Journal of School of Public Health and

Visceral leishmaniasis (VL) has been found as an endemic disease in some areas in northwest and south parts of Iran during recent two decades. The species of the Leishmania has been characterized as L.infantum and the main sources of human infection in the endemic areas is dog. The majority of kala-azar cases are found among children in the age group of 1-4 years. As the delay in diagnosis and treatment of kala-azar cause high mortality in the patients, serological surveillance, using direct agglutination test (DAT), and treatment of seropositive cases who have clinical symptoms are carrying out with cooperation of Provincial Health Services in the endemic foci of Ardebil and East Azerbaijan Provinces in the northwest and Bushehr in the south parts of Iran since 1997.
DAT Leishmania antigen is made in the Protozoology Unit of the School of Public Health with the strain of L.infantum isolated from an infected dog in Iran. The finger prick blood samples are collected by trained Health Workers (Behwarz) from suspected kala-azar patients in the Rural Health Houses. The collected samples are transferred to the near district kala-azar laboratory and tested (using DAT) by the trained technicians. The sero -positive patients are referred to pediatricains or trained general physicians in district hospital or health center for clinical examination and treatment of the seropositive cases (DAT titers of 1:3200 or higher) with kala-azar clinical symptos. For the treatment, usually, meglomine antimongtc (Glucantime) is used via intra-muscular in dosss of 20mg/kg/day for 20 days.
In kala-azar case finding in the serological surveyed areas of Ardebil, East-Azerbaijan and Bushehr provinces during 1997-2001, altogether, 19693 blood samples were collected from suspected kala-azar patients and tested by DAT. Totally , 1274 cases (6.74%) were seropositive in titers of 1:3200 or higher. In the clinical examination of seropositive cases 690 patients (54.16% of sero-positive cases and 3.50% of the total samples) had kala-azar clinical symptoms and therefore they were treated.
This seroloeical surveillance of kala-azar in the endemic area as have detected high number of kala-azar patients among children up to 12 years old, who were subsequently treated on time . This ptoject has prevented the mortality of the disease in the studied areas.

Background and Aim: Visceral leishmaniasis is a systemic parasitic disease with a high fatality rate in under-5-year-old children. The disease is endemic in some parts of Iran, particularly in the north-west region. In 2001 a visceral leishmaniasis (VL) surveillance system was established for children aged ≤ 12 years in the primary health system in Meshkin-Shahr District, Ardebil Province, situated in the north-west of Islamic Republic of Iran.

Materials and Methods: All cases with clinical signs and symptoms of VL and confirmed positive by the direct agglutination test (DAT) were referred for physical examination and treatment.

Results: The mean annual incidence of VL decreased significantly from 1.88 per 1000 children before (1985-2000), to 0.77 per 1000 child population after (2001-07), the intervention. In the control area with no surveillance, it increased from 0.11 to 0.23 per 1000.

Conclusion: Early detection of VL using serological tests and timely treatment of cases can decrease the mortality and morbidity rates of VL in endemic areas.

  Backgrond and Aim: Demodicosis is a common skin disease. Great number of admissions to the clinics is occurring in the country. Regarding the high prevalence of this parasitic arthropod, investigating on pathogenesis, route of transmission and the complications they may produce, is considered of great importance. Generally, demodex parasites often exist in the skin tissue and tend to live in the face specifically in cheeks, forehead and nose, where sebum excretion is active and may provide a favorable habitat for living and breading the parasite. Diagnosis is carried out during an exploratory skin test for a cne, pityriasis rosacea and ophthalmic infectious diseases such as blepharitis. Determination of their biological role in chronicity of general skin disorders is an interesting topic in research.

  Materials and Methods: Patients were admitted to the Razi hospital, Research Center for skin diseases and leprosy, and three other clinical laboratories considered for assays. The questionnaire was filled for each patient and the sample was taken from the affected area. Ecto parasites were transferred to the potassium chloride solution 10% and studied under a light microscope.

  Results: A total of 100 patients were studied, from which 78 patients were diagnosed as infected with the Demodex folliculorum. Of these, (%92) were female and (%7.6) male (p <0.05). The highest frequency was observed in the age group 41 to 50 years (P <0.05).

  Conclusion: In this study, the relative frequency of demodicosis was more common in women and in the middle-aged group. Generally this high level of frequency will intensify the necessity of the identification of parasites and its pathological effects in chronic infectious diseases.

Background and Aim: Considering the ongoing national malaria elimination program in Iran, establishing a bank of human Plasmodium genes and proteins can be very useful for research purposes. This study was conducted to collect some of the native isolates of human Plasmodia from endemic areas in the country.

Materials and Methods: A 2ml vein-punctured blood sample was prepared from each confirmed malaria case. The samples were dispensed in EDTA pre-dosed tubes and cryopreserved for further tests. Moreover, relevant Geimsa-stained thick and thin blood smears were kept in a safe place. Tests for genetic indicators of MSP-1 was performed for each of the P. vivax samples with the RFLP-PCR techniques. In addition, an in vivo drug sensitivity test was performed for each P. falciparum case. Collecting and cryopreserving samples will continue.

Results: A total of 131 samples, including 109, 19 and 3 P. vivax, P. falciparum and mixed samples, respectively, were preserved with relevant data such as species, parasitaemia and nationality of the donor. MSP-1 gene classification resulted in three different haplotypes including Hap.1, Hap.2 and Hap.3 with frequencies of 20.6%, 41.2% and 38.2%, respectively. The In vivo drug sensitivity tests on P. facilparum isolates showed that all of the isolates were sensitive to the current drug of choice, namely, a combination of artesunate and fansidar.

Conclusion: This study resulted in the preservation of considerable amounts of P. vivax and P. falciparum samples for further relevant studies and research purposes.