Effect of Rodent Control Program on Incidence of Zoonotic Cutaneous Leishmaniasis, Iran.

We report the effect of a rodent control program on the incidence of zoonotic cutaneous leishmaniasis in an endemic region of Iran. A 1-year interruption in rodent control led to 2 years of increased incidence of zoonotic cutaneous leishmaniasis. Restarting rodent control led to a decline of zoonotic cutaneous leishmaniasis.

Prevalence of intestinal protozoan parasites among Asian schoolchildren: a systematic review and meta-analysis.

PURPOSE: Intestinal protozoan parasites among Asian schoolchildren are a subject of concern due to their prevalence and potential health impact. Understanding and addressing this issue is crucial for public health in the region. METHODS: We conducted a comprehensive search for articles published up to December 2023 across four databases, including Scopus, PubMed, ProQuest, and Web of Science. To estimate the combined prevalence, a random-effects model with a 95% confidence interval (CI) was applied, and the statistical analysis was performed using meta-analysis packages in R version (3.6.1). This study is registered with PROSPERO (CRD42023481146). RESULTS: Among 131 eligible articles, the prevalence of intestinal protozoan parasites was 0.208 (95% CI = 0.180-0.238). Lebanon and Tajikistan had the highest country-level prevalence at 0.851 and 0.836, respectively, with Giardia duodenalis being the most prevalent species at 0.082. CONCLUSION: In summary, our study highlights the urgent public health issue of protozoan parasites among Asian schoolchildren due to poor sanitation and water quality. Immediate interventions are essential, considering climate and socioeconomic factors, to combat these infections and improve overall health.

The yield of early-pregnancy homeostasis of model assessment -insulin resistance (HOMA-IR) for predicting gestational diabetes mellitus in different body mass index and age groups.

BACKGROUND: Early prediction of gestational diabetes mellitus(GDM) can be beneficial for lifestyle modifications to prevent GDM. The aim of this study was to investigate the predictive values of Homeostasis of Model Assessment -Insulin Resistance (HOMA-IR) in early pregnancy to predict GDM development in different body mass index (BMI) and age risk categories. MATERIALS AND METHODS: This study is part of the Qazvin Maternal and Neonatal Metabolic Study (QMNMS) in Iran (2018-2021). In this prospective longitudinal study, pregnant women with a gestational age ≤ 14 weeks were enrolled in the study using convenience sampling method and were followed up until delivery to investigate risk factors for maternal and neonatal complications. Data collection was done using questionnaires. Serum sampling was done at a gestational age ≤ 14 weeks and sera were frozen until the end of study. GDM was diagnosed at 24-28 weeks of pregnancy using 75gr oral glucose tolerance test. Fasting blood glucose and insulin were measured in sera taken during early pregnancy in 583 participants. The Mann-Whitney U test, independent t-test, and Chi-square test were used for comparing variables between groups. The logistic regression analysis was used to examine the independent association of HOMA-IR with GDM development and receiver operating characteristic analysis was used for finding the best cut-off of HOMA-IR for predicting GDM. RESULTS: GDM was developed in 90 (15.4%) of the participants. The third HOMA-IR tertile was independently associated with 3.2 times higher GDM occurrence (95% CI:1.6-6.2, P = 0.001). Despite the high prevalence of GDM in advanced maternal age (GDM rate = 28.4%), HOMA-IR had no association with GDM occurrence in this high-risk group. In both normal BMI and overweight/obese groups, HOMA-IR was a moderate predictor of GDM development (AUC = 0.638, P = 0.005 and AUC = 0.622, P = 0.008, respectively). However, the best cut-off for predicting GDM was 2.06 (sensitivity 67.5%, specificity 61.1%) in normal BMI and 3.13 (sensitivity 64.6%, specificity61.8%) in overweight/obese BMI. CONCLUSION: The present study revealed the necessity of considering the BMI and age risk groups when using the HOMA-IR index to predict GDM. Using lower cut-offs is more accurate for women with a normal BMI. In the advanced maternal age, there is no yield of HOMA-IR for predicting GDM.

