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PubMed2003

Perinatal and neonatal mortality and morbidity in Iraq.

Perinatal mortality rates in Iraq have been extremely high during the last 10 years, although detailed data are not available due to inadequate collection of health information during the Gulf conflict and the period of sanction which has continued since August 1990 until the present. The average perinatal mortality rate for Iraq was estimated to be 28 per 1000 live births during the period 1980-90 (the period before sanctions). This rate is similar to the rate in other countries in the region in the same period. The average perinatal mortality rate during the period 1990-1999 is estimated to be 107 per 1000 live births, which is quite high. The important causes of neonatal death are low birth weight, perinatal infections and birth asphyxia due to fetal hypoxia. Many of these deaths can be avoided with simple, practical and affordable interventions, such as a reduction in deaths due to infections by early and exclusive breast feeding, screening and management of communicable diseases, by use of tetanous toxoid and good cord care, and improvement of antenatal care by rebuilding new primary health centers, by the introduction of new equipment for diagnosis and management of birth problems, especially infectious diseases, by the improvement of survival rates of low-birth-weight infants, by a reduction of birth asphyxia with trained birth attendants to monitor labor and to resuscitate infants.

Asphyxia Neonatorum↗

PubMed2005

A population survey of smallpox knowledge, perceptions, and healthcare-seeking behavior surrounding the Iraq invasion--Connecticut 2002-03.

BACKGROUND: Knowledge and perceptions about smallpox would probably influence public behavior following an intentional smallpox release. We assessed public knowledge, perceptions, and related healthcare-seeking behavior in Connecticut during the period of heightened interest in smallpox preparedness surrounding the Iraq invasion. METHODS: Smallpox-related questions were added to Connecticut's Behavioral Risk Factor Surveillance System survey, an ongoing statewide adult population-based survey during December 2002-July 2003 and November-December 2003. RESULTS: Among 4,074 respondents, when asked about a hypothetical febrile illness, 72% would first contact their primary care provider (PCP) on weekdays. During nights and weekends, respondents would depend nearly equally on PCPs and emergency departments (37% versus 36%). Most knew smallpox is transmissible from person to person (72%) but not that the majority infected with smallpox survive (38%) or that smallpox is most contagious after the appearance of rash (11%). Knowledge regarding transmissibility and mortality improved during the study period (p < 0.001). Only 31% recognized that vaccinia vaccine is riskier than routine vaccines; 41% would choose vaccination if available. Concern about smallpox's potential use as a weapon was high but decreased after President Bush declared "mission accomplished" in Iraq in May 2003 (p < 0.001). CONCLUSIONS: Despite national coverage of smallpox by the media, most respondents lacked basic knowledge regarding the disease. Incorrect perceptions regarding vaccinia vaccine's risks could increase inappropriate vaccine demand among nonexposed people with vaccine contraindications during a mass vaccination campaign. Current perceptions should inform future smallpox preparedness planning. In addition, both PCPs and emergency medicine clinicians should be targeted for education regarding smallpox diagnosis.

Adolescent↗

PubMed2005

Seasonality of Old World screwworm myiasis in the Mesopotamia valley in Iraq.

Following the first recorded introduction of the Old World screwworm fly (OWS), Chrysomya bezziana Villeneuve (Diptera: Calliphoridae), into the Mesopotamia valley in Iraq in September 1996, cases of livestock myiasis caused by OWS developed a distinctly seasonal pattern. The annual cycle of clinical OWS cases is explained here on the basis of environmental variables that affect the different life-cycle stages of C. bezziana. This analysis suggests that low temperatures restricted pupal development during the winter, whereas the dispersal of adult flies was constrained by hot/dry summer conditions. A restricted number of OWS foci persisted throughout the year. In these foci, pupal development was fastest during the autumn months. In autumn, rapid multiplication, lasting several OWS generations, allowed subsequent adult fly dispersal across the valley floor during the winter. Hence, the monthly incidence of clinical OWS cases in livestock peaked during December-January and was lowest during July-August. In addition to temperature and humidity, vegetation cover played a role in OWS distribution. Hence the majority of OWS cases were clustered in the medium density type of vegetation [normalized difference vegetation index (NDVI) values of 0.2-0.4] along the main watercourses in the marshy Mesopotamia valley. Although sheep were the host most commonly infested by C. bezziana, local sheep density was not found to be a major factor in disease spread. Satellite imagery and the application of Geographical Information System (GIS) tools were found to be valuable in understanding the distribution of OWS in relation to vegetation and watercourses. The presence of screwworm in Iraq, at the perimeter of the intercontinental OWS distribution, may give rise to major seasonal flare-ups.

