Insights into determinants of health-seeking behavior: a cross-sectional investigation in the Iraqi context.

Background: Health-seeking behavior (HSB) is a choice taken by an individual to maintain, achieve, or restore good health and prevent diseases. The purpose of this study is to examine the determinants of HSB among the Iraqi population. Methods: This cross-sectional study in the Rusafa and Karkh districts of Baghdad investigated determinants of HSB from 2022 to 2023. With a sample size of 993 participants meeting inclusion criteria, data were collected through a self-reported questionnaire, utilizing four indicators to measure HSB. The study employed various statistical methods especially logistic regression models, facilitated by Stata 17 software. Results: Results highlights that married individuals consistently have higher odds of having HSB compared to their single counterparts, with an odds ratio (OR) of 2.09 (95% confidence interval: 1.41-3.10). This relationship remains robust even after controlling for other variables. Furthermore, individuals with higher social class exhibit stronger connections to HSB, although the OR is 1.69 (95% CI: 0.47-6.13), indicating a wide confidence interval. Regarding underlying diseases and their duration, the results indicate that chronic diseases are associated with a higher likelihood of HSB, with an OR of 2.05 (95% CI: 1.35-3.11). Additionally, a longer duration of diseases in terms of years is also linked to a stronger association with HSB, with an OR of 2.86 (95% CI: 1.32-6.23). Conclusion: In conclusion, this work provides important insights into HSB. Married people are continuously more likely to engage in HSB than single people, highlighting the importance of customized interventions. Furthermore, persons from higher social classes have stronger ties to HSB, highlighting the importance of socioeconomic considerations. The link between HSB and chronic diseases, combined with longer disease durations, emphasizes the importance of early detection and thorough healthcare management. These findings give critical guidance for healthcare providers, marketers, and politicians developing effective initiatives to promote HSB.

The Cultural Evolution and Social Pressures of Liposuction Among Iraqi Women: Navigating Modern Beauty Standards Amidst Conservative Traditions.

This editorial explores the impact of societal transformation on Iraqi women's lives, particularly concerning beauty standards and cosmetic procedures like liposuction. It examines the influences of modernization, social media, and social pressures juxtaposed with traditional conservative values. The transition from repressive regimes to more open, albeit unstable, political landscapes has led to significant shifts in women's roles, with increased conservatism contrasting with emerging modernist influences. The role of social media in amplifying modern beauty ideals creates internal conflicts for women striving to balance these with traditional expectations. The growing acceptance of cosmetic procedures indicates a shift toward integrating modern beauty standards within Iraqi society.

Epidemiologic Features and Risk Factors for Crimean-Congo Hemorrhagic Fever in Dhi Qar Province, Iraq.

BACKGROUND: Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Iraq, where recurrent epidemics have been constantly observed during the last five years. The present study aimed to determine the factors associated with Crimean-Congo hemorrhagic fever (CCHF) cases in Dhi Qar province during the year 2022. METHODS: A test-negative case-control design was used to analyze 621 CCHF patients, of which 162 were confirmed and 459 were suspected cases. To identify the confirmed and suspected cases, reverse transcriptase polymerase chain reaction (RT-PCR) was used. Suspected patients whose PCR test results were negative were selected as the control group. Data on potential risk factors for CCHF were collected as existing data for previous years for the same geographical locations in Dhi Qar province. Logistic regression analyses were used to determine the correlation between probable risk factors and confirmed CCHF cases. RESULTS: The incidence rate of CCHF was 6.8% per 100,000 people. The total number of deaths was 48 for patients with a case fatality rate of 7.7%. The patients' ages ranged from one year to 65 years, with an overall mean ± SD of 36.08 ± 18.29 years. A total of 98.2% of the patients were between 15 and 65 years of age; 58% of the reported patients were male, and the male-to-female ratio was 1.4:1. Additionally, contact with raw meat, animal contact, and tick bite had the highest percentages for CCHF positivity cases. CONCLUSIONS: Male gender, high-risk jobs like housewives, health staff, shepherds, butchers, animal dealers, slaughterhouse workers, veterinary staff, and farmers, tick bites, and contact with raw meat were statistically significant predictors for increasing CCHF incidence in Dhi Qar province during the year 2022.

