Epidemiological, laboratory, diagnostic and public health aspects of human brucellosis in western Iran

Objective:To determine brucellosis's epidemiologic,laboratory,diagnostic and public health features considering brucellosis is endemic in Azna County,western Iran.Methods:This descriptive cross-sectional study was investigated on 43 patients with brucellosis in Azna County. The subjects were the patients with symptoms correspondent with brucellosis and positive Wright and 2ME tests. A questionnaire about demographic,epidemiological and laboratory findings was filled in. Afterwards,patients were treated using usual antimicrobial drugs regimen. The collected data were analyzed by SPSS software version 16.Results:Forty-three subjects were found to be positive in laboratory tests. Incidence of Brucellosis was 59.31 per hundred thousand population. About 34.9% of patients were female and 65.1%male. Nearly 95.2% of human cases were living in rural and 4.8%in urban areas. Around 20.9%of patients had history of animal contact. The commonest transmission was unpasteurized dairy products(79.1%). The most contagious seasons were summer and spring(60.3%). The most common age group was 15-24(27.9%),and about 60.5%of the patients were between 15-44 years old. Disease was more common among housewives(30.2%) and farmers(20.9%). The majority of the patients had Wright test titre=1:320(54.1%) and 2ME test titre=1:160(56.1%) in serological titration.Doxycycline with Rifampin was used for treatment of the greatest of patients(60.4%).Conclusions:In order to control this zoonotic disease,close cooperation of health and veterinary organizations is necessary.

Epidemiological and demographic study of acute animal biting in Abdanan County,Ilam Province,Western Iran

Objective: To determine the incidence, epidemiology and demography of acute animal bites referred to Abdanan health centers in the years 2009 to 2013. Methods: This study was a descriptive analytical research. Questionnaires for each case of acute animal bite was completed. Data about age, gender, kind of animal, residency, site of bite, etc taken from Abdanan health centers were analyzed. Data were analyzed in SPSS by using descriptive statistics. Results: Total number of exposed persons to acute animal bites was reported 67 in 2009 and 69 in 2013. The average incidence rate was 1.2 per 1 000 population. Bites were frequent among the age group of 20-30 years. Most of the cases were self-employment. Around 83.8% of cases were bitten by dogs. Of total 309 studied patients, 73.8% were male. Feet (71.5%) and hands (22.7%) were the most common body part affected. About 53.1% of cases were in rural population. Conclusions: Dogs seems to play a very important role in the epidemiology of rabies in Abdanan, Iran. No cases of human rabies were observed in our study. This may be because of increasing public awareness and the upgrading of health and treatment centers, all of which in study region provide post-exposure anti-rabies treatment including vaccination, immunoglobulin and wound washing.

Global distribution of human chikungunya arbovirus infection: A review

The five main arbovirus families that cause diseases in humans and other animals are Bunya viridae,Togaviridae,Flaviviridae,Reoviridae,and Rhab doviridae.Chikungunya arbovirus(Togaviridae:Alphavirus),an arbovirus transmitted byAedes spp.,is a well-known global health threat.It has been recognized in more than 60 countries in Asia,Africa,Europe,and the Americas.Pakistan,the eastern neighborhood of Iran,is one of the endemic foci of this disease.As the largest province of Iran,Sistan-Baluchestan has always been threatened by infectious diseases from abroad due to its geographical location and neighborhood with Afghanistan and Pakistan.Contagious diseases are more likely to occur in the eastern borders of Iran arising from(1)lack or limited jobs due to deprivation of the area,the harsh weather conditions,unbearable conditions,traditional society,and lack of industry development;(2)Lack or limited facilities due to the distance from the center of the country and high percentage of illiteracy or low literacy,and traffic to neighboring countries to trade goods and get a job.Therefore,health authorities should pay more attention to trafficking of illegal aliens,traveling of people to high-risk countries,smuggling of livestock,and strengthening of quarantine posts across borders,especially in the eastern borders of Iran.The first case of chikungunya disease was confirmed in Sistan-Baluchestan province in 2019,where most of the cases have been reported.The findings of the present study provide evidence of chikungunya virus in Iran and emphasize the urgency to increase the preventive standards and surveillance system.

