Iranian Journal of Parasitology最新文献

Malaria continues to pose a significant public health challenge, particularly in certain regions of Indonesia, where it remains endemic. Plasmodium falciparum is responsible for the most severe form of the disease, often leading to life-threatening complications such as acute kidney injury (AKI). Here, we report the case of a 22-year-old male from Sikka Regency, East Nusa Tenggara, Indonesia, with a seven-day history of intermittent fever following recent travel to malaria-endemic areas. On physical examination, he appeared somnolent and exhibited icteric sclera, hepatomegaly, and dark yellow urine. Laboratory findings were notable for impaired kidney function (serum creatinine 3.52 mg/dL (311 μmol/L)), elevated transaminases, hyperbilirubinemia, thrombocytopenia, and a P. falciparum parasitemia level of 9.7%. Imaging studies revealed pulmonary edema, enlarged kidneys, ascites, pleural effusion, and hepatomegaly. The patient was diagnosed with severe falciparum malaria, complicated by AKI, pulmonary edema, and jaundice. He was then treated with intravenous artesunate for six days, followed by a three-day course of oral dihydroartemisinin/piperaquine and a single dose of primaquine. Additionally, he underwent two sessions of timely hemodialysis. His clinical condition and kidney function gradually improved thereafter, and he was discharged without sequelae. This case highlights that early diagnosis and appropriate treatment can lead to full recovery from AKI caused by severe P. falciparum malaria.

Cerebral cystic echinococcosis (CCE) and coenurosis are zoonotic diseases caused by the larval stages of Echinococcus granulosus sensu lato (s.l.) and Taenia spp., respectively. Due to the similarity between the symptoms and clinical samples of CCE and cerebral coenurosis, especially in cases with no protoscoleces, the diagnostic methods for the differentiation of CCE from cerebral coenurosis are crucial, especially in countries where both diseases are endemic. To compare CCE and coenurosis, morphometric indices of protoscoleces and molecular methods were used in the present study.

Methods: In this regard, four isolates of human cerebral echinococcal cysts, three isolates of Coenurus cerebralis from sheep, and one non-cerebral Coenurus from sheep muscles were evaluated. The isolated specimens have been collected from Shiraz, Ahvaz, Tehran and Kerman from before 2000 to 2022. The molecular characterization was carried out using the partial NADH dehydrogenase1 (nad1) gene. Phylogenetic analysis was performed using the maximum likelihood method.

Results: In fertile cysts, the total size of the large and small hooks of Coenurus was larger than cerebral echinococcal cyst. These parameters demonstrated significant morphological differences between the C. cerebralis and the cerebral echinococcal cyst. Molecular methods identified the cerebral echinococcal cysts as E. canadensis (G6) genotype. One C. cerebralis and the non-cerebral Coenurus were identified as Taenia multiceps and T. multiceps gaigeri, respectively.

Conclusion: Morphometric indices are significantly different between protoscoleces of C. cerebralis and cerebral echinococcal cysts. Hence, they could be used for differential diagnosis of the fertile cysts of these cestodes. However, in cases with no protoscoleces, molecular methods are essential for the differentiation of CCE from cerebral coenurosis, especially in regions where both diseases are prevalent and endemic.

Background: The use of nanocarriers in combination with other treatments shows significant promise in addressing drug-resistant diseases, particularly malaria. Given the high prevalence of drug-resistant malaria, research into innovative therapies is crucial. This study focuses on a nanoform of chitosan, a biodegradable polymer, combined with Crocus sativus (saffron) and chloroquine to enhance their antimalarial effects.

Methods: Saffron extract and chloroquine were separately conjugated with chitosan, followed by confirmation tests to determine conjugation efficiency. Both chloroquine-resistant and sensitive strains of Plasmodium falciparum were cultured to calculate the IC50 values of various treatments in vitro. This study was conducted at the School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in 2024.

