Lungworms of Non-Ruminant Terrestrial Mammals and Humans in Iran.

With over 300 terrestrial and aquatic mammalian species, Iran is considered a country with an ample mastofauna. Although many studies have assessed the distribution of gastrointestinal helminth parasites in animals and humans in Iran, lungworms have not received adequate attention. Following a previous article in which we reviewed the diversity and prevalence of lungworm infections in pastoral and wild ruminants of Iran, this report compiles the available scientific information about the occurrence of lungworms in non-ruminant mammals and humans from 1980 to 2022 to provide insights into the epidemiology of these infections. International and national scientific databases were searched, and twenty-six articles in peer-reviewed journals, one conference paper, and one D.V.M. thesis were included in the study. In total, 10 species belonging to seven genera, including Dictyocaulus, Deraiophoronema, Protostrongylus, Crenosoma, Eucoleus, Aelurostrongylus, and Metastrongylus, were reported in the respiratory tract or feces of humans, domestic animals (i.e., camels, equids, dogs, and cats), and wildlife species (i.e., hedgehogs, wild boars, and hares). Most of the studies (22/28) were performed using post-mortem examinations. The overall prevalence of respiratory nematode infection varied according to animal species in camels (14.83%), equids (13.31%), dogs (5%), wild boars (45.66%), hedgehogs (42.57%), and hares (1.6%). In addition, pulmonary capillariasis caused by Eucoleus aerophilus was reported in a 9 year old child. The prevalence of lungworm species in domestic camels, equids, and dogs, combined with a lack of labeled anthelmintic products, supports the need to improve our understanding of these important nematode parasites and inform the development of sustainable control strategies. From a zoo and wildlife medicine point of view, there is a shortage of information about the presence and prevalence of lungworm infections in the majority of mammalian species, pending epidemiological studies that integrate classical parasitology and molecular methods.

Parasitological and histopathological features of appendectomy specimens in Fars Province, southern Iran: a retrospective study.

Although the appendix is the most commonly resected and examined intra-abdominal organ, the pathogenesis and etiology of acute nonspecific appendicitis remain enigmatic. This retrospective study aimed to assess the prevalence of parasitic infection in surgically removed appendices and to evaluate the probable associations between the presence of parasites and the occurrence of appendicitis through parasitological and histopathological examinations of the appendectomy specimens. Materials and methods: This retrospective study was carried out from April 2016 to March 2021 among all patients referred to hospitals affiliated with Shiraz University of Medical Sciences, Fars Province, Iran, for appendectomy. Patient information, including age, sex, year of appendectomy, and type of appendicitis, was collected from the available data in the hospital information system database. In positive cases, all pathology reports were retrospectively evaluated for the presence of the parasite and its type, and analytical and descriptive statistics were carried out using SPSS software version 22. Results: A total of 7628 appendectomy materials were evaluated in the present study. Of the total participants, 4528 (59.4%, 95% CI: 58.2-60.5) were males, and 3100 (40.6%, 95% CI: 39.5-41.8) were females. The mean age of participants was 23.87±14.28 years. Overall, Enterobius vermicularis was observed in 20 appendectomy specimens. Fourteen of these patients (70%) were less than 20 years old. Conclusion: This study indicated that E. vermicularis is one of the common infectious agents that could be found in the appendix and may increase the risk of appendicitis. Therefore, in terms of appendicitis, clinicians, and pathologists must be aware of the possible presence of parasitic agents, especially E. vermicularis, to treat and manage the patients sufficiently.

Tracking the existence of Dioctophyma renale in Parthian Empire of Iran (247 BC-224 AD).

Paleoparasitological investigation in the archeological site of the Caspian Sea littoral revealed the presence of human Dioctophyma renale infection, a ubiquitous kidney-residing helminth of mammals, during the Parthian Empire of Iran (247 BC-224 AD). This study reports the oldest human infection with giant kidney worm in the Middle East, mainly in an area where the infection is reported nowadays. The paucity of records throughout the literature suggests that the same species of parasite occurred with low frequency in the past, as well. The cemetery in the archeological site of Kiasar represented a unique opportunity of studying human and animal parasites of the Parthian Empire in Iran.

