Tattooing among Iranian prisoners: results of the two national biobehavioral surveillance surveys in 2015-2016

Abstract Background: Tattooing is among identified risk factor for blood-borne diseases. Objective: This study aims to determine the prevalence of tattooing during lifetime and in prisons and its related factors among Iranian prisoners. Methods: This is a cross-sectional study. The required data was obtained from hepatitis B and C surveillance surveys in prisons in 2015-2016 that was collected through face-to-face interview. 12,800 prisoners were selected by multi-stage random sampling from 55 prisons of 19 provinces in Iran. Weighted prevalence and associated factors (using Chi-Square test and multivariate logistic regression) were determined by Stata/SE 14.0 survey package. Results: Out of 12,800 prisioners, 11,988 participated in the study (93.6% participation rate). The prevalence of tattooing in lifetime and in prisons was 44.7% and 31.1% respectively. The prevalence of tattooing during lifetime was significantly associated with age < 35 years, being single, illiteracy, history of imprisonment, drug use, piercing during lifetime, extramarital sex and history of STI; the prevalence of tattooing in prison had a significant association with history of imprisonment, drug use, piercing in prison, and history of extramarital sex (p < 0.05). Study limitations: Information and selection bias was one of the study limitations. Conclusion: The results of this study showed that the prevalence of tattooing during lifetime and in prison among prisoners was significantly high especially in high-risk groups such as drug users and sexually active subjects. Given the role of tattooing, drug injection and sex in the transmission of blood-borne diseases, harm reduction programs are recommended to reduce these high-risk behaviors in prisons.

Lifetime prevalence, sociodemographic predictors, and comorbidities of oppositional defiant disorder: the National Epidemiology of Iranian Child and Adolescent Psychiatric disorders (IRCAP)

Objective: This was the first national epidemiological study on oppositional defiant disorder (ODD) in Iran, which provided new information about the prevalence, comorbidities, and sociodemographic predictors of ODD. Methods: Data from a face-to-face household survey of 30,532 children and adolescents aged 6-18 years were collected from across all 31 provinces of Iran using a multistage cluster sampling design. The Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL) was used in this study. Results: The lifetime prevalence of ODD was found to be 3.9%. ODD was significantly more common in boys than girls and appeared in late adolescence more frequently than in childhood. A lower prevalence of ODD was found among participants who lived in rural areas. ODD is highly likely to co-occur with attention deficit hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, and depressive disorders. Conclusions: The findings of this national population-based study confirm and extend previous findings on the prevalence, comorbidities, and sociodemographic predictors of ODD.

Predictive determinants of scorpion stings in a tropical zone of south Iran: use of mixed seasonal autoregressive moving average model

Background: More than 1.2 million scorpion stings occur annually worldwide, particularly in tropical regions. In the absence of proper medical care, mortality due to venomous scorpion stings is an important public health issue. The aim of the present study is to explore the temporal trend of scorpionism with time series models and determine the effective factors on this event using regression models. Methods: A retrospective cross sectional study was conducted on 853 scorpion stung patients. They were referred to Haji-Abad Hospital of Hormozgan University of Medical Sciences (HUMS), south Iran, from May 2012 to July 2016. A linear model to describe and predict the monthly trend of scorpion sting cases is fit with autoregressive moving average (ARMA) model. Results: Of 853 victims, 384 (45%) patients were female and 30.2% of them lived in urban areas. The mean (± SD) age of patients was 30.1 (± 19.6) years and the most affected age group was 20-29 years (21.8%). Most victims were unemployed people and farmers (54.7%) followed by housewives (30.2%). The majority of the stings occurred indoors (53.7%), between midnight and 6 a.m. (29.2%), in the summer (44.2%), and the most affected limbs were hands and legs (81.2%). Patient genders and occasions of being stung by scorpions were significantly different between outdoors and indoors (p < 0.001). Scorpion stings due to Odontobuthus doriae were significantly higher than due to other species in urban and rural patients (p = 0.04). Mixed seasonal ARMA at lag 12, ARMA (1, 1) x (0, 1), was selected as the best process for monthly trend of data. Regression results indicated that significant climate factors associated with scorpion stings are temperature (p < 0.001) and relative humidity (p = 0.002). Conclusions: Scorpion stings have a noticeable effect on tropical rural populations, mainly farmers. Two effective climate factors associated positively and negatively with scorpion sting cases are temperature and relative humidity, respectively. The results of time series and regression models to predict the trends and determinants of scorpion stings are almost the same.(AU)

