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Introduction Cystic echinococcosis (CE) or hydatidosis is one of the most common diseases between humans and livestock that humans are considered as an accidental host. This disease has spread globally, especially in the Mediterranean region, including Iran. To the best of our knowledge, no specific research has been conducted to investigate the epidemiological status of this disease in Zahedan, Sistan and Baluchestan Province, Iran. Therefore, this study was performed to achieve that aim for the first time. Methods A cross-sectional study was performed to evaluate the seroprevalence of hydatid cyst among patients (n = 773) referring to Zahedan health centers within 2019–2020. Zahedan health centers were classified into five geographical regions. The sampling process from each area was conducted using a simple randomized cluster method. The correlation between seropositivity and risk factors was evaluated using the Chi-square test. Results The seroprevalence of hydatid cyst in Zahedan city was estimated at 3.6% (28 out of 773 samples). It was found that females were affected by this infection more than males, and the highest hydatid cyst seroprevalence rate was revealed in the age group of 31–50 years and the northeastern area of Zahedan. Although age, gender, vegetable consumption, soil contact had no significant influence on the risk of CE infection (P-value>0.05), the relationship of keeping dogs in the household and the presence of stray dogs in a living environment with seropositivity to CE was significant (P-value Conclusion The findings of this study showed that human hydatid cyst was common in Zahedan. Therefore, the implementation of preventive and hygienic principles, especially the presence of dogs in the household or stray dogs in the environment, should be a priority. Moreover, the various epidemiological aspects of this disease in Zahedan city should be taken into consideration.

Background: Malaria is one of the most serious parasitic diseases and the major health issue in tropical and subtropical countries. Objectives: This study aimed to investigate the type of infection of female Anopheles mosquitoes to sporozoites of Plasmodium species (Plasmodium vivax and Plasmodium falciparum), using nested polymerase chain reaction (PCR) in southeastern Iran. Methods: To determine the infections and Plasmodium species using the nested PCR in Sistan and Baluchestan Province (southeastern Iran), 360 female Anopheles mosquitoes were collected from the control villages of Chabahar and Konarak counties and examined by entomology check stations affiliated with Zahedan University of Medical Sciences in the second half of 2018. The mosquitos were caught manually from indoor places (humans and animals) as well as natural and artificial sites, i.e., pit-shelters. After DNA extraction, the molecular analysis was performed by nested PCR. Results: Of 200 species collected from Daregas, Owraki, and Bahu Kalat in Chabahar, four Anopheles stephensi (2%) were infected with P. vivax, and of 160 samples collected from the rural districts of Konarak, including Zarabad, Heyan, Islamabad, and Joholu, two An. stephensi (1.25%) were infected with P. falciparum. In this study, no mixed infection of Plasmodiumvivax and Plasmodium falciparum were observed. Conclusions: The present study showed that the only species infected with Plasmodium in the aforementioned regions was An. stephensi, which was the most frequent species of Anopheles among other species as well. The nested PCR could be the most suitable method for detecting Plasmodium parasites in malaria vectors, among other diagnostic methods.

Child Toxocariasis (CT) is one of the most important helminthic parasitic diseases in Iran. The current study was aimed to determine the seroprevalence of toxocariasis in children in Zahedan, southeast of Iran. In this cross-sectional study, serum samples of 373 children aged 3–13 years old referred to health centers in Zahedan were collected randomly with criteria based on the parameters that were used in earlier studies and examined for anti-Toxocara antibody using a commercial ELISA kit. Of the 373 recruited subjects, 206 (55.2%) were male and 167 (44.8%) were female. Most of the subjects (36.5%) were in the age group 3–4 years old. Anti-Toxocara antibodies were detected in the sera of five out of 373 individuals, corresponding to a seroprevalence rate of 1.3%. A significant correlation was found between the incidence of disease and eosinophilia, a history of contact with dogs or cats, as well as the consumption of raw vegetables and drinking of contaminated water. There was no significant correlation between prevalence and gender or age. The finding of this study revealed that the prevalent CT is relatively low in Zahedan region. The rate of CT infection in the southeast of Iran was lower than the rate in other parts of Iran.

