Two decades of echinococcosis/hydatidosis research: Bibliometric analysis based on the web of science core collection databases (2000-2019)

Echinococcus granulosus sensu lato and Echinococcus multilocularis are responsible for serious health and economic implications for humans and animals. This study was designed to conduct a bibliometric analysis of global research on echinococcosis/hydatidosis included in the Web of Science Core Collection databases from 2000 to 2019. A total of 7066 relevant articles between 2000 and 2019 were identified. Most articles were published in 2015 (502 articles), 2017 (492 articles) and 2018 (493 articles), with the Veterinary Parasitology journal publishing the largest number of articles (237). Researchers from Xinjiang Medical University, China authored the most articles (388) in the field. Authors Craig, P.S. and Deplazes, P. were the most active in publishing143 and 126 hydatid cyst research papers, respectively. The most echinococcosis/hydatidosis publications originated from Turkey, China and Iran, with 1210, 708 and 531 articles, respectively. The highest levels of research collaboration were evident between China- England, China-France, England-France, China-Australia, and China-Japan. Also, the top researchers in this field had relatively extensive collaborations with each other. Our bibliometric analysis provides a picture of the scientific research into the echinococcosis/hydatidosis field. Further multi-national collaborative research efforts in this field should show promising progress in the future.

An overview on liposomal delivery and adjuvant development for leishmaniosis vaccines

Leishmaniosis is caused by different species of Leishmania parasites. The available treatments for this disease have not provided strong consistent results yet. The weak response of current chemotherapeutics can be attributed to their deficient effects on stealth parasites inside macrophages, rapid clearance from the site of action, and systemic side effects in high doses. To enhance leishmaniosis vaccine efficacy, it is a valuable strategy to use liposomes as vaccine delivery systems due to combined increase in technological advances and understanding of the immune system. Liposomes that contain and deliver immunostimulators and antigens are now being developed to target diseases that require stimulation of both humoral and cell-mediated immune responses. Hence, using particulate adjuvants, like liposomes for effective delivery to the antigen presenting cells (APCs) is important for improving leishmaniosis vaccine efficacy. This study aimed at reviewing liposomal adjuvants in vaccine development with specific accentuation on their adjuvant mechanism and surface charge. It also examined how specific physicochemical qualities of liposomes and the particle size during formulation design can affect the immune response.

Preparation and Characterization of A Nanoliposomal Vaccine of pcLACK Candidate Against Cutaneous Leishmaniasis

BACKGROUND

Leishmaniasis is a public health problem and endemic in countries of the tropics and subtropics. An ongoing project with naked LACK (Leishmania homolog of receptors for activated C-kinase) demonstrated that this case of the gene is entirely susceptible to immune response and it does enter the cells effectively. This study aimed at developing a procedure to prepare a type of lipid nanoparticles overloaded with plasmid LACK (pcLACK) for usage as Leishmania major (L. major) nanoliposomal vaccine.

MATERIALS AND METHODS

The single-gene expression plasmid of pcLACK was encoded in the LACK antigen. Nanoparticles were set up by thin film procedure using cationic lipids 1, 2-Dioleoyl- 3-Trimethylammonium propane (DOTAP), 1, 2-Dioleoyl-snGlycero-3-Phosphoethanolamine (DOPE), and cholesterol in a molar proportion of 2:1:1 molar ratio. Using dynamic light scattering, the particle diameters of empty and loaded lipoplexes were measured in triplicate. The zeta-potential (ζ) was measured with the same instrument using the zeta potential mode as the average of 20 measurements by diluting the particles into a low salt buffer.

RESULTS

The results of the sustainability studies of Liposome-pcLACK formulation showed that there were no significant physical changes up to the 30th day of stability study at the storage condition of 4°C. However, there were significant changes in the formulation content during storage at 25°C for 30 days (204.2±0.90 at Day 30 compared with 207.2±0.26 nm at Day 0). It was observed that the prepared nanoliposomal formulation had more stability under refrigeration.

CONCLUSION

Immunostimulatory cationic lipids bearing a pcLACK encapsulation could serve as an effective delivery system.

