Publications by authors named "Fahimeh Bagheri Amiri"

26 Publications

  • Page 1 of 1

How is the iceberg of COVID-19? Results from a rapid literature review.

Med J Islam Repub Iran 2021 16;35:77. Epub 2021 Jun 16.

Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Given the various reports of the clinical spectrum of the disease, the aim of the present study was to determine possible scenarios of Coronavirus 2019 (COVID-19) iceberg using published articles. The present study was a rapid review of all international databases, including PubMed (Medline), Scopus, Web of Sciences, Embase, and Cochrane Library from January 1 to October 30, 2020. In this review, 7 scenarios were considered for COVID-19 iceberg, in which the range of fatality percentage was estimated to be 0.5% to 7%, the range of asymptomatic cases 1% to 88.6%, the range of cases with mild symptoms 8% to 78%, no symptoms 1 % to 90 %, the range of intensive care unit (ICU) admission was 0.5% to 14.2%, and finally the intubation percentage was estimated to be 0.2% to 12.2%. The Scenarios Diamond Princess Cruise Ship and Iceland are closer to the reality of the clinical spectrum of COVID-19 around the world, which represent 0.6% and 0.5% of deaths, 0.7% and 1% of intubations, 2.5% and 9.7% of ICU admissions, 1.1% and 6% of hospitalizations, 15% and 31% of cases with mild symptoms, and finally 56.9% and 75% of asymptomatic cases of COVID-19, respectively, which should now be considered as the basis of the clinical knowledge of the disease. Understanding the clinical spectrum and natural knowledge of the disease and paying attention to asymptomatic or mild-symptom cases can help to make better decisions and develop more effective interventions to control COVID-19.
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http://dx.doi.org/10.47176/mjiri.35.77DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285553PMC
June 2021

The Prevalence of Vitamin D Deficiency, Its Predisposing Factors and Association with 24-hour Urine Metabolites Among Iranian Kidney Stone Formers.

Iran J Kidney Dis 2021 Jul;15(4):263-269

Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: To study the prevalence of vitamin D deficiency in kidney stone formers and its predisposing factors and to assess the relationship between serum 25-Hydroxyvitamin D and urine metabolites.

Methods: Kidney stone formers were selected from the records of the kidney stone prevention clinic in Labbafinejad hospital, Tehran, Iran. Vitamin D deficiency was defined as 25-Hydroxyvitamin D < 20 ng/mL. The association between vitamin D deficiency and predisposing factors, serum, and urine metabolites was evaluated.

Results: In 1005 patients (66.4% men and 33.6% women), the prevalence of vitamin D deficiency was 44.8%. Vitamin D deficiency was more prevalent in patients under 50 years (P < .001) and patients with hyperparathyroidism (P < .05). The lowest prevalence of hyperparathyroidism was in the 25-Hydroxyvitamin D range of 40 to 49.9 ng/mL, followed by the range of 30 to 39.9 and 20 to 29.9 ng/mL. Patients with vitamin D deficiency had lower serum creatinine (P < .02), lower 24-hour urine calcium (P < .01), and lower 24-hour urine oxalate (P < .05).

Conclusion: Iranian kidney stone formers have a relatively high prevalence of vitamin D deficiency. Our population seems to have different predisposing factors for vitamin D deficiency, i.e., higher prevalence among younger patients and no association between obesity and gender with vitamin D status. According to the parathyroid hormone, the favorable serum 25-Hydroxyvitamin D level was 20 to 49.9 ng/mL in our kidney stone formers.
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July 2021

How Can the Epidemic Curve of COVID-19 in Iran Be Interpreted?

J Res Health Sci 2020 Oct 4;20(3):e00491. Epub 2020 Oct 4.

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

Background: Iran is one of the countries most affected by COVID-19. This review provides possible interpretations of the observed trend of COVID-19 in Iran.

Study Design: A rapid review METHODS: We reviewed the daily new cases of COVID-19 based on hospitalized and outpatients, reported deaths, and diagnostic testing in Iran.

Results: Iran reported its first peak in the number of cases in late March, 2020. From the 1 April to 3 May 2020, the downward trend in the number of cases was started. The death trend also showed a peak in early April as well as a downward trend in late April. During May, the number of death cases showed a stable trend with a daily number of deaths ranging between 50 and 75 cases. Then the number of deaths gradually increased.

Conclusion: The epidemic curve in Iran is a function of different factors such number of total tests, change in mitigation policies, and heterogeneities among different provinces in the country. Therefore it should be interpreted under the light of the effect of such factors.
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http://dx.doi.org/10.34172/jrhs.2020.27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585769PMC
October 2020

Conflict of Interest: Are Iranian Breast Cancer Specialists Prone to it?

Asian Pac J Cancer Prev 2020 Jun 1;21(6):1653-1658. Epub 2020 Jun 1.

Department of Surgery, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Introduction: Giving gifts is a common way to promote and encourage the use of products of trading companies and increase the patient referrals to diagnostic centers. The present study aimed to assess the practice of physicians of different (sub) specialties/educational levels engaged in breast cancer management in some conflict of interest (COI) situations in their relation with pharmaceutical companies and paraclinical centers.

