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Background: Toxocariasis is a disease caused by Toxocara nematodes and occurs from consuming their eggs. The main hosts of these worms are dogs and cats. The disease in humans becomes a visceral larva migrans (VLM). This descriptive cross-sectional study was conducted to determine the prevalence of toxocariasis in children aged 6–14 years. Methods: This cross-sectional descriptive study was conducted from Jun 1 2016 to Dec 1 2017 in Sanandaj, west of Iran. A total of 182 serum samples were collected from children age 6 to14 yr referred to medical diagnostic laboratories. Demographic data (age, sex, and parents' literacy status), clinical signs (cough, headache, fever, abdominal pain), and the history of contact with dogs and cats was collected by a questionnaire. The presence of anti-Toxocara IgG antibody was detected by T. canis IgG ELISA (IBL, Germany) kit. Results: Of 182 subjects, 97 (53.3%) were male and 85 (46.7%) female. The average age was 9.2 years. Antibodies against T. canis were positive in three cases (1.65%) of all the studied subjects. Conclusions: The results showed a low prevalence of toxocariasis in children studied.

Blastocystis sp. is one of the most prevalent human parasites with a vast variety of non-human hosts. The aim of the present study was to determine the subtype distribution of Blastocystis in humans and trace the route of transmission by molecular data and phylogenetic analysis. Stool samples were collected from patients who referred to 14 medical laboratories in Kurdistan, Iran. All the samples were examined using the direct wet mount and formalinether concentration techniques. DNA extraction was carried out for 30 microscopically positive isolates and 33 negative samples. DNA amplification and subtype identification were also performed using the barcoding method and sequencing techniques. Of 1383 stool samples, 239 (17.3%) were infected with Blastocystis sp. Out of the 24 sequenced isolates, two (8.3%), six (25%), and 16 (66.6 %) belonged to the ST1, ST2, and ST3 subtypes, respectively. Bioinformatics analysis indicated that all the isolates were genetically similar to animal isolates. Blastocystis sp. was very common and ST1, ST2, and ST3 subtypes were prevalent in the study population. Bioinformatics analysis suggests that zoonotic transmission plays an important role in Blastocystis sp. distribution in Kurdistan province.

Blastocystis is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of Blastocystis infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single Blastocystis infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that Blastocystis infection can be a neglected cause of urticaria and skin disorders. Since the treatment of Blastocystis infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.

Giardia is a very abundant organism bringing about diarrhoea in human beings. The focus of this analysis was the detection of Giardia lamblia assemblages in human stool specimens in Hamadan, west of Iran, as well as the association between obtained assemblages and clinical symptoms. Faecal samples of 4066 individuals admitted to the medical and health care facilities in Hamadan were inspected microscopically for the existence of Giardia cysts/trophozoites, and the clinical symptoms of the patients were recorded. The DNA of positive samples was isolated from and the nucleotide sequences of both glutamate dehydrogenase (gdh) (n = 15) and triose phosphate isomerase (tpi) (n = 8) genes were analyzed. In direct microscopy, a total of sixty-four samples (1.6%), were considered as positive for G. lamblia cysts or trophozoites. The sequence analysis showed that 18 out of 23 sequenced isolates (78.2%) were assemblage A and 5 (21.7%) were assemblage B. Clinical symptoms were observed in 44.4% and 40% of patients with assemblages A and B, respectively. Overall, the predominant assemblage A detected in the tested samples along with bioinformatics analysis suggest a potential zoonotic transmission in the region of the study. Although advanced analyses are necessary to understand the foundation and path of the infection, it seems that more sanitary regulations regarding contact with livestock and pet animals are essential.

This study aimed to determine the prevalence ofEntamoeba histolytica,Entamoeba disparandEntamoeba moshkovskii(collectively referred to asEntamoebacomplex), using microscopic and molecular methods in Kurdistan Province, northwest of Iran. The relationship between positiveEntamoebaspecies and clinical symptoms was also investigated. Eight positiveEntamoebacomplex, as well as fourEntamoebacomplex-like isolates, were detected by microscopic stool examination. DNA was extracted from all positive and from 55 randomly selected negative stool samples. PCR was performed using species-specific 18S rRNA primers for theEntamoebacomplex. All positive PCR samples were sequenced. In total, 14 (1.01%) out of 1383 isolates, i.e. 12 microscopy-positive andEntamoebacomplex-like isolates and two out of 55 microscopy-negative isolates, were identified via PCR and sequencing. Overall, 0.58% (8/1383) of the isolates wereE.dispar, 0.14% (2/1383)E.histolytica, 0.07% (1/1383)E.moshkovskiiand 0.22% (3/1383) were mixed ofE.histolyticaandE.dispar. Based on our findings, the prevalence ofE. disparis greater than that ofE. histoltyica. On the other hand, a case ofE. moshkovskiiwas reported for the first time in this region. It seems that some gastrointestinal symptoms may be attributed toEntamoebaspecies.

