Climate change and health: The case of mapping droughts and migration pattern in Iran (2011-2016).

INTRODUCTION: Migration and mobility of population have been reported as a common reaction to drought. There is historical evidence to suggest the health effects of droughts and human migration linkage in Iran. This study aimed to map the drought and migration patterns in Iran in 2011 and 2016 and explore their possible health impacts. METHODS: This sequential explanatory mixed-method study was done in two stages of spatial analysis and qualitative study. Data mapping was conducted through the equal interval classification and using drought, migration, and agriculture occupation data based on provincial divisions in Iran in 2011 and 2016. This qualitative study was conducted using the content analysis approach. RESULTS: The in-migration rate was higher in 2011 rather than 2016. Migration to cities was much higher than migration to villages in both years. The frequency of male migrants was higher than females in all provinces in 2011 and 2016. Physical and mental diseases as well as economic, sociocultural, education, and environment effects on health were extracted from the qualitative data. CONCLUSION: A holistic picture of droughts and migration issues in Iran and their health consequences were achieved by the present research. Further research is needed to explore the determinants of health impacts of climate change in vulnerable groups. Public health problems can be prevented by adaptive and preventive policy-making and planning. This can improve the coping capacity of the population facing droughts and enforced migration.

Multi-scale habitat modeling framework for predicting the potential distribution of sheep gastrointestinal nematodes across Iran's three distinct climatic zones: a MaxEnt machine-learning algorithm.

Ecological niche models (ENMs) serve as valuable tools in assessing the potential species distribution, identifying crucial habitat components for species associations, and facilitating conservation efforts. The current study aimed to investigate the gastrointestinal nematodes (GINs) infection in sheep, predict and analyze their ecological niches and ranges, and identify the key bioclimatic variables influencing their distribution across three distinct climatic regions in Iran. In a cross-sectional study, a total of 2140 fecal samples were collected from semi-arid (n = 800), arid (n = 500), and humid-subtropical (n = 840) climates in East Azerbaijan, Kerman, and Guilan provinces, respectively. The flotation method was employed to assess stool samples, whereby the fecal egg count (the number of parasite eggs per gram [EPG]) was ascertained for each individual specimen. Employing a presence-only approach, the multi-scale maximum entropy (MaxEnt) method was used to model GINs' habitat suitability using 93 selected points/locations. The findings revealed that Guilan (34.2%) and East Azerbaijan (19.62%) exhibited the utmost proportion of Strongyle-type eggs. East Azerbaijan province also displayed the highest proportion of Marshallagia and Nematodirus, respectively (approximately 40% and 27%), followed by Guilan and Kerman provinces, while Kerman province had the highest proportion of Trichuris (approximately 15%). Ecological niche modeling revealed that the precipitation of the driest quarter (Bio17) exerted the most significant influence on Marshallagia, Nematodirus, Trichuris, and ُSُُُtrongyle-type eggs' presence in East Azerbaijan and Kerman provinces. For Guilan province, the most influential factor defining habitat suitability for Strongyle-type eggs, Marshallagia, and Nematodirus was increasing slope. Additionally, the distribution of Trichuris was most affected by the variable Bio2 in Guilan province. The study highlights the response of GINs to climate drivers in highly suitable regions, providing insights into ecologically favorable areas for GINs. In conclusion, this study provides a better understanding of GINs and the environmental factors influencing their transmission dynamics.

Geographical and Molecular Analysis of Haplotype Variations in Leishmania major Among Infected Iranian Phlebotomus papatasi.

PURPOSE: Leishmania major is main causative agent and Phlebotomus papatasi is only proven vector of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran. Human leishmaniasis is mostly susceptible to climatic conditions and molecular variations of Leishmania parasites within sandflies. METHODS: L. major was analyzed based on geographical, environmental, climatic changes and haplotype variations within P. papatasi. Molecular tools and different geographical aspects were employed using Arc-GIS software for mapping the geographic distribution of samples and other statistics tests. Fragments of ITS-rDNA, k-DNA, and microsatellite genes of Leishmania were used for PCR, RFLP, sequencing, and phylogenetic analyses. RESULTS: Totally 81 out of 1083 female P. papatasi were detected with Leishmania parasites: 70 and five were L. major and L. turanica, respectively. Golestan and Fars provinces had the highest (13.64%) and lowest (4.55%) infection rates, respectively. The infection rate among female P. papatasi collected from gerbil burrows was significantly higher (15.15%) than animal shelters, yards, and inside houses (4.48%) (P < 0.0%). Microsatellite was more sensitive (22.72%) than k-DNA (18.8%) and ITS-rDNA (7.48%). More molecular variations of L. major were found in Isfahan province. CONCLUSIONS: Arc-GIS software and other statistics tests were employed to find Leishmania positive and haplotype variations among sand flies. Geographical situations, altitude, climate, precipitation, humidity, temperature, urbanization, migrations, regional divergences, deforestation, global warming, genome instability, ecology, and biology of the sand flies intrinsically, and the reservoir hosts and neighboring infected locations could be reasons for increasing or decreasing the rate of Leishmania infection and haplotype variations.

