Letter to the editor
Cancer Epidemiology
Zohreh Shahhosseini; Fatemeh Hamidi
Abstract
Dear Editor,
Coronaviruses are important human and animal pathogens. In December 2019, a new virus from the coronavirus family, called coronavirus disease 2019 (COVID-19), triggered the outbreak of pneumonia from Wuhan across China. The virus originated in bats and was transmitted to humans through ...
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Dear Editor,
Coronaviruses are important human and animal pathogens. In December 2019, a new virus from the coronavirus family, called coronavirus disease 2019 (COVID-19), triggered the outbreak of pneumonia from Wuhan across China. The virus originated in bats and was transmitted to humans through unknown intermediate animals. Currently, the lives of millions of people around the world are affected by the crisis caused by the outbreak of COVID-19 diseases, which has brought huge economic and social costs. Despite the efforts made in many countries to reduce the risks and the negative effects of this crisis, the damage and the resulting costs are still increasing. People with cancer are among the groups that need more attention and are highlighted as high-risk groups. The risk of morbidity and mortality from COVID-19 as a consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is not uniform. Evidence show that patients with cancer have an increased risk of developing severe forms of COVID-19 compared with the non-cancer population. It seems that cancer patients are at a higher risk of respiratory viruses such as influenza because of their frequently observed immunocompromised state. Patients with blood malignancies, such as non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute myeloid leukemia, acute lymphoblastic leukemia, and multiple myeloma, along with those in active treatment for any type of cancer and people who have undergone bone marrow transplants are among the high-risk groups.
According to the existing literature on COVID-19 pathogenesis and cancer, several shared features have been selected to define the risk assessment in cancer patients, including patient characteristics (such as older age, underlying diseases, obesity, and sex), disease characteristics, therapeutic characteristics, and clinical and laboratory variables. Given the competitive risks of cancer-related deaths and serious complications from SARS-CoV-2 and higher mortality, providing care for cancer patients in this crisis is a challenging task. Many cancer patients are seeking to find a cure for their disease due to cancellation or delay in treatment, including surgery, chemotherapy, and radiation therapy. There are also concerns that patients with curable cancers, who need timely treatments, find the risk of COVID-19 higher than the benefits of cancer treatment. New findings from researchers in the United States show that 13% of patients, including cancer patients, who used a combination of azithromycin and hydroxychloroquine or just hydroxychloroquine for treatment died within one month. However, further testing is needed to determine the risks and benefits of these drugs. It has recently been reported that using a combination of the two drugs to treat cancer patients infected with COVID-19 has tripled their risk of death within 30 days. Hence, it is recommended that these patients do not use the mentioned drugs. Insufficient provision of personal protective equipment for health care providers, limited hospital capacity, including intensive care units, may be effective in providing care to people with cancer. Early treatment of cancer patients should not be compromised during the pandemic. However, patient management should be tailored to the best available resources, and the need for any intervention should be balanced against the increased risk of pandemic. In addition, alternative modified procedures, including counseling and treatment services such as home care and tele-nursing should be considered for cancer patients. The goals, alternative modified procedures, including counseling and treatment services, were to ensure the continuity of care and to protect the health care professionals from the infection. Health scholars in different disciplines have proposed another method to manage cancer patients; according to these scholars, in special circumstances, cyberspace like “WhatsApp”, “Telegram”, or “Instagram” should be used to communicate with patients and share educational materials and information. Moreover, training nurses to respond appropriately to patient needs, such as stress management and proper nutrition, is essential. Outpatients should be treated with the safest level of care and away from any danger. Several measures may help reduce the virus transmission as follows: training the proper communication rules and hand hygiene protocols, explaining infection control measures, teaching the signs and symptoms of COVID-19, highlighting the importance of staying home and non-exposure to high-risk individuals, and emphasizing the importance of reporting any new symptoms to physicians and health care providers. Attendance at the clinic should be limited only to patients themselves and a maximum of one companion; in addition, outpatient care clinics, including chemotherapy injection units should have careful screening and be prepared to identify possible cases safely and without risk of transmission. Currently and due to the limited data, there are no international guidelines to address the management of cancer patients in any infectious pandemic, but for each patient, a separate decision should be made according to age, general condition, stage, and spread of the disease, and the patients should consult their physician about this issue. At present, more than ever, the world needs to espouse perspectives free of race, religion, ethnicity, and gender to help countries come together for the sake of the health of all populations. Community participation, attention to the health of all cancer patients in all age groups, non-discrimination, access to quality services and information, and appropriate collaboration can help in this regard.