The Prevalence and Control of Lungworms of Pastoral Ruminants in Iran.

Lungworms of the genera Dictyocaulus, Muellerius, Protostrongylus, and Cystocaulus are common helminths of domestic and wild ruminants with substantial veterinary and economic importance. Several studies have assessed the presence and prevalence of lungworm infections in ruminants in Iran. This report compiles the available scientific information about the occurrence of lungworms in domestic and wild ruminants in Iran between 1931 and June 2022 to give an insight into their epidemiology, and where possible to describe drug treatment efficacy. For this purpose, national and international scientific databases were searched. Overall, 54 publications comprising 33 articles in peer-reviewed journals, 8 conference papers, and 13 dissertations were evaluated regarding prevalence data; and an additional 4 peer-reviewed articles were evaluated regarding drug efficacy. Seven species of lungworms, namely Dictyocaulus filaria, Dictyocaulus viviparus, Dictyocaulus eckerti, Protostrongylus rufescens, Protostrongylus raillietti, Muellerius capillaris, and Cystocaulus ocreatus have been recorded from different ruminant hosts in Iran. Thirty-three studies conducted on small ruminant (sheep and goat) lungworms reported prevalences of lungworm infection of 11.6%, 45.81% and 66.29% using abattoir meat inspection, Baermann technique and fecal flotation, respectively. Eight studies conducted on large ruminants (cattle and water buffalo) reported prevalences of infection of 14.83%, 13.98% and 5% using abattoir meat inspection, the Baermann technique and fecal flotation, respectively. The prevalence of infection in wild ruminants was variable across examined species; 38% in urial, 37% in wild goats, 5% in goitered gazelles and 67% in red deer, in addition to a single case report in roe deer. There are few contemporary studies assessing the efficacy of currently available broad-spectrum anthelmintic compounds against lungworms in Iran. The high prevalence of multiple lungworm species in Iran, combined with a lack of information about drug efficacy, supports the need to improve the understanding of these important nematode parasites and inform the development of sustainable control strategies. The aim of this review and meta-analysis is to provide a baseline for future conventional parasitology and next generation molecular epidemiological studies of lungworm infection in pastoral ruminants in Iran.

First evidence of Brachylaima sp. (Diplostomida; Brachylaimidae) infesting the Etruscan shrew (Suncus etruscus) in Iran.

Of the eleven species of shrews described in Iran, the Etruscan shrew (Suncus etruscus), the smallest known extant mammal by mass, is recorded in northern and southern provinces. During rodent control programs, a female S. etruscus was trapped and found naturally infected with a trematode which was morphologically identified as Brachylaima sp. This finding represents the first report of trematodiasis in this host species.

Prevalence and Predictors of Toxoplasma gondii Infection in Psychiatric Inpatients in Fars Province, Southern Iran.

Background: Psychiatric patients are at increased risk of exposure to Toxoplasma gondii infection, which may be linked to their living facilities and behaviors. Limited knowledge on the prevalence of T. gondii infection and its associated risk factors in psychiatric patients are available to the international medical communities. Thus, the aim of the current study was to assess seroprevalence of T. gondii and its associated risk factors in psychiatric inpatients in Fars Province, southern Iran. Methods: This cross-sectional study was carried out on psychiatric patients hospitalized in Ibn Sina Hospital affiliated to Shiraz University of Medical Sciences, Fars Province, southern Iran, March to July 2021. Blood samples were collected from 318 psychiatric patients and assessed for the detection of IgG against T. gondii using enzyme-linked immunosorbent assay (ELISA). Moreover, structured questionnaires were completed for the participants at the time of sampling. Logistic regression analysis was used to assess possible associations between the latent toxoplasmosis and the variables. Results: The overall seroprevalence of anti-T. gondii IgG in psychiatric inpatients was 22.3% (71/318; 95% CI = 17.9-27.3). Multivariate analyses revealed that age > 30 years [adjusted odds ratio (AOR) = 2.24, 95% CI = 1.10-4.60, p = 0.03], contact with cats (AOR = 2.52, 95% CI = 1.14-5.58, p = 0.03), raw vegetable consumption (AOR = 3.65, 95% CI = 1.74-7.65, p = 0.001), raw/undercooked meat consumption (AOR = 4.30, 95% CI = 1.47-12.63, p = 0.008), suicide attempt (AOR = 3.77, 95% CI = 1.58-8.97, p = 0.003) and cigarette smoking history (AOR = 0.38, 95% CI = 0.17-0.83, p = 0.02) were independent risk factors for T. gondii infection. Conclusion: The current results demonstrated that contact with cats, raw vegetable consumption and raw/undercooked meat consumption were independent risk factors for T. gondii seropositivity. Moreover, the current study showed significant associations between seropositivity of T. gondii and suicide attempts as well as negative associations between seropositivity of T. gondii and cigarette smoking in psychiatric inpatients using multivariate logistic regression.

In vivo anti-leishmanial activity of concocted herbal topical preparation against Leishmania major (MRHO/IR/75/ER).

Cutaneous leishmaniosis (CL) is considered as one of the most important tropical diseases. Herbal therapy is the ideal treatment for CL because of the reduced injection pain, availability, lower cost and non-toxicity effects. The present study aimed to evaluate the in vivo antileishmanial activity of concocted herbal topical preparation (Aloe vera, Perovskia abrotanoides, Nigella sativa, propolis, lavender and olive oil) to evaluate its efficacy against Leishmania major (MRHO/IR/75/ER) in comparison to the gold standard treatment. Following the cause of cutaneous leishmaniosis, the BALB/c mice were divided into three groups, test group (ointment formulation), positive control (Glucantime) and negative control (untreated), respectively, which were treated twice a day for 28 consecutive days. The lesion size and parasite burden were evaluated for in vivo evaluation. The herbal topical ointment was able to significantly decline the lesion progression and reduce parasite burden in mice inoculated with L. major promastigotes in the test group compared with the negative control group (P=<0.001). In mice treated with the formulation, the number of amastigotes significantly decreased (P=<0.001), compared with that in the negative control group. Moreover, comparative features of both treatments showed there was no difference between the herbal-treated and glucantime-treat mice (P=0.63). The herbal topical ointment displayed significant in vivo antileishmanial activities. It may be that using ointment formulation beside other skin repair compounds can be used as an alternative medicine in the treatment and healing of human CL lesions. Further investigations are needed to study the pharmacologic and pharmacokinetics aspects of ointment formulation in the treatment and healing of human CL lesions.

First Report of Passerilepis parina (Cestoda: Hymenolepididae) from Parus major in Iran: A Probable Fatal Case Due to Hyperinfection.

Cestodes are important parasites that can affect the health of humans and wildlife. Among these, the genus Passerilepis is an important endoparasite of Passeriform birds while poorly studied in Iran. During a parasitological field survey in central parts of Iran in 2018, thirty-two cestodes, as an obstructive intertwined mass, recovered from the intestine of a recently dead Parus major (great tit). Morphological characteristics of recovered cestodes were drawn carefully by a camera lucida equipped microscope and identification was carried out using standard keys. All of the collected cestodes were identified as P. parina. In the current study, we recorded P. parina from great tit for the first time in Iran.

Assessment of an In-House Enzyme-Linked Immunosorbent Assay and IgG Avidity Test Based on SAG1 and GRA7 Proteins for Discriminating between Acute and Chronic Toxoplasmosis in Humans.

