Faculty of Health

 

Dean: Dr. Hassan Khorsandi(MD, Ph.D.)

Email: hassankhorsandi@yahoo.com

 

A Brief History:

Our vision in the Faculty of Health is to educate future leaders to redefine and advance health science. We believe the solution to the crisis in health care is to keep more people healthier, longer, with an emphasis on prevention first, then care when needed, to make health and health care sustainable. The Faculty of Health aims to advance health of community by offering helpful courses and programs and paving way for research both locally and globally.
The Faculty of Health offers its scientific plans and programs under the following departments.



Department of Environmental Health Engineering:


Environmental Health is the branch of public health protection that is concerned with all aspects of the natural and built environment that may affect human health. Environmental Health is also a field of science that studies how the environment influences human health and disease. The mission of the department of environmental health is to train and educate environmental health students (both in B.Sc and M.Sc levels) in environmental health sciences such as water quality control, wastewater, soil management and treatment technologies, air pollution, solid waste management, noise control, food health sciences, residential and institutional environmental health, radiation uses and protection, environmental chemistry and microbiology. Members of the department of environmental health also carry out high quality researches on the water and wastewater treatment technologies (Chemical and Biological treatment) and solid waste management.


Mission and Goals:


The main mission and task of the Department of Environmental Health Engineering, include promotion of knowledge about environmental protection and assistance in advancing environmental health in urban, industrial and rural areas as well as training required experts and manpower for work in governmental sections such as Ministry of Health and Medical Sciences, Ministry of Energy, Department of the Environment and also for the private sectors. The department emphasizes the role of air, water and human environment towards bringing about the better environmental health. This important mission is achievable by concerned efforts of the scientific board and personals in educational training, designing research projects and carrying out other related services. The theme of the Department of Environmental Health and Engineering is the identification and prevention of physical and chemical hazards in the environment that influence biological systems, with particular emphasis on the health of humans. Hence, the major goal is to facilitate productive interactions between basic and applied environmental health science and engineering. Another goal is to promote department grant support to facilitate educational and outreach activities in the community.

 

Faculty Members of the Department of Environmental Health:


 Dr. Fathollah Gholami-Borujeni


Assistant Professor of Environmental Health
Web page:
http://health.umsu.ac.ir/images/stories/ftp/CV/Gholami.pdf
Research Interests:
Water and wastewater treatment technologies (Chemical and Biological Treatment)
Water Quality Monitoring, Water desalination, Solid waste management, Air Pollution Monitoring and Control
Environmental Microbiology


 Dr. Hasan Khorsandi


Assistant Professor of Environmental Health
Education:
Ph.D in Environmental Health, Esfahan University of Medical Sciences, Esfahan, Iran, 2010 M.Sc in Environmental Health, Tehran University of Medical Sciences, Tehran, Iran, 1996
Web page: http://health.umsu.ac.ir/images/stories/ftp/CV/khorsandi.pdf
Research Interests:
Environmental Microbiology and Biological Reactors (Chemical and Biological Treatment)
Water and Wastewater Treatment Technologies

 

 Dr. Ali Ahmad Aghapoor


Assistant Professor of Environmental Health
Education:
Ph.D in Environmental Health, Tarbiat Modarres University of Medical Sciences, Tehran, Iran, 2014
M.Sc in Environmental Health, Tehran University of Medical Sciences, Tehran, Iran, 2008

Research Interests:
Water and wastewater treatment technologies (Chemical and Biological Treatment)
Water Quality Monitoring
Environmental Microbiology


 Saeed Hosseinpoor


Education:
MSC of Civil Engineering, Urmia University of Medical Sciences, School of Health
Research Interests:
Civil Engineering,
Geotechnical engineering
Structural engineering


 Nahid Navidjuy


Education:
Ph.D student of Environmental Health, Hamedan University of Medical Sciences
M.Sc in Environmental Health, Esfahan University of Medical Sciences, Esfahan, Iran,
Research Interests:
Water and wastewater treatment technologies (Chemical and Biological Treatment)
Water Quality Monitoring
Environmental Microbiology


 Amir Mohammadi:


Education:
M.Sc in Environmental Health, Esfahan University of Medical Sciences, Esfahan, Iran,
Research Interests:
Water and wastewater treatment technologies (Chemical and Biological Treatment)
Water Quality Monitoring
Environmental Microbiology


Contact:


Address: Department of Environmental Health, Faculty of Health, Urmia University of Medical Sciences, Pardi-e Nazloo, Serow Road, Urmia, Iran P.O Box: 5756116111
Fax: +984412770047
Tel: +984412752311

 

Department of Public Health


Public health by means of "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals, which finally will help to society improvement. This concept has been extended in the human life and guarantee individual and population health.
Students who graduated from this field are expected to have a role in management and supervision of health care delivery from the community level of health system by means of Health House and higher level of health system as a means of Rural and Urban Health Centers.
The vision of Public Health Group is training of students in this field to be knowledgeable, having commitment and actor to their knowledge and skills in order to promote health in individual and society level.
The mission of Public Health Group
• Students training based on Ministry of Health and Medical Education curriculum
• Increasing students' eligibility and competency to promote in Master and PhD level and health promotion in the society
• Providing Master, MPH and PhD level in School of Public Health
Main objective of School of Public Health
• Training of students at bachelor degree based on Deputy of Education at Ministry of Health and Medical Education
• Interaction promotion with health systems
• Quality improvement in theoretical and practical level of public health educational program


Department of Public health


Faculty of public Health
West Azerbaijan Iran
Fax:+984412770047
Tel: +984412752300



Faculty Members of the Department of Public Health:


Dr. Hamidreza Farrokh-Eslamlou
Associate Professor of Maternal & Child Health
Education:
2011 Visiting Sabbatical Centre for Midwifery, Child and Family Health, Faculty of Health,
University of Technology, Sydney (UTS), New South Wales, Australia
2002 PhD in Maternal and Child Health School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, IRAN
1992 Medical Doctorate (MD), School of Medicine, Shiraz University of Medical Sciences, Shiraz, IRAN

 

Dr. Bahram Nabilou


Assistant Professor of Health Services Management
Education:
PhD in health services Management. Iran University of Medical Sciences, Tehran, Iran (2003)
M.Sc in health services Management. Iran University of Medical Sciences, Tehran, Iran (1998)
Research interests:
Health Services Management
Quality Improvement
Educational Evaluation


Dr. Siamak Aghlmand


Assistant Professor of Health Services Management
Education
PhD in Health Services Management, Tehran University of Medical Sciences, Tehran, Iran (2008)
MD in General Practitioner, Tabriz University of Medical Sciences, Tabriz, Iran (1994)
Research Interests:
Quality improvement in health care

 

Dr. Davoud Khorasani Zavareh


Assistant Professor of Health promotion And Injury Prevention
Education:
PhD in Health promotion And Injury Prevention, Department of Public Health Sciences, Division of Social Medicine, Karloinksa Institutet, Stockholm, Sweden
MD in General Practitioner, Urmia University of Medical Sciences, Urmia, Iran

 

Baratali Rezapour
Lecturer in Health Education



Department of Occupational Health & Ergonomics


Occupational health is an area concerned with protecting the safety, health and welfare of people engaged in work or employment. The goals of occupational safety programs are to foster a safe and healthy work environment. Occupational health may also protect co-workers, family members, employers, customers, and many others who might be affected by the workplace environment. Occupational health can also reduce employee injury and illness related costs. Occupational health may involve interactions among many subject areas, including occupational medicine, occupational hygiene, public health, safety engineering, industrial engineering, chemistry, health physics, industrial and organizational psychology, ergonomics and occupational health psychology.
The mission of department is to educate occupational health and ergonomics at graduate and post graduate levels, respectively. Graduated student of occupational health will be able to recognize, evaluate, and assess the work environments to improve the working conditions. Post graduate students of ergonomics will be able to implement interventions and controls to improve the health and wellbeing of employees, and also increase efficiency in the workplaces. Research interests are including work-related disease diagnosis and treatment, especially silicosis, occupational ergonomics, exposure assessments, nanoparticle toxicology, air pollution control technologies, safety and health management systems.

 

Department of Occupational Health


Faculty of Public Health
West Azerbaijan
Iran
Email: Allahyari@umsu.ac.ir
Fax: 00984412770047
Tel: 00984412752298

 

Faculty Members in Department of Occupational Health:


Dr. Iraj Mohebbi


Professor of Occupational Medicine
Education: National Board of Occupational Medicine
Research interest: Occupational medicine
Email: Irajmohebbi@umsu.ac.ir


Dr. Teimour Allahyari


Assistant Professor of Occupational Health
Education:
Ph.D in Occupational Health, Tehran University of Medical Sciences, Tehran, 2008
M.Sc in Occupational Health, Tehran University of Medical Sciences, Tehran,2000
Research interest: cognitive ergonomics, environmental ergonomics, human performance, human error
Email: Allahyari@umsu.ac.ir


Dr. Mohammad Hajaghazadeh


Assistant Professor of Occupational Health
Education:
Ph.D in Occupational Health, Tehran University of Medical Sciences, Tehran, Iran, 2013
M.Sc. in Occupational Health, Tehran University of Medical Sciences, Tehran, Iran, 2006
Research interest
Air pollution control technologies, Air sampling and analysis, Exposure assessment
Email: hajaghazadeh@gmail.com


Mr.Yousef Mohammadian


M.Sc of Occupational Health
Education:
M.Sc in Occupational Health, Tehran University of Medical Sciences, Tehran, Iran, 2011
Research interest:
Air pollution control
Nanotoxicology
Email: Mohammadian_yosef@yahoo.com


Ms. Niloufar Shah Gholi Nejad


M.Sc in Occupational Health
Education:
M.Sc in Occupational Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 2011
Research interest:
Safety and Risk assessment
Human factors (Human errors)
Email: niloufar.shahgholi@yahoo.com


Mr. Abolfazl Ghahramani


M.Sc in Occupational Health
Education:
M.Sc in Occupational Health, Tehran University of Medical Sciences, Tehran, Iran, 2007
Research interest: Occupational Accident, safety, risk assessment
Email: Ghahramani@umsu.ac.ir



Department of Medical Entomology and Vector Control


Department's Post graduate: There are approximately 20 post graduate in the department of "Medical Entomology and Vector Control". They are studying in M.Sc. level. We have two laboratories (entomology lab and pesticides lab), two insectariums and one "insects and venomous animal's museum". Our department has 6 personals (3 faculty members).

 

Faculty Members of the Department


Dr. Farrokh Dabiri

Assistant Professor of Medical Entomology and Vector Control

Education
Ph.D in Medical Entomology and Vector Control, Feb. 2011, Ankara University, Ankara, Turkey
Dissertation: The parasitoid wasps of synanthropic fly pupae in animal husbandries of Urmia (Iran), investigating their natural parasitism rate and identification of insects that grow up in various body viscera of vertebrates
M.S.P.H. in Medical Entomology and Vector Control, 1995, Tehran University of Medical Sciences, Tehran, Iran
B.Sc. Plant Pathology 1990, Isfahan University of Technology, Isfahan, Iran

Professional Experiences and Positions Held
1995_ to date: Academic stuff of Urmia University of Medical Sciences, Urmia, Iran.

1998_ 2002: Academic member of EDC (Educational Development Center), Urmia University of Medical Sciences, Urmia, Iran.

2002_ 2006: Research and Education Deputy, Urmia Faculty of Health Sciences, Urmia, Iran.

2001_ 2006: Member of Board of Directors "Society of Innovators, Inventors and Scientific Researchers of West Azerbaijan"

*Founder of "Entomology Laboratory and Museum" (with over 38000 speciment) at Urmia University of Medical Sciences

*Founder of "Pesticides Toxicology Laboratory" at Urmia University of Medical Sciences
Membership
Member of several Societies and Associations, such as;
_Iranian Entomologists (since 1987),
_Biotechnology of Iran,
_Medical Entomology of Iran,
_Medical Education of Iran,
_Toxicology of Iran,
_Innovators, Inventors and Scientific Researchers of West Azerbaijan
_ Biotechnology of West Azerbaijan
Fields of Research Interests
_Taxonomy of Arthropods
_Forensic Entomology
_Vector Control (especially Biological Control)
_Methods of Sciences Education
_Acarology, Dipterology, etc.
Language Skills: Persian, English, Arabic,
Turkish (Istanbul and Azeri)
Computer Knowledge: SPSS, Word, Power Point, Excell, Internet, Harward
Grphic, Photo Shop, etc.
Address: Department of Medical Entomology and Vector Control,
School of Public Health, Urmia University of Medical Sciences, P.O. Box 57135-163
Urmia, Iran
Tel: (+98 441) 2752296-- 9, 2752305 and 2752311 Extension: 233, 269 and 224
Fax: +98-441-2770047
E-Mails: F_dabiri32@yahoo.com and fdabiri@umsu.ac.ir

 

Dr. Saber Gholizadeh

(PhD) Assistant Professor, Medical Entomology Department

Education
Ph.D in Medical Entomology, 2010, School of Public Health and Institute of Health Research, Tehran University of Medical Sciences (TUMS), Tehran, Iran
M.S.P.H. in Medical Entomology, 2003, School of Medicine, Tarbiat Modares University, Tehran, Iran
B.Sc. in Medical Entomology and Pest Control, 2000, School of Abooreihan, Tehran University of Medical Sciences, Tehran, Iran

Research interests
Malaria Transmission Blocking Vaccine
Molecular analysis of insecticide resistance genes in vectors
Population genetics and molecular systematics of vector species
Functional genome analysis in vectors
Plasmodium-Anopheles Interaction
Molecular Entomology
Malarialogy (Impregnated bednets)

Research experiences and skills
Molecular Techniques Including:
DNA preparation from blood and tissue
Polymerase Chain Reaction (PCR) and electrophoresis analysis
-RAPD-PCR
-rDNA-ITS2
-mtDNA
-Nested-PCR
-RFLP
Gene cloning and expression
SDS-PAGE, Protein purification
Western Blotting
Bioinformatics (Molecular analysis of sequence data, Amino Acid and Protein Structure, Reading Frames, Restriction Sites, Primer designing, Phylogenetic analysis,...).