Original Article
Epidemiology
Saleh Jafarian; Ali Ahmadi; Masoud Amiri; Rahman Biokani; Zohreh Abbaspour; Masoud Mahmoudzadeh
Abstract
Background and aims: Motorcycle accidents are a major concern for countries. One of the most important risk factors for motorcyclists is the lack of helmet use. This study aimed to measure the rate of the helmet use and predictive factors in Shahrekord, Iran. Methods: Using simple random ...
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Background and aims: Motorcycle accidents are a major concern for countries. One of the most important risk factors for motorcyclists is the lack of helmet use. This study aimed to measure the rate of the helmet use and predictive factors in Shahrekord, Iran. Methods: Using simple random sampling method, this cross-sectional study was conducted in 2018 with a sample size of 350 motorcyclists. A researcher-made questionnaire was used to collect data, and the SPSS software version 24 was used to analyze the data. Results: The mean age of participants was 28.8 ± 10.1 years. Out of 350 participants, 15.1% and 1.4% of motorcyclists and their passengers used helmets. The most important predictors of helmet use were age more than 35 years, high education, and having a driving license. The most important reason for using the helmet was protection against injuries in accidents. Conclusion: According to our results, the rate of helmet use was low. Thus, more efforts should be made to intervene and train for the helmet use among community members with an emphasis on younger people, individuals with governmental jobs, and people with lower education level.
Letter to the editor
Health Promotion
Alireza Razzaghi; Mohammad Saadati; Maryam Najafi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2020
Abstract
AbstractEducation is a complex issue and there is a need to consider a several factors to provide an effective training program. In the road traffic crashes issue, there are some contradictory findings of education effectiveness which caused to mistrust among professional circles and experts. Some scientists ...
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AbstractEducation is a complex issue and there is a need to consider a several factors to provide an effective training program. In the road traffic crashes issue, there are some contradictory findings of education effectiveness which caused to mistrust among professional circles and experts. Some scientists believe that most of the training programs do not necessarily cover all aspects and only address some of the concerns. The low effectiveness and efficiency of educational programs can have several causes, which are mentioned below: Non-use of specific educational theory, Non-use of various methods for providing the educational content, Insufficient attention to the causation network of traffic crashes, Insufficient knowledge of the education audience. it is appropriate for researchers and policymakers in this field to consider the theoretical and scientific principles in the design and implementation of educational interventions to increase effectiveness.It is appropriate for researchers and policymakers in this field to consider the theoretical and scientific principles in the design and implementation of educational interventions to increase effectiveness.
Original Article
Health Promotion
Pegah Mohaghegh; Ehsan Abedi; Masomeh Sofian; Fatemeh Rafiei
Articles in Press, Accepted Manuscript, Available Online from 25 November 2020
Abstract
Background: Regarding the COVID-19 epidemic and the resulting health anxiety among people which causes the unreasonable referring to healthcare centers, current study aims to assess health anxiety in persons referring to healthcare centers of arak.Methods: this cross-sectional study examined the health ...
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Background: Regarding the COVID-19 epidemic and the resulting health anxiety among people which causes the unreasonable referring to healthcare centers, current study aims to assess health anxiety in persons referring to healthcare centers of arak.Methods: this cross-sectional study examined the health anxiety related to COVID-19 in people going to urban healthcare centers of Arak in 2020. Participants were selected by quota sampling method from 16 urban healthcare centers of Arak. Salkowski 18-item Health Anxiety Inventory (HAI-18) was completed by 392 people. Collected information was entered in SPSS 24 and was analyzed by Mann-Whitney U and Kruskal-Wallis tests.Results: total mean ± standard deviation score of health anxiety was 28.96 ± 7.62. Most people, i.e. 293 people (74.7%) had medium anxiety and 75 people (19.1%) had high anxiety. Health anxiety level was higher in the 30-59 age range, single people, and students. People with preliminary education levels had lower health anxiety. People with chronic diseases and symptoms of cold, and people who came to healthcare centers due to COVID-19 screening had a higher anxiety level. Having a child in the family increased health anxiety more than having elderly and disabled people in the family.Conclusions: health anxiety was higher in the 30-59 age range, people with chronic diseases, people with symptoms of cold, and in case of having a child in the family. During the current crisis, diagnosing people prone to psychological disorders from different demographic groups is vital to use psychological techniques and interventions appropriate for each demographic group.