Prevalence of ittestinal parasites among food handlers of sari, northern Iran / Prevalência de parasitas intestinais entre manipuladores de alimentos de Sari, Norte do Iran

Parasitic infection is highly prevalent throughout the developing countries of the world. Food handlers are a potential source of infection for many intestinal parasites and other enteropathogenic infections as well. The aim of this study was to determine the prevalence of intestinal parasite carriers among food handlers attending the public health center laboratory in Sari, Northern Iran for annual check-up. The study was performed from August 2011 through February 2012. Stool samples were collected from 1041 male and female food handlers of different jobs aged between 18 to 63 years and were examined following standard procedures. Sociodemographic, environmental and behavioral data analysis of the food handlers were recorded in a separate questionnaire. Intestinal parasites were found in 161 (15.5%) of the studied samples. Seven species of protozoan or helminth infections were detected. Most of the participants were infected with Giardia lamblia (53.9%) followed by Blastocystis hominis (18%), Entamoeba coli (15.5%), Entamoeba histolytica/dispar (5.5%), Cryptosporidium sp. (3.1%), Iodamoeba butschlii (3.1%) and Hymenolepis nana (1.9%) as the only helminth infection. The findings emphasized that food handlers with different pathogenic organisms may predispose consumers to significant health risks. Routine screening and treatment of food handlers is a proper tool in preventing food-borne infections.

Infecção parasitária é altamente prevalente entre os países em desenvolvimento do mundo. Manipuladores de alimentos são fonte potencial de infecção de muitos parasitas intestinais assim como de outras infecções entero-patogênicas. O propósito deste estudo foi determinar a prevalência de portadores de parasitas intestinais entre pessoas que manipulam alimentos e atendem o centro de saúde pública em Sari, norte do Iran para possível check-up. O estudo foi conduzido de agosto de 2011 até fevereiro de 2012. Amostras de fezes foram coletadas de 1041 manipuladores de ambos os sexos e de diferentes funções entre a idade de 18 e 63 anos e foram examinados de acordo com procedimentos standard. Em questionário separado foram colocadas as análises sóciodemográficas, ambientais e de comportamento dos manipuladores de alimentos. Parasitas intestinais foram encontrados em 161 (15,5%) das amostras estudadas. Sete espécies de protozoários ou infecções por helmintos foram observadas. A maior parte dos participantes estava infectada com Giardia lamblia (53,9%) seguida por Blastocystis hominis (18%), Entamoeba coli (15,5%), Entamoeba histolytica/dispar (5,5%), Cryptosporidium sp. (3,1%), Iodamoeba butschlii (3,1%) e Hymenolepis nana (1,9%) como a única infecção por helminto. Os achados enfatizaram que os manipuladores de alimentos, com diferentes organismos patogênicos podem se constituir risco significante para os consumidores. Exames rotineiros e tratamento dos manipuladores de alimentos são as ferramentas apropriadas para prevenir as infecções originadas de alimentos.

