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1.
BMC Public Health ; 19(1): 1687, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842837

RESUMO

BACKGROUND: Adverse childhood experiences (ACEs) are considered as universal public health problem that associate with mental disorders and risky behaviors during adulthood. The aims of the paper are to estimate the prevalence of Adverse childhood experiences (ACEs) among young adults in Iraq as well as to estimate the association between ACEs and depression. METHODS: A convenience sample of young adults of 18-20 years was chosen from centre and west of Iraq, mainly from universities. The adverse childhood experiences were measured by Adverse Childhood Experiences Questionnaire. A depression scale was derived from the Depression, Anxiety and Stress Scales (DASS). Statistical tests: chi square was used to measure the association between adverse childhood experiences and other variables like gender and depression. Odds ratios were computed to estimate the risk for depression. A P value of less than 0.05 was considered statistically significant. RESULTS: The total number of participants was 401, 38.9% of the subjects were men, while 61.1% were women. The mean age of the participants was 18.88 ± 0.745. The results revealed that the most common forms of ACEs among the subjects were physical neglect (19.8%) and emotional neglect (19.2%) followed by physical abuse (17.21%) while sexual abuse was 7.52%. There was statistically significant association between most forms of adverse childhood experiences especially emotional abuse, emotional neglect, physical abuse and physical neglect with depression. CONCLUSION: ACEs are not uncommon among young adults in Iraq and are associated with depression in adulthood. National programmes to support mental health rehabilitation might be necessary to reduce the effect of ACEs among Iraqi people, especially for adolescents and young adults.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Depressão/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Iraque/epidemiologia , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
2.
Int J Infect Dis ; 89: 102-109, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31560993

RESUMO

BACKGROUND: The 2003 invasion of Iraq significantly undermined population health. However, there is a lack of understanding of how it undermined communicable disease control. This study was performed to assess the incidence trends of 32 communicable diseases in post-conflict Iraq. METHODS: Reported incidence data for 32 communicable diseases (2004-2016) were collected from routine reports sent to the Iraqi Ministry of Health by primary health centers, and general and tertiary hospitals. Incidence (per 100 000) was defined as the number of reported incident cases divided by the population size. Joinpoint regression was used to examine the incidence trends and average annual percentage change (AAPC) for each disease, and the overall incidence rate across the period. RESULTS: Communicable diseases increased significantly during the peak years of the war, especially during the US troop surge period (2007-2009). As US troops withdrew (after 2011), overall communicable diseases decreased. The incidence rate of nearly half of the 32 diseases decreased significantly, while the incidence rate of five increased significantly (hepatitis A, varicella, viral meningitis, cutaneous leishmaniasis, extrapulmonary tuberculosis). CONCLUSIONS: The early foundational strength of Iraq's health system may help explain why infectious disease failed to overwhelm the population following the invasion. Iraq's federal government could exercise its legal authority to manage threats to public health security by expanding the disease surveillance system.


Assuntos
Doenças Transmissíveis/epidemiologia , Conflitos Armados , Controle de Doenças Transmissíveis/organização & administração , Doenças Transmissíveis/diagnóstico , Humanos , Iraque/epidemiologia , Saúde Pública
3.
BMC Res Notes ; 12(1): 491, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391105

RESUMO

OBJECTIVES: The purpose of this study to determine the clinical pattern and prevalence of heart disease in pregnancy at the first established cardio-maternal unit in Iraq over the last 4 years; since January 2015 till May 2019. Data are presented as number and percentage. RESULTS: A total of 252 pregnant women presented to cardio-maternal unit included in this study. According to the collected data, among the main diagnosis of heart disease during pregnancy was valvular heart disease 34.1%, followed by congenital heart disease 30.5%, cardiomyopathy 29.8%, pulmonary hypertension 4%, and ischemic heart disease 1.6%. Among subtypes of the main heart diseases in pregnant women, the most clinical pattern was: the prosthetic heart valve (26.7%) in valvular heart disease, both atrial septal defect and ventricular septal defect (35%) in congenital heart disease, and peripartum cardiomyopathy (76%) among cardiomyopathies.


