Microalbuminuria (MAU) is an early marker of diabetic nephropathy (DN), which accounts for a significant reduction in life expectancy of diabetic patients. The progression of DN from the appearance of clinical proteinuria to end stage renal failure is usually irreversible. Increased levels of urinary albumin secretion may represent a more generalized vascular damage. This is the first study conducted in Iraq to determine the prevalence and potential risk factors of MAU among Type 2 diabetes mellitus (T2DM) patients. A cross-sectional study was conducted on a systematic random sample of 224 eligible T2DM patients aged 25-64 years attending a DM clinic in Baghdad. A questionnaire was developed to gather basic and clinical data, besides anthropometric measurements, and laboratory assessment of lipid profile, HbA1c, serum creatinine, albumin, and microalbumin/creatinin in urine. MAU was defined as albumin/creatinine ratio 30-300 mg/g on two occasions. Only 36 cases (16.1%) had MAU. A statistical significant association found between MAU and educational level (P = 0.009), family history of hypertension (P = 0.024) and DN (P = 0.013), history of hypertension (P = 0.001), duration of angiotensin-converting-enzyme inhibitor drug intake in hypertensive patients (P = 0.001), body mass index (BMI) (P = 0.014), and waist to hip ratio (P = 0.006). Logistic regression analyses revealed two independent risk factors influencing MAU: diastolic blood pressure [odds ratio (OR) = 1.08, 95% confidence interval (CI): 1.007-1.118] and BMI (OR = 1.17, 95% CI: 1.037-1.220). The prevalence of MAU is not low among DM patients. Mandatory screening of all DM patients and amelioration of the assigned significant risk factors are recommended.

No abstract

BackgroundDuring mass gatherings, public health services and other medical services should be planned to protect attendees and people living around the venue to minimize the risk of disease transmission. These services are essential components of adequate planning for mass gatherings. The Arbaeenia mass gathering signifies the remembrance of the death of Imam Hussain, celebrated by Shiite Muslims, and takes place in Karbala, which is a city in southern Iraq. This annual mass gathering is attended by millions of people from within and outside Iraq.ObjectiveThis study aimed to map the availability of medical supplies, equipment, and instruments and the health workforce at the temporary clinics located in Al-Karkh, Baghdad, Iraq, in 2014.MethodsThis assessment was conducted on the temporary clinics that served the masses walking from Baghdad to Karbala. These clinics were set up by governmental and nongovernmental organizations (NGOs) and some faith-based civil society organizations, locally known as mawakib. We developed a checklist to collect information on clinic location, affiliation, availability of safe water and electricity, health personnel, availability of basic medical equipment and instruments, drugs and other supplies, and average daily number of patients seen by the clinic.ResultsA total of 30 temporary clinics were assessed: 18 clinics were set up by the Ministry of Health of Iraq and 12 by other governmental organizations and NGOs. The clinics were staffed by a total of 44 health care workers. The health workers served 16,205 persons per day, an average of 540 persons per clinic, and 368 persons per health care worker per day. The majority of clinics (63% [19/30]-100% [30/30]) had basic medical diagnostic equipment. Almost all clinics had symptom relief medications (87% [26/30]-100% [30/30]). Drugs for diabetes and hypertension were available in almost half of the clinics. The majority of clinics had personal hygiene supplies and environmental sanitation detergents (78%-90%), and approximately half of the clinics had medical waste disposal supplies. Instruments for cleansing and dressing wounds and injuries were available in almost all clinics (97%), but only 4 clinics had surgical sterilization instruments.ConclusionsAlthough temporary clinics were relatively equipped with basic medical supplies, equipment, and instruments for personal medical services, the health workforce was insufficient, given the number of individuals seeking care, and only limited public health service, personal infection control, and supplies were available at the clinics.

Background: During mass gatherings (MGs) public health services and other medical services planned to protect MG attendees as well as people living around the venue and minimize risk of disease spread. These services are essential components of adequate planning for MGs. The Arbaeenia MG signifies the remembrance of the death of Imam Hussain, celebrated by Shiite Muslims and it takes place in Karbala, which is a city in southern Iraq. This annual MG is attended by millions of people from within and outside Iraq.Objective: To map availability of medical supplies, equipment, and instruments and the health workforce at the temporary clinics installed in Baghdad Al-Karkh, Iraq, 2014.Methods: This assessment was conducted on the temporary clinics that served the masses walking to Karbala from Baghdad. These clinics were set up by governmental and non-governmental agencies and some faith-based civil society organizations, locally known as mawakib. We developed a checklist to collect information on clinic location, affiliation, availability of safe water and electricity, health personnel, availability of basic medical equipment and instruments, drugs and other supplies and average daily number of patients seen by the clinic.Results: A total of 30 temporary clinics were assessed, 18 clinics were set up by the Iraq Ministry of Health (MOH) and 12 by other governmental and nongovernmental organizations. The clinics were staffed by a total of 44 health care workers. The health workers served 16,205 persons per day, an average of 540 persons per clinic, and 368 persons per health care worker per day. The majority of clinics, 63%-100%, had basic medical diagnostic equipment. Almost all clinics had symptom relief medications (87%-100%). Drugs for diabetes and hypertension were available in less than 55% of the clinics. The majority of clinics had personal hygiene supplies and environmental sanitation detergents (78%-90%), and around 50% had medical waste disposal supplies. Instruments for cleansing and dressing wounds and injuries were available in almost all clinics (97%), but only four clinics had surgical sterilization instruments.Conclusions: While temporary clinics were relatively equipped with basic medical supplies, equipment and instruments for personal medical services, the health workforce was insufficient given the number of individual seeking care, and only limited public health service, personal infection control, supplies were available at the clinics.