Animals↗

PubMed2004

The future of humanitarian action: mapping the implications of Iraq and other recent crises.

In late 2003 the Feinstein International Famine Center, in partnership with institutions in London, Geneva and Washington, organised a series of consultations on the future of humanitarian action post-Iraq. This article is based on those discussions. A number of recurring concerns are elaborated, ranging from the perception of humanitarianism as a Northern-driven and Northern-controlled enterprise, through the politicisation of security and the devaluation of the protective power of emblems, to the very nature of how the crisis in Iraq is perceived. The article explores the implications of such issues for humanitarian workers and their institutions. It concludes by framing an agenda for action by the humanitarian sector.

Afghanistan↗

PubMed2004

Thinking ahead about reproductive health: contingency planning and emergency preparedness in crisis situations (Iraq and West Africa).

The United Nations Population Fund (UNFPA) coordinated efforts to integrate RH into contingency planning for the 2003 Iraq crisis and the 2003 regional response for displaced populations in West Africa. Using UNFPA's network of country offices in the Middle East, staff developed logistics plans, conducted workshops and pre-positioned RH supplies. Though refugee movements did not occur, the contingency planning enhanced the response capacity of UNFPA offices and made it possible to rapidly provide assistance inside Iraq. In West Africa, multi-country workshops and follow-up resulted in country-level and regional action plans useful during the renewed crises of 2003; scarce funding, however, limited their full implementation. UNFPA's experiences show that contingency planning requires committing resources for crises, some of which will not occur; new staff skills; and follow-up. Moreover, RH is considered by some to be additional to the core elements of contingency planning. RH's political sensitivity, particularly with certain donors, further complicated integrated planning.

Africa, Western↗

PubMed2005

Standardising and mapping open-source information for crisis regions: the case of post-conflict Iraq.

Painting an accurate picture of the situation on the ground in countries in crisis is vital for the efficiency of humanitarian aid and reconstruction agencies. This study describes a method for standardising and mapping the plethora of open-source information. The test site for the study is post-conflict Iraq. Important information on aid distribution, reconstruction and security in Iraq can be derived from the reports of humanitarian aid agencies and the media, before being formatted, inserted into a database and mapped. The product is a visual, cartographic structure of otherwise random information, showing which organisations are working in the country, which thematic and geographic areas are being prioritized in the field, and which areas most frequently experience security events. This type of mapping not only highlights the overall working environment within different parts of the country, but it may also serve as a decision-making tool for donors and humanitarian aid agencies planning to deploy personnel.

Decision Making, Organizational↗

PubMed1986

Detection and enumeration of Listeria monocytogenes in a sewage treatment plant in Iraq.

Listeria monocytogenes was isolated from a sewage treatment plant in Baghdad, Iraq, at all stages of treatment. The treatment processes did not yield a sewage sludge cake or a final discharge free of listerias. The agricultural practice of using such sewage products as fertilizers could become a route of spreading the organism in Iraq, particularly by infecting animals that consume vegetation in fields spread with such sewage. Dewatering of sewage reduced the number of L. monocytogenes but long periods of exposure to sun would be needed to obtain a 'safe' sewage sludge cake.

Hydrogen-Ion Concentration↗

PubMed1983

Critical performance analysis of rotating resident doctors in Iraq.

The present study was undertaken to evaluate the competence of rotating residents in handling clinical problems, falling under the purview of the major clinical disciplines, which they come across during their routine work. Three hundred and one rotating residents (55% of the total) who graduated in June 1981 from the four universities of Iraq, namely, Mustansiryia, Basrah, Mosul and Baghdad, and were currently undergoing their residency posting in the various hospitals of Iraq were selected for the study. Two approaches were used to assess the level of competence: first, on the basis of the resident's responses to fifty simulated patient-management problems and, secondly, their critical performance in patient care adjudged by their respective supervisors. A minimum passing level (MPL) was fixed for patient management problems (PMP). The score for the consultant's observations could range from -70 to +100 to represent the very poor and the very good performance. Only 2% of the residents were found to have reached the minimum pass level of competence taking their overall performance in the various disciplines. No significant variation in performance was observed in relation to the university of graduation. None of the residents could reach the MPL in the case of obstetrics and gynaecology. In the case of medicine and medical emergency the findings were almost similar. The residents put up a much better performance in orthopaedics and paediatrics (45.0% and 27.5% respectively). According to the supervisors' assessment nearly two-thirds of the residents secured at least 50% of the maximum score. The study underscores the need to redefine our educational objectives specifically, with aim of developing competences at a defined level in the learner befitting the needs of the health system through a competency-based curriculum.