Prevalence of celiac disease in siblings of Iranian patients with celiac disease / Prevalência de doença celíaca em filhos de pais iranianos com doença celíaca

CONTEXT: Celiac disease, one of the best-known autoimmune human leukocyte antigen-dependent disorders, has a relatively increased prevalence in first-degree relatives. OBJECTIVE: To determine the prevalence of celiac disease in siblings of patients with confirmed celiac disease. METHODS: Siblings of confirmed celiac disease patients in our center were identified and enrolled in this study. Their serum immunoglobulin A and tissue transglutaminase antibody-enzyme-linked immunosorbent assay (anti-tissue transglutaminase, immunoglobulin A, and immunoglobulin G) were measured and multiple endoscopic duodenal biopsy specimens were obtained with parental consensus. Celiac disease was confirmed by observation of characteristic histological changes. RESULTS: A total of 49 children (male, 29; female, 20; age, 2-16 years) with confirmed celiac disease in a pediatric gastroenterology ward were studied from 1999 to 2006. We found 30 siblings (female, 16) all shared in both parents. The only measurement available was for immunoglobulin A tissue transglutaminase antibody. A duodenal biopsy was performed in all 30 siblings. Clinical findings such as abdominal pain, fatigue, growth retardation and diarrhea were found in 53.3 percent of the completely studied siblings, and positive serology without histological changes was identified in four cases. Both serology and biopsy (confirmed new cases) were positive in 2 of the 30 siblings. CONCLUSION: High prevalence of celiac disease among siblings of patients with confirmed celiac disease necessitates serologic screening (and confirmatory biopsy if indicated) in families having celiac disease. It is advantageous to diagnose the disease as soon as possible because early diagnosis and diet intervention may prevent serious complications such as growth retardation, short stature, chronic diarrhea, and malignancy.

CONTEXTO: A doença celíaca, uma das mais conhecidas enfermidades autoimunes humanas, leucocitária antígeno-dependente, tem prevalência relativamente maior em parentes de primeiro grau. OBJETIVO: Determinar a prevalência de doença celíaca em irmãos de pacientes confirmadamente celíacos, filhos dos mesmos pais. MÉTODOS: Os irmãos de pacientes com doença celíaca confirmada no Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, em Ahvaz, Iran, foram identificados e incluídos no estudo. A imunoglobulina A sérica e o anticorpo transglutaminase tecidual por ensaio imunoenzimático (anti-transglutaminase tecidual, imunoglobulina A e imunoglobulina G) foram medidos e múltiplas biopsias endoscópicas duodenais foram obtidas com o consenso dos pais. A doença celíaca foi confirmada pela observação das características histológicas. RESULTADOS: Um total de 49 crianças (29 do sexo masculino; 20 do sexo feminino; de 2 a 16 anos) com diagnóstico confirmado de doença celíaca em uma enfermaria de gastroenterologia pediátrica foi estudado de 1999 a 2006. Encontraram-se 30 irmãos (16 do sexo feminino) e todos compartilhavam os mesmos pais dos pacientes. A única medida disponível foi do anticorpo tecidual imunoglobulina A transglutaminase. A biopsia duodenal foi realizada em todos os 30 irmãos. As manifestações clínicas como dor abdominal, fadiga, retardo do crescimento e diarréia foram encontradas em 53,3 por cento dos irmãos estudados completamente, e a sorologia positiva sem alterações histológicas foi identificada em quatro casos. Ambas, sorologia e biopsia (novos casos confirmados) foram positivas em 2 dos 30 irmãos. CONCLUSÕES: A prevalência de doença celíaca entre irmãos de pais confirmadamente celíacos exige triagem sorológica e biopsia de confirmação, se indicada, em familiares com doença celíaca. Diagnosticar a doença o mais rápido possível traz vantagens, pois o diagnóstico precoce e a intervenção dietética podem prevenir complicações graves, como retardo do crescimento, baixa estatura, diarreia crônica e malignidade.

