Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran.

Background: Intestinal parasitic infections are still a considerable global public health problem. We aimed to determine the frequency of intestinal parasitic infections among people referring to the central laboratory of Meshkin Shahr City, Ardabil Province, Iran. Methods: In this cross-sectional survey, 460 fecal samples were collected randomly from persons referred to the central laboratory of Meshkin Shahr City, from January to June 2022. The samples were examined by direct wet-mount, Trichrome and modified Ziehl-Neelsen staining, formalin ethyl acetate sedimentation, and agar plate culture. Results: The frequency of intestinal parasites was 15.7% (72 out of 460 cases), with some people with numerous intestinal parasites. The frequency of protozoan infections (13.9%) was higher than the helminthic infections (2.6%). Blastocystis spp. (8.1%) was the most prevalent detected intestinal protozoan. Entamoeba coli (5.7%), Dicrocoelium dendriticum (2.2%), Giardia lamblia (1.5%), Fasciola spp. (0.2%), and Hymenolepis nana (0.2%) were other detected parasites. Conclusion: In- spite of betterment of the health condition in Iran and reduction of parasitic infection, intestinal parasitic infections are still a considerable public health issue in some parts of Iran.

Echinococcus granulosus sheep strain (G1) as the predominant genotype in definitive host (dogs) isolates in northeastern Iran.

Echinococcus granulosus sensu lato (E. granulosus s.l.) is a zoonotic parasite, causing cystic echinococcosis in humans. In the present study, prevalence and genotypes of E. granulosus s.l. was assessed in stools collected from 244 dogs including 138 stray and 106 domestic animals using high resolution melting curve (HRM) method. Initially, to detect taeniid eggs in feces, all samples were examined using the formalin-ether techniques. Genomic DNA was extracted from the positive samples and E. granulosus s.l. was differentiated from other Taeniidae parasites using SSU-rDNA gene and E. granulosus s.l. was analyzed for genotyping using HRM based on the cox1 gene. In total, 12.7% (31/244) of the samples were positive for Taeniidae eggs. In addition, among the positive samples, 77.4% (24/31) were positive for E. granulosus s.l.. In details, 11.3% (12/106) of the domestic dogs and 8.7% (12/138) of the stray dogs were positive for E. granulosus s.l.. The results of HRM analysis showed that all E. granulosus s.l. isolates were G1 strain. Findings of the present study indicated a considerable prevalence of E. granulosus G1 among dogs in the northeast of Iran and imply a serious risk of transmitting to humans and livestock.

Estimating Patient Survival and Risk of End-Stage Kidney Disease in Patients With Autosomal Dominant Polycystic Kidney Disease in Iran.

INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary kidney disease that can affect several organs. The clinical course of the disease varies among patients; some never become symptomatic, and others reach end-stage kidney disease (ESKD) in the 5th decade of their life. METHODS: This historical cohort study was conducted on ADPKD patients to investigate kidney and patient survival rates and related risk factors in Iran. Survival analysis and risk ratio calculation were performed using the Cox proportional hazards model, Kaplan- Meier method, and log-rank test. RESULTS: Among the 145 participants, 67 developed ESKD, and 20 died before the end of the study period. Developing chronic kidney disease (CKD) at the age of ≤ 40, baseline serum creatinine level (SCr) of more than 1.5 mg/dL, and cardiovascular disease increased the risk of ESKD by 4, 1.8, and 2.4 times; respectively. Patient survival analysis revealed a fourfold increase in mortality if the glomerular filtration rate (GFR) declined more than 5 cc/min annually and if CKD was diagnosed at the age of ≤ 40. Vascular thrombotic events or ESKD in the course of disease increased the risk of death by approximately 6- and 7-fold, respectively. Kidney survival was 48% by the age of 60 and 28% by the age of 70. Patient survival was 86.05% at the age of 60 and 67.99% at the age of 70. Additionally, men had a significantly better renal function and survival than women. CONCLUSION: Elevated baseline SCr and cardiovascular disease can increase ESKD risk in ADPKD patients. A rapid decline in GFR, ESKD development, and vascular thrombotic events increase the risk of death, but early CKD can affect both.  DOI: 10.52547/ijkd.7551.