Original Article
Social Epidemiology
Ali Ahmadi; maryam sadat ghaemfard; asieh mansouri; Soleiman Kheiri
Articles in Press, Accepted Manuscript, Available Online from 22 December 2020
Abstract
Background and Aim: Social health is "the quantity and quality of individual interaction with society in order to promote the well-being of individuals in society." This interaction promotes social capital, social security, poverty reduction and injustice. So far, no study has been done on ...
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Background and Aim: Social health is "the quantity and quality of individual interaction with society in order to promote the well-being of individuals in society." This interaction promotes social capital, social security, poverty reduction and injustice. So far, no study has been done on the social health situation in Chaharmahal and Bakhtiari province. This study was conducted to determine the social health status in Chaharmahal and Bakhtiari province during 1398.Methods and Materials: This descriptive-analytical cross-sectional study was performed using the data base of the prospective epidemiological study of Shahrekord cohort in Chaharmahal and Bakhtiari province in 1398. To measure social health, a valid Iranian social health questionnaire with a score of 33 to 165 was used.Results: Out of 600 invited samples, 597 people completed the social health questionnaire (99.5% response rate). The mean age of participants was 48.54 9 9.33 years. The mean and standard deviation of the social health score of the subjects was 115.71 22 22.7. This score was higher in men than women (p-value = 0.038).Conclusion: Social health in the study population is moderate and needs the attention of health policy makers and planners. By holding training classes for villagers and teaching them how to interact with each other, especially with family members, and with more participation of women in social affairs and increasing their social relations, as well as counseling on social health of people with abnormal body mass index.
Original Article
Epidemiology
Articles in Press, Accepted Manuscript, Available Online from 23 December 2020
Abstract
Background: Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including but not limited to problematic substance use. Negative urgency is also shaped by family socioeconomic position such as parental educational attainment.Aim: ...
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Background: Negative urgency reflects a specific facet of impulsivity and correlates with a wide range of health-related risk behaviors, including but not limited to problematic substance use. Negative urgency is also shaped by family socioeconomic position such as parental educational attainment.Aim: To investigate sex differences in the boosting effects of parental educational attainment on children's negative urgency in the US. Materials and methods: This is a cross-sectional study using the Adolescent Brain Cognitive Development (ABCD) study. Baseline ABCD included 10535 American children between ages 9 and 10 years old. The independent variable was parental educational attainment. The primary outcome was the negative urgency measured by the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-SS). Mixed-effects regression models were used for data analysis.Results: In the overall sample, parental educational attainment was not associated with negative urgency in the children. Sex showed a statistically significant interaction with parental educational attainment on children's negative urgency, indicating a stronger protective effect of high parental educational attainment for female, compared to male, children. In stratified models, high parental educational attainment was associated with lower levels of negative urgency in female but not male children.Conclusion: Parental educational attainment is a determinant of negative urgency for female but not male American children. American boys have high levels of negative urgency, which is a risk factor of drug use, at all parental education levels.
Original Article
Infectious Disease
Paul I Oyegoke; Busayo O Olayinka; Joseph O Ehinmidu; Babajide A Tytler
Articles in Press, Accepted Manuscript, Available Online from 03 April 2021
Abstract
Background and aim: The spread of antimicrobial resistance (AMR) is a serious public health threat complicating treatment and resulting in prolonged hospitalization. Due to the dearth of appropriate surveillance systems, the prevalence of AMR threat is not well defined. This study sought to assess the ...