Earthquake planning and crisis management with an emphasis on the facilities, utilities, and services of the health care centers of Tiran and Karvan County, Isfahan Province, Iran: A case study

Objective: To study earthquake planning and crisis management with an emphasis on the facilities, utilities, and services of the health care centers of Tiran and Karvan County, Isfahan Province. Methods: This is a descriptive-analytical survey based on the quantitative and qualitative characteristics of Tiran and Karvan County Health Care Centers(HCCs). Twenty quantitative and qualitative indicators were derived from the studied HCCs and analyzed using the strengths, weaknesses, opportunities and threats analysis technique. The top crisis management strategies were identified and a number of strategies and solutions were proposed. Results: The HCC utilities such as water, electricity, gas, and heating and cooling systems were in average condition, whereas the facilities of the majority of HCCs were in vulnerable-to-average condition. In addition, they sustained relatively high degree of instability which calls for reassessment and effective policies to minimize weaknesses and eliminate threats using strengths and opportunities. Conclusions: It is recommended that the condition of Tiran and Karvan County HCCs be enhanced by distributing new HCCs based on the population density, expanding the road network and creating vast, wide-open spaces to enable field hospital construction in times of crisis.

A review on epidemiology and ecology of West Nile fever: An emerging arboviral disease

West Nile virus (WNV) is found in 26 provinces of Iran in humans, horses, and birds. Due to lack of vaccines, the only method to reduce the risk of the disease in communities is to increase people''s awareness. Lack of killing and overhunting of animals does not alter the infected-blood transmission from animals to humans by mosquito bites, but can reduce disease transmission risks including the transmission of West Nile fever (WNF) to humans. WNV is an enveloped Flavivirus that in nature has an enzootic cycle between mosquitoes and birds. The virus has occasional epizootic spillover causing disease in humans and horses. WNV-transmitting mosquitoes are widespread around the world, and the geographical range of transmission and the disease has increased over the past seven decades. Most human infections with WNV are asymptomatic, but severe neurological disease may develop resulting in long-term complications or death. Given the increasing trend of reported human WNF cases, it is necessary to implement surveillance programs and increase awareness of people and health staff about the function of biological factors including carnivores in the hunting of infected animals and collecting their carcass from nature. Hunting and killing of birds and dogs living near humans increase both the risk of deviation of blood-feeding of the zoophilic mosquitoes to humans and the outbreak of the disease.

A comprehensive overview on sandfly fever

Sandfly fever is a febrile emerging arboviral illness which is a huge threat posed to public health.Sandfly fever viruses(Sicilian,Naples,and Toscana)are endemic to the Mediterranean region.Evidence suggests an increase in the activity of sandfly-borne phleboviruses and their extension to other places.The infection is relatively benign but may cause severe clinical manifestations and complications.Sandfly fever viruses belongs to the genus Phlebovirus(family Bunyaviridae),and the four main serotypes include sandfly fever Sicilian virus,sandfly fever Naples virus,sandfly fever Cyprus virus,and Toscana virus.Sandfly fever has flu-like symptoms such as fever,headache,photophobia,malaise,myalgia,and retro-orbital pain.The incubation period of the disease is 4-8 days,and the patient usually recovers within a week.The first infection provides the host with immunity.Sandfly fever viruses are transmitted through the bites of infected female sandflies,thus,the epidemiology of sandfly fever is closely related to the presence and activity of sandfly species that act as the vectors for transmission.Cases and outbreaks of the disease have been reported worldwide for more than 100 years.All in all,this disease is important for non-endemic countries because it is a travel-related and/or imported illness.

Epidemiological analysis of snakebite victims in southwestern Iran

Objective:To investigate the prevalence of snakebites and associated epidemiologic factors in Khorram-shahr County,Iran,between 2013 and 2017.Methods:This was a cross-sectional descriptive-analytical study.Information was collected and recorded via questionnaires.Snakebite data included gender,age,occurrence regions,bite site,time of being bitten,month and season.Data were analyzed by Chi-square and t-tests with SPSS version 18.Results:A total of 102 cases of snakebites occurred in Khorram-shahr County of Khuzestan Province,southwestern Iran.There were 75 men(73.5%)and 27 women(26.4%),without significant difference in incidence.The highest frequency of snakebites was observed in the age group of 41-50 years with 28 cases(27.4%).In total,58 cases(56.9%)occurred in urban areas and 44 cases(43.1%)in rural areas.No statistically significant difference was observed between the age groups or residential areas.Snakebites occurred in May with 19 cases(18.6%),spring with 45(44.1%)and summer with 45(44.1%).The results showed significant difference among different seasons and months of the year.Snakebites were in feet in 62 cases(60.8%)and hands in 36 cases(35.3%)which were bitten more than other organs,respectively,with significant difference among different bite sites in the body.The highest and lowest frequencies of snakebites were observed between 18:00 and 24:00 with 43 cases(42.2%)and between 6:00 and 12:00 with 14 cases(13.7%),with a significant difference among different hours of the day.Conclusions:Useful information about snakebites,venomous snakes,their hazards,prevention of bites and the importance of early hospital referral and treatment of victims should be provided to people using different educational tools.

