Mortality trends in Erbil, Iraq, 2007–2011

Background: Reliable and valid information on trends of mortality and common causes of death is essential to guide priorities for the allocation of resources within the health sector in order to improve health services for the population, increase longevity and improve quality of life.

Aims: This study aimed to determine crude, gender, age and cause specific death rates and to examine mortality trends in a five-year period between 2007 and 2011 in Erbil City, Iraq.

Methods: This study researched 16 780 deaths registered at the statistical unit of the Directorate of Health, Irbil City. Data were reviewed and cleared for the purpose of analysis. Causes of deaths were classified according to body systems.

Results: The average crude death rate was 3.1 per 1000 population with male predominance over females in all the years of study (3.5 and. 2.7, respectively). The age-specific death rates were high in the old and middle age groups in addition to the under 5 years age group. Accidents and circulatory diseases were the leading causes of deaths with rates of 65.2 and 58.3/100 000 population, respectively.

Conclusions: An accurate identification of cause of death suggests that the only use of the death certificate in Erbil is for the purpose of burial and legal issues, and therefore it is imperative for educational efforts to achieve a complete and comprehensive death registration

Developing a socioeconomic index for health research in Iraq

Although socioeconomic status is one of the essential factors in much health research, it is one of the most difficult constructs to measure. The aim of this study was to develop a relatively accurate, easy-to-calculate method to estimate socioeconomic status [SES] for health research in Iraq as well as similar profile countries in the developing world. After reviewing various methods of calculating SES, a new method is proposed based on the 3 main variables: education, occupation and wealth/income. Additional refinement was done based on experience and job status. Content validity was calculated through experts' opinions and reliability through test/retest. Based on experts' opinions, it was found that the calculated content validity ratio for the SES index was relatively high and the correlation coefficient reliability for the six variables [education, occupation, income, wealth, experience and job status] was very high. Thus, the suggested method is reasonably valid, reliable as well as easy to calculate

Prevalence and risk factors for hepatitis C virus infection in hemodialysis pateints in Sulaimani

Haemodialysis patients have an increased risk of exposure to hepatitis C virus [HCV] infection. A high prevalence of HCV infection in hemodialysis [HD] patients has been reported. The study was carried out to determine the prevalence of HCV infection among HD patients and its association with certain sociodemographic variables and risk factors in Sulaimani governorate. A total of 101 patients on hemodialysis in sulaimani dialysis unit were studied from 1[st] October to 31[st] of December 2009. All study subjects were screened for anti- HCV antibody by third generation ELISA and confirmed by RIBA 111. Soci-demographic data and Factors that might be implicated in HCV transmission were collected. The overall prevalence of HCV was 26.7%. A significant association of anti- HCV with dialysis duration, history of blood transfusion, number of transfused blood units was found. HCV is common among Sulaimani hemodialysis patients, and significantly associated with length of dialysis and number of transfused blood units. The use of separate machines for those who are anti-HCV positive should be emphasized

significance of Helicobacter pylori infection in uraemic patients

Helicobacter pylori play an important role pathogenesis of gastritis and peptic ulcer disease in uraemic patients. To assess the prevalence of helicobacter pylori infection in uraemic, and to find the relationship endoscopic findings and the H. pylori infection. Forty patient with chronic renal failure were studied and compared with 38 patients with dyspepsia without any known history of renal disease. All underwent upper gastrointestinal endoscopy and antral biopsies were taken for detection of H.pylori infection using the rapid uraease test as agoldstandard for confirmation of the infection. The prevalence of H.pylori infection was 32.5% in uraemic patient and abnormal endoscopic finding were detected in 70% of the patients with abnormal endoscpic findings. The prevalence of H.pylori in uraemic patients is lower than in patients with the normal renal function, but the difference is not significant statistically

Prevalence of Hepatitis B serological markers among health care workers in Baghdad, Iraq