Status of Anaplasma spp. infection in domestic ruminants from Iran: A systematic review with meta-analysis

Anaplasma species are tick-borne pathogens that are obligatory intracellular of ruminants and other mammalians. In this investigation, we systematically reviewed the distribution of anaplasmosis among domestic ruminants in Iran. Five and four English and Persian databases were studied, respectively, based on keywords and throughout 17 years (2001–2017). Thirty-eight articles were included in this systematic review and meta-analysis. Totally, 5093 cattle, 1958 sheep, and 1232 goats corresponding to prevalence of Anaplasma infection from different areas of Iran were examined. The total prevalence of Anaplasma infection was estimated to be 34% (95% CI 27%, 41%) in domestic ruminants. Based on our data, Khozestan (54%) and Khorasan Razavi (46%) provinces were the most prevalent areas in Iran and Kerman (3%) and Hamedan (1%) provinces are the lowest. The highest prevalence of Anaplasma spp. infection was belonged to A. ovis (44%) and the lowest to A. phagocytophilum (1%) with a significant difference among them (p < .001). In addition, the most common diagnostic tests were PCR (54%), microscopy (35%) and ELISA (7%) assays. The high prevalence of ovine and bovine anaplasmosis in Iran, confirms the stability situations of animal anaplasmosis in the studied regions particularly northeastern and southwestern parts of the country. Our data offer valuable and encouraging information as regards the current situation of anaplasmosis in domestic livestock in Iran, which might be useful for active and passive surveillance and preventing plans.

Scientometric Analysis of Global Research on Trichomoniasis in Scopus Database (1922 -2018)

BACKGROUND

Trichomoniasis is a sexually transmitted disease (STD) prevalent in different parts of the world. The present study was designed to evaluate the scientific output and collaboration of researchers worldwide on trichomoniasis.

METHODS

In the present scientometric research, all papers conducted on Trichomonas vaginalis (T. vaginalis) published in the time period of 1922 to 2018 were extracted from the Scopus database and evaluated according to the aims of the research, using scientometric software.

RESULTS

The results of this search strategy were the retrieval of 12,596 scientific papers authored by a total of 28,822 people during 97 years (1922-2018). Research in this field has encountered success and failure over the years. The first article on trichomoniasis at the Scopus database was published by Musgrave W.E. (1922) in the "Journal of the American Medical Association". Most papers on this subject (352) were published in 2013; and the years 2017 and 2016 are ranked second and third. Researchers from the US Centers for Disease Control and Prevention have the highest number of papers in this field (210). Alderete J.F. with 111 papers is the most active researcher on trichomoniasis in Scopus. Also, researchers from the US ranked the first with 3,236 papers. In Iran, by the end of 2018, 138 papers on trichomoniasis have been registered in Scopus, which accounts for only one percent of the world's science production in this field.

DISCUSSION AND CONCLUSION

The results following about one century indicated that the number of publications on T. vaginalis is growing and that there is a high level of collaboration among researchers in this field. Moreover, many countries have collaborated internationally on trichomoniasis research with the US as the leading country.

Promising In Vitro Anti-Toxoplasma gondii Effects of Commercial Chitosan

CDATA[Background: Toxoplasmosis is a disease that results from infection with an obligate intracellular T. gondii parasite, one of the world's most common parasites. Considering the complications of chemical drugs and the need for an appropriate drug combination for treatment of toxoplasmosis and considering the antimicrobial potential of chitosan, as a natural source, this study was aimed to evaluate in vitro activity of commercial chitosan (CC) on T. gondii.

METHODS

In this experimental study, the tachyzoites of T. gondii were collected from the peritoneal exudates from infected Balb/c mice. The tachyzoites were diluted in phosphate buffer saline (PBS) solution. Chitosan with low molecular weight was commercially purchased. Then, at concentrations of 10, 50, 100, and 200 μg/mL and after 30, 60, 120, and 180 minutes, the viability of tachyzoites was determined by using trypan blue 0.1%. Anti-T.gondii activity of CC in all concentrations was significantly higher than pyrimethamine as the control group (P=0.05).

RESULTS

The concentration of 200 μg/mL of CC had the highest effects and killed 30.5, 52, 59, and 81.5% of tachyzoites after 30, 60, 120, and 180 minutes. Moreover, IC50 values of CC were 515, 171, 12.5, and <10 μg/mL in comparison with pyrimethamine as 58.82 μg/mL for 30, 60, 120, and 180 min of exposure time.