Predicting the environmental suitability for Anopheles stephensi under the current conditions in Ghana.

Vector-borne diseases emergence, particularly malaria, present a significant public health challenge worldwide. Anophelines are predominant malaria vectors, with varied distribution, and influenced by environment and climate. This study, in Ghana, modelled environmental suitability for Anopheles stephensi, a potential vector that may threaten advances in malaria and vector control. Understanding this vector's distribution and dynamics ensures effective malaria and vector control programmes implementation. We explored the MaxEnt ecological modelling method to forecast An. stephensi's potential hotspots and niches. We analysed environmental and climatic variables to predict spatial distribution and ecological niches of An. stephensi with a spatial resolution of approximately 5 km2. Analysing geospatial and species occurrence data, we identified optimal environmental conditions and important factors for its presence. The model's most important variables guided hotspot prediction across several ecological zones aside from urban and peri-urban regions. Considering the vector's complex bionomics, these areas provide varying and adaptable conditions for the vector to colonise and establish. This is shown by the AUC = 0.943 prediction accuracy of the model, which is considered excellent. Based on our predictions, this vector species would thrive in the Greater Accra, Ashanti Central, Upper East, Northern, and North East regions. Forecasting its environmental suitability by ecological niche modelling supports proactive surveillance and focused malaria management strategies. Public health officials can act to reduce the risk of malaria transmission by identifying areas where mosquitoes may breed, which will ultimately improve health outcomes and disease control.

Global epidemiology and spatial distribution of Toxoplasma gondii in goats: Protocol for a systematic review and Bayesian hierarchical meta-analysis.

BACKGROUND: Toxoplasma gondii, a cosmopolitan protozoan parasite causes toxoplasmosis in humans and many species of domestic and wild animals. T. gondii instigates significant economic losses in sheep and goat farming industry and can lead to abortion, stillbirth, congenital malformations and neonatal losses. The objective of this protocol is to evaluate worldwide seroprevalence of T. gondii exposure in goats using Bayesian hierarchical meta-analysis and geographic information system (GIS). METHODS: A comprehensive literature search will be conducted using search engines, including Web of Science, ScienceDirect, Scopus, PubMed, ProQuest, EMBASE, PROSPERO Register and, Google Scholar without date and language restrictions. The authors search for cross-sectional studies that determine the seroprevalence of T. gondii in goats. Two reviewers will independently screen, selected studies; also, they will extract data, and assess the risk of bias. In case(s) of disagreement, a consensus will be reached with the help of a third author. The Bayesian hierarchical meta-analysis will use to estimate country and worldwide true seroprevalence of T. gondii, which is consist of the sensitivity and specificity of the applied serological assays. The obtained data will be used to identify country-level risk factors associated with T. gondii exposure using GIS in the ArcGIS software. DISCUSSION: The systematic review produced from this protocol will provide the true prevalence rate and spatial distribution T. gondii exposure in goats both regionally and globally using Bayesian hierarchical and GIS analysis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020107928.

Mapping current and future risk of scorpion sting from a species with low medical concern, Mesobuthus phillipsii (Scorpiones: Buthidae) in Iran.

Scorpion stings are one of the most important health challenges and high priority research topic in public health. In this study, we aimed to model habitat suitability of the Mesobuthus phillipsii (Pocock 1889), a species with low medical concern, under current and future climatic conditions in Iran. We also identified vulnerable populations to scorpion stings in the country. Scorpion sting risk modeling was done using an ensemble approach by considering two species distribution modeling methods: MaxEnt and Random Forest methods. Distribution modeling was performed using the sdm R package. The results showed that due to climate change in 2070, the high-risk areas will increase from 20,839 to 79,212 km2. Habitats with a moderate risk of scorpion stings will also increase from 139,347 to 222,833 km2. Consequently, the number of villages in high-risk areas of scorpion stings will increase from 2,870 to 7,017, while this number will increase from 12,759 to 20,104 in the case of medium-risk villages. The results of this study can be used for scorpion stings management in Iran. This study can be used as an example for similar studies on scorpions with high medical emergency.

