In recent years, the number of cases of extrapulmonary tuberculosis in Iran has increased. The goal of this study was to determine the epidemiological status, clinical symptoms, diagnostic methods, and treatment strategies of extrapulmonary tuberculosis in Iran, with a focus on tuberculosis meningitis and miliary tuberculosis. Between January 1, 2000 and June 1, 2021, 1 651 cases of tuberculosis meningitis and miliary tuberculosis were discovered in Iran. The prevalence of tuberculosis meningitis was higher in Sistan and Baluchestan, South Khorasan, and Mazandaran compared with other provinces. The most prevalent symptoms of tuberculous meningitis were fever, anorexia, headache, neck stiffness, loss of consciousness, and vomiting. The most commonly used procedures for diagnosing tuberculous meningitis were polymerase chain reaction and cerebrospinal fluid culture. The most prevalent clinical symptoms of miliary tuberculosis were fever, lethargy, weariness, and anorexia. In 70% of chest radiographs, a miliary pattern was visible. Bone marrow biopsy was used to diagnose miliary tuberculosis in 80% of patients, while bronchoalveolar lavage was used in 20% of cases. The conventional 6-month treatment approach for tuberculous meningitis and miliary tuberculosis was used for all of the participants in the investigations. Given the high prevalence of extrapulmonary tuberculosis patients in Iran and the devastating consequences of the disease, the researchers recommend that further study be done to prevent extrapulmonary tuberculosis in the general population.

Objective: To analyze and review the overall seroprevalence rate of Toxoplasma gondii (. T. gondii) infection in cattle from Iran. Methods: In the current study, data collection (published and unpublished papers, abstracts of national scientific congresses and dissertations) using particular terms was carried out systematically on the following electronic databases like PubMed, Google Scholar, Ebsco, Science Direct, Scopus, Magiran, Irandoc, IranMedex and SID (Scientific Information Database). Results: A total of 22 studies since 1983 to 2012 reporting the seroprevalence of toxoplasmosis in cattle from different regions of Iran met our eligibility criteria. The pooled proportion of toxoplasmosis, using random effect model, among cattle in Iran from over the 30-year period was estimated 18.1% (95% CI: 9.9% to 28.2%). Conclusions: This study firstly establishes a crude seroprevalence rate of Toxoplasma infection in cattle which can lead us to understand the condition of cattle toxoplasmosis, which have to take into accounted for an appropriate and effective prevention and controls. Secondly, it compares and discusses elaborately the role of risk factors including sex, age and breed in the epidemiology of the disease. Thus, it determines gaps and drawbacks in the prior studies which are greatly useful to design more accurate investigations in the future.

Objective: To evaluate the prevalence of Candida species in cancer patients with candidemia around the world, and to identify related risk factors and their antifungal resistance, with an emphasis on non-albicans Candida species (NACs). Methods: The published papers related to the subject were systematically searched in databases of MEDLINE (including PubMed), Web of Science, Scopus, Science Direct, and Google Scholar between the 1 st January 2000 and 21 st April 2021. Results: Among the 4 546 records, 69 studies met the inclusion criteria. The pooled prevalence of NACs in cancer patients with candidemia was 62% (95% CI 58%-67%; I 2 =94.85%, P=0.00). Based on type of cancer, the pooled prevalence of NACs in hematologic and solid cancer patients were 68% (95% CI 65%-70%) and 52% (95% CI 49%-54%), respectively. Among NACs, Candida (C.) parapsilosis was the most frequently isolated organism followed by C. tropicalis and C. glabrata. In addition, the therapeutic usage of antibiotics was found as the most common risk factor, accounting for 85% (95% CI 81%-89%) and central venous catheter accounting for 69% (95% CI 62%-77%). Conclusions: The incidence of Candida bloodstream infections among cancer patients is a growing concern, especially when the etiologic agents of candidemia tend to shift towards NACs.

Objective To verify phylogeography and genetic structure of Acanthamoeba populations among the Iranian clinical isolates and natural/artificial environments distributed in various regions of the country. Methods We searched electronic databases including Medline, PubMed, Science Direct, Scopus and Google Scholar from 2005 to 2016. To explore the genetic variability of Acanthamoeba sp, 205 sequences were retrieved from keratitis patients, immunosuppressed cases and environmental sources as of various geographies of Iran. Results T4 genotype was the predominant strain in Iran, and the rare genotypes belonged to T2, T3, T5 (Acanthamoeba lenticulata), T6, T9, T11, T13 and T15 (Acanthamoeba jacobsi). A total of 47 unique haplotypes of T4 were identified. A parsimonious network of the sequence haplotypes demonstrated star-like feature containing haplogroups IR6 (34.1%) and IR7 (31.2%) as the most common haplotypes. In accordance with the analysis of molecular variance, the high value of haplotype diversity (0.612–0.848) of Acanthamoeba T4 represented genetic variability within populations. Neutrality indices of the 18S ribosomal RNA demonstrated negative values in all populations which represented a considerable divergence from neutrality. The majority of genetic diversity belonged to the infected contact lens and dust samples in immunodeficiency and ophthalmology wards, which indicated potential routes for exposure to a pathogenic Acanthamoeba sp. in at-risk individuals. A pairwise fixation index (F

Objective: To identify serodiagnosis and quantification of Toxoplasma gondii (T. gondii) infection among pregnant women in Salmas, northwest of Iran. Methods: In this cross-sectional study, 276 blood samples were collected from pregnant women referred to the health care centers in Salmas city. The demographic variables were also recorded. Titers of anti-Toxoplasma IgM and IgG antibodies (Ab) were determined using the chemiluminescence immunoassay. Quantitative real-time PCR targeting the T. gondii repeated element gene was also performed on the blood sample. Results: Out of all, 19.92% (55/276) and 2.17% (6/276) patients were seropositive for anti-Toxoplasma IgG and IgM Ab, respectively. Moreover, the presence of T. gondii DNA was observed in 12.31% (34/276) blood samples. A significant relationship was observed between the IgG Ab seropositivity and contact with the cat as a risk factor (P=0.022). Conclusions: The seroprevalence rate of T. gondii infection in pregnant women is relatively low. Consequently, the seronegative pregnant women are at risk, and a considerable rate of positive blood samples for the presence of parasite's DNA should not be ignored. Besides, quantitative real-time PCR could be considered as an accurate method for diagnosis of acute toxoplasmosis especially when the precise results are of the most importance in pregnancy. Limiting contact with cats is also suggested for pregnant women.

Objective To evaluate the overall prevalence of Toxoplasma gondii infection among birds and poultries in Iran. Methods Data were systematically collected from 1983 to 2016 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, IranMedex, and Scientific Information Database. Additionally, the abstracts of national scientific congresses and dissertations were included. Results A total of 20 articles in the field of birds and poultries toxoplasmosis, totally examining 4563 cases with 754 positive results reporting the overall prevalence of infection from all parts of Iran could fulfill our eligibility criteria. The overall estimated prevalence included in chicken 20% (95% CI: 3%–38%) in chicken, pigeons 8% (95% CI: −17%–33%) and in sparrows 15% (95% CI: −25%–54%). Conclusion Although there is a lack in data about poultries and birds toxoplasmosis in Iran, our meta-analysis revealed that infection rate is high among birds and poultries in Iran. More studies are needed to manage controlling programs and prevention strategies among poultries in Iran.

Objective To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country. Methods All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis. Results Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi. Conclusions This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.