The epidemiology of 32 selected communicable diseases in Iraq, 2004-2016.
Communicable disease
Conflict
Iraq
Vaccine-preventable disease
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
24
06
2019
revised:
18
09
2019
accepted:
19
09
2019
pubmed:
29
9
2019
medline:
18
2
2020
entrez:
28
9
2019
Statut:
ppublish
Résumé
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. 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. 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). 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 31560993
pii: S1201-9712(19)30380-7
doi: 10.1016/j.ijid.2019.09.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102-109Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.