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran. Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

Toxoplasma gondii is zoonotic protozoa that spread throughout the world. The aim of current study was determination of the prevalence of T. gondii infection in patient undergoing chemotherapy for malignancies using ELISA and two different molecular tests including Nested-PCR and LAMP techniques. This study was carried out in Ali Ibn Aboutaleb hospital in Zahedan cities, southeast of Iran. Totally, 154 serum samples from patient were test for detection of IgG and IgM antibodies against T. gondii by ELISA test. All of the samples were also test by Loop amplification (LAMP) and Nested-PCR with RE gene. Totally, 39.4% of the sample sera from cases were positive for IgG against T. gondii. After using RE-Nested-PCR technique, 29.8% sample sera were positively. After using LAMP technique, 33.1% of the samples were found to be positive. Based on our result, the RE-LAMP technique was more effective than RE-nested-PCR method in the detection of T. gondii DNA.

Parasitological methods are not helpful for the diagnosis of fascioliasis in acute and invasive periods of the disease. Detection of coproantigens seems to be a suitable alternative approach in the diagnosis of fascioliasis. The present study aimed to develop a reliable antigen detection system, using monoclonal antibodies raised against excretory-secretory (ES) antigen of Fasciola hepatica, for the diagnosis of fascioliasis. Fasciola adult worms were collected from the bile ducts of infected animals. Species of the fluke was determined by polymerase chain reaction-restriction fragment length polymorphism (RFLP-PCR). ES antigen of F. hepatica was prepared. For production of monoclonal antibodies, mice were immunized with ES antigens of F. hepatica. Spleen cells from the immunized mice were fused with NS-1 myeloma cells, using polyethylene glycol. Hybridoma cells secreting specific antibody were expanded and cloned by limiting dilution. Moreover, polyclonal antibody was produced against F. hepatica ES antigen in rabbits. A capture enzyme-linked immunosorbent assay (ELISA) system, using produced monoclonal antibody, was designed and stool samples of infected animals along with control samples were tested by the system. The capture ELISA detected the coproantigen in 27 of 30 (90%) parasitologically confirmed fascioliasis cases, while 4 of 39 (10.25%) samples infected with other parasitic infections showed a positive reaction in this system. No positive reactivity was found with healthy control samples. Accordingly, sensitivity of 90% and specificity of 94.2% were obtained for the capture ELISA system. The results were compared with those obtained with commercial BIO-X ELISA, and a very good (kappa = 0.9) agreement was found between the commercial kit and the developed capture ELISA. Findings of this study showed that the produced monoclonal antibody has appropriate performance for the detection of Fasciola coproantigen in stool samples and can be appropriately used for the diagnosis of fascioliasis.

Cystic echinococcosis (CE) is one of the most important zoonotic diseases in different geographical areas of the world including Iran. The current study aimed to assess the seroprevalence of human cystic echinococcosis (CE) in healthy blood donors in Fars province, southern Iran. A total of 1068 serum samples were collected from blood donors from five blood service centers of Fars province in south of Iran. Antigen B was prepared from sheep hydatid cyst fluid and collected sera were evaluated for anti-hydatid cyst antibodies, using antigen-B ELISA. Demographic features of the participants were also recorded during the sample collection. Anti hydatid cyst antibodies were detected in sera of 60 out of 1068 blood donors corresponding to overall seroprevalence of 5.6% in this population. Rate of seroprevalence was 6.7% in females and 5.5% in males. The highest rate of infection (8.3%) was found in age group of higher than 50 years old. There were no significant differences between seropositivity to CE and sex, age or place of residence of the participants (P > 0.05). Findings of this study showed that the rate of CE infection in Fars province, southern Iran, is relatively high. Some of these seropositive cases may have active hydatid cyst in their tissues without overt sign or symptoms.

Human Fascioliasis (HF) is a foodborne neglected parasitic disease caused by Fasciola hepatica and Fasciola gigantica. New epidemiological data suggest that the endemic areas of the disease are expanding and HF is being reported from areas where it was previously not observed. Diagnosis of HF is challenging. Performances of parasitological approaches, based on the detection of parasite's egg in the stool, are not satisfactory. Currently serological methods for the diagnosis of HF are mainly based on detection of anti-Fasciola antibodies in serum. Although, there have been some improvement in the development of immunological diagnostic tests for the diagnosis of HF, yet these tests suffer from insufficiency in sensitivity or/and specificity. Detection of antigens, rather than antibodies, seems to be a suitable approach in the diagnosis of HF. Antigen can be detected in sera or stool of the fascioliasis patients. Circulating antigen in serum disappears within a short time and most of the circulating antigens are in immune complex forms which are not freely available to be detected. Therefore, antigenemia might not be an appropriate method for the diagnosis of HF. Detection of antigen in stool (coproantigens) seems to be a suitable alternative method for the diagnosis of HF. Recent data provided convincing evidence that detection of coproantigen improved and simplified the diagnosis of HF. The present review highlights the new achievements in designing and improvement of diagnostic approaches for the immunodiagnosis of HF. Moreover, current status of the available immunodiagnostic techniques for the diagnosis of HF, their strengths and weaknesses has been discussed.