Assuntos
Cardiomiopatias/epidemiologia , Comunicação Interatrial/epidemiologia , Comunicação Interventricular/epidemiologia , Doenças das Valvas Cardíacas/epidemiologia , Hipertensão Pulmonar/epidemiologia , Isquemia Miocárdica/epidemiologia , Complicações Cardiovasculares na Gravidez/epidemiologia , Adulto , Cardiomiopatias/diagnóstico , Feminino , Comunicação Interatrial/diagnóstico , Comunicação Interatrial/cirurgia , Comunicação Interventricular/diagnóstico , Comunicação Interventricular/cirurgia , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas/estatística & dados numéricos , Unidades Hospitalares , Humanos , Hipertensão Pulmonar/diagnóstico , Iraque/epidemiologia , Isquemia Miocárdica/diagnóstico , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/cirurgia , Prevalência
4.
East Mediterr Health J ; 25(5): 315-321, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31364756

RESUMO

Background: Reliable and valid information on trends of mortality and common causes of death is essential to guide priorities for the allocation of resources within the health sector in order to improve health services for the population, increase longevity and improve quality of life. Aims: This study aimed to determine crude, gender, age and cause specific death rates and to examine mortality trends in a five-year period between 2007 and 2011 in Erbil City, Iraq. Methods: This study researched 16 780 deaths registered at the statistical unit of the Directorate of Health, Irbil City. Data were reviewed and cleared for the purpose of analysis. Causes of deaths were classified according to body systems. Results: The average crude death rate was 3.1 per 1000 population with male predominance over females in all the years of study (3.5 and. 2.7, respectively). The age-specific death rates were high in the old and middle age groups in addition to the under 5 years age group. Accidents and circulatory diseases were the leading causes of deaths with rates of 65.2 and 58.3/100 000 population, respectively. Conclusions: An accurate identification of cause of death suggests that the only use of the death certificate in Erbil is for the purpose of burial and legal issues, and therefore it is imperative for educational efforts to achieve a complete and comprehensive death registration.


Assuntos
Mortalidade/tendências , População Urbana , Adolescente , Adulto , Idoso , Causas de Morte , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Lactente , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Asian Pac J Cancer Prev ; 20(8): 2339-2343, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450904

RESUMO

Cancer is responsible for substantial burden on communities and more specifically on less developed countries. The incidence of cancer is on the rise due to population growth and aging, also due to increment of the risk factors such as smoking, increasing weight, low physical activity associated with adoption of western lifestyle. Around 14 million cases of new cancer and 8 million deaths from cancer is estimated to occur by 2012. This cross-sectional study was conducted in Baghdad from June 2016 to October 2016. Participants were selected according to our inclusion criteria, namely aged between 18 to 40 years and not being diagnosed with any chronic diseases. Those who fulfilled the inclusion criteria were 700 participants who completed the questionnaire. Results showed that most of our participants had low perceived susceptibility to cancer risk (62.4%), low perceived severity (59.8%), but good perceived benefits of screening (56.6%). Hierarchal linear regression analysis showed that sociodemographic factors of gender, marital status, and education level were statistically significant. Moreover, factors of health behaviour such as practice towards health and preventive behaviour were associated with the outcome. Finally, treatment control and emotional factors were mostly predicting the outcome. Perceived susceptibility to cancer along with its psychological factors and behaviour were important contributors to self-perceived health in this study. Hence there is association between perception and future morbidity and mortality, thus it is crucial for public health policy. Comprehensive health programs that include health promotion campaigns and proper health care services that deals with secondary prevention.


Assuntos
Suscetibilidade a Doenças/psicologia , Detecção Precoce de Câncer/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estilo de Vida , Neoplasias/psicologia , Adolescente , Adulto , Estudos Transversais , Exercício , Feminino , Seguimentos , Humanos , Incidência , Iraque/epidemiologia , Masculino , Morbidade , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Percepção , Projetos Piloto , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
6.
J Res Health Sci ; 19(2): e00445, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31278219

RESUMO

BACKGROUND: An escalation, as three times more, had been recognized in cases of hepatitis A (HAV) from 2009 to 2014 among Iraqi people. Regarding hepatitis B and C, Iraq is considered as a low endemic country comparing to neighbors. STUDY DESIGN: A retrospective cohort study. METHODS: Data incorporated from 2007 to 2016 were collected through a federal survey conducted by the Health Directorate of Karbala, who administrates all hospitals (three public hospitals and five private hospitals) and 40 health centers in Karbala City, Iraq. The four types of hepatitis and demographic information of all cases were included. RESULTS: A vivid shifting in the prevalence of HAV showed a decreasing pattern, that is, from 632 cases (PR=61) in 2007 to 314 cases (PR=33) in 2008. In 2012, its prevalence was twice greater (695 cases, PR=63.2). The PR of HBV also changed from 52 cases (PR=5.8) in 2007 to 26 cases (PR=2.8) in 2008. Regarding HCV, a decreasing pattern with 13 cases (PR=1.4) in 2007 and 12 cases (PR=1.2) in 2009 was seen. This number increased to 60 cases (PR=3.9) in 2016. For HEV, more cases were reported (47 cases, PR=4.7) in 2010. CONCLUSION: The four types of hepatitis have been highly prevalent since 2010. The high number of migrants to Karbala Governorate and unavailability of immunization might be reasons behind the high prevalence of the four-types of hepatitis.


