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1.
PLoS One ; 17(11): e0274526, 2022.
Article in English | MEDLINE | ID: covidwho-2140527

ABSTRACT

Several messenger ribonucleic acid (mRNA) and inactivated COVID-19 vaccines are available to the global population as of 2022. The acceptance of the COVID-19 vaccine will play a key role in combating the worldwide pandemic. Public confidence in this vaccine is largely based on its safety and effectiveness. This study was designed to provide independent evidence of the adverse effects associated with COVID-19 vaccines among healthcare workers in Iraq and to identify the attitudes of healthcare workers who rejected the vaccination. We conducted a cross-sectional study to collect data on the adverse effects of the Pfizer, AstraZeneca, and Sinopharm vaccines. Data were collected between October 2021 and February 2022. A total of 2,202 participants were enrolled in the study: (89.97%) received injections of the COVID-19 vaccines and (10.03%) were hesitant to receive the vaccination. Participants received either the Pfizer vaccine (62.9%), AstraZeneca vaccine (23.5%) or Sinopharm vaccine (13.6%). Most adverse effects were significantly less prevalent in the second dose than in the first dose. Notably, the adverse effects associated with the Pfizer vaccine were significantly more prevalent in females than in males. Following the first dose, the participants experienced more adverse effects with the AstraZeneca vaccine. Following the second dose, more adverse effects were associated with the Pfizer vaccine. Interestingly, the prevalence of COVID-19 infection in participants who received two doses of the Pfizer vaccine was significantly reduced compared to those who received two doses of either the AstraZeneca or Sinopharm vaccines. According to vaccine-hesitated participants, insufficient knowledge (29.9%), expeditious development (27.6%) and lack of trust in the vaccines (27.1%) were the three major reasons for refusing the vaccines. The results of our study indicated that these adverse effects do not present a significant problem and should not prevent successful control of the COVID-19 pandemic.


Subject(s)
COVID-19 Vaccines , COVID-19 , Vaccines , Female , Humans , Male , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Health Personnel , Iraq/epidemiology , Pandemics , Surveys and Questionnaires , Vaccination/adverse effects
2.
BMJ Open ; 12(11): e064301, 2022 11 21.
Article in English | MEDLINE | ID: covidwho-2137765

ABSTRACT

OBJECTIVES: The aim of this study was to first assess the knowledge and perception of first-year university students in Iraq about COVID-19 in general and SARS-CoV-2 latest variant of concern, and to evaluate the attitudes towards protection measures including vaccination. STUDY DESIGN: A cross-sectional study was conducted among newly enrolled students at the American University of Iraq-Baghdad. Mann-Whitney U and Kruskal-Wallis tests were used to test an association between the outcomes measured on a 5-point Likert scale and the binary and the categorical independent variables, respectively. χ2 test was used to test the association between nominal categorical variables, while Kendall's τ-b was used for ordinal variables. PARTICIPANTS: Students (n=432) were invited to fill out a survey specifically tailored to assess their knowledge, perception and attitude towards Omicron variant and COVID-19 vaccines acceptance. 363 students enrolled in various majors participated in this study. RESULTS: Assessment of COVID-19 knowledge and perception revealed that students still lack reliable info and data about FDA-approved treatment options (70.5%), SARS-CoV-2 variants (96.5%) and approved vaccines. Students' attitude and practices towards recommended safety measures should be reassessed to better manage the pandemic. Adherence level was shown to be associated with the belief in its capacity to effectively manage the new variant. Interestingly, 85% of the students have received at least one dose of approved vaccine. A significant positive correlation was detected between the level of adherence to recommended precautions and the intention to take a third booster shot if proven effective. CONCLUSIONS: Students' reliable knowledge about COVID-19 pandemic including the various strains and approved vaccines should be improved to better manage the pandemic and set foundations for a more appropriate approach when another pandemic occurs. Special workshops should be organised to ensure that students and the public have a more trusted source of information about COVID-19.