Methods: A self-administered online questionnaire including questions on demographic and professional information as well as the attitude of physicians toward COI by answering the questions in three different practical scenarios was developed. Respondents were asked to answer each question by selecting one of the five options: strongly agree, agree, undecided/neutral, disagree, and strongly disagree in their own practices as well as the same questions asking the same subject for what they think of the other physicians. Descriptive statistical analysis was used to report qualitative and quantitative variables.

Result: The response rate was 66.24%. In general, physicians considered their performance better than that of other physicians in the situations asked. More than 90% stated that they would participate in the sponsorship congress for introducing new drugs. One fifth of the physicians stated that they would accept the 30% financial proposition for the referral of every single patient to other clinics. More than half of the physicians stated that they had considered the risks resulted from the COI for referring patients to private radiobiological centers.

Conclusion: This study indicated that physicians in the field of breast cancer were at the risk of COI. Even within the medical field, there is not sufficient trust in the proper functioning of doctors in dealing with COI situations.
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http://dx.doi.org/10.31557/APJCP.2020.21.6.1653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568883PMC
June 2020

Results of Pediatric Kidney Transplants in an 8-Year Period: A Retrospective Study.

Transplant Proc 2020 Apr 4;52(3):793-799. Epub 2020 Mar 4.

Department of Urology, Imam Reza Hospital, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Background: Patient survival and quality of life is better after a kidney transplant compared with dialysis. In this retrospective study, we analyzed the results of pediatric kidney transplants in an 8-year period in our center.

Methods: We reviewed the files of 166 children and adolescents who had undergone kidney transplants between 2008 and 2015 in our center. All the patients were younger than 18 years old and had been followed up for at least 2 years.

Results: The transplanted kidneys were taken from live donors in 146 (88%) of the cases and from cadavers in 20 (12%) of the cases. They were procured from unrelated and related donors in 129 (90%) and 17 (10%) of the cases, respectively. Laparoscopic nephrectomy was done on 141 donors. The kidney vessels were anastomosed to the aorta, the common iliac, and the internal iliac in 3.6%, 56%, and 40.4% of cases, respectively. Preemptive kidney transplants were performed on 62 patients. The mean of patient survival was 124 ± 1.37 months. One- and five-year patient survival rates were 99% and 97%, respectively. The mean of graft survival was 118.29 ± 2.47 months. One- and five-year graft survival rates were 94% and 93%, respectively. Preemptive kidney transplants had a higher graft survival rate (P < .02).

Conclusion: Kidney transplant is a safe and feasible procedure in children and adolescents based on patient and graft survival outcomes. In our center, surgery complications led to kidney loss in very few cases.
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http://dx.doi.org/10.1016/j.transproceed.2019.12.047DOI Listing
April 2020

Serological evidence of leptospirosis in Iran; A systematic review and meta-analysis.

Microb Pathog 2020 Jan 4;138:103833. Epub 2019 Nov 4.

National Reference Laboratory of Plague, Tularemia and Q Fever, Pasteur Institute of Iran, Tehran, Iran. Electronic address:

Leptospirosis is a neglected infectious zoonotic disease that affects domestic animals and wildlife as well as humans. Although leptospirosis is known as an endemic disease in Iran, there is no accurate information on the overall prevalence of this disease in humans and animals. The aim of this systematic review and meta-analysis was to estimate the seroprevalence of leptospirosis among human and domestic and wild animals in Iran. A systematic review of English and Persian articles (since 1998 to December 2017) was conducted using Google Scholar, Medline/PubMed, Science Direct, Scopus, Web of science and Iranian databases Iranmedex, Scientific Information Database (SID), Magiran, and IRANDOC. Search terms include leptospirosis, Leptospira, serology, seroprevalence, seroepidemiology, serological, Iran, cow, goat, sheep, camel, dog, cat, equine, donkey, horse, mule and rodent. In Eventually 66 articles were selected to analyze based on inclusion criteria. Seroprevalence of leptospirosis in human was 27.84% (95% CI: 13.22-22.47) and 19.71% (95% CI: 6.78-32.65%) based on ELISA and MAT, respectively. The pooled prevalence of leptospirosis in cow, sheep, goat and camel was 26.62% (95% CI: 18.76-34.48), 17.38% (95% CI: 13.32-21.43), 12.18% (95% CI: 9.96-14.41) and 22.68% (95% CI: 18.97-26.40), respectively. The prevalence of leptospirosis in horse, donkey, and mule was 19.99% (95% CI: 13.32-26.68), 40.59% (95% CI: 33.20-47.97) and 9.10% (95% CI: 2.90-15.30), respectively. The prevalence in dog and cat were estimated 14.63% (95% CI: 3.49-25.77) and 14.44% (95% CI: 3.25-25.65), respectively. The prevalence of seropositivity in rodents was estimated 20.96% (95% CI: 10.62-31.30). This study is a very comprehensive report on the status of leptospirosis in Iran. Based on our results, leptospirosis has considerable seroprevalence among human and animals in Iran. This high seroprevalence of leptospirosis showed should be given more attention for this disease in Iran and thus health measures must be taken to diagnosis, control and prevent it.
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http://dx.doi.org/10.1016/j.micpath.2019.103833DOI Listing
January 2020

Q Fever Endocarditis in Iran.

