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PubMed1992

The prevalence of Echinococcus granulosus in stray dogs in Iraq.

The present paper records the prevalence of Echinococcus granulosus in stray dogs of Al-Tamim (northern Iraq), Diala (mid Iraq) and Theqar province (southern Iraq), where many people are infected with hydatid disease. Of 150 dogs examined in three provinces in Iraq, 57 (38%) were infected with E. granulosus. The prevalence of the worm was higher in the dogs of Theqar province (56%) than in those of Al-Tamim (20%) and Diala Provinces (38%). Infections were light (1-200 worms) in eight (14%) of the infected dogs, medium (201-1000 worms) in 14 (24.6%) and high (over 1000 worms) in 35 (61.4%). The mean worm burden was 1844 and the maximum number of worms was 15,182 recorded in a male dog from Theqar province. The reasons for such a high rate of infection in the dogs are discussed.

Animals↗

PubMed2004

Leishmaniasis among soldiers of stabilization forces in Iraq. Review article.

The results of studies concerning the incidence of leishmaniasis among soldiers of Stabilization Forces serving in Iraq in the years from 2003 to March 2004 are presented in this article, in the light of a possibility of importation of this disease to the countries of their origin. Epidemiology, clinical picture, laboratory diagnosis, treatment and prevention of leishmaniasis are described. In mid-2004, more than 2400 Polish soldiers served in Iraq. By the end of June 2004 no case of leishmaniasis was diagnosed among them. Among American troops serving in Iraq, 653 cases of cutaneous and 2 cases of visceral leishmaniasis were reported by the end of March 2004. According to the U.S. sources, the number of infected American soldiers could have been higher, from 750 to 1250 or even more, what made up to nearly 1% of U.S. troops serving in Iraq in 2003-2004.

Humans↗

PubMed1997

Iraq's biological weapons. The past as future?

Between 1985 and April 1991, Iraq developed anthrax, botulinum toxin, and aflatoxin for biological warfare; 200 bombs and 25 ballistic missiles laden with biological agents were deployed by the time Operation Desert Storm occurred. Although cause for concern, if used during the Persian Gulf War, Iraq's biological warfare arsenal probably would have been militarily ineffective for 3 reasons: (1) it was small; (2) payload dispersal mechanisms were inefficient; and (3) coalition forces dominated the theater of war (ie, they had overwhelming air superiority and had crippled Iraq's command and control capability). Despite the Gulf War defeat, the Iraqi biological warfare threat has not been extinguished. Saddam Hussein remains in power, and his desire to acquire weapons of mass destruction continues unabated. In this context, the international community must be firm in its enforcement of United Nations resolutions designed to deter Iraq from reacquiring biological warfare capability and must take steps to develop a multidisciplinary approach to limiting future development of weapons of mass destruction.

Aflatoxins↗

PubMed2003

Prevalence rates of viral hepatitis infections in refugee Kurds from Iraq and Turkey.

BACKGROUND: Since little is known about the burden of viral hepatitis in Kurds, the prevalence of infection with hepatitis A virus (HAV), hepatitis E virus (HEV), hepatitis B virus (HBV) and hepatitis C virus (HCV) was investigated in a sample of refugee Kurds from Iraq and Turkey. PATIENTS AND METHODS: A cross-sectional study was carried out. Serological markers to hepatitis viruses were determined for 1,005 subjects from all age-groups of which 36.6% were from Turkey and 63.4% from Iraq. RESULTS: Overall seroprevalence for anti-HAV was 94.4% and 14.8% for anti-HEV. A significantly higher prevalence for anti-HEV was found among Iraqis (17.5%) compared to Turkish immigrants (10.0%). The prevalence of hepatitis B surface antigen (HBsAg) and total anti-HBc (core) was 6.8% and 35.6% in Turkish Kurds and 2.2% and 12.7% in Iraqis, respectively. Only 10% of children aged up to 10 years and 2.8% of subjects aged 11-20 years had been vaccinated against HBV, the majority of them coming from Iraq. One subject was confirmed as positive for anti-HCV (0.1%) and HCV-RNA and analysis showed a 4c/4d genotype. CONCLUSION: This survey shows a high prevalence of enterically transmitted viral hepatitis in Kurds. HBV infection is moderately endemic, while the prevalence of HCV infection is low. There is a need for a universal immunization strategy for HBV in the Kurd population.

Adult↗

PubMed1980

Serum protein levels in Iraq.

Since some serum protein levels in Iraq appear to differ from those accepted for European populations, normal standards for Iraq adults were sought. The sample comprised 1,031 subjects who were examined for the following: IgG, M, A and E; the components C3, C4 and C3 proactivator of complement; alpha 2 globulin, albumin and total protein. The mean levels show some differences from those in European sera. Differences occur between various peoples and regions of Iraq, and reasons for these are suggested.

