Prevalence and antimicrobial resistance profile of Salmonella typhi infection in Iraq, 2019-2021.

INTRODUCTION: Salmonella typhi could infect the intestinal tract and the bloodstream or invade body organs and secrete endotoxins. It is endemic in developing countries. It is increasingly evolving antimicrobial resistance to several commonly used antimicrobial agents. MATERIALS AND METHODS: A cross-sectional study was done at Iraqi Communicable Disease Control Center, where all confirmed cases of Salmonella typhi are reported, for a period 2019-2021. All demographic, epidemiological and clinical characteristics of patients, comorbidities, type of samples, distribution of S. typhi by age and gender, time distribution in each year and profile of bacterial resistance and sensitivity to antibiotics were gathered and analysed. RESULTS: Most samples were taken from blood. The mean age of cases during 2019, 2020 and 2021 was 18.7 ± 6.5, 17.7 ± 14.1 and 17.3 ± 12.8. Males constituted 56.7%, 58.5% and 39.8%, respectively. Some cases had comorbidities. Most cases had headache and fever. Some of them had nausea, diarrhoea, vomiting and epigastric pain. The age and sex were significantly associated with years of reporting. The most months of case reporting were June-July (2019 and 2021), Jan. -Feb. (2020). There was an obvious increase in S. typhi resistance to ceftriaxone (92.2%, 86.1%, 88.8%) and ampicillin (77.1%, 76.9%, 81.27%). There was a gradual increase in sensitivity to tetracycline (83.1%, 88.1%, 94%), cotrimoxazole (86.7%, 86.1%, 92.2%), ciprofloxacin (78.3%, 90.1%, 87.8%) and cefixime (77.7%, 72.3%, 72.7%). CONCLUSIONS: There was a sharp rise in resistance rates of the S. typhi in Iraq (during 2019-2021) to ceftriaxone and ampicillin, while there were highest sensitivity rates to imipenem, aztreonam and chloramphenicol. The following recommendations were made: (1) Improvement of general hygiene and food safety measures. (2) Emphasis on vaccination and surveillance of Salmonella infection. (3) Rational use of appropriate antibiotics through implementation of treatment guidelines. (5) Educate communities and travelers about the risks of S. typhi and its preventive measures.

The association between COVID-19 and atopy in Baghdad, Iraq, 2022.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has high morbidity and mortality especially in preexisting risk groups. In atopic diseases the IgE and eosinophils are commonly elevated. This study aims to determine the potential association between COVID-19 and atopic diseases in Iraqi patients. MATERIALS AND METHODS: A cross-sectional study done in Baghdad on 112 patients who attended Al-Zahraa Allergic Center. Their demographic characteristics, total IgE, eosinophil counts and PCR result for COVID-19 were determined. RESULTS: The means for IgE and eosinophils were 245.7±260.1IU/ml and 444.5±117.1cells/microliter sequentially. Around 32.1% had high IgE level (i.e., atopic) and 11.6% had COVID-19. Among the atopic patients, 33.3%, 30.5% and 36.2% had atopic dermatitis, allergic rhinitis and asthma respectively. More than half (58.3%) of them were male, 55.5% aged <45 years, 36.2% were retired or had no job, 69.5% were graduated from secondary school or more and 88.8% lived in urban areas. There is no significant association in IgE level between those with and without COVID-19, which means that exposure to SARS Cov2 virus could not be a trigger or exacerbation for atopic diseases. Also, there was no association between atopic patients with COVID-19 and those without it regarding type of atopy, age, sex, occupation, education, type of living area. CONCLUSIONS: Atopy is not a risk factor for COVID-19.

The prevalence and correlates of intermittent explosive disorder in Iraq.

OBJECTIVE: Intermittent explosive disorder is common, begins early in life, and is associated with considerable impairment in the United States. The epidemiology of IED outside the United States is unknown. We examined the prevalence and correlates of IED in Iraq, where exposure to violence has been widespread during the last three decades. METHOD: Data were drawn from a national survey of the Iraq population, the Iraq Mental Health Survey (IMHS), conducted in 2006-2007. The WHO Composite International Diagnostic interview was used to assess DSM-IV disorders, including IED. The response rate was 95.2%. RESULTS: Lifetime and 12-month prevalence estimates of IED were 1.7% and 1.5%. Mean age of onset was 18.5. The mean number of lifetime attacks was 141.6 attacks, and IED-related injuries occurred 61 times per 100 lifetime cases. IED was significantly comorbid with mood and anxiety, but not substance, disorders. CONCLUSION: Although the prevalence of IED is lower in Iraq than in the United States, the disorder has an early age of onset, is highly persistent, and is associated with substantial comorbidity and functional impairment. Iraq lacks national policies or systematic programmes to reduce aggression, highlighting the importance of implementing violence prevention programmes to reduce the societal burden of violence in Iraq.