Sci Rep 2019 10 24;9(1):15276. Epub 2019 Oct 24.

National Reference Laboratory for Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Iran.

Patients with the underlying valvular heart disease are at the high risk of developing sub-acute or chronic endocarditis secondary to Coxiella burnetii. Q fever endocarditis is the most common manifestation along with persistent the infection. There is some serologic and molecular evidence of C. burnetii infection in humans and livestock in Iran. As it is possible to observe chronic Q fever in Iran, it seems necessary to study the prevalence of Q fever endocarditis in this country. In the present study, Infective Endocarditis (IE) patients (possible or definite based on Duke Criteria) hospitalized in Rajaie Cardiovascular Medical and Research Center were enrolled from August 2016 to September 2018. Culture-negative endocarditis patients were evaluated by Raoult criteria for diagnosis Q fever endocarditis. The serological results for brucellosis were negative for all subjects. All blood and tissue samples including valve samples were tested for C. burnetii infection using serology and Polymerase Chain Reaction (PCR). In this study, 126 patients who were admitted to the hospital were enrolled; of which 52 subjects were culture-negative IE. Among the participants, 16 patients (30.77%) were diagnosed with Q fever IE and underwent medical treatment. The mean age of patients was 46.6 years ranging from 23 to 69 years and 75% of them were male. Considering the high prevalence of Q fever IE, evaluation of the patients with culture-negative IE for C. burnetii infections was highly recommended.
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http://dx.doi.org/10.1038/s41598-019-51600-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813299PMC
October 2019

Seroepidemiological study of Q fever, brucellosis and tularemia in butchers and slaughterhouses workers in Lorestan, western of Iran.

Comp Immunol Microbiol Infect Dis 2019 Oct 19;66:101322. Epub 2019 Jun 19.

National Reference Laboratory of Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar-Ahang, Hamadan, Iran; Department of Epidemiology and Biostatics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran. Electronic address:

Most zoonoses are occupational diseases. Q fever, brucellosis and tularemia are major zoonotic diseases for butchers and slaughterhouse workers. However, little information is available about these infectious diseases in such professional populations in western of Iran. The aim of this study was to investigate the seroprevalence and risk factors associated with these three zoonoses among butchers and slaughterhouse workers in the Lorestan province of Iran. In 2017, 289 individuals (144 butchers or slaughterhouse workers, and 145 people from the general population) were enrolled in 11 different counties of this province. Collected serum samples were tested by ELISA for detection of IgG antibodies against Coxiella burnetii, Brucella spp. or Francisella tularensis antigens. The seroprevalence of Q fever, brucellosis and tularemia among all participants were 23.5%, 31.8% and 3.8%, respectively. The seroprevalence of brucellosis and Q fever among butchers and slaughterhouse workers (43.7% and 29.8%, respectively) were significantly higher (p < 0.05) than those of the general population (20% and 17.2%, respectively). A contact history with small ruminants (sheep and goats) was associated with a higher risk of positive serology for all three studied zoonoses. The high seroprevalence for Q fever and brucellosis we found among butchers and slaughterhouse workers suggests that both diseases are common in these populations of the Lorestan province. Since these two infectious diseases are clinically unspecific, they must be systematically included in the etiological diagnosis of infectious diseases occurring in these at-risk populations. In addition, we recommend specific training programs as well as the use of personal protective equipment in these occupational groups to reduce the occurrence of these zoonotic diseases.
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http://dx.doi.org/10.1016/j.cimid.2019.06.003DOI Listing
October 2019

Effect of vitamin D supplementation on 24-hour urine calcium in patients with calcium Urolithiasis and vitamin D deficiency.

Int Braz J Urol 2019 Mar-Apr;45(2):340-346

Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear.

Materials And Methods: In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed.

Results: Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH.

Conclusions: The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.
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http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541149PMC
July 2019

Evaluating the associations between urinary excretion of magnesium and that of other components in calcium stone-forming patients.

Int Urol Nephrol 2019 Feb 4;51(2):279-284. Epub 2018 Dec 4.

Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, No. 103, 9th Boostan Street, Pasdaran Avenue, Tehran, Iran.

Purpose: Magnesium plays numerous vital roles in human's body. It is known as a protective factor in stone formation by binding to oxalate in the intestinal and urinary system, and decreasing its absorption and crystallization, respectively. Due to controversies about the association between the 24-h urine magnesium and other urine metabolites in different studies, this study was designed to find a clear answer to this question.

Methods: In this retrospective cross-sectional study, data from 24-h urinalysis of the calcium stone-forming (CSF) patients were assessed. The correlation between 24-h urine (24-U) magnesium to creatinine ratio (Mg/Cr) with other 24-U metabolites to creatinine ratio was assessed, using Spearman correlation test. The association between 24-U magnesium and 24-U oxalate was also studied in a multivariate logistic regression model.