To improve serodiagnostic methods for diagnosis of acute from chronic toxoplasmosis, an economical in-house enzyme-linked immunosorbent assay (ELISA) for measuring Toxoplasma-specific IgG, IgM, and IgG avidity has been developed and assessed based on use of various Toxoplasma gondii antigens, including SAG1, GRA7, and a combination of SAG1 and GRA7 (SAG1+GRA7), as well as Toxoplasma lysate antigens (TLAs). Performances of in-house IgM, IgG, and IgG avidity assays were compared to those of ELISA commercial kits and VIDAS Toxo IgG avidity. A set of 138 sera from patients with acquired T. gondii infection and seronegative people were assessed. Receiver operating characteristic (ROC) analysis revealed an area under curve (AUC) of 0.98, 0.97, 0.99, and 0.99 for IgM-TLAs, IgM-SAG1, IgM-GRA7, and IgM-SAG1+GRA7, respectively. Furthermore, AUC was calculated as 0.99, 0.99, 0.98, and 0.99 for IgG-TLAs, IgG-SAG1, IgG-GRA7, and IgG-SAG1+GRA7, respectively. The current study showed that GRA7 included 100% sensitivity for the detection of Toxo IgM, while SAG1 included 89.7% sensitivity. Furthermore, the highest specificity (97.2%) to detect Toxo IgM was achieved using SAG1+GRA7 antigen. For the detection of Toxo IgG, the highest sensitivity (100%) was recorded for SAG1+GRA7, followed by TLAs (97.9%). The SAG1+GRA7 showed the greatest potential for assessing avidity of IgG antibodies, with 97.1% sensitivity and 96.6% specificity compared to those of VIDAS Toxo IgG avidity. The preliminary results have promised better discriminations between acute and chronic infections using a combination of SAG1 and GRA7 recombinant antigens compared to those using TLAs.

First report of Spirocerca lupi larva in dung beetles (Scarabaeus armeniacus) in the central region of Iran: A morphological and molecular identification.

Dung beetles as detritivores insects, naturally use feces of vertebrates as foods and reproduction beds. This leads to frequent contacts between dung beetles and parasitic helminths. The current study was carried out to assess infections of dung beetles with larval stages of helminths in rural areas of Taleqan County, Alborz Province, Iran. A total number of 200 dung beetles were collected randomly in June 2017 from the highlands of Taleqan County. Beetles were dissected in normal saline and carefully studied using a stereomicroscope. Morphological characteristics of the recovered larvae were drawn using a camera lucida equipped microscope at 400× magnification. Then, genomic DNAs of the recovered larvae extracted and PCR amplifications of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene were carried out and the amplicons were sequenced. All collected dung beetles identified as Scarabaeus armeniacus from the Scarabaeidae family (55.5 % were male and 44.5 % female). Three females of the beetles have been found to be naturally infected with the third stage larvae of Spirocerca lupi. The average length and width of the larvae were 2.95 (2.81-3.15; CI 95 %) and 0.12 (0.1-0.15; CI 95 %) mm, respectively. The phylogenetic analysis showed that S. lupi belonged to a clade within the Spirocercidae family. In the current study, S. armeniacus introduced as a potential biological vector for transmission of S. lupi to vertebrates in the region. To the best of the authors' knowledge, this is the first report on the larval stages of S. lupi in S. armeniacus.

Intestinal parasites among intellectually disabled individuals in Iran: a systematic review and meta-analysis.

BACKGROUND: Poor self-care skills and personal hygiene resulted from limitations in learning and understanding, put intellectually disabled individuals at greater risk for intestinal parasitic infections (IPIs). Despite several regional reports in Iran, the overall burden on IPIs among intellectually disabled individuals is poorly understood. Hence, the present study aimed to estimate the pooled prevalence of IPIs among intellectually disabled individuals in Iran. METHODS: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from seven electronic databases (PubMed, Web of Science, Scopus, Embase, and ProQuest for English articles, as well as SID and Magiran for Persian) from their inception up to December 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran's Q-test. RESULTS: Exactly 1263 of the 3004 intellectually disabled individuals examined by 14 studies across 10 provinces of Iran were positive for IPIs. Overall pooled prevalence estimate was 41% (95% CI 29-53%) with a range of 21% (95% CI 10-32%) to 68% (95% CI 55-80%) across sub-groups. Entamoeba coli (16.2%; 95% CI 10.3-22%), Blastocystis spp. (12.2%; 95% CI 7.2-17.2%), and Giardia duodenalis (11.9%; 95% CI 7.4-16.3%) were the most prevalent protozoan species. In terms of helminthic agents, the most prevalent species were Enterobius vermicularis (11.3%; 95% CI 6.3-16.3%) followed by Strongyloides stercoralis (10.9%; 95% CI 5.0-16.9%) and Hymenolepis nana (2.8%; 95% CI 0.4-5.2%) CONCLUSION: IPIs are highly prevalent among intellectually disabled individuals in Iran. Improving the health status and implementing infectious disease prevention strategies in rehabilitation centers, health promotion interventions to improve personal hygiene of intellectually disabled individuals, as well as utilize sensitive diagnostic methods besides routine stool examination techniques, and treatment of infected individuals will help in the control of these infections among intellectually disabled individuals.