Background Antibodies play an important role in neutralizing invading pathogens and protecting the host against re-infection. Thus, the accurate assessment of antibodies during a pandemic can provide important evidence for monitoring pathogen exposure, understanding the role of antibodies in protective immunity, and helping vaccine development. Methods In this study, 96 west Iranian recovered COVID-19 subjects were recruited and, based on clinical symptoms and disease severity, categorized into three different groups: mild, moderate, and severe. In addition, the presence and dynamic change of SARS-CoV-2-specific IgG antibody three, four-, and six months post symptom onset (PSO) were measured. Also, the association between IgG antibody titer with clinical symptoms and disease severity was examined. Results Although in real-time RT-PCR-positive samples negative IgG antibody results were found, most subjects mount humoral immune responses that could raise a robust SARS-CoV-2-specific IgG antibody. Furthermore, this antibody persisted in the serum of most recovered COVID-19 subjects at least six months PSO and demonstrated little to no decrease. Also, specific IgG antibody titer was strongly correlated with clinical symptoms and disease severity. Conclusions These results provide an insight into the presence and persistence of the SARS-CoV-2-specific IgG antibody. Although serological tests could not be used as the primary diagnostic test, they may support real-time RT-PCR results. Also, they could be used for diagnosing COVID-19 subjects tested later outside of the optimal period. Thus, the SARS-CoV-2-specific IgG antibody is an excellent marker of COVID-19 infection or vaccination and provides an additional diagnostic tool for verifying results and helps monitor and control COVID-19 spread.

Cryptosporidium species and microsporidia, which can cause zoonotic intestinal infections in humans, have become an emerging public health concern. It seems that the identification and genotyping of these parasites are necessary for the prevention, control, and establishment of appropriate treatment. This study aimed to evaluate the distribution and zoonotic transmission routes of Cryptosporidium species and microsporidia to humans referred to medical laboratories of Kurdistan Province, Iran. A total of 1,383 stool samples were collected and investigated. Cryptosporidium spp. and microsporidia were detected using microscopic methods (i.e., formol-ether concentration, Ziehl-Neelsen staining, and modified trichrome staining methods). DNA was extracted from positive samples, and specific fragments of the Cryptosporidium GP60 gene and microsporidia SSU rRNA gene were amplified. Furthermore, positive samples were sequenced for genotype identification and bioinformatics analysis. Based on the microscopic analysis of 1,383 stool samples, 5 (0.36%) and 6 (0.43%) samples were considered positive for Cryptosporidium oocysts and microsporidia spores, respectively. Molecular analysis of positive samples identified the isolates as Cryptosporidium parvum and Enterocytozoon bieneusi. According to comparative phylogenetics, cryptosporidiosis and microsporidiosis may occur via zoonotic transmission in this region. Therefore, proper control and health education are strongly recommended to prevent zoonotic diseases.

Objective: Intestinal parasitic infections are among the main health problems worldwide. The signs and symptoms depending on the type of parasite and conditions of host can be mild, moderate, or severe. In the present study, we attempted to determine the prevalence and risk factors for intestinal parasitic infections in individuals referred to medical laboratories in Sanandaj city, in the center of Kurdistan province, northwest Iran. Methods: This cross-sectional study was done from 1 June 2015 to 31 August 2016, during which 1383 fecal samples were collected randomly from individuals who were referred to medical laboratories. All the samples were examined using direct slide smear, formalin-ether concentration, and staining methods. Results: Out of the 1383 stool specimens examined, 297 (21.5%) were infected with single or multiple intestinal parasites. Protozoan parasites were detected the most from the samples and helminths were very much less prevalent. Finally, the analyzed data showed a significant difference between intestinal parasitic infections and reasons for referral (p = 0.002), age groups (p ≤ 0.01), education (p ≤ 0.01), and seasonal variation (p ≤ 0.01). Conclusions: Intestinal parasitic infections especially protozoan parasites are still prevalent in the center of Kurdistan province. Therefore, health providers are recommended to consider this health problem by establishing accurate diagnosis and designing interventional program to decrease the rate of such infections in this district.