Development of a degree-day model to predict the growth of Anopheles stephensi (Diptera: Culicidae): implication for vector control management.

Anopheles stephensi is an efficient vector of malaria parasites in Iran. Despite its importance in malaria transmission, there is a scarcity of accurate predictive models of its rates of development at different temperatures. A laboratory colony of An. stephensi, collected from Bandar Abbas County, southern Iran, was established, and all its developmental stages were maintained in temperature-controlled incubators so that the water temperature set at 5, 8, 10, 12.5, 14, 28, 38, 39.5, 42, and 45(±0.2) °C for different treatments until subsequent adult emergence. The Lower and Upper Developmental Temperatures (LDT and UDT) and the growth degree-day (GDD) were calculated for each development stage. A 12-mo population dynamics survey of the larvae and adults of An. stephensi was performed in 3 malaria-endemic villages (Geno, Hormoodar, and Sarkhoon) of Bandar Abbas County, and the obtained data were matched with the constructed GDD model. Based on the field meteorological and dynamics data, the model was verified in the field and used to determine the appropriate date to start spraying. The LDT was determined to be 8.19, 9.74, 8.42, 5.6, 13.57, and 10.03 °C for egg hatching, first, second, and third ecdysis, pupation, and eclosion events, respectively. The UDT was 38 °C for all developmental stages. The thermal requirement for the development of all immature stages of An stephensi was determined to be 187.7 (±56.3) GDD above the LDT. Therefore, the appropriate date to start residual spraying is when the region's GDD reaches 187.7 (±56.3). Given the climatic conditions in Bandar Abbas County, it is expected that the first activity peak of adult An. stephensi would be in March. Field observations showed that An. stephensi activity starts in February and peaks in March. The GDD model can provide a good estimate for peak An. stephensi activity and indicate the optimal deployment time of residual spraying operations against the multiplication and development of malaria parasites inside the vector.

Worldwide Status of Insecticide Resistance of Aedes aegypti and Ae. albopictus, Vectors of Arboviruses of Chikungunya, Dengue, Zika and Yellow Fever.

Background: Controlling of Aedes aegypti and Ae. albopictus, vectors of five important mosquito-borne diseases, is known as the most effective method to prevent the transmission of arboviruses to humans, but the emergence of insecticide resistance is threat for control and prevention of vector borne diseases. A better understanding of mosquito resistance to insecticides will help to develop more effective methods to control insecticide resistance in mosquito vectors. Methods: Worldwide geographical distribution of insecticide resistance in Ae. aegypti and Ae. albopictus by the available papers and map of the data for carbamates, organochlorines, organophosphates, pyrethroids, microbial and insect growth regulator insecticides were reviewed. Article data published up to December 2022 were investigated by searching the following databases: "Google Scholar", "PubMed", "Scopus", "SID" and "Web of Knowledge". Results: The results showed that the susceptibility and resistance status of Ae. aegypti and Ae. albopictus to insecticides in the world is very diverse. Conclusion: Due to the importance of Ae. aegypti and Ae. albopictus in the transmission of mosquito-borne arboviruses, resistance management should be given more attention worldwide to prevent insecticide resistance in the arbovirus vector and replace the new approach for vector control.

Evaluation of the Time Course on the Effectiveness of WHO Standard Pyrethroid and Carbamate Impregnated Test Papers against Anopheles stephensi, the Main Malaria Vector in Iran.

Background: Anopheles stephensi is a major vector of malaria in some parts of the world. A standard method for determining resistance in adult mosquito populations is the bioassay test recommended by the world health organization (WHO). The papers used in this method have an expiry date. This study aimed to determine the effectiveness of outdated susceptibility test papers for use in insecticide resistance monitoring programs. Methods: Beech and Bandar Abbas strains of An. stephensi were reared in the insectary. Permethrin 0.75%, Deltamethrin 0.05%, and Bendiocarb 0.1% impregnated test papers prepared by Universiti Sains Malaysia were used. Probit analysis was used to analyze the results and prepare time-mortality regression lines of LT50 and LT90. Results: There was a difference in the mortality of both tested strains of An. stephensi was exposed to all tested insecticides. Both expired and not expired Permethrin and Deltamethrin papers induced 100% mortality at the diagnostic time (60min), but their insecticidal properties were reduced gradually in serial times. The highest efficacy of test papers was in the first trimester after the expiry date and decreased over time. Conclusion: At the diagnostic time of 60 minutes, the mortality rate of both dated and expired papers was 100% in the pyrethroid insecticides, even three years after expiry dates, if stored in the package provided by the producer, in a refrigerator. This value was reduced to less than 100% in the expired papers of Bendiocarb comparing the dated papers that induced 100% mortality.