Most previous studies on the prevalence of hepatitis B markers among Iraqi health care workers [HCW's] were limited to detection of HBsAg and anti-HBs antibodies. This work is a comprehensive one carried out to determine the prevalence of serological markers of HBV among a sample of Iraqi HCW's, and to elucidate the effect of various health professions, duration of professional practice, and the practice in different hospitals on exposure to HBV. A total of 1656 HCW's selected from various hospitals and medical units in Baghdad, together with 238 apparently healthy subjects [as control group] were screened for HBsAg and anti-HGs antibodies in the period from June 1995 to April 1998.All HBsAg positive subjects [HCWs and controls] were tested for anti-HBc [IgM], HBeAg and anti-HBe. Serum testing was carried out by enzyme-linked immunosorbent assay [ELISA]. A higher rate of HBsAg [5.4%] was observed among HCW's than controls [3.4%]. A significantly higher prevalence rate of anti-HBs antibodies in HCW's [39.3%] than controls [24.4%] was demonstrated. A significant difference in the prevalence of HBsAg was detected in the renal dialysis group only when each group was compared with the controls. The frequency of HBV infection was more than two times higher in HCW's with more than twenty years duration of professional practice compared to those with less than one year duration of practice. The lowest rate of HBsAg was seen among HCW's in general hospitals [4.8%], wherase the highest rate seen among those infectious diseases hospitals [9.0%]. HCW's still represent a high-risk group for HBV infection, and they may act as a potential source of infection to their contacts. Therefore vaccination of HCW's should be vigorously applied

Epidemiology of poisoning in hospitalized children: a 10 years cross-sectional study in a teaching pediatric hospital, Baghdad, 1993-2002

Poisoning is an important cause of childhood and adolescence hospital emergency presentations and admissions and a major health problem in this population sector. The present study was designed to describe the epidemiology and pattern of poisoning in addition to its case fatality rate. A total of 1450 pediatric cases with poisoning admitted to the Central Teaching Hospital of Pediatrics, Baghdad, during the 10 years study period extending from the 1st of January 1993 to 31st of December 2002 were analyzed. The peak age for poisoning cases in the present study was 1-4 years, constituting about three quarters of total pediatric admissions with poisoning. Males were more frequent than females in the present work, and this gender bias was more evident in younger ages and less evident in teenagers. Non-medicinal substances were responsible for the major part [three-quarters] of poisoning cases, especially petroleum products and pesticides. The overall case-fatality rate was 2.6%. The risk of death was higher in the more vulnerable age groups [infants and neonates]. It was also higher in males and in cases with poisoning by other noxious substances eaten as food, followed by metals [mainly lead], systemic antibiotics and pesticides. However out of a total of 37 deaths attributed to poisoning that occurred during the present study period of 10 years, non-medicinal substances [especially petroleum products, pesticides and metals] were responsible for three-quarters of these deaths. Children under 5 sears of age are the most-vulnerable group for poisoning incidents. In addition Petroleum products, insecticides and lead metal were responsible for the highest proportion of poisoning admission and fatality necessitating special steps directed towards the prevention of these problems

Effect of disease duration and age on validity parameters of rk39 dipstick test in diagnosis of visceral leishmaniasis in Iraq

Visceral leishmaniasis is an important endemic disease in Iraq. To evaluate the performance characteristics and validity of rk39 dipstick test in diagnosis of visceral leishmaniasis, taking into account the effect of age and duration of the disease on validity. A sample of 300 inpatients with a provisional diagnosis of visceral leishmaniasis and available results of rk39 dipstick test were studied. The standard for establishing the disease status was a combination of classical clinical features together with good response to treatment with Pentostam. The longer the duration of symptoms the higher is the sensitivity and to a lesser extent the specificity of rk39 test. The sensitivity was significantly higher one week after the start of fever [96.8%] compared to the group of patients tested during the first week of their illness [61 .2%]. The specificity was slightly higher during the 2[nd] and 3[rd] week of starting fever [100%] compared to the first week of illness [94.4%]. On the other hand the age of patient had no impact on the validity of rk39 test. Both the positive and negative rk39 test results were highly reliable in confirming and excluding the diagnosis of visceral leishmaniasis assuming the clinical suspicion of the disease is in favour of clinical opinion and provided that the patient is symptomatic and the duration of fever is longer than one week