Subject(s)
COVID-19 , Vaccines , Humans , United States , COVID-19 Vaccines/therapeutic use , SARS-CoV-2 , Cross-Sectional Studies , Universities , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , Iraq , Health Knowledge, Attitudes, Practice , Students , Perception
3.
Immunobiology ; 227(6): 152301, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2119151

ABSTRACT

Coronavirus disease-19 (COVID-19) has recently emerged as a respiratory infection with a significant impact on health and society. The pathogenesis is primarily attributed to a dysregulation of cytokines, especially those with pro-inflammatory and anti-inflammatory effects. Interleukin-38 (IL-38) is a recently identified anti-inflammatory cytokine with a proposed involvement in mediating COVID-19 pathogenesis, while the association between IL38 gene variants and disease susceptibility has not been explored. Therefore, a pilot study was designed to evaluate the association of three gene variants in the promoter region of IL38 gene (rs7599662 T/A/C/G, rs28992497 T/C and rs28992498 C/A/T) with COVID-19 risk. DNA sequencing was performed to identify these variants. The study included 148 Iraqi patients with COVID-19 and 113 healthy controls (HC). Only rs7599662 showed a significant negative association with susceptibility to COVID-19. The mutant T allele was presented at a significantly lower frequency in patients compared to HC. Analysis of recessive, dominant and codominant models demonstrated that rs7599662 TT genotype frequency was significantly lower in patients than in HC. In terms of haplotypes (in order: rs7599662, rs28992497 and rs28992498), frequency of CTC haplotype was significantly increased in patients compared to HC, while TTC haplotype showed significantly lower frequency in patients. The three SNPs influenced serum IL-38 levels and homozygous genotypes of mutant alleles were associated with elevated levels. In conclusion, this study indicated that IL38 gene in terms of promoter variants and haplotypes may have important implications for COVID-19 risk.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/genetics , Genotype , Pilot Projects , Iraq , Case-Control Studies , Promoter Regions, Genetic/genetics , Polymorphism, Single Nucleotide , Alleles , Haplotypes , Cytokines/genetics , Interleukins/genetics , Genetic Predisposition to Disease , Gene Frequency
4.
J Int Med Res ; 50(11): 3000605221133147, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2108537

ABSTRACT

OBJECTIVE: The primary goals of this research were to analyze the relationship between ABO blood types and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and investigate the effect of vaccination in Iraq. METHODS: Data and outcomes were gathered from the medical records of 200 patients. Patients were categorized by blood group and vaccination status in the analysis. RESULTS: In total, 200 hospitalized patients (125 men and 75 women) with confirmed SARS-CoV-2 infection and blood group (ABO) and clinical data were enrolled. Of the 200 patients, 155 (77.5%) were vaccinated against SARS-CoV-2. The results illustrated that 25 patients died, which might have been attributable to a lack of vaccination or older age. Our analysis revealed that blood group O individuals were much less likely to be infected by SARS-CoV-2 than non-O subjects, whereas blood group A individuals carried a higher risk of infection. CONCLUSIONS: Our findings illustrated that immunization significantly reduces COVID-19 risk across all age groups, but there has been an increase in the number of cases because of decreased vaccine efficacy in older patients and persons with comorbidities. However, 45% vaccination coverage lowered the outbreak's peak.


Subject(s)
COVID-19 , SARS-CoV-2 , Male , Humans , Female , Aged , ABO Blood-Group System , COVID-19/epidemiology , Iraq/epidemiology , Vaccination
5.
Saudi Med J ; 43(10): 1165-1167, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2081102

ABSTRACT

To present an unusual and a rare pulmonary affection by coronavirus disease-19 (COVID-19), in which only one lung is affected. Coronavirus disease-19 attacks the lungs and interferes seriously with their functions. The attack is usually bilaterally, while a uni lateral pulmonary affection is unusual. The presentation, both clinical and radiological findings, bronchoscopy appearance, the strange operative findings of the resected mass, the uneventful post-operative course, in addition to the histopathological report, will be presented.In conclusion, unilateral lung affection is unusual and post-viral pneumonia COVID-19 should be considered as a possible aftermath, which may not be uncommon in Iraq.


