Epidemiology of Accidents and Traumas in Qom Province in 2010

Background: Accidents are the most important public health challenges in our society. To prevent\n the accidents, the identification of their epidemiological features seems necessary. Objectives: This study was conducted to reveal the epidemiological features of accidents and their\n casualties in Qom province in 2010. Patients and Methods: A cross–sectional study was conducted on 29426 injured people referred to Qom\n province hospitals in 2010. Information about place, time, type of accidents and traumas\n and demographic variables had been collected in a veteran hospital. Data were analyzed\n by SPSS (version 16) software, using chi-square test and logistic regression. Results: The incidence of accidents was about 27/1000 per year. The incidences of traffic\n accidents, motorcycle accidents, violence, burns, poisoning and suicides were 3, 1.6,\n 1.2, 0.3, 0.8, 0.37 cases per 1000 people respectively. Strikes (65%) and falls (12%)\n were the main causes of traumas. Forty-six percent of all injuries had occurred in 16 -\n 30 years groups. Most frequent accidents were as follows: fall (97%) and strike (50%) in\n < 12, violence (46%) in 20 - 29, suicide (71%) in 15 - 29, poisoning (34%) and burns\n (20%) among < 5 years old. Pedestrian and motorcycle accidents among +60 years old\n people were significantly higher than other (P = 0.000). Odds ratio for suicide among\n female was about 3.36 and in 16 - 30 age-group was 15.7 more than +60 years old group (P\n = 0.000). Conclusions: Most traumas in Qom province occurred among younger age-groups and strikes and falls\n are the main causes of such traumas. Therefore, safeties to prevent falls and traffic\n regulations to reduce strikes can be effective strategies

The bacterial infection of German cockroach (Blatella germanica) in hospitals of western Iran

Cockroaches are considered a serious health problem in some medical centers. They can move freely in hospital wards and transmit pathogenic organisms. This study was carried out in order to detect and identify bacterial infection on outer surface and in digestive organs of Blatella germanica as a dominant species of cockroach in hospitals. In this cross-sectional study 222 B. germanica were collected from 14 different wards and units of 5 hospitals in the city of Hamedan in western Iran. Most of them were collected from dining room (34.2%) followed by urology ward (13.5%). After applying anesthesia and washing in 2cc physiology serum, the culture was prepared from this suspension for identification of bacterial infection on outer surface. Next, the outer surface of each cockroach was sterilized and their guts were isolated from mouth to anus. Bacteria extraction and culture were done accordingly. A total of 12 bacteria species were identified from outer surface and digestive system of cockroaches. On outer surface, Escherichia coli was the most dominant species (40%) followed by Staphylococcus epidermidis (20%). In digestive system E. coli had also the highest percentage (45%) followed by Entrobacter aeroginosa (20%). This study can show the importance of cockroaches as potential vectors of medically important microorganisms such as pathogenic bacteria in hospitals. Control programs for removing cockroaches, especially in the hospitals are recommended

Head lice infestation (Pediculus humanus capitis) prevalence and its associated factors, among the kormanj tribes in North Khorasan Province

Background: Human pediculosis is an important factor in assessing the level of public health and personal hygiene. Objectives: The aim of this study was to determine the prevalence of pediculosis (head lice infestation) and the factors affecting the rate of infestation. Methods: A cross-sectional study design was used to conduct the study among the Kormanj tribes in North Khorasan province, northeastern Iran. The study was conducted between April to June of 2016. A total of 867 subjects were selected randomly and an interviewer questionnaire was used on each subject to sort for information on demographic profile and factors associated with rate of infestation to pediculosis. Results: Data was statistically analyzed using Excel 2015 and SPSS Statistics 24 software; t-test and Chi-square tests were used to check for any statistical significant association between the variables. A total of 28 cases (3.2) were found to be infected with head lice, 10 cases (35.7) out of the 3.2 prevalence had a history of infestation with head lice in the past while the remaining 18 cases (64.3) had no history of lice infestation in the past. Significant statistical association was observed between the sex and history of head lice infestation (P < 0.05). There was no significant difference between lice infestation and the level of education of the subjects, family size, sharing of personal belongings, length of hair, hair posture, showering frequency, the frequency of brushing hair, and permanent scarf coverings at home. Conclusions: The pediculosis is one of the main public health problems in nomadic tribes such as Kormanj tribes in North Khorasan province. It seems that improvement of personal health conditions in females and also appropriate treatment in previous infestations for nomadic tribes could significantly reduce the prevalence of human head lice infestation. © 2018, Author(s)