Periplaneta americana (Blattodea: Blattidae) fungal pathogens in hospital sewer systems: molecular and phylogenetic approaches.

Cockroaches are known as mechanical vectors of some pathogens that can infect humans. The present study aims to rapidly identify Periplaneta americana fungal pathogens from sewer systems of public hospitals in Esfahan using the polymerase chain reaction (PCR) technique. A total of 55 P. americana cockroaches were randomly collected by direct trapping from sewer systems of seven hospitals and screened for fungal infectious agents using standard morphological methods and the PCR sequencing. From the American cockroach, we isolated 62 yeasts and 31 molds from the surface, hemocoel, and digestive tract of P. americana. Based on DNA sequence comparisons and other taxonomic characteristics, they were identified as more than four species of yeast and four species of mold. Yeast species including Pichia kudriavzevii, Candida glabrata, Pichia kluyveri, and Candida viswanathii, and molds such as Aspergillus niger, Penicillium italicum, Mucor plumbeus, and Rhizopus oryzae were isolated repeatedly from the surface, hemocoel, and digestive tract of P. americana. Our results show that the use of a combination of morphological, molecular techniques, and phylogenetic analysis can lead to the identification of pathogenic fungal agents in American cockroaches and also knowledge of fungal pathogens-arthropod host relationships.

Ongoing increase in incidence and prevalence of multiple sclerosis in south-eastern Iran: A three decade study.

BACKGROUND: Prevalence of multiple sclerosis has been increased during the last decades throughout the world. Epidemiological studies could improve our understanding relating to its intrinsic and extrinsic causes. OBJECTIVES: The current study has been conducted to determine the epidemiological features of MS in south-eastern Iran which is a semi-tropical area with different ethnicities. METHODS: This longitudinal descriptive study was carried out in south-eastern Iran, based on information of MS patients registered at Zahedan University of Medical Sciences database from 1990 to 2020. RESULTS: A total of 1045 cases were enrolled into the study. The age-standardized prevalence ratio of MS increased to 42.2/100,000 population by 2020. These figures showed increasing trends both in females and males and reached to 61.5 and 22.6 per 100,000 population, respectively by the year 2020. Likewise, the total incidence rate grew to its maximum amount of 4.5 in 2015. Female incidence also revealed an upward trend and peaked in 2016 to 6.4 while male incidence rate reached at its highest level of 1.8 in 2009. CONCLUSION: MS prevalence ratios and incidence rates in south-eastern Iran have been increasing steadily, especially in women during the last three decades. The south-eastern part of Iran should be considered a high-risk region.

Acute adverse events following immunization with DTP-HB-Hib pentavalent vaccine in the first year of life.

Background: Since November 2014, the pentavalent (Diptheria+Tetanus+Pertussis and Hepatitis B and Hib or DTP-HBHib) vaccine has been integrated into the Iranian national vaccination programme. Aims: We conducted a prospective study in Zahedan in the southeast of the Islamic Republic of Iran to determine the incidence of adverse events following immunization (AEFI) with the pentavalent vaccine in children aged under one year. Methods: Using cluster sampling, 1119 children aged 2-10 months at 15 public health clinics were invited, through their parents, to participate in the study. The parents were trained to register and report any AEFIs in a questionnaire. They were instructed to return the child to the clinic for further examination by a physician if they observed any complications within 3 days of vaccination. Results: The most commonly reported AEFIs were fever (50.94%), mild (41.46%) and severe (1.70%) injection site complications, persistent crying for 3 hours or more (1.88%), hypotonic hyporesponsive episode (0.36%), vomiting (1.88%), diarrhoea (2.95%), and sterile abscess (0.62%). There were no cases of convulsion, purulent abscess or rash. The work experience of vaccinators (OR = 1.85; 95% CI: 1.4-2.46) showed a significant statistical association with the incidence of mild local complications at the injection site. Those with a history of Bacillus Calmette-Guérin (BCG) lymphadenitis (OR = 3.89; 95% CI:1.04-14.49) had a higher risk of severe local complications at the injection site. Conclusions: The observed incidence of serious AEFIs following pentavalent vaccine injection in the study population was within the expected range. However, some of the relationships observed in this study require further research.