Prevalence of intestinal parasites in a population in south of Tehran, Iran / Prevalência de parasitas intestinais em população no sul do Teerã, Irã

The aim of this study was to describe epidemiologic characteristics of intestinal parasites in a population in south of Tehran, Iran. A retrospective cross-sectional study of patients with suspicious intestinal parasitic infections referred to the Zakaria Razi Laboratory in Shahre-Ray, southern Tehran, Iran, was conducted from April 21, 2004 to October 20, 2005. All stool samples were examined and socio-demographic informations were retrieved. Of 4,371 referred patients, 466 (239 males and 227 females) were laboratory diagnosed with intestinal parasites, with a period prevalence of 10.7 percent. Blastocystis hominis (B. hominis) and Giardia lamblia (G. lamblia) were the most frequent intestinal parasites. More than half of patients aged ³ 18 years had a low level of educational attainment (e.g. illiterate, primary school, high school) (170/331, 54.1 percent). Further, majority of patients were homemakers (42.3 percent, 140/331) or workers (28.1 percent, 93/331) employed in various business settings such as food industry and construction. Findings of this study showed that intestinal parasitic infections are still a major public health challenge in Iran that needs to be addressed. We believe that public education, improving sanitation conditions of underdeveloped areas/communities, community involvement, and supporting evidence-based practice/programs are the major keys to success in preventing the spread of intestinal parasitic infections in Iran.

O própósito deste estudo foi descrever as características epidemiológicas dos parasitas intestinais em população do sul de Teerã, Irã. Um estudo retrospectivo seccional cruzado de pacientes com suspeita de infecções parasitárias intestinais enviados ao Laboratório Zakaria Razi em Shahre-Ray, sul do Teerã, Irã foi conduzido de 21 de abril de 2004 a 20 de outubro de 2005. Todas as amostras de fezes foram examinadas e as informações sócio-demográficas recuperadas. De 4371 pacientes enviados, 466 (239 homens e 227 mulheres) foram diagnosticados laboratorialmente como portadores de parasitas intestinais com prevalência no período de 10,7 por cento. Blastocystis hominis (B. hominis) e Giardia lamblia (G. lamblia) foram os parasitas intestinais mais frequentes. Mais da metade dos pacientes ³ 18 anos tinham baixo nível educacional (por exemplo: analfabetos, escola primária, 2º grau completo) (170/331, 54,1 por cento). Mais ainda, a maioria dos pacientes eram empregados domésticos (42,3 por cento, 140/331) ou trabalhadores (28,1 por cento, 93/331) empregados em diversos tipos de serviços, tais como a indústria de alimentos e construção. Achados deste estudo mostraram que as infecções parasitárias intestinais são ainda um desafio importante em saúde pública no Irã que necessita ser resolvido. Acreditamos que a educação pública, a melhoria das condições sanitárias em áreas pouco desenvolvidas/comunidades, envolvimento da comunidade, e programas práticos baseados nas evidências, são as principais chaves do sucesso na prevenção da disseminação das infecções parasitárias no Irã.

Clinical and biochemical manifestation produced by scorpion (Hemiscorpius lepturus) venom in experimental animals

Several studies have been published about the clinical and biochemical manifestations produced by the venom of scorpions of the Buthidae family, but very few reports have indicated the manifestations induced by the venom of the Scorpionidae family. Hemiscorpius lepturus is an important scorpion species present in the south and southwestern part of Iran, causing morbidity and mortality in children and adults. For the present study, H. lepturus venom was extracted by electric shock and subcutaneously injected (6.3mg/kg) into a group of six rabbits. Blood collection was carried out before and three hours after venom injection for determination of osmotic fragility and levels of blood sugar, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine phosphokinase (CPK) and alkaline phosphatase (ALP). In vitro studies were also carried out to verify the osmotic fragility of red blood cells (RBCs) exposed to venom concentrations ranging from 0-90µg/2ml blood. Results showed the extreme effect of this venom on the lysis of RBCs both in vitro and in vivo. Venom injection caused significant (p>0.001) increase in ALT, AST, LDH and blood sugar levels. There was also an increase in CPK, and ALP levels after venom injection; however, it was not statistically significant. All animals died four hours after having received the venom. The current study revealed that the neurological effect of H. lepturus venom is similar to that of scorpions of the Buthidae family. However, they differ in RBCs lysis, which was highly significant when induced by H. lepturus venom, probably due to the presence of a type of phospholipase in this venom. Further studies are needed to provide a clearer view of the mechanism of action of H. lepturus venom.(AU)