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.

Background: Depression in caregivers of leukaemic children is usually overlooked and hence missed, as doctors mostly focused on patient's evaluation and condition. Early attention to symptoms of depression may help to prevent the development of a more serious depression over time. Aims: This study was conducted to estimate the prevalence, assess severity and identify determinants of depressive disorder among caregivers of children with leukaemia in Baghdad, Iraq, 2014. Methods: This cross sectional study was conducted on a convenience sample of caregivers of 250 leukaemia children aged <15 years admitted to Child Welfare Teaching Hospital, Baghdad, Iraq. Socio-demographic variables were collected and the presence of depressive disorder was assessed using the Arabic Version of Beck Depression Inventory II (BDI-II); those with a score of >16 were considered depressed. Results: The prevalence of depression was 72% (95% CI: 66-77.5%); classified to 18.9% having borderline clinical depression, 36.7% moderate depression, 27.8% severe depression and 16.7% extreme depression. Presence of depression was significantly higher among younger age caregivers, disease duration of >12 months and frequent hospital admission. Conclusions: The high prevalence of depression among care givers of leukaemia patients urge health care professionals to pay more attention to the psychological aspects of the families of leukaemia patients and ensure referring them for psychiatric support.

This cross-sectional study was conducted to estimate the prevalence and identify determinants of chronic obstructive pulmonary disease (COPD) among a convenience sample of 325 adult smokers in Baghdad, Iraq, 2014. Beside demographic variables, participants had Lung Function Questionnaire to assess respiratory symptoms; individuals with a score of ≤18 had a spirometry examination. Those with FEV1/FVC ratio <70% had post bronchodilator spirometry; those with FEV1/FVC% of <70% and <200 ml improvement of FEV1 were considered COPD cases. Staging of COPD is done according to the degree of FEV1 reduction. The prevalence of COPD was 15.1% (95% confidence interval 11.5-19.4%); 62.5% had moderate and 27.1% had severe COPD. Only 12.5% had a prior physician diagnosis. Age >55 (OR=2.14, 95% confidence interval = 1.04-4.39), and pack year smoking >40 (OR =5.37, 95% confidence interval = 1.70-16.91) were the significant independent determinants. All adult smokers should have a spirometry testing and counseled to stop smoking.

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ObjectivesThe objective of this study was to assess the resilience of health services in four governorates affected by conflict from 2014-2018, and to convey recommendations.MethodsHealth managers from Al Anbar, Ninawa, Salah-al-din, and Kirkuk governorates assessed resilience factors of Primary Health Care services affected by the 2014-2017 ISIS insurgency. Additional information was gathered from key informants and a health facility Unicef survey. Three specific aspects were examined: 1) meeting health needs in the immediate crisis response, 2) adaptation of services, 3) restructuring and recovery measures. Data from and MoH/UNICEF national health facility survey were 2017-2019 analyzed for functionality.FindingsThere were many common themes across the four governorates, with local variations.1. Absorption. The shock to the public sector health services by the invasion by ISIS caught the in the four governorates unprepared, with limited abilities to continue to provide services. Pharmacies and private clinics sometimes withstood the initial shock better. 2. Adaptation. After the initial shock, many health facilities adapted by focused on urgent needs for injury and communicable disease care. In most locations, maternal, neonatal, and child health (MNCH) preventive and promotive services stopped. Ill persons would sometimes consult health workers in their houses at night for security reasons. 3. Restructuring or transformative activities. In most areas, health services restructuring was continuing in 2020. Some heavily damaged facilities are still functioning below pre-crisis level, with reduced service availability. Rebuilding lost community trust in the public sector is proving difficult, though in some communities, trust remained strong.ConclusionHealth services generally had little preparation and limited resilience to the ISIS influx. Governorates are, in places, still restructuring services after the liberation from ISIS in 2017. Disaster planning was identified by all participants as a missing component, as managers anticipated future emergencies.