title: The Endemicity of Human Fascioliasis in Guilan Province, Northern Iran: the Baseline for Implementation of Control Strategies.
abstract: BACKGROUND
  The largest global outbreaks of liver fluke disease (Fascioliasis) in humans, caused by species of the genus Fasciola, have occurred in Guilan Province of Iran, affecting more than 15000 people. Although, different aspects of fascioliasis have been the subject of various researches during last two decades, nevertheless no community-based study has been performed in endemic regions of Guilan. The aim of present study was to obtain the basic information needed to develop future control strategies.
  
  
  METHODS
  Fecal and blood samples were collected from 1,984 volunteers in the Bandar-Anzali district, the region where previous epidemics occurred. Fecal samples were examined by Kato-Katz and formalin-ether methods for the presence of Fasciola eggs. Sera samples were analyzed by ELISA to detect anti-cathepsin L antibodies.
  
  
  RESULTS
  Twenty-seven (1.36%) individuals were seropositive, 9 (0.45%) individuals were egg positive (mean egg count 50.7 (±30.36) eggs per gram of faeces) and 30 individuals (1.51%) were positive using both methods. No statistical association was observed between infection and age, gender, location, occupation, educational status and dietary habits. The prevalence of intestinal parasites is also included.
  
  
  CONCLUSIONS
  Human fascioliasis is hypoendemic in this region and recommends a passive case-finding approach, effective primary prevention measures, health education through mass media and effective veterinary public health measures for control of human disease.
authors.affiliation: Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Keyhan
authors.initials: K
authors.lastname: Ashrafi
authors.affiliation: Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Farshid
authors.initials: F
authors.lastname: Saadat
authors.affiliation: School of Biotechnology, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin, Ireland.
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Behnaz
authors.initials: B
authors.lastname: Rahmati
authors.affiliation: Dept. of Microbiology, Faculty of Science, Azad University of Lahijan, Iran.
authors.forename: Hadid
authors.initials: H
authors.lastname: Amin Tahmasbi
authors.affiliation: School of Biological Sciences, Queen's University Belfast, Medical Biology Centre, Belfast, Northern Irland.
authors.forename: John
authors.initials: J
authors.lastname: Pius Dalton
authors.affiliation: Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences. Iran.
authors.forename: Abolhassan
authors.initials: A
authors.lastname: Nadim
authors.affiliation: Dept. of Biochemistry and Biophysics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Asadinezhad
authors.affiliation: Dept. of Communicable Diseases Control, Guilan province Health Center, Rasht, Iran.
authors.forename: Sayed Mahmood
authors.initials: SM
authors.lastname: Rezvani
keywords: Control; Endemicity; Epidemiology; Fasciola hepatica; Human fascioliasis; Iran