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 071 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 502% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.SUPPORTING INFORMATION : FIGURE S1. Data coverage by year. Here we visualise the volume of data used in the analysis by country and year. Larger circles indicate more data inputs. ‘NA’ indicates records for which no year was reported (eg, ‘pre-2000’). https://doi.org/10.1371/journal.pntd.0008824.s001FIGURE S2. Illustration of covariate values for year 2000. Maps were produced using ArcGIS Desktop 10.6. https://doi.org/10.1371/journal.pntd.0008824.s002FIGURE S3. Environmental suitability of onchocerciasis including locations that have received MDA for which no pre-intervention data are available. This plot shows suitability predictions from green (low = 0%) to pink (high = 100%), representing those areas where environmental conditions are most similar to prior pathogen detections. Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s003FIGURE S4. Environmental suitability prediction uncertainty including locations that have received MDA for which no pre-intervention data are available. This plot shows uncertainty associated with environmental suitability predictions colored from blue to red (least to most uncertain). Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s004FIGURE S5. Environmental suitability of onchocerciasis excluding morbidity data. This plot shows suitability predictions from green (low = 0%) to pink (high = 100%), representing those areas where environmental conditions are most similar to prior pathogen detections. Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s005FIGURE S6. Environmental suitability prediction uncertainty excluding morbidity data. This plot shows uncertainty associated with environmental suitability predictions colored from blue to red (least to most uncertain). Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. https://doi.org/10.1371/journal.pntd.0008824.s006FIGURE S7. Covariate Effect Curves for all onchocerciasis occurrences (measures of infection prevalence and disability). On the right set of axes we show the frequency density of the occurrences taking covariate values over 20 bins of the horizontal axis. The left set of axes shows the effect of each on the model, where the mean effect is plotted on the black line and its uncertainty is represented by the upper and lower confidence interval bounds plotted in dark grey. The figures show the fit per covariate relative to the data that correspond to specific values of the covariate. https://doi.org/10.1371/journal.pntd.0008824.s007FIGURE S8. Covariate Effect Curves for all onchocerciasis occurrences (measures of infection prevalence and disability). On the right set of axes we show the frequency density of the occurrences taking covariate values over 20 bins of the horizontal axis. The left set of axes shows the effect of each on the model, where the mean effect is plotted on the black line and its uncertainty is represented by the upper and lower confidence interval bounds plotted in dark grey. https://doi.org/10.1371/journal.pntd.0008824.s008FIGURE S9. ROC analysis for threshold. Results of the area under the receiver operating characteristic (ROC) curve analysis are presented below, with false positive rate (FPR) on the x-axis and true positive rate (TPR) on the y-axis. The red dot on the curve represents the location on the curve that corresponds to a threshold that most closely agreed with the input data. For each of the 100 BRT models, we estimated the optimal threshold that maximised agreement between occurrence inputs (considered true positives) and the mean model predictions as 0·71. https://doi.org/10.1371/journal.pntd.0008824.s009TABLE S1. Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) checklist. https://doi.org/10.1371/journal.pntd.0008824.s010TABLE S2. Total number of occurrence data classified as point and polygon inputs by diagnostic. We present the total number of occurrence points extracted from the input data sources by diagnostic type. ‘Other diagnostics’ include: DEC Patch test; Knott’s Method (Mazotti Test); 2 types of LAMP; blood smears; and urine tests. https://doi.org/10.1371/journal.pntd.0008824.s011TABLE S3. Total number of occurrence data classified as point and polygon inputs by location. https://doi.org/10.1371/journal.pntd.0008824.s012TABLE S4. Covariate information. https://doi.org/10.1371/journal.pntd.0008824.s013TEXT S1. Details outlining construction of occurrence dataset. https://doi.org/10.1371/journal.pntd.0008824.s014TEXT S2. Covariate rationale. https://doi.org/10.1371/journal.pntd.0008824.s015TEXT S3. Boosted regression tree methodology additional details. https://doi.org/10.1371/journal.pntd.0008824.s016APPENDIX S1. Country-level maps and data results. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s017This work was primarily supported by a grant from the Bill & Melinda Gates Foundation OPP1132415 (SIH). Financial support from the Neglected Tropical Disease Modelling Consortium (https://www.ntdmodelling.org/), which is funded by the Bill & Melinda Gates Foundation (grants No. OPP1184344 and OPP1186851), and joint centre funding (grant No. MR/R015600/1) by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union (MGB).The Neglected Tropical Disease Modelling Consortium which is funded by the Bill & Melinda Gates Foundation, the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union (MGB).http://www.plosNTDS.orgam2022Medical Microbiolog

