Iranian Journal of Infectious Diseases and Tropical Medicine
Year:2007 | Volume:12 | Issue:36|Papers Count:24

Background and objective: Cholera is one of the most important epidemic-prone infectious diseases which has been caused seven pandemics with significant mortality in recent two centuries.In this regard, cholera has been a public health emergency with international concern. Iran is an endemic country for cholera and some cases registered annually since 1344.Material and methods: This is a descriptive, cross-sectional study, which was done in Iran during 1384. Rectal swab specimen from all suspected cases examined about vibrio cholerae. All patients with positive culture were investigated and was gathered all data.Results: Totally 354000 specimens received by district health centers laboratories and there were 1133 confirmed cholera cases whom infected with Eltor biotype, serogroup O1. Disease reported from 26 universities of medical sciences (from 41 universities). Approximately 80% of cases lived in urban areas and the rest in rural areas. There was not significant difference between male and female. Most of cases were in 15-39 years old group. Almost all cases (98%) infected with Inaba serotype and just 2% with Ogawa serotype. In this epidemic 12 persons died and Case Fatality Rate was 1.06%.Conclusions: despite significant progress of public health in Iran, cholera is a high priority disease so due to some reasons including: neighborhood with endemic countries, not full accessibility to safe water in rural areas, absence of swage collecting system and low level sanitation in slum areas.

Background and objective: The live attenuated oral poliovirus vaccine (OPV), used for many years resulted in obviously reducing the poliomyelitis cases world wide. Most RNA viruses have highly mutable genomes and polioviruses are among the most rapidly evolving of all RNA viruses. Mutations naturally occur during their replication in recipients or their contacts and in rare circumstances it can be caused reversion to neorovirulance (vaccine-associated paralytic poliomyelitis). For many years the role of some critical nucleotides in 5 non-coding region in vaccine-associated paralytic poliomyelitis was known but these years investigators have focused on the importance of other nucleotides in capsid regions such as VP1. So, mutations in this region of polioviruses isolated from acute flaccid paralysis cases are analyzed. In Iran the WHO eradication program has been done since 1373 and all acute flaccid paralysis has been studied.Materials and methods: During the years 1380-1381 from all AFP cases, we found 5 patients with residual paralysis which 5 vaccine-like polioviruses were isolated from them by using micronutralization test and intratypic differentiation tests (ELISA, probe-hybridization and RTPCR). Three isolates(no:1,3 and4) were vaccine-like polioviruses type 1 and 2 other isolates (no:2 and 5) were vaccine-like polioviruses type 2.The VP1 region of theses isolates was sequenced and analyzed.Results: Sequence analysis showed that 3 vaccine-like polioviruses type 1(no:1,2,4) had 4,2 and1nucleotide substitutions in VP1 region in comparison with reference Sabin strain 1 and in vaccine-like polioviruses type2(no:2,5) there were 1 and 2 nucleotide substitutions in this region in comparison with reference Sabin strain 2 respectively.Conclusion: Eradication of wild polioviruses is near and it is time to identify any mutations in all three Sabin strains and improve our knowledge about molecular pathogenesis of theses viruses.

Background and objective: Bacterial meningitis caused by different groups of Neisseria meningitidis is still one of the serious health problems worlds wide. The serum bactericidal assay (SBA) to meningococci is the most important test in immunological evaluation of meningococcal infection after vaccination. The SBA has been adapted as the gold standard for immunity against different serogroups of Neisseria meningitides after immunization.Material and methods: In at present investigation, standard group B strain of Neisseria meningitidis (CSBPI, G-245) were grown under controlled-submerge cultural conditions in fermenter containing 40 liters of modified Frantz medium. The cells were harvested at late exponential growth phase. OMV were extracted from cell wall according to the Deoxycholate Extraction Technique. The pletted OMVs were homogenized in PBS containing sucrose and thiomersal as preservative and further evaluation was performed. OMV and control were injected intramuscularly into groups of five rabbit with boosters on days 14, 28 and 42 after the primary immunization. The serum collected on days 0, 14, 28, 42 and 56 were tested by complement mediated bactericidal assay according to the world health organization protocol.Results: More than 70-90 % of the OMV retained their native configurationally structure with size ranges from 50 to 150 nm after extraction and purification procedures. This was shown by micrograph scanning of OMV in Zeisse CEM 902-A electron microscope. Purified vesicle showed a strong band of 40-45 KD molecular weights when run on 10% polyacrylamide gel electrophoresis with SDS. Identities of the OMVs were determined by Double Diffusion Gel Technique using hyperimmune rabbit anti OMV-PorA antisera against purified vesicles.The results of SBA with OMV revealed a significant increase in serum bactericidal titer against serogroup B meningococci after 56 day in comparison with the control group.Conclusion: The results indicate that OMV is able to induce a high level of bactericidal antibody response. Therefore, this paper shows that OMV could be a candidate for Vaccine toward serogroup B meningococci.