Subject(s)
COVID-19 , Pneumonia, Viral , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Lung/diagnostic imaging , Bronchoscopy , Iraq
6.
J Infect Dev Ctries ; 16(9): 1439-1444, 2022 09 30.
Article in English | MEDLINE | ID: covidwho-2066662

ABSTRACT

INTRODUCTION: COVID-19 incidence was relatively high among dentists in Iraq, reflecting the high number of cases in the community. Therefore, possible epidemiological features of COVID-19 infection were investigated among dentists in Iraqi Kurdistan Region. METHODOLOGY: A cross-sectional study has been conducted among dentists using a structured questionnaire. The questionnaire included demographic and working characteristics, self-reported COVID-19 history, and prevention practices toward SARS-CoV-2 during the pandemic. An online questionnaire was developed and spread with a snowball method among dentists. RESULTS: We analyzed the responses of 83 participants (31 women and 52 men, mean age 33.8 ± 6.8 years). They had a mean of 10.6 ± 6.5 years of work experience and 20.2 ± 12.6 hours of weekly working time. In total, 46 (55.4%) of the participants reported COVID-19 infection. Only 29 (34.9%) participants always followed the hygiene rules. The most common personal precautions were mask-wearing (98.8%) and hand hygiene as a part of institutional protective precaution (51.8%). Of the infected dentists, 24 (52.2%) did not know the source of infection. Of the remaining 16 (34.8%) were infected from family and/or friends circle, and five (10.9%) from patients. Eleven of them (23.9%) reported transmitting the infection to at least one person. In the multivariate analyses, working in Sulaymaniyah Province (p = 0.031) and working only in a public hospital (p = 0.029) were significant risk factors for COVID-19 infection. CONCLUSIONS: The high risk of COVID-19 infection among dentists in the Iraqi Kurdistan Region relates to their family and friends rather than their occupation.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Dentists , Female , Humans , Iraq/epidemiology , Male , SARS-CoV-2 , Surveys and Questionnaires
7.
J Environ Public Health ; 2022: 8516944, 2022.
Article in English | MEDLINE | ID: covidwho-2053439

ABSTRACT

Background: Hepatitis B virus (HBV) is still a major health problem worldwide, placing healthcare workers, medical and dental students, and professionals at higher occupational risk. The present study aimed to evaluate the level of knowledge about this virus and relevant safety precautions among dental students in the Kurdistan region of Iraq. Materials and methods. This cross-sectional study was conducted among the third, fourth, and fifth stage dental students of Hawler Medical, Sulaimani, and Duhok universities. Data on the students' demographic characteristics and their knowledge about HBV (16 close-ended questions) and safety precaution measures (10 close-ended questions) were collected by means of a questionnaire. Analysis of variance was used to compare the mean of knowledge and safety precaution scores. Results: In total, 372 students (mean age 21.77 ± 1.31 years) completed the questionnaires. The mean scores for knowledge and safety precautions were 13.17 ± 2.09 and 8.05 ± 1.61, respectively. Respondents from Hawler Medical University showed statistically significantly higher knowledge levels than their counterparts in Sulaimani and Duhok universities (p = 0.012). Conclusions: The majority of surveyed dental students are aware of HBV, its mode of transmission, infection, complications, vaccination, and safety precautions required to prevent the spreading of the virus. While the levels of knowledge about HBV and safety precautions among the dental students in the Kurdistan region of Iraq were generally acceptable, differences in knowledge level were identified between the universities, and these may be related to their educational and training programs.


Subject(s)
Hepatitis B virus , Hepatitis B , Adult , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Humans , Iraq , Students, Dental , Surveys and Questionnaires , Young Adult
8.
Braz J Infect Dis ; 26(5): 102677, 2022.
Article in English | MEDLINE | ID: covidwho-2035805