Background: Toxoplasma gondii is a cosmopolitan protozoan, which infects the human body and many warm-blooded animals including wild boars. Wild boars have an important role in maintenance and transmission of T. gondii and may pose a potential risk to humans and wildlife health. Objectives: The current study was conducted to find out the seroprevalence and genotypes of T. gondii in wild boars in southwest of Iran. Methods: Twenty five adult wild boars were hunted, in 2013. Blood and tissue samples (muscle, tongue, liver, and brain) were collected from each animal. Blood samples were assessed for antibodies against T. gondii by the modified agglutination test. DNA was extracted from the tissues and PCR-amplified, targeting a 529 bp DNA fragment of T. gondii. The PCR products were purified and sequenced. Results: Anti-T. gondii antibodies were detected in sera of 4 out of the 25 (16%) wild boars. There was no gender or age-related differences in seroprevalence of T. gondii in the studied animals. PCR detected the 529 bp band of T. gondii in brain samples of 5 out of 25 (20%) of animals. Molecular evaluation confirmed the presence of type III (4 cases) and type I (1 case) of T. gondii in the studied wild boars. Conclusions: Findings of the study demonstrated that the T. gondii infection is common in wild boars in southwest Iran and could represent a significant health risk for animals, hunters, and local residents who may consume wild boar meat.

Backgrounds. Wild rodents are reservoirs of various zoonotic diseases, such as toxoplasmosis, babesiosis, and leishmaniasis. The current study aimed to assess the protozoan infection of rodents in Boyer-Ahmad district, southwestern Iran.Materials and Methods. A total of 52 rodents were collected from different parts of Boyer-Ahmad district, in Kohgiluyeh and Boyer-Ahmad province, using Sherman live traps. Each rodent was anesthetized with ether, according to the ethics of working with animals, and was dissected. Samples were taken from various tissues and stool samples were collected from the contents of the colon and small intestines. Moreover, 2 to 5 mL of blood was taken from each of the rodents and the sera were examined for anti-Leishmaniaantibodies, by ELISA, or anti-T. gondiiantibodies, by modified agglutination test (MAT). DNA was extracted from brain tissue samples of each rodent and PCR was used to identify the DNA ofT. gondii.Results. Of the 52 stool samples of rodents studied by parasitological methods, intestinal protozoa infection was seen in 28 cases (53.8%). From 52 rodents, 19 (36.5%) were infected withTrichomonas, 10 (19.2%) withGiardia muris, and 11 (21.2%) withEntamoebaspp. Also, 10 cases (19.2%) were infected withBlastocystis, 3 (5.8%) were infected withChilomastix, 7 (13.5%) were infected withEndolimax, 1 (1.9%) was infected withRetortamonas, 3 (5.77%) were infected withT. gondii, and 6 (11.54%) were infected withTrypanosoma lewisi. Antibodies toT. gondiiwere detected in the sera of 5 (9.61%) cases. Results of the molecular study showedT. gondiiinfection in 3 (5.77%) of the rodents. Findings of this study showed that rodents in Kohgiluyeh and Boyer-Ahmad province, southwestern Iran, are infected with several blood and intestinal parasites; some of them might be potential risks to residents and domestic animals in the region.

