Prevalence and risk factors of obesity and overweight among children in Duhok, Kurdistan region, Iraq

There has been a rapid increase in the prevalence of obesity and overweight among children in several developing countries, having resulted in an increase of potentially severe medical and psychological complications, in addition of being a risk factor for increased morbidity and mortality in adulthood. Despite that, few studies have been conducted in Iraq in general and Kurdistan Region in specific. The aim of this study is to compute the prevalence of obesity and overweight in children in Duhok city, Kurdistan Region, Iraq, and to assess factors leading to these conditions. A cross-sectional community based study design was adopted for this study which was performed during a 4 month period in 2006. Body mass index [BMI] cut-off points defining obesity and overweight were applied. A total of 820 children in the age group of 2-8 years were included from thirty administrative sectors of Duhok city chosen randomly by multistage cluster sampling. Information about risk factors was obtained by direct interview of parents. The present study shows that the prevalence of overweight [BMI >/= 85[th] percentile for age] and obesity [BMI >/= 95[th] percentile for age] were 8.3% and 7.9%, respectively. Significant association was found between obesity/overweight status and the following factors: number of main meals and snacks per day, frequency of consumption of fried foods, fatty dairy products, soft drinks, sweets and meat, low level of physical activity and parental overweight status. No significant associations were found, however, with parental level of education, socio-economic status, and main type of feeding during infancy. Authors recommend that more attention should be paid by health authorities to this important health problem including the endorsement of a well designed preventive program

Patient satisfaction in Duhok, Kurdistan region of Iraq: family medicine center vs. primary health care centers

Family Medicine came to the fore as a specialty in Kurdistan Region of Iraq in 2006; however, no study to date has been done to evaluate its acceptance among the general population. The aim of this study is to compare patient satisfaction at the first family medicine center in Duhok with that at two traditional primary health care centers in the same city quarter. A modified SERVQUAL survey of 16 questions with single-option variables in a three-point Likert scale was used to identify patient satisfaction at Zanest Family Medicine Center compared to Barzan Primary Health Care Center as well as Shahidan Primary Health Care Center in a four week period during August 2008. The study showed significant higher patient satisfaction at the family medicine center in all five SERVQUAL dimensions: tangibles, reliability. Responsiveness, assurance, and empathy. However, in the dimension responsiveness, the statistical difference was barely reached. There was a trend observed that older, less educated, and male patients were more satisfied than younger, higher educated, and female patients, yet without statistical significance. Patients are satisfied with the first Family Medicine Center in Duhok compared to that provided by traditional PHCCs. This finding may forecast a greater future acceptance of similar services. The researchers recommended a wider adoption of family medicine services by all traditional PHCCs

Risk factors in schizophrenia - A case control study

to examine local risk factors attributed to the development of schizophrenia in northern Iraq; which will be essential for planning an effective programme. Study design: A case control study. Setting: Al-Zahrawy hospital in Mosul. Iraq Study period: from 1st January to 30th June 2000. Participants: Cases are schizophrenic patients of both sexes who were attending the Psychiatric Clinic of the hospital. Controls are patients attended the same hospital for diseases other than psychiatric illnesses. A total of [104] cases and [116] control were selected. The disease was significantly prevalent among males In the age group of < 25 years, and among females in the age group of [25-44] years. Family history among parents, brothers, sisters and relatives was significantly common in cases than controls. Early age of onset was significantly among those with a positive family history. Pre-eclampsia and difficult labour are significantly associated and strongly related to the disease development; while no association was observed regarding cesarean section. Childhood and developmental abnormalities, CNS infections and accidents were significantly associated with schizophrenia. Also stressful life events, being single or divorced, were also strongly related to the development of the disease. Conclusions: Various risk factors were found to be significantly reated to the development of schizophrenia. Other factors were either not related to the disease development like cesarean section or act as a protective factor to it, like marriage. Futher investigations of these factors are required to evaluate their role in the disease development in locality

