Molecular Detection of Leishmania Infection in Phlebotomine Sand Flies from an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in Iran.

Background: Due to the outbreak of zoonotic cutaneous leishmaniasis (ZCL), a disease caused by Leishmania major and mainly transmitted by Phlebotomus papatasi, in Damghan City, Semnan Province, the probable vectors of the disease were investigated in the city from 20 March 2016 to 20 January 2018. Methods: Sand flies were collected from indoors and outdoors biweekly by sticky traps in different parts of the city. The trapped sand flies were stored in 70% ethanol. They were identified and checked for Leishmania infections using nested-PCR method and specific primers; CSB1XR, CSB2XF, LiR, and 13Z. Results: Overall, 1862 phlebotomine sand flies of Ph. papatasi (48.8%), Ph. andrejevi (8.3%), Ph. caucasicus (7.7), Ph. mongolensis (2%), Ph. sergenti (1.2%), Ph. alexandri (0.7%), Sergentomyia murgabiensis sintoni (29.3%), and Se. sumbarica (2%) were collected indoors (31.1%) and outdoors (68.9%). The highest and lowest numbers of collected sand flies were belonging to Ph. papatasi (48.8%) and Ph. alexandri (0.7%) respectively. 2.2% of the examined sand flies were shown to be infected with L. major and all were belonging to Ph. papatasi. Conclusion: This study confirms the report of Ph. papatasi infection with L. major and also the existence of Ph. sergenti and Ph. alexandri, the potential vectors of L. tropica and L. infantum respectively, in Damghan City. According to the findings, it is necessary for health officials to plan and take action to prevent the occurrence of ZCL epidemic in the city as well as the occurrence of other forms of leishmaniasis.

Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran.

OBJECTIVES: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. METHODS: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. RESULTS: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. CONCLUSIONS: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

Genotyping of Toxoplasma gondii Strains from Goats in Jahrom District, Southern Iran.

PURPOSE: Toxoplasma gondii is transmitted congenitally or acquired by consumption of food and water contaminated with cysts or oocysts. This study aimed at genotyping T. gondii strains from slaughtered goats in Jahrom. METHODS: A total of 561 specimens (heart, diaphragm, and tongue) from 187 slaughtered goats were collected from Jahrom slaughterhouse. After DNA extraction, the T. gondii strains were genotyped by the nested PCR-RFLP based on GRA6 and 3', and 5' ends of the SAG2 gene. RESULTS: T. gondii infection was present in 18.2% of cases. Among the examined organs, the diaphragm was more disposed to the infection (10.2%). Furthermore, infection rates of the heart and tongue were 8.6% and 3.7%, respectively. Concurrent infection in the heart and diaphragm, tongue and diaphragm, and heart and tongue were 3.2%, 0.5%, and 0.5%, respectively. In genotyping experiments, genotype I was the most frequent genotype of T. gondii (58.8%), followed by type II (23.5%), type III (11.8%), and a combination of type I and II (5.9%). CONCLUSIONS: The results of this study showed the presence of different genotypes of T. gondii in goats including three major and mixed genotypes. These results can be useful in toxoplasmosis control and prevention.

Molecular Detection of Leishmania major in Hemiechinus auritus: A Potential Reservoir of Zoonotic Cutaneous Leishmaniasis in Damghan, Iran.

BACKGROUND: Zoonotic cutaneous leishmaniasis caused by Leishmania major is endemic in 17 of 31 Iranian provinces. Various species of rodents have been introduced as the main reservoirs of the disease. This study was conducted to determine the natural infection of hedgehogs with Leishmania spp. in an endemic area of the disease, northern Iran. METHODS: Fifteen long-eared hedgehogs were captured alive during 18 months study period, from Apr 2015 to Sep 2016, in Damghan City, Semnan Province, Iran. The animals were identified using apparent characteristics and to determine the Leishmania infection, impression smears were prepared from their ear lobes, hind feet, livers, and spleens. Microscopic examination and semi-nested PCR were applied to determine the infection and to identify the parasites species respectively. RESULTS: All examined animals were identified as Hemiechinus auritus (Family: Erinaceidae). In microscopic examination, 8 (53.3%) samples were shown to be infected with Leishmania parasites. The higher and lower rate of the infection was observed in the ears as well as the feet and in the liver specimens, 53.3%, and 33.3% respectively. Forty percent (6/ 15) of the samples were molecularly positive and all were identified as L. major parasites. All the examined animals in autumn and 50% of them in summer were shown to be infected with Leishmania parasites. CONCLUSION: This study demonstrated the natural infection of H. auritus with L. major for the first time in Damghan City and introduced these mammals as new potential reservoirs of ZCL in the study area.

