The epidemiology of 32 selected communicable diseases in Iraq, 2004–2016

Abstract

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.

<p>Secular Seasonality and Trend Forecasting of Tuberculosis Incidence Rate in China Using the Advanced Error-Trend-Seasonal Framework</p>

“…We examined the secular TB epidemic trends and changes with the measures of annual percent change (APC) and average annual percentage change (AAPC) using the joinpoint regression program (version 4.7.0). 23 We employed the forecasting function of SPSS software (version 17.0, IBM Corp, Armonk, NY) and the packages of "forecast"…”

Association Between Subnational Vaccine Coverage, Migration, and Incident Cases of Measles, Mumps, and Rubella in Iraq, 2001–2016

“…The primary dataset for this analysis comes from the Iraqi Ministry of Health (MoH). The dataset contains records at the governorate level for 32 communicable diseases across four broad categories: (1) vaccine-preventable diseases, (2) other World Health Organization (WHO) surveillance diseases, (3) other vector-borne and zoonotic diseases, and (4) reemerging diseases ( 14 ). Per Iraqi MoH policy, all public-sector hospitals and primary health care centers report their monthly case totals of vaccine-preventable diseases to the Preventive Health Department at the Directorate General of Health for their respective governorate.…”

“…A recent analysis of communicable disease incidence by Zhao et al, using the same dataset as this paper, provides insights into national trends of vaccine-preventable disease in the post-invasion years ( 14 ). Outbreaks of measles, mumps, and rubella were observed, with 30,321 measles cases in 2009, 12,815 and 74,212 mumps cases in 2004 and 2016, respectively, and 290 rubella cases in 2004 ( 14 ).…”

“…A recent analysis of communicable disease incidence by Zhao et al, using the same dataset as this paper, provides insights into national trends of vaccine-preventable disease in the post-invasion years ( 14 ). Outbreaks of measles, mumps, and rubella were observed, with 30,321 measles cases in 2009, 12,815 and 74,212 mumps cases in 2004 and 2016, respectively, and 290 rubella cases in 2004 ( 14 ). Further analyses performed by Lafta and Hussain examined the relationship between national vaccine coverage and outbreaks of vaccine-preventable illness, finding that fluctuations in vaccine coverage precipitated outbreaks ( 15 ).…”

The lessons of COVID-19 pandemic for communicable diseases surveillance system: A qualitative study in the Kurdistan region-Iraq

“…As the most devastating threat to human societies after World War II, COVID-19 has illustrated the urgent need to strengthen the CDSS anywhere, particularly in the LMICs (9). In Iraq, especially after the US invasion in 2003, as the burden of communicable diseases has been raising, the demands for improving the surveillance system has increased (10)(11)(12).The Kurdistan region is located in the north of Iraq and governed by the Kurdistan regional government. However, the CDSS in the Kurdistan region is centralized and directed by the Iraqi ministry of health under the WHO supervision.…”