Adult↗

PubMed2000

Sanctions and childhood mortality in Iraq.

BACKGROUND: In 1999 UNICEF, in cooperation with the government of Iraq and the local authorities in the "autonomous" (northern Kurdish) region, conducted two similar surveys to provide regionally representative and reliable estimates of child mortality (the subject of this paper) and maternal mortality. METHODS: In a cross-sectional household survey in the south/centre of Iraq in February and March, 1999, 23105 ever-married women aged 15-49 years living in sampled households were interviewed by trained interviewers with a structured questionnaire that was developed using the Demographic and Health Surveys questionnaire and following a pre-test. In a similar survey in the autonomous region in April and May 14 035 ever-married women age 15-49 were interviewed. FINDINGS: In the south/centre, infant and under-5 mortality increased during the 10 years before the survey, which roughly corresponds to the period following the Gulf conflict and the start of the United Nations sanctions. Infant mortality rose from 47 per 1000 live births during 1984-89 to 108 per 1000 in 1994-99, and under-5 mortality rose from 56 to 131 per 1000 live births. In the autonomous region during the same period, infant mortality declined from 64 to 59 per 1000 and under-5 mortality fell from 80 to 72 per 1000. Childhood mortality was higher among children born in rural areas, children born to women with no education, and in boys, and these differentials were broadly similar in the two regions. INTERPRETATION: Childhood mortality clearly increased after the Gulf conflict and under UN sanctions in the south/centre of Iraq, but in the autonomous region since the start of the Oil-for-Food Programme childhood mortality has begun to decline. Better food and resource allocation to the autonomous region contributed to the continued gains in lower mortality, whereas the situation in the south/centre deteriorated despite the high level of literacy in that region.

Adolescent↗

PubMedDate not supplied

Mortality before and after the 2003 invasion of Iraq: cluster sample survey.

BACKGROUND: In March, 2003, military forces, mainly from the USA and the UK, invaded Iraq. We did a survey to compare mortality during the period of 14.6 months before the invasion with the 17.8 months after it. METHODS: A cluster sample survey was undertaken throughout Iraq during September, 2004. 33 clusters of 30 households each were interviewed about household composition, births, and deaths since January, 2002. In those households reporting deaths, the date, cause, and circumstances of violent deaths were recorded. We assessed the relative risk of death associated with the 2003 invasion and occupation by comparing mortality in the 17.8 months after the invasion with the 14.6-month period preceding it. FINDINGS: The risk of death was estimated to be 2.5-fold (95% CI 1.6-4.2) higher after the invasion when compared with the preinvasion period. Two-thirds of all violent deaths were reported in one cluster in the city of Falluja. If we exclude the Falluja data, the risk of death is 1.5-fold (1.1-2.3) higher after the invasion. We estimate that 98000 more deaths than expected (8000-194000) happened after the invasion outside of Falluja and far more if the outlier Falluja cluster is included. The major causes of death before the invasion were myocardial infarction, cerebrovascular accidents, and other chronic disorders whereas after the invasion violence was the primary cause of death. Violent deaths were widespread, reported in 15 of 33 clusters, and were mainly attributed to coalition forces. Most individuals reportedly killed by coalition forces were women and children. The risk of death from violence in the period after the invasion was 58 times higher (95% CI 8.1-419) than in the period before the war. INTERPRETATION: Making conservative assumptions, we think that about 100000 excess deaths, or more have happened since the 2003 invasion of Iraq. Violence accounted for most of the excess deaths and air strikes from coalition forces accounted for most violent deaths. We have shown that collection of public-health information is possible even during periods of extreme violence. Our results need further verification and should lead to changes to reduce non-combatant deaths from air strikes.

Adolescent↗

PubMed2006

The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study.

BACKGROUND: Concerns have been raised about the mental and physical health of UK military personnel who deployed to the 2003 war in Iraq and subsequent tours of duty in the country. METHODS: We compared health outcomes in a random sample of UK armed forces personnel who were deployed to the 2003 Iraq war with those in personnel who were not deployed. Participants completed a questionnaire covering the nature of the deployment and health outcomes, which included symptoms of post-traumatic stress disorder, common mental disorders, general wellbeing, alcohol consumption, physical symptoms, and fatigue. FINDINGS: The participation rate was 62.3% (n=4722) in the deployed sample, and 56.3% (n=5550) in the non-deployed sample. Differences in health outcomes between groups were slight. There was a modest increase in the number of individuals with multiple physical symptoms (odds ratio 1.33; 95% CI 1.15-1.54). No other differences between groups were noted. The effect of deployment was different for reservists compared with regulars. In regulars, only presence of multiple physical symptoms was weakly associated with deployment (1.32; 1.14-1.53), whereas for reservists deployment was associated with common mental disorders (2.47, 1.35-4.52) and fatigue (1.78; 1.09-2.91). There was no evidence that later deployments, which were associated with escalating insurgency and UK casualties, were associated with poorer mental health outcomes. INTERPRETATION: For regular personnel in the UK armed forces, deployment to the Iraq war has not, so far, been associated with significantly worse health outcomes, apart from a modest effect on multiple physical symptoms. There is evidence of a clinically and statistically significant effect on health in reservists.

