Cystic echinococcosis is a zoonotic infection of humans and domestic animals caused by the larval stages of the cestode Echinococcus granulosus. Cystic echinococcosis is one of the most important zoonotic diseases in Iran, where human cases are frequently reported from different regions of the country. The objective of this study was to determine the sero-epidemiological and surgical cases of human hydatidosis in the Yasuj district, a region in southwest of Iran. Serum samples were taken from 500 individuals attending Yasuj health centers. Anti-hydatid cyst antibody was checked by enzyme-linked immunosorbent assay (ELISA), using antigen B. Moreover, retrospective studies were carried out using local hospital records of CE patients between 1997 and 2006. Results of the sero-epidemiological study showed that 36 out of 500 cases (7.2%) have antibody against hydatid cyst. Of these 36 cases, 49.6% were women and 50.4% were men. The highest rate of infection was recorded in individuals aged between 30 and 39 years. Hospital records showed that during the 10 years, 105 cases of hydatidosis were admitted in Yasuj hospitals. Of all cases, 70 (66.7%) were women and 35 (33.3%) were men. Hepatic cyst was recorded in 81% of the cases where nephrotic cysts were the second most prevalent ones. Recurrence of the disease was noted in 14.3% of all cases. Results of this study demonstrated that hydatidosis is an important endemic disease, with a nearly constant prevalence rate during the last 10 years, in Yasuj district in Iran. Further studies are needed to investigate the reasons for high rate of surgical cases in housewives and striking prevalence of hydatidosis in a specific (30-40 years) age group.

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.

Cystic echinococcosis (CE) is a zoonotic parasitic infection caused by the larval stage of Echinococcus granulosus. Diagnosis of CE mainly relies on a combination of serological testing along with imaging approaches. A variety of serological methods, mainly based on hydatid cyst fluid, antigen B (AgB) and antigen 5, have been developed and used for immunodiagnosis of CE, yet their performances are not satisfactory. Although utilizing of recombinant or synthetic antigens, improved the performance of serological tests, it has not applicably overcome the problem of low sensitivity and cross reactivity, seen in the diagnosis of CE. Performances of immunodiagnostic tests based on AgB subunits are promising. The 8 kDa subunit of AgB is the most studied antigen in native, synthetic or recombinant form for diagnosis of CE. From the 5 subunits of AgB, antigen B8/1 and B8/2 provided the highest diagnostic sensitivity and specificity. Moreover, detecting of specific antibodies of IgG subclasses has improved the efficacy of immunodiagnostic tests. Among the IgG subclasses, both IgG2 and IgG4 are considered as good markers for diagnosis and IgG4 as a suitable marker for follow up of the patients. In this review an overview of immunodiagnostic methods, related antigens and their performances in the diagnosis of CE are given. The paper highlights pitfall and challenges in the serological diagnosis of CE. Moreover, limitation of currently available immunodiagnostic tests and the most recent development in the designing and application of serological assays for diagnosis of CE in human are addressed.

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Visceral leishmaniasis (VL), caused by Leishmania infantum, is an endemic zoonosis in Iran. In recent years, Leishmania infection in cats has been reported in several countries where leishmaniasis is present. The aim of this study was to survey Leishmania infection in cats and to detect its causative agents in VL endemic areas in Iran. Forty stray cats were captured from two areas where VL is endemic, Fars and East Azerbaijan provinces. Infection with Leishmania was evaluated by parasitological and molecular methods. Leishmania parasites were detected in 4 out of 40 cats (10%). The parasite was isolated from the spleen of three and the liver of one cat and mass cultivated in the culture medium. Molecular and isoenzyme characterization revealed that the parasites isolated from the four cats were all L. infantum. Considering the high rate of feline Leishmania infection in this study, it may be suggested that cats have an epidemiological role in areas where VL is endemic in Iran.

BackgroundParasitic infections are still a significant health problem in rural areas in developing countries including Iran. There is no recent population-based data about the prevalence of human intestinal parasites in most rural areas of Iran. The current study aimed to determine the prevalence of intestinal protozoan infection in inhabitants of rural areas of Boyer-Ahmad district, Southwestern Iran.MethodsA total of 1025 stool samples were collected from the inhabitant of 50 randomly selected villages in Boyer-Ahmad Township. The stool samples were evaluated by parasitological methods including, direct wet-mounting, formalin ethyl acetate concentration, zinc sulfate floatation, and Trichrome permanent stain for detection of protozoan infections. Diarrheic samples were further evaluated with a modified Ziehl–Neelsen staining method for detection of coccidian parasites.ResultsThe prevalence of both pathogenic and nonpathogenic intestinal parasites in the population was 37.5% (385 out of 1025 cases), some individual with multiple infections. Giardia lamblia was detected in 179 (17.46%), Blastocystis hominis in 182 (17.76%), Entamoeba histolytica/dispar in 9 (0.87%), Endolimax nana in 216 (21.07%), Entamoeba coli in 151 (14.73%), Ioedamoeba butschlii in 45 (4.39%), Chillomastix mesnili in 22 (2.14%), Trichomonas hominis in 2 (0.19%) and Dientamoeba fragillis in 2 (0.19%) of cases. Multivariate logistic regression revealed significant associations between protozoan infection (pathogenic protozoa) and contact with animals (OR yes/no = 2.22, p < 0.001) and educational status (OR higher/illiterate = 0.40, P = 0.01).ConclusionFindings of this study demonstrated that protozoan infection rate in rural areas of southwestern Iran is still high and remained as a challenging health problem in these areas.

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In this study, insufficient knowledge of community about infection nature, vector, transmission mode and preventive measures of CL, highlights the needs for a health education initiative to enhance the awareness of people about CL. This would improve inhabitants' contribution in control program of CL in this area.