Seroprevalence of Toxocara spp. in Pregnant Women: A Systematic Review and Meta-Analysis.

Background: Toxocariasis is an important health problem caused by the parasitic species Toxocara canis (T. canis) and Toxocara cati (T. cati). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports. Methods: The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software. Results: Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of Toxocara spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant. Conclusions: In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.

Toxoplasma gondii seroprevalence in the Iranian blood donors: A systematic review and meta-analysis.

Background: The present systematic review and meta-analysis was done to assess the rate of Toxoplasma gondii (T. gondii) exposure among Iranian healthy blood donors. Methods: We searched four English (PubMed, Scopus, Web of Science, and Science Direct) and two Persian databases (Magiran and SID) as well as Google Scholar as a specialized article search engine using specific keywords for relevant papers from the inception up to November 30, 2023. Results: In total, 19 studies enrolling 8226 apparently healthy blood donors were examined regarding T. gondii-specific IgG and/or IgM antibodies, among which 2666 [32.9% (95% CI: 25.3%-41.6%)], 168 [1.4% (95% CI: 0.9%-2.1%)], and 83 [1.7% (95% CI: 1.3%-2.1%)] subjects were seropositive regarding IgG, IgM, and both IgG/IgM antibodies, respectively. Five risk factors were significantly associated with T. gondii seroprevalence, including gender (OR = 1.98; 95% CI: 1.52-2.58; P < 0.001), contact with cat (OR = 2.41; 95% CI: 1.70-3.41; P < 0.001), contact with soil (OR = 2.83; 95% CI: 1.07-7.45; P = 0.035), consuming raw/undercooked meat (OR = 1.95; 95% CI: 1.03-3.70; P = 0.039), and raw/unwashed vegetables (OR = 1.70; 95% CI: 1.25-2.31; P = 0.001). Conclusion: A moderate rate of T. gondii exposure was found in the Iranian blood donors, with the association of several risk factors, including gender, contact with cat, contact with soil, consumption of unwashed vegetables and/or undercooked meat. Still, more studies are recommended regarding T. gondii exposure among blood donors in Iran.

Seroprevalence and Potential Risk Factors of Toxocariasis among General Population in Southwest Iran: Implications on the One Health Approach.

Toxocariasis is one of the most common zoonotic diseases distributed worldwide. This study aimed to estimate the seroprevalence of anti-Toxocara immunoglobulin G (IgG) antibodies and the associated risk factors among general populations living in urban and rural areas of Abadan and Khorramshahr cities in Khuzestan Province, Southwest Iran. This cross-sectional study was conducted between March and September 2022. There were 363 participants (190 females and 173 males) aged from <20 to ≥60 years old. Anti-Toxocara IgG antibodies in serum samples were measured using a commercially available enzyme-linked immunosorbent assay (ELISA). A structured questionnaire was employed to collect information regarding sociodemographic status and probable risk factors associated with toxocariasis. It was found that the seroprevalence rate in males (15.0%, 95% CI = 10.47-21.11) was higher than in females (10.5%, 95% CI = 6.92-15.70). Moreover, we observed that the seroprevalence was higher in participants at younger ages compared to other age ranges (COR = 2.55, 95% CI = 0.92-7.12, p =0.073). The findings of the univariate analysis revealed that residency in rural areas (p < 0.001), using unpurified water (p < 0.001), contact with dog (p =0.002), contact with soil (p < 0.001), consumption of improperly washed vegetables (p < 0.001), and history of drinking untreated water (p < 0.001) were risk factors associated with toxocariasis. Further comprehensive studies with a focus on humans and animals should be designed in different areas of the Province. The data represented by the current study are useful to health policymakers to consider precise surveillance and effective prevention measures to control this zoonotic infection among general populations.

Fabrication of controlled-release silver nanoparticle polylactic acid microneedles with long-lasting antibacterial activity using a micro-molding solvent-casting technique.

