Genotyping of acanthamoeba in rural drinking water sources in Kashan and Aran-Bidgol, Iran

Background and purpose: Acanthamoeba spp. are an opportunistic protozoan in environmental sources that can cause respiratory infection and keratitis. The present study was conducted to determine the prevalence and genotypes of Acanthamoeba in rural drinking water sources in Kashan and Aran- Bidgol, Iran. Materials and methods: In this study, 162 samples from 54 drinking water sources were collected in 2017. After samples filtration, they were cultured on non-nutrient agar to isolate free-living amoeba. After DNA extraction, the Polymerase Chain Reaction using JDP1, JDP2 primers was performed to detect Acanthamoeba spp. and finally the genotype of eight isolates was determined. Data analysis was done in SPSS applying Chi-square and Fisher�s exact test. Results: Among the samples 35.2 were found to be contaminated with free-living amoeba, among which 19 isolates (11.7) were confirmed as Acanthamoeba. The rates of free-living amoeba and Acanthamoba were 35.4 and 11.8, respectively, in Kashan, which were higher than those in Aran- Bidgol. Frequency of free-living amoeba in Qanat, well, and spring was 55.6, 30.2, and 26.7, respectively. Acanthamoeba contamination rates were 13.9, 11.5 and 10, respectively. Acanthamoeba contamination rate was higher in surface wells than that in deep wells. The genotype of all Acanthamoeba isolates belonged to T4. Conclusion: This study revealed that drinking water sources were contaminated with free-living amoeba and Acanthamoeba. All isolates were T4 genotype, therefore, these sources could be considered as a risk factor for public health. © 2018, Mazandaran University of Medical Sciences. All rights reserved

Survey of museum beetle (Dermestes sp.) damage to the scorpion collection in the Health Faculty of Kashan University of Medical Sciences

ABSTRACT The result showed that all the drawers containing the scorpion preservation boxes were found damaged by Dermestes sp. Totally, 210 Dermestes larvae were collected. On a average 15 larvae were collected from each drawer. The length of the mature larva was 10-12 mm. The larvae were oval shaped with bodies covered hearly by strands of hair. The incurred damages to the collections were huge because of lack of supervision. Key words : Collection, Dermestes, museum beetle, pest, scorpion

Contamination status of hospitals and health care centers by rodents (Rodentia: Muridae) in Iran

Introduction: Rats are considered as an important potential reservoir for some zoonotic diseases and have an important role in the transmission and spreading them. This research was performed with the purpose of studying the contamination status of hospitals and health care centers in Kashan. Materials and Methods: In this descriptive study, six hospitals and 17 health care centers in Kashan were studied. Traps were placed in different parts of the hospitals and health care centers. Rats were recognized based on their morphological parameters and the related information was recorded in the questionnaires. After extracting the necessary data, tables and graphs were drawn and the results were analyzed. Results: This study showed that out of six studying hospitals, four were contaminated by rats and out of these four hospitals, one unit was contaminated by Rattuss rattusus and three units by Mus musculus. Also out of 17 health care centers, four were contaminated by house mice. Discussion and Conclusion: Contamination and damage by rats in hospitals and health care centers is significant. It is recommended that authorities take necessary measures to prevent the contamination of hospitals and health care centers by rats. They should also try to control or eradicate them. Copyright © 2018 Journal of Communicable Diseases

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016

Objectives To use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016. Design Systematic analysis. Main outcome measures Crude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education). Results The total number of deaths from suicide increased by 6.7 (95 uncertainty interval 0.4 to 15.6) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7 (27.2 to 36.6) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0, 95 uncertainty interval 42.6 to 54.6) than men (23.8, 15.6 to 32.7). Conclusions Age standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates. © Published by the BMJ Publishing Group Limited

Surveying the type and amount of pesticide use in agricultural sector of Kashan, Iran

Pesticides in addition to eliminating pests pollute the environment and cause disease. According to the statistics the total cultivated lands of Kashan province totaled 15894.1 hectares. Due to the importance of pesticide use in agricultural and dry and desert areas of Kashan which is very fragile due to low rainfall, this study was conducted to determine the type and amount of pesticide use in different parts of agriculture in Kashan during 2015 crop year. The results showed that a total of 16 types of poisons were used in the agricultural sector of Kashan, of these 5 types (31.25%)are of the phosphorus group, 3 types (18.75%) pyroclastic group, 2 types (12.5%) copper compounds and 6 types (37.5%) other types of pesticides. The data from this study show that most of the pesticides used are organophosphates, among them the most commonly used was diazinon. Keywords Agriculture, Kashan, organophosphate, pesticide

Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. Findings: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching$7·9 trillion (95% uncertainty interval 7·8–8·0) in 2017 and is expected to increase to $11·0 trillion (10·7–11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was$20·2 billion (17·0–25·0) and on tuberculosis it was $10·9 billion (10·3–11·8), and in malaria-endemic countries spending on malaria was$5·1 billion (4·9–5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019,$374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6–81·7) in 2015 to 83·1% (82·8–83·3) in 2030. Interpretation: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed