دکتر سید ناصرالدین مصطفوی
فوق تخصص عفونی اطفال
مقالات و کنفرانس های بین المللی
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فیلتر بر اساس نوع
Seroepidemiology of Toxoplasma gondii infection in Isfahan province, central Iran: A population based study
مجلات علمیAbstract
BACKGROUND
Toxoplasmosis is a worldwide infection. Most studies on toxoplasmosis are in women in child bearing ages. We conducted an epidemiological survey on the population of the Isfahan Province to identify characteristics of the individuals associated with seropositivity.
METHODS
In a cross sectional study, 599 serum samples were randomly collected for seroepidemiology of Hepatitis A and E, and were also used for titration of IgG anti-toxoplasma gondii antibody by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed using SPSS software15. Chi square and Fisher exact tests were employed to examine antibody status in different age, gender, education and residency groups.
RESULTS
The overall prevalence was 41.4% (248/599). There was a statistical significant association between seroprevalence with age, education, and gender (p < 0.05) but not with residency state. The peak age for acquisition of the infection in females was 20-29 and in males 20-39 years old.
CONCLUSIONS
Results of current study showed a moderate prevalence of toxoplasma gondii infection. However higher seroconversion rate in active social and reproductive ages, females and low educated individuals necessitate active preventive programs in these high risk groups.
Toxoplasma gondii infection in women of childbearing age of Isfahan, Iran: A population-based study
مجلات علمیAbstract
Background
We conducted an epidemiological survey on seroprevalence of toxoplasma infection in women of childbearing age in Isfahan Province.
Materials and Methods
In a cross-sectional study in 2010, 217 women in the age range of 10–50 years were randomly selected. The blood samples examined for the presence of IgG anti-Toxoplasma gondii antibody by a commercial ELISA kit (Dia-Pro, Milan, Italy). Chi-square and Fisher’s exact tests were employed to examine the antibody status in different age, marriage, education, and residence groups.
Results
The overall prevalence was 47.5% (103/217). The peak age of infection acquisition was in the range 30–40 years in rural areas and 20–30 years in urban districts. There was no significant association between residence, education, and marriage groups on the one hand and chance of T. gondii infection on the other hand.
Conclusions
The findings of the study suggest a moderate prevalence of T. gondii infection, but a high prevalence in ages of high reproductive activities.
Systematic review and meta-analysis on the age-specific seroprevalence of hepatitis A in Iran
مجلات علمیBackground
Hepatitis A virus (HAV) is a major cause of acute viral hepatitis worldwide. Annual medical and work loss costs of hepatitis A are significant even in low-endemic countries. It is recommended that each country should collect and review the information needed to estimate its national burden of hepatitis A to provide evidence for health policy makers to implement appropriate and cost-effective preventive strategy for HAV infection. The objective of this study was to estimate accurate prevalence of HAV infection in Iran for best preventive measures.
Materials and Methods
MEDLINE, Institute of Scientific Information, Scopus, Iranmedex, Irandoc, Magiran and Scientific Information Database were searched. The seroprevalence of HAV were pooled by age, sex and residence using fixed and random effect models.
Results
Sixteen papers representing 11857 subjects were included. The overall HAV seroprevalence was 51% (confidence interval [CI] 95%: 50-52%) in fixed and 66% (95% CI: 50-79%) in random effects models. The prevalence was 32% (CI 95%: 11-63%) in less than 20, 50% (CI 95%: 24-75%) in 20-30, and 67% (CI 95%: 17-95%) in more than 30 years of age. The difference was not significant in gender or residence subgroups.
Conclusion
HAV infection in Iran may be considered as low or very low. Therefore, targeted vaccination of high-risk groups and more improvement in environmental sanitation would be the best preventive measure.
SURVEILLANCE OF ANTIBIOTIC CONSUMPTION POINT PREVALENCE SURVEY 2014: ANTIMICROBIAL PRESCRIBING IN PEDIATRICS WARDS OF 16 IRANIAN HOSPITALS
مجلات علمیAbstract
BACKGROUND: Antibiotics are among the most commonly prescribed drugs in pediatrics. Due to lack of uniformity in pediatric antimicrobial prescribing and the emergence of antibiotic resistance, appropriate drug utilization studies have been found to be crucial to evaluate whether these drugs are properly used.
