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Background: Strongyloides stercoralis, a soil transmitted helminth, is well known as a potentially fatal parasite in immunosuppressed patients. Objectives: The current study aimed to evaluate the prevalence of strongyloidiasis in diabetic patients, in the central parts of Mazandaran province, Iran, using coprological examination and enzyme-linked immunosorbent assay (ELISA). Methods: Fresh stool and serum samples were obtained from diabetic patients. The stool samples were examined using direct smear and formalin-ether concentration methods. The serum samples were tested for the existence of Strongyloides sp. antibodies using a commercial diagnostic kit (Strongyloides - ELISA). Results: The overall prevalence rates were 13.3% (4/30) and 25.6% (46/180) using parasitological and ELISA methods, respectively. The sensitivity and specificity of ELISA compared with stool examination were 100% and 84.6%, respectively. The seroprevalence rate of this infection was higher in females (27.3%) than males (19.5%), and among participants living in rural regions (31%) compared with urban areas (20%). The prevalence rate of Strongyloides sp. infection was higher in patients with diabetic foot (39.1%) compared with cases with non-diabetic foot (23.6%). It also was higher in insulin dependent patients (29.9%) compared with non-insulin dependent subjects (23%). However, these differences were not statistically significant which may have resulted from the small sample size. Conclusions: Our findings demonstrated a high seroprevalence of Strongyloides sp. infection in diabetic patients. Furthermore, this is the first seroprevalence study of strongyloidiasis in diabetic patients from Iran. It seems that the ELISA technique can be used for the diagnosis of individual cases and is a good screening assay to rule out strongyloidiasis in diabetic patients.

Background: Demographic transition and increasing elderly population in Iran can be associated with age related disorders such as dementia. Recently, Helicobacter pylori infection was considered as a risk factor for cognitive impairment. Objectives: This study aimed to examine this relationship between H. pylori infection and cognitive impairment in Iranian elderly. Methods: This cross-sectional study was performed on elderly subjects initially enrolled in the Amirkola health and ageing project. Demographic information was collected using a questionnaire and all participants filled the mini-mental state examination (MMSE) questionnaire. The maximum MMSE score is 30 points. Scores of 25 to 30 out of 30 are considered normal 21 to 24 as mild, 10 to 20 as moderate and 20 ur/mL was considered positive. Results: The study was performed on 1514 individuals with an average age of 69.37.4 years. Overall, 836 (55.2 %) of the participants were male. Furthermore, 68.7% of the participants had normal MMSE score and 75.7% were seropositive for H. pylori. The risk of cognitive disorder in H. pylori positive patients (29.8%) was lower than H. pylori positive patients (35.9%) (RR = 0.81, CI95% = 0.67 - 0.97). No significant correlation was detected between H. pylori antibody level and MMSE score (r = 0.039, P = 0.129). Conclusions: In our population of elderly individuals in northern Iran, H. pylori infection was not associated with cognitive impairment in this large population.