CONCLUSION

Our results indicate that chitosan in low molecular weight had potent activity against T. gondii tachyzoites and could be an appropriate candidate for the treatment of at least acute toxoplasmosis, certainly, after complementary in vivo experiments.

Initial Evidences of Salt and Pepper Retinal Lesions (SPRL) in Patients with Intestinal Protozoan Infections in Iran

BACKGROUND

It is made clear that salt and pepper retinal lesion (SPRL) has subsequently associated with the infection with Giardia lamblia (G. lamblia). However, little is known regarding the prevalence of SPRL among patients suffered from parasitic infections in the world.

OBJECTIVE

This study aimed to determine the prevalence of SPRL among patients with intestinal protozoan infections, for the first time, in Sari, northern Iran.

METHODS

In this case-control study, a total of 150 subjects participated: 75 were in the patients group diagnosed to have an intestinal parasite and 75 in the control group without any intestinal infection. Fecal samples were obtained from all participants and examined with wet mount and formalin-ether methods. The retina of both groups was examined by an ophthalmologist.

RESULTS

Overall, salt and pepper retinal changes were diagnosed in 12 (16 %) patients with at least one parasitic infection (7 females and 5 males). G. lamblia was diagnosed in 6 subjects (50%), Blastocystis hominis in 5 (41.6%), and Entamoeba coli in 1 (8.3 %). Most of the patients (58.3%) had a mild infection. Bilateral retinal involvement was observed in 75% of the patients. Furthermore, macula involvement was observed in 91.7 % with SPRL.

CONCLUSION

Our findings indicated the relatively high prevalence of SPRL in subjects with giardiasis and blastocystosis. It can be concluded that not only G. lamblia but also B. hominis can cause SPRL in Sari, Iran. Further studies are needed to find other etiologic parasites able to cause retinal damages.

Status of fasciolosis among domestic ruminants in Iran based on abattoir data: a systematic review and meta-analysis

Fasciolosis is considered as an ongoing neglected zoonotic disease in tropical regions of the world, relating to notable financial and public health issues. The current systematic review and meta-analysis was planned to determine the status of fasciolosis among domestic ruminants, including cattle, buffalo, goat, and sheep at the industrial slaughterhouses in Iran, between the years 2000 and 2016. Eight databases, four English and four Persian, were searched. Our findings demonstrated that 2.6% of all inspected livers of slaughtered ruminants were infected with Fasciola spp. during 2000–2016. The mean prevalence of fasciolosis for cattle, buffalo, goat, and sheep was 21%, 4.2%, 2%, and 2.4%, respectively. Additionally, most studies were performed on cattle 25 (39.6%), sheep 24 (38 %), and goat 12 (19%), respectively, and just 2 (3.1%) studies were performed on buffalo. The prevalence of animal fasciolosis has significantly decreased among domestic ruminants in Iran except for cattle. In addition, the prevalence of this disease in Northern and Western regions of the country has remained at hypo-endemic level. The results present updated gathered information on the epidemiology of fasciolosis in domestic ruminants in Iran, and will expand the screening strategies to improve health and reduce economic impacts among farm animals.

Geospatial analysis and epidemiological aspects of human infections with Blastocystis hominis in Mazandaran Province, northern Iran

OBJECTIVES

Blastocystis hominis is a very common large intestinal protozoan with global prevalence in humans and non-human hosts. No precise statistics exist regarding the geographical distribution of Blastocystis that would enable the identification of high-risk communities. Therefore, the current research aimed to characterize the spatial patterns and demographic factors associated with B. hominis occurrence in northern Iran.

METHODS

The current study was performed among 4,788 individuals referred to health centers in Mazandaran Province, from whom stool samples were obtained. Socio-demographic data were gathered using a questionnaire. Samples were examined by a direct wet mount, the formalin-ethyl acetate concentration technique, and trichrome staining. Moran local indicators of spatial association and a geographically weighted regression model were utilized to analyze the results.

RESULTS

Generally, the infection rate of Blastocystis parasites was 5.2%, and was considerably higher in the age group of 10-14 years (10.6%) than in other age groups (p=0.005). Our data showed important associations between the occurrence of B. hominis and age, residence, job, contact with domestic animals, anti-parasitic drug consumption, and elevation above sea level (p<0.001).