Address: Medical Entomology, School of Public Health, Medical Entomology Department, Urmia University of Medical Sciences
P. O. Box: 5756116111 Tel/Fax: +984412752311/+984412770047,
E-mail: sabergholizadeh@yahoo.com, saber@umsu.ac.ir


Dr.Ali Reza Chavshin

Assistant Professor, Medical Entomology Department

Education:
Complementary research fellowship (2011) Paratransgenesis and Genetic Transformation of Bacteria, Dept. of Biotechnology, Dept. Of Ecology, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden

PhD Medical Entomology and vector Control (2011). School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

M.S.P.H. Medical Entomology and vector Control (2006). School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

B.Sc. Medical Entomology and vector Control (2002). School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Research interests:
-Molecular Entomology
-Transgenesis and Paratransgenesis in the field of Medical Entomology
-Molecular systematic of Disease Vectors
-Molecular epidemiology of Vector-borne Diseases
-Interaction between Vector-Pathogens

Research experiences and skills
1. Basic Entomology techniques:
- Sample collection from field using different methods,
- Sample preparation and Morphological Identification using standard keys

2. Molecular techniques:
- DNA Extraction, Different PCR amplification methods ( Conventional,
RAPD-PCR, Multiplex, RT-PCR, Nested-PCR, Real Time, ...) RFLP, Data
Anlysis (Gel Electrophoresis, PAGE, ...)
- Conventional T/A cloning, DATA analysis
- Expressional Cloning,
- Genetic Manipulation (Plasmid Preparation, Targeted Digestion, Chemical-
Competent cell preparation, Electrocompetent Cell preparation,
Electroporation, Data Analysis,...)
- Targeted Bacteria Genetic Transformation (Plasmid Based, Chromosomal
Integration,...)

3. Bioinformatics
- DNA and Protein Sequnces analysis and structure, Primer Designing,
- Phylogenetic Analysis,
- Using Related Softwares ' ( MEGA5, BioEdit, NebCutter, ClustalW,
Scientific Training Courses:
1- Advanced Cloning, Plasmid designing and genetic manipulation of bacteria (plasmid transformation and chromosomal integration), Sept-Nov, 2011, Uppsala, Sweden
2- (WHO supported) 1st Asian Training course on Biosafety and biosecurity Assessment for Human Health and Environment using Genetically Modified Vectors. 2009, Madurai-India
3- 3rd WHO-TDR-Supported Training course on Bioinformatics and Functional Genomics Applied to Insect Vectors of Human Diseases, 2006, Bangkok, Thailand.
4- Cloning and Genetic engineering methods, National institute of genetic engineering and Biotechnology, Ministry of sciences and research and technology, 2010
5- Geographic Information System (GIS), School of Environment, University of Tehran, 2001
Honors, Distinctions:
- Honor degree (First Rank) in the 10th National Election of MSc thesis of Iran
- Researcher of Razi (National Medical sciences festival) selected project
- Researcher of Avicenna (TUMS festival) selected project
- Honor degree in MSPH National Conquer Exam
- Honor degree in PhD National Conquer Exam

Software abilities:
- Bioinformatics analysis software's ( Mega 5, BioEdit, ClustalW, Phylip, ...)
- Using Molecular Biology Databases (NCBI, ExPASy, RPDI, EMBL, SwissPro,...)
- Microsoft Operating System (Windows) and operational Office Package
- GIS related software (ArcGIS)
- Photo and Movie Editing systems (Pinnacle, Power Director, Ulead Video, Photoshop, ...)
Language Skills: Persian, English, Turkish (Azeri), Kurdish
Address: Department of Medical Entomology, School of Public Health, Urmia
University of Medical Sciences, Urmia, Iran
Email: alichavshin@yahoo.com, chavshin@umsu.ac.ir


Abdollah Naghian: PhD student in Medical Entomology and Vector Control


Address: Department of Medical Entomology and Vector Control, School of Public Health, Urmia University of Medical Sciences, P.O. Box 57135-163 Urmia, Iran
Tel: (+98 441) 2752296-- 9, 2752305 and 2752311 Extension: 233, 269 and 224
Fax: +98-441-2770047
E-Mails: abdolla_naghian@yahoo.com


Moloud Moahmmadi

PhD student in Medical Entomology and Vector Control
Contact:
Address: Department of Medical Entomology and Vector Control, School of Public Health, Urmia University of Medical Sciences, P.O. Box 57135-163 Urmia, Iran
Tel: (+98 441) 2752296-- 9, 2752305 and 2752311 Extension: 233, 269 and 224
Fax: +98-441-2770047
E-Mails: mulud.muhammady@yahoo.com



Why Urmia (IRAN) and why Medical Entomology?


