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.

BACKGROUND AND OBJECTIVESHelicobacter pylori is a Gram negative bacteria that causes peptic ulceration and gastric adenocarcinoma. H pylori virulence factors, such as cagA and dupA, are important to study in populations as they contribute to disease risk. This study aimed to look at the distribution of the cagA and dupA genes in H pylori strains isolated from patients suffering from gastroduodenal diseases in Kurdistan region, Iraq.DESIGN AND SETTINGSA cross-sectional study conducted between June 2011 and January 2012. Biopsies were collected from the Endoscopy Department in Duhok and Sulaimania hospitals, Kurdistan region, northern Iraq.PATIENTS AND METHODSUpper gastrointestinal (GI) endoscopy examination was performed and 4 gastric biopsies (2 from the antrum and 2 from the corpus) were obtained from 204 patients. H pylori positivity was examined by CLO test; then the association between disease status and virulence factors was assessed by polymerase chain reaction.RESULTS154 (75%) of our samples were found to be H pylori + by CLO test. Endoscopic diagnoses for those who were positive were as follows: peptic ulcer disease (PUD) including duodenal ulcer, 45; gastric ulcer, 23; and no ulcer (NPUD), 86. The overall prevalence rates of cagA and dupA were 72.7% and 18.8%, respectively. While a significant association between cagA and PUD was observed (P ≤ .017; OR=0.4; CI=0.18–0.85), no relationship between dupA and PUD could be seen.CONCLUSIONThese data suggested that the presence of cagA may be a predictor of clinical outcome in Kurdistan region, northern Iraq.

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Background: Hepatitis B virus (HBV) is one of the major etiological agents causing acute and chronic liver disease worldwide with significant morbidity and mortality. The high genetic variability of HBV is reflected by eight genotypes (A to H), each with a particular geographical prevalence.Objectives: The study was conducted to find out HBV genotypes in chronic hepatitis B- (CHB) carriers in association with serological markers of HBV.Methods: This work was carried on from March to, December 2012 in Duhok/Iraq and enrolled 134 HBsAg positive carrier cases. recruited to Central Public Health Lab. Specific primers PCR technique was used to detect HBV genotypes. The carrier cases were screened for markers of HBV infection by Enzyme Linked Immunosorbent Assay (ELISA). Automated machine for quantitative determination of ALT was used.Results: The carrier cases were 91 males (67.9 %), 43 females (32.1 %), and their age range was 10-87 year old (mean=31.4 SD± 13.3). Among the studied patients 133(99.2%) were found to have genotypes D including 91(67.9%) males and 42(31.3%) females and only one female patient carried genotype B (0.8%). Anti-HBc(total), IgM anti-HBc, HBeAg and Anti HBeAb were detected in rates of 100%,0%,50%and 46.9 % respectively. The patient with genotype B had positive HBe Ag, negative HBeAb and normal ALT level.Conclusion: This study revealed that hepatitis B virus genotype D is the main genotype in Duhok/ Iraq followed by genotype B. High percentage of CHB patients with genotype D are HBeAg positive. Most of CHB patients with high ALT level had positive HBeAg rather than negative HBeAg.

Human Papilloma virus infection is the fundamental reason for the development of ano-genital malignancies and knowing the best tool for diagnostic purposes is mandatory. This study investigated the prevalence and genotype distribution of HPV genotypes in formalin-fixed paraffin-embedded (FFPE) blocks from patients with different anogenital lesions. In this cross-sectional retrospective study, 125 blocks from patients with different anogenital lesions were collected. Three internal sections were taken for HPV detection and genotyping using the paraffin tissue processing kit and HPV Direct Flow CHIP. HPV positivity was detected in 90 (72.0%), with 77 (85.6%) females and 13 (14.4%) males as follows: SCC 64.0%, CINIII 66.7%, CINII 100.0%, CINI 83.3%, KA 83.7%, NILM 44.0%, Anus 66.6%. A total of 44% of histologically unremarkable (negative) cases were positive for HPV genotypes while in only 64% of SCC were HPV genotypes detected. Sixty-six (73.3%) cases were low-risk, and 16 (17.8%) cases were high-risk genotypes, mostly cervical lesions, while seven (7.8%) cases showed a mixed viral detection. The most frequent low-risk genotype was HPV6 genotype (62–68.9%), while the prevalent high-risk HPV was HPV16 genotype (12–13.3%). In this study, HPV16 was more frequently detected than HR-HPV, but mainly in cervical lesion, while HPV6 topped the LR-HPV infections amongst different anogenital lesions in Duhok-Iraq. Higher HPV positivity among cytological unremarkable and abnormal cases may reflect the higher sensitivity of the direct flow CHIP diagnostic technique. The results demonstrate that screening for HPV is essential to reduce cancer development and planning for the vaccine’s introduction in Iraq.