Association between DLCO index and the severity of heart failure: a cross-sectional study.

BACKGROUND: The prognostic role of diffusing capacity of the lung for carbon monoxide (DLCO) in heart failure has not been thoroughly investigated. Therefore, this study aimed to evaluate DLCO variation in different systolic and diastolic heart failure stages. METHODS: This was a prospective cross-sectional study on 51 patients with systolic (reduced LVEF) or diastolic (preserved LVEF) chronic heart failure (CHF). All patients underwent a standard DLCO test. The associations between the severity of heart failure and reduced carbon monoxide transfer factor (TLCO), carbon monoxide transfer coefficient (KCO), and alveolar volume (VA) were investigated. Data were analysed using SPSS software version 16. p-Values below 0.05 were considered statistically significant. RESULTS: The mean age of participants was 59.29 ± 14.91 years, with 72% of the study population being male. Systolic heart failure was observed in 47% of patients, diastolic heart failure in 18%, and a mixed systolic and diastolic pattern in 35%. There were significant differences between TLCO percentage in patients with CHF types and the New York Heart Association (NYHA) functional classes (p = 0.042). Overall, an ejection fraction (EF) of less than 25% correlated with 3%, 53%, and 0.78 declines in TLCO, KCO%, and KCO index, respectively. CONCLUSION: Despite the lack of statistically significant differences between DLCO indices and CHF severity, decreased DLCO parameters correlated with reduced EF. Therefore, DLCO testing might be helpful to predict HF severity.

BAT25, ACVR2, and TGFBR2 Mononucleotide STR Markers: A Triplex Panel for Microsatellite Instability Testing in Colorectal Tumors.

Background: Microsatellite instability (MSI) in colorectal cancer (CRC) patients is considered as a diagnostic and prognostic marker. MSI is a consequence of mismatch repair deficiency which is evaluated using the different microsatellite markers on the whole genome. In this pilot study, the diagnostic value of a novel triplex panel including three mononucleotide markers has been evaluated in comparison to the standard Promega kit for MSI testing in CRC patients with Amsterdam II criteria. Materials and Methods: DNA extracted from tumors and normal Formalin-Fixed Paraffin-Embedded (FFPE) tissues of index cases from 37 HNPCC (Hereditary non-polyposis colorectal cancer) families were evaluated for MSI state. Primer design for three markers, including BAT25, ACVR2, and TGFBR2, was performed using 19 nucleotides of the M-13 phage. The instability of each marker was assessed through fragment analysis in comparison with Promega kit markers for all patients. The sensitivity and specificity of each marker have been calculated. Results: The comparative evaluation of MSI in both tumors and normal adjacent FFPE tissues demonstrated a separate sensitivity as 100%, 83.3%, and 76.9% for BAT25, ACVR2, and TGFBR2, respectively, and 100% sensitivity in the form of a triplex. Moreover, the specificity for each of these three markers in MSI testing was estimated as 100%, separately and in the form of the triplex in comparison with the Promega pentaplex standard Kit. Conclusions: A high sensitivity and specificity for the novel triplex panel in MSI-testing were estimated among Iranian patients. More studies are recommended to confirm this panel as a diagnostic kit for MSI testing.

Immunization coverage of children aged 24-35 months in the Islamic Republic of Iran: a national cluster coverage survey.

