Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control

The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination

Toxocariasis: a silent threat with a progressive public health impact

Background: Toxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed. Main text: Over the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity. Conclusions: Although progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease

Identifying Socioeconomic Factors Affecting theAdoption of Modern Conservation Tillage Technologies in Darab Region (Multinomial Logit Model Approach)

To investigate factors affecting the adoption of conservation tillage systems, the tillage methods utilized by wheat producers in the central Darab county are categorized into conventional, reduced-tillage and no tillage systems. For this purpose, multinomial logit model approach using the stata software was applied to the data set collected by random cluster sampling method. The explanatory variables consisted of farmer’s age, farm land size, farmer’s level of education, farmer’s experience on conservation tillage methods, number of family members, off-farm employment, number of land parcels and farmer ‘s information on conservation tillage methods.The results indicated that some variables such as farmer ‘s level of education, farmer’s experience on conservation tillage methods, off-farm employment, farm land size and farmer’s information on conservation tillage systems have positive and significant effect on the adoption of reduced-tillage systems, while the variable of the number of land parcels has a negative and significant effect. Other variables such as the farmer’s age and the number of family members were found insignificants

Identification of helicobacter pylori in the milk of sheep and goat using incubation and PCR methods in Mashhad suburb

Background: Helicobacter pylori (HP) is identified as the most common gastrointestinal (GI) infection agent in the world. According to some findings shepherd's Helicobacterial infection is due to their contacts to sheep. Considering the controversy, the transmission of HP from the milk of small ruminates to humans and the possibility of the Zenotic nature of the disease has not proven yet. Thus, recognition of the routes of transmission of bacterium to human is vital. Materials and Methods : Using random clustering, 100 samples (81 sheep and 19 goat's samples) were taken from 20 villages of Mashhad suburb during two years. A questionnaire regarding the health status of the shepherds and their family from the point of view GI discomfort was taken. All taken samples were incubated on two specific HP media, HPSPA (Helicobacter pylori Special Peptone Agar) and Columbia Agar including antibiotics. Following centrifugation, DNA extraction was carried out on all precipitated samples. The specific Urease C gene of HP was traced through polymerase-chain reaction (PCR). Results: Considering the negative results of both PCR and isolation tests, neither culture media nor PCR could prove the existence of HP gene or the Urease C gene for the specific HP in samples. Information showed that 20 of shepherds and 25 of their families and also 10 of both are complaining of GI discomfort, without any clear relation to HP. Conclusion: The results showed that two incubation procedures could not detect HPÂ or its gene, Urease C. Probably, the reason could be due to some multifactorial agents, essential for the determination of the strategy of prevention and health. Possibility of transmission of the agent from the small ruminants and milk to humans needs further investigation