Most topical drug delivery techniques do not provide therapeutic concentrations for treatment of surgical site and other local infections and, therefore, require some kind of enhancement, such as physical methods like microneedles, the subject of the present investigation. Here, controlled-release long-lasting antibacterial polylactic acid (PLA) microneedles containing 1, 3, and 5% silver nanoparticles (AgNP) were prepared using micro-molding solvent-casting technique. Microneedles were characterized using optical microscopy, SEM, FTIR, XRD, and DSC. Also, mechanical strength, barrier disruption ability, insertion depth, in-vitro release kinetics, antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa, and silver permeation through rat skin were studied. Microneedles showed good mechanical strength with no signs of failure at an optimum PLA concentration of 25% (w/v). FTIR revealed no chemical interaction between ingredients, and XRD confirmed presence of AgNP in microneedles. Microneedles penetrated the skin model at depth of up to 1143 µm resulting 5-7 times increase in transepidermal water loss (TEWL). Release studies showed 2.2, 6.8, and 8.1 µg silver release from the whole body (obeying Higuchi's release model) and 0.33, 0.45, and 0.78 µg from the needles alone (obeying Fickian-cylindrical type release) for 1, 3, and 5% AgNP microneedles, respectively. Also, prolonged antibacterial activity (for 34 days) was observed. Skin studies over 72 h indicated that besides needles, silver is also released from the baseplate which had a marginal share in total silver permeation through the skin. In conclusion, a straightforward solvent-casting technique can be used to successfully prepare strong AgNP-containing PLA microneedles capable of long-lasting antibacterial activity.

Intestinal parasites and diabetes: A systematic review and meta-analysis.

Background: Investigating the association between infectious agents and non-communicable diseases is an interesting emerging field of research. Intestinal parasites (IPs) are one of the causes of gastrointestinal complications, malnutrition, growth retardation and disturbances in host metabolism, which can play a potential role in metabolic diseases such as diabetes. The aim of the present study was to investigate the prevalence of IPs in diabetic patients and the association between IPs and diabetes. Methods: A systematic literature search was conducted from January 2000 to November 2022in published records by using PubMed, Scopus, and Web of Science databases as well as Google scholar search engine; Out of a total of 29 included studies, fourteen cross-sectional studies (2676 diabetic subjects) and 15 case-control studies (5478 diabetic/non-diabetic subjects) were reviewed. The pooled prevalence of IPs in diabetics and the Odds Ratio (OR) were evaluated by CMA V2. Results: In the current systematic review and meta-analysis, the pooled prevalence of IPs in diabetic patients was 26.5% (95% CI: 21.8-31.7%) with heterogeneity of I2 = 93.24%; P < 0.001. The highest prevalence based on geographical area was in Region of the Americas (13.3% (95% CI: 9.6-18.0)).There was significant association between the prevalence of intestinal parasites in diabetic cases compared to controls (OR, 1.72; 95% CI: 1.06-2.78). Conclusion: In line with the high prevalence of IPs in diabetic patients, significant association was found however, due to the limitations of the study, more studies should be conducted in developing countries and, the prevalence of IPs in diabetics should not be neglected.

Global prevalence of Trichinella in pigs: A systematic review and meta-analysis.

BACKGROUND: Investigating the global epidemiological patterns of Trichinella in pigs is required for accurate recognition and to establishing proper control programmes and preventive measures, as well as to decrease human exposure. OBJECTIVES: To obtain a better understanding of the global prevalence of Trichinella in domestic pigs and factors that might influence the prevalence, a systematic review and meta-analysis was performed. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Multiple databases were used to identify literature published between January 2000 and December 2021, representing studies from 1985 to 2021, on Trichinella prevalence in domestic pigs. Prevalence was calculated on a global and country level, by country Human Development Index (HDI), climate, pig management system, and diagnostic test. RESULTS: The global pooled prevalence based on 60 manuscripts representing 32 countries and 65 pig populations was 2.02% (95% confidence interval [CI]: 0.88-3.62) and the estimated pooled prevalence in different continents ranged from 0.00% to 11.8%. Trichinella was highest in low HDI countries (21.6%; 95% CI: 4.3-47.2), tropical wet climates (20.9%; 95% CI: 10.3-34.1), and non-intensive pig farming systems (6.1%; 95% CI: 1.0-15.5). CONCLUSIONS: While there were regional differences in Trichinella prevalence in domestic pigs, these were likely driven by country HDI and pig farming systems versus climatic factors. Increased biosecurity in outdoor pig production systems, focused meat inspections and promoting awareness could potentially decrease risk of infection.

Seroprevalence and risk factors of Toxocara canis infection in children aged 2-15 years from the southwest Iran.