ABSTRACT

Despite vaccine development and vaccination programs underway around the globe, the coronavirus disease 2019 (COVID-19) pandemic has not been controlled as the SARS-CoV-2 virus is evolving and new variants are emerging. This study was conducted to sequence and molecularly characterize the representing samples from the early fourth SARS-CoV-2 wave in Iraq. Here, we have performed next-generation sequencing of whole-genome sequencing of two representing samples from the country's early beginning of the fourth pandemic wave. The samples were sequenced using Illumina Miseq system, and the reference sequences were retrieved from GISAID database. Phylogenetic analysis was performed through Mega software. This study provides an initial sequence analysis and molecular characterization of the first Omicron variant cases recorded in the country. Our analysis revealed many mutations on the spike glycoprotein, especially on the receptor binding domain, with potential impact on immune escape and infectivity. The study findings suggest considering the highly mutated immunogenic epitope of the Omicron variant as a reference for developing a new vaccine for combating the ongoing pandemic.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Epitopes , Humans , Iraq/epidemiology , Mutation , Phylogeny , SARS-CoV-2/genetics , Sequence Analysis
9.
J Infect Dev Ctries ; 16(8): 1370-1371, 2022 08 30.
Article in English | MEDLINE | ID: covidwho-2030099

ABSTRACT

The aim of this letter is to discuss the pandemic management measures, including social distancing and community containment, taken in Duhok city in Northern Iraq, where a few patients were infected with COVID-19. During the first three months of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, 15 patients were diagnosed with SARS-CoV-2 in Duhok city. All the patients were asymptomatic and were discharged to their home within 10 ± 3.2 days after throat swabs indicated a negative SARS-CoV-2 Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test. The social distancing and lockdown measures taken by the city were implemented in three stages. In the first stage, all educational institutions including schools, colleges and universities were closed. In the second stage, all gatherings were banned. Finally, state-imposed community-wide containment was declared. The social distancing measures helped control infections in the city. Gradual reopening is recommended to avoid the spread of infection.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Humans , Iraq/epidemiology , Physical Distancing , RNA, Viral/analysis
10.
Turk J Med Sci ; 52(4): 910-916, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2026909

ABSTRACT

BACKGROUND: Middle East respiratory syndrome (MERS) is a zoonotic viral disease transmitted from dromedaries to humans. To date, more than 1500 cases of MERS have been reported and 80% of all cases have occurred in the Kingdom of Saudi Arabia (KSA). This cross-sectional study was carried out to figure out the rate of infection among humans and dromedary camels and to explore the risk factors. METHODS: This study was conducted in Diyala Province, Iraq for the period from August 2017 to October 2018. Human subjects included 90 participants; 34 (37.8%) were females and 56 (62.2%) were males. Additionally, 90 dromedary camels were also included, 50 (55.6%) males and 40 (44.4%) females. Serum samples from subjects were collected and tested for the presence of anti-MERS-coronavirus (CoV) immunoglobulin g (IgG). RESULTS: The results revealed that 46 (51.1%) of human subjects were positive for anti-MERS-CoV IgG, (95% confidence interval (CI) for the prevalence rate 40.9-61.3) with a mean titer of anti-MERS-CoV IgG antibodies (Ab) of 81.2 U/mL. The anti-MERS-CoV IgG positivity rate was insignificantly higher, but the mean of anti-MERS-CoV IgG titer was significantly higher among females (p = 0.12 and p < 0.004, respectively). Furthermore, the anti-MERS-CoV IgG positivity rate and Ab titer were significantly higher among those people who visited KSA for Hajj or Umrah (p < 0.001 and p < 0.001, respectively). In camels, 81 (90.0%) were positive for anti-MERS-CoV IgG, (95% CI for the prevalence rate 82.5-94.9), with a mean titer of 99.8 U/mL. DISCUSSION: The MERS-CoV infection rate was high among both Iraqi humans and dromedary camels. Further confirmatory studies are needed, and setting up of national precaution program is essential.