Association of weekly or biweekly use of 50 000 IU vitamin D3 with hypervitaminosis D.

Since the beginning of the COVID-19 pandemic, many Iranian people have been taking 50 000 IU of vitamin D3 on weekly or biweekly bases in order to enhance their immune system function. This cross-sectional study was conducted on the patients of endocrinology clinic to compare 25(OH)D levels of weekly or biweekly consumption with the monthly users of vitamin D3 50 000 IU. The level >100 ng/mL of 25(OH)D was defined as hypervitaminosis D. In total, 211 patients (108 and 103 patients in monthly and weekly/biweekly groups, respectively) were studied. In the subgroups of weekly and biweekly users, the rates of hypervitaminosis were 18.9% and 4.5%, respectively. In contrast, only 0.9% of monthly users had hypervitaminosis D. The highest vitamin D value of 185 ng/mL was detected in a patient who had consumed 50 000 IU vitamin D3 weekly for 6 years. No hypercalcaemia was detected in patients with hypervitaminosis D.

Hypocalcemia in hospitalized patients with COVID-19: roles of hypovitaminosis D and functional hypoparathyroidism.

INTRODUCTION: Despite the high prevalence of hypocalcemia in patients with COVID-19, very limited studies have been designed to evaluate etiologies of this disorder. This study was designed to evaluate the status of serum parameters involved in calcium metabolism in patients with COVID-19 and hypocalcemia. MATERIALS AND METHODS: This cross-sectional study was conducted on 123 hospitalized patients with COVID-19. Serum concentrations of PTH, 25 (OH) D, magnesium, phosphate, and albumin were assessed and compared across three groups of moderate/severe hypocalcemia (serum total calcium < 8 mg/dl), mild hypocalcemia (8 mg/dl ≤ serum total calcium < 8.5 mg/dl) and normocalcemia (serum total calcium ≥ 8.5 mg/dl). Multivariate analyses were performed to evaluate the independent roles of serum parameters in hypocalcemia. RESULTS: In total, 65.9% of the patients had hypocalcemia. Vitamin D deficiency was found in 44.4% and 37.7% of moderate/severe and mild hypocalcemia cases, respectively, compared to 7.1% in the normal serum total calcium group (P = 0.003). In multivariate analysis, vitamin D deficiency was independently associated with 6.2 times higher risk of hypocalcemia (P = 0.001). Only a minority of patients with hypocalcemia had appropriately high PTH (15.1% and 14.3% in mild and moderate/severe hypocalcemia, respectively). Serum PTH was low/low-normal in 40.0% of patients with moderate/severe low-corrected calcium group. Magnesium deficiency was not associated with hypocalcemia in univariate and multivariate analysis. CONCLUSION: Vitamin D deficiency plays a major role in hypocalcemia among hospitalized patients with COVID-19. Inappropriately low/low-normal serum PTH may be a contributing factor in this disorder.

Molecular identification and phylogenetic analysis of free-living amoeba in the water resources of Arak, Iran.

The aim of the present study was to detect free-living amoeba (FLA) in the water resources of Arak, Iran using molecular tools. A total of 154 samples were collected from different water supplies. Molecular analyses, sequencing, and phylogenetic study were conducted to confirm the species and genotypes of FLA. Fisher exact test was used to determine the significance. Of 154 water samples, 19 (12.3%) samples were tested positive for FLA. Three genotypes of Acanthamoeba including T4, subtype D, and T5 were identified among the isolates. The pathogenicity assay showed that the isolate of Acanthamoeba in drinking water was highly pathogenic. Three species of Naegleria, including N. australiensis, N. pagei, and N. gruberi were found among the samples. Six isolates of Vermamoeba were identified as V. vermiformis. Meanwhile, three other species including Vannella sp., Vahlkampfia avara, and Stenamoeba polymorpha were also recovered from the water samples. Statistical analysis showed a significant difference between the various water resources contaminated with FLA. This is the first study to reveal the presence of S. polymorpha in water sources in Iran. According to the findings of the present study, health officials should be beware of potential public health impacts of FLA in water resources.