Human toxocariasis (HT) is one of the most prevalent zoonotic diseases with a worldwide distribution. There is no epidemiological study showing the seroprevalence of toxocariasis among children in southwest Iran, Khuzestan Province. Accordingly, this study was designed to estimate the seroprevalence of Toxocara canis (T. canis) IgG antibodies in children (2-15 years old) and assess the main risk factors associated to human infection. In this cross-sectional study, a total of 259 children were invited to participate from the southwest Iran (Abadan and Khorramshahr cities, Khuzestan Province) between April to August 2021. Serum anti-T. canis IgG antibodies were measured using a commercially available enzyme-linked immunosorbent assay (ELISA). A structured questionnaire was also employed to collect some socio-demographic information and probable risk factors associated to T. canis infection. The overall seroprevalence rate of T. canis in children was 7.3% (95% CI = 4.75 - 11.17%). The univariate analysis demonstrated that living in rural communities (P < 0.001), drinking unpurified water (P < 0.001), contact with cat (P = 0.033), consumption of improperly washed vegetables (P = 0.002), and history of drinking water from unsafe sources (P = 0.003) were risk factors associated with T. canis seroprevalence in children. However, after adjusting for confounders, multivariable logistic regression analysis verified that only drinking unpurified water (P = 0.016) remained a significant risk factor. In addition, both univariate (P = 0.032) and multivariate logistic regression analysis (P = 0.037) revealed that seropositivity of T. canis infection was significantly associated with asthma. The current report provides beneficial baseline epidemiological findings regarding the seroprevalence of T. canis in children as a vulnerable group for this infection. This data can be used by health policy makers to plan effective prevention programs and control this neglected infection among high risk subjects.

Co-infections of Schistosoma spp. and Malaria with Hepatitis Viruses from Endemic Countries: A Systematic Review and Meta-Analysis.

BACKGROUND: Co-infection of schistosomiasis and malaria with hepatitis B virus (HBV) and hepatitis C virus (HCV) are common in countries where schistosomiasis and malaria are endemic. OBJECTIVE: The present systematic review and meta-analysis was conducted to assess the prevalence of malaria/hepatitis viruses and Schistosoma/hepatitis viruses' co-infections. MATERIALS AND METHODS: Relevant published studies on the co-infection of malaria and Schistosoma spp. with HBV and HCV were retrieved via international databases (PubMed, Scopus, Web of Science, and Google Scholar). Regarding meta-analysis, the random-effect model was employed by forest plot with a 95% of confidence interval (CI). RESULTS: A total of 22 studies, including 15 studies with malaria/hepatitis viruses' co-infection and 7 studies with Schistosoma/hepatitis viruses' co-infection met the eligibility criteria. The co-infection of malaria/HCV and malaria/HBV in different populations were 15% (95% CI, 0-77%) and 5% (95% CI, 1-10%), respectively. Moreover, Schistosoma/HCV and Schistosoma/HBV co infection were detected in 7% (95% CI, 0-54%) and 2% (95% CI, 0-7%), respectively. CONCLUSION: The overlaps between Schistosoma spp. and malaria with hepatitis B and C viruses in endemic countries with lower income levels were high, which deserve further attention.

The prevalence of human trichuriasis in Asia: a systematic review and meta-analysis.

Trichuriasis is one of the most common soil-transmitted helminth (STH) infections, affecting populations globally. The condition is particularly prevalent in tropical and subtropical areas with low levels of sanitation and poor living conditions. The objective of this systematic review and meta-analysis was to evaluate the prevalence of Trichuris trichiura infection in Asia at the country and region level. Multiple databases/academic search engines (Web of Science, PubMed, ProQuest, Scopus, and Google Scholar) were searched for literature on T. trichiura prevalence in Asia published through January 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 13,836 articles, 226 studies (5,439,500 individuals) from 26 countries met the inclusion criteria. Of the 226 studies, 151 were community-based studies that included individuals across the age spectrum, while 75 studies focused on school children (typically in the 5-16 years age range). The overall T. trichiura pooled prevalence was 15.3% (95% CI: 12.4-19.1%), with a pooled prevalence of 13.3% (95% CI: 10.0-17.1%) for the community studies and 20.9% (95% CI: 14.7-27.9%) for the studies only including school children. For studies including all age groups, individuals in the 1-15 years age group had the highest pooled prevalence at 23.4% (95% CI: 1.7-49.4%). There was a significant difference found in overall pooled prevalence by sex (p < 0.001) and community type (rural versus urban) (p < 0.001). Although prevalence appears to be decreasing, study findings suggest that T. trichiura infection continues to be a public health problem in Asia. Therefore, control programs focused on at-risk individuals in endemic areas are needed.