Subject(s)
Coronavirus Infections , Middle East Respiratory Syndrome Coronavirus , Male , Animals , Female , Humans , Camelus , Cross-Sectional Studies , Iraq/epidemiology , Antibodies, Viral , Coronavirus Infections/epidemiology , Immunoglobulin G
11.
Wiad Lek ; 75(6): 1734-1740, 2022.
Article in English | MEDLINE | ID: covidwho-1994975

ABSTRACT

OBJECTIVE: The aim: To develop a quantitative tool to identify the cost and benefits of the appropriate and inappropriate laboratory tests. PATIENTS AND METHODS: Materials and methods: This is a retrospective study, conducted in Al Zahraa teaching hospital for children's health and maternity in a period between March 2021 to March 2022. We study the total laboratory investigation done in three years; before the COVID-19 era (1-3-2018 to 1-3-2019) and two consecutive years (1-3-2020 to 1-3-2021 and 1-3-2021 to 1-3-2022) to exclude the effect of COVID-19 pandemic on the results. And try to divide these test numbers according to each hospital department and the position of the test ordering doctor (senior or junior). We compare the total number of laboratory investigations with the total patient seeking medical care in Al Zahraa hospital, out or inpatient, i.e., ORDERING INDEX. Also, we calculate the (AVERAGE ORDERING INDEX) by dividing the number of all ordered tests by one specific test. RESULTS: Results: The total number of laboratory tests ordered in three (pre and peri COVID-19 pandemic) years show a significant increment in the last year (78249, 73600, and 1740249) respectively. Test ordering index, in the same way, shows significant increments over years (0.65, 0.64 Aand11.2) respectively. Biochemistry investigations constitute the largest proportion (50%) of all investigations that have been ordered last year. CBC is the most commonly ordered single test, in outpatient clinics, it is done 19510 times (Obstetrics and Gynecology 11850 vs Pediatric 7660). The positive (abnormal) results were only 4.8%. CONCLUSION: Conclusion: For more and more years, laboratory investigations have been overused. A large number of normal results indicate that the test order was chosen at random. The most commonly overused test is the complete blood count.


Subject(s)
COVID-19 , Diagnostic Tests, Routine , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , Child , Cost-Benefit Analysis , Female , Hospitals, Teaching , Humans , Iraq , Pandemics , Pregnancy , Retrospective Studies
12.
Int J Environ Res Public Health ; 19(16)2022 08 16.
Article in English | MEDLINE | ID: covidwho-1987800

ABSTRACT

Due to political conflict, insurgency, and the COVID-19, the number of displaced households in need of humanitarian support in Iraq has increased. This study investigated factors related to desire of displaced households to receive humanitarian information. Data from the eighth round of the Iraq Multi-Cluster Needs Assessment was used. We classified the household displacement status, identifying levels and types of humanitarian information that the households sought, together with whether the households were impacted by COVID-19. We identified safety and security, housing, water and electricity services, education, health care, and levels of humanitarian assistance resulted in significant differences between internally displaced person (IDP) and returnee households in terms of interest in receiving humanitarian information. The desire to receive humanitarian information was related to whether household members were unemployed due to COVID-19, displacement status, and walking time to reach the nearest health care facility and marketplace. Returnees and IDPs in Iraq are facing a new crisis. Their individual, structural, and environmental vulnerabilities are increasing commensurately. New strategies such as strategies using online or mobile communication that provide humanitarian information are needed to provide humanitarian information to vulnerable groups such as those who have lost jobs due to COVID-19, female heads of households, and those with health problems. In addition to traditional cash and voucher support, the use of the latest technologies such as smartphones and mobile clinics in humanitarian settings would be new strategies.


Subject(s)
COVID-19 , Refugees , COVID-19/epidemiology , Family Characteristics , Female , Humans , Iraq , Needs Assessment
13.
J Infect Dev Ctries ; 16(7): 1126-1130, 2022 07 28.
Article in English | MEDLINE | ID: covidwho-1974970