Prevalence of skin disorders among primary-school children in Baghdad governorate, Iraq.

To determine the prevalence of skin diseases among primary-school children in Baghdad, Iraq, a total of 2160 schoolchildren were randomly selected from 30 primary schools. Sociodemographic data were collected from each pupil and exposed parts of the body of each child were clinically examined. The overall prevalence of skin diseases was 40.9%. A significant association between the prevalence of skin diseases with education level of parents was demonstrated. The prevalence rates of transmissible and nontransmissible skin diseases were 8.8% and 33.7% respectively. The high prevalence rate may reflect prevailing low socioeconomic conditions.

Viral hepatitis E outbreak in Al-Sadr city, Baghdad, Iraq.

Hepatitis E virus (HEV) is a major cause of acute hepatitis in many developing countries. This study describes an outbreak of HEV infection in Al-Sadr city, Baghdad. Blood samples obtained from patients with jaundice attending 19 primary health care centres in AI-Sadr city during a 6-month period in 2005 were tested for HEV. HEV (IgM) antibodies were detected in 38.1% of 268 patients. The association of HEV infection with unacceptable residual chlorine concentrations and/or bacteriologically unsafe water samples was significant. High rates of HEV infection, low chlorine concentrations and unsafe water were reported in June. Gross isruption of sanitation and water supplies was the most likely contributing factor.

Viral hepatitis E outbreak in Al Sadr city, Baghdad, Iraq

Hepatitis E virus [HEV] is a major cause of acute hepatitis in many developing countries. This study describes an outbreak of HEV infection in Al-Sadr city, Baghdad. Blood samples obtained from patients with jaundice attending 19 primary health care centres in Al-Sadr city during a 6-month period in 2005 were tested for HEV. HEV [IgM] antibodies were detected in 38.1% of 268 patients. The association of HEV infection with unacceptable residual chlorine concentrations and/or bacteriologically unsafe water samples was significant. High rates of HEV infection, low chlorine concentrations and unsafe water were reported in June. Gross disruption of sanitation and water supplies was the most likely contributing factor

Prevalence of skin disorders among primary-school children in Baghdad governorate, Iraq

To determine the prevalence of skin diseases among primary-school children in Baghdad, Iraq, a total of 2160 schoolchildren were randomly selected from 30 primary schools. Sociodemographic data were collected from each pupil and exposed parts of the body of each child were clinically examined. The overall prevalence of skin diseases was 40.9%. A significant association between the prevalence of skin diseases with education level of parents was demonstrated. The prevalence rates of transmissible and nontransmissible skin diseases were 8.8% and 33.7% respectively. The high prevalence rate may reflect prevailing low socioeconomic conditions

Effect of surgical removal of hydatid cyst on echinococcus-specific and polyclonal IgE antibodies: An aid for postoperative follow-up studies.

To evaluate the significance of IgE antibodies in postoperative follow-up studies of patients with primary hydatidosis, 24 patients with detectable levels of Enchinococcus granulosus-specific IgE as determined by radioallergosorbent test (RAST) were re-examined one month and four months after surgical resection of the cyst. Serum levels of polyclonl IgE as determined by paper radiommunosorbent test (PRIST) were also determined before and after surgery. Anti-Enchinococcus IgE was undetected in 75% and 89% of patients with hepatic or pulmonary hydatidosis, respectively, four months after surgery. In addition, significant decline was observed in the serum polyclonal IgE four months after surgical removal of the cyst in both hepatic and pulmonary hydatidosis. However, surgical removal of pulmoary cyst alone showed no such effect on either polyclonal or Enchinococcus-specific IgE in hepatopulmonary hydatidosis. The results suggest that determination of specific an polyclonal IgE antibodies provide useful serological tests for prognosis and early detection of persistence and recurrence of hydatid disease postoperatively.