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.

A systematic review and meta-analysis on the co-infection of Helicobacter pylori with intestinal parasites: public health issue or neglected correlation?

The current study was conducted to assess the prevalence and odds ratio (OR) of co-infection of Helicobacter pylori (H. pylori) and intestinal parasites (IPs). English databases were searched. A total of 18 studies including 14 studies with cross-sectional design (a total of 3739 participants) and 4 studies with case-control design (397 patients and 320 controls) met the eligibility criteria. The pooled prevalence of H. pylori, intestinal parasite infections (IPIs), and their co-infections in different populations were 48.3% (95% CI, 34.1-62.8%), 15.4% (95% CI, 10-22.8%), and 11% (95% CI, 6.7-17.6%), respectively. The co-infection of H. pylori and Giardia was 7.6% (95% CI, 4.9-11.7%). Although statistically not significant, the risk of co-infection of H. pylori and IPIs was higher in case group compared to control group (OR, 1.59; 95% CI, 0.77-3.25). The overlaps between H. pylori and IPIs in countries with lower human development index (HDI) and income levels were high.

A case report of rhino-facial mucormycosis in a non-diabetic patient with COVID-19: a systematic review of literature and current update.

BACKGROUND: COVID-19 disease may be associated with a wide range of bacterial and fungal infections. We report a patient with COVID-19 infection who developed rhino-facial mucormycosis during treatment with corticosteroids. CASE PRESENTATION: A 59-year-old non-diabetic male patient was admitted with a diagnosis of COVID-19 based on positive RT-PCR and CT of the lungs. Due to sever lung involvement, he was treated with methylprednisolone. The patient was re-admitted to hospital, due to nasal obstruction and left side facial and orbital swelling, several days after discharge. In sinus endoscopic surgery, debridement was performed and the specimens were sent to pathology and mycology laboratories. A nasal biopsy showed wide hyphae without septa. The sequenced PCR product revealed Rhizopus oryzae. Despite all medical and surgical treatment, the patient died. In addition, the characteristics of patients with COVID-19-associated mucormycosis were reviewed in 44 available literatures. In most studies, diabetes mellitus was the most common predisposing factor for mucormycosis. CONCLUSION: Our report highlights the need for assessing the presence of mucormycosis in patients with COVID-19 and also it shows that physicians should consider the potential for secondary invasive fungal infections in COVID-19 cases.

Global prevalence of Trichomonas vaginalis among female sex workers: a systematic review and meta-analysis.

Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite, Trichomonas vaginalis. Female sex workers are intensely affected by the infection, since they have frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of T. vaginalis in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of T. vaginalis was 16% (95% CI 13-19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12-19%), 16% (95% CI 10-24%), and 22% (95% CI 13-32%), respectively. Moreover, the infection was most prevalent at the mean age of 30-36 (20%, 95% CI 11-30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7-46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14-34%). Our results revealed that the worldwide prevalence of T. vaginalis was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent T. vaginalis infection in sex workers.

Prevalence of Toxocara and Toxascaris infection among human and animals in Iran with meta-analysis approach.