Prevalence of Strongyloides stercoralis in the immunocompetent and immunocompromised individuals in Iran: a systematic review and meta-analysis.

Strongyloidiasis is a neglected tropical disease mostly distributed in tropical and subtropical regions. The current study evaluated the prevalence of Strongyloides stercoralis in immunocompetent and immunodeficient patients in Iran. The available online literature published from June 1994 to October 2020 was obtained from multiple English databases (PubMed, Science Direct, Scopus, Web of Science and Google Scholar) and four Persian databases (Magiran, Iran Medex, Iran Doc and SID). All statistical analyses were performed using R software (version 3.6) meta-package and p-values <0.05 were considered significant. From 1051 articles, 74 studies (248 656 individuals) met the inclusion criteria. The pooled prevalence of S. stercoralis was 2% (95% confidence interval [CI] 1 to 3) and 4% (95% CI 1 to 8) in immunocompetent and immunodeficient patients, respectively. In immunodeficient cases, the pooled prevalence of studies utilizing serology, culture and microscopic methods was 10% (95% CI 2 to 23), 1% (95% CI 0 to 6) and 1% (95% CI 0 to 1), respectively. In immunocompetent cases, the pooled prevalence of studies utilizing microscopic, culture and molecular methods was 2% (95% CI 1 to 3), 2% (95% CI 1 to 4) and 2% (95% CI 0 to 6), respectively. We propose an appropriate screening and control program along with comprehensive research regarding the frequency of strongyloidiasis in the country.

Detection of Acute and Chronic Toxoplasma gondii Infection among Women with History of Abortion in the Southwest of Iran.

BACKGROUND: Toxoplasma gondii (T. gondii) is one of the most common intracellular protozoan parasites, which can infect humans and a wide range of mammals and birds. The current study is aimed at investigating the occurrence of T. gondii infection in women with a history of abortion in Khuzestan, Iran. MATERIALS AND METHODS: A total of 480 women with an abortion history, as well as 200 pregnant women with a normal delivery, were examined in this study. The blood, placenta, and umbilical cord blood samples were assessed by the enzyme-linked immunosorbent assay (ELISA) and nested-polymerase chain reaction (PCR) assay. RESULTS: Based on the results of ELISA assay, the prevalence of toxoplasmosis was 30.83% in women with a history of abortion (25.62% with T. gondii IgG and 5.20% with T. gondii IgM). According to the IgG avidity test, 60.16% of IgG-positive samples showed high avidity, while 27.64% showed low avidity. On the other hand, the prevalence of toxoplasmosis in women with a normal delivery was 23% (21.5% with T. gondii IgG and 1.5% with T. gondii IgM). According to the IgG avidity test, 81.39% of these women showed high avidity, while only 4.65% showed low avidity. Based on the nested-PCR method, T. gondii DNA was detected in 14.18% of blood samples, 4.69% of placental samples, and 1.34% of umbilical cord samples, collected from 148 seropositive women with a history of abortion. Besides, using this method, the parasite DNA was identified in 4.34% of blood samples, collected from 46 seropositive women with a normal delivery, but not in any of the umbilical cord or placenta samples. CONCLUSION: The present results showed that T. gondii infection contributes to abortion in Khuzestan Province, Iran. Therefore, it is essential to investigate toxoplasmosis in pregnant women, especially in those who are seronegative, using molecular and serological methods and inform them about their disease and the associated risks.

Immunoinformatic Analysis of Calcium-Dependent Protein Kinase 7 (CDPK7) Showed Potential Targets for Toxoplasma gondii Vaccine.