METHODS: Data were collected between January 2014 and February 2014 in 16 Iranian pediatric hospitals using a standardized method. The point prevalence survey included all inpatient beds.
RESULTS: Of 858 children, 571 (66.6%) received one or more antimicrobials. The indications were therapeutic in 60.6%. The parenteral route was used in 92.5% of therapeutic indications. Ceftriaxone was the most prescribed antimicrobials for therapeutic indications (32.4%) and combination-therapy was the most type of therapy in pediatric intelligent care unit (PICU).
CONCLUSION: According to results of this study, antibiotics’ prescribing in pediatrics wards of Iranian hospitals is empirical. Therefore, for quality improvement of antimicrobial use in children continuous audit process and antibiotic prescriptions require further investigation.
Keywords
ANTIBIOTIC, EMPIRIC THERAPY, POINT PREVALENCE, PROPHYLAXIS, TARGETED THERAPY
Seroprevalence of hepatitis A in Iranian adolescents: is it time to introduce a vaccine?
مجلات علمیRetroperitoneal abscess due to disseminated Bacille Calmette-Guerin infection
مجلات علمیSUMMARY
Disseminated mycobacterial infection after Bacille Calmette-Guérin (BCG
vaccination is a rare disorder, usually presenting with fever, weight loss, anemia,
lymphadenopathy and hepatosplenomegaly. We report a case of disseminated BCG
infection in a 28-month-old girl with prolonged fever and abdominal mass due to
retroperitoneal abscess. Appropriate therapy resulted in a good response. This is the
second reported case of retroperitoneal abscess complicating BCG vaccination.
The rate of antibiotic utilization in Iranian under 5-year-old children with acute respiratory tract illness: A nationwide community-based study
مجلات علمیBackground
To investigate the prevalence of antibiotic usage in children aged <5 years with acute respiratory tract illness (ARTI) in Iran.
Materials and Methods
Data were collected from a national health survey conducted in 2010 (Iran’s Multiple Indicator Demographic and Health Survey). Participants of this cross-sectional study were selected by multistage stratified cluster-random sampling from 31 provinces of Iran. Parents of children with <5 years of age responded to questions about the occurrence of any cough during the previous 2 weeks, referral to private/governmental/other health care systems, and utilization of any oral/injection form of antibiotics. Data were analyzed using SPSS software18. The chi-square test was used to determine antibiotic consumption in various gender and residency groups and also a place of residence with the referral health care system.
Results
Of the 9345 children under 5 years who participated in the study, 1506 cases (16.2%) had ARTI during 2 weeks prior to the interview, in whom 1143 (75.9%) were referred to urban or rural health care centers (43.4 vs. 30.4%; P < 0.001). Antibiotics were utilized by 715 (62.6%) of affected children. Injection formulations were used for 150 (13.1%) patients. The frequency of receiving antibiotics was higher in urban than in rural inhabitants (66.0% vs. 57.7% P < 0.05).
Conclusion
The prevalence of total and injection antibiotics usage in children <5 years with ARTI is alarmingly high in Iran. Therefore, interventions to reduce antibiotic use are urgently needed.
Persistence of endothelial cell damage late after Kawasaki disease in patients without coronary artery complications
مجلات علمیAbstract
Background
Recent studies proposed an increased risk of atherosclerosis in patients with a history of Kawasaki disease. This study aimed to investigate the persistence of vascular injury after an acute phase of the Kawasaki disease.
Materials and Methods
We determined the number of circulating endothelial cells (CEC) in the peripheral blood of 13 patients with a history of Kawasaki disease within four to ten years, in comparison with 13 healthy relative controls. The CECs were counted as CD146+/CD34 + cells by the standard flow cytometry technique, and the independent t-test was employed to compare the mean number of CECs in the two groups.
Results
The mean number of CECs was significantly higher in patients than in controls (12 ± 3.03 vs. 2.38 ± 0.87, respectively, P < 0.001).
Conclusion
This study elucidates the persistence of vascular injury late after Kawasaki disease. This finding suggests that prolonged administration of vascular anti-inflammatory agents might be beneficial for preventing atherosclerosis in the subsequent years, in these patients.