BACKGROUND: Toxocariasis is a worldwide zoonotic parasitic disease caused by species of Toxocara and Toxascaris, common in dogs and cats. Herein, a meta-analysis was contrived to assess the prevalence of Toxocara/Toxascaris in carnivore and human hosts in different regions of Iran from April 1969 to June 2019. METHODS: The available online articles of English (PubMed, Science Direct, Scopus, and Ovid) and Persian (SID, Iran Medex, Magiran, and Iran Doc) databases and also the articles that presented in held parasitology congresses of Iran were involved. RESULTS: The weighted prevalence of Toxocara/Toxascaris in dogs (Canis familiaris) and cats (Felis catus) was 24.2% (95% CI: 18.0-31.0%) and 32.6% (95% CI: 22.6-43.4%), respectively. Also, pooled prevalence in jackal (Canis aureus) and red fox (Vulpes vulpes) was 23.3% (95% CI: 7.7-43.2%) and 69.4% (95% CI: 60.3-77.8%), correspondingly. Weighted mean prevalence of human cases with overall 28 records was 9.3% (95% CI: 6.3-13.1%). The weighted prevalence of Toxocara canis, Toxocara cati, and Toxascaris leonina was represented as 13.8% (95% CI: 9.8-18.3%), 28.5% (95% CI: 20-37.7%) and 14.3% (95% CI: 8.1-22.0%), respectively. CONCLUSION: Our meta-analysis results illustrate a considerable prevalence rate of Toxocara/Toxascaris, particularly in cats and dogs of northern parts of Iran. The presence of suitable animal hosts, optimum climate and close contact of humans and animals would have been the reason for higher seroprevalence rates of human cases in our region. Given the significance clinical outcomes of human Toxocara/Toxascaris, necessary measures should be taken.

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.

The global prevalence and associated risk factors of Eimeria infection in domestic chickens: A systematic review and meta-analysis.

BACKGROUND: Eimeria is a protozoan parasite that affects poultry, particularly chickens, causing a disease known as coccidiosis. This disease imposes substantial significant economic challenges to the poultry sector. OBJECTIVES: The current study aimed to estimate the global prevalence and associated risk factors of Eimeria in domestic chickens. METHODS: Multiple databases (Scopus, PubMed, ProQuest, Web of Science and Google Scholar) were searched for articles published until June 2023. The pooled prevalence was estimated using a random-effects model with a 95% confidence interval. The statistical analysis was conducted using meta packages in R version (3.6.1). RESULTS: In total, 41 articles fulfilled the eligibility criteria. The global pooled prevalence was 44.3% (36.9%-51.8%) with Eimeria tenella (38.7%, 30.1%-47.7%) as the most prevalent species. The highest pooled prevalence was related to the Western Pacific Region (80.5%, 72.6%-87.3%) and urban areas (44.4%, 36.5%-52.6%). Moreover, areas with humid subtropical climates represent the highest overall prevalence (75.8%, 46.6%-95.9%). CONCLUSION: The necessity for robust and innovative strategies for preventing and managing this disease cannot be overstated. Addressing Eimeria impact is crucial not only for safeguarding poultry health but also for sustaining the economic viability of the poultry industry.

First molecular insights into gastrointestinal helminths of domestic birds in the Caspian Sea Littoral of Iran with an emphasis on the One Health concern.

The current investigation was carried out during the period from July 2022 to March 2023, aiming to investigate the prevalence of gastrointestinal helminths in domestic birds collected from traditional markets in Guilan province. One hundred forty-eight domestic birds, including chickens (Gallus gallus domesticus), domestic ducks (Anas platyrhynchos domesticus), greylag geese (Anser anser), and domestic turkeys (Meleagris gallopavo domesticus) were examined. Totally, 42.56% of the investigated birds were positive for helminthic parasites. Morphological analysis revealed varying infection rates among birds: Echinostoma revolutum (5.40%), Hypoderaeum conoideum (2.02%), Cloacotaenia megalops (0.67%), Hymenolepididae family (4.05%), Ascaridia galli (16.89%), and Heterakis gallinarum (4.72%). The investigation involved molecular analysis of the 18S and ITS1 + 5.8S + ITS2 rRNA gene regions. The findings indicated that the 18S region of nematode isolates exhibited a similarity of 92 to 100% with sequences in the GenBank, whereas trematode and cestode isolates showed a gene similarity ranging from 88 to 99%. The ITS regions of nematode, trematode, and cestode isolates exhibited genetic similarities ranging from 87 to 100%, 73-99%, and 75-99%, respectively. Furthermore, phylogenetic analysis confirmed the categorization of the identified species within the Ascaridiidae, Heterakidae, Hymenolepididae, and Echinostomatidae families, indicating their close affinity with previously documented species. Implementing precise control measures such as consistent monitoring, adequate sanitation protocols, and administering anthelmintic treatments is crucial for effectively managing parasitic infections in free-range and backyard poultry farms. Additionally, conducting further surveys is advisable to assess the impact of these parasites on the health and productivity of poultry in the investigated area.