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Background and aim: The spread of antimicrobial resistance (AMR) is a serious public health threat complicating treatment and resulting in prolonged hospitalization. Due to the dearth of appropriate surveillance systems, the prevalence of AMR threat is not well defined. This study sought to assess the prevalence of AMR among bacterial isolates from sputum specimens obtained from patients with pneumonia presenting at two secondary healthcare facilities in Zaria over 3 months (June 1 to August 31, 2018). Methods: Standard methodology was followed in processing sputum samples that met the acceptance criteria. The antibiotic susceptibility patterns of bacterial pathogens cultured from sputum specimens obtained over a 3-month period (June 1 to August 31, 2018) was evaluated using the Clinical and Laboratory Standards Institute’s recommendation. Data analysis was carried out using descriptive statistics.Results: Acinetobacter spp were the predominant pathogens accounting for 32% of recovered isolates, followed by Staphylococcus spp (18%) and Klebsiella spp (17%). AMR was seen in 91% of the isolates. Most isolates were resistant to erythromycin (80%) and amoxicillin (83.3%). Multiple antibiotic resistance (MAR) index ≥ 0.3 was observed in 76% of the isolates. Conclusion: This study showed that AMR rates were observed to be high and may display a serious therapeutic challenge to the management of community-acquired pneumonia. Concerted efforts are needed to combat the worrisome AMR trends revealed in this study.
Original Article
Epidemiology
Articles in Press, Accepted Manuscript, Available Online from 03 April 2021
Abstract
Background: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups ...
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Background: While increased parental education reduces children’s sleep problems, less is known about racial variation in such protection. According to Minorities’ Diminished Returns (MDRs) theory, economic resources such as parental education show weaker health effects for minority groups such as Blacks and Latinos than non-Latino Whites, which is due to racism and social stratification. Aim: In this study, we investigated the association between parental education and children’s sleep problems, as a proxy of sleep problems, by race. Methods: This cross-sectional study included 11718 American children aged 9-11. All participants were recruited to the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental education, a five-level nominal variable. The dependent variable, sleep problems, was a continuous variable. Race/ethnicity was the effect modifier. Age, gender, and marital status were the covariates. Mixed-effects regression models were used for data analysis. Results: Parental education was inversely associated with children's sleep problems. However, there was a weaker inverse association seen in Black families when compared with White families. This was documented by a significant statistical interaction between race and parental education on children’s sleep problems. Conclusion: Diminished protective effect of parental education on children’s sleep problems for Black and Latino families compared to non-Latino White families is similar to MDRs and reflects the higher-than-expected health risk to middle-class Black and Latino children.
Letter to the editor
Epidemiology
Jamal Ahmadzadeh; Arash Aliasghari; Marzieh Hossini; Fatemeh Rahimi; Kazhal Mobaraki
Articles in Press, Accepted Manuscript, Available Online from 03 April 2021
Abstract
As a result of the global crisis related to coronavirus disease 2019 (COVID-19), confusion, anxiety and fear and other psychological effects have been created among the general population in this global village. Unfortunately, these factors have provoked inappropriate behavior, and in aspect of socially, ...
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As a result of the global crisis related to coronavirus disease 2019 (COVID-19), confusion, anxiety and fear and other psychological effects have been created among the general population in this global village. Unfortunately, these factors have provoked inappropriate behavior, and in aspect of socially, it seems to converting to a social stigma which affects the dignity of the morbid persons with COVID-19. In addition to the patient, the stigma can also affect interpersonal relationship among nurses, family, friends and also relationships of the communities. In this critical situation in which each person in this global village is involved, we need to take care of each other with empathy, and that is key to solve and passing the problem and preventing of the social stigma associated with COVID-19 disease. This commentary provides the effects of social stigma related to COVID-19 and practical measures for the world communities to deal with this social problem.
Original Article
Epidemiology
Eidha Ali Bin-Hameed; Huda Ameen Joban
Articles in Press, Accepted Manuscript, Available Online from 06 April 2021
Abstract
AbstractBackground and aim: Cholera is a disease of acute watery diarrhea caused by Vibrio cholerae which is usually transmitted through contaminated water. In this study, we collected and analyzed the related epidemiological data to determine the outbreak of cholera in Hadhramout, Yemen during the epidemiological ...