Assuntos
Hepatite Viral Humana/epidemiologia , Hepatite Viral Humana/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hepacivirus , Vírus da Hepatite A , Vírus da Hepatite B , Vírus da Hepatite E , Humanos , Imunização , Lactente , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Migrantes , Adulto Jovem
7.
Diabetes Metab Syndr ; 13(2): 1241-1244, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336471

RESUMO

AIMS: Visceral Adiposity Index (VAI) is suggested as a surrogate marker for visceral adipose tissue dysfunction. It is an empirical-mathematical model, sex-specific, based on metabolic and anthropometric parameters. Diabetes mellitus is growing in an expanding fashion globally. The aim of this study to study the association between VAI and glycemic control in women with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A total of 300 T2DM female aged (25-60 years) were enrolled in this cross-sectional study. Subjects were recruited from Baghdad medical city during the period from January 2017 to July 2018. Body mass index (BMI), waist circumference (WC), blood pressure was measured and fasting blood sample was analyzed for blood glucose, glycated hemoglobin(HbA1c), and lipid profile. VAI was calculated in addition to triglyceride-glucose (TyG) derived indices. Statistical analysis was done by SPSS version 23. The study was ethically approved. RESULTS: Patients with high VAI showed poor glycemic control, dyslipidemia, elevated TYG index, TYGWC and TYGBMI. The number of diabetics with poor glycemic control increased across the VAI quartiles. The area under the curve in ROC analysis demonstrated that VAI had a good predictive ability to identify the state of glycemic control as compared to other anthropometric measures (WC, BMI) or combined metabolic and anthropometric measures (TyGWC, TyGBMI). CONCLUSION: increased VAI adversely affects the glycemic control in women with T2DM.


Assuntos
Adiposidade , Biomarcadores/análise , Diabetes Mellitus Tipo 2/complicações , Hiperglicemia/diagnóstico , Gordura Intra-Abdominal/fisiopatologia , Obesidade Abdominal/fisiopatologia , Adulto , Glicemia/análise , Estudos Transversais , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Hiperglicemia/epidemiologia , Hiperglicemia/etiologia , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Fatores de Risco , Circunferência da Cintura
8.
Diabetes Metab Syndr ; 13(2): 1629-1632, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336532

RESUMO

BACKGROUND: Type 2 diabetes (T2D) is a polygenic and multi-factorial complex disease, the challenge to find genetic markers that could explain the risk of development of this disease still remains unresolved. The Arab region is one among the populations with a high prevalence of T2D and a large number of studies have been carried out in exploring the genetic factors associated with T2D risk. AIM: To summarize the recent developments in the Arab world based on the recent studies that had looked into genetic factors associated with the development of T2D in the Arab populations. METHODS: A systematic literature search was conducted to identify studies published between 2015 and 2018 reporting genetic factors or polymorphisms associated with the risk of T2D in the Arab world. The online databases PubMed and Web of Science were used to perform the literature search. CONCLUSION: The present study has evaluated 14 studies published during the year 2015-2018. Studies from Egypt, Iraq, Jordan, Oman, Qatar, Saudi Arabia, Tunisia, and United Arab Emirates had been explored studying the associations of GIPR, ADIPOQ, FTO, (GRCh38.p12), MLXIP, AKNAD1, KCNJ11 CDKAL1, CDKN2A/2B, TCF7L2, ACE, SNAP25, ELMO1, VDR, KCTD8, GABRA4 and PRKD1 genes with T2D development.