Results: Among 965 patients, the level of Mg/Cr showed a direct association with all other 24-U metabolite to Cr ratio (p-value < 0.001 for all analyses). The result of multivariate regression analysis showed that the higher quartile of 24-U oxalate (> 47 mg/24 h) increased the odds of 24-U magnesium more than 75 mg/24 h (data median) (OR 1.89, 95% CI 1.14-3.13) comparing with the lower quartile of 24-U oxalate (≤ 26 mg/24 h).

Conclusions: In a routine dietary habit, since rich sources of magnesium contain a high amount of oxalate at the same time, it is not surprising that magnesium level in 24-h urinalysis showed a direct association with 24-h urine oxalate.
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http://dx.doi.org/10.1007/s11255-018-2036-1DOI Listing
February 2019

Knowledge, Attitude, and Practices Regarding HIV and TB Among Homeless People in Tehran, Iran.

Int J Health Policy Manag 2018 06 1;7(6):549-555. Epub 2018 Jun 1.

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

Background: Homeless people are at high risk of HIV and tuberculosis (TB) infection due to living in poor sanitary conditions and practicing high-risk behavior. The aim of this study is to assess the knowledge, attitude, and practice (KAP) of homeless people in Tehran regarding TB and HIV.

Methods: Using a convenience sampling, we performed a cross-sectional study on homeless people in Tehran from June to August 2012. Participants aged 18-60 years having at least 10 days of homelessness in the preceding month to the study period were included. All required data were collected through face-to-face interviews conducted using a researcherdesigned questionnaire. Each score in KAP of TB and HIV was separately divided by the maximum score and multiplied by 100 to attain percentage scores. The mean scores were compared using analysis of variance (ANOVA) and student's t test. A Tukey test was used for post hoc analysis and two-by-two comparisons.

Results: In this study, 593 participants consisting of 513 men and 80 women were included. The mean age of the participants was 41.74 ± 0.45 years. Moreover, the total mean score of KAP toward HIV was 79.24 (95% CI: 77.36, 81.12), 57.13 (95% CI: 55.12, 59.14), and 21.14 (95% CI: 18.35, 23.93), respectively. The total mean score of knowledge and practice regarding TB was 62.04 (95% CI: 59.94, 64.14) and 42.57 (95% CI: 40.36, 44.78), respectively.

Conclusion: Although a relatively acceptable knowledge was detected in this high-risk population, practices regarding TB and HIV showed some weaknesses. Developing special programs to improve the healthy behavior of this population is highly recommended.
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http://dx.doi.org/10.15171/ijhpm.2017.129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015517PMC
June 2018

Prevalence of HAV Ab, HEV (IgG), HSV2 IgG, and Syphilis Among Sheltered Homeless Adults in Tehran, 2012.

Int J Health Policy Manag 2018 03 1;7(3):225-230. Epub 2018 Mar 1.

Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

Background: This study investigated the prevalence for hepatitis A virus (HAV), hepatitis E virus (HEV), herpes simplex virus type 2 (HSV2) and syphilis among homeless in the city of Tehran.

Methods: In this cross-sectional study, 596 homeless were recruited in Tehran. A researcher-designed questionnaire was used to study demographic data. Using enzyme-linked immunoassay, and rapid plasma reagin (RPR) test, we evaluated the seroprevalence of HAV anti-body, HEV IgG, herpes, HSV2 IgG, and syphilis among sheltered homeless in Tehran. The associations between the participant's characteristics and infections were evaluated using logistic regression and chi-square.

Results: A total of 569 homeless, 78 women (13.7%) and 491 men (86.3%) were enrolled into the study from June to August 2012. Their age mean was 42 years and meantime of being homeless was 24 months. Seroprevalence of syphilis, HEV IgG, HSV2 IgG and HAV Ab was 0.55%, 24.37%, 16.48%, and 94.34%, respectively. History of drug abuse was reported in 77.70%; 46.01% of them were using a drug during the study and 26.87% of them had history of intravenous drug abuse. Among people who had intravenous drug abuse, 48.25% had history of syringe sharing.

Conclusion: The prevalence of HAV, HEV and HSV2 were higher than the general population while low prevalence of syphilis was seen among homeless peoples who are at high risk of sexually transmitted infection (STD). Our findings highlighted that significant healthcare needs of sheltered homeless people in Tehran are unmet and much more attention needs to be paid for the health of homeless people.
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http://dx.doi.org/10.15171/ijhpm.2017.74DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890067PMC
March 2018

Seroepidemiology and risk factors of Crimean-Congo Hemorrhagic Fever among butchers and slaughterhouse workers in southeastern Iran.

Int J Infect Dis 2017 Nov 19;64:85-89. Epub 2017 Sep 19.

Infectious Disease and Tropical Diseases Research Center, Zahedan University of Medical Sciences, Boo-Ali Hospital, Zahedan, Iran.