Findings of a Community Health Needs Assessment Survey in Al Najaf Governorate Iraq: A Snapshot of Al Marashda's Health Status.

BACKGROUND: Community health assessment (CHA) is a well-known method for identifying and analyzing community health needs. This CHA survey aimed to identify and analyze community health needs and assets to prioritize these needs and to plan and act upon significant unmet community health needs. METHODS: The CHA was planned based on the suggested standard of the North Carolina Guide including eight phases from July to December 2023. The CHA survey was performed among Al-Marashda region residents in the Al-Manathera district. The sample size of our study was 184 interviews of 12536 population. The primary data, which included demographic information, quality of life statements, and community improvement, were collected from the community using a questionnaire through opinion surveys and focus groups, while the secondary data which included the social, health, and economic status of Al-Marashda region residents were obtained from district and governorate sources. Analysis of whole data sources allowed 10 areas of community concern to be identified. RESULTS: Findings from the CHA survey showed that diabetes and high blood pressure, poverty and unemployment, and air pollution were the most common public health problems as priorities. CONCLUSIONS: The high-priority problems of Al-Marashda are in common with the noncommunicable diseases (NCDs) priority in Al Najaf. However, poverty and air pollution are specific to the Al-Marashda region. Public health authorities and the city governorate are advised to consider, support, and develop community diagnosis documents to implement appropriate interventions.

Dega Osteotomy for the Treatment of Developmental Dysplasia of the Hip, a Clinical Evaluation and an Anatomic Study based on X-ray and CT Scan.

Background: Dega osteotomy is becoming more widely used for the treatment of developmental dysplasia of the hip (DDH). Objective: A thorough description of this procedure is needed as many of the technical aspects are not fully defined. Moreover, more follow-up series are also needed to evaluate its outcomes. Methods: In this study, we gave a detailed anatomic description for this procedure and also presented our experience as a retrospective radiographic and case-note study. We examined the clinical and radiographic records of 44 patients (48 hips) with varying degrees of DDH. Results: The average age of the patients was 2 months and 7 months while the average follow up period was 41 months. Clinical and radiographic assessment including CT with 3D reconstruction to examine the anatomic characteristics of the osteotomy were undertaken. We found that concentric reduction was achieved in 93.7% with excellent clinical and radiographic outcomes. Only 3 cases needed revision of the Dega osteotomy. The re-operation rate was 12.5%. CT scan revealed that the arcuate line was crossed by the osteotomy in the majority of cases. In 20.7% of cases, a bone cut that was intended to be a Dega osteotomy was found to have been inadvertently implemented as another osteotomy variant. However, this bore no significant effect on the outcome. Conclusion: We found that a well-implemented Dega osteotomy is a reliable tool to cope with the acetabular changes in DDH.

The Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation and Distal Clavicle Fractures.

Background: Acromioclavicular joint (ACJ) dislocation and distal clavicle fractures are common shoulder injuries. Different methods of fixation are used to treat such injuries, each has its advantages and disadvantages. In this study, we tested fixation using the hook plate. We think that it is technically simple, reliable and more effective in certain surgical situations. However, it is not gaining adequate popularity due to the potential complications of the plate placement including subacromial osteolysis, impingement, rotator cuff injury and others. A second surgery for plate removal is classically indicated to cope with such complications. Objective: The aim of this study included evaluating the clinical and radiological healing after hook plate fixation in ACJ dislocation and distal clavicle fractures and assessing the incidence and clinical significance of subacromial osteolysis. Methods: It is a prospective observational study with a total of 96 cases including 64 ACJ dislocations and 32 distal clavicle fractures. Constant-Murley score was used for clinical evaluation. The patients were evaluated regularly with a minimum follow up of 12 months after plate removal. Results: At the end of the study we found that the results of the hook plate fixation for both groups were good clinically and radiologically. The clinical result score was found to be initially higher among the patients of the ACJ dislocation mainly due to the earlier plate removal in these patients. However, the final score was found to be comparable in both groups. The incidence of the subacromial osteolysis was found to be higher among the patients with clavicle fractures as the plate was retained for a longer time. However we found that subacromial osteolysis did not imply any increased rate of symptoms over the patients who did not show this complication on the X-ray. Conclusion: Based on these observations, we recommend the hook plate fixation to be added to the armamentarium of the orthopaedic surgeon treating such injuries as it is simple to implement, durable and capable of dealing with difficult situations. The main disadvantage of this method is the need for a second surgery for plate removal.