Clinical Competence↗

PubMed1989

Professional nursing in Iraq.

This paper examines professional nursing in Iraq, with emphasis on selected sociopolitical policies and the role of women. A baccalaureate program in nursing was established at the University of Baghdad in 1963, followed by a masters' program in 1986. Although modernization policies encouraged the development of nursing, the profession was influenced negatively by the restricted role and low status of women in Arab society. Shortly after the ceasefire in the Iran-Iraq war, the professional nursing program was closed by the government. The analysis suggests that nursing leaders have not had access to sources of power through a role in policy making and thus have not been able to ensure the development of the profession.

Education, Nursing, Baccalaureate↗

PubMed1978

Rheumatoid arthritis in population samples in Iraq.

A prevalence survey for rheumatoid arthritis was carried out during the summer of 1975 in persons aged 16 years and over in areas of Iraq representative of differences in geography and ethnicity. Definite rheumatoid arthritis was observed in 1% of the 6999 individuals studied, but differences in occurrence rates in relation to various associated characteristics were not detected. It is concluded that present rheumatological services in Iraq have not developed in response to the magnitude of the existing burden. Morning stiffness was reported fairly frequently by individuals without rheumatoid arthritis, but the significance of this observation is not easy to determine. Raynaud's phenomenon was also recorded, but comparative evaluation of the findings is not possible.

Adolescent↗

PubMed2005

The role of the physician in modern military operations: 12 months experience in Southern Iraq.

OBJECTIVES: To examine the profile of medical morbidity and the role of the physician in modern conflict. METHODS: Retrospective survey of admission records at a British Military Field Hospital on operational duty in Southern Iraq. RESULTS: 62.5% of 4870 admissions to the Field Hospital in Shaibah during the first 12 months of military operations in Iraq were under the care of physicians. Of these 1531 (31.4%) were due to diarrhoea and vomiting (D&V) and 764 (15.7%) due to heat illness. The incidence of heat illness rose with ambient temperature, but soldiers were more likely to be admitted with heat illness shortly after arrival in theatre than when fully acclimatised. There was also a steady flow of admissions with a broad spectrum of medical pathology requiring the clinical skills of a general physician. CONCLUSIONS: A general physician is a necessary part of the clinical team in modern conflict. The incidence of D&V and of heat illness on military operations remains high. Planners for any operation in tropical climates should take this into consideration and put preventative measures into place early.

Health Care Surveys↗

PubMed1980

Glyoxalase I (GLO; EC4.4.1.5): gene frequency variation in Iraq.

472 individuals were studied for the gene frequency variation Glyoxalase I (GLO) in three different regional populations of Iraq. No genetic heterogeneity exists among the three populations of the country but the GLO1 gene in Iraq appears to share European frequency.

Gene Frequency↗

PubMed1982

Carcinoma of the pancreas in Iraq.

This paper presents clinical observations on 130 patients with carcinoma of the pancreas, including 19 with periampullary cancer, the first large study of this disease in Iraq. All of the patients were admitted to the First (one of three) Surgical Unit of the University of Baghdad Teaching Hospital (the Medical City) during the period 1965-1977. The diagnosis and extent of disease were confirmed surgically in all patients. The clinical presentation, histopathologic characteristics, and prognostic features of the disease in Iraq seem no different from those seen in other parts of the world. Though relatively uncommon (1.4% of all male and 1.2% of all female cancers in the Baghdad Cancer Registry), cancer of the pancreas is the second most common tumor of the digestive system, next to that of the stomach.

Adenocarcinoma↗

PubMedDate not supplied

Conjunctival dysplasia in soldiers exposed to mustard gas during the Iraq-Iran war: scrape cytology.