Assuntos
Árabes/genética , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Marcadores Genéticos , Genômica/métodos , Polimorfismo Genético , Egito/epidemiologia , Humanos , Iraque/epidemiologia , Jordânia/epidemiologia , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia
9.
Asian Pac J Cancer Prev ; 20(7): 2059-2064, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31350966

RESUMO

Background/Objective: Cervical cancer ranks the second among the most common gynecologic cancers. This study was established to determine the distribution of cervical HPV genotypes among different Pap readings in Duhok/Iraq. Methods: Between January and September-2016, HPV-DNA was tested in 64 women. Genotyping was carried out by the hybridization reverse blot technique. Cervical smears were taken, performed by ThinPrep technique and stained by Pap stain. Results: Twenty six (40.6%) cases were positive for HPV, 12 (46.2%) in normal and 14 (53.8%) in abnormal Pap smears. 39 (19 high-risk and 16 low-risk) genotypes were identified. The high risk group comprised 6 HPV16, 4 HPV18, 2 HPV66, 2 HPV52, 2 HPV39, 1 HPV56, 1 HPV31 and 1 HPV45. The 16 low risk strains encompassed 4 HPV6 strains, 4 HPV71, 2 HPV54 and 2 HPV83, HPV11, HPV61 HPV84, and HPV62. Mixed infections were described in 4 women (6.25%), limited to the NILM, ASC-US and LSIL smears. They included variable admixtures of 7 high risk genotypes, HPV39 (both copies), HPV66 (both copies), HPV52, HPV31, HPV45 and 6 low risk strains: HPV83, HPV6, HPV11, HPV54, HPV62 and HPV71. Conclusions: The higher frequency of HR-HPV than the LR-HPV with identification of 4 mixed cases indicates that our women are at risk of developing cervical cancer. Detection of HR-HPV in NILM and ASC-US smears with restriction of some strains to these 2 categories highlights the great value of HPV genotyping as a surrogate test to pick up unscreened women at risk of developing cervical malignancy particularly when a proper screening program is absent.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Programas de Rastreamento/métodos , Papillomaviridae/classificação , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/classificação , Adolescente , Adulto , Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/virologia , DNA Viral/genética , Feminino , Seguimentos , Genótipo , Humanos , Iraque/epidemiologia , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Prognóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/estatística & dados numéricos , Adulto Jovem
11.
Acta Trop ; 197: 105058, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31185223

RESUMO

Vector-borne diseases (VBDs) of domestic and wild carnivores are of major public health concern both in industrialized and developing countries, especially in poor socioeconomic settings. War-torn areas specifically suffer from absence of veterinary surveillance of VBDs, resulting in lack of scientific knowledge on this topic. To investigate occurence and prevalence of several vector-borne pathogens (VBPs) in some carnivore species from Iraq, blood samples (n = 397) were obtained from 190 canids [97 stray dogs (Canis familiaris), 55 jackals (Canis aureus) and 38 red foxes (Vulpes vulpes)] and 207 stray cats (Felis catus) collected during a feral animal control and zoonotic disease surveillance program in several United States military bases in Iraq. The presence of Babesia spp., Hepatozoon spp., Ehrlichia spp., Anaplasma spp., Dirofilaria spp. and Leishmania spp. DNA was molecularly investigated. Out of 397 animals tested, 176 (44.3%; 95% CI: 39.5-49.2%) were positive for at least one pathogen with the highest prevalence in foxes (73.7%; 95% CI: 58-85%), followed by jackals (54.5%; 95% CI: 41.5-67%), dogs (38.1%; 29.1-48.1%) and cats (39.1%; 95% CI: 32.7-45.9%). Up to five pathogens were diagnosed in dogs. Hepatozoon canis was the most prevalent VBP in jackals (49.1%; 95% CI: 36.4-61.9%), foxes (47.3%; 95% CI: 32.5-62.7%) and dogs (33%; 95% CI: 24.4-42.8%), whereas Hepatozoon felis was the only species detected in cats (39.1%; 95% CI: 32.7-45.9%). A species of Babesia related to but different from Babesia lengau and designated as Babesia sp. MML was detected in six foxes (15.8%; 95% CI: 7.4-30.4%) and in one jackal (1.8%; 95% CI: 0.3-9.6%). This finding suggested the existence of a new species in the genus Babesia as inferred by molecular and phylogenetical analysis. Further, Babesia vulpes was identified only in two foxes (5.3%; 95% CI: 1.5-17.3%). All samples were negative for Leishmania spp. and Ehrlichia spp. Co-infection with H. canis and Babesia spp. was the most prevalent (5/176, 2.8%, i.e., 4 foxes and 1 jackal), followed by H. canis and Dirofilaria immitis (1/176, 1.3%, i.e., in 1 jackal), H. canis and Dirofilaria repens or Acanthocheilonema reconditum (1/176, 1.3%, i.e., in one dog, each). Data presented fill gaps into knowledge of VBPs in dogs, cats and wild canids in Iraq, indicating that different pathogens circulate amongst animal populations living in the same areas, possibly sharing the same tick vectors. Large-scale surveys are urgently needed to further assess VBPs distribution in Iraq and establish preventative strategies in domestic animals to minimize the risk of infection for animals and humans.