Apicomplexan parasites, including Toxoplasma gondii (T. gondii), express different types of calcium-dependent protein kinases (CDPKs), which perform a variety of functions, including attacking and exiting the host cells. In the current bioinformatics study, we have used several web servers to predict the basic features and specifications of the CDPK7 protein. The findings showed that CDPK7 protein has 2133 amino acid residues with an average molecular weight (MW) of 219085.79 D. The aliphatic index with 68.78 and grand average of hydropathicity (GRAVY) with -0.331 score were estimated. The outcomes of current research showed that the CDPK7 protein included 502 alpha-helix, 1311 random coils, and 320 extended strands with GOR4 method. Considering the Ramachandran plot, the favored region contains more than 92% of the amino acid residues. In addition, evaluation of antigenicity and allergenicity showed that CDPK7 protein has immunogenic and nonallergenic nature. The present research provides key data for more animal-model study on the CDPK7 protein to design an efficient vaccine against toxoplasmosis in the future.

The Probable Association between Chronic Toxoplasma gondii Infection and Type 1 and Type 2 Diabetes Mellitus: A Case-Control Study.

PURPOSE: The probable association between Toxoplasma gondii (T. gondii) infection and diabetes mellitus (DM) is still controversial, and there are several studies with conflicting results. Thus, this study was performed to assess the possible association between chronic T. gondii infection and type 1 diabetes mellitus (T1DM) and T2DM. METHODS: In this case-control study, a total of 105 diabetic subjects including 36 patients with T1DM and 69 patients with T2DM were recruited. In addition, 150 nondiabetic subjects were enrolled as controls. Each case group had its own control group. Each participant completed a structured questionnaire obtaining demographic information. Serum samples were examined for T. gondii-specific IgG antibody using enzyme-linked immunosorbent assay (ELISA) method. RESULTS: Analysis revealed that 69.4% and 34.0% of patients with T1DM and control subjects were serologically positive for T. gondii, respectively (odds ratio (OR): 4.41; 95% confidence interval (CI): 1.75-11.06; P=0.001). Moreover, 72.5% of T2DM patients and 29.0% of healthy individuals were seropositive for T. gondii (OR: 6.44; 95% CI: 3.25-12.74; P < 0.001). Among risk factors, only contact with cats was significantly associated with IgG seroprevalence in both T2DM patients (P < 0.001) and control subjects (P=0.045). CONCLUSION: Although the results showed that chronic T. gondii infection is significantly associated with T1DM and T2DM, there remain many questions regarding the exact mechanisms of T. gondii in the pathogenesis of DM.

Detection of Anti-Toxoplasma gondii IgG and IgM Antibodies and Associated Risk Factors during Pregnancy in Southwest Iran.

Background: This research was aimed at evaluating the seroprevalence of acute and chronic Toxoplasma gondii (T. gondii) infection in pregnant women and related risk factors in southwest Iran. Methods: In this cross-sectional study, eighty-eight pregnant women were included from October 2019 to December 2019. The presence of anti-T. gondii IgM and IgG antibodies was measured using the enzyme-linked immunosorbent assay (ELISA). In addition, a questionnaire consisting of demographic information was completed for each subject. Results: The overall seroprevalence of T. gondii infection was estimated to be 34.09% (30/88). Of these, 1 (1.13%) and 29 (32.95%) samples were found positive for IgM and IgG, respectively. Regarding the risk factors, the consumption of raw/undercooked meat (P value = 0.007) and history of abortion (P value = 0.017) were significantly associated with IgG seroprevalence in pregnant women. Conclusion: The results showed that the pregnant women of southwest Iran might be moderately exposed to T. gondii. Since the risk of acute T. gondii infection in this susceptible group is very important, regular screening tests to diagnose the infection are recommended before pregnancy.

Global prevalence of Cryptosporidium spp. in cats: A systematic review and meta-analysis.

The One-Health approach highlights that the health of human populations is closely connected to the health of animals and their shared environment. Cryptosporidiosis is an opportunistic zoonotic disease considering as global public health concern. Cats are considered as one of potential host for transmitting the Cryptosporidium spp. infection to humans. A random-effects meta-analysis model was used to estimate the overall and the subgroup-pooled prevalence of Cryptosporidium spp. across studies, and the variance between studies (heterogeneity) were quantified by I2 index. Eighty articles (including 92 datasets), from 29 countries met eligibility criteria for analysis. The pooled global prevalence (95% CI) of Cryptosporidium spp. in cats was 6% (4-8%), being highest in Africa 14% (0-91%) and lowest in South and Central America 4% (3-7%) countries. Considering the detection methods, the pooled prevalence was estimated to be 26% (1-67%) using serological detection methods, 6% (3-10%) using coproantigen detection methods, 5% (3-7%) using molecular detection methods, and 4% (3-7%) using microscopic detection methods. The highest prevalence of Cryptosporidium spp. was found in stray cats 10% (5-17%), while pet (domestic) cats 4% (3-7%) had the lowest prevalence. These results emphasize the role of cats as reservoir hosts for human-infecting Cryptosporidium spp. Prevention and control of this zoonosis in cats should receive greater attention by health officials and health policymakers, especially in countries where prevalence are highest.

