A Systematic and Meta-Analysis Study on the Prevalence of Tuberculosis and Relative Risk Factors for Prisoners in Iran.

INTRODUCTION: Tuberculosis (TB) is a serious infectious disease that affects human health globally. The incidence of TB in prisons is usually much higher than the general population in different countries. The aim of this study was to evaluate the incidence of TB among prisoners in Iran, estimating the relative risk factors by performing a systematic and meta-analysis study on the related articles. METHODOLOGY: Our systematic and meta-analysis study was performed according to the PRISMA guidelines. Two authors systematically searched Scopus, Iran doc, Cochrane, Pubmed, Medline, Embase, Iran medex, Magiran, SID, Google Scholar, and EBSCO. The quality assessment of articles was performed by using the Newcastle-Ottawa Scale. After article quality assessment, a fixed or random model, as appropriate, was used to pool the results in a meta-analysis. Heterogeneity between the studies was assessed using I-square and Q-test. Forest plots demonstrating the point and pooled estimates were drawn. RESULTS: Overall, data from 19562 prisoners indicated 63 cases of TB. The prevalence of TB in prisoners was reported to range from 0.025% to 52% in eight studies. The highest prevalence of tuberculosis was related to the study of Rasht, 517 in 100,000, and the lowest rate was related to the study of Sought Khorasan, 25 in 100,000. The ES of the random effect model is 0.003 (95% CI, 0.001-0.005) and p-value <0.0001. The Higgins' I2 of all studies is 86.55%, and the p-value of the Cochrane Q statistics is <0.001, indicating that there is heterogeneity. Based on the Egger regression plot (t=2.18, p = 0.08, CI 95%: -0.001, 0.005), no publication bias existed. CONCLUSION: According to the analysis findings, the frequency of tuberculosis among the prison in Iran was low. The highest prevalence obtained in our systematic study was 517 in 100,000 in Rasht, which was near the world statistics in the systematic review of world studies. Due to significant limitations in this study, it is not possible to indicate the exact prevalence of TB in prisons in Iran and compare this with the general population. However, more studies are needed to assess the related risk factors for designing health intervention plans to decrease the incidence rate of TB among prisoners.

Occult Hepatitis C Virus Infection among Hemodialysis Patients: An Iranian Experience.

BACKGROUND: Patients with chronic kidney failure and those undergoing chronic hemodialysis (CHD) treatment are at high risk of infection with hepatitis C virus (HCV). The incidence of occult HCV infection (OCI) in CHD remains controversial and the real burden of HCV in this population may be affected by the rate of OCI. This study evaluates the molecular assessment of OCI in CHD in an Iranian population. METHODS: All subjects on CHD in the South Khorasan province of Iran were invited for participation in the study. Whole blood samples were taken and serological, clinical, and demographic information was recorded. HCV-RNAs were checked in serum and peripheral blood mononuclear cells (PBMCs) using an in-house semi-nested PCR assay. Viral load was determined using a real-time PCR-based quantification kit. Sequencing was performed to determine genotypes. RESULTS: Overall, 120 cases participated in the study; 57.5% were male and the rest were female. In serum samples, no positive case was found for HCV-RNA. In PBMC samples, 2/120 (1.6%) were positive for HCV-RNA (95% CI, 0.002 to 0.059); the mean age of OCI positive cases was 37.5 ± 19.2 years which was significantly lower than OCI negative cases (P = 0.026). Only one case had detectable viral load which was 49 IU/mL. The only HCV genotype identified was 1a. CONCLUSION: This study showed that there is a risk of OCI among CHD patients; the very low and undetectable viral loads of OCI warrant further follow-up molecular testing for earlier diagnosis and treatment in the era of DAA.