CONCLUSIONS

The current study characterized for the first time the infection rate and risk of B. hominis in the north of Iran, and produced a prediction map. It is expected that this map will help policymakers to plan and implement preventive measures in high-risk areas and to manage already-infected patients.

A bibliometric analysis of global research on toxoplasmosis in the Web of Science

Aim:

This study was designed to evaluate the network productions and research collaborations on toxoplasmosis worldwide.

Materials and Methods:

A bibliometric research was carried out using the Web of Science (WOS) database. The analysis unit was the original research articles about toxoplasmosis published between 2000 and 2016 (17 years).

Results:

Totally, 6,550 articles about toxoplasmosis were indexed in the WOS with the following information: (A) 18,410 researchers played a role in drafting the articles; (B) 33 different countries have contributed in the toxoplasmosis studies; (C) the USA was ranked at the first place with 2,162 publications about toxoplasmosis; and (D) “Dubey JP” was compiled and participated in 401 articles from the USA, as the highest number and main core of publications in the toxoplasmosis network.

Conclusion:

The main focus of the toxoplasmosis research activities in the world was article production in the indexed journals in WOS. Hence, it is necessary to strengthen the collaboration networks to improve the quality of articles. Furthermore, the priority would be the identification of institutions with a higher number of research article productions in WOS, to perform toxoplasmosis collaborative original researches according to the strategic roadmap and scientific plan of each country.

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND

The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.

METHODS

We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.

FINDINGS

Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]).

INTERPRETATION

Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury.

FUNDING

Bill & Melinda Gates Foundation.

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND

Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment.

METHODS

We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.

FINDINGS

The global median health-related SDG index in 2017 was 59·4 (IQR 35·4-67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6-14·0) to a high of 84·9 (83·1-86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030.

INTERPRETATION

The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains-curative interventions in the case of NCDs-towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions-or inaction-today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.

FUNDING

Bill & Melinda Gates Foundation.

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND

The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.

METHODS

We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.

FINDINGS

Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]).

INTERPRETATION

Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury.

FUNDING

Bill & Melinda Gates Foundation.

Is urine a reliable clinical sample for the diagnosis of human visceral leishmaniasis? A systematic review and meta-analysis

Visualization of amastigotes in lymph nodes, bone marrow, and other tissues samples remains the gold standard method for the diagnosis of visceral leishmaniasis (VL) in humans. This gold standard diagnostic method uses a technically challenging microscopy procedure that is often not accessible in many places in the world where VL is endemic. Here, we report the current systematic review and meta-analysis to evaluate whether urine is a reliable clinical sample for diagnosis of human VL. Data were extracted from ten available databases during the period from 2002 to 2017. Overall, 29 articles fulfilled the inclusion criteria and were used for data extraction in this systematic review. Most studies (72.4%) using urine specimens were reported from five countries: India 6 (20.7%), Iran 5 (17.2%), Bangladesh 4 (13.8%), Japan 3 (10.3%) and Spain 3 (10.3%), respectively. The most common diagnostic tests performed on urine were Katex (62.1%), ELISA (24.1%), and the rK39 (17.2%) assays. In meta-analysis the sensitivity and specificity of the three most commonly used diagnostic assays were rK39 (97%; CI: 91-99; 98%;76-100), ELISA (91%; 82-95; 99%; CI: 94-100), and Katex (83%; 73-90; 98%; 98-100), suggesting that the rK39 assay provided the highest sensitivity and the ELISA assay provided the highest specificity for diagnosis of VL from urine samples. Our findings suggest that urine is a valuable clinical sample for the diagnosis of human VL, particularly in areas where the gold standard test for VL is not available.

Status of theileriosis among herbivores in Iran: A systematic review and meta-analysis

Aim:

Theileriosis is a protozoal disease caused by Theileria spp. mostly in warm-blooded vertebrates worldwide. It is one of the common tick-borne diseases among domestic animals in tropical and sub-tropical regions, which have a variety of unlikable effects on health economy and animal welfare. In the present study, the prevalence of theileriosis among domestic farm animals in Iran was systematically evaluated.

Methods:

To identify the related papers, 10 English and Persian databases, including PubMed, Science Direct, Scopus, Web of Science, Medical Subject Headings, Google Scholar, Magiran, Barakatns (formerly Iranmedex), Elm net, and Scientific Information Database, were appraised for articles published throughout 1999-2017.