Assuntos
Gatos/parasitologia , Cães/parasitologia , Raposas/parasitologia , Chacais/parasitologia , Anaplasma/isolamento & purificação , Animais , Babesia/isolamento & purificação , Gatos/microbiologia , Vetores de Doenças , Cães/microbiologia , Ehrlichia/isolamento & purificação , Feminino , Raposas/microbiologia , Iraque/epidemiologia , Chacais/microbiologia , Leishmania/isolamento & purificação , Masculino , Prevalência
12.
J Spec Oper Med ; 19(2): 87-90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31201757

RESUMO

BACKGROUND: Airway obstruction is the second most common cause of potentially preventable death on the battlefield. We compared survival in the combat setting among patients undergoing prehospital versus emergency department (ED) intubation. METHODS: Patients were identified from the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016. We defined the prehospital cohort as subjects undergoing intubation prior to arrival to a forward surgical team (FST) or combat support hospital (CSH), and the ED cohort as subjects undergoing intubation at an FST or CSH. We compared study variables between these cohorts; survival was our primary outcome. RESULTS: There were 4341 intubations documented in the DODTR during the study period: 1117 (25.7%) patients were intubated prehospital and 3224 (74.3%) were intubated in the ED. Patients intubated prehospital had a lower median age (24 versus 25 years, p < .001), composed a higher proportion of host nation forces (36.1% versus 29.1%, p < .001), had a lower proportion of injuries from explosives (57.6% versus 61.0%, p = .030), and had higher median injury severity scores (20 versus 18, p = .045). A lower proportion of the prehospital cohort survived to hospital discharge (76.4% versus 84.3%, p < .001). The prehospital cohort had lower odds of survival to hospital discharge in both univariable (odds ratio [OR] 0.60, 95% confidence interval [CI] 0.51-0.71) and multivariable analyses controlling for confounders (OR 0.70, 95% CI 0.58-0.85). In a subgroup analysis of patients with a head injury, the lower odds of survival persisted in the multivariable analysis (OR 0.49, 95% CI 0.49-0.82). CONCLUSIONS: Patients intubated in the prehospital setting had a lower survival than those intubated in the ED. This finding persisted after controlling for measurable confounders.


Assuntos
Obstrução das Vias Respiratórias/terapia , Serviços Médicos de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Intubação Intratraqueal/estatística & dados numéricos , Lesões Relacionadas à Guerra/terapia , Adulto , Afeganistão/epidemiologia , Obstrução das Vias Respiratórias/mortalidade , Estudos de Coortes , Humanos , Iraque/epidemiologia , Sistema de Registros , Análise de Sobrevida , Resultado do Tratamento , Lesões Relacionadas à Guerra/mortalidade , Adulto Jovem
13.
J Spec Oper Med ; 19(2): 91-94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31201758

RESUMO

BACKGROUND: Airway compromise is the second leading cause of preventable death on the battlefield. Unlike a cricothyrotomy, supraglottic airway (SGA) placement does not require an incision and is less technically challenging. We compare the survival of causalities undergoing cricothyrotomy versus SGA placement. METHODS: We used a series of emergency department (ED) procedure codes to search within the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016. This is a subanalysis of that data set. RESULTS: During the study period, 194 casualties had a documented cricothyrotomy and 22 had a documented SGA as the sole airway intervention. The two groups had similar proportions of explosive injuries (57.7% versus 63.6%, p = .328), similar composite injury severity scores (25 versus 27.5, p = .168), and similar AIS for the head, face, extremities, and external body regions. The cricothyrotomy group had lower AIS for the thorax (0 versus 3, p = .019), a trend toward lower AIS for the abdomen (0 versus 0, p = .077), more serious injuries to the head (67.5% versus 45.5%, p = .039), and similar rates of serious injuries to the face (4.6% versus 4.6%, p = .984). Glasgow Coma Scale (GCS) scores were similar on arrival to the ED (3 versus 3, p = .467) as were the proportion of patients surviving to discharge (45.4% versus 40.9%, p = .691). On repeated multivariable analyses, the odds ratios for survival were not significantly different between the two groups. CONCLUSIONS: We found no difference in short-term outcomes between combat casualties who received an SGA vs those who received a cricothyrotomy. Military prehospital personnel rarely used either advanced airway intervention during the recent conflicts in Afghanistan and Iraq.