A retrospective study of Crimean-Congo hemorrhagic fever in Iraq.

Background: CCHF is transmitted via ticks biting and directly by contact with tissue or blood of infected patients or viremic animals. This study intends to determine the occurrence of CCHF in Iraq between 2015 and 2019. Methods: This study was designed as a retrospective and descriptive cross-sectional study. It was approved the occurrence of CCHF in Iraq with relation to some epidemiological and demographic data reported in the Iraqi Communicable Diseases Control Center (CDC)/zoonotic diseases section between 2015-2019. Results: Out of 206 suspected cases, only 17 were diagnosed as CCHF with a total fatality ratio of 52%, 25%, and 80% in 2015 and 2018 respectively. However, no mortality was reported during 2016, 2017, and 2019. The mean age of the patients was 33 years± 18 SD, in males mainly (76%). Moreover, the risk groups were 29 %, 23 %, 18 % 12 %, and 6 % for butchers, animal dealers, gainers, both housewives and students and children respectively. Conclusion: Strict precautions and precise surveillance should be implemented to control the disease and protect the community by improving the diagnosis and treatment of CCHF. The authors recommend another future study to detect the genotyping and sequencing of CCHFV in Iraq.

Human Brucellosis in Iraq: Spatiotemporal Data Analysis From 2007-2018.

Background: Brucellosis is both endemic and enzootic in Iraq, resulting in long-term morbidity for humans as well as economic loss. No previous study of the spatial and temporal patterns of brucellosis in Iraq was done to identify potential clustering of cases. Objective: This study aims to detect the spatial and temporal distribution of human brucellosis in Iraq and identify any changes that occurred from 2007 to 2018. Methods: A descriptive, cross-sectional study was conducted using secondary data from the Surveillance Section at the Communicable Diseases Control Center, Public Health Directorate, Ministry of Health in Iraq. The trends of cases by sex and age group from 2007 to 2018 were displayed. The seasonal distribution of the cases from 2007 to 2012 was graphed. We calculated the incidence of human brucellosis per district per year and used local Getis-Ord Gi* statistics to detect the spatial distribution of the data. The data were analyzed using Microsoft Excel and GeoDa software. Results: A total of 51,508 human brucellosis cases were reported during the 12-year study period, with some missing data for age groups. Human brucellosis persisted annually in Iraq across the study period with no specific temporal clustering of cases. In contrast, spatial clustering was predominant in northern Iraq. Conclusions: There were significant differences in the geographic distribution of brucellosis. The number of cases is the highest in the north and northeast regions of the country, which has borders with nearby countries. In addition, people in these areas depend more on locally made dairy products, which can be inadequately pasteurized. Despite the lack of significant temporal clustering of cases, the highest number of cases were reported during summer and spring. Considering these patterns when allocating resources to combat this disease, determining public health priorities, and planning prevention and control strategies is important.

Epidemiology and aetiology of the 2023 meningitis outbreak among children in Iraq.

Background: Meningitis is still a major public health challenge globally. Both the viral and bacterial forms of the disease have been reported worldwide. In 2023, around 200 children with suspected meningitis were admitted to hospital in Halabja Governorate, Iraq. No outbreak of meningitis had been reported previously in that region. Aims: To investigate the aetiology and epidemiology of meningitis among children in Halabja Governorate, Iraq, and expedite clinical management and prevention. Methodology: Blood and cerebrospinal fluid specimens were collected from 197 children admitted to Halabja Paediatric and Maternity Teaching Hospital from 1 March to 1 July 2023 and analysed. The sample t-test was used to compare the haematological, serological and biochemical characteristics of the samples. Results: The majority (76.6%) of the children were aged 2-9 years and 54% were males. The clinical manifestations of the disease were fever (100.0%), headache (89.0%), vomiting (85.7%), and photophobia (72.4%); none of the children had convulsions. The mean values for both neutrophil count and C-reactive protein were statistically significantly raised (P < 0.05) and the red blood cells, white blood cells and neutrophil counts, and lactate dehydrogenase values were statistically significantly raised (P < 0.05). The causative organism was enterovirus (98.5%), with sporadic cases of streptococcal meningitis (1.5%). All the patients recovered fully. Conclusion: The rapid diagnosis of the disease was crucial to the therapeutic and prevention control measures for the outbreak. Although it is still unclear how and where this outbreak started, contaminated drinking water and transmission among children in nurseries and schools are suspected. Further investigations are recommended to determine the source of the enterovirus and identify the virus species and serotypes.