Bioinformatics analysis of calcium-dependent protein kinase 4 (CDPK4) as Toxoplasma gondii vaccine target.

OBJECTIVES: Toxoplasma gondii (T. gondii), an obligate intracellular apicomplexan parasite, could affect numerous warm-blooded animals, such as humans. Calcium-dependent protein kinases (CDPKs) are essential Ca2+ signaling mediators and participate in parasite host cell egress, outer membrane motility, invasion, and cell division. RESULTS: Several bioinformatics online servers were employed to analyze and predict the important properties of CDPK4 protein. The findings revealed that CDPK4 peptide has 1158 amino acid residues with average molecular weight (MW) of 126.331 KDa. The aliphatic index and GRAVY for this protein were estimated at 66.82 and - 0.650, respectively. The findings revealed that the CDPK4 protein comprised 30.14% and 34.97% alpha-helix, 59.84% and 53.54% random coils, and 10.02% and 11.49% extended strand with SOPMA and GOR4 tools, respectively. Ramachandran plot output showed 87.87%, 8.40%, and 3.73% of amino acid residues in the favored, allowed, and outlier regions, respectively. Also, several potential B and T-cell epitopes were predicted for CDPK4 protein through different bioinformatics tools. Also, antigenicity and allergenicity evaluation demonstrated that this protein has immunogenic and non-allergenic nature. This paper presents a basis for further studies, thereby provides a fundamental basis for the development of an effective vaccine against T. gondii infection.

Synergistic Anti-Leishmanial Activities of Morphine and Imiquimod on Leishmania infantum (MCAN/ES/98/LIM-877).

BACKGROUND: This study was performed to evaluate in vitro and in vivo Leishmanicidal potential of morphine (Mph), imiquimod (IQ), and their combination. METHODS: Leishmania infantum promastigote and amastigote assays were performed at the presence of 0.015-150µM Mph, 0.04-416µM IQ, and their combination. The inhibition effects of these drugs on promastigotes were evaluated after 24, 48, and 72h. The cytotoxic effects of the drugs were evaluated by MTT as well as flow cytometry after 72h. We explored the therapeutic effects of Mph and IQ in BALB/c mice at the end of the treatment using parasite load determination and cytokine assay. One group of mice received Mph for three weeks before infection. RESULTS: The results of promastigote and amastigote assays showed the cytotoxic effects of the drugs at low concentrations. The cytotoxic effects were higher on promastigotes than amastigotes (p< 0.05). There was a negative correlation between drug concentration and amastigote/promastigote viability. Imiquimod alone or combined with Mph showed remarkable cytotoxic effects at all concentrations (p< 0.05). Flow cytometry results revealed apoptosis in the parasite following exposure to the drug combinations. Accordingly, the reduction of parasite loads in the spleen and liver was observed (p< 0.05) with simultaneous increases in IFN-γ and IL-4. We believe that the in vivo leishmanicidal effect was mediated by Mph through IL-4 and by IQ through both IL-4 and IFN-γ. CONCLUSION: Results pointed out the promising effects of Mph and IQ at low concentrations, especially when combined.

Comparison of the Effects of Sambucus ebulus Leaf and Fruit Extracts on Leishmania major In Vitro.