Background and objective: One of the mechanisms for carbapenem resistance in P.aeruginosa is production of metalo-betalactamases. carbapenem resistance among P.aeruginosa is becoming a critical therapeutic problem worldwide. Given the importance of Carbapenem-resistant p.aeruginosa strains as multidrug-resistant pathogens and our recognition of their presence in Tehran, we under took a study to investigate the outcomes of these strains and production of metalo-beta-lactamase in these bacteria.Material and methods: Antibiotic susceptibility testing of 350 P.aeruginosa isolated strains was performed as recommended by NCCLS using disk containing ceftazidime (CAZ), Ceftriaxone(CRO), cefotaxime (CTX), ceftizoxime(ZOX), piperacilin (PIP), piperacilin/tazobactam(PT), gentamicin(GM), amikacin (AN), imipenem (IMP), ciprofloxacin (CIP) (BBL).MICs for ceftazidime were determined by micro dilution method.For detection of MBLs we used double disk diffusion test. Results: In our study IMP was the most sensitive antibiotic (% 95) and ZOX was the most resistance to the p.aeruginosa strains. 43% isolates showed MIC>16mg/ml for ceftazidime (Emam Khomeine 64.2% and markaze tebi-kodakan 21.5%).Discussion: Our results showed that antibiotic resistance to CAZ and IMP in P.aeruginosa is increasing. MBL -producing strains are of additional important from an infection-control perspective, because they may be responsible for horizontal transmission of the resistant genes conferring carbapenem resistance in other strains of P.aeruginosa or even in unrelated gram negative organisms. Care should be taken to use imipenem just in critical condition.

Background and objective: Chronic pulmonary in patients with cystic fibrosis is predominantly due to infection by mucoid strains of Pseudomonas aeruginosa and alginate is a key factor in pathogensis of P.aeruginosa .Although, patients with CF generate a vigorous Antibody response to alginate that are ineffective at eliminating the bacteria.On the other side, garlic extract and immunomodulator fraction of garlic extract can modulate immune responses in murine model.Consequently the effect of P.aeruginosa alginate and immunomodulator fraction of garlic on humoral immunity of BALB/c mice was studied.Materials and methods: Alginate was purified from Pseudomonas aeruginosa strain 8821 M ATCBacteria were grown in Modified Mian' s medium, crude alginate was precipitated from. supematant by addition of ethanol then DNase I , RNase and Proteinase K were added Subsequently, alginate was purified by applying to a sephacryl S400 column.Eluted fractions were assayed for Uronicacid contentby carbazole- borate method in microtiter plate.Female BALB/c mice (6-8 weeks olds) were injected with either garlic extract, alginate, R10, garlic extract - alginate and R10- alginate.Subsequently, IgG antibody titers from immunized mice were determined by enzyme-linked immunosorbent assay.Results: The purified alginate contained 38 mg/ml uronic acid and 0.5 mg/ml nucleic acid, 1.45 mg/mlprotein and 0.08mg/ml LPS.While the combination of Paeruginosa alginate and garlic extract was poorly immunogenic in murine model but that the compound of P.aeruginosa alginate and immunomodulator fraction of garlic induced high levels of IgG antibody against P.aeruginosa alginate.Conclusion: Our results indicate the compound of Paeruginosa alginate and immunomodulator fraction of garlic enhances immunogenicity to Paeroginosa by the elicitation of opsonic antibodies in BALB/c mice.Subsequently, it is possible to use immunomodulator fraction of garlic (R10) as a carrier for alginate in a conjugate vaccine against P.aeruginosa but more investigation require with respect to Immunoglubolin subclasses.