An Assessment of the Ocular Toxicity of Two Major Sources of Environmental Exposure.

The effect of airborne exposure on the eye surface is an area in need of exploration, particularly in light of the increasing number of incidents occurring in both civilian and military settings. In this study, in silico methods based on a platform comprising a portfolio of software applications and a technology ecosystem are used to test potential surface ocular toxicity in data presented from Iraqi burn pits and the East Palestine, Ohio, train derailment. The purpose of this analysis is to gain a better understanding of the long-term impact of such an exposure to the ocular surface and the manifestation of surface irritation, including dry eye disease. In silico methods were used to determine ocular irritation to chemical compounds. A list of such chemicals was introduced from a number of publicly available sources for burn pits and train derailment. The results demonstrated high ocular irritation scores for some chemicals present in these exposure events. Such an analysis is designed to provide guidance related to the needed ophthalmologic care and follow-up in individuals who have been in proximity to burn pits or the train derailment and those who will experience future toxic exposure.

Molecular epidemiology of the Old World screwworm fly (OWSF) in Iraq, and the genetic structure of various OWSF populations worldwide.

Despite being endemic in Iraq, no reports have been published in the past 10 years to update the molecular epidemiology of the Old World screwworm fly (OWSF), Chrysomya bezziana, in this country. In the present study, 130 sheep from 10 Iraqi governorates were found infected with C. bezziana larvae, whose identities were PCR-confirmed based on the cytochrome b (Cytb) gene, and 23 isolates from various tested governorates were successfully sequenced. Although most isolates (n = 20) belonged to the common haplotype circulating in Iraq, two new haplotypes were detected. Significant changes in OWSF epidemiology in Iraq were also suggested, since infestations were detected, for the first time, in Nineveh governorate. Isolates of the present study were combined to those previously published from Iraq and worldwide, collected after searching the GenBank, and various genetic and population structure analyses were conducted. These isolates displayed a great statistically significant value when tested for the purifying (negative) selection, suggesting the limited occurrence of genetic variations, which was evidenced by the high sequence conservation (C = 0.937) value detected. A few isolates from Africa were revealed during our search, and clustered in a separate lineage other than that of the Asian isolates. The latter displayed different genetic variation patterns when compared. For example, isolates from geographically separate regions, e.g., the Gulf Arab countries and South-Eastern Asia had marked genetic differences. On the other hand, isolates from regions with close geographic proximity (the Gulf Arab countries and Iran) had limited genetic subdivision. This is not the case when comparing isolates from 10 islands in the Indonesian Archipelago. Populations from Sumatra and Sumba were isolated and displayed high genetic variations toward the other populations. On the contrary, populations from Sulawesi, Lombok and Sumbawa displayed limited genetic variations. This is particularly important, since it can help detecting the dynamics of establishing the sterile insect technique over various regions as an effective control strategy against the OWSFs.

Knowledge and Attitudes Regarding Depression Among a Sample of Iraqi Non-Psychiatric Nurses: A Cross-Sectional Study.

Introduction: Nurses, comprising the largest profession in healthcare, play a significant role in the identification and management of mental health disorders in hospitals. Objectives: The study assessed the knowledge and attitudes of non-psychiatric nurses and their encounters with depressive patients throughout their careers. Methods: This was a cross-sectional descriptive study with 400 non-psychiatric nurses from different hospitals in the Kurdistan Region of Iraq during October and November 2022. The independent Student's t-test, one-way analysis of variance, and binary logistic regression were used to assess possible factors associated with knowledge and attitude toward depression. Results: In this study, 400 non-psychiatric nurses were examined, revealing a mean age of 31.57 ± 8.59 years. Their mean scores for knowledge and attitude toward depression were 5.41 out of a maximum of 11 (standard deviation 1.15) and 5.15 out of 18 (standard deviation 1.83), respectively. Notably, differences in mean knowledge scores were observed concerning participant marital status (P = .044), while disparities in mean attitude scores are related to participant gender (P = .010). Upon binary logistic regression analysis, none of the independent variables exhibited an association with good knowledge. Nevertheless, gender emerged as a significant factor influencing attitude toward depression (odds ratio: 0.51; 95% confidence interval: 0.30-0.86; P = .012). Subsequently, in the multivariate binary logistic regression analysis, gender sustained significance (adjusted odds ratio: 0.573; 95% confidence interval: 0.348-0.942; P = .028) as the key variable impacting attitudes toward depression among non-psychiatric nurses. Conclusion: Based on the results of this study, nurses have insufficient awareness and management skills for depression. It has been experienced and reported that nurses lack knowledge and an attitude toward depression management. The study highlights a significant gap in nurses' skills for managing depression, urging the immediate improvement of training programs. Customizing these programs to enhance nurses' abilities in identifying and managing depression is crucial.