Expression analysis of centrin gene in promastigote and amastigote forms of leishmania infantum iranian isolates: a promising target for live attenuated vaccine development against canine leishmaniasis.

BACKGROUND: Leishmania parasites express various essential proteins in different growth phases (logarithmic/stationary) and forms (promastigote/amastigote). Targeting the genes encoding such proteins paves the way for controlling these parasites. Centrin is an essential gene, which its protein product seems to be vital for the proliferation of Leishmania parasites. Herein, this study was contrived to analyze the expression level of the centrin gene in different growth phases and forms of Leishmania infantum (L. infantum) parasites isolated from various endemic areas of canine leishmaniasis (CanL) in Iran. RESULTS: All three collected isolates were identified as L. infantum using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Real-time reverse transcription (RT)-PCR revealed a statistically significant up-regulation (3.13-fold) in the logarithmic phase promastigotes compared to stationary ones (p < 0.01), whereas centrin was expressed equally in intracellular amastigotes at different time points during cell culture. Also, our finding revealed a slight up-regulation of the centrin gene (1.22-fold) in the intracellular amastigotes compared to logarithmic phase promastigotes, which was found statistically non-significant (p > 0.05). CONCLUSIONS: Centrin gene in Iranian isolates of L. infantum is more expressed in exponential than stationary phases and seems to be considered as a promising target in the development of a genetically modified live attenuated vaccine for CanL control.

Intestinal parasites among food handlers in Iran: A systematic review and meta-analysis.

Regarding preparing and serving foods, food handlers have an influential role in the spreading of foodborne infections. Due to the great potential to cause foodborne infections, intestinal parasites (IPs) are considered a significant public health problem in today's societies. In Iran, despite several regional reports, national data on IPs prevalence in food handlers are lacking. The aim of the present study, therefore, is to estimate the pooled prevalence of IPs infections and associated pooled odds ratio of educational level among food handlers in Iran. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and SID and Magiran databases (national) were systematically searched for studies that reporting the prevalence of IPs in food handlers in Iran, published between 2000 and 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran's Q-test. The overall pooled prevalence estimate for IPs was 19.3% (95% CI = 14.9-23.7%). Prevalence of the protozoan parasites (20%, 95% CI = 13.7-26.3%) was significantly higher than that of the helminthic parasites (1.6%, 95% CI = 1.1-2.0%). Giardia lamblia (5.2%), Entamoeba coli (5.0%), and Blastocystis spp. (4.4%), as protozoan parasites, and Ascaris lumbricoides (1.4%), Enterobius vermicularis (0.9%), and Hymenolepis nana (0.5%), as helminthic parasites, were the most commonly reported species. Food handlers with low educational levels were 20% more exposed to IPs infection, compared to those with high educational levels (OR = 1.21, 95% CI = 0.88 to 1.65). The prevalence of IPs infections among food handlers in Iran is significant. Besides taking into account this epidemiologic information, a holistic approach, including periodic stool screening, health education, and treatment of infected food handlers, will help in the control of these infections in Iran.

A systematic review and meta-analysis of Hymenolepis nana in human and rodent hosts in Iran: A remaining public health concern.