Cohort Studies↗

PubMed1983

Different aetiology of chronic active hepatitis in U.K. and Iraq.

We have compared the clinical, biochemical and immunological features of patients with biopsy-proven chronic active hepatitis from Iraq and from the United Kingdom. Clear-cut differences emerge, which can mostly be attributed to the HBV status, as 91% of patients from Iraq were HBsAg-positive compared to only 6% from the U.K. Most patients from Iraq presented insidiously with established cirrhosis, while those from the U.K. presented more acutely and systemic symptoms were more common. Autoantibodies and associated autoimmune conditions were common in U.K. patients but extremely rare in Iraqis.

Adult↗

PubMed2006

Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study.

OBJECTIVE: To assess whether screening for mental disorder before the start of the 2003 Iraq war would have predicted subsequent mental disorders. DESIGN: Longitudinal cohort study of the United Kingdom armed forces. PARTICIPANTS: 2820 of 2873 personnel of the three services who completed an initial questionnaire in 2002 were asked to complete a second questionnaire between June 2004 and 2 March 2006. SETTING: Regiments, air stations, bases, ships, and homes for those who had left the services. MAIN OUTCOME MEASURES: Positive and negative likelihood ratios, and positive and negative predictive value of first assessment compared with assessment two to three years later of post-traumatic stress disorder, general health questionnaire, physical symptoms, self perception of health, and alcohol misuse for the entire group and for those deployed to the Iraq war. RESULTS: The response rate to the follow-up questionnaire was 69%, adjusted for return to senders. The positive likelihood ratio of post-traumatic stress disorder was high (13.1, 95% confidence interval 7.2 to 23.8), but the negative likelihood ratio was close to 1 (0.78, 0.67 to 0.91). The positive predictive values were low because of the low prevalence of post-traumatic stress disorder in the period before the Iraq war. The positive likelihood ratios for the other psychological assessments varied between 2.7 and 5.6, and the negative likelihood ratios were slightly lower than for post-traumatic stress disorder, indicating that these were not good candidates for screening. Results were the same for the analyses restricted to those who were deployed. CONCLUSIONS: Screening for common mental disorders before deployment in this cohort would not have reduced subsequent morbidity or predicted post-traumatic stress disorder, but this may change if there is a considerable increase in the prevalence of the disorder.

Cohort Studies↗

PubMed2007

Association of posttraumatic stress disorder with somatic symptoms, health care visits, and absenteeism among Iraq war veterans.

OBJECTIVE: Studies of soldiers from prior wars conducted many years after combat have shown associations between combat-related posttraumatic stress disorder (PTSD) and physical health problems. The current Iraq war has posed a considerable PTSD risk, but the association with physical health has not been well studied. METHOD: The authors studied 2,863 soldiers using standardized self-administered screening instruments 1 year after their return from combat duty in Iraq. RESULTS: Among all participants, 16.6% met screening criteria for PTSD. PTSD was significantly associated with lower ratings of general health, more sick call visits, more missed workdays, more physical symptoms, and high somatic symptom severity. These results remained significant after control for being wounded or injured. CONCLUSIONS: The high prevalence of PTSD and its strong association with physical health problems among Iraq war veterans have important implications for delivery of medical services. The medical burden of PTSD includes physical health problems; combat veterans with serious somatic concerns should be evaluated for PTSD.

Absenteeism↗

PubMed2005

On the eve of war: authoritarianism, social dominance, and American students' attitudes toward attacking Iraq.

In the week before the 2003 American attack on Iraq, the effects of authoritarianism and the social dominance orientation on support for the attack were examined. Based on prior research on the nature of these constructs, a structural model was developed and tested. As predicted, authoritarianism strengthened support for the attack by intensifying the perception that Iraq threatened America. Social dominance increased support by reducing concern for the likely human costs of the war. Both also increased blind patriotism, which in turn reduced concern for the war's human costs and was reciprocally related to the belief that Iraq threatened America.

Adolescent↗

PubMed1999

Outbreak of poliomyelitis--Iraq, 1999.

