Prevalence of Hepatitis C Virus Infection in General Population of Mashhad, Northeastern Iran.

BACKGROUND: Hepatitis C Virus (HCV) infection is one of the major blood-borne infections worldwide. HCV carriers may develop chronic hepatitis leading to liver cirrhosis and hepatocellular carcinoma (HCC). There is no overall estimate of the infection prevalence in the northeast of Iran. We have performed this research in order to determine accurately the prevalence and risk factors of HCV infection among general population in Mashhad. METHODS: During 2009, 1678 people between 1 to 90 yr old with the mean age of 29.1±18.5 yr were selected randomly by multistage sampling from different geographical regions of the city proportionate to sex and age distribution of population in 2006 census. ELISA was used to screen for antibodies and RT-PCR tested the positive samples. RESULTS: HCV infection was detected in 7/1654 cases; overall prevalence of the infection was 0.42% (95%CI: 0.17-0.87%), 0.80% and 0.11% among males and females, respectively (P= 0.051). One HCV-infected subject was also positive for hepatitis B surface antigen (HBsAg), however, no cases showed HIV or HTLV seropositivity. CONCLUSION: In comparison with similar studies, the prevalence of HCV infection in Mashhad is low.

Anemia as a public health issue in Mashhad, Iran: evidence from the first population-based study.

Anemia is one of the main conditions that impose an adverse impact on the socioeconomic state of any country; however, evidence on the prevalence of anemia is scant in Northeastern Iran. This study was conducted to determine the overall and age- and sex-specific prevalence of anemia in the city of Mashhad, Iran. In a cross-sectional, population-based survey, 1675 individuals aged 1-90 years (29.1±18.5 years) were selected from approximately 2.4 million residents by a multistage cluster sampling method during May to September 2009. Blood samples were evaluated to determine erythrocyte indices and anemia was defined according to hemoglobin (Hb) levels based on World Health Organization (WHO) guidelines. The prevalence of anemia was 9.7% with considerable difference between both sexes; 6.2% and 12.7% in males and females, respectively (P<0.001). The higher prevalence of anemia was detected in females of 15-54 and ≥ 65 years old (16% and 12.5%, respectively). However, the higher rates were observed in males 65 years and older as well as boys below 5 years old (16.3% and 14.6%, respectively). Current findings show that anemia is a considerable public health problem in the population of Mashhad, Iran, especially among the pre-school children, adult women and the elderly. Great attention should be paid to the pre-school boys who are more affected by anemia than what was previously assumed.

Sexual and Reproductive Behaviors among Undergraduate University Students in Mashhad, a City in Northeast of Iran.

BACKGROUND: The incidence of sexual transmitted infections (STIs) and HIV/AIDS is globally higher in young people. This study evaluated the prevalence of sexual reproductive behaviors among undergraduate students of Mashhad, Iran. METHODS: The study was conducted on 605 students in twelve non-medical faculties of a great university of Mashhad. A self-administered questionnaire was completed on demographic information, sexual contact in the lifetime and during the last three months, and age of first sex. Kaplan-Meier statistic was used to calculate the mean age of initiation of sex. A p < 0.05 was considered statistically significant. RESULTS: After exclusion of individuals over 25 years of age, among 590 students with a mean age of 20.8±1.5 years included in the analysis, 71.4% were female and 85.3% were single. Prevalence of at least one sexual contact in life was 15.1% and 35.3% of single sexually experienced students reported to have sex in the last three months. The lifetime prevalence of sexual relationship in males was significantly higher than females (32.9% vs. 7.6%, p < 0.001). The mean age of first sexual experience was 23.7 years with a significant difference between both sexes (p < 0.001). In single sexually experienced students, the mean age at first sex was 17.6±3.3 years, 24% started sexual activity at <15 years, 34.3% had at least 3 partners and only 40.6% stated using condom in their last sex. CONCLUSION: Although very small proportion of females reported premarital sex, a significant minority of male students experienced sexual and risky behaviors. Therefore, the use of educational programs on related issues to reduce the risk of STIs/HIV among youth including university students seems to be a necessity.

No Evidence of HTLV-II Infection Among Immonoblot Indeterminate Samples Using Nested PCR in Mashhad, Northeast of Iran.

OBJECTIVE(S): Although HTLV-I infection is endemic in different geographical parts of the world including Northeast of Iran, there have been no documents of HTLV-II infection in this region. It is reported that one possible reason for seroindeterminate state in HTLV western blot is HTLV-II virus. This study aimed to investigate the presence of HTLV-II among blood donors with seroindeterminate western blot results. MATERIALS AND METHODS: Three ml whole blood obtained from 50 blood donors referring to Mashhad Blood Transfusion Organization who had reactive Elisa for HTLV-I and seroindeterminate HTLV western blot state. A conventional PCR was applied to detect HTLV-I provirus using specific primers while a nested PCR was designed with specific external and internal primers for the detection of HTLV-II. RESULTS: The average age of participants, 39 males and 11 females, was 37.12± 14.36 years. The average OD of the Elisa assay was 1.767± 1.195. The most common indeterminate patterns were Rgp46-II alone (n=12, 27.3%), Rgp46-I alone (n=7, 15.9%), and Rgp46-I with GD21 (n=7, 15.9%).After introducing the DNA to the PCR tests, results revealed 10 (20%) HTLV-I PCR positive samples while no HTLV-II positive sample was detected by nested PCR. There were no significant age, blood group, Optical Density of the Elisa assay, and western blot indeterminate pattern differences between HTLV-I PCR positive and negative samples. Conclusion : No HTLV-II positive sample was detected in this study which confirms the absence of HTLV-II infection in this region. However, high frequency of HTLV-I PCR positive samples among the seroindeterminate cases implies on the important role of molecular techniques for further confirmation of the infection.

High prevalence of HTLV-I infection in Mashhad, Northeast Iran: a population-based seroepidemiology survey.

BACKGROUND: Mashhad, in the northeast of Iran has been suggested as an endemic area for human T cell lymphotropic virus type I (HTLV-I) infection since 1996. OBJECTIVES: We performed a community-based seroepidemiology study to examine the prevalence and risk factors for HTLV-I infection in the city of Mashhad. STUDY DESIGN: Between May and September 2009, overall 1678 subjects from all the 12 geographical area of Mashhad were selected randomly by multistage cluster sampling for HTLV antibody. The study population included 763 males and 915 females, with the mean age of 29.1 ± 18.5 years. 1654 serum samples were assessed for HTLV antibody using ELISA and reactive samples were confirmed by Western blot and PCR. RESULTS: The overall prevalence of HTLV-I infection in whole population was 2.12% (95% CI, 1.48-2.93) with no significant difference between males and females (p = 0.093) and the prevalence of HTLV-II seropositivity was 0.12% (95% CI, 0.02-0.44). The HTLV-I Infection was associated with age (p<0.001), marital status (p<0.001), education (p = 0.047), and history of blood transfusion (p = 0.009), surgery (p<0.001), traditional cupping (p = 0.002), and hospitalization (p = 0.004). In logistic regression analysis, age was the only variable that had a significant relation with the infection (p = 0.006, OR = 4.33). CONCLUSIONS: Our results demonstrated that Mashhad still remains an endemic area for HTLV-I infection despite routine blood screening. Thus, further strategies are needed for prevention of the virus transmission in whole population.