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Shahcheraghi F.,Pasteur Institute of Iran | Lotfi M.N.,Pasteur Institute of Iran | Nikbin V.S.,Pasteur Institute of Iran | Shooraj F.,Pasteur Institute of Iran | And 4 more authors.
Jundishapur Journal of Microbiology | Year: 2014

Background: Whooping cough was considered as one of the major causes of childhood morbidity and mortality worldwide. Resistant isolates of Bordetella pertussis to macrolides in some countries have been recently reported. Objectives: Recent reports on macrolide-resistant B. pertussis isolates and lack of evidence for such resistance in clinical isolates of the Iranian patients led the authors of the current study to study antibiotic susceptibility of the collected isolates in the country. Susceptibility of the B. pertussis isolates to three antibiotics was studied. Relatedness of the strains recovered in this research was also examined. Materials and Methods: The antibacterial activities of erythromycin, azithromycin, and clarithromycin antibiotics against the recovered isolates of 779 nasopharyngeal swabs were examined using MIC (Minimum Inhibitory Concentration) method. Relationship of the strains was characterized by Pulsed-field Gel Electrophoresis (PFGE). Results: Among the specimens, 11 cases (1.4%) were culture-positive. Among these isolates, only two isolates had high MIC values for erythromycin and clarithromycin. Pulsed-field gel electrophoresis analysis of the isolates revealed 6 PFGE profiles (A-F) among which three and two isolates had the same patterns in profiles A and B, respectively. Conclusions: Azithromycin can be a good drug of choice to treat patients infected by B. pertussis in Iran. Clonal relationship of the isolates showed that the same B. pertussis strains were isolated from different patients in Iran. © 2014, Ahvaz Jundishapur University of Medical Sciences. Source


Rajabi M.,Lund University | Pilesjo P.,Lund University | Shirzadi M.R.,Center for Communicable Diseases Control | Fadaei R.,Isfahan University of Medical Sciences | Mansourian A.,Lund University
Environmental Modelling and Software | Year: 2016

Cutaneous Leishmaniasis (CL) is an endemic vector-borne disease in the Middle East and a worldwide public health problem. The spread of CL is highly associated with the socio-ecological interactions of vectors, hosts and the environment. The heterogeneity of these interactions has hindered CL modeling for healthcare preventive measures in endemic areas. In this study, an agent-based model (ABM) is developed to simulate the dynamics of CL spread based on a Geographic Automata System (GAS). A Susceptible-Exposed-Infected-Recovered (SEIR) approach together with Bayesian modeling has been applied in the ABM to explore the spread of CL. The model is then adapted locally for Isfahan Province, an endemic area in central Iran. The results from the model indicate that desertification areas are the main origin of CL, and riverside population centers have the potential to host more sand fly exposures and should receive more preventive measures from healthcare authorities. The results also show that healthcare service accessibility prevented exposures from becoming infected and areas with new inhabitants experienced more infections from same amount of sand fly exposures. © 2016 Elsevier Ltd. Source


Zamani S.,Kyoto University | Radfar R.,Health and Culture Institute | Nematollahi P.,Isfahan University of Medical Sciences | Fadaie R.,Isfahan University of Medical Sciences | And 5 more authors.
International Journal of Drug Policy | Year: 2010