Background: Although vaccination coverage against a disease is not exactly the same as community immunity against that disease, it is undoubtedly directly related to it and provides an estimate of the coherence and efficacy of community health infrastructure. Aims: To evaluate the vaccination coverage of children throughout the Islamic Republic of Iran in 2019. Methods: This was a cross-sectional study. A probability proportional to size cluster sampling method was used and the vaccination data of 8682 children aged 24-35 months were collected in the form of 1447 clusters, each comprising six participants. Only valid data, including vaccination card or electronic health files, were used. The results were reported in the form of descriptive tables. Results: Overall, 97.82% of Iranian participants (8068 of 8248) and 90.32% of non-Iranian participants (392 of 434) had received all essential childhood vaccination by the time of interview. In total, 93.02% of all participants had presentable vaccination cards, and the immunization history of 535 (6.16%) children was retrieved using their electronic health files. The dropout rate between receiving pentavalent vaccine 1 and pentavalent vaccine 3 was 0.01%. In 29 provinces, vaccination coverage was ≥ 95%. In the other two provinces, the figure was 93.30%. Conclusion: Immunization coverage of children aged 24-35 months fully complied with eradication/elimination goals of vaccine-preventable diseases. In 2019, measles and rubella elimination was certified in the Islamic Republic of Iran. However, non-Iranian residents with immunization coverage < 95% constitute a high-risk group for possible outbreaks.

Leishmania spp. infection in Rhombomys opimus and Meriones libycus as main reservoirs of zoonotic cutaneous leishmaniasis in central parts of Iran: Progress and implications in health policy.

Rodents from the subfamily Gerbillinae are the principal reservoir of cutaneous leishmaniasis (CL) caused by Leishmania major in the center and northeast of Iran. This study was conducted to determine both naturally occurring Leishmania infection rates and the distribution of Leishmania species in the central parts of Iran during 2019-2020. In this regard, presence of Leishmania parasites were confirmed by microscopic examination and the species were identified by nested-PCR using the Internal Transcribed Spacer2- Ribosomal DNA (ITS2-rDNA). Finally, some samples were sequenced and, the blast analysis of L. major samples, showed a 92.45-100% homology to the L. major sequence. Of the 181 wild gerbils collected (Rhombomys opimus=157 and Meriones lybicus=24), 88 (48.6%) tested positive for Leishmania sp. by microscopic examination whereas 162 (89.5%) were positive by nested-PCR. Of the 162 infected gerbils, 103 showed single strain infections (30 L. major, 28 L. gerbilli and 45 L. turanica), 43 showed dual infections with only the non-human species (L. gerbilli and L. turanica), and 16 were mixed infections of L. major and L. turanica (n = 14) or L. gerbilli (n = 2). All single or mixed L. major infections were detected in gerbils from areas with reports of human CL during the last decade. These findings suggest that Rhombomys opimus and Meriones libycus have a potential role in the maintenance of human and non-human transmission of Leishmania species in the CL foci.

Infliximab and Intravenous Gammaglobulin in Hospitalized Severe COVID-19 Patients in Intensive Care Unit.

BACKGROUND: Severe coronavirus disease 2019 (COVID-19) may lead to the cytokine storm syndrome which may cause acute respiratory failure syndrome and death. Our aim was to investigate the therapeutic effects of infliximab, intravenous gammaglobulin (IVIg) or combination therapy in patients with severe COVID-19 disease admitted to the intensive care unit (ICU). METHODS: In this observational research, we studied 104 intubated adult patients with severe COVID-19 infection (based on clinical symptoms, and radiographic or CT scan parameters) who were admitted to the ICU of a multispecialty hospital during March 2020 in Tehran, Iran. All cases received standard treatment regimens as local protocol (Oseltamivir + hydroxychloroquine + lopinavir/ritonavir or sofosbuvir or atazanavir ± ribavirin). The cases were grouped as controls (n = 43), infliximab (n = 27), IVIg (n = 23) and combination (n = 11). RESULTS: There was no significant difference between controls and treatment groups in terms of underlying diseases or the number of underlying diseases. The mean age (SD) of cases was 72.42 (16.06) in the control group, 64.52 (12.965) in IVIg, 63.40 (17.57) in infliximab and 64.00 (11.679) in combination therapy; (P = 0.047, 0.031 and 0.11, respectively). Also, 37% in the infliximab group, 26.1% in IVIg, 45.5% in combination therapy, and 62.8% in the control group expired (all P < 0.05). Hazard ratios were 0.31 in IVIg (95% CI: 0.12-0.76, P = 0.01), 0.30 in infliximab (95% CI: 0.13-0.67, P = 0.004), 0.39 in combination therapy (95% CI: 0.12-1.09, P = 0.071). CONCLUSION: According to the findings of this study, it seems that infliximab and IVIg, alone or together, in patients with severe COVID-19 disease can be considered an effective treatment.