Results: Confirmation tests (FTIR, DLS, Zeta potential, TEM) verified proper drug conjugation to nanocomposites, with observed nanosize, the percentage of conjugation was 64.4% for chloroquine and 42.9% for saffron. Toxicity and hemolysis tests confirmed safe doses. The IC50s values for Chloroquine, Nanoparticle-Chloroquine, Saffron, and Nanoparticle-Saffron were 0.3, 0.8, 42.5, and 6.24 μg/ml, respectively, for the sensitive strain, and 5, 1, 12.5, and 3.12 μg/ml, respectively, for the resistant strain. Combination therapy with the fixed ratio method showed synergistic effects. Statistical analysis revealed synthesized nanocomposites' superior inhibition of P. falciparum growth compared to non-nano. Significant differences were observed in some cases (P< 0.05).

Conclusion: Utilizing nanocarriers and combination therapy is an appropriate strategy for addressing drug resistance. Saffron's anti-malarial effects on P. falciparum were notably increased when linked to chitosan nanocomposites. Furthermore, employing a fixed ratio technique enhanced the therapeutic effectiveness of saffron when combined with chloroquine and chloroquine-nanocomposites across all concentrations.

Background: We aimed to investigate the presence of thyroid peroxidase antibodies (anti-TPO) in women with spontaneous abortion, both with and without toxoplasmosis. This was achieved by evaluating and comparing the serum levels of interleukins IL-4, IL-6, IL-10, IL-17, and TNF-α in women who experienced abortion due to toxoplasmosis, categorized by positive and negative anti-TPO status, with those who were toxoplasmosis-negative and also negative for anti-TPO.

Methods: We evaluated the serological presence of IgG and IgM antibodies to Toxoplasma using an ELISA method, in Samarra City, Salah al-Din Governorate, Iraq in 2021-2022. A sample of 153 women with spontaneous abortion were enrolled. We also measured the serum levels of interleukins IL-4, IL-6, IL-10, IL-17, TNF-α, and anti-TPO using the same technique.

Results: Overall, 103 were Toxoplasma-positive. Of these, 14 had positive anti-TPO results (13.5%), compared to only 3 positive cases among the 50 matched controls who were Toxoplasma-negative (6.0%). The difference between Toxoplasma-positive and Toxoplasma-negative women regarding anti-TPO status was statistically significant for interleukins IL-4 (P=0.010), IL-6 (P=0.017), and IL-10 (P=0.003), but not for IL-17 or TNF-α. Additionally, the statistical analysis revealed a highly significant difference in the average concentrations of interleukins IL-4 (P=0.013) and IL-10 (P<0.001) between the Toxoplasma-positive/anti-TPO-positive group and the Toxoplasma-negative/anti-TPO-negative group of aborted women.

Conclusion: Elevated concentrations of IL-4, IL-10, and IL-6 have been associated with women undergoing recurrent miscarriages and negative anti-TPO results. The complex interaction between pro-inflammatory and anti-inflammatory cytokines is essential for immunological balance and pregnancy outcomes in a condition of toxoplasmosis. An increase in IL-4 and IL-10 levels in anti-TPO-positive individuals may lead to an imbalance in immune response, facilitating the development of autoimmune thyroid disease.

Background: Respiratory infections caused by Lophomonas blattarum and Pneumocystis jirovecii are significant threats, especially to immunocompromised patients. Both pathogens are associated with severe pneumonia and are often underdiagnosed due to the challenges in identifying them accurately, particularly in co-infections. We aimed to evaluate the prevalence and clinical impact of co-infections with L. blattarum and P. jirovecii in patients with respiratory symptoms.

Methods: This cross-sectional study involved 111 patients admitted to the Pulmonary Ward of Imam Reza Hospital in Mashhad, Iran in 2023. Bronchoalveolar lavage (BAL) samples were collected from all patients and analyzed microscopically and molecularly. PCR amplification targeting L. blattarum and P. jirovecii was performed, with subsequent sequencing for molecular identification. The presence of Pneumocystis was identified using a 346-bp PCR band.

Results: Of the 111 patients, Lophomonas was detected in 48 patients (43.2%), and Pneumocystis in 47 patients (42.3%). Co-infections were identified in 26 patients (23.6%). Both infections were more common in males, though the difference between genders was not statistically significant. The highest prevalence was observed in patients over 60 years, with 18% and 19.8% infection rates for Lophomonas and Pneumocystis, respectively. Co-infection rates were significantly higher in older patients and in males (P= 0.028).