Background: The control of blood-borne infections including HIV and hepatitis C (HCV) amongst injecting drug users (IDUs) is a challenge for health authorities in Iran. Hence, more reliable estimates of the levels of blood-borne infections and their associated factors are critically needed. Methods: Active IDUs were recruited using peer-driven sampling in a bio-behavioural survey in 2008. Over 8 weeks, data were collected from adults living in a city in Isfahan Province who had injected drugs in the past month. Participants provided a whole blood sample and answered questions on sexual and drug-related risk characteristics. Participants were provided post-test counselling and a non-monetary incentive for their participation. Excluding two inactive cases, the initial recruits resulted in 2-8 waves of recruitment. Results: Overall, 118 IDUs including three females participated. The estimated population proportions of HIV, hepatitis B, and HCV infections were 0.7% (95% CI, 0.6-2.3), 0.7% (95% CI, 0.1-2.1), and 59.4% (95% CI, 47.4-68.7), respectively. Responses indicated that 31% (95% CI, 20-44.5) of the IDUs ever shared a needle/syringe for drug injection, and 77% (95% CI, 65-84) had ever injected an addictive solution marketed widely as Temgesic. Multivariate analyses revealed that the high prevalence of HCV infection amongst IDUs is associated with the lifetime duration of drug injection (AOR, 1.17; 95% CI, 1.01-1.34) and with having injected Temgesic (AOR, 4.73; 95% CI, 1.52-14.69). Conclusion: Our experience in Iran indicates that IDUs can be recruited effectively in a bio-behavioural survey through peer-driven sampling and using only a single primary incentive. The high prevalence of HCV associated with injecting Temgesic is important evidence for harm-reduction policies in Iran. © 2010 Elsevier B.V. Source


Aryan E.,Mashhad University of Medical Sciences | Makvandi M.,Ahvaz Jundishapur University of Medical Sciences | Farajzadeh A.,Ahvaz Jundishapur University of Medical Sciences | Huygen K.,Scientific Institute of Public Health WIV ISP | And 4 more authors.
Journal of Infection | Year: 2013

Objectives: A fundamental to global tuberculosis (TB) control is timely and accurate diagnosis of infectious cases of the disease. Among various methods, techniques based on nucleic acid amplification are the ones with promising prospects. The present study evaluates the diagnostic value of the recently developed IS. 6110-based loop-mediated isothermal amplification (LAMP) for detection of Mycobacterium tuberculosis complex (MTBC) in sputum specimens. Methods: In this cross-sectional study (2008-2009), IS. 6110-LAMP was evaluated on 101 sputum specimens from 93 highly suspected TB patients and compared to Amplicor MTB test and in-house IS. 6110-PCR and -nested PCR assays. Culture results or clinical recovery following anti-TB therapy was considered as a reference to prove the TB cases. Results: The overall sensitivity of IS. 6110-LAMP, Amplicor, nPCR, and PCR were respectively 89.6% (69/77 specimens; 95% confidence interval [CI], 80.5-95.4%), 76.6% (59/77 specimens; CI, 65.6-85.5%), 79.2% (61/77 specimens; CI, 68.5-87.6%) and 59.7% (46/77 specimens; CI, 47.9-70.8%). The specificity and positive predictive value (PPV) were 100% for all the tests, and the negative predictive value (NPV) of IS. 6110-LAMP, Amplicor, nPCR, and PCR were respectively 75%, 57.1%, 60%, and 43.6%. There was an excellent overall agreement between LAMP and nPCR (. k 0.828), and between LAMP and Amplicor (. k 0.746), in addition to a better tolerance of IS. 6110-LAMP to inhibitors present in clinical specimens. Conclusion: The better diagnostic performance of IS. 6110-LAMP compared to Amplicor (. p = 0.009), nPCR (p = 0.013) and PCR (. p < 0.0001) besides its rapidity, simplicity, and cost-effectiveness makes it a valuable method for the detection of MTBC in clinical samples, particularly in resource-limited settings. © 2013 The British Infection Association. Source


Moradi G.,Kurdistan University of Medical Sciences | Mohraz M.,Iranian Institute for Reduction of High Risk Behaviours | Gouya M.M.,Center for Communicable Diseases Control | Dejman M.,University of Social Welfare and Rehabilitation Sciences | And 3 more authors.
Eastern Mediterranean Health Journal | Year: 2015

This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders — service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) — participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients’ substance abuse; patients’ fear of stigma; occupational burnout of certain service providers; patients’ dissatisfaction with some of the services provided by counselling centres/clinics; medical staff’s failure to observe confidentiality; and patients’ lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region. © 2014, World Health Organization. All rights reserved Source

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