ABSTRACT

INTRODUCTION: In 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of Coronavirus Disease 2019 (COVID-19), spread all over the world. This global pandemic spread rapidly to more than 195 countries and caused over 200 million infections with a mortality rate of 2%. This study aimed to detect seropositivity against the SARS-CoV-2 virus among outpatients, symptomatic and asymptomatic individuals. METHODOLOGY: A total of 489 individuals of age 5-70 years (mean 38.0 ± 17 SD) were enrolled for a cross-sectional study. They were tested for presence of SARS-CoV-2 IgM/IgG antibodies in serum samples using Enzyme-linked Immunofluorescent Assay (ALFA). RESULTS: A higher seroprevalence was recorded for IgM among females (34.96%) than males (28.83%). In the case of IgG, and IgG + IgM, both males and females had similar values. A significant correlation was identified between seropositivity and age; higher seropositivity (IgG, IgM, and IgG + IgM) was recorded in age groups 51-60 and ≥ 61 years, relative to the younger age groups. No significant correlation was found between symptomatic and asymptomatic individuals. No significant correlation was detected between seropositivity and RT-PCR positive and negative cases. CONCLUSIONS: COVID-19 is spreading rapidly and there is a high percentage of asymptomatic carriers. The sensitivity of RT-PCR tests is not uniform and may not be able to detect all cases. On the other hand, serology can be used for large scale testing to detect the real extent to which the disease has spread.


Subject(s)
COVID-19 , SARS-CoV-2 , Adolescent , Adult , Aged , Antibodies, Viral , COVID-19/diagnosis , COVID-19/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Immunoglobulin G , Immunoglobulin M , Iraq/epidemiology , Male , Middle Aged , Prevalence , Seroepidemiologic Studies , Young Adult
14.
BMC Ophthalmol ; 22(1): 265, 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1951120

ABSTRACT

Dry eye syndrome (DES), is a multifactorial disease that affects the ocular surface and contributes to the ocular symptoms. The COVID-19 pandemic influenced the general population and university students' health in different ways. The pandemic forced many people including university students around the world to use virtual platforms on their digital devices, such as computers and smartphones, to work from a distance. This study aimed to explore the visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. This was a cross-sectional study that was conducted in Iraq and Jordan using online questionnaire tool for the duration between November 2021 and January 2022. University students in Jordan and Iraq were invited to participate in this study and formed the study population. No restrictions on study level or field of study were applied. A previously developed and validated questionnaire tools were used in this study (National Eye Institute Visual Functioning Questionnaire - 25 (VFQ-25) and the Women's Health Study Questionnaire (WHS), which was developed by Schaumberg et al.). A total of 1,431 university students were involved in this study (1,018 students from Iraq, 71.1%). Around one third the study participants (29.0%) reported that have been diagnosed by a clinician as having dry eye syndrome. Around15.3% of the total study participants reported that they feel their eyes are dry (not wet enough) and 17.3% reported that they feel their eyes are irritated. Based on Women's Health Study Questionnaire (WHS) criteria, a total of 479 participants (33.4%) are symptomatically diagnosed with DES. Students aged 27-29 years, those at their fifth year of study, and those who wear contact lenses are at higher risk of developing DYS compared to others. Dry eye syndrome is common health problem among university students. Further studies are required to identify other risk factors associated with DES. Future research should focus on identifying strategies that could help reduce the risk of developing DES as a result of the inevitability of long-term use of digital devices among many categories of society, including university students.


Subject(s)
COVID-19 , Dry Eye Syndromes , COVID-19/epidemiology , Cross-Sectional Studies , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/epidemiology , Female , Humans , Iraq/epidemiology , Jordan/epidemiology , Pandemics , Prevalence , Students , Surveys and Questionnaires , Universities
15.
Eur J Med Res ; 27(1): 84, 2022 Jun 03.
Article in English | MEDLINE | ID: covidwho-1951357