Introduction: The Middle East encompasses more than 6 million sq km of land. Each country has its own unique geographic character, which ranges from the mountains of Turkey, ringed by fertile coastal plains, to the extensive low, flat deserts of Saudi Arabia. Relief varies from the highest peak, Qolleh-ye Damavand in northern Iran at 5,671 m above sea level, to the Dead Sea, bordered by Jordan, which at 400 m below sea level is the lowest spot on earth. This region is bordered on the north by the Black and Caspian Seas and the countries of Georgia, Armenia, Azerbaijan, and Turkmenistan; on the east by Afghanistan and Pakistan; on the south by the Arabian Sea and Gulf of Aden; and on the west by the Mediterranean and Red Seas and the Sinai Peninsula. It is, and has been throughout recorded history, a major crossroads of transportation and trade. Water is a very precious resource throughout the Middle East. In many countries, supplies of safe drinking water cannot meet demands. Overuse, depletion of groundwater, and contamination (pollution) of natural surface water and aquifers by human, animal, industrial and agricultural wastes have further reduced supplies. Air and soil pollution are significant concerns in certain places. Poor sanitation due to inadequate water and waste treatment facilities, indiscriminate disposal of wastes, and unsafe food handling practices throughout most of the Middle East, poses serious health risks and supports large populations of rodents, flies, mosquitoes and other vectors. Iran.

a. Geography. Iran is slightly larger than Alaska, with a total land area of 1,648,000 sq km. Most of the country lies above 458 m, and one-sixth of it rises more than 1,981 m. Three distinct physiographic areas exist: (1) The principal mountain ranges include the Zagros Mountains in the west and south, and the Elburz Mountains in the north. Most of these mountains are higher than 2,440 m. Some peaks are higher than 4,268 m in the Zagros and 5,486 m in the Elburz, including Qolleh-ye Damavand at 5,671 m. (2) Most of the rest of the country consists of a plateau that contains several closed basins and two salt deserts, the Dasht-e Kavir and the Dasht-e Lut. Much of the plateau has interior drainage and is characterized by many intermittent streams, intermittent salt lakes, and wet salt flats. (3) Smaller lowland plains are located along the Caspian Sea, Persian Gulf, and Gulf of Oman. Iran also controls about a dozen islands in the Persian Gulf.
b. Climate. Iran has a combination of arid and semi-arid climates. Temperature extremes vary greatly from summer to winter. Summer (June to August) is intensely hot, except in the high mountains. Temperatures in Tehran may reach a daily high of 46oC and an evening low of 11oC. In the low coastal area surrounding Bandar Abbas, the high and low are 44oC and 24oC. Winter (December to February) temperatures in Tehran
sometimes reach a daily high of 21oC and an extreme evening low of -13oC. In Bandar Abbas, the summer highs and lows are 32oC and 2oC. Only the Caspian coastal zone and some high mountain regions receive appreciable annual precipitation. Snow remains on the highest summits most of the year. Winter is normally the rainy season for the country overall. The Caspian coast, the most humid area of Iran, receives the greatest annual precipitation, varying from 800 to 2,000 mm, with the majority falling between late summer and mid winter. Dust and sandstorms frequently occur in desert regions, severely reducing visibility.

Why Medical Entomology?!
Ample waste, garbage, and standing water provide excellent breeding sites for filth flies, rodents, and mosquitoes, as well as many vector-borne human pathogens.

LEISHMANIASIS
Cutaneous leishmaniasis is moderately or highly endemic regionally. As many as 90% of the people in some areas of Southwest Asia have scars from previous infections. Two species of Leishmania cause skin lesions in the region. The less severe and rurally distributed Leishmania major is a parasite of desert rodents, especially gerbils such as the fat sand rat, Psammomys obesus. The most commonly implicated vector is the  sand fly Phlebotomus papatasi. Leishmania tropica is usually a parasite of man in urban environments and is transmitted by P. sergenti. Cases of visceralizing Le. tropica were reported among US personnel stationed in Saudi Arabia during the Persian Gulf War. Visceral leishmaniasis, caused by Le. infantum and Le. donovani, is a less prevalent but more severe systemic disease. It generally occurs in rural foci. The most common reservoirs for Le. infantum are believed to be domestic dogs and wild canines, such as jackals and foxes. Transmission occurs during the warmer months of April through October, coinciding with the activity of vector sand flies. Phlebotomine sand flies bite from dusk to dawn but may feed during the day if hosts enter their resting habitat. The distribution of sand flies and the diseases they carry is very focal because of their limited flight capabilities.