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AbstractBackground and aim: Cholera is a disease of acute watery diarrhea caused by Vibrio cholerae which is usually transmitted through contaminated water. In this study, we collected and analyzed the related epidemiological data to determine the outbreak of cholera in Hadhramout, Yemen during the epidemiological weeks 2019.Methods: A retrospective study conducted according to screening rapid diagnostic and confirmatory laboratory culture testing methods used for diagnosis the suspected clinically cholera cases.Results: A total of 794 suspected cases cholera, 399(50.5%) positive cases were detected by rapid diagnostic test, 76(9.6%) of them were confirmed by laboratory culture test with statistically significant (P-value 0.05). The highest proportion of cholera cases 224(28.2%) were reported in less than 15 years age group with statistically significant (P-value=0.003) when tested by rapid diagnostic test, and 45(5.66%) when confirmed by laboratory culture test with no statistically significant (P-value >0.05). Hajr directorate was the most effected 242(30.47%) followed by Mukalla city directorate 108(13.60%) when tested cases by rapid diagnostic test (P-value >0.05), while Hajr and Mukalla city directorates reported 55(7.0%) and 15(2.0%) respectively when confirmed by laboratory culture test with statistically significant (P-value = 0.002).Conclusion: Recognition of cholera outbreak highlight the need for consistent laboratory and epidemiological based surveillance that can support prevention and control activities.
Original Article
Epidemiology
Sajad Bagherian; Majid Mardaniyan Ghahfarrokhi; Ebrahim Banitalebi
Articles in Press, Accepted Manuscript, Available Online from 12 April 2021
Abstract
Background: According to WHO, immediate self-quarantine is assumed as the best course of action for highly contagious diseases. But, many individuals have so far become overweight and are also suffering from physical problems. Therefore, the present study aimed to effect of the COVID-19 pandemic on interest ...
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Background: According to WHO, immediate self-quarantine is assumed as the best course of action for highly contagious diseases. But, many individuals have so far become overweight and are also suffering from physical problems. Therefore, the present study aimed to effect of the COVID-19 pandemic on interest in home-based exercise.Methods: This descriptive study with a comprehensive electronic systematic search in the Google Trends database using the keyword of “home-based exercise” retrieved the relevant data about the Internet search activity of people in the Iranian community. The data were accordingly obtained within two-time intervals, i.e., from February 18, 2020 to October 18, 2020 and eight months prior to the outbreak of COVID-19 (namely, June 18, 2019 to February 18, 2020). The Wilcoxon test and the Spearman’s correlation coefficient used to analyze the data.Results: The results established significant increase in “home-based exercise” Google search in the eight-month time interval during COVID-19 compared with the same period before the pandemic (p<0.001). As well, the findings revealed a significant correlation between “home-based exercise” Google search and positive COVID-19 cases in the time intervals of February 18, 2020 to April 18, 2020 (r=0.756, p=0.0001), April 18, 2020 to June 18, 2020 (r=-461, p=0.0001) but not, June 18, 2020 to August 18, 2020 (r=0.044, p=0.737), August 18, 2020 to October 18, 2020 (r=0.246, p=0.056), and over time (r=-0.083, 0.0195).Conclusion: The prevalence rate of the COVID-19 pandemic and social constraints including self-quarantine seem to have raised people’s interest in doing exercises, especially home-based exercises.
Original Article
Epidemiology
Khosrow Sardarian; Mohammad Fallah; Mohammad Mehdi Majzoobi; Amir Hossein Maghsood; Mohammad Matini
Articles in Press, Accepted Manuscript, Available Online from 13 April 2021
Abstract
AbstractBackground: Previous studies had indicated the intestinal parasites had the high prevalence in Hamadan Province but, there was not up-to-date information about this problem. This study aimed to determine the prevalence of intestinal parasites in different habitats of Hamadan Province (urban ...