Background: Hepatitis A virus infection is widespread in Iraq. Detecting its seroprevalence is important to evaluate the feasibility of infection control strategies in the community. Aims: To determine hepatitis A virus seroprevalence in a representative sample in Duhok Governorate, northern Iraq, evaluate changes in the epidemiological pattern of hepatitis A virus prevalence and assess factors associated with hepatitis A virus seropositivity. Methods: This cross-sectional study was conducted from July 2020 to November 2021. Random cluster sampling was used to select participants aged 5–74 years. Hepatitis A virus immunoglobulin G (IgG) was determined in participants and demographic data were collected on: sex, residency (urban or rural), age, history of jaundice, number of family members (≤ five or > five) and source of drinking-water. Results: A total of 1052 participants (625 males and 427 females) were enrolled. The overall seroprevalence of hepatitis A virus IgG was 68.3%: 24.4% in ages 5–10 years; 38.3% in ages 11–15; 86.9% in ages 16–20; 85.4% in ages 21–30; 95.3% in ages 31–40; and 89.2% in ages > 40 years. Factors significantly associated with hepatitis A virus IgG positivity were rural residence, male sex and family size greater than five members (all P < 0.01). Conclusion: Hepatitis A virus seroprevalence has declined in the past decade indicating intermediate-to-low endemicity of hepatitis A virus in Iraq. Thus, there are a greater number of susceptible people, which suggests the need to introduce vaccination against hepatitis A virus in Iraq.

Objective: Human papillomavirus (HPV) has been identified as an important causative factor in cervical cancer development. Cervical cancer is the fourth most prevalent malignant tumor among women globally. The purpose of this study was to investigate the prevalence and genotyping sequences of HPV in formalin-fixed paraffin-embedded (FFPE) cervical tissue using conventional polymerase chain reaction (PCR), and HPV-DNA sequencing. Material and Methods: Retrospective cross-sectional study. Forty (FFPE) blocks with different cervical lesions were taken; patients’ ages ranged from 24 to 65 years. Detection and sequencing of HPV DNA were done by conventional PCR (L1 gene), which was achieved by universal PCR primers (MY09/11 oligonucleotides). Then sequencing and phylogenetic tree was constructed. Results: Nine samples were found positive and detected by conventional PCR, they were identified in CIN1 and SCC at 7.5% (n=3) for each, 5.0% (n=2) KA, and 2.5% (n=1) in CIN3 cases, after sequencing were submitted to GenBank and accession numbers were obtained. The phylogenetic tree was constructed and the aligned sequences showed high homology with the nucleotide sequence of the references from the Genbank database. HPV 11, 16, 18, 22, 33, 52, and 58 were found to have little nucleotide heterogeneity and thus no amino acid heterogeneity. Conclusion: Sequencing and phylogenetic analysis of circulating HPV types in Duhok provides very essential data about nucleotides and amino acid heterogeneity, to reveal genetic diversity with strains included in the vaccines that have not been introduced to Iraq yet.

Aim: To determine the seroprevalence of Chlamydia trachomatis in a group of randomly selected pregnant women, using the ELISA IgG and IgM assays. The study included 88 married women whose age range was 19-38 years. This study was conducted in the Microbiology lab at Azadi Teaching Hospital from February 2009 to Dec 2009 in Duhok city. Two endocervical swabs were taken from each woman, the first to be examined as wet preparation stain to find bacteria, RBCs, epithelial cells, monilia, Trichomonas vaginalis, the second swab was used to examine for the presence of Chlamydia trachomatis antibodies by ELISA anti Chlamydia specific IgM, and anti Chlamydia specific IgG. The wet preparation examination of the swabs revealed Trichomonas vaginalis in 4 patients. Gram's stain revealed the presence of Gram positive Streptococci in 10 patients, Gram negative bacilli in 6 patients, and no bacteria was found in 45 patients. ELISA test to detect anti Chlamydia Antibodies (IgM), all the 88 examined women were negative. ELISA test to measure the anti Chlamydial antibodies (IgG) detect chronic infections and the results showed ten positive cases, 10/88 (11.3%). The age group of eight out of ten IgG positive cases is between 21-30 years old, for the remaining two cases is between 31-40 years old. Five of the IgG positive cases had history of ectopic pregnancies; another two had history of acute conjunctivitis in their newborn babies, while the remaining three had chronic infection and discharge. The results of this study revealed that the commercially available rapid test is of no value in detection of Chlamydia in endocervical swabs. The trend should be toward the substitution of this test by the direct immunoflourescence test. The nucleic acid amplification test which is highly sensitive should be used in future studies to detect the prevalence of Chlamydia infection.