The Co- Infection of Crime Congo Hemorrhagic Fever and Brucellosis: A Case Report

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background and Objectives:&lt;/em&gt;&lt;/strong&gt; Crimean-Congo Hemorrhagic fever (CCHF) is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are: encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Case Report:&lt;/em&gt;&lt;/strong&gt; In this article, we’ve discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. (AST) was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10–which were carried out in pasture Institute-were reported to be positive. According to the patient’s history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. (Wright=1.320, 2ME=1.160 (The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City.&lt;/p&gt;&lt;p&gt; &lt;/p&gt

A Case Report of a Rare Leishmaniasis Patient with More than 29 Acute lesions

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background and Objectives:&lt;/em&gt;&lt;/strong&gt; Leishmaniasis is one of the parasitic diseases causing a limited number of skin lesions in patients suffering from it; but in some patients a greater number of these lesions are observed which need systemic treatment and active follow -up.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Case Report:&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt; &lt;/strong&gt;The patient is a 56 years old female suffering from lesihmaniasis who lives in Farajabaad village from the central district of Qom province. She referred to Qomrood health center for treatment. This patient had more than 29 lesions in her different organs, while The leishmaniasis patients usually have limited number of wounds (maximum 5 lesions in most cases).&lt;strong&gt;&lt;em&gt;&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt

Fauna and Monthly Activity of Sand Flies at Zoonotic Cutaneous Leishmanianisis Focus in Qomrooddistrict of Qom Province in 2009

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background and Objectives:&lt;/em&gt;&lt;/strong&gt; Zoonotic cutaneous leishmaniasis (ZCL) is a parasitological disease transmitted by female sand flies. There are several endemic foci of disease in different parts of Iran. The disease is mostly reported from central part of Qom Province including the villages Ghanavat and Qomrood. It is clear that knowledge on sand flies ecologyhas the main role in planning the control of cutaneous leishmaniasis (ZCL). This study was carried out to determinecutaneous leishmaniasis vectors in Gomrood district of Qom provincein 2009. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt; &lt;/strong&gt;The present study was a descriptive, cross-sectional one conducted on sand flies (the leishmaiosis vectors). It was carried out in Qomrood area of central district of Qom province during 2009. Sand flies were collected biweekly from indoors (bed rooms, stables, etc.) and outdoors-rodent burrows of three villages in Gomrood district, using 180 sticky traps (castor oil coated white paper 20 x 32 cm) from the beginning (May) to the end (November) of the active season. For species identification, sand flies were mounted in Puri’s medium and identified after 24 hours using the keys of Theodor and Mesghali (1964).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results:&lt;/em&gt; &lt;/strong&gt;A total of 10252 adult sand flies (4578 from indoors and 5674 from outdoors) were collected and identified during May and November 2009. The following seven species were found in indoors: Phlebotomuspapatasi (86.1%), p. salehi (0.021%), P. sergenti (1.74%), p. caucasicus (1.26%), p. alexandri(0.24%), Sergentomyiasintoni (10.35%) and S. theodori(0.26%). The collected species of oudoors were Phlebotomuspapatasi (54.67%), P. sergenti (0.35%), p. alexandri(0.035%), S. sintoni (44.02%) S. dentata (0.21%) S. clydei (0.19%), S. theodori (0.46%) and S. pawlowski (0.05%). The most common sand flies in indoors and outdoors resting places were P. papatasi and S. sintoni. P. salehi was the lowest collected species in Gomrood district. The active peaks of sand flies were observed in late May and late August.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;The sex ratio i.e. number of males/100 females of P. papatasi was calculated to be 241.5 and 307.3 in indoors and rodent burrows, respectively.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Conclusion:&lt;/em&gt; &lt;/strong&gt;Our entomological survey showed that P. papatasi was the dominant species in indoors and outdoors. It seems this species can be probable vector for ZCL in the study area. Nevertheless, it is necessary that more studies are suggested (specially using molecular methods) in order to determinethe proven vector (s).&lt;/p&gt