Objective: Crimean-Congo Haemorrhagic Fever (CCHF) is a viral zoonotic disease. Butchers and slaughterhouse workers are considered to be high risk occupational groups for the disease. Sistan and Baluchistan province is an area in southeastern Iran which is endemic for CCHF, and the most confirmed cases of the disease are reported from this province. The aim of this study was to investigate the seroprevalence of CCHF and risk factors for seropositivity among them in Sistan and Baluchistan province in 2011.

Methods: Questionnaire data and blood sample collection were carried out for each participant and the sera samples were sent to the national reference laboratory for ELISA IgG testing.

Results: In this study, the seroprevalence of CCHF among 190 butchers and slaughterhouse workers from 11 counties was 16.49%. 79% of participants were aware that they were at risk of zoonosis and 39.7% did not use any personal protective equipment during their work. Of 31 CCHF IgG positive individuals in this study, eleven individuals had a previous record of CCHF infection in 57 months prior to the study.

Conclusions: High seroprevalence of CCHF among butchers and slaughterhouse workers and minimal use of personal protective equipment's during daily work indicates the need for training courses, for these groups to increase their knowledge, attitude and practice with respect to zoonosis.
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http://dx.doi.org/10.1016/j.ijid.2017.09.008DOI Listing
November 2017

Seroprevalence of Q fever among human and animal in Iran; A systematic review and meta-analysis.

PLoS Negl Trop Dis 2017 04 10;11(4):e0005521. Epub 2017 Apr 10.

Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: Q fever is a main zoonotic disease around the world. The aim of this meta-analysis was to estimate the overall seroprevalence of Coxiella burnetii among human and animal population in Iran.

Methods: Major national and international databases were searched from 2005 up to August 2016. We extracted the prevalence of Q fever antibodies (IgG) as the main primary outcome. We reported the prevalence of the seropositivity as point and 95% confidence intervals.

Results: The overall seroprevalence of IgG phase I and II antibodies of Q fever in human was 19.80% (95% CI: 16.35-23.25%) and 32.86% (95% CI: 23.80-41.92%), respectively. The herd and individual prevalence of C. burnetii antibody in goat were 93.42% (95% CI: 80.23-100.00) and 31.97% (95% CI: 20.96-42.98%), respectively. The herd and individual prevalence of Q fever antibody in sheep's were 96.07% (95% CI: 89.11-100.00%) and 24.66% (95% CI: 19.81-29.51%), respectively. The herd and individual prevalence of C. burnetii antibody in cattle were 41.37% (95% CI: 17.88-64.86%) and 13.30% (95% CI: 2.98-23.62%), respectively. Individual seropositivity of Q fever in camel and dog were 28.26% (95% CI: 21.47-35.05) and 0.55% (0.03-2.68), respectively.

Conclusion: Seroprevalence of Q fever among human and domestic animals is considerable. Preventative planning and control of C. burnetii infections in Iran is necessary. Active surveillance and further research studies are recommended, to more clearly define the epidemiology and importance of C. burnetii infections in animals and people in Iran.
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http://dx.doi.org/10.1371/journal.pntd.0005521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398711PMC
April 2017

Serological survey of leptospirosis among different groups in western Iran.

Trop Doct 2017 Apr 2;47(2):124-128. Epub 2016 Sep 2.

9 Associate Professor and Head of Department, Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran.

Leptospirosis is a zoonosis and a major public health problem. Blood sampling was done in the province of Kurdistan from 250 members of different groups, including hunters and their families, butchers and slaughterhouse workers, healthcare workers (HCWs) and those referred to medical diagnostic laboratories for routine testing. Sera were tested using an ELISA method to detect specific Leptsopira IgG antibodies. We found 20.80% (95% confidence interval, 16.23-26.25%) to be positive. The highest and lowest seroprevalence were in hunters (26%) and HCWs (18%). There was significant positive correlation between age and seropositivity ( P = 0.01). Hunting and eating the meat of the hare and exposure to dead or dying wild animals were found to be the main risk factors ( P < 0.05).
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http://dx.doi.org/10.1177/0049475516665766DOI Listing
April 2017

HIV, HBV and HCV Coinfection Prevalence in Iran--A Systematic Review and Meta-Analysis.

PLoS One 2016 31;11(3):e0151946. Epub 2016 Mar 31.

Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America.

Background: worldwide, hepatitis C and B virus infections (HCV and HCV), are the two most common coinfections with human immunodeficiency virus (HIV) and has become a major threat to the survival of HIV-infected persons. The review aimed to estimate the prevalence of HIV, HBV, HCV, HIV/HCV and HIV/HBV and triple coinfections in different subpopulations in Iran.

Method: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports on prevalence of HIV, HBV, HCV and HIV coinfections in different subpopulations in Iran. We systematically reviewed the literature to identify eligible studies from January 1996 to March 2012 in English or Persian/Farsi databases. We extracted the prevalence of HIV antibodies (diagnosed by Elisa confirmed with Western Blot test), HCV antibodies and HBsAg (with confirmatory laboratory test) as the main primary outcome. We reported the prevalence of the three infections and coinfections as point and 95% confidence intervals.