Predicting current and future high-risk areas for vectors and reservoirs of cutaneous leishmaniasis in Iran.

Climate change will affect the distribution of species in the future. To determine the vulnerable areas relating to CL in Iran, we applied two models, MaxEnt and RF, for the projection of the future distribution of the main vectors and reservoirs of CL. The results of the models were compared in terms of performance, species distribution maps, and the gain, loss, and stable areas. The models provided a reasonable estimate of species distribution. The results showed that the Northern and Southern counties of Iran, which currently do not have a high incidence of CL may witness new foci in the future. The Western, and Southwestern regions of the Country, which currently have high habitat suitability for the presence of some vectors and reservoirs, will probably significantly decrease in the future. Furthermore, the most stable areas are for T. indica and M. hurrianae in the future. So that, this species may remain a major reservoir in areas that are present under current conditions. With more local studies in the field of identifying vulnerable areas to CL, it can be suggested that the national CL control guidelines should be revised to include a section as a climate change adaptation plan.

Modeling the Effect of Climate Change on the Distribution of Main Malaria Vectors in an Endemic Area, Southeastern Iran.

Background: Although malaria is endemic in some areas of southeastern Iran, following the successful national malaria elimination plan (NMEP), the local transmission area has been shrunk. This study was aimed to evaluate the effect of climate change on the distribution of main vectors. Methods: All documents related to research investigations conducted in Kerman Province on malaria vectors published during 2000-2019 were retrieved from scientific databases. Spatial distributions of the main vectors were mapped and modeled using MaxEnt ecological model. The future environmental suitability for main vectors was determined under three climate changes scenarios in the 2030s. Results: Five malaria vectors are present in Kerman Province. The best ecological niches for these vectors are located in the southern regions of the province under the current climatic condition as well as different climate change scenarios in the 2030s. Conclusion: Climate change in 2030 will not have a significant impact on the distribution of malaria vectors in the region. Entomological monitoring is advised to update the spatial database of Anopheles vectors of malaria in this malaria receptive region.

Risk Mapping and Spatial Modeling of Human Cystic Echinococcosis in Iran from 2009 to 2018: A GIS-Based Survey.

Background: Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis. Methods: The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test. Results: Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001). Conclusion: The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis.

Climate Change and Gender: Mapping Drought and Gender Gap in Literacy and Employment Sections in Iran between 2011 and 2016.

Background: Drought is one of the most frequent natural hazards in Iran. Gender analysis can highlight the different needs and capacities of men and women to manage drought hazards. Thus, the present study aimed to map drought and the gender gap in drought data based on the provincial zones in 2011 and 2016. Methods: This cross-sectional study was conducted in 2 stages establishing a database and spatial analysis. Data mapping was done based on provincial divisions, sex-disaggregated distribution of literacy, and employment rate as well as drought patterns in Iran in 2011 and 2016 using ArcGIS software. Descriptive statistics were applied to analyze and report the sex-disaggregated literacy and employment data. Results: About 80.73% and 75.27% of women and 80.89% and 74.74% of men experienced severe and very severe droughts in 2011 and 2016, respectively. Gender inequality in the aspects of literacy and employment in drought-affected regions was found in 2011 and 2016. Conclusion: Community-based planning and management in regions exposed to climate change are suggested for reducing the consequences of climatic disasters such as droughts. Women need to be empowered and trained for innovative livelihood activities in rural and urban areas in Iran and other developing countries affected by long-term droughts.

War, displacement, and the best location for temporary sheltering: a qualitative study.