First Report on the Lipid Profile Late after Kawasaki Disease in Iranian Children
مجلات علمیSeroprevalence of Cytomegalovirus infection and estimate of congenital Cytomegalovirus infection in Isfahan state, Iran: A population based study
مجلات علمیAbstract
Objective: Cytomegalovirus (CMV) is a well-known virus with major consequences in growing fetus, premature infants, and immune deficient individuals. There are few reports in prevalence of CMV infection in Iran, mainly in pregnant women. We conducted an epidemiological study to investigate the age-stratified seroprevalence and epidemiological characteristics of CMV infection in total inhabitants of Isfahan state, central Iran.
Methodology: In a cross sectional study 595 serum samples which were collected randomly from total population of Isfahan state, Iran were used for IgG anti-CMV antibody titration by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Data were analyzed by Statistical Package for Social Sciences for Windows version 15(SPSS). Chi-squar and Fisher exact tests were applied to determine antibody status in different age, gender, education, family member, and residency groups.
Results: The overall prevalence was 98.2 %( 586/595). The prevalence in age groups of 6-9, 10-19, 20-29, 30-39, 40-49 and above 49 years were 95.7, 98.6, 97.8, 100, 96.6, and 100 percent respectively. There was no statistical significant association between CMV seroprevalence with age, gender, education, family member, and residency groups (P < 0.05).
Conclusions: This study elucidates a very high prevalence of CMV infection in population which acquired it from early childhood. So it is necessary to initiate measures to reduce the burden of CMV disease in fetuses, premature infants, and immune deficient individuals. To treat hearing loss in inapparent congenitally infected infants, repeated auditory exams up to 5 years old has paramount importance.
Effect of corticosteroid therapy in esophageal stricture of a child with chronic granulomatous disease
مجلات علمیAbstract
In chronic granulomatous disease (CGD) patients, esophageal stricture is a rare
complication and the treatment of choice is still controversial. There are few reports of
successful therapy with antibiotics, corticosteroids, multiple balloon dilatations or their
combination.
KEYWORDS
Does Vitamin C improve endothelial function in patients with Kawasaki disease?
مجلات علمیComparison of the Prevalence and Risk Factors of Hepatitis A in 10 to 18-Year-Old Adolescents of Sixteen Iranian Provinces: The CASPIAN-III Study
مجلات علمیAbstract
Background
Hepatitis A is a common health concern both in developing and developed countries. Hygienic and socioeconomic parameters deeply impact the prevalence and transmission of this disease. Evaluating the epidemiological distribution and risk factors for Hepatitis A virus (HAV) is necessary for policy makers to improve local and national preventive measures.
Objectives
The aim of this study was to compare the prevalence of hepatitis A infection in a sample of Iranian adolescents living in different provinces of Iran and to assess its family- and community-related risk factors.
Methods
In this cross-sectional study, serum samples of 10 to 18-year-old adolescents, who were studied in a national health survey, were examined for anti-HAV antibodies. A total of 2,494 subjects were included from 16 provinces by multistage random cluster sampling. Demographic and socioeconomic factors related to HAV transmission were extracted by valid questionnaires. A multilevel analysis using mixed-effects logistic regression (melogit) was used to evaluate the association of risk factors with HAV infection.
Results
The weighted prevalence of HAV varied significantly across the studied provinces (P = 0.001), ranging from 50.43% in the Fars province to 78.81% in Markazi province. HAV was significantly more prevalent in children whose mothers worked outside of the home (OR, 1.73; 95% CI, 1.14-2.62; P = 0.009).
Conclusions
The risk of symptomatic HAV infection is considerable in adolescents of all studied provinces; thus, universal HAV vaccination is recommended for all adolescents, regardless of their socioeconomic level. However, the risk is higher in some provinces, which seem to be transitioning from intermediate to low endemicity.
Resistance of Shigella strains to extended-spectrum cephalosporins in Isfahan province
مجلات علمیAbstract
Background
Hepatitis A is a common health concern both in developing and developed countries. Hygienic and socioeconomic parameters deeply impact the prevalence and transmission of this disease. Evaluating the epidemiological distribution and risk factors for Hepatitis A virus (HAV) is necessary for policy makers to improve local and national preventive measures.