Background: Toxoplasmosis is a life-threatening infection in organ transplant recipients, people receiving corticosteroid or radiation therapy, people with malignancies, and AIDS patients. Objectives: The current study aimed to determine the prevalence of toxoplasmosis in patients receiving chemotherapy for malignancies in the Bushehr province of southwest Iran. Methods: Blood samples were taken from 86 patients who were continuously referred to the chemotherapy center in Bushehr province and evaluated by ELISA to determine anti-Toxoplasma IgG and IgM antibodies. Moreover, a blood buffy coat of each sample was assessed by polymerase chain reaction (PCR), targeting a 529 bp gene of T. gondii. PCR products of the positive samples were sequenced to determine the genotype of the parasite. Results: Anti-Toxoplasma IgG antibodies were detected in the sera of 21 (24.4%) cases. All of the patients were negative for anti-Toxoplasma IgM antibodies. No statistically significant correlation was found between seropositivity to Toxoplasma and duration of chemotherapy or having contact with cats. PCR detected a 529 bp band of T. gondii in the buffy coats of two out of 86 (2.3%) cases. The sequence analysis demonstrated that both cases were 95% identical to type III (VEG strain) of T. gondii. Conclusions: Findings of this study demonstrated the presence of type III T. gondii in the buffy coats of patients undergoing chemotherapy. Given that toxoplasmosis is a life-threatening infection in immunocompromised patients, these patients should be screened for toxoplasmosis before and during chemotherapy to prevent acute toxoplasmosis.

Background: Seroprevalence of toxoplasmosis in different populations in Iran varies according to the people eating behaviors and also geographic and climatic differences of each area. Objective: The current study aimed to provide recent data regarding the seroprevalence of toxoplasmosis among female university students in Shiraz University of Medical Sciences, in Fars province, southern Iran. Materials and Methods: The subjects of the study were 503 female university students. Blood samples were collected from each participant and tested for anti-Toxoplasma IgG and IgM antibodies, using a commercial Enzyme-Linked Immunosorbent Assays (ELISA) kit. Demographic characteristics and risk factor related to Toxoplasma were also recorded during the samples collection. Results: The mean age of participants was 22.2 (±3.83) years and the majority (54.9%) of subjects was in the age group of 20-25 years old. Anti T. gondii antibodies was detected in sera of 43 out of 503 enrolled students, corresponding to an overall seroprevalence of 8.5%. Of these, 37 (7.4%) were seropositive for only IgG, 7 (1.4%) were seropositive for only IgM and 1 (0.2%) were seropositive for both IgG and IgM. The differences between age and animal contact with seropositivity to toxoplasmosis were not statistically significant. Conclusion: The findings of the study indicated that more than 90 % of the female university students in this study were seronegative for toxoplasmosis. As these students are in their childbearing age, there is a possibility for their newborns to become infected with Toxoplasma. The control and preventative measurements are necessary to reduce the rate of T. gondii infection in such individuals.

Visceral Leishmaniasis (VL) is an endemic parasitic disease and remains as a major health concern in southwestern Iran. The current study describes clinico-hematological, epidemiological and therapeutic features of VL cases, admitted to university-affiliated hospitals, during 1999-2014 in Fars province, southwestern Iran. A total of 380 VL cases were recorded during a 16 years period, giving an average annual admission of 23.75 cases/year in which 217 (57.1%) were male and 163 (42.9%) were female. Mean age of the patients was 3.7 years. The majority of the cases (91.5%) were ≤ 5 years old. Bone-marrow aspiration detected Leishmania amastigotes only in 26.6% of cases. Fever (98.1%), abdominal protrusion (65.1%) and hepatosplenomegaly (63.7%) were the most common clinical presentations of the patients. Pancytopenia was noted in 43.1, anemia in 87.3 and thrombocytopenia in 64% of cases. Increase in the level of AST (aspartate aminotransferase), ALT (alanine aminotransferase), alkaline phosphatase, LDH (lactate dehydrogenase) and CRP (C-Reactive Proteins) were seen in 84.9, 53.6, 44.4, 72.5 and 83.1% of cases, respectively. Mortality was noted in 5.3% of cases. Deranged haemato-biochemical parameters including total and direct bilirubin, PLT (platelet) and pancytopenia were significantly contributed to mortality from VL. Moreover, clinical features such as severe splenomegaly as well as bacterial infections were meaningfully contributed to death from VL. The majority of patients (74.9%) were treated with meglumine antimoniate. Amphotericin B was administrated in 59 of cases, 11 of them were initially treated with meglumine antimoniate with a shift to amphotericin B, because of treatment failure. Findings of the current study demonstrated that VL is present in southwest of Iran with a fairly continual rate during the last 16 years period. Deranged haemato-biochemical parameters along with severe splenomegaly contributed to mortality from VL.