A global systematic review and meta-analysis on the babesiosis in dogs with special reference to Babesia canis.

BACKGROUND: Canine babesiosis is a clinically significant tick-transmitted disease caused by several species of the intraerythrocytic protozoan parasite Babesia, which result in a wide range of clinical manifestations, from mild, transient infection to serious disease and even death. OBJECTIVES: The current study aimed to estimate the global prevalence and associated risk factors of Babesia in dogs. METHODS: Multiple databases (PubMed, Scopus, ProQuest, Web of Science and Google Scholar) were searched for relevant literature published from January 2000 up to December 2022. The statistical analyses were performed based on the R software (version 3.6) meta-package. RESULTS: Out of 23,864 publications, 229 studies met the inclusion criteria. The pooled prevalence of canine babesiosis was 0.120 (95% CI; 0.097-0.146). The highest pooled prevalence was found in Europe (0.207, 95% CI; 0.097-0.344). Among several species, Babesia canis was the most prevalent parasite (0.216, 95% CI; 0.056-0.441). The highest pooled prevalence of Babesia in dogs was observed in the summer season (0.097, 95% CI; 0.040-0.174). CONCLUSIONS: Regular screening and appropriate control strategies are recommended for the prevention of transmission of tick-borne disease transmission among dogs.

Global prevalence of Toxoplasma gondii in birds: A systematic review and meta-analysis.

Among the potential animal reservoirs of the zoonotic parasite T. gondii, birds have received relatively little attention. This systematic review and meta-analysis aimed to assess the global status and to provide an overview of the epidemiology of T. gondii infection in birds. The standard protocol of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Scopus, PubMed, Web of Science, Science Direct, ProQuest, and Google Scholar were searched for relevant publications from January 1990, to March 2024. All peer-reviewed original research articles describing the prevalence of T. gondii in birds were included. Inclusion and exclusion criteria were applied, and both direct and indirect detection were considered. The point estimates and 95% confidence intervals were calculated using the meta-package in R (version 3.6.1). The variance between studies (heterogeneity) was quantified by the I2 index. Finally, 258 articles (including 380 datasets) were eligible for inclusion in the systematic review and meta-analysis. The global pooled prevalence was 24% (21 - 26%). The highest prevalence of T. gondii was observed in buzzards (52%, 34 - 70%), turkeys (31%, 17 - 46%), and chickens (30%, 26 - 34%). The present study provides a comprehensive view of the global prevalence of T. gondii in birds.

A systematic review and meta-analysis of protozoan parasite infections among patients with mental health disorders: an overlooked phenomenon.

BACKGROUND: Patients with mental disorders have a high risk of intestinal parasitic infection due to poor hygiene practices. Hence, to better clarify this overlooked phenomenon, the current study is conducted to determine the global prevalence of protozoan parasite infections in patients with mental disorders and investigate the associated risk factors. METHODS: Several databases (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched for papers published until December 2022. The fixed effect meta-analysis was used to estimate the overall odds ratio (OR) and pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI). RESULTS: Totally, 131 articles (91 case-control and 40 cross-sectional studies) met the eligibility criteria. Patients with mental disorders were significantly at higher risk for protozoan parasites than healthy controls (OR: 2.059, 1.830-2.317). The highest pooled OR (2.485, 1.413-4.368) was related to patients with neurodevelopmental disorders, and the highest pooled prevalence was detected in patients with neurodevelopmental disorders (0.341, 0.244-0.446), followed by bipolar and related disorders (0.321, 0.000-0.995). Toxoplasma gondii was the most prevalent protozoan parasite (0.343, 0.228-0.467) in cross-sectional studies and the highest pooled OR was related to Cyclospora cayetanensis (4.719, 1.352-16.474) followed by Cryptosporidium parvum (4.618, 2.877-7.412). CONCLUSION: Our findings demonstrated that individuals afflicted with mental disorders are significantly more susceptible to acquiring protozoan parasites in comparison to healthy individuals. Preventive interventions, regular screening, and treatment approaches for parasitic diseases should be considered for patients with mental disorders.

