Anti-malarial seroprevalence assessment during an elimination programme in Chabahar District, south-eastern Iran.

BACKGROUND: Iran has achieved a substantial decline in malaria incidence over the past decades. A common feature of malaria-endemic settings is the requirement for more sensitive techniques to describe levels of low transmission. In this study, serological and parasitological methods were used to measure transmission levels of Plasmodium falciparum and Plasmodium vivax during an elimination programme (2012) in Chabahar District, Sistan and Baluchistan Province, south-eastern Iran. METHODS: Participants were randomly selected from 64 different geographical clusters in Chabahar city and surrounding villages. Antibody responses to P. falciparum and P. vivax blood-stage antigens were assessed by ELISA, while microscopy and molecular testing were used to determine parasite carriage by species. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCR). RESULTS: There was no evidence of recent transmission in the study areas, indicated by an absence of parasite infections in all ages and low or absent serological responses to either species in young children. The best model for age P. falciparum seroconversion was one with a change in exposure 21 years before sampling was done in Chabahar city (P = 0.018) and 4 years in the villages (P = 0.039). There was a higher level of recent P. vivax transmission compared to P. falciparum, based on the SCRs, in both the city and village settings. CONCLUSION: Serological analysis identified a decline in P. falciparum transmission in the urban areas of Chabahar, consistent with a previously described decrease in malaria in the early 1990s, demonstrating the utility of this approach to reconstruct exposure history. At present, it remains unclear whether the P. vivax antibody responses reflect active transmission due to new infections or relapse infections. The absence of parasitological and serological evidence of recent malaria transmission in Chabahar District is viable evidence for certification of elimination

Non-variant specific antibody responses to the C-terminal region of merozoite surface protein-1 of Plasmodium falciparum (PfMSP-119) in Iranians exposed to unstable malaria transmission

<p>Abstract</p> <p>Background</p> <p>The C-terminal region of <it>Plasmodium falciparum </it>merozoite surface protein-1 (PfMSP-1₁₉) is a leading malaria vaccine candidate antigen. However, the existence of different variants of this antigen can limit efficacy of the vaccine development based on this protein. Therefore, in this study, the main objective was to define the frequency of PfMSP-1₁₉haplotypes in malaria hypoendemic region of Iran and also to analyse cross-reactive and/or variant-specific antibody responses to four PfMSP-1₁₉variant forms.</p> <p>Methods</p> <p>The PfMSP-1₁₉was genotyped in 50 infected subjects with <it>P. falciparum </it>collected during 2006-2008. Four GST-PfMSP-1₁₉variants (E/TSR/L, E/TSG/L, E/KNG/F and Q/KNG/L) were produced in <it>Escherichia coli </it>and naturally occurring IgG antibody to these proteins was evaluated in malaria patients' sera (n = 50) using ELISA. To determine the cross-reactivity of antibodies against each PfMSP-1₁₉variant in <it>P. falciparum-</it>infected human sera, an antibody depletion assay was performed in eleven corresponding patients' sera.</p> <p>Results</p> <p>Sequence data of the PfMSP-1₁₉revealed five variant forms in which the haplotypes Q/KNG/L and Q/KNG/F were predominant types and the second most frequent haplotype was E/KNG/F. In addition, the prevalence of IgG antibodies to all four PfMSP-1₁₉variant forms was equal and high (84%) among the studied patients' sera. Immunodepletion results showed that in Iranian malaria patients, Q/KNG/L variant could induce not only cross-reactive antibody responses to other PfMSP-1₁₉variants, but also could induce some specific antibodies that are not able to recognize the E/TSG/L or E/TSR/L variant forms.</p> <p>Conclusion</p> <p>The present findings demonstrated the presence of non-variant specific antibodies to PfMSP-1₁₉in Iranian falciparum malaria patients. This data suggests that polymorphism in PfMSP-1₁₉is less important and one variant of this antigen, particularly Q/KNG/L, may be sufficient to be included in PfMSP-1₁₉-based vaccine.</p

Multiple Genotypes of the Commonly Co-Segregating Toll-Like Receptor 4 Asp299Gly and Thr399Ile in Baluchi Malaria Patients from Iran

Objective: Different studies have shown an association of TLR4 polymorphisms with susceptibility/resistance to malaria disease. In the current immunogenetic study, we assessed the TLR4 genotypes formed by the two common single nucleotide polymorphisms (SNPs) (Asp299Gly and Thr399Ile) in the co-segregate state in Baluchi Plasmodium falciparum infected and healthy populations from malaria hypoendemic areas of Iran. The study was performed to evaluate the distribution and correlation of TLR4 co-segregating genotypes in patients with mild malaria. Moreover, the frequency of these genotypes was compared with reported results from other populations in similar or contrasting malaria settings around the world.Materials and Methods: In this case control study, the presence of 2 SNPs in the TLR4 gene (Asp299Gly and Thr399Ile) were analyzed in 350 Baluchi patients with mild malaria and 350 unrelated healthy controls by using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) techniques followed by sequencing analysis. Differences in the TLR4 co-segregate genotype frequencies among the studied group were determined by Fisher’s exact test.Results: Although the distribution of the two commonly co-segregating TLR4 genotypes presented a diverse and distinct pattern in the Baluchi population, no significant difference was detected between the cases and controls (p>0.05). A lower frequency of TLR4 Asp299Gly/Thr399Thr was observed in Baluchis with mild malaria compared to African populations (p<0.05).Conclusion: Differences in the co-segregation patterns of TLR4 Asp299Gly/Thr399Ile genotypes in the Baluchi population compared to other malaria endemic populations may suggest different local evolutionary pressure on TLR4 polymorphisms by malaria in this region. The higher frequency of Asp299Gly/Thr399Ile genotypes among the Baluchi population compared with the African population (p<0.05) which suffers from a larger number of severe cases might suggest that this genotype has a role in protecting against severe malaria. These findings are useful for further understanding the pathogenesis of severe malaria

Analyzing demographic features of medical abortion applicants in legal medical department of Tehran province between 2020 and 2021

Introduction: We are permitted to terminate the pregnancy for therapeutic reasons or when it is medically necessary for these situations. Sometimes fetal, other times maternal, for these reasons. This indicates that we sometimes do abortions to protect the mother's health, and other times we do so because of defects in the fetus. This study was done to look at the demographics of people who applied for medical abortions in Tehran province's legal medical department between 2020 and 2021. Method: The current study was descriptive-cross-sectional-retrospective, and the legal medical department of Tehran Province's abortion applicants' files between 2020 and 2021 were inspected. The data collecting form from the legal medical office's prepared files and comparing fetal malformations and maternal conditions leading to abortion served as the study instrument. The data was statistically analyzed after being entered into the statistical program SPSS version 24. Finally, requests' outcomes and abortion instances involving maternal and fetal illnesses were analyzed. Findings: The findings showed that the most typical fetal age was between 16 and 19 weeks, the most typical maternal age was between 31 and 45 years old, and 50.8% of women had filed for a license in 1400.&nbsp