Background and objective: Hematological abnormalities are among the most common manifestations of advanced Human Immunodeficiency Virus (HIV) infection and Acquired Immuno-Deficiency Syndrome (AIDS). The prevalence of anemia in HIV disease varies considerably, ranging from 1.3% to 95%. Some studies showed that anemia was associated with CD4+ cell count below 50/microL, female sex, black race, a viral load above 100,000 copies/mL, zidovudine use, and older age. We aimed to determine the prevalence of anemia and associated factors in HN infected patients.Material and methods: 143 (123 male and 19 female) HIV positive patients enrolled in this study. Mean age of our patients were 37.1±2. In this cross-sectional study, 143 HN positive patients who referring to behavioral disease consulting center in Tehran, Shemiranat, North of Tehran and AIDS research center, were screened for anemia from may 2004 to February 2007. We tested hemoglobin in all of the patients. CD4 counting was also done by flow cytometry. We defined mild to moderate anemia as hemoglobin 8 to 12 g/dL in female and 8-14 in male. Severe anemia was defined as hemoglobin less than 8 g/dL.Results: The CD4 lymphocytes were between 30 and 1413.5 (mean 394.5±229.2 cells/mm3). Mean of hemoglobin was 13.5±2.1 g/dl (minimum 8.1 and maximum 19.9). We observed mild to moderate anemia in 46% and severe anemia in 0%. There was not any significant difference between patients with and without anemia, regarding age, sex, stage of the infection, CD4 count, concurrent anti-retroviral therapy, but risk behaviors for HIV acquisition was associated to anemia(p<0.05).Conclusion: Mild to moderate anemia was common problem in HIV positive patients but severe anemia was less prevalent in this study population.

Background and objective: Legionella are ubiquitous in natural aquatic environments, capable of existing in waters with varied temperature, PH levels, and nutrient and oxygen contents. Hot water systems provide ideal environment for proper growth legionella. Contamination by legionella occurs in the distribution system of many hospitals. The primary detection of legionellosis is necessary for treatment and control and prevent of disease. The aim of current study is detection and presentation control methods of legionella in hospital water distribution systems.Materials and methods: Water samples were provided from hospital water distribution systems. Briefly The specimen should then be concentrated by filtration, treated with an acid buffer and thermal to enhance legionella recovery, and cultured on a BCYE agar medium. In the present investigation the efficacy and accuracy of mip gene based primers were tested in PCR for culture negative samples.Results: A total of number 110 sample from showerheads, ventilator system and nebulizer were positive 29(26.5%) sample. The highest was related to nebulizer and lowest to shower head. Of 26.6% positive samples ventilator systems 13.3% related to chiller and 13.3 to cooler. Of 20% positive samples shower heads 16.4% related to warm water and 3.6% to cold water. PH, chloride water samples measured with DPD method. PH and chloride amounts were measured 6.6, 6.8, 7.2, 7.4, 7.6 and 0.18, 0.2, 0.22, 0.3, 0.4, 2.2 mg/l respectively.Conclusion: In this study all hospitals used filtrated urban waters however, was found that 26.4% contaminated with legionella that be arised from disinfectant resistant or disinfectant drawback. The polymerase chain reaction and standard culture method were utilized to detect legionella species and L.pneumophila. The results showed that routine surveillance for a hospital water distribution system is fundamental for public health.Approaches used for controlling the growth of legionella in treated water, frequently used in combination, include heat, chlorination, ultraviolet light, copper-silver ionization and Ozone treatment, use of terminal tap water filters systems, chlorine dioxide, mono-chloramines disinfection and hyper chlorination.

Background and objective: Today, it is important to affect a rapid and accurate etiological identification because development of treatment strategies that target specific species of dermatophytes. Many countries benefit from a number of different molecular techniques to routinely diagnose a wide range of infective diseases. Likewise in our country some of the researchers, through employment of some of these techniques in addition to the use of colonies from patient's skin culture, have been able to distinguish dermatophytes sporadically. However, in this research for the first time in Iran we had the opportunity to evaluate the quick and direct specification of these fungi by using PCR on patient's skin specimen and young colony culture.This method has been tested world wide on a small scale.Material & Methods: In our present study we investigated different methods for homogenizing patient's skin specimen and deconstructing fungus cell wall along with improving the conditions for DNA purification via common methods and available kits. In addition, in order to apply PCR, different parameters like using multiple primer pairs, DNA polymerase enzymes, changes in PCR temperatures and times program were evaluated.Results: Along the way we were faced with different obstacles such as: fungus's hard cell wall, low amounts of fungus DNA in relation to the total purified DNA, different influential factors in the DNA purification and PCR process, for which different solutions were examined. Finally through improvement of purification conditions and considerable amounts of fungus DNA extracts from a three sample mixture of patients skin specimen (dermatophytes the same species), a positive PCR result were found. However, this method is not a justifiable and applicable way of routinely identification dermatophytes.Conclusions: Despite the applied strategies in this study to instill the use of PCR for quick specification of dermatophytes in patient's skin sample and the positive results that were obtained, it seems that with respect to the limitation on the amounts of patients skin specimen and the presence of potential inhibitors of DNA polymerase action in the skin specimen, it would be better to use dermatophyte colonies in the early stages of culturing instead of the skin specimen in addition to the complementary investigations and improvement of the methods.