The Prevalence,laboratory confirmation,clinical features and public health significance of cutaneous leishmaniasis in Badrood city,an old focus of Isfahan Province,Central Iran

Objective:To investigate the status of cutaneous leishmaniasis(CL)during 2008 through 2012 in Badrood City.Methods:This is a descriptive--analytical study that was conducted during 2008-2012.The statistical population consisted of all patients,who were under treatment and follow up with the diagnosis of CL through laboratory confirmation(amastigotes view in the lesion smear)and clinical symptoms.The impression smears were prepared from the sides of ulcers of all patients by scraping;then,they were fixed in methanol,stained by standard Geimsa method,and observed exactly under the microscope.For this purpose,a researcher--made questionnaire was completed;after extracting the information,the results were analyzed using the SPSS version 17.Results:Among the number of 499 patients studied,297 cases(59.5%)were male and the 202 cases(40.4%)were female.Slides prepared from the lesions of these patients had a Leishmania parasite with large vacuole(the features of Leishmania major).The highest cases of disease were related to the year 2012 with 190 patients,and later 2010,2009,2008,and 2011 respectively had the highest cases.In total,26 patients(5.2%)have had the disease history.The highest incidence of the disease was respectively in the months of September(143 cases),August(112 cases)and October(106 cases).The most ulcers(38.08%)were observed on the hand;then the foot and face had the maximum number of the ulcer.Also,in most patients(53.9%)over an ulcer were observed.Conclusions:The results of this study showed an increase in the prevalence of CL during the years 2008 to 2012.It can be said that the main reason for this increase is people's lack of awareness of the disease transmission method.The increased disease process can be controlled through education and appropriate prevention methods.

Epidemiological features,clinical manifestation and laboratory findings of patients with cutaneous leishmaniasis in Genaveh County,Bushehr Province,Southern Iran

Objective:To examine the epidemiological features of cutaneous leishmaniasis in Genaveh County,Southern Iran.Methods:This descriptive study was conducted during 2004-2008.A questionnaire was completed for each case regarding age,gender,place of residence,the number and location of cutaneous leishmaniasis lesions etc.Suspected active lesions were scraped with a sterile blade and the samples smeared onto glass slides,fixed with methanol,stained with Giemsa and examined under a light microscope for the presence of amastigotes.Results:Totally,135 cases of cutaneous leishmaniasis came to the health centers.The highest number of patients catching cutaneous leishmaniasis was found in 2006(n=54).Most cases(56.3%)occurred during winter.The most highly infected age group was 1 to 10 years.The hands were the most affected parts of the body.About 54%of the patients had one lesion.The most cases(53.3%)occurred in rural areas.Concluions:It is important for the health authorities to take powerful actions to control cutaneous leishmaniasis.Meanwhile,It is significant to prepare quick treatment of cases.

Scorpion envenomation study in Behbahan County,Southwest Iran

Objective:To study the incidence and epidemiology of scorpion sting cases that were referred to the health services centers of Behbahan County,Khuzistan Province,southwestern Iran,during the two yeare(2007-2008).Methods:In this descriptive retrospective research,the data has come from files of scorpion-stung patients referring to the health services centers of Behbahan during study period.A special scorpion sting sheet was prepared and completed for every case of scorpion sting.Analysis of 3441 case sheets received during this period was carried out.The frequencies of medical and entomo-epidemiologic parameters were turned to the percentage position.Results:A total of 3441 cases of scorpion stings were reported during the two-year period from 2007 to 2008.The average incidence of scorpion stings was 8.8‰in the two years.The frequency of cases was higher during August,September,June and July that 2056 cases of scorpion stings were reported.Most stings were occurred during summer.Nearly 51.3%of the cases were men.All cases had received antivenin.Majority of scorpion sting cases(56.5%)lived in the rural areas.The most common sting site was the hand.About 74.4%have received the antivenin 0-6 h after the sting.The early injection of the antivenin is very important.The most of the cases of scorpion stings(59%)were occurred by yellow scorpions.Conclusions:Surveillance for cases of scorpion stings must begin at all regions of Behbahan County.Treatment of cases of scorpion stings is conducted according to a protocol set by the Ministry of Health,Treatment and Medical Education.This protocol included directions for lines of treatment and the dose of antivenin recommended.Thereafter all cases are referred to hospital for further observation and management.