Findings: HIV prevalence varied from %0.00 (95% CI: 0.00-0.003) in the general population to %17.25 (95% CI: 2.94-31.57) in people who inject drugs (PWID). HBV prevalence ranged from % 0.00 (95% CI: 0.00-7.87) in health care workers to % 30.9 (95% CI: 27.88-33.92) in PWID. HCV prevalence ranged from %0.19 (95% CI: 0.00-0.66) in health care workers to %51.46 (95% CI: 34.30-68.62) in PWID. The coinfection of HIV/HBV and also HIV/HCV in the general population and in health care workers was zero, while the most common coinfections were HIV/HCV (10.95%), HIV/HBV (1.88%) and triple infections (1.25%) in PWID.

Conclusions: We found that PWID are severely and disproportionately affected by HIV and the other two infections, HCV and HBV. Screenings of such coinfections need to be reinforced to prevent new infections and also reduce further transmission in their community and to others.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151946PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816272PMC
August 2016

Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran.

PLoS One 2016 5;11(1):e0144953. Epub 2016 Jan 5.

Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran.

Zoonotic diseases can be occupational hazards to people who work in close contact with animals or their carcasses. In this cross-sectional study, 190 sera were collected from butchers and slaughterhouse workers in different regions of the Sistan va Baluchestan province, in Iran in 2011. A questionnaire was filled for each participant to document personal and behavioural information. The sera were tested for detection of specific IgG antibodies against brucellosis, leptospirosis, and Q fever (phase I and II) using commercial enzyme-linked immunosorbent assays (ELISA). The seroprevalence of brucellosis was 7.9%, leptospirosis 23.4%, and phase I and II of Q fever were 18.1% and 14.4%, respectively. The seroprevalence of Q fever and leptospirosis, but not brucellosis, varied among regions within the province (p = 0.01). Additionally, a significant relationship was found between seropositivity of Q fever and camel slaughtering (p = 0.04). Reduced seropositivity rate of brucellosis was associated with use of personal protective equipment (PPE) (p = 0.004). This study shows that brucellosis, leptospirosis and Q fever occur among butchers and slaughterhouse workers in this area.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144953PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701462PMC
July 2016

Detection of Salmonella spp in commercial eggs in Iran.

Iran J Microbiol 2015 Feb;7(1):50-4

Department of Pathobiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.

Background And Objective: Salmonellosis can be acquired through consumption of infected raw or undercooked eggs. The aim of this study was isolation and identification of Salmonella spp from the eggshells and the egg contents samples of Tabriz retails.

Methods: A total number of 150 samples of eggs were analyzed for the presence of Salmonella spp. using conventional culture method and multiplex-PCR.

Results: Two (1.33%) out of 150 samples from eggshells were determined as contaminated with Salmonella spp. Salmonella spp was not isolated from the egg contents. Salmonella serovar was determined as enteritidis and typhimurium.

Conclusion: The results of the present study provide the recent dataset of the prevalence of S. enteritidis and S. typhimurium in eggs at retail shops in the northwest of Iran. It is important to remember that control is required at all levels in the food chain and by separating cooked and raw.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670468PMC
February 2015

Comparison of an interferon-gamma release assay and the tuberculin skin test for diagnosis of latent tuberculosis in homeless people in Iran: a cross-sectional study.

Infect Dis (Lond) 2015 Aug 2;47(8):536-41. Epub 2015 Apr 2.

From the Department of Epidemiology, Pasteur Institute of Iran , Tehran.

Background: The aim of this study was to evaluate of the concordance between the results of the tuberculin skin test (TST) and an interferon-γ release assay (QuantiFERON test, QFT-GIT) for diagnosis of latent tuberculosis infection (LTBI) in homeless people in Tehran city, Iran.

Methods: This cross-sectional study was conducted from June to August 2012. Homeless people were eligible to participate in the study if they were 18-60 years old.

Results: Among 569 homeless people, 46.22% (95% confidence interval (CI) = 42.16-50.33%) and 20.39% (95% CI = 17.28-23.9%) were QFT-GIT and TST positive, respectively. Among these participants, the prevalence of LTBI with positivity of at least one of the tests was 52.2%. The overall agreement between QFT-GIT and TST was 62.21% (kappa = 0.21, 95% CI = 0.13-0.29, p < 0.001). Factors associated with positive results in QFT-GIT and TST were older age, being male, having a longer history of homelessness and having a history of incarceration in the last 10 years.

Conclusions: A high prevalence of LTBI was seen among homeless people in this study. There was a poor concordance between QFT-GIT and TST among this group. To better assess the utility of QFT-GIT in detection of LTBI further studies with a low prevalence of LTBI in this group are recommended.
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http://dx.doi.org/10.3109/23744235.2015.1026934DOI Listing
August 2015

Isolation of Listeria monocytogenes from milks used for Iranian traditional cheese in Lighvan cheese factories.

Ann Agric Environ Med 2014 ;21(4):728-9

Department of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.

