Accepted Manuscript Trachoma prevalence in rural areas of eastern Iran Javad Sharifi-Rad, Fatemeh Fallah PII:
S2052-2975(16)00032-9
DOI:
10.1016/j.nmni.2016.03.001
Reference:
NMNI 143
To appear in:
New Microbes and New Infections
Received Date: 25 February 2016 Revised Date:
1 March 2016
Accepted Date: 7 March 2016
Please cite this article as: Sharifi-Rad J, Fallah F, Trachoma prevalence in rural areas of eastern Iran, New Microbes and New Infections (2016), doi: 10.1016/j.nmni.2016.03.001. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT 1
Trachoma prevalence in rural areas of eastern Iran
2
Javad Sharifi-Rad 1, 2 and Fatemeh Fallah3, 4
3 1) Department of Pharmacognosy, Faculty of Pharmacy, Zabol University of Medical Sciences,
5
Zabol, Iran, 2) Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences,
6
Zabol, Iran, 3) Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti
7
University of Medical Sciences, Tehran, Iran, 4) Department of Microbiology, School of Medicine,
8
Shahid Beheshti University of Medical Sciences, Tehran, Iran
9
Corresponding author: J. Sharifi-Rad, Department of Pharmacognosy, Faculty of Pharmacy, Zabol
SC
University of Medical Sciences, Zabol, Iran. E-mail:
[email protected]
M AN U
10
RI PT
4
AC C
EP
TE D
11
1
ACCEPTED MANUSCRIPT Trachoma prevalence in rural areas of eastern Iran
1 Abstract
3
We investigated the trachoma prevalence in rural areas of eastern Iran. We collected swabs from 150
4
children at three areas. PCR results showed presence to chlamydia in 4 male (5.97%) and 9 female
5
(10.84%). We suggested the in assessing the elimination of trachoma WHO must consider border
6
areas between countries.
7 Keywords: Chlamydia trachomatis, children, PCR
SC
8
RI PT
2
9
Trachoma is the most common infectious cause of blindness. Trachoma, caused by the
11
obligate intracellular parasite Chlamydia trachomatis, remains a leading cause of blindness
12
throughout the world [1]. The infection is transmitted through contact with eye and nose
13
discharge of infected people, particularly young children who are the principal reservoir of
14
infection. It is also spread by flies which have been in contact with the eyes and noses of
15
infected people [2, 3]. Trachoma rates increased extremely as crowding and poor living
16
standards [4,5]. Environmental risk factors influencing the transmission of the disease
17
include: poor hygiene, crowded households, water shortage, and inadequate sanitation.
18
Trachoma is hyperendemic in many of the poorest and most rural areas of 51 countries of
19
Asia, Africa, Central and South America, Australia and the Middle East. Zabol is a city in the
20
Sistan and Baluchistan Province, in Iran. It borders Afghanistan to the north, Chehl-
21
dokhtaran (Forty girls) and Malek-siah-kuh (Black King) Mountains to the west and south-
22
west, and Pakistan to the south and south-east. Zabol lies within a dry-temperate zone in De
23
martonne climatic zonation system. Zabol is located near Lake Hamun and the region is
24
irrigated by the Hirmand River. Lake Hamun is a seasonal lake that is often dry. Zabol area is
AC C
EP
TE D
M AN U
10
1
ACCEPTED MANUSCRIPT well known for its "120 day wind" (bād-e sad-o-bist-roz), a highly persistent dust storm in
26
the summer which blows from north to south.
27
During a visit to the Zabol rural areas near to Afghanistan board in June 2014, we observed
28
that several of the children showed signs of follicular conjunctivitis. To confirm the suspicion
29
that this was due to trachoma, swabs were collected from 150 children (67 male and 83
30
female) with age range 6-11 at three areas that were near to border Afghanistan. The upper
31
eyelid was everted using a sterile cotton bud and the eyelid swabbed three times using a
32
nasopharyngeal swab. The swab was placed in a dry DNA-free tube. Sampling was done with
33
precautions to prevent transfer of agents between people under study [6]. Amplicor PCR
34
analysis [7], showed the presence to chlamydia in 4 male (5.97%) and 9 female (10.84%).