SCHISTOSOMIASIS
Schistosomiasis produces serious acute and chronic morbidity and has had a significant impact on military operations in the past. Schistosoma mansoni (urinary schistosomiasis) and S. haematobium (intestinal schistosomiasis) are endemic in the Middle East. Intestinal schistosomiasis occurs primarily in Turkey, Syria, Saudi Arabia, Iran, Iraq and Yemen. Urinary schistosomiasis predominates in Saudi Arabia, Oman and Yemen. Incidence is low, except for focal areas of Yemen and Saudi Arabia. Infection rates are commonly high among migrant foreign workers. Consequently, nonendemic countries frequently report imported cases. Infection is acquired when free-swimming larval forms of these trematode parasites penetrate the skin. The larvae develop in freshwater snails of the genus Bulinus, the intermediate host for S. haematobium, and the genus Biomphalaria in the case of S. mansoni. The snail intermediate hosts prefer slow-moving shallow water associated with rivers and their tributaries, marshes, irrigation canals, cisterns, aqueducts, and seasonally wet streambeds. Extensive irrigation projects in Turkey, Syria, Jordan and other countries have expanded snail distribution and the risk of infection. Humans are the reservoir host. Untreated individuals can remain infected for many years. Cases often are not diagnosed until after returning from endemic areas. Military personnel should avoid contact with potentially contaminated water.

MALARIA
A low to moderate risk of malaria exists in parts of Iran, Iraq, Oman, Saudi Arabia, Syria, Turkey, the United Arab Emirates (UAE), and Yemen. Nearly a dozen species of Anopheles mosquitoes act as primary or secondary vectors throughout the region. Limited rainfall in the arid and semiarid Middle East restricts the natural distribution of malaria vectors. Irrigation projects for agriculture have extended the ranges of malaria vectors in many countries, so disease prevalence may increase in such areas. Insecticide resistance in many vector populations hasresulted from decades of malaria control operations. The sporozoan parasite Plasmodium vivax predominates in Iran, Iraq, Syria and the UAE, while P. falciparum is more frequent in Oman, Saudi Arabia, Turkey and Yemen. Plasmodium malariae occurs at low levels in Yemen and Iran. Transmission may occur year-round in most areas. Because competent vectors exist in countries considered malaria-free, imported immigrant cases have the potential to initiate indigenous transmission of malaria. Infected foreign troops can be expected to spread malaria into malaria-free areas. Chloroquine resistance has been documented in Iran, Iraq, Oman, Saudi Arabia, UAE and Yemen. Fansidar resistance occurs in Iran, Iraq and Oman. Mefloquine resistance is suspected in Iran. Chemoprophylaxis should be strictly enforced in military personnel at risk of infection.

a. Iran: Malaria occurs throughout Iran in rural areas at elevations up to 1,500 m. The city of Tehran is considered malaria-free. Highest malaria incidence occurs in the southeastern provinces of Sistan va Baluchestan, Kerman, and Hormozgan, and south of the Zagros Mountains along the Persian Gulf littoral and the Khuzestan plain. Transmission peaks during April and May. Transmission occurs primarily from June
through August in northern provinces of the Caspian Sea littoral, especilly Gilan and Mazandaran, and along the Turkmenistan border. Plasmodium vivax predominates in all but southeastern endemic areas. Cases of P. malariae have been reported.

b. Iraq: Malaria transmission occurs from May through November in the northern provinces of Dahuk, Erbil, Ninawa, Sulaimaniya, and Tamim below 1,500 m, as well as in the southern province of Basrah. Scattered outbreaks may occur year-round in central and southern areas from the Tigres-Euphrates River Basin east to the Iranian border. Nearly all cases are vivax malaria. Malaria is absent from Baghdad and its immediate
vicinity. The annual incidence of malaria increased from 87 cases per 100,000 population in 1989 to 129 per 100,000 in 1994, particularly in the north. Resurgence after the Persian Gulf War has been attributed to Kurdish resettlement in the north, lack of vector control programs, and increased rice farming.

c. Turkey: Malaria cases are reported countrywide, but transmission is highest in southern and eastern Turkey, particularly the provinces along the Mediterranean coast from Antalya eastward, Diyarbakir and Siirt Provinces, and the provinces bordering Syria, Iraq, and Iran. Transmission peaks in most areas during the summer months of June through November. Outbreaks of P. vivax have increased more than tenfold since 1990
due to reductions in vector control programs, population increases, and the ambitious irrigation project in southeastern Turkey.