OBJECTIVE: To describe the conjunctival scrape cytology findings in Iraq-Iran war veterans exposed to mustard gas and to detect malignant transformation at an early stage. STUDY DESIGN: Twenty-two male war veterans (29-54 years old) who were exposed to chemical bombing about 14 years earlier, formed the base of this study. All of them had chronic eye problems, such as dryness, conjunctival scarring and decreased visual acuity. Conjunctival scrape cytology was performed for cytologic study. RESULTS: Among 22 cases of conjunctival scarring, 9 were diagnosed as dysplasia. Mild inflammation and squamous metaplasia were also noted. Squamous cell carcinoma was not identified. CONCLUSION: Conjunctival scraping cytology is useful for the diagnosis of dysplasia in soldiers exposed to mustard gas during of the Iraq-Iran war. This method is also effective for follow-up study.

Adult↗

PubMed2006

Mental distress among younger veterans before, during, and after the invasion of Iraq.

OBJECTIVE: The purpose of this study was to determine whether patients receiving care from the Department of Veterans Affairs (VA) reported more mental distress as the war in Iraq began or reintensified compared with other respondents to national health surveys. METHODS: Data from the 2000 and 2003 Behavioral Risk Factor Surveillance System (BRFSS) health surveys were analyzed. Unlike in other years, these particular surveys asked respondents whether they were military veterans. As in other years' surveys, these surveys also asked whether respondents used VA medical care. Male respondents were stratified by age and separated into three groups: VA patients, other veterans, and nonveterans. The proportions of respondents who reported five or more recent days of poor mental or physical health were analyzed with chi square tests. RESULTS: Although the number of recent days of poor mental health among nonveterans, other veterans, and older VA patients were stable from 2000 to 2003, younger VA patients in 2003 reported substantially more days of poor mental health in two intervals: during the Iraq war buildup and invasion, and later, when resistance on the ground reintensified. Comparable changes in physical health complaints were not observed. CONCLUSIONS: In times of war, the VA may anticipate more mental health problems among its current patients, particularly younger veterans.

Adolescent↗

PubMed2005

Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq.

BACKGROUND: The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. METHODS: An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999-2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. RESULTS: The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. CONCLUSION: A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established.

Adult↗

PubMed2005

Acute military psychiatric casualties from the war in Iraq.

BACKGROUND: The view that most military personnel evacuated from war zones are suffering from combat stress reactions, or are otherwise traumatised by the horrors of war, has an impact on all aspects of military psychiatry. AIMS: To delineate the reasons for psychiatric aeromedical evacuation from Iraq from the start of build-up of UK forces in January 2003 until the end of October that year, 6 months after the end of formal hostilities. METHOD: A retrospective study was conducted of field and in-patient psychiatric assessments of 116 military personnel evacuated to the UK military psychiatric in-patient facility in Catterick Garrison. RESULTS: Evacuees were mainly non-combatants (69%). A significant proportion were in reserve service (21%) and had a history of contact with mental health services (37%). Only 3% had a combat stress reaction. In over 85% of cases evacuation was for low mood attributed to separation from friends or family, or difficulties adjusting to the environment. CONCLUSIONS: These findings have implications especially for screening for suitability for deployment, and for understanding any longer-term mental health problems arising in veterans from Iraq.

Acute Disease↗

PubMed2003

Neoechinorhynchus (Neoechinorhynchus) zabensis sp. n. (Acanthocephala: Neoechinorhynchidae) from freshwater fish in northern Iraq.

Neoechinorhynchus (Neoechinorhynchus) zabensis sp. n. (Acanthocephala: Neoechinorhynchidae) is described from Capoeta damascina (Valenciennes, 1842) (type host) and Capoeta trutta (Heckel, 1843) in the Greater and Lesser Zab Rivers, northern Iraq. The new species is unique among all other species of the genus by its characteristic paired para-vaginal muscular appendage and fragmented giant nuclei in the lemnisci. Eleven of the other 88 valid species of Neoechinorhynchus and N. zabensis have middle and posterior hooks of equal length. However, N. zabensis is distinguished from the others by size of trunk, proboscis, proboscis hooks and lemnisci, number of giant nuclei, position of female gonopore, and geographical and host distribution. It is also distinguished from six other species of Neoechinorhynchus previously reported from Iraq. Other distinguishing features are also included.

Acanthocephala↗