Hymenolepis nana, as a neglected zoonotic helminth, naturally occurs in both humans and rodents. Herein, a systematic review and meta-analysis was carried out to estimate pooled prevalence of H. nana infection among human and rodent hosts for the first time in Iran. PubMed, Web of Science, Scopus, and Embase databases (English articles) and SID and Magiran databases (Persian articles) were systematically searched for relevant studies published from inception till May 24, 2020. Chi2 and I2 index were used to assess the heterogeneity of the included studies. Publication bias was assessed using Egger's intercept and visual inspection of the funnel plot. Pooled prevalence was estimated using random-effects model with 95 % confidence interval (CI) and depicted as a forest plot. STATA software was used for analysis. The overall pooled prevalence estimate of H. nana in humans included 1.2 % (95 % CI = 1.0-1.4%). Subgroup analysis revealed 2.2 % (95 % CI = 1.8-2.6%) and 0.5 % (95 % CI = 0.3 to 0.8 %) of H. nana infection among school children and food handlers, respectively. In terms of rodent hosts, the overall pooled prevalence of H. nana infection included 13 % (95 % CI = 9.3-16.6%). Subgroup analysis revealed the highest rate of the infection was in Rattus spp. (19.6 %; 95 % CI = 10.6-28.6%), a genus with synanthropic behavior. It seems, despite the advancement in sanitation infrastructure and hygiene status, the H. nana infection compares to other helminthic diseases remains a challenging public health problem in Iran.

High-Resolution Melting Analysis in Comparison with Microscopic Method: An Experimental Study to Diagnosis of Plasmodium Species Infections in Human.

BACKGROUND: Among the human parasitic diseases, malaria is the main cause of morbidity and mortality. To prevent the high mortality and tracking malaria elimination efforts, a prompt and sensitive diagnosis is essential. This study aimed to compare High-Resolution Melting (HRM) and microscopic methods to diagnose Plasmodium falciparum and P. vivax. METHODS: Eighty-one blood samples were collected from patients with clinical symptoms who were suspect to malaria in Chabahar district, southeastern Iran and also, from those who were referred to Malaria National Laboratory in the Tehran University of Medical Sciences, Tehran, Iran. Microscopic examination and HRM method were used to the diagnosis of Plasmodium parasites simultaneously. RESULTS: Microscopic results revealed 45 positive cases (12 P. falciparum and 33 P. vivax) out of 81 collected samples while according to HRM analysis results 11 and 33 samples were identified as P. falciparum and P. vivax, respectively. HRM analysis also revealed 1 mixed infection of P. falciparum and P. malariae. CONCLUSION: HRM analysis provides a promising mean for simultaneous detection and discrimination of the Plasmodium spp. especially in mixed infection cases.

Intestinal helminthic parasites of rodents in the central region of Iran: first report of a capillariid nematode from Dryomys nitedula.

OBJECTIVES: Rodents play an important role to spread zoonotic diseases through society. The current study was carried out to collect informative data on the intestinal helminthic infections of wild rodents in Taleqan County, Alborz Province, the center of Iran, emphasizing their zoonotic aspects. RESULTS: Sixty-two killed rodents by local farmers belonging to five species were collected, among which 24 were identified as Mus musculus, 15 as Meriones persicus, 12 as Meriones libycus, 10 as Apodemus witherbyi, and 1 as Dryomys nitedula. Of them, 30 (48.4%) were infected with at least one helminth species. Rodents were infected with Hymenolepis diminuta (42%), Syphacia obvelata (21%), Hymenolepis nana (17.7%), Heligmosomoides polygyrus (9.6%), Trichuris muris (8%), and as well as a capillariid nematode that was isolated for the first time from D. nitedula in Iran. The findings of the present study revealed a significant intestinal helminthic infection of rodents in Taleqan County. Improving hygiene practices, and making a preventive attitude can be helpful to reduce the hazards of rodent-borne diseases in the area where humans, livestock, and synanthropic rodents are living close to each other.

Blackfly fever and dermatitis caused by Simulium kiritshenkoi: a human case report in Iran.