Traditional Lighvan cheese is a semi-hard cheese which has a popular market in Iran and neighboring countries. The aim of this study was evaluating the contamination of milks used for Lighvan cheese making with Listeria monocytogenes. Raw milk samples were randomly collected from different cheese producing factories (sampling carried out from large milk tanks used cheese making in factories). Isolation of L. monocytogenes was performed according to ISO 11290 and biochemical tests were done to identify and confirm L. monocytogenes. 9 samples (50%) of the 18 collected samples from milk tanks in Lighvan cheese producing factories were contaminated with L. monocytogenes. The concentration of L. monocytogenes in all 9 positive samples was 40 CFU/ml. This study is the first report of L. monocytogenes contamination in raw milks used for Lighvan cheese production in Iran. Regarding the fact that these cheeses are produced from raw milk and no heating process is performed on them its milk contamination can be a potential risk for consumers.
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http://dx.doi.org/10.5604/12321966.1129923DOI Listing
August 2015

Serological survey of tularemia among butchers and slaughterhouse workers in Iran.

Trans R Soc Trop Med Hyg 2014 Aug 18;108(8):516-8. Epub 2014 Jun 18.

Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran Research Centre for Emerging and Reemerging Infectious Diseases (Akanlu), Pasteur Institute of Iran, Kabudar-Ahang, Hamadan, Iran

Background: Tularemia is a zoonotic disease caused by the Gram-negative bacterium Francisella tularensis. Human infections often occur through manipulation of infected animals or animal carcasses.

Methods: In this study, we determined the tularemia seroprevalence in butchers and slaughterhouse workers in 10 counties of Sistan and Baluchestan Province in Iran.

Results: A mean seroprevalence of 6.5% for IgG antibodies against F. tularensis was seen. The highest seropositivity rates were observed in the counties of Zabol and Nikhshahr. There was no difference in the seroprevalence rates between butchers and slaughterhouse workers (p=0.25).

Conclusion: These data suggest that tularemia is endemic in Sistan and Baluchestan Province in Iran.
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http://dx.doi.org/10.1093/trstmh/tru094DOI Listing
August 2014

Vulnerability of homeless people in Tehran, Iran, to HIV, tuberculosis and viral hepatitis.

PLoS One 2014 4;9(6):e98742. Epub 2014 Jun 4.

Department of Epidemiology, Pasteur Institute of Iran, Tehran, Iran; Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Research Centre for Emerging and Reemerging Infectious Diseases (Akanlu), Pasteur Institute of Iran, Kabudar Ahang, Hamadan, Iran.

Background: Homeless people are at risk of contracting communicable infectious diseases, as they indulge in risky behaviours and lifestyle. This study was conducted to determine the prevalence of the aforementioned infections and related risk behaviours among homeless people in Tehran.

Methods: In this study a convenience sample of 593 homeless individuals was studied. The ELISA method was used for the detection of HIV, HCV and HBV. Clinical symptoms, sputum cultures, acid fast bacilli smears, and chest X-rays were used to identify active pulmonary tuberculosis, and the Interferon Gamma Release Assay (IGRA) test was used to identify latent tuberculosis.

Results: The prevalence of HIV, HBV, HCV and latent tuberculosis was 3.4%, 2.6%, 23.3% and 46.7%, respectively. Active pulmonary tuberculosis was found in 7 persons (1.2%). Injection drug use was an independent risk factor for HIV, HCV and HBV infections. Older people had a higher proportion of Mycobacterium tuberculosis infection (OR: 2.6, 95%CI: 1.9, 3.7) and HCV positivity (OR: 1.7, 95% CI: 1.1, 2.5).

Conclusion: Our findings highlighted that much more attention needs to be paid to the health of homeless people.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0098742PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045893PMC
August 2015

Seroprevalence survey of Q fever among sheep in northwestern Iran.

Vector Borne Zoonotic Dis 2014 Mar 27;14(3):189-92. Epub 2014 Feb 27.

1 Department of Epidemiology, Pasteur Institute of Iran , Tehran, Iran .

Q fever is a disease caused by Coxiella burnetii, which infects both humans and certain animals, and is considered a public health problem. There is a lack of information on its status in most parts of Iran, including the northwestern area, which is one of the main centers of animal husbandry in Iran. This study was carried out to evaluate the seroprevalence of Q fever among sheep in the province of Ardabil in northwestern Iran. In all, 253 sheep samples were collected from different regions (north, central, and south) of Ardabil Province. Sera were tested by a CHEKIT Q fever enzyme-linked immunosorbent assay (ELISA) kit for detection of C. burnetii immunoglobulin G (IgG). A total of 33.6% of sheep sera and 87.50% of herds were positive for C. burnetii IgG. There was a significant difference between the regions studied (p<0.001) and the highest and the lowest rate of seroprevalence were seen in the south (58.6%) and central (23.3%) regions, respectively. Most of the seropositive cases were observed in 3- to 4-year-old the sheep (46.1%). There was no relationship between gender and the seroprevalence rate. Although this study was the first survey of Q fever in northwestern Iran, the high seroprevalence rate indicates that further attention should be paid to this disease in this region of the country.
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http://dx.doi.org/10.1089/vbz.2013.1382DOI Listing
March 2014

Seroepidemiological survey of Q fever and brucellosis in Kurdistan Province, western Iran.