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AbstractBackground: Previous studies had indicated the intestinal parasites had the high prevalence in Hamadan Province but, there was not up-to-date information about this problem. This study aimed to determine the prevalence of intestinal parasites in different habitats of Hamadan Province (urban and rural areas) and compare the findings with previous reports of these parasites in this region with other parts of Iran.Methods:In a cross-sectional study, a total of 2948 fecal samples collected from all the rural and urban inhabitants of the province (including 12 cities) by cluster random sampling method. Fecal samples were examined using the direct smear and formalin ether concentration techniques. A questionnaire was used to collect relevant epidemiologic information about the study population.Results: In this study, the gender of all workers those ale wTotally, 52.2% of samples were from rural and the rest from urban areas; 50.6% was male and 49.4% was female (Mean age 29±12.3). The infection rate was 4.9% both for pathogenic and non-pathogenic parasites. Only 4 specimens were positive for ova (Ascaris lumbricoides, Hymenolepis nana and, pinworm). A total of 69 specimens (2.3%) were positive for pathogenic parasites and 73 specimens (2.5%) were positive for non-pathogenic (E. coli). The most important intestinal parasite in this region is G. lamblia; totally 2.3% of the studied population was infected by this parasite. ConclusionThis study indicates, the intestinal parasites are not a problem in this area at present. Only G. lamblia could consider as a moderate parasitic problem in this province.
Original Article
Epidemiology
Sima Afrashteh; Abbas Abbasi-Ghahramanaloo; Mohebat Vali; Mehdi Sharafi; Maria Khishdoost Borazjan; Hossein Darabi; Leila Moftakhar; Haleh Ghaem
Articles in Press, Accepted Manuscript, Available Online from 13 April 2021
Abstract
Background: Violence is recognized as a significant public health problem throughout the world. The present study was aimed to evaluate the prevalence of violence-related behaviors and its relation with other risky behaviors, family support and religiosity among Bushehr students.Methods: This cross-sectional ...
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Background: Violence is recognized as a significant public health problem throughout the world. The present study was aimed to evaluate the prevalence of violence-related behaviors and its relation with other risky behaviors, family support and religiosity among Bushehr students.Methods: This cross-sectional study was conducted on a total of 977 students in Bushehr city, southern Iran in 2016. Required data were collected using a self-administered questionnaire comprised of data on violence-related behaviors and other risky behaviors. Also, family support scale and religious belief questionnaire were applied. Data analysis was performed using SPSS 16.0 with Chi-square, t-test, and logistic regression model. Results: The overall prevalence of weapon carrying and physical fight were 9.1 and 7.1%, respectively. The findings of this study revealed that hookah use (OR: 2.93), physical fight (OR: 5.64), and having unsafe sex (OR: 2.42) were associated with weapon carrying. Also, male gender (OR: 3.36), illicit drug use (OR: 3.64), weapon carrying (OR: 5.24), and family support (OR: 0.97) were shown to be associated with physical fight.Conclusion: The results of the present study suggest co-occurrence nature of risky behaviors. Given the high prevalence of violence-related behaviors, implementation of preventive intervention for college students is of great importance.
Original Article
Epidemiology
Rahman Abdizadeh; Mohsen Cheshmpanam; Koroush Manouchehri Naeini; Soleiman Kheiri
Articles in Press, Accepted Manuscript, Available Online from 03 May 2021
Abstract
Background: Acanthamoeba spp. as opportunistic microorganisms are widespread in a wide range of environmental sources in the world and may cause severe diseases in immune deficient patients. The aim of this study was to determine the prevalence and genotypes of Acanthamoeba spp. in hemodialysis patients ...
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Background: Acanthamoeba spp. as opportunistic microorganisms are widespread in a wide range of environmental sources in the world and may cause severe diseases in immune deficient patients. The aim of this study was to determine the prevalence and genotypes of Acanthamoeba spp. in hemodialysis patients in Shahrekord county of Chaharmahal and Bakhtiari province.Methods: In this cross-sectional study, 79 oral swabs collected from the mouth of patients with chronic renal disorder undergoing hemodialysis during June to October 2018. The samples were cultured on non-nutrient agar (NNA) and examined by Giemsa staining, polymerase chain reaction (PCR), sequencing and tolerance testing methods.Results: Morphological investigations indicated that 30.4% (24/79) of the subjects were infected with some of free living amoebae (FLA) and PCR showed that only 3 samples contained Acanthamoeba spp. Sequencing of the latter samples showed that these isolates were belonged to T2 and T4 genotypes. After carry out the assay tolerance test, 2 of these 3 isolates were belonged to the T4 genotypes that indicated a high pathogenic potance.Discussion: The infection of hemodialysis patients with some of Acanthamoeba spp. particularly, T4 genotype should be considered important for these patients. Therefore, it is recommended to check and disinfect dialysis machines and dialysis units in hospitals, periodically.
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