Evaluation of three health education trials in AIDS prevention

the aim of this study was to evaluate general public knowledge concerning AIDS and the effectiveness of 3 different methods of health education in people with varying levels of education in Mosul, Iraq. a total of 725 persons [351 males and 374 females] with a mean age of 20.5 +/- 4.7 years with different educational levels was randomly selected for the study. Initially, a baseline evaluation of knowledge regarding modes of transmission and prevention of AIDS was conducted. Three different methods of health education were applied: lecture, small group discussion, and lecture accompanied by audio-visual aids. Following the health education programs, reevaluation of knowledge was conducted for all participants. the study found that health education was significantly effective in reducing the number of incorrect responses in both sexes, with a reduction of such responses from 38.4% and 42.5% to 7.4% and 5.7% in males and females respectively. The study also found that participants with higher levels of education had more knowledge originally and had better correct response rates after the health education campaign. The study also showed that all three methods of health education were significantly effective in reducing incorrect responses, but that the method incorporating lectures accompanied by audio-visual aids was by far the most effective type of health education. the study demonstrated the effectiveness of health education in reducing incorrect information and beliefs concerning the transmission and control of AIDS, especially when lectures were combined with audio-visual aids

Epidemiology of meningitis: a Retrospective study of 1197 cases

The aim was to determine the extent of morbidity and mortality of Meningitis according to age, sex, season and to causative microorganisms. A retrospective study was conducted on 1197 cases diagnosed as meningitis in Mosul, Iraq between 1988 and 1995. The study found that meningitis was an important constituent of infectious diseases representing 18.4% of total admissions and 24.2% of total deaths. The study revealed a predominance of male cases with the highest attack rate and mortality among infants. About 50% of the cases have been becteriologically identified. The commonest three pathogens were M. meningitides, H. influnzae and S. pneumoniae. Viral infections were suspected in 23.3% and tuberculosis was the cause of 2.2% of meningitis cases. The disease was common in winter and spring, with the highest admission rate in1990. A total of 84.2% were cured, 9.7% died and 3.1% developed complications. The highest cure rate was observed in viral meningitis [97.8%] while the lowest was in tuberculous meningitis [38.5%]. The study pointed to the importance of meningitis as a common health problem. Doctors, particularly newly graduated, should be aware of the size of the problem and of criteria for early diagnosis and treatment

Diagnosis of acute appendicitis: a comparison of the efficacy of clinical signs and symptoms and laboratory investigations

the purpose of the study was to compare the validity of clinical presentations and laboratory tests in the diagnosis of acute appendicitis, the major cause of emergency surgical procedures. Patients and a total of 200 patients with suspected acute appendicitis who underwent surgery were included in the study. Clinical history, detailed physical examination, and laboratory investigations were reviewed. The postoperative findings were obtained directly from the operating surgeon. in this group, 69% had acute appendicitis, 9% had acute appendicitis with complications, and the remaining 22% had normal appendices. Right iliac fossa pain, nausea and vomiting were sensitive but not specific symptoms. Tachycardia, hypotension, and fever were of low sensitivity but high specificity. Tenderness in the right iliac fossa and rebound tenderness were highly sensitive but not specific. The WBC count was a sensitive test in the diagnosis of acute appendicitis in comparison with ultrasound examination, which showed a low sensitivity. General urine examination was not valuable in the diagnosis. acute appendicitis is a condition, which requires immediate treatment. The use of highly sensitive tests with high positive predictive value, though of low specificity, favors the appropriate diagnosis and treatment and minimizes the risk of missing cases

Effectiveness of UNICEF programme for anaemia control during pregnancy

To evaluate the size of the problem of iron deficiency anaemia among women in Mosul, Iraq and to determine the effectiveness of using Ferrous/Folate pills suggested by the UNICEF to be given to all pregnant women attending antenatal care units. Design: An interventional study was conducted by giving Ferrous Folate pills to anaemic pregnant women Setting: A primary health care centre in Mosul, Iraq; during the summer of 1996. Participants: A total of 150 anaemic pregnant women in their 2nd and 3rd trimester selected from all pregnant women who have been attending the centre for routine antenatal care. Intervention: Ferrous folate pills were given to all anaemic Women in the beginning of the study. Reevaluation of their hemoglobin was conducted after one month to estimate the effectiveness of the program. The prevalence of anaemia. was 59% among all women attending the antenatal care clinic, The trial showed an improvement in haemoglobin level in about 85% of women taking the pills and the treatment was significantly more effective in those taking 3 pills a day. Premature cessation of treatment was observed in 35% of women mainly due to the undesirable effects of the pills. Iron deficiency anaemia is a very common problem among Iraqi pregnant women. The suggested programme for giving Ferrous Folate pills to pregnant women is highly effective in reducing anaemia among them