Background and objectives: Strongyloides stercoralis is a nematode parasite of human with world wide distribution especially in tropical and subtropical areas. Although in most patients the infection is benign, however, in immunocompromised patients S. stercoralis can leads to hyper infection or disseminated strongyloidiasis, which may leads to death.In respect to increasing the number of immunocompromised patients in Iran, current study was undertook to have an understanding on strongyloidiasis and molecular characterization of S. stercoralis in Khouzestan province which had been an endemic area for this parasite for a long time. Material and methods: During 2004-2006, a total of 200 fresh stool samples were collected from patients referred to some hospitals and diagnostic laboratories in Khouzestan and exmined for S. stercoralis.DNA was extracted from filariform larvae, obtained from agar plate culture. ITS1 region of all isolates were amplified by PCR processing.Results: 6 cases were found infected with S. stercoralis, all presenting hyperinfection syndrome. Comparison of the PCR products and sequences with nucleotide sequences submitted to GenBank confirmed all 6 cases as S. stercoralis.Conclusion: This study is the first research on molecular aspects of S. stercoralis in isolates from Khouzestan province and emphasizes the health importance of this opportunistic nematode in this province and needs for further more research on this unique parasite.

Background and objective: Community acquired pneumonia (CAP) is the forth common cause of mortality in elderly. Regarding higher incidence and mortality of CAP in this population, the identification of risk factors of the prognosis in pneumonia can reduce mortality in this patient. Material and methods: We performed a retrospective case-control study in the elderly patients, with CAP who were hospitalized in Imam Komeini, Amir Alam and shariati hospitals during 1996- 2004. Cases included 22 patients who have died during hospitalization and controls included 88 patients who survived. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes and were analyzed by SPSS software.Results: According to the results, there is a definite relationship between low level of consciousness, hypotension, metabolic acidosis, anemia, history of immune deficiency with patients' mortality rate.Conclusion: Regarding these results, we can identify a predictive model for determining the prognosis of CAP in elderly. We conclude that early diagnosis and treatment the patients with these risk factors are necessary to improve the prognosis.

Background and Objectives: Current cross-sectional research carried out to study the prevalence of asymptomatic bacteriuria among pregnant women (first trimester) who referred to the health service centers and hospitals of Hamedan University of medical sciences.Material and methods: The Patients were from of all Hamedan areas including Hamedan town and villages. A questionnaire with various questions designed to completed by cases. Midstream urine samples collected using sterilized bottles at central laboratory. Biochemical analysis of urine performed by dipstick method. About 10 ml of urine centrifuged for microscopy analysis. Urine was streaked on the blood and E.M.B medium agar using a calibrated wire loop and incubated at 37°C for 24 hours. Bacterial Colonies were identified by biochemical and serological tests. The organisms were further studied for antibiotic sensitivity using standard disk diffusion method. Results: Results showed that 10.1% of pregnant women were suffered from asymptomatic bacteriuria. Common bacterial uropathogens include E. coli (68.4%), S. epidermidis (10.5%), and K. pnumoniae (7.9%). Antimicrobial sensitivity of isolates showed that the most of bacterial isolates were resistant to Ampicillin.Conclusion: There was a correlation between the asymptomatic bacteriuria and urinary infections. Urine examination is recommended for monitoring the suspected cases with asymptomatic bacteriuria.