Results:

A total of 56 papers, providing the examination of 11,317 cattle, 9394 sheep, 2991 buffaloes, 1504 horses, 600 goats, and 212 donkeys were analyzed, matching for the prevalence of theileriosis from different parts of Iran were permitted for our allowing checklist. The overall prevalence of theileriosis among domestic herbivores was expected to be 19% (95% confidence interval: 15%, 22%). Our findings highlighted the average of the maximum prevalence in Razavi Khorasan (60.4%) and West Azerbaijan (49.1%) and the minimum in Mazandaran (1.1%) and East Azerbaijan provinces (2.2%), respectively. The high prevalence of Theileria infection in the herbivores (mainly sheep) verifies the well-known enzootic episode of theileriosis in Iran, predominantly in northeastern and western parts of the country.

Conclusion:

Our results suggested updated and imperative information on the true burden of theileriosis in Iran. Moreover, it could be supporting the gaps among monitoring, prevention, and control arrangements to improve the health economy, particularly among dairy farm animals.

A decade bibliometric analysis of global research on leishmaniasis in Web of Science database

BACKGROUND

Leishmaniasis is an extremely relevant tropical disease, with global distribution. It still remains a main public health concern in low-income countries, and it is necessary to support more research on this common disease. Thus, a bibliometric analysis of the global scientific production on leishmaniasis was carried out.

METHODS

All the articles registered in Web of Science with the subject of leishmaniasis between 2006 and 2015 were analysed, using Pajek and VOS viewer as tools.

RESULTS

13,658 records in the field of leishmaniasis were indexed in the Web of Science database for this ten-year study period (2006-2015). This shows that studies on leishmaniasis have been growing, from 1071 in 2006 to 1537 in 2015. "Sundar S" is the most active researcher in the field of leishmaniasis, compiling and participating in 232 Articles. Brazil ranks first in scientific production, by performing 3315 studies on leishmaniasis. The United States, United Kingdom and Australia had the most collaboration in performing the studies of leishmaniasis with each other. In addition, PLOS NEGLECTED TROPICAL DISEASES published the most articles, with 483.

CONCLUSION

Our data shows an increase in the number of publications in the field of leishmaniasis. In addition, Brazil, USA, and India lead scientific production on leishmaniasis research.

Intestinal perforation and peritonitis due to Taenia saginata: A case report from Iran

Taenia saginata (T. saginata) is one of the most common cestode in human. We report a case of intestinal perforation caused due to T. saginata infection. The patient, 54-year-old female, had intermittent abdominal pain, diarrhea and vomiting on referral. Intestinal obstruction and perforation leading to necrosis, and volvulus due to an impacted tapeworm was observed. Histopathological examinations showed acute inflammation with mucosal ulceration, and luminal exudates accompanied by an elongated and flattened segment of the helminth. Taenia infections should be considered in differential diagnosis of peritonitis and gastrointestinal tumors, particularly in endemic countries including Iran.

Global status of visceral leishmanial infection among blood donors: A systematic review and meta-analysis

INTRODUCTION

Transmission of Leishmania through transfusion has been reported from various Visceral leishmaniasis (VL) endemic areas of the world. The true burden of Leishmania infection in blood donors remains generally unknown. Thus, the present systematic review attempted to determine the global prevalence of Leishmania infection among blood donors.

METHODS

Data were extracted through five English and five Persian databases during the period from 1997 to 2016. Overall, 16 articles fulfilled the inclusion criteria and were used for data extraction in this systematic review.

RESULTS

In total, 13,743 blood donors from different regions of world were examined. The prevalence rate of Leishmania infection according to seropositivity obtained 7% (95%CI: 5%, 8%). The lowest and the highest prevalence were related to Bangladesh 0.25% (95%CI: 0.0%, 1.0%) and Brazil, 16% (95%CI: 12%, 19%). Seroprevalence rate of leishmaniasis among females was more (4.60%) than males. Of 15 studies included in the meta-analysis, the pooled prevalence rate of molecular tests was obtained 2% (95%CI: 1%, 3%) in which Iran and Spain had the lowest and the highest prevalence, 0.05% and 7%, respectively. Our analysis showed that L. infantum was more common than L. donovani as etiological agent of VL among all donors.