Objectives
The aim of this study was to compare the prevalence of hepatitis A infection in a sample of Iranian adolescents living in different provinces of Iran and to assess its family- and community-related risk factors.
Methods
In this cross-sectional study, serum samples of 10 to 18-year-old adolescents, who were studied in a national health survey, were examined for anti-HAV antibodies. A total of 2,494 subjects were included from 16 provinces by multistage random cluster sampling. Demographic and socioeconomic factors related to HAV transmission were extracted by valid questionnaires. A multilevel analysis using mixed-effects logistic regression (melogit) was used to evaluate the association of risk factors with HAV infection.
Results
The weighted prevalence of HAV varied significantly across the studied provinces (P = 0.001), ranging from 50.43% in the Fars province to 78.81% in Markazi province. HAV was significantly more prevalent in children whose mothers worked outside of the home (OR, 1.73; 95% CI, 1.14-2.62; P = 0.009).
Conclusions
The risk of symptomatic HAV infection is considerable in adolescents of all studied provinces; thus, universal HAV vaccination is recommended for all adolescents, regardless of their socioeconomic level. However, the risk is higher in some provinces, which seem to be transitioning from intermediate to low endemicity.
Antibiotic susceptibility patterns of isolates from children with urinary tract infection in Isfahan, Iran: Impact on empirical treatment
مجلات علمیAbstract
Objectives
The aim of this study was to identify the antibiotic susceptibility of bacteria causing urinary tract infections (UTIs) in children in Isfahan, Iran.
Methods
Retrospective and prospective analyses were conducted on isolates from children with UTIs in a referral teaching hospital of Isfahan during 2013–2015. Findings were compared between first episode versus recurrent, nosocomial versus community-acquired, previous antibiotic use versus no previous antibiotic use, and febrile versus afebrile cases.
Results
Among 364 patients, 68.1% had no previous UTI, 19.7% has received antibiotics prior to infection and 96.2% were infected outside the hospital. Escherichia coli was the leading cause of UTI (68.1%), followed by Enterobacter (9.3%), Klebsiella (8.8%) and other bacteria (13.7%). Most isolates were relatively highly susceptible to imipenem (79.2%), ciprofloxacin (78.0%) and nitrofurantoin (70.8%), whereas sensitivity to cefotaxime (53%), cefalexin (39.8%) and trimethoprim/sulfamethoxazole (SXT) (26.1%) was low. Resistance to imipenem, cefotaxime and cefalexin was more prevalent in recurrent cases as well as in patients consuming antibiotics prior to UTI. Resistance of nosocomial cases to nitrofurantoin and cefotaxime was higher. In addition, afebrile patients had isolates that were more resistant to imipenem, ciprofloxacin and cefotaxime. Significant cross-resistance was found between most of the studied antibiotics.
Conclusions
Urinary pathogens showed low susceptibility to cefalexin, SXT and cefotaxime and high susceptibility to imipenem, ciprofloxacin and nitrofurantoin. Therefore, use of imipenem and ciprofloxacin should be considered in hospitalised children with severe or complicated disease. In addition, nitrofurantoin is a good option in afebrile cases and for UTI chemoprophylaxis in this area.
Keywords
Overview of hydatid disease in Iranian children
مجلات علمیSeroprevalence of Human Cytomegalovirus Diseases in Isfahan, Iran.
مجلات علمیAbstract
Background: Human cytomegalovirus (HCMV) is one of the commonest agents that cause congenital malformation such as mental retardation and deafness. Seroprevalence of HCMV varies in different populations and age groups. This study tried to determine the seroprevalence and contributory factors of CMV in order to develop successful strategies for HCMV diseases prevention. Methods: We examined 595 serum samples from different age groups for the presence of IgG antibodies against HCMV by enzyme-linked immunosorbent assay (ELISA) technique. Findings: Overall, 586 out of 595 cases were seropositive for HCMV-IgG while 9 cases were seronegative. Educational level, sex, marital status, and place of residence were not associated with CMV seropositivity. Conclusion: Our results indicated that in Isfahan, Similar to other developing countries, most patients are infected during puberty and not through sexual intercourse. Therefore, frequent audiological assessments and urine samples to evaluate CMV in case of defect in hearing ability are mandatory. We also recommend transmission of eradicated blood for immunocompromised patient and immature neonates.
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