ABSTRACT

BACKGROUND: During the last 2 years, in the Kurdistan Region, Northern Iraq, there were thousands of COVID-19 cases that have not been reported officially, but diagnosed and confirmed by private laboratories and private hospitals, or clinicians based on typical clinical signs, as well as few people using home self-test after appearing of some flu-like clinical symptoms. Thus, this study aims to assess the misdiagnosis and mismanagement of cases before COVID-19 confirmation. METHODS: This study enrolled 100 consecutive patients who visited an outpatient clinic of Shar Hospital that had symptoms highly suspicious of COVID-19 infection while misdiagnosed previously to have other types of disease. Detailed questionnaires were filled for all studied patients, including age, gender, main presenting symptoms, and duration of these symptoms with the following questions: who made the false diagnosis, depending on which diagnostic test the false diagnosis was made, which medication was used for the false diagnosis, who prescribed those medications, and how long those medications were used. They were investigated by RT-PCR on their nasopharyngeal swab for confirmation. RESULTS: Most of the false diagnoses were typhoid (63%), influenza (14%), pneumonia (9%), gastroenteritis (5%), common cold (4%), brucellosis (4%), and meningitis (1%). Regarding the false diagnosis of cases, 92% were made by non-physician healthcare workers, and only 8% were made by physicians. All false diagnoses with typhoid, gastroenteritis, and common cold were made by non-physician healthcare workers, together with about half of the diagnosis of pneumonia and brucellosis, with statistically significant results (P < 0.001). CONCLUSIONS: We realized that some patients had been misdiagnosed before the COVID-19 infection confirmation. Their health conditions improved drastically after correct diagnosis and treatment, and this research is considered the first research to be conducted in Iraq in this regard.


Subject(s)
Brucellosis , COVID-19 , Common Cold , Gastroenteritis , Typhoid Fever , COVID-19/diagnosis , Diagnostic Errors , Humans , Iraq/epidemiology , SARS-CoV-2/genetics
16.
Epidemiol Health ; 44: e2022035, 2022.
Article in English | MEDLINE | ID: covidwho-1939240

ABSTRACT

OBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants' parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors. RESULTS: The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively). CONCLUSIONS: The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.


Subject(s)
COVID-19 , Measles , BCG Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Cross-Sectional Studies , Humans , Infant , Iraq/epidemiology , Measles/epidemiology , Measles/prevention & control , Pandemics/prevention & control , Vaccination Coverage
17.
J Med Virol ; 94(11): 5244-5250, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1925947

ABSTRACT

The aims of this study were: to determine the incidence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among vaccinated healthcare workers (HCWs), assess risk factors associated with the vaccine breakthrough (BT), and compare the effectiveness of vaccine manufacturers against SARS-CoV-2 variant of concern among HCWs in Duhok governorate. It is a multicenter retrospective cohort study, which enrolled 944 HCWs through March 2022. COVID-19 vaccinated HCWs aging 18 and above were included. A random sampling process was performed by asking the participants to fill out a standardized questionnaire by means of interviews or participant-completed surveys. Fully vaccinated HCWs with positive polymerase chain reaction tests were considered to have vaccine BT infection. Two hundred and eighty-four (30.1%) out of 944 vaccinated HCWs had SARS-CoV-2 infection postvaccination, of whom 241 (84.9%) were fully vaccinated, concluding that the incidence of BT infection is 25.5%. There were 422 (44.7%) males and 522 (55.3%) females. Most vaccine BT infections had developed in SARS-CoV-2 Omicron variant (53.5%). The majority of BT infections were mild to moderate (95.5%). Occupation, namely dentist was a significant risk factor, with a p value of 0.001. HCWs with a history of SARS-CoV-2 infection prevaccination were more prone to a vaccine BT infection (p value =0.002). Pfizer vaccine manufacturers revealed the highest effectiveness against BT infection (p value =0.0001). Paramedics showed a significant association with the disease severity (p value =0.02). The three available vaccine manufacturers in the Duhok governorate are effective against COVID-19 BT infections. Dentists and paramedics were significantly associated with poor COVID-19 outcomes.


Subject(s)
COVID-19 , Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Female , Health Personnel , Humans , Iraq/epidemiology , Male , Retrospective Studies , SARS-CoV-2/genetics
18.
PLoS One ; 17(6): e0270537, 2022.
Article in English | MEDLINE | ID: covidwho-1910684

