Background Enteric fever is a severe systemic illness characterized by fever and abdominal pain that is caused by dissemination of typhoid Salmonella serovar, Typhi and Paratyphi. These organisms have no known hosts other than humans. Most commonly, foodborne or waterborne transmission occurs as a result of faecal contamination by ill or asymptomatic chronic carriers. Objectives The aim of this study was to determine the risk factors, clinical features in paediatric enteric fever infections along with the antimicrobial susceptibility pattern of the causative agents. Patients and methods This is a prospective-hospital based study, done in Sulaimani Paediatric Teaching Hospital. During the study period 250 cases suspected to have typhoid fever were admitted over a period of 3 month from 1st May-1st Augusts 2008; 95 cases with positive blood culture for typhoid were studied for clinical presentation, risk factors and drug susceptibility of isolates in comparison with a control group. Salmonella strains were identified based on their biochemical properties and antimicrobial susceptibility was determined with Kirby- Bauer disk diffusion method. Results Out of 250 clinically suspected cases of enteric fever, only 95 (38%) were culture positive for Salmonella. The antimicrobial susceptibility of isolate showed that more than 97% of the isolates were resistant to chloramphenicol, ampicillin and co-trimoxazole. Significant risk factors were eating food outside home (P=0.001, OR, 10.788; 95%, CI: 4.292 -27.112), low socioeconomic status (P=0.017, OR 0.437, 95%, CI: 0.229 -0.832), and household contact (P=0.001, OR=15.864, 95% CI: 6.648 -37.854). Conclusion Enteric fever remains one of the endemic febrile illnesses among paediatric age in our community and mainly caused by multi drug resistant Salmonella sereovar Typhi. The most common symptoms indicating infection were fever, headache, vomiting and abdominal pain. Risk factors were eating food outside home, low socioeconomic status and household contact with index cases.

Background: Congenital hypothyroidism is one of the most common preventable causes of intellectual disability. Most neonates born with congenital hypothyroidism are normal on clinical examination. Hypothyroidism in the newborn period is almost always overlooked, and as a result delay in management will cause profound neurological insult and mental retardation. Neonatal screening in Sulaimani city (center of Sulaimani governorate in north of Iraq) had started in 2013 for screening of Phenylketonuria, congenital hypothyroidism and glucose 6 phosphatase deficiency. Subject and Method: All neonates born in Sulaimani city including all hospital deliveries (both private and public governmental hospitals) in addition to the home deliveries that were referred to (Registration Bureau of Births and Deaths) during the period from January 1st to December 31st 2014 were included. Thyroid stimulating hormone was measured from heel prick blood samples obtained from neonates aged between 3 and 10 days. Neonates showing a TSH level of ≥ 5mIU/L were recalled to Sulaimani pediatric teaching hospital for confirmation of diagnosis. Aim of our study was to determine annual incidence of congenital hypothyroidism in the city. Results: Among 13050 neonates screened for congenital hypothyroidism, 75 (0.5%) were recalled (TSH, ≥ 5mIU/L). Congenital hypothyroidism was detected in 11 (14.6%) recalled neonates (incidence of congenital hypothyroidism in our study 1 in 1186 live births). Conclusions: According to this result, we concluded that Sulaimani city have high incidence of congenital hypothyroidism and in future, all newborn should be screened in this region including district areas. Duhok Med J 2017; 11 (2): 27-36.