Prevalence, clinico-epidemiological features, and molecular characterization of bovine papular stomatitis virus in cattle in Iraq.

Bovine papular stomatitis virus (BPSV) is a parapoxvirus that infects cattle, causing skin lesions on the udder and mouth. There have been few studies on the prevalence and molecular characteristics of BPSV in Iraq. Here, we describe the prevalence, phylogenetic analysis, and clinico-epidemiological features of BPSV in cattle in Al-Qadisiyah, Iraq. A total of 264 animals were examined for teat and oral lesions, and BPSV was detected by PCR in 79.9% (211/264) of cattle and calves with skin lesions. The lesions included ulcers, papules, and scabby proliferative areas. The BPSV strains from Iraq clustered phylogenetically with BPSV strains detected in the USA. Further studies are needed to explore the evolution and epidemiology of this virus in the region.

Epidemiological trends, antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah, Iraq.

Dermatophytes show a wide geographic distribution and are the main causative agents of skin fungal infections in many regions of the world. Recently, their resistance to antifungal drugs has led to an obstacle to effective treatment. To address the lack of dermatophytosis data in Iraq, this study was designed to investigate the distribution and prevalence of dermatophytes in the human population and single point mutations in squalene epoxidase gene (SQLE) of terbinafine resistant isolates. The identification of 102 dermatophytes isolated from clinical human dermatophytosis was performed through morphological and microscopic characteristics followed by molecular analysis based on ITS and TEF-1α sequencing. Phylogeny was achieved through RAxML analysis. CLSI M38-A2 protocol was used to assess antifungal susceptibility of the isolates to four major antifungal drugs. Additionally, the presence of point mutations in SQLE gene, which are responsible for terbinafine resistance was investigated. Tinea corporis was the most prevalent clinical manifestation accounting for 37.24% of examined cases of dermatophytosis. Based on ITS, T. indotineae (50.98%), T. mentagrophytes (19.61%), and M. canis (29.41%) was identified as an etiologic species. T. indotineae and T. mentagrophytes strains were identified as T. interdigitale based on TEF-1α. Terbinafine showed the highest efficacy among the tested antifungal drugs. T. indotineae and T. mentagrophytes showed the highest resistance to antifungal drugs with MICs of 2-4 and 4 µg/mL, while M. canis was the most susceptible species. Three of T. indotineae isolates showed mutations in SQLE gene Phe397Leu substitution. A non-previously described point mutation, Phe311Leu was identified in T. indotineae and mutations Lys276Asn, Phe397Leu and Leu419Phe were diagnosed in T. mentagrophytes XVII. The results of mutation analysis showed that Phe397Leu was a destabilizing mutation; protein stability has decreased with variations in pH, and point mutations affected the interatomic interaction, resulting in bond disruption. These results could help to control the progression of disease effectively and make decisions regarding the selection of appropriate drugs for dermatophyte infections.

Characterization of ß-glucan obtained from Candida albicans of caprine mastitis.