BACKGROUND: Besides the considerable role of blackflies to the transmission of many disease agents, these flies considered as annoying biting pests of wildlife, livestock, poultry, and humans. There are few literature reports of blackfly fever following Simulium spp. This study describes a case of blackfly fever and dermatitis following blackflies numerous bites in Iran. CASE PRESENTATION: The present report describes a 25-year-old man that was attacked by numerous flies while fishing and camping near Namrood river in Firuzkuh County, Tehran Province, Iran. Pruritic dermatitis with marked edema appeared mainly on the hands and legs and subsequently, the patient's condition worsened with swollen lymph nodes, joints aching, and 40 °C fever. The patient's clinical signs and symptoms were alleviated by injection of intramuscular Dexamethasone Phosphate (DEXADIC®) 8 mg/2 ml after 24 h. CONCLUSIONS: This study reported a human case with blackfly fever and dermatitis following numerous bites of Simulium kiritshenkoi, for the first time in Iran.

A Systematic Review and Meta-analysis of Toxocariasis in Iran: Is it Time to Take it Seriously?

BACKGROUND: Toxocariasis is one of the neglected zoonosis with considerable public health importance around the world. The current study aimed to elucidate the overall prevalence of Toxocara infection in human and definitive hosts and also the contamination of soil and raw vegetables with the ova of these parasites, in Iran, using systematic review and meta-analysis. METHODS: Six English and Persian databases were explored from 2000 to 2017 using the terms toxocariasis, Toxocara spp., visceral larva migrans, Iran, epidemiology, and prevalence. This meta-analysis conducted using STATA, and for all statistical tests, a p value less than 0.05 was considered significant. The random-effects model was used to the report of the pooled prevalence with a 95% confidence interval (CI). RESULTS: The pooled prevalence of toxocariasis in human was calculated as 11% (95% CI 8-13%). In terms of definitive hosts, the pooled prevalence of Toxocara infection in dogs and cats were calculated as 17% (95% CI 14-20%) and 37% (95% CI 26-48%), respectively. Also, the pooled prevalence of Toxocara spp. eggs in the soil and raw vegetable samples were calculated as 18% (95% CI 13-23%) and 2% (95% CI 1-3%), respectively. CONCLUSIONS: The results of current study demonstrate that toxocariasis should be taken more seriously by health authorities. Implementing an appropriate control program is necessary to reduce the incidence of this disease in Iran.

Role of Toxoplasma gondii IgG Avidity Testing in Discriminating between Acute and Chronic Toxoplasmosis in Pregnancy.

Risk of mother-to-child transmission of Toxoplasma gondii during pregnancy is much greater in women who are exposed to primary T. gondii infection (toxoplasmosis) after conception compared to those who were exposed to the infection before conception. Therefore, laboratory tests that help classify recent primary toxoplasmosis are important tools for the management of pregnant women suspected to have T. gondii exposure. Detection of Toxoplasma IgM (Toxo IgM) is a sensitive indicator of primary toxoplasmosis, but the indicator specificity is low because sometimes natural IgM antibodies react with Toxoplasma antigens in the absence of the infection. Furthermore, Toxo IgM sometimes persists in blood serum for several months or years following the primary infection. In recent decades, Toxo IgG avidity assay has been used as a standard diagnostic technique for a better estimation of the infection acquisition time and identification of the primary T. gondii infection during pregnancy. Avidity is described as the aggregate strength; by which, a mixture of polyclonal IgG molecules reacts with multiple epitopes of the proteins. This parameter matures gradually within 6 months of the primary infection. A high Toxo IgG avidity index allows a recent infection (less than 4 months) to be excluded, whereas a low Toxo IgG avidity index indicates a probable recent infection with no exclusions of the older infections. This minireview is based on various aspects of T. gondii IgG avidity testing, including (i) description of avidity and basic methods used in primary studies on T. gondii IgG avidity and primary infections; (ii) importance of IgG avidity testing in pregnancy; (iii) result summary of the major studies on the use of T. gondii IgG avidity assay in pregnancy; (iv) brief explanation of the T. gondii IgG avidity values in newborns; (v) result summary of the major studies on T. gondii IgG avidity and PCR; (vi) discussion of commercially available T. gondii IgG avidity assays, including newer automated assays; and (vii) current issues and controversies in diagnosis of primary T. gondii infections in pregnancy.