BACKGROUND: Leishmaniasis is one of the major diseases caused by the intracellular parasite of Leishmania. It has become one of the most dangerous health problems today. Our aim of the present study is to compare the effects of Sambucus ebulus leaf and fruit extracts on Leishmania major in vitro. METHODS: In this study, we used MTT, promastigote and amastigote assay to evaluate the effect of different concentrations of the extract on parasite and we compared their effects. The flow cytometry technique was also used to detect the apoptotic effect of the extracts on promastigotes. RESULTS: According to MTT experiment IC50 concentration of leaf and fruit extracts on parasite was 157 µg/ml and 265 µg/ml, respectively. After analysis by flow cytometry, leaf and fruit extracts also showed the apoptosis effect. Leaf and fruit extract caused 40.2 and 2.67 percent apoptosis. CONCLUSION: Based on the above assessment, we determined that the S. ebulus leaf extract has a more toxic effect on promastigotes and amstigotes than its fruit extract and maybe in the future that be used as a drug candidate.

Low Serum Levels of Selenium, Zinc, Iron, and Zinc/Copper Ratio in an Endemic Region of Cutaneous Leishmaniasis in Southwest Iran.

Leishmaniasis is a widespread tropical infection; cutaneous leishmaniasis (CL) is the most common form of this disease known to cause significant morbidity. Trace metals, including selenium, zinc, iron, and copper, are required for the activity of several enzymes involved in immune system responses. The aim of this research was to measure the serum levels of selenium (Se), zinc (Zn), copper (Cu), iron (Fe), and Zn/Cu ratio in patients with CL. In this case-control study, 80 patients with CL and 80 healthy volunteers (not exposed to CL) from a CL endemic region in southwest Iran agreed to participate. Both clinical and parasitological verifications were made to include each subject as a CL-positive case. A questionnaire was completed for each participant which included the following criteria: age (year), height (cm), weight (kg), body mass index (kg/m2), and duration of disease (day). The biochemical assays were performed according to the standard protocols, and the values of Zn, Cu, Se, and Fe were expressed in micrograms per deciliter (µg/dl). All results were expressed as mean ± standard deviation (SD), and the statistical significance level was defined to be less than 0.05 (P < 0.05). There were no statistically significant differences in terms of mean values of age, body weight, height, and body mass index between CL patients and the control group (P > 0.05). The mean ± SD concentrations of Zn, Fe, and Se in the control group were found to be 118.87 ± 6.35 µg/dl, 123.00 ± 8.40 µg/dl, and 11.26 ± 1.88 µg/dl, respectively. These trace elements (TEs) were statistically lower (P < 0.001) in patients with CL (case group) with values of 83.05 ± 7.32 µg/dl for Zn, 86.51 ± 10.09 µg/dl for Fe, and 3.83 ± 1.20 µg/dl for Se. We have also observed that serum levels of Cu in CL-positive group were significantly higher than in the controls (P < 0.001). Furthermore, CL patients had significantly lower Zn/Cu ratio than controls (0.63 ± 0.05 µg/dl vs. 1.11 ± 0.10; P < 0.001). The alternation in serum levels of TEs may be a part of the defense strategy of the organism. Based on these results, it can be suggested that serum levels of these TEs can be a useful marker to estimate the prognosis of CL infection.

Toxoplasma oocysts in the soil of public places worldwide: a systematic review and meta-analysis.

Toxoplasmosis is a zoonotic and cosmopolitan infection. Although a few studies have evaluated the prevalence of Toxoplasma oocysts in the soil of public places, the present study was conducted to provide insights into environmental contamination levels and its potential transmission to humans on a global scale. A systematic search was conducted using bibliographic databases through 30 August 2020. A random effects model was utilized to estimate pooled prevalence with 95% confidence intervals (CIs). Subgroup analysis and meta-regressions were also performed on the geographical and environmental parameters. Finally, 22 articles, wherein 15 420 soil samples were examined, met the systematic review and meta-analysis requirements. The mean pooled prevalence of Toxoplasma oocysts was estimated at 16% (95% CI 10 to 26) in public places. The estimated prevalences in Europe, South America, Asia and North America were 23% (95% CI 4 to 65), 22% (95% CI 18 to 26), 15% (95% CI 0.06 to 33) and 8% (95% CI 0.00 to 97), respectively. An increasing trend was observed in the prevalence of Toxoplasma oocysts with increasing latitude (41-56°), decreasing longitude (0-40°) and increasing relative humidity (≥76%). Loop-mediated isothermal amplification and polymerase chain reaction methods revealed the highest and lowest prevalence rates, respectively, in the detection of Toxoplasma oocysts. Awareness of the health authorities and people about Toxoplasma prevalence in the soil of public places and its risk factors is of great importance to developing effective strategies to prevent infection.