Background: Beta-glucan (ß-glucan) is a polysaccharide containing ß-glycosidic bonds that is an important structure part of different yeast cells. Aim: The purpose of the study is to characterize ß-glucan obtained from Candida albicans (C. albicans) isolated from caprine mastitis. Methods: The ß-glucan was extracted by using utilizing an Alkaline-acidic extraction technique. The dry weight of extracted ß-glucan was 7.47/150 g with 4.98%. Results: The findings demonstrated that the extracted ß-glucan had similarity in the primary peak 5.78 of liquid samples using the method of high-performance liquid chromatography when compared to the standard form of ß-glucan. However, scanning electron microscopy studies revealed that the standard of ß-glucan was distinct in morphology but similar to ß-glucan isolated from C. albicans in terms of particle sizes in the range of 1.60-2.65 m and the lack of cell wall traces. The findings of an investigation using energy-dispersive X-ray fluorescence spectroscopy (EDS/EDX) of extracted and standard ß-glucan, showed the principal elements discovered were carbon (C), oxygen (O), and nitrogen (N). Aluminum (Al), silicon (Si), nickel (Ni), and gold (Au) were also present, but in less amounts. Conclusion: The extracted ß-glucan displayed a high degree of similarity and purity to the standard ß-glucan, according to the findings of Fourier transform infrared spectroscopy (FT-IR) research.

Organic geochemistry of the middle Paleozoic Ora Formation in Iraq: Implications for source rock assessment and hydrocarbon potentiality.

The Ora Formation (late Devonian-early Carboniferous) is thought to be a potential source rocks for the Paleozoic petroleum system of Iraq. The source potential from the Ora Formation is evaluated for the first time ever in this study from western and northern Iraq which integrates data from organic geochemistry including Total Organic Carbon (TOC) analysis, HAWK pyrolysis, gas chromatography (GC), and gas chromatography mass spectrometry (GC-MS) and mineralogical X-ray diffraction and scanning electron microscopy. The shale and muddy carbonate succession within the Ora Formation from surface section in northernmost Iraq and subsurface section from two wells (Akkas-1 and Akkas -3) from western Iraq have been employed to assess the source rock potentiality, thermal maturity, kerogen type, organic content, and depositional environment. In addition to organic geochemical analyses, mineralogical XRD and SEM-EDS were used to support the paleoenvironmental interpretation of the Ora Formation. The results from TOC and HAWK analyses reveal that the Ora Formation ranges from poor to good as a source rock. However, the HAWK data suggests that the surface samples from northernmost Iraq are highly mature, highly weathered, or both. Kerogen analysis revealed that the Ora Formation contains immature type III and mixed II-III kerogens. Low TOC values were attributed to factors such as significant clastic input, weathering effects, and the prevailing oxic environment during deposition. The presence of detrital influx of quartz and feldspars, along with the occurrence of illite and kaolinite clay minerals, suggest a detrital input with weathering influence under hot arid and warm humid conditions. Biomarker analysis of the light hydrocarbons using GC and GC-MS revealed that these light hydrocarbons were generated from marine planktonic algae sources, possibly with some contributions from terrestrial and/or microbially reworked organic matter. These high mature light hydrocarbons in subsurface section were originated from anoxic marine shale source rocks. They were most likely from the Cambro-Ordovician Khabour Formation and were contaminated from another source.

Knowledge, attitudes, and practices related to the prevention of adverse pregnancy outcomes among samples of females in Al-Suwaira city, Wasit Governorate, Iraq.

Introduction: Adverse pregnancy outcomes pose serious health risks to both periconceptional women and newborns. This study aimed to investigate the levels of knowledge, attitudes, and practice (KAP) toward adverse pregnancy outcomes among women of reproductive age in Al-Suwaira, Wasit governorate, Iraq. Methods: During November 2021 to February 2022, cross-sectional research of randomly selected women was performed. The KAP was evaluated with a standard, self-administered questionnaire. The outcomes were described using a descriptive analysis. Results: The questionnaire was completed by 118 women. Participants had good knowledge and positive attitudes and practices toward adverse pregnancy outcomes. The findings revealed that the majority of participants were between the ages of 20 and 25 (n = 57, 48.3%) and had a Bachelor's degree (n = 106, 89.8%).Knowledge gaps were discovered in the areas of the danger of pregnancy at a young age of less than 17 years (30.5%), the link between lack of maternal education and poor births (24.6%), and the influence of drug misuse on the fetus (17.8%). The participants learn more around pregnancy-related risk factors via internet (n = 38, 32.2%) and university (n = 34, 28.8%). Conclusions: The participants in this study had good knowledge, positive attitude, and positive practice regarding adverse pregnancy outcomes. However, there were some knowledge gaps. Therefore, to raise awareness among local women, it seems advisable to strengthen and strictly apply awareness-raising plans.

