Healthcare workers (HCWs) are at increased risk of infection with Mycobacterium tuberculosis (Mtb) and, hence, of developing tuberculosis (TB) disease. The aims of this study are to identify the prevalence and determinants of latent TB infection (LTBI) among HCWs in Duhok Province. This is a cross-sectional prospective study conducted during April–July 2018 in different health care facilities of Duhok province. HCWs at multiple levels were selected by a non-systematic random sampling method. Information on demographic and associated risk factors of LTBI were collected by using a standardized questionnaire. Thereafter, all HCWs underwent QuantiFERON Gold Plus (QFT-Plus) assay. HCWs with indeterminate QFT-Plus underwent a Tuberculin Skin Test. HCWs with positive results were further evaluated by smear microscopy investigation and chest X-ray examination. Three hundred ninety-five HCWs were enrolled; 49 (12%) tested positive for LTBI. The mean age of the HCWs was 33.4 ± 9.25 with a female predominance (51.1%). According to the univariate analysis, LTBI was significantly higher among HCWs with the following: age groups ≥ 30 years, alcohol intake, ≥ 11 years of employment, high risk stratification workplaces, and medical doctors. In the multivariate analysis, the age group of 30–39 years (OR = 0.288, 95% CI: 0.105–0.794, p value = 0.016) was the only risk factor associated with LTBI. Further medical investigations did not reveal active TB cases among HCWs with LTBI. With regards to prophylactic treatment, 31 (63.3%) LTBI HCWs accepted the treatment, whereas 18 (36.7%) declined the chemoprophylaxis. Of these 31 HCWs on chemoprophylaxis, 12 (38.7%) received isoniazid (INH) for six months, 17 (54.8%) received INH in combination with rifampicin (RMP) for three months, and two (6.5%) received alternative therapy because of anti-TB drug intolerance. In conclusions, although Iraq is a relatively high TB burden country, the prevalence of LTBI among Duhok HCWs is relatively low. It is important to screen HCWs in Duhok for LTBI, particularly medical doctors, young adults, alcoholics, and those whom had a long duration of employment in high-risk workplaces. The acceptance rate of HCWs with LTBI to chemoprophylaxis was low. Therefore, ensuring medical efforts to educate the healthcare staff particularly, non-professionals are a priority to encourage chemoprophylaxis acceptance.

Urinary tract infections represents one of the most common diseases encountered in medical practice affecting people of all ages from the neonate to the geriatric age group. The aim of this study was to determine and evaluate the antimicrobial susceptibility patterns for most common strains of bacterial urine isolates taken from patients at Azadi teaching hospital laboratories in Duhok city/Kurdistan region in Iraq, for two years (2014 and 2015). A retrospective survey study was conducted and 1003 data of urine culture sensitivity test were collected from recorded archives of the Azadi hospital of two years; 2014 and 2015.  The study included all recorded positive urine samples cultures isolated from inpatients and outpatients. Results revealed that the female to male ratio for urinary tract infection was 2.7:1 and the most common microorganisms isolated were Escherichia coli (52%), Staphylococcus aureus (11%), Staphylococcus haemolyticus (9.6%) and Klebsiella pneumoniae (8.1%). In general maximum sensitivity was seen for Meropenem (94.9%), followed by Imipenem (89.7%) and Ertapenem (88.7%). The maximum resistance was seen against Cefazolin (79.7%) and Amoxicillin/clavulanic acid (77.5%). The antibiotic sensitivity pattern of E. coli reveals that the maximum sensitivity was seen for Meropenem (97.3%) and Imipenem (95.6%). The maximum resistance was seen against Amoxicillin/clavlanic acid (83.1%). The resistance against many commonly used antibiotics have been increased which limit the options for treating urinary tract infection. This is resulted from uncontrolled use of the antibiotics and lack of policies and guidelines for their use in public health.

Introduction: Brucellosis is a zoonotic disease contributing to significant health and economic problems worldwide. The aim of this study was to investigate the seroprevalence and the associated risk factors of brucellosis among people admitted to Azadi general hospital, Duhok, Iraq. Patients and Methods: A total of 1283 patient blood samples (603 males and 680 females) were collected through the period of January 2017 to December 2017 from people at different age groups admitting Azadi general hospital, Duhok, Iraq. All collected sera were screened for the seroprevalence of Brucella using Rose Bengal plate test kit. Results: Among the 1283 blood samples, the overall seroprevalence of brucellosis was 17.8%. The highest rate was recorded in age group between 21–30 years(22.7%) and the different distribution of human brucellosis among age groups was statistically significant (p=0.0076). The frequency of brucellosis in females (20%) was significantly higher than males (15.3%) (p=026). The distribution of brucellosis according to the seasonal changes was statistically significant (p= 0.003) (25.64% in July and 9.75% in December). Conclusions: The incidence of the brucellosis is high, and it remains a challenging health problem. The age, gender, and seasonal changes are considered as important risk factors for the distribution of the diseases. Surveillance programs and active screening for brucellosis are essential to prevent, control, and to reduce the incidence of the brucellosis.

Background: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world. There is a continuous change in the patterns of microbial flora and their antimicrobial susceptibility. The aim of this study was to determine the microbial agents causing neonatal sepsis, the susceptibility of these microorganisms to the commonly used antimicrobial agents at Hevi Hospital and to compare the causative agents during the last four years. Methods:A retrospective study was conducted over a period of four years. From the recorded data of archives of Hevi Teaching Hospital from 2014 till 2017, a total of 1058 blood cultures were taken. The positive and negative cultures were 536 and 522 respectively. From the positive cultures, 555 pathogens were isolated. Results: The present study revealed that the female to male ratio for neonatal sepsis was 1.5:1 and the most common microorganisms isolated were Coagulase-Negative Staphylococci consisting (58.5%) of cases; followed by Staphylococcus aureus (16.6%) and Escherichia coli (7.6%). The higher percentage of neonatal sepsis (30%) was recorded in 2017. There is no statistical significant difference regarding the causative microorganism for the early and late neonatal sepsis except for the Enterococcus species; with their highest percentage among late neonatal sepsis. Conclusions: This study revealed that resistance against many commonly used antibiotics have been increased which limits the options for treating of neonatal sepsis. This is resulted from uncontrolled use of the antibiotics and lack of policies and guidelines for their use in public health. Duhok Med J 2019; 13 (2): 84-95.