Vector Ecology Profiles:
Worldwide, about 70 species of Anopheles transmit malaria to man, but of these only about 40 are important. The distribution of malaria vectors in the Middle East region is complex. Primary malaria vectors are present throughout each country and include Anopheles maculipennis, An. sacharovi, An. superpictus, An. pharoensis, An. sergentii, and An. arabiensis. Secondary vectors include An. claviger, An. culicifacies, An. d'thali, An. fluviatilis, An. multicolor, An. pulcherrimus, and An. stephensi. However, what are normally primary vectors in most countries may be secondary vectors in other countries. The reverse may also be true, as is shown in the following list of the geographic distribution of vectors, where the primary vectors are marked with an asterisk. Mosquitoes reported from the region are listed and vector ecology profiles of malaria vectors are summarized in below:

Iran and Iraq: An. culicifacies, An. maculipennis, An. sacharovi (coastal and inland areas), An. stephensi (along the Persian Gulf and in the southeastern provinces), An superpictus (central plateau), An. d'thali, and An. Pulcherrimus, An. fluviatilis.
Turkey: An. maculipennis, An. sacharovi, An. sergentii, and An. superpictus.

An. culicifacies - Prefers domestic animals, but bites man and animals indoors and outdoors. Feeds throughout the night, with peak biting activity before midnight. No specific flight range data have been reported.
An. d'thali - Bites indoors and outdoors, with peak activity in the early evening hours. Rests primarily indoors. No flight range information has been reported.
An. fluviatilis - Bites man and domestic animals, indoors and outdoors. Strong preference for human blood. Rests indoors or outdoors after feeding. Considered a short-range flier; probably does not travel over 2 km from its larval habitat.
An. maculipennis - Feeds on man and domestic animals. Rests indoors or outdoors after feeding. No flight range information is available.
An. pulcherrimus - Feeds primarily outdoors and preferably on cattle. Usually feeds before midnight, but feeding continues throughout the night. Rests indoors and outdoors. The flight range is not known.
An. sacharovi - Feeds on man and animals, both indoors and outdoors. Rests in human dwellings or animal shelters after feeding. This species is a strong flier and may travel 10 km or more.
An. sergentii - Feeds on man and animals, both indoors and outdoors. Rests in human dwellings or caves after feeding. This species is a moderately strong flier, with a flight range that may exceed 5 km.
An. stephensi - Feeds on man and animals, both indoors and outdoors. Rests indoors after feeding. This mosquito is a short-range flier and rarely travels more than 0.5 km from its larval habitat.
An. superpictus - Feeds on man and animals, both indoors and outdoors. Rests in human dwellings, caves, or animal shelters after feeding. Generally a short- to medium-range flier, rarely traveling more than 5 km from its larval habitat.


ARBOVIRUSES


Over 100 arthropod-borne viruses produce disease in humans worldwide. Many of these have short incubation periods and elicit clinical symptoms ranging from acute benign fevers of short duration to acute central nervous system illness, hemorrhagic fevers, polyarthritis, and rash. They can have a serious medical impact on military personnel. Many illnesses diagnosed as fevers of unknown origin are the result of arboviral infections. New arboviruses are discovered every year, and some are emerging as serious threats to human health.
Sand fly fever is the most widespread arbovirus in the Middle East and is the greatest arboviral threat to military personnel operating in the region. Local populations are generally immune as a result of childhood infection. Both the Naples and Sicilian viruses are circulating in the Middle Eastern region, and the risk of infection is high between April and October, when sand flies are most active. Humans are the reservoir of this debilitating disease, although gerbils are suspected reservoirs.
Historically, dengue fever has been endemic throughout the region, and the primary mosquito vector, Aedes aegypti, currently occurs in every Middle Eastern country. Female Ae. aegypti lay eggs in artificial containers in urban areas. Aedes albopictus, another dengue vector, has been found in Italy and may spread to the Middle East, especially Turkey. The only recent outbreaks of dengue occurred during 1994 and 1995 in the Saudi Arabian cities of Jeddah and Medina. Serological studies and viral isolates from mosquitoes indicate that Sindbis and West Nile viruses are probably enzootic at low levels in every country of the region except Cyprus. However, they present minimal risk to military operations. Batai and Tahyna viruses, also mosquito-borne, have been reported from Turkey. The tick-borne Bhanja virus has been associated with domestic ruminants in Iran. The health risks of these viruses are not well known. Tick-borne encephalitis virus is known only from Turkey, where it is transmitted by Ixodes spp. ticks in discrete foci within forest habitats. Few human cases have been reported, but the disease can be severe. Soldiers operating in Turkish forests would have a high risk of exposure to vector ticks. Crimean-Congo hemorrhagic fever is the most widespread tick-borne virus. It infects domestic animals in every country in the region except Cyprus. The disease is contracted by the bite of infected Hyalomma ticks or by exposure to secretions or blood from infected animals or humans. Troops had frequent exposure to camels, goats and other domestic animals during the Persian Gulf War, although there were no cases of this disease in US military personnel. Medical workers treating patients are at high risk of becoming infected. Clinical symptoms can be severe, and mortality rates may reach 50%. Military personnel should avoid exposure to sheep, goats, cattle, and other domestic animals.