Vector Borne Zoonotic Dis 2014 Jan 20;14(1):41-5. Epub 2013 Dec 20.

1 Department of Epidemiology, Pasteur Institute of Iran , Tehran, Iran .

Given that the there is little information about the current status of brucellosis and Q fever in most parts of Iran, the aim of this study was to assay the seroprevalence of these two diseases in high-risk populations of Kurdistan Province in western Iran. Two hundred fifty sera samples were collected from hunters and their families, butchers, health care workers, and those referred to medical diagnostic laboratories in the southwestern regions of Kurdistan Province. Sera were tested to detect specific immunoglobulin G (IgG) antibodies against brucellosis and Coxiella burnetii (phase I and II). The seroprevalence of brucellosis and Q fever (C. burnetii IgG phase I and II) was 6.4% and 27.83% (20% and 14.52%), respectively. The highest seroprevalence of Q fever (38%) and brucellosis (12%) was seen in butchers, who handled cattle, sheep, and goats during their work. Age had a significant positive association with Q fever seropositivity (p=0.04). The seroprevalence of Q fever was higher in those people who had been in employment for more than 10 years (21.88%) compared to others (7.79%) (p=0.02). The keeping of animals (p=0.03), hunting and eating the meat of wild animals (p=0.02), and not disinfecting hands and faces after working (for health care workers and butchers) (p=0.02) were risk factors for Q fever seropositivity. This study showed a relatively high seroprevalence of brucellosis and Q fever in high-risk populations of Kurdistan Province. It is suggested that complementary studies be carried out in other parts of western Iran to clarify the epidemiological aspects of these diseases.
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http://dx.doi.org/10.1089/vbz.2013.1379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880925PMC
January 2014

Seroepidemiological survey of tularemia among different groups in western Iran.

Int J Infect Dis 2014 Jan 2;18:27-31. Epub 2013 Oct 2.

Department of Epidemiology, Pasteur Institute of Iran, No. 69, Pasteur Ave., Postal Code 1316943551, Tehran, Iran. Electronic address:

Background: The first human case of tularemia in Iran was reported in 1980 and there have been no subsequent reports of tularemia in the country. The aim of this study was to carry out a survey of tularemia among different groups in the province of Kurdistan in western Iran.

Methods: The following information was collected by means of an in-house questionnaire: participant demographic characteristics, exposure to risks, and use of appropriate personal protective equipment and disinfectant in their occupation. A blood sample was collected from each participant. Sera were tested using an ELISA kit (Virion\Serion) to detect specific IgG antibodies against Francisella tularensis.

Results: Of a total of 250 serum samples, 14.40% had anti-tularemia IgG antibodies. The highest seroprevalence was found in hunters (18%) and the lowest in health care workers (12%). Age had a significant positive association with tularemia seroprevalence (p<0.001). The seroprevalence of tularemia in people exposed to foxes (hunting or eating the meat) (25%) was significantly higher than in others (8.65%) (p = 0.01).

Conclusions: According to the findings of this study, it is highly recommended that physicians and health care workers are informed about bacteria circulating in this area. By sensitizing the health system, it is expected that some cases of the clinical disease will be reported in the near future. Similar studies in other parts of the country and on domestic and wild animals will clarify the epidemiology of tularemia in Iran.
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http://dx.doi.org/10.1016/j.ijid.2013.08.013DOI Listing
January 2014

Seroepidemiological survey of Crimean-Congo hemorrhagic fever among sheep in Mazandaran province, northern Iran.

Vector Borne Zoonotic Dis 2012 Sep 23;12(9):739-42. Epub 2012 Aug 23.

Department of Epidemiology, Pasture Institute of Iran, Tehran, Iran.

Crimean-Congo hemorrhagic fever (CCHF) is a disease prevalent among humans and animals and is endemic in Iran. Although CCHF has been reported in all of its neighboring provinces, in Mazandaran in northern Iran there have been no reports of any cases of human infection. This research has been carried out to clarify the epidemiological aspects of CCHF infection among sheep in various geographical regions of Mazandaran province. In this survey, 270 blood samples were collected from sheep in eastern, central, and western Mazandaran between 2010 and 2011, and the specific ELISA test for CCHF virus was carried out on the blood samples in the National Reference Laboratory in the Pasteur Institute, Tehran, Iran. The CCHF infection rate according to this study was 3.7%. A weak statistical relationship (p=0.063) was seen between the different geographical regions, with a gradual decrease in the infection rate noted, stretching from the eastern to the western portions of the province (eastern 6.8%, central 2.8%, and western 0%). Older sheep were 2.7 times more likely to be infected with the virus (OR 2.70; 95% CI 1.50,4.87; p<0.001). As the infection rate in Mazandaran is low among sheep, and as yet there have been no reports of human infection in this province, CCHF disease is not considered a serious health problem in Mazandaran. It is recommended that further research be carried out on other animals, high-risk human groups, and ticks, in order to more completely reveal the status of the disease in this province.
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http://dx.doi.org/10.1089/vbz.2011.0958DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438841PMC
September 2012
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