BACKGROUND: One of the most important consequences of man-made disasters in the world is the loss of homes and, ultimately, forced population displacement. The sheltering of forcibly refugees to safe areas requires the study of scientific criteria. METHODS: This qualitative content analysis study was conducted in Iran to identify the criteria for the sheltering of refugees due to conflict. Participants in the study comprised experts and managers who had expertise, experience, or knowledge in the shelter for refugees. Data was collected in semi-structured interviews with 20 individuals and analyzed by qualitative content analysis to extract and categorize the factors affecting sheltering for refugees. RESULTS: The results of this study showed that a wide range of factors should be considered in the sheltering of refugees due to conflict, including land type, access to facilities, access to infrastructures, homogeneity, and similarities, security, distance from danger, environmental factors, economic issues, and political and legal issues. These nine categories covered 53 subcategories and 188 factors. CONCLUSIONS: The comprehensiveness of the factors mentioned in this study showed that the sheltering of refugees due to conflict requires planning, training, culture building, promoting readiness, and inter-organizational coordination. Moreover, managers, policymakers, decision-makers in relief agencies, humanitarian organizations, and organizations involved in sheltering of refugees due to conflict should attend to these factors to improve the process and prevent problems.

Contamination of Vector Snails with the Larval Stages of Trematodes in Selected Areas in Northern Iran.

Background: Identification of freshwater snails and possible trematodes transmission sites are essential to continue monitoring the potential for disease outbreaks in areas with a history of parasitic infections. We aimed to search some areas in the margin of the Caspian Sea, northern Iran to identify the snail fauna of this area and verify the contamination of vector snails. Methods: More than 5,308 snails from 51 diverse and permanent habitats were studied from April 2019 to October 2021. Snails were collected randomly and identified using shell morphology. Trematode infection in snails was investigated by the release of cercariae and dissection methods. Results: Five families of freshwater snails including Lymnaeidae, Physidae, Planorbidae, Bithyniidae, and Viviparidae were investigated in the Caspian Sae Litoral of Iran. Physidae were found as the most prevalent snails (55.1%) followed by Lymnaeidae (29.4%). The parasitize rate was observed as 20% using releasing cercaria technique. Echinostomatoidea (31%), Schistosomatoidea (8%), and Diplostomoidea (21%), and Plagiorchioidea (40%) were seen as detected parasites. Meanwhile, 60% of the studied snails illustrated the other stages of trematodes. Conclusion: The rate of infection of snails with different cercaria in northern Iran is significant. It needs further deep studies to clarify the situation of zoonoses transmitted by snails in the region. Policy makers should pay attention more to this area in terms of monitoring the snail-transmitted diseases.

Criteria for Locating Temporary Shelters for Refugees of Conflicts: A Systematic Review.

Background: We aimed to identify the indicators and criteria to locate temporary shelters for conflict refugees. Methods: This systematic review evaluated the full-text of the related articles in international electronic databases, such as Web of Science, Scopus, PubMed, Cochran, and Google Scholar from the beginning and without time limit to 1 June 2019. In addition, this search was based on a strategy developed by the researchers. The studies were selected regardless of their methods and two data extraction forms were used to extract the most relevant and important information. Results: Among 10124 cases of primary documents, 38 articles were selected, and 25 articles were analyzed in full-text. Totally, 45 indicators were identified and classified into two main categories of physical and non-physical indicators with six subcategories of land ownership, host government, access to infrastructures, site safety, land characteristics, and economic, social, and cultural considerations. Conclusion: The selection of temporary shelters for the conflict refugees requires the identification of all the specific influential factors not properly addressed. The final indicators obtained in our review could be incorporated into the development of the models required in this regard.

Temporal Monitoring and Predicting of the Abundance of Malaria Vectors Using Time Series Analysis of Remote Sensing Data through Google Earth Engine.

In many studies regarding the field of malaria, environmental factors have been acquired in single-time, multi-time or a short-time series using remote sensing and meteorological data. Selecting the best periods of the year to monitor the habitats of Anopheles larvae can be effective in better and faster control of malaria outbreaks. In this article, high-risk times for three regions in Iran, including Qaleh-Ganj, Sarbaz and Bashagard counties with a history of malaria prevalence were estimated. For this purpose, a series of environmental factors affecting the growth and survival of Anopheles were used over a seven-year period through the Google Earth Engine. The results of this study indicated two high-risk times for Qaleh-Ganj and Bashagard counties and three high-risk times for Sarbaz county over the course of a year observing an increase in the abundance of Anopheles mosquitoes. Further evaluation of the results against the entomological data available in previous studies showed that the high-risk times predicted in this study were consistent with an increase in the abundance of Anopheles mosquitoes in the study areas. The proposed method is extremely useful for temporal prediction of the increase in abundance of Anopheles mosquitoes in addition to the use of optimal data aimed at monitoring the exact location of Anopheles habitats.