Norwegian Scabies in a 70-Year-Old Renal Transplant Recipient: A Case Report.

Crusted scabies (CS) is an extremely contagious variant of classical scabies with substantial morbidity and mortality. It is the most prevalent in immunocompromised patients, those with some underlying diseases, and individuals with physical and mental disabilities. Herein, we report a 70-year-old woman who presented with generalized erythema with itchy hyperkeratotic plaques and crusted lesions on her face, hands, between fingers, neck, scalp, abdomen, and legs up to the knees. She was diagnosed with CS and subsequently isolated and treated with ivermectin (200 µg/kg) and 5% permethrin cream. She died a short time after being admitted, and it was due to severe septic shock and cardiac arrest. Immediate isolation and treatment of CS patients is essential to prevent morbidity and mortality. Prompt diagnosis and precise medical management in both patients and healthcare settings is required.

Anti-parasitic activity of a chimeric peptide Cecropin A (2-8)-Melittin (6-9) (CM11) against tachyzoites of Toxoplasma gondii and the BALB/c mouse model of acute toxoplasmosis.

Toxoplasmosis is a zoonotic disease that infects most animals, including humans. Pyrimethamine/sulfadiazine is the standard treatment for toxoplasmosis. Although this treatment has been successful, it is often associated with side effects that cannot be tolerated. Therefore, various compounds have been proposed as alternative treatments for toxoplasmosis. Antimicrobial peptides (AMPs) act on various pathogens, from viruses to protozoa. The purpose of the present study was to evaluate the effects of CM11 on in vitro and in vivo Toxoplasma gondii infection. For in vitro experiments, VERO cells were treated with different concentrations of CM11 (1-128 µg/ml) compared to sulfadiazine (SDZ) (0.78-100 µg/ml). MTT and lactate dehydrogenase (LDH) assays evaluated the cell viability and plasma membrane integrity. Then, the inhibitory concentration (IC50) values were determined for treating tachyzoites of T. gondii before or on cells previously infected. Annexin V-FITC/propidium iodide (PI) staining was used to distinguish viable and apoptotic cells. The effect of CM11, SDZ, and a combination of CM11 and SDZ was evaluated in the BALB/c mouse model of acute toxoplasmosis. CM11 was effective on tachyzoites of T. gondii and had a time and dose-dependent manner. The results of the MTT assay showed that the CC50 values of CM11 and SDZ were estimated at 17.4 µg/ml and 62.3 µg/ml after 24-h, respectively. The inhibitory concentration (IC50) of CM11 and SDZ on infected cells was estimated at 1.9 µg/ml and 1.4 µg/ml after 24-h, respectively. The highest rate of apoptosis (early and late) in high concentrations of SDZ and CM11 was determined for tachyzoites (2.13 % and 13.88 %), non-infected VERO cells (6.1 % and 19.76 %), and infected VERO cells (7.45 % and 29.9 %), respectively. Treating infected mice with CM11 and a combination of CM11 and SDZ had increased survival time. Based on the mentioned results, it can be concluded that CM11 has a beneficial effect on tachyzoites of T. gondii in vitro. The result of the mouse model suggests that CM11, either alone or in combination with other chemotherapeutic agents, could be a potential therapeutic for toxoplasmosis. Hence, antimicrobial peptides could be applied as promising anti-toxoplasma agents for treating toxoplasmosis.