Assuntos
Manuseio das Vias Aéreas/métodos , Serviços Médicos de Emergência/estatística & dados numéricos , Intubação Intratraqueal/métodos , Traqueostomia/estatística & dados numéricos , Lesões Relacionadas à Guerra/terapia , Afeganistão/epidemiologia , Manuseio das Vias Aéreas/instrumentação , Humanos , Intubação Intratraqueal/instrumentação , Iraque/epidemiologia , Análise de Sobrevida , Resultado do Tratamento , Lesões Relacionadas à Guerra/mortalidade
14.
PLoS One ; 14(5): e0217683, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150485

RESUMO

Leishmaniasis is caused by protozoan parasites of the genus Leishmania and is a major health problem in various parts of the world. Cutaneous leishmaniasis (CL) occurs, among others, in unpredictable outbreaks after wars and disasters. After the last war in Iraq, the collapse of the health system led to the spread of infectious diseases, including CL. Between September 2016 and November 2017, all patients with confirmed CL having one or more skin lesion(s) were referred to a regional health center in Musol City within the Rabeea District. During this period, 1539 patients visited the clinic. A total of 190 patients were excluded from the study because of poor follow-up. The treatment success rate was 97.7% (1319/1349). Statistically significant associations were found between number of lesions and treatment failure (p = 0.0018; OR = 1.4430; CI = 1.1466-1.8161), number of doses and number of lesions (Pearson's correlation coefficient = 0.095; p = 0.001), and the lack of municipality services and number of doses used for the treatment (p = 0.008; OR = 1.0629; CI = 1.0158-1.1122). To conclude, the highest number of patients with CL in the city of Musol was recorded after the war in Iraq. The treatment success rate was high, which reflected the strict treatment and follow-up program. An urgent plan is needed to stop the spread of infection.


Assuntos
Leishmania/patogenicidade , Leishmaniose Cutânea/epidemiologia , Dermatopatias/epidemiologia , Pele/parasitologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Iraque/epidemiologia , Leishmaniose Cutânea/parasitologia , Leishmaniose Cutânea/patologia , Masculino , Pessoa de Meia-Idade , Pele/patologia , Dermatopatias/parasitologia , Dermatopatias/patologia , Adulto Jovem
15.
Inquiry ; 56: 46958019845280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31081421

RESUMO

Hemophilia is an inherited bleeding disorder that mainly affects males. Globally, there are about 400 000 people with hemophilia and only 25% of them receive adequate treatment. There is insufficient epidemiological data on hemophilia in Iraq; so, this study was conducted to determine the trend of the prevalence and incidence and to identify certain clinical and epidemiological characteristics of patients with hemophilia in Baghdad, Iraq, 2016. This cross-sectional study was conducted in the 4 hemophilia centers in Baghdad. The data were compiled by reviewing all hemophilia patients' records and the centers' registry books between 2007 and 2016. Corresponding population data of Baghdad were obtained from the Ministry of Health. The total number of currently registered patients who are residents of Baghdad was 654. The prevalence of hemophilia increased from 7.2/100 000 males in 2007 to 15.9/100 000 males in 2016. Similarly, the incidence of hemophilia had increased from 8.4/100 000 livebirths in 2007 to 16.3/100 000 livebirths in 2016. Severe hemophilia represented 63.4% of all types. The prevalence of hepatitis C virus (HCV), hepatitis B virus (HBV), and HIV infections were 22.9%, 0.9%, and 0.2%, respectively. Clotting factor inhibitors were positive in 11.6% and target joints were found among 45.1% of patients. About 27% were on prophylactic therapy. Only one death was recorded in 2016. The prevalence and incidence of hemophilia in Baghdad was doubled in 10-year period. The prevalence of different complications was almost close to the rates in the neighboring countries.