LOUSE-BORNE DISEASE

Sporadic cases of louse-borne relapsing fever have been reported from Iran and Iraq, but endemic foci may exist elsewhere in the region where body louse infestations are common. Epidemic typhus, also transmitted by body lice, has occurred in Lebanon. Both diseases proliferate under crowded and unsanitary conditions resulting from the social upheaval of war or natural disasters.

 

TICK-BORNE DISEASE


Tick-borne relapsing fever, transmitted from rodent reservoirs to humans by soft ticks, is enzootic in many rural areas. Vector ticks commonly infest caves, bunkers and tombs. Human infections are most often reported from Iran, Iraq, Jordan, Syria, and Yemen.
Boutonneuse fever (also termed Mediterranean fever), transmitted by the brown dog tick, Rhipicephalus sanguineus, and other ixodid ticks, is distributed countrywide in Jordan, Lebanon, and much of Turkey and Iran. The risk of infection is highest in rural areas. Q fever is an acute febrile rickettsial disease contracted primarily from airborne pathogens or contact with secretions of infected domestic animals. Serological surveys indicate that Q fever is highly endemic throughout the region. Three US military personnel became infected with this disease during the Persian Gulf War. Troops should avoid contact with domestic animals. Other closely related tick-borne rickettsiae are enzootic in northern Iran, northeastern border areas of Turkey. Lyme disease, vectored by Ixodes ticks, principally I. ricinus, has been reported from Lebanon and may be present in Turkey.

 

FLEA-BORNE DISEASE

Murine typhus is enzootic throughout the Middle East in domestic rats and mice and possibly other small mammals. Infected rat fleas (usually Xenopsylla cheopis) defecate infective rickettsiae while sucking blood. Airborne infections can occur. Sporadic human cases have been reported in the region. Enzootic plague foci are known from Iran, Iraq, Lebanon, Saudi Arabia, Turkey and Yemen, although human cases are rare. Military personnel should not handle wild or domestic rodents, especially if these animals show signs of illness.

 

FILARIAL DISEASE

Onchocerciasis, a filarial disease transmitted by black flies of the Simulium damnosum complex, is endemic in southwestern Saudi Arabia, throughout the length of Yemen, and may occur in Oman. Serious ocular complications can occur when microfilariae invade the eye. Sporadic
cases of mosquito-borne Bancroftian filariasis have been reported from Iran, Oman and Yemen but pose little threat to military personnel.

 

RODENT-BORNE DISEASE

Hantaviral diseases occur in western areas of Russia, Greece, and Bosnia and Herzegovina, and may be enzootic within Turkey. Field rodents are reservoirs for several closely related viruses that can be transmitted to humans as airborne pathogens from dried rodent excretions. This clinically severe, highly infectious disease could seriously impact military operations. Leptospirosis is enzootic in most countries of the Middle East. The spirochete is transmitted when skin or mucous membranes are contacted by water contaminated with urine of infected domestic and wild animals, especially rats. Military personnel would be at high risk of infectionby this disease. Troops should not handle rodents and should not sleep or rest near rodent burrows.

 

VENOMOUS ANIMALS

There are 31 species of venomous terrestrial snakes regionally distributed in diverse habitats. In addition, 12 species of venomous sea snakes inhabit the waters of the Arabian Sea, Gulf of Oman, and Persian Gulf. Military personnel should be thoroughly briefed on the risk and prevention of snakebite, as well as the steps to take immediately after snakebite. The Middle East is also inhabited by some of the world's most venomous scorpions. However, scorpion stings rarely require hospitalization. Troops should be warned not to tease or play with snakes and scorpions.

 

Address:

Department of Medical Entomology and Vector Control, Faculty of Health, Urmia University of Medical Sciences West Azerbaijan Province, I. R. Iran