Determining the bacterial and viral meningitis trend in Iraq from 2007 till 2023 using joinpoint regression.

Background: Acute meningitis is a disease with case fatality and disability rate that is dependent on the causative agent. Objective: Determine the meningitis trend in Iraq from 2007 to 2023 using a joinpoint regression at national and sub-national levels and describe the epidemiology. Methods: Joinpoint regression model was used on surveillance data from Jan 2007 until May 2023, to calculate annual and average annual percent changes to determine the trend. Meningitis total count was modelled by year of reporting and province using the log transformation and Poisson variance. Best-fit model was chosen based on the weighted BIC criteria as the final point. Results: Bacterial meningitis was higher than viral meningitis from 2007 to 2018, then viral meningitis started to exceed till 2023. Meningococcal meningitis was lower than other bacterial and viral meningitis from 2007 to 2023. Most meningitis cases across the years were lower than 15 years, at almost 80 %, while 20 %-40 % were lower than one year. Across all years, 55 % of the cases were males; apart from 2019, 70 % were females. Conclusion: In Iraq, viral meningitis has been the predominant type since 2018. Most meningitis patients were lower than 15-year-old males. The meningitis trend in Iraq was stable from 2007 till 2023.

Enhancing Public Health Surveillance: Outbreak Detection Algorithms Deployed for Syndromic Surveillance During Arbaeenia Mass Gatherings in Iraq.

BACKGROUND: Large gatherings often involve extended and intimate contact among individuals, creating environments conducive to the spread of infectious diseases. Despite this, there is limited research utilizing outbreak detection algorithms to analyze real syndrome data from such events. This study sought to address this gap by examining the implementation and efficacy of outbreak detection algorithms for syndromic surveillance during mass gatherings in Iraq. METHODS: For the study, 10 data collectors conducted field data collection over 10 days from August 25, 2023, to September 3, 2023. Data were gathered from 10 healthcare clinics situated along Ya Hussein Road, a major route from Najaf to Karbala in Iraq. Various outbreak detection algorithms, such as moving average, cumulative sum, and exponentially weighted moving average, were applied to analyze the reported syndromes. RESULTS: During the 10 days from August 25, 2023, to September 3, 2023, 12202 pilgrims visited 10 health clinics along a route in Iraq. Most pilgrims were between 20 and 59 years old (77.4%, n=9444), with more than half being foreigners (58.1%, n=7092). Among the pilgrims, 40.5% (n=4938) exhibited syndromes, with influenza-like illness (ILI) being the most common (48.8%, n=2411). Other prevalent syndromes included food poisoning (21.2%, n=1048), heatstroke (17.7%, n=875), febrile rash (9.0%, n=446), and gastroenteritis (3.2%, n=158). The cumulative sum (CUSUM) algorithm was more effective than exponentially weighted moving average (EWMA) and moving average (MA) algorithms for detecting small shifts. CONCLUSION: Effective public health surveillance systems are crucial during mass gatherings to swiftly identify and address emerging health risks. Utilizing advanced algorithms and real-time data analysis can empower authorities to improve their readiness and response capacity, thereby ensuring the protection of public health during these gatherings.

Iraqi Population Trusts in Electronic Healthcare Records: A Cross-sectional Study.

This study investigated the perceptions of Iraqi patients regarding Electronic Healthcare Records (EHRs) in terms of trust and propensity to share and exchange medical and personal information and data within the healthcare ecosystem. During the period of April to June 2022, a researcher-assisted questionnaire was disseminated to adult Iraqi patients attending public or private healthcare facilities in a subset of Iraqi governorates. Data collection was followed by descriptive and inferential analyses. In total, 552 respondents filled out the questionnaire. The findings revealed that 71.6% of respondents were conversant with EHRs and trusted them as data collection and storage systems. In addition, 10% of respondents did not want their EHRs to be shared between healthcare professionals and institutions. However, only 3.6% of participants were willing to share all of their personal information with healthcare professionals. Female respondents were considerably more willing to share their full names with healthcare professionals than male respondents, despite the society's reputation for conservatism. The findings of this study highlighted the necessity of tailoring initiatives to enhance patients' trust in EHRs and their interactions with healthcare professionals other than medical physicians.