Assuntos
Hemofilia A/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Iraque/epidemiologia , Masculino , Prevalência , Adulto Jovem
16.
Inquiry ; 56: 46958019845960, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31081429

RESUMO

This study aimed to estimate the prevalence and determinants of mental disorders (MDs) among elderly people residing in nursing homes (NHs) and those living with their families (WF) in Baghdad, Iraq, 2017. A cross-sectional study was conducted on all elderly individuals residing in all NHs in Baghdad and an equal number of elderly people residing WF. MDs were defined based on Kessler Psychological Distress Scale (K10). We used relevant World Health Organization-accredited tools to identify the types of MDs. The prevalence of MDs among elderly people was 38.7%, being statistically significantly ( P < .01) higher among those in NH (55.8%) compared with those living WF (21.5%). The proportion of types of MDs among NH versus WF residents was as follows: depression (35.4% vs 16.6%), anxiety (32.6% vs 9.9%), dementia (19.3% vs 5%), and suicide thoughts (25.4% vs 4.4%). The multivariate analysis showed many factors that were associated with MD. Low income, dependency on others, and being neglected were stronger determinant of MD among elderly people living WF. However, chronic joint pain, visual impairment, auditory impairment, and economic status deterioration were stronger determinant among those in NHs. The prevalence of MDs in the NH is more than double the prevalence in the community. We recommended enhancing elderly mental health care services including curative, preventive, and promotive activities.


Assuntos
Vida Independente , Transtornos Mentais/epidemiologia , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Escalas de Graduação Psiquiátrica Breve , Estudos Transversais , Depressão , Feminino , Humanos , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Pobreza , Prevalência
17.
Artigo em Inglês | MEDLINE | ID: mdl-31064051

RESUMO

Knowledge of etiology causes of diarrheal illness is essential for development and implementation of public health measures to prevent and control this disease syndrome. There are few published studies examining diarrhea in children aged <5 years in Iraq. This study aims to investigate the occurrences and epidemiology of selected bacterial (Salmonella spp. and Campylobacter spp.), viral (adenovirus, norovirus GI and GII, and astrovirus), and parasitic (Entamoeba spp. and Giardia spp.) agents in stool samples from 155 child diarrheal cases enrolled between March and August 2017, in a hospital-based cross-sectional study in Thi-Qar, southeastern Iraq. Using molecular techniques and sequence-based characterization, adenovirus was the most frequently detected enteropathogen (53/155 (34.2%)), followed by Salmonella spp. (23/155 (14.8%)), Entamoeba spp. (21/155 (13.5%)), and Campylobacter spp. (17/155 (10.9%)). Mixed infection with Salmonella spp. and Campylobacter spp. was evident, and the same was revealed between various enteric viruses, particularly adenovirus and norovirus. The most frequent co-infection pattern was between adenovirus and Campylobacter spp., in seven cases (7/155 (4.5%)). Whole-genome sequencing-derived typing data for Salmonella isolates (n = 23) revealed that sequence type 49 was the most prevalent in this sample set (15/23 (65.2%)). To the best of our knowledge, this study provides the first report on detection and identification of floR, blaCARB-2, and mphA antimicrobial resistance genes in Salmonella isolated from children in the Middle East region. Logistic regression analysis pointed to few enteropathogen-specific correlations between child age, household water source, and breastfeeding patterns in relation to the outcome of detection of individual enteropathogens. This study presents the first published molecular investigation of multiple enteropathogens among children <5 years of age in Iraq. Our data provide supporting evidence for planning of childhood diarrhea management programs. It is important to build on this study and develop future longitudinal case-control research in order to elaborate the epidemiology of enteropathogens in childhood diarrhea in Iraq.


Assuntos
Diarreia/epidemiologia , Diarreia/microbiologia , Doença Aguda , Adenoviridae/genética , Astroviridae/genética , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Campylobacter/genética , Pré-Escolar , Coinfecção , Entamoeba/genética , Fezes/microbiologia , Feminino , Giardia/genética , Humanos , Iraque/epidemiologia , Masculino , Norovirus/genética , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/microbiologia , Salmonella/genética , Viroses/epidemiologia , Viroses/microbiologia
18.
South Med J ; 112(5): 271-275, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31050794