Evaluation of the Anti-Leishmanial Effect of Recombinant Clostridium α-Toxin.

BACKGROUND: Leishmaniasis is an infectious disease common in tropical and subtropical regions caused by the genus Leishmania, which is transmitted by the bite of female sandflies. In this study, we evaluate the anti-leishmanial effect of recombinant Clostridium α-toxin protein alone and the combination with glucantime through in vitro and in vivo. MATERIALS AND METHODS: Production, expression, and purification of recombinant α-toxin were evaluated by SDS-PAGE and Western blotting techniques. The antileishmanial activities of the purified α-toxin plus and without glucantime were examined in vitro and in vivo. RESULTS: The results indicated successful expression of α-toxin as a 48 kDa band on SDS-PAGE and Western blot methods. Also, evaluation of α-toxin IC50 showed the strong fatal effect of it, and glucantime on medium proliferated Leishmania promastigotes at lower concentrations compared with glucantime or α-toxin alone. Moreover, in vivo surveys showed that at the end of treatment courses, the mean of lesion size diminished in glucantime plus α-toxin treated mice versus negative control groups (p < 0.001). Also, there was a significant difference in the parasite burden of the spleen and liver of the control versus the test groups (p < 0.001). CONCLUSION: The results showed recombinant α-toxin has synergistic effects with glucantime in destroying Leishmania parasites.

Frequency and Molecular Identification of Cryptosporidium Species among Immunocompromised Patients Referred to Hospitals, Central Iran, 2015-16.

BACKGROUND: The purpose of this study was to determine the prevalence and genotype of Cryptosporidium spp. in different groups of immunocompromised patients admitted to the referral hospitals in center of Iran during 2015-2016. METHODS: This cross-sectional study was conducted on 346 immunocompromised patients (HIV+/AIDS, Lymphoma, Leukemia and organ transplants) in referred hospitals from central parts of Iran including Isfahan, Markazi, Yazd and Chaharmahale Bakhtiari provinces. Stool samples were analyzed for Cryptosporidium species, modified Ziehl-Neelsen staining techniques followed by the semi-nested PCR and DNA sequencing methods. RESULTS: The total rate of Cryptosporidium spp. was 3.46% (12/346) in the patients, however, the prevalence of the parasite, was 4.6% (4/87) in HIV+/AIDS patients, 3.6% (6/168) in patients with blood malignancy and 2.1% (2/91) in organ transplant recipients. The SSU rRNA gene of Cryptosporidium spp. in all microscopic-positive samples was effectively amplified by the semi-nested PCR and DNA sequences, exposed the existence of two Cryptosporidium species, including C. hominis 91.6% (11/12) and C. parvum 8.3% (1/12). CONCLUSION: The predominance of C. hominis in the present study may be certifies the importance of anthroponotic transmission of cryptosporidiosis in center of Iran.

Seroprevalence of anti-rubella and anti-measles antibodies in women at the verge of marriage in Iran.