Background and objective: Data on tuberculosis (TB) of the spine from Iran, especially Southeast of Iran is scanty despite the endemic of the disease. In order to determine the prevalence of spinal tuberculosis in Zahedan region, this study was conducted.Material and methods: In this routine data base study, in a time period of ten years, from Feb 1994 to Dec 2005, in Zahedan (Southeast of Iran), documents of all patients who were treated for spinal TB in the medical and orthopedic wards in Zahedan university hospitals and Zahedan tuberculosis center were evaluated. After recording the demographic data, the clinical notes, radiographs and hematology results of the patients were evaluated and then analysed.Results: One hundred eighteen patients were seen, 82 males and 36 females, age range 4-73 years (mean 29.2 +/- 23.7 years). One hundred seven patients had complete clinical data in their case notes. Twenty eight patients had paraplegia and eighty six had concomitant pulmonary TB, more old tuberculosis. The thoracic spine was the commonest site of involvement. Two thirds (78 patients) had positive mantoux test. All patients had chemotherapy and only six cases were lost to follow up within three months because they had been expired. Only four patients had surgical intervention.Conclusion: Upon our results, spinal TB is still a common disease in Southeast of Iran with significant complication. There is need for patient health education, contact tracing, provision of free hospitalization and a general improvement in the economy to reduce the prevalence of spinal TB in the country.

Background and objective: Hepatitis B is one of the most common infections of community that can injury to liver and also other organ can by immune system. The most common forms of transmission are sexual contact, blood and parental. The aim of study is to find important risk factors of HBV infection in blood donors of Hamedan.Material and methods: 119 HbsAg positive patients and 452 HbsAg negative blood donors were evaluated. Two groups were matched by sex, age and city (rural, urban). We used Logistic Regression to compute Odds Ratio (OR) of risk factors.Results: 27.6% were female that this proportion is equal in two study groups. 88.6% were urban and others were rural. 65.7% were married and others were single. The most common risk factors was "history of surgery" (OR=3.11) and then is "family history of liver disease"(OR=2.9). Instead of our expectance, human bite, dental filling and needle medicine had OR less than one.Conclusion: In studied risk factors, history of surgery was the most important one that suggests probability of transmission by surgeon or surgery ward. The important risk factors in this study were adjusted to other studies but it needs further evaluation.

Background and objective: Diabetic foot Infection is caused by gram positive and gram negative aerobic and anaerobic bacteria and most of them are resistant to antibiotics.Material and methods: In this cross sectional study 32 patients with diabetic foot ulcer that referred to Razi hospital were admitted. All patients were evaluated by punch biopsy and samples were sent to microbiology laboratory of medical faculty of Ahvaz Jondishapur medical university for aerobic and anaerobic cultures and determining antibiotic susceptibility pattern.RESULTS: Twenty five samples (78%) had poly-microbial positive cultures (aerobic and anaerobic bacteria).Most of them was multi-drug resistant. conclusion: Foot infection is one of the most important limbs threatening complication of diabetes and due to poly-microbial and antibiotic resistant pattern, surgical intervention most is concerned.

Background and objective: Pediculus capitis is a worldwide problem and is still a common disease in some countries. Although Pediculus capitis can occur in all ago groups, it is more prevalent among children of primary school ago group and especially in girls. In this study, the prevalence of Pediculus capitis and the factors influencing its prevalence in primary school female students in Sanandaj in year 1384 is evaluated.Material and methods: In this study, 600 female students at the level of primary girls school that were chosen randomly in different parts of Sanandaj and in every school 50 students were chosen by chance and examined. The major criterion of diagnosis was detection of the mature parasite or its egg (nit) on the hair of students. The information obtained by this physical examination and the demographic information about all students were recorded in separate questionnaires. Then the information was analyzed by SPSS and chi-square or T test statistical tests.Results: Among the 600 girls, 46 (7/7%) has Pediculus capitis. There are no meaningful correlation between the rate of infestation and the length of hair t occupation and the level of education of fathers, but there is a statistical correlation between rate of infestation and the level of education of mothers.Conclusion: Student's parents and teachers will be trained about this problem and the ways of spread of louse in family and school in order to limit breakout of infestation. Therefore the complications and expenditure of treatment of the disease will be reduced.