Conclusion: The study demonstrates a significant prevalence of co-infections with L. blattarum and P. jirovecii in patients with respiratory conditions, particularly in the elderly. The findings underscore the need for comprehensive diagnostic strategies, including molecular and microscopic approaches, to accurately diagnose and manage these co-infections in high-risk populations.

Background: We aimed to conduct a comprehensive analysis of cutaneous leishmaniasis's (CL) clinical polymorphism by examining the relationship between clinical forms, duration of illness, and their spatiotemporal distribution.

Methods: A retrospective study at University of Gondar Hospital analyzed cutaneous leishmaniasis patients treated from 2022 to 2024. Demographic and epidemiologic data were collected, with parasite detection via microscopic and clinical examination.

Results: Overall, 454 CL cases from 49 districts were diagnosed, predominantly affecting males aged ≤30, with a mean age of 25.31 yr (SD ±18.3). Significant differences were noted in age and sex (P<0.05). Approximately 70% had lesions ≥4 cm. Most CL cases had 2+ parasite loads. Sodium stibogluconate (SSG) remained the primary treatment choice for patients. The spatial distribution of CL cases covered a larger geographical area, although the cases (>20) were concentrated in Central Gondar. The mucosal CL shared a similar geographical pattern with the recurrent CL type. Notably, 48% had chronic presentations and lived with the disease for ≥12 months. In diffuse CL (DCL) a longer delay was seen and its clinical presentation was associated with longitudinal time series. Acute patients exhibited a higher parasitic load than chronic ones (38% vs. 24%), respectively.

Conclusion: CL significantly affected school-aged children. The symmetrical distribution of cases in districts studied could increase the attention of clinicians and enhance management strategies. Extended disease durations necessitated specialized treatments for clinical transitions.

Background: Cytauxzoon felis is a protozoan parasite transmitted by ticks and affects felids. Acute infection in domestic cats is characterized by symptoms such as lethargy, anorexia, fever, and anemia.

Methods: The present study focuses on diagnosing and molecularly identifying C. felis using a real-time PCR method in cats from Semnan, Iran. During the winter and spring of 2024, two hundred cats were randomly selected from veterinary clinics in Semnan. Blood samples were collected from the cats for DNA extraction and molecular analysis. Samples were divided into 40 pooled of 5 samples, each consisting of a combination of 5 blood samples. Then, the genomic DNAs were extracted from blood specimens and screened by real-time PCR (RT-PCR) for the presence of C. felis infection by amplifying of ITS2 gene belonging to the Cytauxzoon genus.

Results: The results indicated that 6 out of the 200 blood samples were infected (3%).

Conclusion: This study was conducted for the first time in Semnan and shows that the prevalence of C. felis in cats is significant.

Background: The Mediterranean form of visceral leishmaniasis (VL) is endemic in some regions of Iran and is often seen in children under 10 years old. There is a 90% mortality in patients, if diagnosis and treatment are not done on time. Canids, as reservoirs, play an important role in the spread of the disease.

Methods: Bushehr Province, southern Iran is always mentioned as one of the endemic areas for VL, so for this purpose, as the first study in the region, 112 sheltered dogs in Bushehr City were evaluated for canine leishmaniasis (CanL) using serological Direct Agglutination Test (DAT) as well as detailed clinical examinations.

Results: Out of 112 samples collected, 71.4% of cases had anti-L. infantum IgG antibody titers of 1:80 and higher and therefore considered as seropositive. Furthermore, from the 70 seropositive dogs with antibody titer of 1:320 and higher, 47 (42%) had at least one of the clinical symptoms associated with VL and considered as cases with CanL.

Conclusion: The current seroprevalence situation of dogs in this region, is very noticeable and can be an important alarm for policymakers and health system practitioners. More comprehensive and complementary parasitological studies should be carried out on a number of reservoirs in the region for diagnosis and treatment and to accurately determine the statistics of the disease compared to the obtained seroprevalence status.