ABSTRACT

PURPOSE: COVID-19 infection is normally followed by several post-COVID effects. This study aimed to investigate to evaluate menstrual changes in females following COVID-19 infection, and to evaluate female perception about the effect of COVID-19 on their menstrual cycles. METHODS: During this cross-sectional survey-based study, a convenience sample of 483 women from Jordan and from Iraq, who had infected with COVID-19 were invited to fill-out the study questionnaire. RESULTS: The study was conducted on the females, with a median age 31 years old. Results showed that 47.2% of them (n = 228) suffered from a change in the number of days between two consecutive periods, as well as from a change in the amount of blood loss. Also, more than 50% of them believed that COVID-19 infection may cause changes in the amount of blood loss during the cycle (n = 375, 56.9%), and changes in the number of days between the two consecutive periods (n = 362, 54.2%). Regression analysis showed that participants with higher educational level (bachelor or higher) (Beta = -0.114, P = 0.011), and those living in Iraq (Beta = -0.166, P<0.001) believed that COVID-19 has lower tendency to cause menstrual changes. In addition, non-married females (Beta = 0.109, P = 0.017), and those who are current smokers (Beta = 0.091, P = 0.048) believed that COVID-19 has higher tendency to cause menstrual changes. CONCLUSION: his study revealed that COVID-19 infection could affect the menstrual cycle for the females. Further prospective studies should be done to confirm these findings and evaluate how long these menstrual irregularities lasted.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Iraq/epidemiology , Jordan/epidemiology , Menstrual Cycle , Prospective Studies
19.
BMJ Glob Health ; 7(Suppl 3)2022 06.
Article in English | MEDLINE | ID: covidwho-1909732

ABSTRACT

The purpose of this study is to evaluate Iraq's health facility preparedness for the surge of hospitalised cases associated with the ongoing COVID-19 pandemic. In this article, we review pandemic preparedness at both general and tertiary hospitals throughout all districts of Iraq. COVID-19 pandemic preparedness, for the purpose of this review, is defined as: (1) staff to patient ratio, (2) personal protective equipment (PPE) to staff ratio, (3) infection control measures training and compliance and (4) laboratory and surveillance capacity. Despite the designation of facilities as COVID-19 referral hospitals, we did not find any increased preparedness with regard to staffing and PPE allocation. COVID-19 designated hospital reported an increased mean number of respiratory therapists as well as sufficient intensive care unit staff, but this did not reach significant levels. Non-COVID-19 facilities tended to have higher mean numbers of registered nurses, cleaning staff and laboratory staff, whereas the COVID-19 facilities were allocated additional N-95 masks (554.54 vs 147.76), gowns (226.72 vs 104.14) and boot coverings (170.48 vs 86.8) per 10 staff, but none of these differences were statistically significant. Though COVID-19 facilities were able to make increased requisitions for PPE supplies, all facility types reported unfulfilled requisitions, which is more likely a reflection of global storage rather than Iraq's preparedness for the pandemic. Incorporating future pandemic preparedness into health system strengthening efforts across facilities, including supplies, staffing and training acquisition, retention and training, are critical to Iraq's future success in mitigating the ongoing impact of the ongoing COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Delivery of Health Care , Hospitals , Humans , Iraq
20.
Saudi Med J ; 43(5): 500-507, 2022 May.
Article in English | MEDLINE | ID: covidwho-1903980

ABSTRACT

OBJECTIVES: To detect the epidemiological trend of coronavirus disease-19 (COVID-19) in Iraq, the distribution of cases by age, gender, and governorates, and to assess its burden on the health system by estimating morbidity and mortality rates. METHODS: This biometric study was carried out in 2021. The distribution, incidence, mortality, and case fatality rates in a 17-month period was sketched in a biometric design. A semi-structured questionnaire was distributed to a number of decision makers in the Ministry of Health regarding health system challenges that have been faced during this pandemic. RESULTS: More than half (55.1%) of the cases were among males, and 67.5% were in the age group 30-60 years. Mortality was also predominant among males (62.7%), and 50.0% of the deaths were in the age group >50 years. The predominant age group for both genders was 30-60 years. Case fatality rate was 1.2%; again higher among males (1.3% versus 1.1%). CONCLUSION: The trend of COVID-19 in Iraq showed 2 peaks, August-October 2020 and March-July 2021, with males being more affected by morbidity, mortality, and fatality. The main challenge faced by the Iraqi health system was the rapid increase of COVID-19 cases with limited bed capacity and medical equipment.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Female , Humans , Incidence , Iraq/epidemiology , Male , Middle Aged , Morbidity , Mortality , Pandemics
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