Situation of insecticide resistance in malaria vectors in the World Health Organization of Eastern Mediterranean region 1990-2020.

Malaria is the most important mosquito-borne disease, which is transmitted by Anopheles species. According to the recent report of World Health Organization, there were an estimated 229 million malaria cases in 2019 in 87 malaria endemic countries. There are several vector control method specially using pesticides. The aim of this study was to collect all the data about insecticide resistant of malaria vectors in the Eastern Mediterranean region countries. In this study, all the published papers related to insecticide resistance of malaria vectors in the region were collected and resistant status of vectors in the countries was mapped. Resistance to different insecticide classes such as pyrethroids, organophosphate, organochlorine and carbamates were evaluated using World Health Organization guidelines. Results showed a wide variety of susceptibility/resistance status to these chemicals according to the location, historical context of pesticide used, genetic background of vectors, age and abdominal conditions of adults may play a role in the susceptibility status of these species to different insecticides. The results of this study is providing a guideline for countries to manage their vector control activities against insecticide resistance of malaria vectors and provide novel approaches such as male sterility, using Wolbachia, using new insecticide with new mode of action.

A Comparative Study on the Biodiversity and Species Richness of Phlebotomine Sand Flies (Diptera: Psychodidae) in Kermanshah and Khuzestan Provinces of Iran.

Background: Leishmaniasis is one of the most important vector-borne and neglected tropical diseases in many parts of the world. The main objective of this study was to determine the biodiversity of phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae) in Khuzestan and Kermanshah Provinces of Iran. Methods: Sampling was conducted in Khuzestan and Kermanshah Provinces using sticky paper traps and CDC light traps. The samples were then stored in 96% alcohol-containing vials, mounted, and identified. Afterward, the alpha diversity (using Simpson's, Shannon-Weiner's diversity, evenness, Maghalef's, Menhinick's, Hill N 1 and N 2 indices) and beta diversity indices (using Sorensen's and Jaccard's coefficients) were calculated. Results: A total of 4302 sand flies were caught and identified which comprised mostly of Phlebotomus papatasi, Ph. alexandri and Ph. sergenti. It was found that among the four counties of Ahvaz, Shush, Shushtar and Dezful in Khuzestan Province, Shush had the lowest, and Shushtar, the highest amount of species diversity and evenness. In the four studied counties of Kermanshah Province, species diversity in Kermanshah County had the lowest amount and Sarpol-e-Zahab, the highest. The species richness in Kermanshah County was the lowest, while Qasr-e-Shirin County had the highest amount. Conclusion: An overview of the biodiversity of phlebotomine sand flies in Kermanshah County in Kermanshah Province, and Shush County in Khuzestan Province, showed less stability in community structure of these vectors, which can be counted as an alarm for emerging dominant vectors among the studied counties and have the potential to increase the prevalence of leishmaniasis.

Scabies as a Neglected Tropical Disease in Iran: A Systematic Review with Meta-Analysis, during 2000-2022.

Background: Scabies is referred to the infestation of skin by an ectoparasite, Sarcoptes scabiei. Having considerable financial consequences, this disease is a public health concern in several countries. In this review, we aimed to determine the current status of scabies in different provinces of Iran. Methods: Google Scholar, PubMed, Scopus, Science Direct, Scientific Information Database (SID), Sci-explore, Civilica, Magiran, Iranian Research Institute for Information Science and Technology and Elmnet databases were searched to find the related data in the time period within 2000-2022. To have a better insight into the status of prevalence of scabies in Iran, a meta-analysis and meta-regression was performed. Results: A total of 943 relevant studies were retrieved from the databases, and 62 eligible studies met all the needed criteria for inclusion in this systematic review. Scabies was investigated and reported in at least 22 and 21 provinces of Iran respectively. Most of the studies were conducted in Tehran, Razavi Khorasan, Hormozgan, Fars and Guilan Provinces. Positive samples of scabies belonged to humans, sheep, goats, dogs, rabbits, mice and gazelles. Meta-analysis showed that the overall estimated presence of scabies in Iran during 2000-2022 was 7% (95% CI 4.7-10.3%, P< 0.001). Conclusion: Infestations due to S. scabiei in Iran occur in different geographical locations and different climates. As a neglected tropical disease, the literature about the burden of scabies in Iran is inadequate. The present review highlights the importance of development of comprehensive strategies for the diagnosis and control of scabies, especially the provinces with high infestation rates.