Since May 1999, 86 cases of acute flaccid paralysis (AFP) have been reported in Iraq. Sixteen cases with onset during May-July have been confirmed as paralytic poliomyelitis by isolation of wild poliovirus type 1; the remaining cases are either negative, pending virus isolation (n=10), or positive for type 1 poliovirus with intratypic differentiation pending (n=nine). The first confirmed case occurred in a person residing in Ninevah governorate in the northern part of the country; subsequently, confirmed cases were reported from nine of the 18 governorates in Iraq, suggesting widespread transmission of poliovirus. Before this outbreak, the last confirmed cases of wild polioviruses occurred in Iraq during April-May 1997.

Disease Outbreaks↗

PubMed2000

The use of reed plants for wastewater treatment: the Iraq experience.

The use of plants, especially of species that grow naturally and under harsh environmental conditions, offers a simple and economic method of wastewater treatment. This method has been gaining wide popularity throughout the world over the last decades. Iraq is considered to be a country with environmental conditions favourable for the natural growth of many aquatic plants such as reed (Qassab). The root-zone method of treating wastewater is suitable for Iraq, e.g. because of its economy and the fact that such treatment does not need sophisticated mechanical or electrical equipment, or chemical materials. The most important aspect is that this method makes use of a weed, namely the reed. A mobile test tank for root-zone treatment stationed in the Rustamya sewage treatment plant and run for nearly 34 weeks. A total of 768 samples of the influent and effluent sewage were analysed. Average removal efficiencies for biological oxygen demand, suspended solids, chloride, phosphate and ammonia ranged from 92 to 82%, and chloride was removed with 13% efficiency. These results indicate that the root-zone method is adequate for the treatment of domestic sewage and can compete with conventional treatment methods whose average effluent concentrations for BOD5 and suspended solids are similar. A survey of water quality was conducted on a drainage ditch north-west of Baghdad to assess its natural purification process. The ditch that was chosen was infested with reed plants and other aquatic weeds. The role of the macrophytes was found to be essential in the process of self-purification of the water body. Results of the survey indicate that such ditches and streams could be used as disposal points for domestic sewage and industrial wastes. However, further assessment of their performance particularly for removal of suspended solids, pathogens, phosphate and nitrogen is necessary. The results indicate that reed beds may be suitable particularly for treatment of wastewater from small and remote towns and villages in Iraq.

Developing Countries↗

PubMed1976

Poisoning caused by the consumption of organomercury-dressed seed in Iraq.

In 1971-72, a large outbreak of poisoning caused by the consumption of seed dressed with organomercury compound occurred in Iraq. International assistance was requested by the Government of Iraq in investigating this outbreak. The results of the investigations to date were presented at the Conference on Intoxication due to Alkylmercury Treated Seed, held in Baghdad, Iraq on 9-13 November 1974. This paper summarizes the main findings and recommendations of the Conference.

Disease Outbreaks↗

PubMed2005

[Medical support for northern Iraq].

I had a chance to visit northern Iraq, as a member of a medical support program for Sulaimany Teaching Hospital in northern Iraq. Medical equipment and supply to the hospital had improved, comparing to the condition ten years before just after the Gulf War. What Iraqi doctors need now is to obtain new medical information or technique, which they could not absorb during the last ten years under economic sanctions. In anesthetic field, my activity was mainly to teach regional anesthesia or regional block, because Iraqi anesthetists have enough knowledge in anesthesiology. Similar support is necessary for all of Iraq.

Anesthesia, Conduction↗

PubMed1988

A general survey of blood and tissue parasites of some rodents in Arbil province, Iraq.

In a survey of blood and tissue parasites from 233 mice and rats, consisting of 105 specimens of house mice (Mus musculus), 99 black rats (Rattus rattus), and 29 Norway rats (Rattus norvegicus), collected from different localities of Arbil province, northern Iraq, Trypanosoma lewisi was found in 7 (7.07%) of 99 R. rattus and in 5 (17.86%) of 29 R. norvegicus, while Trypanosoma musculi was found in 4 (3.80%) of 105 M. musculus and this is the first record of this trypanosome from rodents in Iraq. During the preparation of tissue impression smears we came across 2 specimens of Fasciola hepatica in the livers of 2 R. norvegicus and the incidence of infection was 6.89%. Examination of other organs revealed no parasites. F. hepatica which is recorded, in the present study, for the first time from rodents in Iraq, is of particular importance since it infects both humans and domestic animals.

Animals↗

PubMed1972

Glucose-6-phosphate dehydrogenase deficiency among ethnic groups in Iraq.

A total of 889 cord blood samples collected from newborn infants of both sexes and 563 samples of venous blood collected from adult males in Iraq were examined for evidence of glucose-6-phosphate dehydrogenase (G6PD) deficiency. The deficiency was proved to exist in all ethnic groups in Iraq and in both adult males and infants. The overall incidence of the deficiency was 8.9% in the adults and 8.4% in the infants. The difference is not statistically significant. Evidence is given to suggest that favism ("khsaissa") is known to the people of southern Iraq.

Adolescent↗