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We investigated the prevalence of intestinal protozoan parasites in patients with gastrointestinal complaints in medical centers in Zahedan, Iran. A total of 1562 stool samples was examined from July 2004 to January 2006 using microscopy (direct smear, formalin-ether concentration), xenic culture and PCR techniques. Four hundred and twenty-seven (27.3%) of the patients were infected with one or more intestinal parasites. Giardia lamblia (10.1%), Entamoeba coli (10%), E. hartmanni (1.7%), Blastocystis hominis (2.2%), Chilomastix mesnili (1.7%), Trichomonas hominis (0.7%), E. histolytica/E. dispar (0.51%) and Iodamoeba butschlii (0.45%) were the most prevalent protozoa detected with microscopy. Of the eight microscopy-positive E. histolytica/E. dispar samples, six were identified as E. dispar by PCR/gel electrophoresis, whereas E. histolytica was not detected at all. Although Zahedan is an area with poor hygiene located in a tropical area near the border of Pakistan and Afghanistan, the prevalence of E. histolytica and E. dispar here compared with other parasites and infectious diseases is unexpectedly low.

Although much is known about the mechanisms affecting cholera spread, cholera outbreaks occur annually in Iran. The aim of this study was to characterize and assess the clonal correlation of strains obtained from an outbreak in 2013 in Iran. Thirty-three strains of Vibrio cholerae were isolated from stool sample of patients majority of them belonged to Afghan nationality. PCR and sequencing analysis was performed to characterize virulence and resistance associates genes and cassettes. Clonality of isolates was assessed by Pulsed-field gel electrophoresis (PFGE) method. The ctx, zot, and tcp genes were present in 100 % of isolates. The wbeT gene was absent in all V. cholerae outbreak isolates, integrity of which is essential for Ogawa phenotype. This correlates with Inaba phenotype of all isolates under study. Sequencing of the ctxB (+) strains revealed that all isolates (El Tor strains) possessed the ctxB sequence of classical biotype allele known as El Tor variant strains. No class 1 or 2 integrons were detected among the isolates which indicate that in spite of high rate of resistance, integrons do not play an important role in V. cholerae resistance. All isolates were chloramphenicol sensitive all of which showed resistance to tetracycline and harbored the tetB resistance gene. PFGE analysis showed identical pulsotypes indicative of clonal dissemination of a single V. cholerae strain among the patients under study. Clonal cholera outbreak in boarder cities is alarming due to fear of import and spread of V. cholerae strains from out of the country which may lead to more spreading epidemics.

Background: Malaria, as a parasitic disease, is one of the most important public health problems in Iran. Malaria is mainly diagnosed by peripheral blood smear, stained by Giemsa; in Iran it is also diagnosed by blood smear that is highly depends on technician's skills and laboratory properties. Objectives: Correct diagnosis of malaria and identification of human malaria species in spite of the measures taken to eliminate the disease in Iran, have made the complete understanding of malaria epidemiology critical. Therefore, the current study aimed at investigating the epidemiology of 2 species of human Plasmodium in Sistan and Baluchistan province using polymerase chain reaction (PCR) method. Methods: The present descriptive study was conducted on 100 patients suspected to malaria infection who referred to health centers of Chabahar, Iranshahr, Nikshahr, and Sarbaz districts. DNAs were extracted from blood samples using the specific kit, and nested-PCR reaction was performed to identify the Plasmodium species according to NP-2013 protocol. Results: Molecular analysis was performed on 100 samples suspected of malaria; 84 negative and 16 positive samples were detected including 8 Plasmodium vivax, 2 P. falciparum, and 6 mixed infections (P. vivax and P. falciparum). No P. ovale or P. malariae was observed. Conclusions:The results showed that malaria had a decreasing trend in Sistan and Baluchistan province. Therefore, the malaria elimination program is applicable and attainable in this region as a goal.

Background: Since Iran is one of the malaria endemic areas, diagnosis of this disease is important. Although the microscopic study of stained peripheral blood smears is as a gold standard of malaria diagnosis, this method requires a microscope, the equipment, and trained people. Because of some problems associated with microscopic method in some situations, rapid diagnostic test (RDTs) can be a suitable alternative. Nevertheless, then diagnosis of malaria should be approved by microscopic Objectives: The rapid diagnosis of disease and treatment of patients is necessary to identify the contributing factors and break the cycle of transmission. In order to achieve this goal, we need a method that requires no special equipment such as microscopes, paint trays, and specially trained technicians for microscopic detection method Patients and Methods: Blood sample were drawn from the finger of 178 patients with suspected malaria by a technician. Two methods of microscopic detection and RDT kits with immune chromatographic procedures were employed to diagnose malaria. Finally, all slides and cassettes of RDT kits were transferred to Zahedan for reviewing and control. Results: After data collection, the results of 178 samples were reported according to the Plasmodium species. RDT detected 71.4% of Plasmodium vivax while microscopic method had detected all the cases (100%). Although there was a significant difference between two methods of diagnosis in detecting P. vivax (P < 0.05), the results were the same in diagnosing Plasmodium falciparum (100%). Conclusions: Our study showed that only 71.4% of all positive samples for P. vivax were detected by RDT. The results were the same for both methods in diagnosis of P. falciparum.

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Background:Toxoplasma gondii is an important opportunistic parasite in immunocompromised people. On the other hand, diabetes is a systemic disease which affects the immune system and minimizes cellular and humoral immunity and thus diabetic patients have an increased susceptibility to protean infections. Objectives:The aim of the current study was to determine the serum levels of toxoplasma antibodies in diabetic patients. Patients and Methods:In this cross-sectional study, 205 serum samples were collected from diabetic patients referred to diabetes center in Ali Asghar Hospital in Zahedan (southeastern Iran). We evaluated the levels of IgG and IgM antibodies against T. gondii in the patients' sera using the Enzyme-Linked Immunosorbent Assay. Results: A total of 205 blood samples obtained from diabetic patients (42 men and 163 women with age range 13 -60 years) were examined for the presence of toxoplasma antibodies. Among patients, 60 cases (29.3%) were seronegative and 145 patients (70.7%) were seropositive, included 53.145 (36.6%) (IgG+, IgM+) acute phase, 72.145 (49.6%) (IgG+, IgM-) chronic phase and 20.145 (13.8%) (IgG-, IgM+) false positive. The relationship between diabetes and toxoplasmosis was evaluated using the chi-square test (P < 0.05). The difference between age, gender, meat consumption, Fasting Blood Sugar (FBS) and the presence of toxoplasma antibodies was statistically significant (P < 0.05). There was no relation between optical disease and abortion with infection. The highest seroprevalence rate of T. gondii IgM and IgG antibodies was observed in the group of women. Conclusions: Diabetes and consumption of half-cooked meats increase the chance of toxoplasmosis. Thus, it is recommended to study the serum level of antibodies against toxoplasmosis in diabetic patients and repeat it periodically.