BACKGROUND: Measles and rubella as two highly contagious eruptive diseases are on the agenda to be eliminated in Iran by 2020. To evaluate the seroimmunity of the future mothers against rubella and measles, a nationwide serosurvey was implemented in 10 provinces, selected at random from 31 provinces in the country. METHODS: using a multistage sampling method, 1600 participants were interviewed and blood sampled in 40 'Pre-marriage Consultation Centers' across 40 districts. Using ELISA method, the sera were tested for anti-rubella and anti-measles IgG antibodies in the National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. RESULTS: Of the 1600 initial participants, the sera of 1573 participants were tested for rubella and 1569 for measles. The total seroprevalence of anti-rubella and anti-measles antibodies were 90.6% (95%CI: 89.1 to 92.0%) and 80.7% (95%CI: 78.7 to 82.6%) respectively. After 14 years, the effect of the immunization campaign of 2003 against rubella and measles on the age group of 5 to 25 years, was still apparent, i.e., there was a sharp difference between the seroprevalence of antibody (against both measles and rubella) of those who at the time of the present study were above 18 years with the younger age cohorts. For both diseases, higher seroprevalence of antibodies was detected in women above 18 years old. CONCLUSION: Implementation of a Supplemental Immunization activity or revision of the national immunization schedule to add a third dose of measles and rubella containing vaccine during adolescence are/might be considered as possible options for bridging the gap in the seroimmunity of the younger age groups.

A Novel Strategy for Enhance Potentiation of Meglumine antimoniate against Leishmania major In Vitro.

BACKGROUND: We aimed to design a different method of drug delivery for increased transfer of the choice drug (meglumine antimoniate) within the host cells. Therefore, listeriolysin O (LLO), a bacterial product which is a member of pore-forming peptides was used as an enhancer factor with meglumine antimoniate in order to facilitate the transition of the drug across macrophage membrane. METHODS: LLO was produced in Isfahan University of Medical Sciences in 2016, by expressing the hlyA gene in Escherichia coli and purified using affinity chromatography. Cytotoxicity of the purified protein was investigated in an in vitro model of macrophage Leishmania infection. RESULTS: LLO was cytotoxic against murine macrophage cells (J774-A1) and amastigote forms of L. major (MRHO/IR/75/ER). It was less toxic to macrophages (CC50=2.56 µg ml-1 ±0.09) than to the parasites (IC50=1.72 µg ml-1 ±0.07). Moreover, noncytotoxic concentration of LLO (0.006 ug ml-1) potentiated the cytotoxicity induced by low dose concentration of meglumine antimoniate. Very little dose of meglumine antimoniate was needed when combined with the LLO (IC50=12.63 µg ml-1 ±0.13) in comparison with the cytotoxicity induced when the drug is used alone (IC50=46.17 µg ml-1 ±0.28). CONCLUSION: The combination of pore-forming proteins with anti-leishmanial agents could increase the advantage of anti-leishmanial drugs. Since lower concentrations of anti-leishmanial drugs can reduce undesirable side effects of chemotherapy trials carried out in animal models and then in humans with this system.

Effects of coenzyme Q10 supplementation on oxidative stress and antioxidant enzyme activity in glazers with occupational cadmium exposure: A randomized, double-blind, placebo-controlled crossover clinical trial.

TRIAL REGISTRATION:: Iranian Registry of Clinical Trials Registration Number: IRCT2016061228407N1 ( www.who.int/ictrp/network/irct/en/ ).

Reiteration of the elimination status of measles in the southeast of Iran, 2015.

During 2015, the number of measles cases reported from Iran increased about three times the previous year; and Sistan-va-Baluchestan Province, located in the southeast of Iran, was the hottest point at the center of the dilemma. The main objective of the present study was to evaluate the situation of the population with regard to the elimination goals. The files of all measles cases were reviewed and categorized again based on surveillance system definitions; and the effective reproduction numbers, attack rates, and epidemic curves were calculated and graphed. In total, 152 laboratory-confirmed cases occurred in 2015 in the study population. The highest attack rate belonged to infants being in their first year of life and the lowest to the age groups 16 to 40. The estimated 'Effective Reproduction Number' for the eight districts ranged from 0.70 to 0.93; and considering the subsidence of all outbreaks by themselves, it might be speculated that elimination state is still in effect and accountable. Considering the large number of the susceptible islands among the sea of herd immune population, implicated by the large number of outbreaks, implementation of a supplementary immunization intervention is highly recommended.

The biochemical effects of occupational exposure to lead and cadmium on markers of oxidative stress and antioxidant enzymes activity in the blood of glazers in tile industry.