validity of widal test in diagnosing typhoid fever

Aim: To examine the validity of Widal test in the diagnosis of typhoid fever. Setting: Teaching Hospitals and Central Public Health Laboratories in Mosul, Iraq; during one year period 1996-1997. Participants: Inpatients [372] investigated with Widal test were traced for final diagnosis. Main outcome measures: Sensitivity, specificity, positive and negative predictive values and the likelihood ratio of Widal test. The study showed that only 11% of the studied patients were diagnosed as typhoid fever. The sensitivity, specificity, positive and negative predictive values and the likelihood ratio of the test were 61%, 89%, 95%, 42% and 5.8 respectively at titers of 1/160 or higher dilutions. There has been over-usage of the Widal test among suspected cases. The posteriori evaluation of the validity indicates that Widal test is more useful to exclude the presence of typhoid fever than to prove a diagnosis; due to the low specificity of the test

Evaluation of the role of health education in breast self examination

To evaluate knowledge of women towards Breast self examination [BSE]. To educate these women about the practice of BSE. To reassess the benefit gained after the education program. A community based study conducted on women living in urban and rural areas in or around the city of Mosul, Iraq. One thousand women in the age 19-65 years. The study showed that only 1% of women were aware about the technique of BSE. It also found that 11 women were having breast masses at the time of examination which all turned to be benign lesions. Re-evaluation of the knowledge and practice of 150 women revealed that all have benefited from the education campaign. It also showed that the degree of knowledge and practice gained were significantly higher in younger women. Evaluation of women in BSE utilizing knowledge, attitude and practice of 1000 women. Implementation of education and training program in the form of personal encounter with each women in the sample. Assessment of knowledge, attitude and practice modification in a sample of 150 from the 1000 women who participated in the education and training programs 5 month after the campaign. This trial is expected to be used as a model for enhancing the BSE technique in a nationwide screening Program for breast Cancer

epidemiology of cigarette smoking in a rural community nearby Mosul, Iraq

A cross-sectional study was conducted on 374 inhabitants of two villages nearby Mosul to estimate the prevalence of smoking habit among them their attitude towards smoking and their awareness of its hazard. The overall prevalence of current smokers was 16%; this is significantly higher among males [35%] than among females [8.9%]. The study showed that more than one third of female smokers and two thirds of male smokers smoked twenty or more cigarettes per day. Moreover, smoking was found to be proportionally related with age among both sexes. The study showed that a measurable number of smokers [48%] had tried unsuccessfully to stop the habit. Psychological problems were the main reason for starting smoking. The importance of imitation within the family, particularly the influence of smoking fathers was confirmed. The study showed that both smokers and nonsmokers were aware about the danger of tobacco and were in favour for smoking control legalization. Nonsmokers, however, were more aware, than smokers, of these dangers and more in favour of such legalization

Cigarette smoking: knowledge, attitude and behaviour of Mosul University students

A questionnaire study was carried out to ascertain the prevalence of smoking in the University of Mosul first year students. 1101 students, 834 males and 267 females, completed the questionaire on their attitude towards smoking and their awareness of its hazards. The prevalence of smoking among males was 23.6% and none of the females was a smoker. The study showed that one third of the smokers smoked twenty or more cigarettes a day. Two thirds of the smokers had tried to stop smoking in the past. Study related and social problems were the main reasons given for starting smoking. The importance of the influence of irritation within the family, particularly the influence of smoking mothers and other relatives living in the same premises was confirmed. The study revealed that most of both smokers and nonsmokers were aware of the dangers of smoking and passive smoking; however nonsmokers were significantly more aware of these dangers. Similar findings were also obtained regarding the approval of smoking control legislation in both groups