CONCLUSION

Our data confirms the presence of asymptomatic carriers of VL in endemic areas and supplies as an attentive to the likelihood of these carriers acting as blood donors. Moreover, we conclude that molecular tests for screening in asymptomatic blood donor provide an accurate estimate of the rate of infection over serological tests.

Medicinal plants with promising antileishmanial activity in Iran: a systematic review and meta-analysis

BACKGROUND

Leishmaniasis is a major public health problem worldwide. The aim of the present study was to investigate medicinal plants with anti-Leishmania activity which used in Iran.

METHODS

Data were systematically gathered from five English databases including Ebsco, Science Direct, PubMed, Google Scholar and Scopus, four Persian databases including Magiran, Iran doc, Iran medex and the Scientific Information Database (SID) from 1999 to April 2015. Information obtained included plant family, extraction method, concentrations of extracts, animal models and parasite strains.

RESULTS

A total of 68 articles including 188 experiments (140 in vitro and 48 in vivo) between 1999 and 2015, met our eligibility criteria. Thoroughly, 98 types of plants were examined against three genera of Leishmania spp. For the heterogeneity study conducted, it was showed that there was a great deal of variation among studies. Based on random effect, meta-analysis pooled mean of IC50 was obtained 456.64 (95% CI: 396.15, 517.12).

CONCLUSION

The most Iranian plants used as anti-leishmanial activity were Artemisia species, Allium sativum, Achilleamille folium, Peganum harmala and Thymus vulgaris. The present systematic and meta-analysis review provide valuable information about natural products with anti-Leishmania activity, which would be examined in the future experimental and clinical trials and herbal combination therapy.

Asymptomatic human blood donors carriers of Leishmania infantum: Potential reservoirs for visceral leishmaniasis in northwestern Iran

BACKGROUND

Little is known regarding transfusion-transmitted leishmaniasis (TTL) and the real global incidence of visceral leishmaniasis (VL) among blood donors as carriers of Leishmania spp. in endemic VL foci including Iran. Recent epidemiological evidences indicate that blood donor may be harbor of Leishmania infantum (L. infantum) infection in Iran.

METHODS

The aim of the present study was to determine the prevalence of Leishmania infection among blood donors in a main endemic focus of VL in Iran using DAT and polymerase chain reaction (PCR) based methods Between July-September 2016, blood samples were collected from 600 apparently healthy blood donors from six blood donation centers and blood donation mobile unit in Ardabil Province, where VL cases had been recorded. Each of these samples was tested for anti-Leishmania antibodies, in direct agglutination test (DAT), and for L. infantum kDNA, the PCR-based assay.

RESULTS

Of 600 blood donors, which were examined, 23 (3.8%) blood donors were seropositive by DAT and of 23 seropositive subjects, 82.6% (19/23) were positive by PCR. All the seropositive cases were males except one of them was female.

CONCLUSIONS

Our findings showed that many asymptomatic human carriers of L. infantum live in the endemic regions of northwestern Iran and potentially act as reservoirs of infection; those must be considered carefully by arrangement VL control strategies in the country.

Serological evidence of human cystic echinococcosis and associated risk factors among general population in Mazandaran Province, northern Iran

The aim of the present study was to determine the seroprevalence of CE among human referring to Health Centers in Mazandaran Province, northern Iran and to identify the risk factors involved in spreading the disease. Between 2013 and 2014, the serum samples were taken randomly from 600 subjects referring to health centers in Mazandaran Province. After obtaining informed consent for each participant, a questionnaire including demographic characteristics and associated risk factors was filled for each individual. Anti-CE antibody was tested by enzyme-linked immunosorbent assay (ELISA), using native antigen B. Our results showed 31.6% (n = 190) seropositivity. There were significant difference between seropositivity and sex and residence. Males were significantly more seropositive than females (24.6% versus 7%, P = 0.0001). Regression analysis showed that the subjects who are living in rural areas were 4.4 times more likely to be at risk to CE than urban areas (OR = 4.4; 95% CI = 2.91, 6.64). Contact with dogs, soil and consumed raw vegetables was appeared as main risk factors for CE among community in Mazandaran and it may increase the probability of infection. The high prevalence of CE among individuals indicated that hydatidosis is still a major health problem among community in the investigated areas.