Prevalence of alcohol consumption and related factors among students of higher education centers in one of the northeastern cities of Iran.

INTRODUCTION: Knowing the prevalence and the factors associated with alcohol abuse among students can be an important step in initiating preventive measures. The purpose of this study was to determine the prevalence of alcohol consumption and its related factors in students of higher education centers in one of the northeastern cities of Iran in 2017. METHODS: This descriptive-analytical study was performed on 668 students from 7 higher education centers. The samples were selected by stratified random sampling. The valid researcher-made questionnaires were issued to the subjects, and were collected immediately after being filled out. The obtained data were analyzed using appropriate statistical tests. RESULTS: Ninety-two (13.77%) students had history of alcohol consumption, with 55.6% continued to drink alcohol. The mean age of the consumers was 23.92 years, of whom 77.41% were male, 75% were single, 55.43% were non-indigenous, and 74.46% had history of smoking. 81.52% of the subjects were undergraduates, while 36.95% studied mathematics and engineering. There was a significant relationship between alcohol consumption and age, gender, GPA, being non-indigenous, personal residence, smoking, history of alcohol consumption in family and friends, satisfaction with academic major and city in which they study (p < 0.05). CONCLUSION: The findings showed that alcohol consumption was relatively high in students of higher education centers and many variables (ten out of fifteen studied variables) were involved in this process. Therefore, careful planning and serious measures are needed to prevent this problem.

Natural infection of Nesokia indica with Leishmania major and Leishmania infantum parasites in Damghan city, Northern Iran.

Various species of rodents are proven reservoir hosts of zoonotic cutaneous leishmaniasis in different provinces of Iran and potential reservoir hosts of zoonotic visceral leishmaniasis. Therefore, this study was conducted to determine the leishmanial infection of rodents in Damghan city from April to September, 2015. Sum of 100 rodents of three species; Nesokia indica (95), Mus musculus (3), and Microtus socialis (2), were trapped alive and their tissue samples were examined using parasitological and molecular (nested-PCR) methods. A total of 71% (71/100) of examined rodents were parasitological positive for Leishmania spp. amastigotes. The highest rate (72.6%; 69/95) of infection was related to the N. indica species. The microscopic observations showed that 42% of ear samples were positive. Additionally, 12% of rodents with negative ear result were positive in liver. 16 out of 41 (39%) parasitological positive samples, belonging to the N. indica, were shown molecularly positive. Of which, 15 were L. major (13 of ear and 2 of spleen samples) and one of spleen samples was L. infantum. This is the first report of N. indica natural infection with L. infantum parasite. To understand the role of this rodent as reservoir host of L. infantum, extant ecological and epidemiological studies are needed.

Evaluation of Correlation between the In Vitro Susceptibility of Field Isolates of Leishmania major and Clinical Outcomes of Meglumine Antimoniate Therapy in Fars Province, Iran.

BACKGROUND: This study was designed to detect whether there is a correlation between in vitro susceptibility of field isolates of Leishmania major and the clinical outcomes of meglumine antimoniate (Glucantime®) therapy, the mainstay of cutaneous leishmaniasis treatment in Iran. METHODS: Forty-three patients infected with L. major were enrolled in this study from October 2009 to March 2010 and categorized as responsive or unresponsive to Glucantime® treatment after receiving the appropriate therapy. Then, intracellular amastigote approach was conducted on these field strains to investigate in vitro drug susceptibility as well. RESULTS: At clinical level, out of 43 patients, 15 were clinically non-responsive and 28 were responsive to antimony therapy. All those 28 clinically sensitive strains were susceptible to antimony in the in vitro assay, whereas merely 11 isolates from 15 non-healing isolates were resistant in vitro. Finally, a good correlation (78.9%) with high sensitivity, specificity (100/73) between clinical outcomes and the in vitro susceptibility test was achieved. CONCLUSION: The intracellular amastigote model could be an appropriate assay for evaluation of the in vivo drug sensitivity of field isolates. However, more comprehensive studies with larger sets of isolates are needed to confirm these preliminary data.