Background and objective: In addition to changes in sexual behavior among adolescents in recent years, a high number of travels from Ardabil province border areas to newly independent republic countries (previous USSR) after the opening of borders, aroused the suspect in increased syphilis prevalence in these areas. Our aim was to study serologic prevalence of syphilis infection among residents of Ardabil's border areas with Azerbaijan republic.Materials and methods: This cross- sectional study was conducted in two phases: in the first phase, 2168 adults within 20-50 years of age were selected through 110 clusters (each including 10 households) then VDRL and RPR tests were done on serum taken from study subjects after an interview done by general practitioners. In second phase, 117 cases were sampled and then FTA- ABS Tests were done. Data collected were processed and analyzed by SPSS 11 statistical software.Results: 53.4% and 16% of samples were from Parsabad and Bilesavar districts respectively. 1311 of samples (59.6%) were from females and 887 of samples from (40.4%) to males. Mean for age of participants was 31.6±8.6 years (Mean±SD).In first phase, there were 14 cases with positive RPR test, 7cases with positive VDRL, and 15 cases positive through both tests. In second phase, there were 20 cases (17%) with positive FTA test from 117 sampled cases, including two persons with positive RPR and VDRL tests.Conclusion: Contrary to a low rate of acute syphilis infection, life-time prevalence of syphilis infection was high.It is probable that positive cases, were due to primary and secondary transmissions, or even from triads of syphilis transmission occurred in early times of opening the borders of newly independent republic countries (previous USSR) to Iranians.

Background and objective: HTLVI/IlI is a member of retroviridae family and subfamily of oncovirinae. HTLV infection is transmitted in at least three ways: from mother to child, especially in breast milk; through sexual activity; more commonly from men to women and through the blood- Via contaminated transfusions or contaminated needles. Since HTLV can transmitting through parentral drug abuse and is a rather widespread infection between IVDU, we decide to evaluate prevalence of HTLV in IVDU for first time in Iran.Material and methods: this was descriptive study in which blood samples of IVDU that were admitted in infectious disease ward of Loghman hospital were taken.Blood samples for detection of HTLVI/II infection markers were tested by Eliza method. A questioner was provided for data collection of each person the collected data was analyzed with using SPSS software.Results: Out of 96 IVDU, HTLVI/II antibody was positive in 12 cases (12.5%). The mean age of patients was 35.3 year, (range 21-60 years). The average of injection duration was 3.7 years (Range 1-20 years). The average of injection duration in with and without positive serology was 3.9 and 3.7 years respectively.There was no significant difference between injection duration, history of prison residency, History of blood transfusion and mean age of patients with and without positive serology though.Conclusions: the prevalence of HTLVI/II in IVDU patients of Loghman hospital was lower compared to other study. However, Regarding to high prevalence rate of this Virus in IVDU It is needed to give more attention to prophylactic measures for prevention of spread of HTLV in this group.

Background and Objectives: Recently there has been special interest in the donor selection strategies in blood banks in order to provide safer blood supply. Important steps are exclusion of paid and replacement donation and increase in the number of regular donors. In this survey the seroprevalence of blood-borne infections among regular, sporadic (lapsed) and first-time blood donors were compared (from March 2005 to February 2005).Materials and Methods: In a retrospective study the prevalence of transfusion transmitted infections was compared among regular, sporadic (lapsed) and first-time blood donors of Boushehr city. The total of 19627 blood donors donated blood during March 2005 to February 2005 in Boushehr; out of this number, 7282 were regular donors (37.1%), 728 sporadic donors (3.7%), 11617 first-time donors (59.18%) and 414(2.1%) donors were determined as self-exclusion. Data were collected from the computerized data source of Boushehr Blood Transfusion Center and were then compared by the Chi-square statistical test.Results: Out of 7282 regular donors, 6 (0.082%) HBsAg positive, 6 (0.08%) HCV-Ab reactive, and all were HIV-Ab negative. Whereas out of 728 sporadic donors one (0.13%) was HBsAg positive, and all were HCV-Ab and HIV-Ab negative. Out of 11617 first-times blood donors, 65 (0.55%) were HBsAg positive, 41 (0.35%) HCV-Ab reactive and 3 (0.02%) were HIV-Ab reactive. The prevalence of blood-borne infections (hepatitis B, hepatitis C, HIV and syphilis) was less in regular than sporadic and first-time blood donors. P value of HBsAg factor was p=0.000003 for regular and first-time donors, also P value of HCV-Ab factor was p=0.00049 for regular and first time donors that these difference were significant.Conclusions: Regular blood donation is one of the important steps in blood safety; hence, retention of regular donors, and awareness-raising and recruitment of sporadic and first-time donors can increase the rate of regular donation leading in turn to higher blood safety, so implementation of self-exclusion plan in order to improve blood safety is imperative.