Khaleel Hanan Abdulghafoor, Alhilfi Riyadh Abdulameer, Brown Sabrina
Communicable Diseases Control Centre, Directorate of Public Health, Ministry of Health, Baghdad, Iraq.
Directorate of Public Health, Ministry of Health, Baghdad, Iraq.
Glob Epidemiol. 2025 May 10;9:100205. doi: 10.1016/j.gloepi.2025.100205. eCollection 2025 Jun.
Since the start of the first large outbreak of Crimean Congo Hemorrhagic Fever (CCHF) in Iraq in 2022, there has been no assessment of clustering of cases by district. The aim of this study is to identify clusters of high and low incidences of human CCHF to guide preventive and control measures, and distribute limited resources.
This is a cross-sectional study of reported and confirmed CCHF cases in Iraq from January 1, 2023 to December 11, 2023. We used a retrospective purely spatial Poisson scan statistic model to identify clusters of high and low incidences of CCHF at the district level ( < 0.05).
There were 580 confirmed CCHF cases, distributed in 149 districts. The incidence was 1.3 per 100,000. There were eight statistically significant clusters (three high-incidence and five low-incidence). The three high-incidence clusters were in the southeast while the five low-incidence clusters were mostly in the north and middle-east Iraq.
There is evidence of CCHF clustering in 40 districts in six governorates in south and mid-east Iraq. Additionally, there is evidence of low-incidence clustering of CCHF in 17 governorates, in north and central Iraq, and a risk for future outbreaks. Identifying clusters allows for focused preventive activities, such as insecticide spraying to reduce the tick population, controlling the spread of ticks by treating animals with repellents and other chemicals, and modifying landscapes. Distributing educational materials about handling meat and livestock products and engaging the community can help reduce exposure to ticks and the spread of disease.
自2022年伊拉克首次大规模爆发克里米亚-刚果出血热（CCHF）以来，尚未对按地区划分的病例聚集情况进行评估。本研究的目的是确定人类CCHF高发病率和低发病率的聚集区，以指导预防和控制措施，并分配有限的资源。
这是一项对2023年1月1日至2023年12月11日伊拉克报告并确诊的CCHF病例的横断面研究。我们使用回顾性纯空间泊松扫描统计模型来确定地区层面CCHF高发病率和低发病率的聚集区（<0.05）。
共有580例确诊的CCHF病例，分布在149个地区。发病率为每10万人1.3例。有8个具有统计学意义的聚集区（3个高发病率和5个低发病率）。3个高发病率聚集区在东南部，而5个低发病率聚集区大多在伊拉克北部和中东地区。
有证据表明伊拉克南部和中东六个省份的40个地区存在CCHF聚集情况。此外，有证据表明伊拉克北部和中部的17个省份存在CCHF低发病率聚集情况，且未来有爆发风险。识别聚集区有助于开展有针对性的预防活动，如喷洒杀虫剂以减少蜱虫数量，通过给动物使用驱虫剂和其他化学品来控制蜱虫传播，以及改造景观。分发有关处理肉类和牲畜产品的教育材料并让社区参与进来，有助于减少接触蜱虫和疾病传播。