RESUMO

OBJECTIVE: Military providers frequently treat civilians, including pediatric patients. Cervical spine injuries in pediatric trauma patients occur infrequently, with limited data on the incidence. The aim of this study was to describe the incidence of cervical spine injuries in pediatric patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry for all pediatric encounters from January 2007 to January 2016. We searched within that dataset for all cervical spine fractures. RESULTS: From January 2007 through January 2016 there were 3439 pediatric encounters. There were 36 subjects identified (1.0%) with a cervical spine fracture. Of those with a cervical spine fracture, 6 (17%) had a prehospital cervical collar placed, which did not improve survival to hospital discharge (collar, 66.7% vs no collar, 83.3%, P = 0.573). Of those with a cervical spine fracture, 6 (17%) had a documented spinal cord injury. The median age of subjects with a cervical spine fracture was 9.5 years and the majority (63.9%) were male. Most were injured by explosion (41.7%). The median composite injury score was higher in subjects with a cervical spine fracture compared with those without one (16.5 vs 10, P < 0.001). Subjects with a cervical spine fracture had longer lengths of stay in the intensive care unit (median 3 days vs 1, P = 0.012) and a trend toward worse survival to hospital discharge (80.6%, n = 29, vs 90.3%, n = 3074, P = 0.079). CONCLUSIONS: Cervical spine injuries occurred infrequently in pediatric patients in Iraq and Afghanistan. When a fracture was present, almost one in five patients had spinal cord involvement. The pediatric prehospital literature would benefit from the development of a clinical decision tool to guide prehospital personnel as to when a cervical collar is indicated. Moreover, appropriate size equipment should be available when caring for host national civilians.


Assuntos
Vértebras Cervicais/lesões , Serviços Médicos de Emergência/estatística & dados numéricos , Sistema de Registros , Traumatismos da Coluna Vertebral/epidemiologia , Afeganistão/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Iraque/epidemiologia , Masculino
19.
Pharm. pract. (Granada, Internet) ; 17(1): 0-0, ene.-mar. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184610

RESUMO

Background: Optimal prescribing of secondary prevention medications after acute coronary syndrome (ACS) events has been shown to reduce morbidity and mortality. However, it is unknown whether these medications are optimally prescribed at discharge from acute care in Iraq. Objective: To evaluate whether patients with ACS received optimal secondary prevention medications: antiplatelets, statins, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs), and beta-blockers at discharge from a cardiology unit, and to assess whether statins, ACEI/ARBs and beta-blockers were prescribed at target doses based on the American Heart Association/American College of Cardiology (AHA/ACC) guidelines. Methods: Observational retrospective cross-sectional study of patients with ACS admitted to a hospital in Baghdad and survived to discharge between May 2016 and January 2017. Patient-level data and secondary prevention medications at discharge were extracted from routine medical records. Optimal dosing was defined as ≥75%, moderate dosing as 50-74%, and low dosing as <50% of the target dose. Results: 45.6% (200/439) of eligible patients were included in the study who were aged 25 to 90 years (mean 57.8 years) with 78.0% (156/200) being male. Of those included, 84.5% had a myocardial infarction and 15.5% unstable angina, and the length of hospital stay ranged from 1 to 29 days (median 4 days). In total, 53.5% of patients were prescribed all five secondary prevention medications at discharge, and after accounting for contraindications, 60.0% were treated according to AHA/ACC guidelines. The prescription rate of dual antiplatelet therapy, statins, ACEI/ARBs and beta-blockers was 92.5%, 94.5%, 69.5% and 87.0% respectively. Hypertension, diabetes mellitus and the prescription of oral nitrates were associated with the prescription of optimal secondary prevention therapy. Although 80.9% of patients were prescribed target doses of antiplatelets and statins, only 12.2% and 9.2% were prescribed target doses of ACEI/ARBs, and beta-blockers respectively. Conclusions: Approximately one in two patients received the recommended secondary prevention therapy. However, only a minority of patients were prescribed optimal doses of ACEI/ARBs and beta-blockers, in line with guidance. Quality improvement strategies should be implemented, which may include greater involvement of pharmacists within the cardiology multidisciplinary team


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Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Síndrome Coronariana Aguda/tratamento farmacológico , Prescrições de Medicamentos/estatística & dados numéricos , Sumários de Alta do Paciente Hospitalar/estatística & dados numéricos , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Antagonistas de Receptores de Angiotensina/uso terapêutico , Iraque/epidemiologia , Síndrome Coronariana Aguda/epidemiologia , Prevenção Secundária/métodos , Indicadores de Morbimortalidade , Estudos Retrospectivos , Continuidade da Assistência ao Paciente/estatística & dados numéricos
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