The aim of the present study was to evaluate the effects of occupational exposure to lead (Pb) and cadmium (Cd) on markers of oxidative stress in glazers in tile industries. Total antioxidant capacity (TAC), malondialdehyde (MDA), and the activity of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were determined in the blood of 80 subjects, including 40 glazers and 40 nonexposed subjects. Mean levels of blood Cd (8.90 ± 2.80 µg/L) and blood Pb (62.90 ± 38.10 µg/L) of glazers showed a significant increase compared with the control group. In the serum of glazers, the level of MDA was significantly higher and the level of TAC was significantly lower than the control group. We have noted a disturbance in the levels of antioxidants by a significant increase in the CAT activity and a significant decrease in the activities of SOD and GPx in the serum of glazers compared with the controls. Correlation analysis demonstrated that the serum MDA level and CAT activity were positively associated with the blood levels of Pb and Cd. Also, GPx and SOD were negatively correlated with blood Cd levels. The study clearly indicated that co-exposure to Cd and Pb can induce oxidative stress in glazers, resulting in increased lipid peroxidation and altered antioxidant enzymes.

Seroprevalence of antibodies to measles and rubella eight months after a vaccination campaign in the southeast of Iran.

Eight months after the mass immunization campaign of November 2015 against measles and rubella in the southeast of Iran, in order to evaluate the sero-immunity level of the people living in the mentioned region, a serosurvey study was performed. Using a multi-stage probability proportional to size cluster sampling, the sera of 1,056 participants, ranging from 15 months to 20 years old, were tested for measles and rubella IgG antibodies in the National Reference Laboratory at Tehran University of Medical Sciences, Tehran, Iran. The seroprevalence rates of antibodies against measles and rubella in the age groups below 16 years were respectively 98.4 and 93.2%. In the age group of 16 to 20 years, who was not the target of the mass immunization campaign, the said rates were respectively 91.7% and 87.4%. The herd immunity of the age groups below 16 years, who were the target of the campaign, is favourably high and reassuring both for measles and for rubella. Campaigns of supplementary vaccination play a substantial role for filling the gaps in the herd immunity.

Head-to-head immunogenicity comparison of Edmonston-Zagreb vs. AIK-C measles vaccine strains in infants aged 8-12 months: A randomized clinical trial.

BACKGROUND: A non-inferiority multi-centre parallel randomized double-blind trial was implemented in Zahedan district, Sistan-va-Baluchestan province, Iran, to compare the performance of the two measles vaccines which are in use in the National Immunization Programme of Iran and are of two different measles virus vaccine strains: Edmonston-Zagreb (EZ) strain vs. AIK-C strain. The main outcome measure was appearance of anti-measles antibody in sera. METHODS: 200 infants, 8-12 months old, whose parents consented for their children to be included in the study, were randomized in permutation blocks of size 4-8 in four Urban Health Clinics. Having given a pre-vaccination blood sample, they received measles-rubella vaccine containing one of the vaccine strains mentioned before. After 60 days, the second blood sample was taken. The sera of the pre- and post-vaccination blood samples were tested for anti-measles antibodies in the National Reference Measles Laboratory. Parents, laboratory technicians and statistician were blind to groupings. RESULTS: Of the 200 children equally randomized in the two arms, 185 who were seronegative before vaccination (88 in the EZ arm and 97 in the AIK-C arm) were entered in the final analysis. The seroconversion rate in the EZ arm was 76.1% (95% CI: 60.2-85.2%), and that in the AIK-C arm was 58.7%; (95% CI: 48.8-68.7%). The absolute rate difference was 17. 4% (4.1-30.9%; P-value: .012), and the relative seroconversion rate of EZ to AIK-C was 1.3 (95% CI: 1.1-1.6; P-value: .012). No adverse events were reported during the study period. CONCLUSION: A considerable difference in the seropositivity of different measles containing vaccines could be demonstrated in the first year of life. TRIAL REGISTRATION: Iranian Registry of Clinical Trials Registration Number: IRCT2016032827144N1; May 10, 2016 (www.who.int/ictrp/network/irct/en/).