35
Notwithstanding more than 70% of the participants access to clean water, sanitation and
36
facial cleanliness during study, but 85% lived near uncovered wastelands, kept animals in
37
close to their houses and had frequent contact with flies.
38
In the current study, the prevalence of trachoma in these older people was surprisingly high.
39
WHO reported that seven countries had achieved the elimination of trachoma, and had
40
progressed to the surveillance phase [2]. These countries are Gambia, Ghana, Morocco,
41
Myanmar, Oman, Viet Nam and importantly Iran.
42
One reason for the persistence of trachoma in this study may be the interaction with people in
43
Afghanistan. Study participants said they frequently communicate with the Afghan people
44
living near border. Therefore it is very important that the country trachoma elimination must
45
consider migration that can effect on the trachoma disease. The Afghan people who live the
46
near Iran board have much poorer living condition than Iranians living on the other side of
47
the border. Furthermore, the continuing prevalence of trachoma in Zabol rural areas near, can
48
related to the absence of a specific trachoma control program in these areas. Another factor
49
that may have contributed to the high prevalence of infection at these areas is dust storms in
AC C
EP
TE D
M AN U
SC
RI PT
25
2
ACCEPTED MANUSCRIPT these areas. A dry dust climate has long been important as a factor with high prevalence of
51
trachoma [8]. Further study is needed to better understand the importance and threshold of
52
each factor.
53
We suggested the in assessing the elimination of trachoma WHO must consider border areas
54
between countries. In conclusion, the results of this study demonstrate that trachoma is a still
55
disease of public health importance in this population at Zabol rural areas near to near to
56
Afghanistan border and additional elimination efforts need to continue to satisfy the target set
57
by the World Health Assembly resolution, which is elimination of trachoma as a public
58
health problem by 2020.
SC
RI PT
50
M AN U
59
Conflict of Interest
61
None declared.
62
Acknowledgments
63
We would like to show our gratitude to the Professor Hugh R Taylor AC, Melbourne
64
Laureate Professor, Harold Mitchell Chair of Indigenous Eye Health Melbourne School of
65
Population and Global Health, University of Melbourne, Australia for sharing assisting us
66
during the writing of this paper.
EP
TE D
60
68
AC C
67
References
69
[1] Taylor HR, Rurton MB Haddad D, West S, Wright H. Trachoma. Lancet 2014; 384: 2142-52.
70
[2] WHO. Trachoma. http://www.who.int/mediacentre/factsheets/fs382/en/ (accessed May,
71
2015).
72
[3] Zahirnia Z, Eslami G, Goodarzi H, Taheri S, Fallah F, Taheripanah R, Taherpoor A,
73
Mehdighal S. Evaluation of the prevalence of infection with Chlamydia trachomatis in
74
spontaneous abortions, by Nested PCR method. Res Med 2013; 37: 67-72. 3
ACCEPTED MANUSCRIPT 75 76
[4] Taylor HR. Trachoma: A blinding scourge from the Bronze Age to the twenty-first century. Melbourne: Centre for Eye Research Australia, 2008. [5] Fallah F, Eslami G, Bootorabi M, Kazemi B, Goudarzi H, E Mozaheri. The isolation of
78
chlamydia pneumoniae in atherosclerosis patients in Iran by PCR method. Gene Ther Mol
79
Biol 2006; 10: 109-112.
RI PT
77
80
[6] West ES, Munoz B, Mkocha H, et al. Mass treatment and the effect on the load of Chlamydia
81
trachomatis infection in a trachoma hyperepidemic community. Invest Ophthalmol Vis Sci
82
2005; 46: 83-87.
[7] Quinn TC, Welsh L, Lentz A, Crotchfelt K, Zenilman J, Newhall J, Gaydos C. Diagnosis by
84
AMPLICOR PCR of Chlamydia trachomatis infection in urine samples from women and men
85
attending sexually transmitted disease clinics. J Clin Microbiol 1996; 34(6): 1401-1406.
M AN U
EP
TE D
[8] Duke-Elder, S. 1938. "Text-book of Ophthalmology", vol. 2, p. 1596. Kimpton, London.
AC C
86
SC
83
4
