migratory ducks in the winter through spring. Recent reports have detected the presence of both nasal and visceral schistosomes in ducks in this area but with little species characterization. In this study, we examine a diversity of aquatic birds to determine the distribution, prevalence and bird host use of nasal schistosomes. We apply for the first time a molecular identification and phylogenetic analysis of these schistosomes. From 2012 to 2014, the nasal cavity of 508 aquatic birds from Mazandaran Province were examined that included species in Anseriformes, Gruiformes, Charadriiformes and Phoenicopteriformes. Nasal schistosomes were found in 45 (8.9%) birds belonging to Anseriformes (Anas platyrhynchos and Anas clypeata). Phylogenetic analysis of the nuclear internal transcribed spacer 1 rDNA and the mitochondrial cytochrome oxidase1 gene of isolated eggs revealed that all samples grouped in a sister clade to the European Trichobilharzia regenti. However, Trichobilharzia from this study were more similar to a unique haplotype of Trichobilharzia, isolated from the nasals of an A. clypeata in France. The genetic and phenotypic differences between the species found herein and T. regenti from Europe, may prove with additional data to be a distinct species of Trichobilharzia.

Prevalence of parasites in patients with gastroenteritis at East of Mazandaran Province, Northern Iran.

Parasitic gastrointestinal infections are one of the most important health problems in the developing countries, which lead to the onset of intestinal disease particularly diarrhoea. Due to the particular geographic situation in the Mazandaran province, individuals are infected with various intestinal parasites. The aim of this study was to determine the prevalence rate of enteropathogenic parasites in the patients with gastroenteritis living at the east of Mazandaran province (Sari, Nekah and Joybar cities), northern Iran. This descriptive study was carried out from September 2009 to March 2010. Faecal samples were collected by randomized cluster method from 962 patients with gastroenteritis who were refered to the Health Service Centers of Sari, Neka and Joybar cities. All data about the patients were recorded in questionnaire. Stool specimens were examined by direct wet mounting, formolether concentration, and Ziehl-Neelsen acid fast stain and Auramin Phenol fluorescence (APF) method for the investigation of Cryptosporidium and Isospora. Prevalence of intestinal parasites and their relationship with gender, age, and season were investigated, and the obtained data were analyzed with χ² test using the SPSS software (16.0). Out of 962 patients with gastroenteritis, overall infection was 9.1%; Giardia lamblia (4.1%) with the highest and Enterobius vermicularis (0.2%) with the lowest prevalence rate. Prevalence rate of other parasites were as follow: Cryptosporidium, 0.1%; Entamoeba histolytica, 0.1%; Chilomastix mesnili, 0.1%; Entamoeba coli, 1.2%; Blastocytis hominis, 1.8%; Trichostrongylus spp., 0.4% and Hymenolepis nana, 0.9%. Findings showed that Giardia is the most common cause of intestinal infection at the east of Mazandaran province, and could be defined as the most important parasitic agent of gastroenteritis. On the other hand, infection with enteropathogenic parasites as compared with the previous reports showed significant decline, which reveals the coverage of health education, increase of public knowledge on the parasitic diseases and sanitation of living environment.